i
SOGURO’S DILEMMA IN DEALING WITH PARADOXICAL
MEDICAL ETHICS DURING WORLD WAR II AS SEEN IN
SHUSAKU ENDO’S
THE SEA AND POISON
AN UNDERGRADUATE THESIS
Presented as Partial Fulfillment of the Requirements For the Degree of Sarjana Sastra
in English Letters
By
BERTHA YENNI FINDRIANA
Student Number: 044214100
ENGLISH LETTERS STUDY PROGRAMME DEPARTMENT OF ENGLISH LETTERS
FACULTY OF LETTERS SANATA DHARMA UNIVERSITY
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The wo rld is da ng e ro us pla c e to live in
No t b e c a use o f tho se who do e vil
But b e c a use o f tho se who se e it a nd le t it
ha ppe n.
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I DEDICATED THIS THESIS
TO
My beloved MOM and DAD
My sister CIPLUK
Grandpa SUPIT
Abe
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ACKNOWLEDGEMENTS
First of all, I would like to thank Jesus Christ because He always gives me spirit and strength in facing my life so I could accomplish this thesis with all of my effort. I also thank Him for providing me with many people who have been so kind and willing to help me in conducting the study and writing this thesis.
I would like to express my gratitude to my advisor, Ni Luh Putu Rosiandani, S.S., M. Hum, who has willingly spent his precious time to read, reread and guide me in accomplishing this thesis. I would thank also to my co-advisor, Tatang Iskarna, S.S., M. Hum for giving me precious advices and revising my thesis. I would also thank my main examiner J. Harris Hermansyah Setiajid, S.S, M.Hum for giving me final advices.
I thank to my parents, Sofie Yosefien Ngantung and Agung Widodo, S.H, who always pray for me and stand beside me. Thank you for my one and only sister, Selvie Febrianie, S.S., for driving me to my campus.
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my Sunday school teaching and mbak Arum for borrowing his printer. My gratitude also goes to Handa ‘Kripik’ for borrowing his computer and his home sweet home. The last but not least, I want to deeply express my gratitude to Abram ‘Abe’ Suseno, S.H., the right person in the right time, who has given his totality to help me.
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LEMBAR PERNYATAAN PERSETUJUAN PUBLIKASI TABLE OF CONTENTS ……… viii
1. Theory of Character and Characterization ……… 9
2. Theory of Medical Ethics ………. 11
3. Review on the Relation between Literature and Psychology….. 13
4. Theory of Dilemma ……….. 14 A. The Characterization of Soguro ……… 27
1. Empathetic ……….. 27
2. Responsible ……….. 31
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4. Idealistic ……….. 35
B. Soguro’s dilemma dealing with paradoxical medical ethics ……... 36
1. Soguro’s dilemma in relation with Japan’s government ……... 41
2. Soguro’s dilemma in relation with the Japanese doctors ……… 44
i. Toda ……… 48
ii.The Old Man ……… 49
C. Soguro’s decision making to manage his dilemma dealing with paradoxical medical ethics ……… 52
1. Soguro’s decision making to manage his dilemma in relation with Japan’s government ………. 57
2. Soguro decision making to manage his dilemma in relation with the Japanese doctor ………... 58
i. Toda ……….. 59
ii. The Old Man ……… 60
CHAPTER V: CONCLUSION ……… 62
BIBLIOGRAPHY ………. 66
APPENDIX... 68
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ABSTRACT
BERTHA YENNI FINDRIANA (2009): SOGURO’S DILEMMA IN DEALING WITH PARADOXICAL MEDICAL ETHICS DURING WORLD WAR II AS SEEN IN SHUSAKU ENDO’S THE SEA AND POISON.
Yogyakarta: Department of English Letters, Faculty of Letters, Sanata Dharma University.
Medical Ethics had been functioned to protect the patients from any harmful conduct of physicians (doctor or nurse). The matter is how if the medical ethics is distorted in order to support the glory of war. The Sea and Poison reveals the inhuman conduct of Japanese doctors to their patients and the prisoners of war in Fukuoka hospital during World War II. It is ordered by the government in order to win the war. The medical ethics becomes paradox of the doctor’s crimes. However, Soguro, a doctor in that hospital, keeps his profession oath firmly and places the patient’s life as his first priority. He has deep empathy and loyalty to his principle as a doctor and citizen. It creates dilemma when he must choose to be loyal to his profession or his country.
This study is to analyse the above issue by pointing three problems. The first is how the characteristics of the main character, Soguro are. This problem reveals Soguro’s characteristics that make him in dilemmatic situation. Second, what Soguro’s dilemma is. This problem analyzes Soguro’s dilemma and the conflict that makes him in dilemmatic situation. The third is how Soguro manages his dilemma. This last problem analyses Soguro’s motive to be a doctor and related with his decision making.
The method that was conducted in this study is library research method by collecting the data and the theories that support this research. The writer applied psychological approach since the purpose of this study is to analyse Soguro’s characteristics in relation with his dilemma, the conflicts which place him in dilemmatic situation and how he manages it.
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ABSTRAK
BERTHA YENNY FINDRIANA (2009): SOGURO’S DILEMMA IN DEALING WITH PARADOXICAL MEDICAL ETHICS DURING WORLD WAR II AS SEEN IN SHUSAKU ENDO’S THE SEA AND POISON.
Yogyakarta: Jurusan Sastra Inggris, Fakultas Sastra, Universitas Sanata Dharma.
Etika medis telah berperan untuk melindungi para pasien dari segala tindakan membahayakan yang dilakukan oleh para pelaku medis (dokter atau perawat). Permasalahannya adalah bagaimana jika etika medis diselewengkan untuk mendukung kemenangan dalam perang.
The Sea and Poison mengungkap perbuatan yang tidak manusiawi yang telah dilakukan oleh dokter- dokter Jepang terhadap pasien-pasien mereka dan para tawanan perang di rumah sakit Fukuoka selama perang dunia ke II. Hal ini diperintahkan oleh pemerintah untuk meraih kemenangan dalm perang. Etika medis menjadi paradoks atas kejahatan dokter-dokter itu. Namun, Soguro, salah satu dokter di rumah sakit itu memegang teguh sumpah jabatannya dan menempatkan nyawa pasien sebagai hal yang utama. Dia mempunyai empati dan kesetiaan terhadap prinsipnya sebagai dokter dan rakyat. Hal ini menimbulkan dilema ketika dia harus memilih untuk setia pada profesinya atau negaranya.
Skripsi ini bertujuan untuk menganalisis persoalan di atas dengan merujuk pada tiga permasalahan. Pertama adalah bagaimana watak dari tokoh utama, Soguro. Permasalahan ini mengungkap watak-watak Soguro yang membuatnya dalam situasi dilematis. Kedua, bagaimana dilemma Soguro. Permasalahan ini menganalisa tentang dilemma yang dihadapi oleh Soguro dan konflik yang membuatnya dalam situasi dilematis. Ketiga adalah bagaimana Soguro mengatasi dilemanya. Permasalahan yang terakhir menganalisa tentang motif Soguro menjadi seorang dokter dan berhubungan dengan pembuatan keputusannya.
