Hiroshima Maidens Page 12
Once the donor site was determined, a “pedicle graft” was the procedure of choice. It was an extraordinarily complicated process of moving skin that, in short, called for the transportation of middle-body tissues to the face in stages, using the arm as a carrier. Typically, the patient was put under general anesthesia and two parallel cuts were made in the abdomen, approximately 9 inches long, 4 inches apart, and ½ inch deep. The flesh was then pulled up, folded in on itself, and sutured between the incisions to form a cylindrical roll. Several weeks later, one end was severed and sewn to the wrist, connecting the blood vessels. A month was generally considered time enough for new blood circulation to be established in the tube, and then the other end was detached from the abdomen and planted in the face. In the final stage, the roll of flesh was disconnected from the arm and slit open, the facial keloid was excised, and the graft spread over the gaping wound. Since straight scars often healed in a pucker, the edges of the graft were Z-stitched, and an effort was made to put the seams along a natural crease in the face.
These were demanding and exhausting operations that required a great deal of patience and attention to the most minute detail, and which lasted anywhere from two to four hours at a time. It was a slow process, day by day, operation by operation, without any dramatic climaxes that represented turning points. After three months, Dr. Barsky was cautiously pleased with the progress but less than delighted with the publicity. Not that the newspaper notices he was receiving were negative or unfriendly. The headline that bannered the front page of the World Telegram & Sun, SURGEON’S KNIFE BATTLING A-BOMB, while a little too dramatic for his liking, caught the spirit of the majority of press reports. But he was disturbed by rumors that had come back to him that some of his distinguished colleagues were suspicious of his motives and, behind his back, accused him of participating in a publicity stunt. An ill-timed article in Time that left the impression Barsky and his associates were America’s three foremost plastic surgeons did not help matters; but it was the antics of his medical counterpart on the project that he held accountable for the impression they were playing this up for their own gain.
Dr. William Hitzig’s bombastic personal style was at complete odds with Dr. Barsky’s reserved, professional manner. An alternately exuberant and moody man who dressed dapperly, Hitzig could be both a charming character and an unsufferable egotist. His penchant for baring his soul whenever he spoke his mind and his transparent attempts to ingratiate himself with the press made him seem at times like the public relations manager of the project. (Somehow he always managed to wind up in the center of the newspaper photographs with his arms draped around two Hiroshima Maidens like a proud papa; for some reason the accompanying articles were consistently unable to get his title and position straight, and compositely referred to him as a Quaker plastic surgeon who was director of Mount Sinai Hospital, when he was neither.) For Dr. Barsky, Hitzig was one more thing to worry about, and it came as no surprise that Dr. Hitzig turned up at the center of their first crisis.
One day, unannounced, Dr. Hitzig, accompanied by another gentleman wearing a white coat, appeared on the ward and asked Helen Yokoyama to bring one of the Maidens who was in line for surgery to the nurse’s station. Thinking this was just another pre-operative interview, she followed his instructions, and after all four of them had taken a seat in the private cubicle, Dr. Hitzig said, “This is Dr. Kauffman and he is a member of the Mount Sinai staff. If you don’t mind, he would like to ask you a few questions.”
Through Mrs. Yokoyama’s translation, the girl said she would be glad to cooperate, and everything was fine until Dr. Kauffman went from general questions about how she was enjoying her stay to a more probing inquiry into her personal history. She glanced at Helen Yokoyama and said she did not understand the meaning of this line of questioning. Neither did Helen Yokoyama, and she asked Dr. Hitzig what was going on. Hitzig then explained that Dr. Kauffman was the chairman of the hospital’s psychiatry department and was interested in doing a psychological study of the Hiroshima Maidens. Helen Yokoyama tried to translate, but the direct translation of psychiatry into Japanese connoted “mental illness,” and when the girl heard that, she yelled, “I’m not crazy,” and ran down the hall to alert the other girls on the ward that the critics in Japan were right, they were going to be put through all kinds of tests just like guinea pigs.
Helen Yokoyama turned on Dr. Hitzig. “Why didn’t you give me time to explain if that was what you intended to do? You should have told me beforehand.”
Flustered, he protested. “But it’s a common practice...”
“In the States, maybe, but in Hiroshima it’s virtually unheard of.”
At a subsequent meeting, in Norman Cousins’s Saturday Review office, of a steering committee formed to deal exclusively with the Maidens Project, Dr. Hitzig defended his decision to bring a psychiatrist onto the scene by making the case that the Maidens had lived through the single greatest disaster known to man, and surely it had left them with lifelong psychological problems that would benefit from analysis and counseling. At the same time, he said, they constituted a test group like no other in history and were in a position to make a contribution to medical history and posterity.
Dr. Kauffman proceeded to elaborate. From the scientific point of view, the opportunity to interview Hiroshima survivors and document the impact of this sequence of events in which they were involved could supply the kind of information which was not available in any other circumstances and which until now his profession could only imagine. An investigation into the Maidens’ reactions to the atomic bomb, the inner emotional turmoil they endured, the adjustment required to seek salvation from the very perpetrators of their misery, were fascinating components of an extraordinary psychological constellation.
