An author better known for his best-selling detective stories tones down the suspense and mystery to bring readers a thought-provoking novel about the dividing line between life and death. The story centers on a family with a brain-dead child whose heart continues to beat with amazing strength.
Six-year-old Mizuho is rushed to the emergency room one summer day after a near drowning in a swimming pool. The finger she poked into the drain at the bottom of the pool got stuck, and held her under the water. By the time anybody noticed, her vital signs had shut down. Although medical personnel succeed in restarting her heart, she remains without any detectable brain activity, and spontaneous respiration fails to resume. The doctor asks parents Kazumasa and Kaoruko Harima whether they would consider offering Mizuho’s organs for transplant. Under Japan’s somewhat unusual laws, if they agree to organ transplants, Mizuho will be declared brain dead, while if they don’t, she will be kept on life support and declared dead only when her heart stops beating. After a night of indecision, Kazumasa and Kaoruko agree to transplants, but then as they are saying their final goodbyes, they both feel movement in their daughter’s hands and experience a change of mind. They are convinced that she is still alive.
Kazumasa is president of Harima Techs, a precision equipment maker founded by his grandfather. It is eight years since he married Kaoruko and in addition to Mizuho they have a four-year-old boy, Ikuto. But the two are headed for divorce owing to Kazumasa’s infidelity, and some time ago now he moved out of their posh home in an upscale Tokyo neighborhood, where the children have remained with their mother.
Kaoruko brings Mizuho home to this house and throws herself heart and soul into her care, following the instructions she received at the hospital. For the next three and a half years, Mizuho shows remarkable resilience. A “brain-machine interface” technology being developed by Harima Techs is brought in, and following surgery, she is once again able to breathe without a respirator. Treatments in which her muscles are moved by stimulating the spinal cord help maintain her physical condition, and even though her brain remains nonfunctional, her body properly regulates its temperature and even undergoes further growth.
Although Kazumasa’s assets and technology and Kaoruko’s tireless nursing produce these remarkable results, as time goes on both parents begin to have doubts. What meaning is there in artificially keeping a dead person “alive”? Are they merely being selfish in their refusal to allow organ transplants? In a climactic scene on Ikuto’s birthday, with family gathered to help celebrate, Kaoruko grabs a kitchen knife and threatens to use it on Mizuho. She personally calls the police, and when they arrive, demands to know whether she will be prosecuted for murder if she kills her daughter. If “brain dead” means Mizuho is dead, then surely she will have to be considered innocent. The police have no answer.
On the eve of the new school year when she would have entered the fourth grade, Mizuho appears before Kaoruko in the middle of the night to thank her and bid farewell. Immediately thereafter, her health goes into a sudden decline and she is rushed back to the hospital. Kaoruko and Kazumasa agree to allow organ transplants, and Mizuho’s still remarkably strong heart saves a young boy’s life.
The debate about whether brain death constitutes death has been ongoing in Japan since the 1980s. Even after legal standards were established for determining brain death, the number of transplants has been slow to grow, and especially in the case of young children, those in need of transplants have sometimes had to seek them from overseas at extreme expense. Author Keigo Higashino provides a highly effective treatment of this sharply divided debate, illumining the broader social dimensions of the issue while zeroing in on a woman whose boundless love for her daughter nearly drives her mad at the wrenching choice she must make.