Metode yang dilakukan dalam penelitian ini adalah metode penelitian pustaka denagn mengumpulkan data dan teori-teori yang mendukung penelitian ini. Penulis menerapkan pendekatan psikologis karena penelitian ini bertujuan untuk meneliti watak- watak Soguro yang terkait dengan dilemanya, konflik-konflik yang menempatkannya dalam situasi dilematis dan bagaimana dia mengatasinya.
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CHAPTER I
INTRODUCTION
A. Background of the Study
We live in the society in which all things are measured with right or wrong. If our morality works well as a measurement tool, we can live peacefully. Yet not everybody has the same quality of measurement tool. People tend to forget about the moral values they have and rebel to free themselves from all kind of social norms. It will be a crucial matter if the environment supports the crime.
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People have different motives when they act. For example, the motive of studying is to achieve better knowledge, to please their parents, to pass the examination etc. However, the motive of studying can also be used to support a crime such as mastering the security system of bank and later using it to steal the money. The motives can be different between one to another. In doctor’s case, the public is usually easily manipulated by the doctor’s motive. Meanwhile, they tend to see the doctor’s motive in curing their disease is to help them. However, the motive must be questioned. The public’s opinion on their motives can be true. Yet, they must look deeper at their real motives because they are also a human who can make a mistake and sin.
goes, he will bring his or her patient into death. How a doctor can be the angel of death, how the process to decide to do those crimes, what the motives behind those crimes are the polemics in the medical world.
The doctor’s crime has been a ‘pathological diseases’ since the war began. The nations such as Germany and Japan have developed a biomedical experiment to support their victory of the war. The Germany with its Nazi’s doctor has killed mass of people. A Nazi doctor, Joseph Mengele, has performed many deadly human experiments such as injecting a chemical liquid to children’s eyes to change the eye color to blue and it caused immense pain and even blindness, removing limbs or sex organ without anesthesia, tossing babies into crematoria (a room which functioned like an oven), sending anyone with an imperfection (including imperfect weight) to the gas chamber, etc. He is like a serial killer, Jack the Ripper and ironically the government protects and supports his cruel experiments. Even, Japan’s government at wartime also allowed the experiment using human and developed a deadly virus and mass killing. Those facts are the bad records in the history of medical ethics. The motivation of the doctor has been changed. They are the killing machines of its country. Now the most frightening fact is doctor is a potential killer because they can kill anyone freely and the people will not be suspicious about their crimes. Yet, what motivate them to do those crimes is still questioned. Today the modern doctors still follow their ancestors to do the malpractice.
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his or her country and the medical institution is only a cover to hide the crimes. The doctor must make a decision based on those conflicting motives. Sometimes the society influences someone in making decision. The condition or circumstances in the society can be the determinant key of the decision. Meanwhile, the society has important role in shaping the morality.
The works of literature can be the best choice to solve the matter because they give a vision of morality. We can learn morality from each character’s experience in a novel, poem, play, etc. According to Hough in An Essay on Criticism, literature can convey social phenomenon. Through literature the author wants to communicate his idea about the moral values in the society to a person, number of people, nation, a world in a higher level. The values suggested by a work of literature are suggested as significant to a group, a class, a nation, or to everyone (1966: 30). Novel is a part of literature which contains some values that can be valuable for human life. Clara Reeve states that a novel is a picture of real life and manner (Wellek and Warren, 1956: 216). Novel does not only give a fantasy and enjoyment for the reader but it contains moral values that govern human behavior.
doctor who is obliged to participate in the vivisection of the prisoners war” (Endo, 1972: 174).
However, through this novel it can be seen the dilemma of Soguro, a doctor, who must face the shocking fact about paradoxical medical ethics during the war. The process of making decision involves his motive to be a doctor which is really different with the other doctor’s motives. No one in the hospital supports his motive. The dilemma is stronger when his sole motive to be a doctor is opposed with his close friend, Toda and a senior doctor, who is his role model, also violated the medical ethics. Through Soguro’s character, it can be seen the struggle of a doctor to keep his noble motive even though his surrounding environment does not support him.
B. Problem Formulation
Referring to the title above, the writer states three problem formulations in order to guide the analysis as follows:
1. How is Soguro, the main character, characterized in Shusaku Endo’s The Sea and Poison?
2. How is Soguro’s dilemma in dealing with the paradoxical medical ethics depicted through the novel?
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C. Objective of the Study
The focus of this thesis is the exploration of Soguro’s character in dealing with the paradoxical medical ethics. Given the problem above, the first problem formulation is meant to depict the characteristics of Soguro in resistance of the morality against the evil condition which is full of ambition for seeking important position, the malpractice and so on. The second is to find out Soguro’s dilemma dealing with paradoxical medical ethics. The next analysis will be on how he faces and manages his dilemma.
D. Definition of the Term
There are three terms to be defined in this study: ‘moral dilemma’, ‘paradoxical’ and ‘medical ethics’.
1. Dilemma
According to American Psychological Association Dictionary of Psychology, dilemma is a situation necessitating a choice between two equally desirable or undesirable alternatives ( Vandenbos, 2007: 282).
2. Paradoxical
In The New Oxford American Dictionary, paradoxical is something ‘having the nature of ‘or expressing paradox (a seemingly absurd or self contradictory statement or proposition that when investigated or explained may prove to be well founded or true) (Mckean, 2005: 1232).
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CHAPTER II
THEORETICAL REVIEW
A. Review on Related Studies
Since it is difficult to find the sources from the published book, there are many sources that are taken from the Internet site. Michael Gallagher, the translator of The Sea and Poison says that, “This powerful novel describes the disintegration of a Japanese doctor who is obliged to participate in the vivisection of prisoners of war”. The other critics, Pung Yai, in his article entitled The Only Thing Necessary for the Triumph of Evil, says that The Sea and Poison is one that delves into some very deep issues about morality and Ethics of passively accepting evil in one’s presence. (http:/www.amazon.com/Sea-Poison-New-Directions-Paperbook/dp/0811211983). The other comments comes from Mihoko Tokoro, she says that “This is a fiction based on what happened in Unit 731 (Japanese Imperial Army) in Manchuria where live vivisection and human experimentation were performed biological weapon. Doctors were young, innocent and ambitious and committed heinous sins on POW’s (Prisoners of War) (http:/www.amazon.com/gp/product/costumer-reviews/08112211983/ref).