In a soft but firm voice, Helen Yokoyama countered that such a study was impossible. Psychiatry may be fashionable in the United States, she explained, but in Japan few people were familiar with the practice. Putting aside for the moment the question of whether the theories and therapies of Western-oriented psychological studies would be of help in maintaining the mental health of the individual Maidens, it was her opinion that such a study could not be conducted without implying that the girls were either losing their minds or being brainwashed; and if word of that got back to Japan, she warned, even though it might be a misinterpretation of what was really happening, it would be disastrous.
“Besides, the girls won’t understand the need of it. It’s a departure from the original purpose. They are here for surgery, and are not interested in posterity.”
Listening to all this, Dr. Barsky had to will himself to stay calm. When patients in a hospital were assigned to a particular service, it was considered proper procedure to discuss with the chief of that service any projects involving those patients before proceeding, and he was irate that Dr. Hitzig had taken it upon himself to initiate this study without even discussing it with him first. He knew that successful plastic surgery considered every aspect of the patient’s well-being and not merely the local symptoms in a problem area, but he was unpersuaded that psychiatric care was required. If no one in Japan saw a psychiatrist unless they were psychotic, which these girls were not, then that was all he needed to hear.
What Dr. Barsky said was, “We can’t judge this by our standards; we must judge it by theirs. The information to be gained is not worth the risk of misunderstanding and the bad effects of probing.” What he did not say but thought was that disturbed females made bad patients, and he would not permit any activity that upset them as long as he was in charge.
After considering the various viewpoints, Norman Cousins wondered if a compromise might not be worked out so that such a study could be useful both to medicine and to the girls.
During the ensuing discussion the question of whether or not the data would be true to the facts if the girls did not cooperate willingly was raised. It was suggested that perhaps they could each be approached personally, alerted to the
possible value of this phase of treatment and asked to participate on the basis of making a contribution to science, as a way of repaying the people who were doing so much for them.
At this point the Quaker representative, Mrs. Ida Day, a slender, bespectacled former school counselor who was the project’s designated Hospitality Coordinator, spoke; her voice was choked with indignation. “I speak for the Friends and we think it would be a shabby exploitation of the girls. We feel the only person who would profit from such a study would be the person publishing the article or writing a book about it. We feel strongly that rehabilitation is the most important thing, and psychiatrists are not the only ones who can do this. What is already being done for the girls, from the human angle, is enough. They are adjusting just fine.”
There was silence in the room. His arms folded, chin upraised, Dr. Barsky rocked back in his chair. He thought she had answered wonderfully. Indeed, the voice in favor of a psychological study of the Hiroshima Maidens was never heard from again.
*
When the Maidens’ idyllic interlude at Pendle Hill drew to its conclusion, Michiko Sako, in a gesture of gratitude that humbled the residents, who had come to feel they had received as much as they had given, gave the director of the retreat a handful of morning glory seeds that she had brought from her garden in Japan. Exactly what the Pendle Hill experience had done for them would be difficult to describe, but each girl felt it and showed it the day the American families came to take them away. Where once the move would have filled them with apprehension, now they were bursting with anticipation.
The decision had been made to send them into American homes in pairs, as a way of minimizing loneliness, and the task of deciding upon roommates was left up to Helen Yokoyama. It was her idea to put girls together who were not only compatible but who would be good for each other, and for that reason she tried to mix rather than match personalities, placing the more outgoing girls with shy, introverted partners. But since she did not know any of the girls well and there was not enough time to learn about them in any depth, she had to go with her first impressions.
Nor had there been enough time for Ida Day to carefully investigate the suitability of individual homes. She had thought it a good idea to place the women in homes outside the New York metropolitan area because living in the city was apt to produce confusion and not the sense of community that she felt would be valuable in terms of a representative American experience. Other than insisting that the homes be located within a reasonable driving distance from Mount Sinai Hospital, the only guidelines she was able to pass down were that the chosen homes should be able to offer a comfortable, private living space for the guests, and the mother of the family should be a housewife who stayed home during the day. She left the screening of the homes up to the special committees each Friends Meeting had formed to handle this concern. In recognition of the haphazard character of the pairing process, however, Helen Yokoyama and Ida Day agreed that it would be best if the first home-stays were considered a trial period to see how well the girls got along — with each other as well as their new families.
The Quakers went all-out to make the Maidens’ move to their new and strange homes a smooth one. The Ridgewood, New Jersey, hostess, for example, brought along the Japanese wife of a neighbor, a war bride who had married an American GI, as interpreter; and in an effort to make her house seem familiar to the girls, she had arranged for a “Japanese evening,” complete with koto music on the phonograph and an American version of sukiyaki for dinner. A similar evening was planned in Rockland County, New York, but there the hostess did not have the advantage of an interpreter and learned quickly that the language barrier, coupled with the inherent timidity of the girls, doubled the chances for misunderstanding. It was late in the afternoon when she took her guests to their room and told them dinner would be ready when they were. Hours passed and it was getting late but the girls had not appeared. When she finally went to call them, she found they had changed from Western dress into silk kimonos to make a ceremonial occasion of their first meal, but after dressing had been sitting, waiting, afraid to go downstairs.
