The doctor’s wife is the third Ariyoshi novel that I’ve read. The other two – The River Ki and The twilight years – I read well over a decade ago. According to Wikipedia The doctor’s wife is considered her best novel. All, though, are fascinating reads providing an insight into a culture which is so different from my own but in which, at the same time, people experience similar desires, pressures and emotions.

The twilight years is set in 1970s Japan and beautifully captures the cultural changes that were occurring around the time as Japan was (and still probably is) moving from  feudal/traditional parent child relationships to our more modern independent ways, with women caught in the middle. The River Ki chronicles three generations of women from the late 19th to mid 20th century, exploring changing attitudes and expectations of women. You are probably getting a picture here and you’d be right: Ariyoshi’s overriding theme concerns the role of women in Japanese society, both historically and in modern times. (Ariyoshi died in 1984.)

The doctor’s wife is an historical novel, spanning 70 years from around 1760 to 1830 and based on the life of famous Japanese doctor Hanaoka Seishu. A quick plot summary. The doctor’s wife is Kae, a young woman from a wealthy family, who is lured to become Seishu’s bride by his ambitious mother Otsugi, herself a woman married from a wealthy into a poorer family. The novel then chronicles Kae’s life in this extended family household as Seishu develops his medical skill and training until, near the end, he performs the world’s first surgery under anaesthetic (1804, breast cancer)*. While Seishu’s development as a doctor frames the novel, the real plot concerns the relationship between Kae and Otsugi.

The novel is told in third person, mostly the more objective omniscient voice, but occasionally we feel we are specifically in the heads of Kae or Otsugi. According to my edition’s introduction, Ariyoshi had access to Seishu’s personal records, diaries and books. However, being a man of his time and a doctor focused on his research, he did not, I assume, document much of his family life. The story, then, of the women is largely fictional. Mostly through dialogue, with description as needed, Ariyoshi describes how the loving supportive role Otsugi initially presented towards her daughter-in-law changes when her son (who had been married to Kae in absentia some three years before) returns home from his medical studies in Kyoto. Overnight, the relationship, to Kae’s shock and distress, changes into a competitive one – a competition that has serious consequences as they vie to be guinea pigs for his experiments in anaesthesia. Both women are presented as flawed, but as it is Kae who opens the novel and is the more powerless, it is with her that we are most keen to identify and empathise.

Why has Ariyoshi chosen to tell this story of conflict and competition within an historically based story of a great man? Does the historical “truth” add credibility to her exploration of familial power discrepancies? I’m not sure it’s necessary, but perhaps it helps … It is a very human tale – the grand gestures made by the women to support his research are small in the scheme of things though the impact on them, particularly on Kae, is immense. Ariyoshi realistically explores the nuances of their relationship through the normal day-to-day patterns of life (weaving, cooking, house management, childbirth) suggesting that this sort of conflict doesn’t have to be but that it often (traditionally, even) is. In fact, we readers are lulled into seeing it as the norm – the lot of women – until we are shocked out of that frame of mind near the end by Seishu’s unmarried sister who says (in broken speech because she is ill):

I think this sort of tension among females . . . is . . . to the advantage . . . of . . . every male.

She continues to explain her particular perspective on women’s secondary lot, and pronounces that:

as long as there are men and women side by side on this earth, I wouldn’t want to be reborn a woman into such a world.

Clearly, given the story Ariyoshi has told, she rather agrees  – or, at least, agrees for such societies as she depicts here in which women’s lot is not only an inferior one but which work to discourage them from cooperating and supporting each other. The novel may be set in Japan, but the fundamental truths, unfortunately, are not so confined.

What I have described here is the main story, but there’s more here that can be discussed, including the development (or history) of medicine in the east and west, the experimentation on animals and humans, and Japanese social life and customs in the Tokugawa period.

It’s a short but engrossing read. It falters a little I think right at the end when the historical facts are presented so prosaically that they threaten to overwhelm its novelistic achievements, but the last line fuses the two so beautifully that you forgive this.  The doctor’s wife is a fascinating and keenly observed novel that deserves to be read.

*Ironically, in 1811, novelist Fanny Burney underwent a horrific mastectomy without anaesthesia because it was unknown in the west!

Sawako Ariyoshi
The doctor’s wife
(trans. by Wakako Hironaka and Ann Silla Kostant)
Tokyo: Kodansha International, 1966 (orig ed), 1978 (trans)
174pp.
ISBN: 0870114654