In an article entitled An Exquisite Analysis of the Death of Goodness, there is stared that this dark novel (The Sea and Poison) by Endo explores the anguished feelings of various doctors and nurses in a fictional Japanese hospital during World War II. This work is a searing tragedy about the death of goodness as a result of ambition, exigency and human weakness. (http:/www.amazon.com/gp/product/costumer-review/08112211983/ref
From the above comments, it can be concluded that the people tend to see moral values of The Sea and Poison. It is truly about the immorality of Japanese doctors. Those comments are right that The Sea and Poison depicts the degradation of morality, the death of goodness, heinous sins which are surprisingly done by the prestigious community, the Japanese doctors. The purpose of doing the human experiment is to invent the new technique in curing the sick person. Although it is morally wrong, the medical invention will be useful for the advance of medical treatment.
B. Review of Related Theories
1. Theory of Character and Characterization
According to Abrams, character is a person presented in dramatic or narrative work, who are interpreted by the reader as being endowed with moral and disposition qualities that are expressed in what they say-the dialogue-and they do-the action (1981: 20).
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personalities, the presence of creatures in art that seems to be human beings of one sort another (1986: 81).
Stanton in his book An Introduction to Fiction stated that character could be described in two ways. Character is the “individuals who appear in the story and also the mixture of interests, desires, emotions and moral principles that makes up each of these individuals” (1965: 17)
say often give us a clue to the character of the person spoken about (Murphy, 1992:167). The sixth is reaction. Someone’s characteristic can be seen from the way that character reacts to various situation and events. The seventh way is by observing the direct comment. In the novel, sometimes the author gives the author gives the clue about the characteristics by describing or commenting on a person’s character directly. The eight way is by observing the character’s thought. Murphy states that the author gives the reader direct knowledge of what the character is thinking about. Sometimes the author writes about the thing that he cannot do in the real life. It is like the imagination of the author. It can tell the reader what different people are thinking about. The last but not least, the ninth way is by observing the mannerism and habits, the author wants to tell us about the character personalities. Murphy’s theory is actually can make reader of the character personalities.
2. Theory of Medical Ethics
Since the works about medical ethics, the theory of bioethics is also applied in order to support the analysis.
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According to International Encyclopedia of Ethics, medical ethics is a part of bioethics, the multidisciplinary study of ethical problem of humanity arising from scientific advances in medicine and technology examined in the light of moral values and principles (1995: 85). Bioethics is the part of Ethics. In discussing medical ethics, it cannot be separated from moral principles. In medical ethics, there is a familiar term that is Hippocratic Oath. In other words, it is called codes of ethics or principles of ethics. Talking about principles, there is a set of moral principles. According to Beauchamp and McCullogh, there are kinds of principles such as justice, liberty, respect for autonomy, equal treatment, beneficence and utility. Yet, the most important moral principles in medical ethics are the principle of beneficence (one should provide benefits and prevent or remove harms to others) and principle of respect for autonomy (one should regard others as rightfully self-governing (autonomous) in matters of their choice and actions, whereas beneficence requires us to provide positive benefits as well as to prevent and remove harmful condition. (1978: 14).
According to Shannon, there are principles of double effect in medical ethics. The basic principle of medical ethics is “First of all, do no harm”, it means the physicians can benefit someone, then at least they should do that person no harm (1995: 6).
3. Review on the Relation between Literature and Psychology
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4. Theory of Dilemma
According to Gilbert Ryle, dilemmas result when the conduct of the new conscript diverges from the imposed standard. A well-tried control fails to control it. According to American Psychological Association Dictionary of Psychology, dilemma is a situation necessitating a choice between two equally desirable or undesirable alternatives (Vandenbos, 2007: 282). In International Encyclopedia of Ethics, dilemma is choices (usually forced) that, no matter how they are decided, have negative consequences (Roth, 1995: 228).
The dilemma which is analyzed in the novel is closely related with physician’s dilemma dealing with his codes of ethics and the external factor. When physicians must face this ethical dilemma, they do not have the luxury of referring to comparable paradigm cases. They must recognize and resolve ethical dilemmas based on the accepted principles of medical ethics, the policies and standards of their institutions, and the law of the land.
Like most physicians, they have direct contact with the institutions with which they are affiliated. In addition, they frequently have direct contact with the patient and the society as well. Some of the ethical dilemmas that are encountered by physicians are directly linked to the individual, the institution, and the community at large.
patient should pay his treatment bill. He cannot afford to pay the bill. Should the physicians pay his bill or should he let him died without treatment or let him ‘died’ in the hand of the institution. It is really complicated.
The ethical dilemma involves society. The society’s perspective is different with the physician’s ethics. The society’s norms are sometimes opposed with the medical decision. For example, euthanasia, assisted suicide, in the society is a killing, but in medical world it obeys the principle of autonomy. It is the patient’s demand to end his life because maybe he cannot endure his illness.
There is a fourth cause of ethical dilemmas. It is the physician’s responsibility to self. The physician sees a wide variety of patients with an even wider variety of conditions but has a very limited amount of time with each patient. Physicians do not have time to examine each case in detail to determine whether it presents an ethical dilemma, and then to weigh all the alternatives to arrive at the right solution. Physicians must recognize the subtle ethical dilemmas encountered in each case and construct a framework for evaluating them when they occur. (http://www.residentandstaff.com/issues/articles/2006-10_01.asp)
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goals in such a way that they perceive that one goal only can emerge (Beaty, 1989:60).
According to Kurt Lewin in Psychology, there are two kinds of conflicts. First is intrapersonal conflict. This kind of conflict happens in the person’s self. Furthermore, this kind of conflict is divided into four types. The first type is Approach-approach conflict. It results when the individual is motivated to approach two positive goals but can attain only one. It means the closer one is to the goal, the stronger will be the drive toward that goal. The second is Avoidance-avoidance conflict. This type of conflict occurs when the individual must choose between two equally unattractive goals. It means that whenever the individual gets near to one negative goal, the drive to avoid that goal increases. The third is Approach-avoidance. This type of conflict involves only one goal that has both attractive and unattractive qualities associated with it. It means the individual’s own desire to both obtains the goal and escape from it traps him in conflict. The fourth is double approach-avoidance. This type of conflict can involve having to choose between two goals, each of which has positive and negative aspects. It means that the individual involve in choosing whether to approach or avoid a goal that has two positive and two negative aspects. The other type of conflict instead of intrapersonal conflict is interpersonal ones. Interpersonal conflict involves two or more persons ( Stagner, 1952: 493).
state in an organism used to explain its choices and goal-oriented behavior (Bruno, 1986: 141). Motive arouses and directs our behavior toward some goals. Motivation is the forces that initiate and direct behavior and the variables that determine the intensity and persistence of the behavior. The initiation of behavior can be prompted from the external environment. For example, we might be hungry because the blood sugar level in the body decreases (internal cue) or because we just see a delicious looking dessert (external cue). Motivation determines the intensity and persistence of our behavior. Intensity has to do with how strong behavior is. For instance, if you are only a little hungry, you might eat if food is readily available, but if there is no food in immediate vicinity you would probably engage in some other behavior. On the other hand, if you are extremely hungry, you would most likely look for something to eat, doing whatever it took to obtain goal. How motivated we are will likewise influence our persistence. Sometimes, we will persist in obtaining goal for along time, while at the other times we give up after a brief try.