In every household a special effort was made to make the Hiroshima Maidens feel welcome, but the most effective gestures were the unplanned and spontaneous acts of thoughtfulness. Her first evening in an American home, Hiroko Tasaka retired early to her second-floor bedroom, only to be wakened at dawn by sunlight streaming in the east-facing windows. She could find no curtains to draw, nor could she hear any stirrings in the rest of the house, so she just lay in bed thinking when she heard the creak of a door opening and footsteps quietly enter the room. She lay perfectly still, pretending to be asleep, and through half-closed lids watched her hostess tiptoe over to each window and lower the Venetian blinds. The room was dark when the hushed footsteps left, but Hiroko was unable to go back to sleep. The good lady would never know how much that simple act meant, or in what giant way it relieved; but Hiroko could palpably feel the foreignness of her surroundings and the nervous uncertainties that had collected since arriving in America melt away.
As it happened, such moments were taking place in many of the homes opened to the Maidens, which was reassuring to the host families for whom all this was new, too. One of the most touching occurred in Flushing, New York, where Yoshie Harada had gone. Yoshie was one of the shyer girls because she had not been a member of the Reverend Tanimoto’s original group. Because of her injuries, she was unable to get around and she had not even known of the existence of the other girls until she read about the project in the newspaper. For a year and a half after the bombing she had lain on the floor on her right side, unable to move, unable to roll over, and as a result her entire right side was nerve-dead. When she walked, she dragged one leg behind like something stepped on, she had trouble holding things in her right hand, and one side of her face was pinched as if she were screwing her eye up. After a quiet meal, Yoshie Harada was left sitting in front of the television set while her host and hostess disappeared into the kitchen to clean up. Shortly, the picture on the television turned to vertical lines. She did not know what had happened or how to fix it so she soon limped toward the kitchen to see if she could be of help. At the entranceway she stopped, suddenly unable to remember the names of the people she was staying with. She wanted to address her hostess but was at a loss when all of a sudden she recalled a doll that her father had given her as a child that had been made in the United States. When it was stood up its mouth opened and a two-syllable sound came out, “Mom-mee.” Softly, Yoshie said, “Mommy?” Her hostess turned, astonished. She was so moved, tears sprang to her eyes as she embraced Yoshie in her arms. Yoshie was not sure what she had done, but she would always remember that incident.
On the whole, the Maidens were eager to conform to the customs of their host country, and over the ensuing weeks their thoughts and interests were turned fully to learning the ordinary ways of doing things in America. They learned, for example, that they did not have to take their shoes off before entering the house. They learned how to sit in chairs rather than Japanese fashion on a floor mat, and how to eat with a knife and fork instead of chopsticks. They learned that Americans would just as soon stand under a shower as soak themselves in a tub when it came to bathing, and that they slept on boxed mattresses instead of bedding spread on the floor.
The customs of every country are strange to first-time visitors, but an extra measure of difference was added in this case because of the enormous gap in living standards between the two nations at the time. The austerity and privation of postwar Japan was not only a world away, but decades behind the America of the mid-fifties. Coming from war-ravaged and impoverished Hiroshima subtracted another ten years in time, making the airlift to the progressive, modern suburbs of New York tantamount to traveling through time to the future.
Landing in upper middle class homes, the Maidens were dazzled by the latest in automatic amenities. And while they marveled over the way music and movies could be broug
ht into the living room at the touch of a button, they were naturally just as curious about the work and time-saving devices that allowed the American housewife to do her chores in a fraction of the time it took a Japanese wife to complete the routines of housekeeping. To date there had been little progress in modernizing the Japanese kitchen. Except in certain urban areas, gas was not generally used for cooking, so women had to rise early to make a charcoal fire in the brazier. Lack of refrigeration meant food spoiled rapidly, which meant going to market on a daily basis, sometimes prior to each meal. Because so many more bowls and plates were used than in Western cooking, washing dishes was a tedious process. So it was with amazement and delight that the Maidens discovered that the modern American kitchen was a virtual appliance center. Everywhere they turned, a shining gadget beckoned — an electric stove, a toaster, a Mixmaster, “the fridge,” a freezer, a dishwasher, a garbage disposal — and they exulted in the testing of one after another.
It was the effort to adjust to the American cuisine that presented them with the greatest challenge. Their hosts were well aware that the Japanese were inveterate rice eaters, that it was their staple and no meal was substantial without a large helping of rice. For that reason, they were fully prepared to serve rice three meals a day if that was what their guests wanted. But in their desire not to inconvenience, the Maidens did not insist on rice, and in fact even developed a liking for most Western dishes, especially those that came with a generous portion of red meat. Beef in Japan was in such short supply it was used mainly to flavor foods, so they were thrilled to find themselves eating a T-bone steak or a couple of hamburgers, and sometimes consumed more meat at a single sitting than their annual intake at home.