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The third is belongingness and love need. The characteristic of this need is feeling for desire for friend, family and social contact. We need to belong to a group or family. The fourth is esteem need. This need cover a high evaluation of oneself, self-respect, achievement and recognition by others. Someone reaches achievement to gain people’s respect. The last is self-actualization. This need refers to the attainment of one’s individual abilities.(Atkinson, 1953: 210)
5. Theory of Personality
According to Florence Littauer who has adopted and developed Hippocrates theory of personality, states that every people has unique characteristics that differentiate him with the other (1996: 4). According to APA Dictionary of Psychology, personality is the configuration of characteristics and behavior that comprises an individual’s unique adjustment to life (Vandenbos, 2007: 689). Therefore, every individual have different response in facing and solving their problems.
type is choleric. Choleric person is ambitious, highly motivated, manipulative, good leader. His weaknesses are individualistic and difficult to cooperate with other. When this type of person faces problem, he will solve it strategically and systematically.( 1996: 26)
The third is melancholic. Melancholic person is difficult to have friend, likes to be alone, conservatives, thinker, dreamer, loyal, good listener and observer, perfectionist, selective in friendship. The weaknesses are unrealistic, postponing something, easily depressed. When they face a problem, they will think it deeply and decide it. (1996: 24). The fourth is phlegmatic. The phlegmatic person is flexible, easily have friend, peaceful, not like to be exposed, and comfortable. When they face a problem, they will face it calmly, step backward to think and decide the best but do not want to communicate it to the other. He cannot decide something easily because he is easily influenced with the other’s opinion. Therefore, whenever he faces a problem, he only follows the other. (1996: 27). However, it is possible that a person can have one or two combination of these types, such as melancholic phlegmatic, sanguine choleric, melancholic choleric and so on. Yet, there is always a characteristic that is most dominant and prominent.
7. Review on the human value during World War II
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during World War II seemed to be violated by the physicians such as doctor and nurse. Many kinds of diseases were used for war sake. The physicians and army conducted the human experiment and biological warfare. Crimes against humanity namely, murder, slavery and other inhuman acts committed against civilian population during the war. Germany was the first country that violated Human Rights. They practiced mass killing by gas chamber (a chamber occupied by the prisoners and they are slowly died because of the toxic which contain in the air.
of the Imperial Japanese Army during World War II. Victims were experimented to vivisection and amputation without anesthesia and were used to test biological weapons among other experiments. Anesthesia was not used because it was believed to affect results.
According to the International Symposium on the Crimes of Bacteriological Warfare, the number of people killed by the Imperial Japanese Army germ warfare and human experiments division is around 580,000.Tens of thousands and perhaps 400,000 Chinese died of bubonic plague, cholera, anthrax and other diseases resulting from the use of biological warfare.”
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C. Theoretical Framework
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CHAPTER III
METHODOLOGY
In this chapter, there are three parts of discussion. The first is the object of the study, second, the approach to analyze the work, and the third is method of the study.
A. Object of the Study
The type of literature, which is analyzed here, is a novel entitled The Sea and Poison written by Shusaku Endo. Actually, the original title is Umi to Dokuyaku. This Japanese novel was first published by Bungei Shunju Co, Ltd, Tokyo in 1958. It was then translated into English by Michael Gallagher. The English version was published by Tuttle Publishing and entitled The Sea and Poison in 1973. Shusaku Endo writes this story as a serial in three parts.
This story is fictive but it contains reality happened in the past especially the Japan medical history during the World War II. The Sea and Poison consists of 167 pages, which are divided into three parts with its own title. There is additional information from Michael Gallagher in the beginning of the story. It gives brief introduction about Shusaku Endo’s autobiography.
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Poison won him prestigious Akutagawa Prize, the highest award for Japanese novelist. Even The Sea and Poison becomes well known. It is translated both into English and Russian. Ken Kumai, a well-known director in Japan, adapted The Sea and Poison into a movie. This novel has contributed much to the idea of moral values such as the opposites between good and evil.
The Sea and Poison is basically a novel that reveals the badness of medical practice during the World War II. The main character of the story is Soguro, a young intern who must witnesses and involved indirectly in the doctor’s malpractice of the prisoner of the war. The prisoners are the object of illegal biological research such as vivisection, the removal of lung, the injection of air, viruses and normal saline into the blood stream. Normally those practices will cause constant death of the living object. Mostly the victims of the illegal operation area died because they awake suddenly during the operation. Thus they must endure their suffering because of the vivisection or lung removal.
B. Approach of the Study
Since the thesis deals with dilemma of the main character and how he deals with it, the approach that is applied here is psychological approach. According to Kalish in The Psychology of Human Behavior, “psychology is the science that attempts to understand, describe, predict, and influence behavior- particularly human behavior.” (1971: 4) Psychological approach is a suitable approach to analyze a work of literature such as novel. Kalish stated that
more lifelike than the real people whose behavior the psychologist attempt to describe. Writers can use the understanding provided by psychologist to enrich their stories, and psychologist can gain in their understanding of human behavior by drawing from the deep sensitivity of good author.” (1971: 8)
By using the psychological approach, the writer believes that it can support this thesis. The analysis of the main character and how the character manages his dilemma are closely related with the psychological condition whenever he wants to make decision.
C. Method of the Study
In order to complete all sources, the writer conducted library research. This method consists of two types of sources, primary and secondary sources. The novel written by Shusaku Endo entitled The Sea and Poison was the writer’s choice for the primary source. The writer did close reading toward the novel in order to get deeper understanding about the novel. Several books were read as the references for answering the three problem formulations. There were five books for additional information. The first is Medical Ethics and Medicine and Christian Morality. These books were used to compare the right medical ethics and the one in the novel. The third and the fifth books were Japan’s War, Japan Past and Present and Japan at War. These three books gave vivid condition of the Japanese society and also the medical ethics during World War II.
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was finding some references such as A Glossary of Literary Term, Understanding Unseen’s, International Encyclopedia of Ethics, An Introduction to Bioethics and A Handbook of Critical Approaches to Literature. Some articles were taken from Internet in order to complete the sources.
The writer applied several theories such as theory on character and characterization, theory on medical ethics, theory of conflict, theory of motivation, theory of personality and theory of dilemma. Then the writer applied an approach to analyze the topic. It is Psychological approach.
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CHAPTER IV
ANALYSIS
A. The Characterization of Soguro
Soguro is a Japanese doctor who feels repressed with the political condition during World War II. In the wartime, especially in Japan, all civilians must dedicate their loyalty to their country based on their profession. Thus, as a doctor he must give his knowledge, and skill to serve his country. Soguro grew up in the society who was the follower of Shinto the belief which centered the person to be loyal to the emperor and obliged the society with fanatical devotion to the emperor, to build unquestioning loyalty and obedience. Japanese was taught to believe that the emperor’s wishes must be obeyed blindly by all his loyal subjects. However, it is a dilemmatic problem because Soguro’s characteristic is opposed to the general view of the government that human life is no longer precious. He has a true loyalty to his profession as a doctor and his country as its civilian. Yet, these things are opposed to each other. His true loyalty to his profession is opposed to his loyalty to his country. As a doctor he has empathy to his patients and takes his responsibility as a doctor to take care his patients properly and equally. In general, he is empathetic, responsible, idealistic and unconfident.
1. Empathetic
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so that one vicariously experiences the person’s feelings, perceptions, and thoughts of another (2007: 327). It means that empathetic person has the ability to understand another person's perceptions and feelings. This characteristic can be found in Soguro.
As a doctor, Soguro is very open to his patient. He listens to his patient’s complaints, problems and their sufferings. Soguro has the ability to sense and understand the other’s feelings as if they were his own. He could not bear to see his patients in miserable condition. As an example, even though he is a doctor, he does not recommend an operation to each of his patients, because he knows there is a little chance to survive from the operation. Moreover, the operation is really painful and he could not tell his patient about the consequences of the operation because the chance to live is only little.
Soguro had no idea what to tell her. For him the cruel things were to submit this dying woman to the further pain of an operation. What else was there for Soguro to do but to blink his eyes.” (46)
Soguro understands the painful effect of the healing or examination process to the patient. He also cares about the way the patient is examined. The patient must follow further examination before the doctors held the surgery, although, the process of that examination is really painful.
“Well, I was going to but….” Soguro answered frowning. “You’ve got to use the tube with her and it causes her a lot of pain. It’s really pitiful.” (p. 37)
“I don’t like seeing her there every morning in the ward, with that yellow hair she has. Just seeing those hands of hers like chicken legs is unpleasant enough. To confess as much was painful.” (33)
Because of close relationship between Soguro and his patients, these patients never feel hesitate to ask about the medication given to them. They are reluctant to ask for it to the other doctors. It is because they trust him. Soguro can compromise with their behavior in asking medicine for bartering.
Soguro shows his empathy by giving the medicine to his patient. Although he already knows the medicine would be bartered for food by them. He gives them the medicine, pain killer drug named dextrose. This drug can be bartered to get food which is in wartime is difficult to be found. He understands his patient’s difficulties in getting food because of the food shortage. However, he gives it to his patient so they can barter it to food. In wartime, medicine is really precious because it is needed to cure the wounded soldier. It proves Soguro’s empathy to his patient.
One day during his rounds, he secretly left a lump of dextrose beside the old lady’s pillow. It was not the first time Soguro had done this sort of thing for his welfare patient.
“Doctor, could I have some calcium pills?” Soguro knew what they were up to. They secretly hoarded whatever they could get out of him and used it for bartering to supplement the skimpy ration of potatoes and beans that made up their diet.” (38)
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suffering to him. His empathy results in the openness and close relationship between Soguro and his patients. They will be more comfortable with him than when they must be examined by the other doctor.
“Soguro noticed that, depending upon whether he was with the Old Man or alone when he came into the ward, the expression on the faces of the patients were utterly different. When he came alone, they would smile slyly from their tattered beds, complaining of various grievances and pleading with him: “Dr. Soguro. How about some cough medicine. I can’t sleep with this cough.” (38)
Soguro’s emphaty could be seen from one of his case in giving treatment such as in Mrs. Tabe’s case. She is one of Soguro’s patients. Mrs. Tabe’s disease can only be cured by an operation. During the operation, Soguro could understand and feel the suffering which is shown in the expression of Mrs. Tabe. The suffering is caused by the decreasing effect of the anesthetic drug. Soguro could understand how painful the operation is. However, Soguro cannot do anything neither to decrease her suffering nor to save her life. When Mrs. Tabe died in the operating table, Soguro only could squat down on the floor and could not believe it.
keep his empathy by stopping Mrs. Tabe’s operation and giving her a painkiller or continue the operation by doing what a doctor should do even though it will cause further pain to his patient.
2. Responsible
According to Oxford dictionary, responsible person is someone that having to do something as a duty and you can trust and rely on. (2000: 1089). Soguro has a responsible characteristic. He has willingness as a doctor and as a citizen.
As a doctor, Soguro has a willingness to cure his patient even though his colleagues give up curing the patients. It is because the war has changed the people’s point of view about life. Patient who does not die in the hospital might be the victim of air raid or bombing. However, Soguro is still optimistic that he can help to cure the patient and preserve their life much longer. He dedicates his time and thought to realize the patient’s opportunity to live longer.
“Is that right? Still at it, eh? Said Toda, feigning great surprise “why don’t you give up on it? You’re always going to extra trouble for that welfare case”. “It doesn’t take any trouble. None at all.” (32)
Soguro never gives up even though his seniors or the experts hopelessly say that they cannot do anything with the patient. Since the disease has occupied half of the patient’s lung. It means that medically the patient does not have a chance to life. He takes the responsibility and finds out any possibilities in curing the patient although there is no hope for the patient.
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Soguro tries to find out new methods in curing and saving his patient. He tries to explore new idea about the operation and forces himself to do the best for his patient even there is no hope at all. He tries to invent new method.
‘Actually, he knows himself there is no hope, but Soguro has some idea about an operation.’ ‘it’s rather a good opportunity. In the left lung, there are two diseased areas, and there’s an area of permeation in the right. Therefore, the idea would be an experimental operation on both lungs.’(41)
In the other hand, as citizen he also serves his country because he is loyal to his Emperor. He shows his loyalty by dedicating his life for the sake of his country even though he must sacrifice his life. He is proud he can devote himself to serve his country as a doctor.
‘Dying a private as good as any other way. For myself, for the war, for Japan, for everything let thing go just as they like.’ (72)
Soguro is really responsible with his duty. He really tries to do his best. Soguro knows it is his duty to cure his patients (as could as he can) although his colleagues ensure his failure. However, because of this responsible nature, Soguro feels guilty when his patient died. Therefore, he tries to cure his patients the best he could do.
3. Unconfident
or the Old Man. This Old Man’s achievement in life really makes Soguro admires him. This man graduated from Germany and has a German wife. He is one of the candidates of the next head of hospital. Soguro wishes he can be like him. However, he is afraid to realize it because he is only a person who is come from a village and he only studies in a local university. He is from an ordinary family. This reality makes Soguro unconfident. He thinks he is not deserved to achieve a big dream and it is too high for him.
Studying in Germany is a dream for a doctor, like Soguro. Germany is a best place to learn about medical knowledge since its development in science and technology has widespread around the world. He has a dream to achieve that knowledge and it will make him an expert doctor. However, before he realizes it, he makes a limitation on his own capability. He thinks he can only achieve the ordinary one, such as going to a small village and establishing a hospital. He is afraid that he cannot realize his dreams then he decides to change his dream into the ordinary one. He chooses not to try to achieve his dream. Whenever he faces a challenge, he will move backward. He is trapped in his own world. He really admires the Old Man fortunes and he hopes he can be like him.
Once the War was over, he too, like the Old Man, could go to Germany to study and have a love affair with a girl there. And if this were too much, then something ordinary- it didn’t matter. To go to a small town somewhere, have a little hospital, marry the daughter of one of the town notables- that would be all right too. If he did that, he would be able to take care of his parents, who lived in Itojima, easily enough. The ordinary, that was the best, Soguro thought (44)
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for him because it is too high to be achieved. He thinks he is incapable to reach this dream.
Soguro recalled that the Old Man had fallen in love with the German woman who was now his wife when he had been a student in Europe. ‘Nothing like that would ever happen to a country boy like me,’ he reflected unhappily. (37).
This thought influences Soguro’s attitude. He feels inferior to the other doctors and always follows what they said. He is afraid to state his own opinion and rejects their orders although he knows that his opinion is true.
Thinking. Sleeping. No matter how much you think, it doesn’t help. I’m just one person. What can I do with the world?’ Soguro would fall asleep; then his eyes would open again. (33)
Soguro feels unconfident to make some differences of the world around him. He thinks that he cannot afford to fight the immorality around him alone. Someone who is lack of confident usually cannot do anything by himself. He has negative image about his own self. Therefore, Soguro always needs support and motivation from the other especially from his close friend. However, he does not get those things. If he does not get them, he will feel alone. Soguro feels alone and he thinks he cannot make changes to his world. He gives up to make differences before he tries to do that. He cannot do that because he is not sure with his own self.
By saying ‘I don’t know…’, it means that Soguro cannot decide surely what is the best for his patient. In this case, Soguro actually knows exactly that the operation will result in the death of the patient because the diagnosis of the patient does not support to do it. However, when Soguro reports the diagnosis, he doubtfully tells his colleagues about the result of his diagnosis. Whereas, Soguro knows exactly that his diagnosis is right. This thing proves that Soguro feels unconfident to state his opinion in front of the other doctor.
According to Maslow, a person who has adequate self esteem will be more capable and productive. In contrast, he will be covered with unconfident and powerless feeling. It can create desperate feeling (Goble, 1987: 76). In this case Soguro realizes that he is only a doctor who comes from village. This reason causes Soguro’s has inadequate self-esteem to actualize himself as a doctor. Soguro’s lack of confident also has significant impact whenever he wants to decide something. He is easily influenced by other’s statement and he really cares about the other’s opinion about himself.
3. Idealistic
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the patient equally without differentiating their status. He treats the welfare patient properly even though they are poor. He shows his idealism when he sees the treatment differences between the previous Dean’s relative, Mrs. Tabe and the common patient in the ward, which is dark and dirty.
Was he jealous of the girl’s husband, jealous of a happiness which Soguro himself would never be able to gain? Or was it rather that he simply felt a sort of just anger on behalf of all those patients who lay in the dark ward? Whatever it was he felt, he couldn’t explain it to himself(57)
In the other hand, he also has idealism as Japanese. He has true loyalty to his Emperor. He wants to dedicate his life for the sake of his country even though he must sacrifice his life.
For myself, for the war, for Japan, for everything let thing go just as they like.’ (72)
Even when Soguro feels jealous, as doctor he thinks about the unfair treatment of the patients. His idealism is a doctor must treat his patients equally. Therefore he becomes angry whenever a patient gets unfair treatment. Meanwhile, as a Japanese Soguro has obligation to defend his country, no matter what it cost. Even he must pay it with his blood if it is necessary. Soguro wants to fulfill his loyalty to his country as a citizen and his profession as a doctor in a perfect way.
B. Soguro’s dilemma in dealing with paradoxical medical ethics
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operation. In this case, there are different motives between Soguro and Dr. Asai. Soguro’s motive as a doctor is reflected in his idealism which is to preserve human’s life. Meanwhile Dr. Asai’s motive is to reach his ambition to have higher position. These contradicted motives creates Soguro’s conflict. Soguro is trapped in the Avoidance-avoidance conflict because he must choose to follow Dr Asai’s command or to reveal the truth about the real reason of Mrs.Tabe’s death. Whether he tells the truth to her family or not, Soguro cannot face them because he is indeed involved in that operation. As a responsible person, he fails to do his duty and he feels that he has responsibility to expose the truth to Mrs. Tabe’s family. Yet, he will be abandoned by his colleagues, if he tells the truth. However, if he obeys Dr Asai’s command, he will feel guilty since he betrays his principle of life, his own self. Moreover, he will violate the principle of justice. It makes him depressed. This conflict leads him to his dilemma, to survive his principle or to survive his image.
‘Soguro leaved the room. He was at loss to know what to do. At Asai’s order to removed the hypodermic needle for the Ringer Solution which was plunged into the leg of the dead woman. He seemed to hear a sound like a clock tickling inside his head, the same sound over and over again: ‘What’s the use? What’s the use? What’s the use? (65).
other hand, Soguro is disappointed that he cannot save Mrs. Tabe’s life. In this case, it can be seen the opposition of Soguro’s motive and Dr. Shibata’s motive. Soguro’s motive is to cure and save his patient’s life. Meanwhile, Dr. Shibata’s motive is to reach highest position in the hospital. These different motives creates Soguro’s conflict. As an idealistic person, he thinks that his knowledge, all of his knowledge that he learned from the medical school is useless. His purpose to be a doctor in order to safe human’s life is no longer precious since he is powerless to fight that immorality. Soguro repeatedly asks himself what exactly the real purpose of being a doctor. He realizes that Dr. Shibata is his senior and has a higher authority. Therefore, he is not brave to state his disappointment to Dr. Shibata and his lack of confidence prevents Soguro to do it. He struggles with himself after he considers that the destiny to be a doctor is only to support the ambition and also he sees the immorality which is done by the other doctor, his colleagues. As an empathetic person, he cannot accept Dr. Shibata’s jokes because he could feel the sadness of Mrs. Tabe’s family. Soguro faces Avoidance-avoidance conflict. First, Soguro must defeat Dr. Shibata who is his senior. Second, Soguro must defeat his own self, his incapability. He must accept the fact that he is one of the doctors who involve in Mrs. Tabe’s surgery. Soguro faces dilemma inside himself because he is also a part of the profession. Soguro is confused with his purpose to be a doctor because of Dr. Shibata’s decision.
Dr Shibata announced in an offhand way, two or three days after Mrs. Tabe’s death, that the operation on the old lady would be postponed for two or three months.
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on another planet…. ‘Well, what now?’ Soguro from time to time would ask himself. ‘Is this what it means to be a doctor? Is this a medical school?’ (67)
These external factors are the determinant keys, the factors that lead him to his dilemma. It is caused by the conflict between the internal factors (Soguro’s characteristic, personality and his perception on his surrounding environment) and the external factor (the government, the medical ethics (his code of profession) and his colleagues). Those external factors have significant influence in creating his dilemma.
how it is related with Soguro’s dilemma in dealing with the principle of medical ethics in the war-time.
The principle of medical ethics in war-time is usually deviated. The profession as a doctor is a mask to cover the doctor’s crime. During World War II, like Germany Nazi with the cruel doctor Mengele, who performed a lot of killing surgery to the prisoner of war, the doctors in Japan were the same. In the novel, the Japanese doctors perform the surgery because of their curiosity about the human body. Some of them only use the medical ethics and their profession as a cover to hide their evil desires. The medical ethics becomes the paradox of their crimes. In order to comprehend the background of the distortion, it is better to observe from the subjects who perform it. They are Japan’s government and the doctors.
1. Soguro’s dilemma in relation with Japan’s government
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the victory. The militaristic indoctrination was by building up an elaborate state of Shinto, centered on the person to be loyal to the emperor and by indoctrinating school children with fanatical devotion to the emperor, to build unquestioning loyalty and obedience. Japanese was taught to believe that the emperor’s wishes must be obeyed blindly by all his loyal subjects. Becoming a soldier is an honorable and devoted life for Japan.
‘There are going to be some vivisections perform on American prisoners.’ Why did I have to get involve in that vivisection business? I didn’t have a fair chance. If it had only occurred to me to refuse there in Dr Shibata’s room, I would have refused.’ (75)
The war has changed the government in valuing about human life. By focusing the goal of the country to win the war, the government supports any kind of effort to reach the goal. In Japan, the ultranationalists who dominated Japan awake the superiority views among Japanese to other nations. It influenced every aspects of Japanese society including in the medical world. In the novel, the doctors treat the American soldiers unfairly. The government wanted the doctors to perform illegal surgery or human experiment to find new way to cure the soldiers injured in the battlefield to defeat the country’s enemies. Besides showing their loyalty to the emperor, actually these doctors’ basic reason to do the experiment was to satisfy their curiosity. In The Sea and Poison, the doctors perform the experiment to satisfy their curiosity. However, the government also supports these violations. The medical ethics such as the principle of beneficence, do not harm someone’s life is changed into allowing someone in danger to win the war. The government allows those experiments to win the war. Every experiment is allowed as long as it will result to a very deadly and effective weapon. The government supports that doctor’s crimes.
2. Soguro’s dilemma in relation with the Japanese doctors
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supported their conducts. The medical institution which supposedly served as an institution to cure and heal human’s sickness was used for a place to kill and did inhuman experiment. During the war, there were a lot of prisoners of war. The prisoners were sitting ducks for doctor’s curiosity. Then, these people were sent to hospital. The purpose was not to cure them but to make them as the doctor’s experiment.
The doctors are like a child who gets a new toy. The prisoners of war became the object of the doctor’s curiosity. The violation of the principal of beneficence (not to harm someone’s life) is considered never happened. The medical ethics during the war is directed to win the war. Surprisingly, it is not only the prisoners of war that become the object of doctor’s experiment but also their own ‘brother’, the Japanese patient. Moreover, the sadness of the patient’s death is not because they feel sympathetic but they regret the loss of opportunity to try their new techniques to that death patient.
‘Why, that ward patient died before I could get to her. I was going to try that new method.’ said Dr. Asai.
Why can’t they come to the point?’ though Soguro choking back the nausea. (74)
doctors but he will betray his idealism, it means he will betray his principle, his own self or defending his idealism, it means he will be abandoned and isolated by his colleagues. It is a violation of the principal of justice and equal treatment. It is described that the doctors are curious of the reaction of the human body to chemical substance, the organ of human body, how the human body works, etc. Basically, every doctor has a willingness to reveal the mystery of human body. For instance, the doctors use the trial and error technique to know the exact dosage of drug to cure the patient. The war has given an opportunity to satisfy their curiosity. The war has decreased the value of human life because there are countless victims of the war. In this case, Soguro is trapped in Approach-avoidance conflict. Toda tries to correct his argument by giving a reliable fact about the impact of war and he tries to ensure Soguro that behind all of his conduct there is some valuable meaning. Soguro is in dilemma because he actually knows what the meaning of Toda’s statement is but he is afraid to believe it.
‘Oh come of it! Killing a patient isn’t so solemn a matter as all that. It’s nothing new in the world of medicine. That’s how we’ve made our progress! Right now in the city all kinds of people are dying all the time in the air raids, and nobody thinks twice about it. Rather than have the old lady die in an air raid, why not kill her here at the hospital. There’d be some meaning in that.’ Toda argued.
‘What kind of meaning?’ Soguro muttered in a hollow voice.(51)
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do the experiment because the profession of doctor is an untouchable place to conduct a crime even the government will not punish them. The objects of the experiment are not suspicious with what the doctor will do them because they think that a doctor’s professional duty is cure the sick or wounded people.
The patient seemed to become more relaxed as the examination progressed and followed all Asai’s directions obediently. It was evident from his gentle blue eyes and the frequency of his friendly smile, that he had not the slightest misgivings about Soguro and the others. It seemed that the confidence that men have in doctors as a profession was quite enough to put the prisoner at ease.(133)
must face the institution where he works. In this case, there are different motives between Soguro and his institution. His motive is to protect the patient from any harmful conduct of his collegues. Meanwhile, his institution’s motive is to save its good image in the patient’s eyes. Soguro is trapped in Avoidance-avoidance conflict. He must chose between two unattractive goals. He must choose his responsibility to his institution or his responsibility to his patient. If he chooses his responsibility to his institution, it means he lets the people being manipulated by the good image of the doctor. If he chooses the other one, he is a traitor to his institution and breaks doctor’s prestige in the public.
The situation where Soguro works also influences his dilemma, with whom he works, what kind of people they are, their perspectives about human life, their motives to be a doctor and his role model of doctor. Soguro is surrounded by immoral doctor such as Toda and the Old Man.
Toda is Soguro’s friend since he was in college. Toda is Soguro’s close friend in the hospital where Soguro works. Soguro always shares his view with him. This person has significant role in creating Soguro’s dilemma. The Old Man is Soguro’s idol. Dr. Hashimoto or the Old Man is Soguro’s senior doctor in the hospital where he works. Dr. Hashimoto is an ambitious person. He also has significant role in creating Soguro’s dilemma and influences Soguro’s mind especially his decision making.
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Toda is the most influencing person of Soguro’s decision. Toda has pessimistic view of preserving human life. Toda always oppresses Soguro by telling the fact about the degradation of human value. The war has killed a lot of people. In his opinion, using human as an object of experiment is appropriate. It is better to make them as an object than to let them killed uselessly in the bomb attack. The medical ethics of preserving life is opposed with killing patient is revealed through Toda who sees that life is not precious anymore.
‘Oh come off it! Killing a patient isn’t so solemn a matter as all that. It’s nothing new in the world of medicine. That’s how we’ve made our progress! Right now in the city all kinds of people are dying all the time in the air raids, and nobody thinks twice about it. Rather than have the old lady die in an air raid, why not kill her here at the hospital. There’d be some meaning in that, boy!’(51)
Basically every doctor wants a significant progress in the world of medicine and healing methods. During World War II, especially in Japan, several doctors used the human body as their experiment object to reach that progress. This experiment was supported by the government. Toda uses this support as a chance to satisfy his desire to observe the human body deeply. According to Toda, it is more accurate to have experiment by using human body than animal. Thus, for inventing new technique or medicine, he thinks that it is necessary to sacrifice someone’s life. He argues that it is worth with the opportunity.
‘And when they want to try out new techniques, they don’t limit their experiments to monkey and dogs’ Toda said.(50)
influence Soguro by giving the ironical fact about human experiment and it can give new hope to the world of medicine. The experiment can save more life but in other hand, the experiment endangers someone’s life. Toda’s motive can give a new hope to the patients with incurable disease. Soguro faces Approach-avoidance conflict. Soguro knows that the fact is true and can save more human’s life but he also considers the consequences behind that experiment. Soguro is in dilemma because Soguro knows that by doing human experiment, the progress on medical world will be more significant. Moreover, he also considers that by using human as the object of experiment, the result will be more accurate and save more life.
ii.The Old Man
The Japanese doctors in the novel are like a scientist who always curios to try new technique in curing disease. Sometimes the trial is not to cure the sick person but to gain their careers and popularity. They dedicate their services for the patient who can be their vehicles to support their careers. They do not treat the welfare patient, the patient who is helped by the government, properly. They do not pay attention whether (the patient’s life is in danger or not). They see the patient’s life is precious if it can lead to their career’s progress
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his career. He has an ambition to be an important person in Fukuoka hospital, the hospital where Soguro works. He is the nominator of the next dean of the hospital. He does not care with the patients as long as this patient does not give advantages for him.
The Old Man only gives his best treatment if the patient is important person. For instance, he treats Mrs. Tabe, a patient who is one of the relative of the previous Dean in Fukuoka hospital, properly. He shows his politeness to her but if his patient is a common people, he will treat them inappropriately. The violation of the medical ethics, the principal of equal treatment (to treat every patient equally without considering their social status, race, education, property and so on), happens because the patient does not come from wealthy and noble family.
‘The old lady’s going into Dr. Shibata’s experimental lab, and Mrs. Tabe is going to be a means toward The Old Man’s advancement.’
‘of course?what do you want?....Toda grinned, looking at Soguro’s distraught face.’Yes, what’s so bad about it?’
‘I don’t know how to put it, but…’(50)
It is really contrast with the treatment for the welfare patients. Their rooms are dirty and it smells not good, even they must cook their meals themselves. Although in the wartime, it can be understood that the hospital’s service was not comfort enough; at least, the patient should get better treatment such as receiving clean bed. However, the reality is not like that. They get bad treatment. Their room smells not good because the nurse seldom wastes the patient’s urine in the jar.
firewood with that of the dirty bedding and the urine jars stored beneath the beds to form an amalgamated stink which floated out into the corridor. (38)
Moreover, from the patient’s reaction, it can be seen what kind of doctor they are. Every time the Old Man examines the patients, they seem afraid. The patients think it is like condemnation if the Old Man makes a surgery decision on them. By having surgery, it means death.
In general the chances of the patients in here surviving an operation were no more than fifty-fifty. Furthermore, on the entire history of the Medical School, there had been only two operations successfully performed upon patients who had both lungs infected. In the other ninety-five per cent of such operations, the result had been the death of the patient. But whether there were an operation or not, certainly within half a year her infirmities would prove too much for her and she would die of sheer weakness. (42)
They do not feel comfort with him because they know that this doctor will bring them into death. They try to cover their illness symptoms.
But when the Old Man came in once a week, flanked by interns and medical students, the patients hastily made themselves as inconspicuous as possible….and the patient, his eyes narrowed and filled with distress, would cringe before the great ones as though awaiting a sentence of condemnation. They would try desperately to conceal it of their fevers had gone up or their coughs grown more severe. They would sit, shoulder hunched, hands on knees, hoping to escape the scrutiny of these awesome doctors as quickly as possible (39)
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someone to share his idea and becomes his role model. Soguro is in conflict because his motive is opposed with the Old Man’s motive. The Old Man, or Dr. Hashimoto is really ambitious to be a Dean in the next election in the Fukuoka hospital. In order to achieve his ambition, the Old man uses any kind of strategies. There are by applying discriminative treatment to his patient and his involvement in supporting the government’s order on the human experiment. Meanwhile, Soguro’s motive is to help his patient equally. However, the Old Man is Soguro’s idol. Soguro dreams that he can be like him whether from his education and the way he is respected by the others in the hospital. Soguro is involved in Approach-avoidance conflict. He must choose the attractive one, his dream to be like the Old Man or he must hold his idealism to treat and preserve the patient fairly. It means he does not speak the same language with the Old Man or he will be the Old Man’s opposition.
C. Soguro’s decision making to manage his dilemma in dealing with
paradoxical medical ethics
knowing and understanding Soguro’s personality and the tendency of his behavior, it will be apparent how he reacts to the conflict. In the novel, Soguro is a person who likes to be alone when he must make a decision. However, when he is forced to decide something, he tends to be influenced by the other’s opinion, easily depressed, he is idealistic, easily to befriend, peaceful and easily conformed, avoiding conflict, unconfident, responsible and empathetic. According to Hippocrates in his theory of personality, those Soguro’s characteristics are categorized in the melancholic phlegmatic personality. The most dominant characteristic is melancholic. According to Florence Littauer in his book
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adjusts to the world, its feelings, its values, and the ways in which it deals with these problems. (Kalish, 1973: 52). Therefore, someone’s reaction in perceiving problem in his life is relatively different one and another depending on his characteristics. The strengths and weaknesses of someone’s characteristics determine the way he faces problems. This thing can be proven in the case when Soguro must face dr. Shibata in relation with ethical decision.
He must make decision but his decision is influenced by his characteristics. In deciding something, Soguro is hesitated because he tries to avoid conflict with the other because Soguro is only a country boy and tries to gain recognition of his existence in front of the other doctors with trying to avoid differences with them. In other word, Soguro feels unconfident and tries to be accepted.
‘Doctor, this operation is going to help me, isn’t it?’
When she questioned him like this, there was a little he could say to console her. What could he say to her- she who with or without an operation would die within a few months anyway?’
Soguro had no idea what to tell her. For him the cruel things were to submit this dying woman to the further pain of an operation. What else was there for Soguro to do but to blink his eyes?”
‘At any rate, there is the matter of her heart getting weaker. Soguro made his report to Asai. Asai was having a glass of wine, from the hospital medicinal stock, with Dr Shibata. ‘I don’t know, but it seems to me that an operation might not be advisable.’(46)
