KOTSUAGE, my story about grief in 2 cultures, for ENDPAIN

KOTSUAGE, by Roland Kelts
Photos by Yuki Iwanami

The doctor's pencil drawing reminded me of one of those Etch A Sketch toys from the 70s. Its gray lines were asymmetrical and squiggly or squared off like sidewalk curbs. Other times they looped from what I guessed were the body’s nether regions back up to the heart.

He held the sheet of paper to the window’s hazy light. “It’s really just plumbing,” he said.

He was the handsome younger surgeon, swarthy and Mediterranean-looking, and what he was showing us, my younger sister and me, was a solution to the problems they’d found in our father’s chest. Until our meeting that morning, the problem had been singular: an ascending thoracic aortic aneurysm, a swelling of his heart’s central artery that could be life-threatening if untreated.

But when they injected dye into his chest to get a clearer sense of the problem, the problem became plural. The procedure was called a cardiac catheterization, and it transformed his arteries into a multi-colored subway map, where you could see the blood routes that were slowed or nearly blocked.

“We have to combine the aortic surgery with a double-bypass,” the doctor said. “He has two more blocked arteries, here, and here. We need to create detours for the blood and will need to transplant one artery from his leg. It’s fairly standard. While we have him open, we should fix everything we can.”

“Standard.” “Plumbing.” Hardware fixes for the homeowner. Let Western science and its medical toolkit repair what’s broken in your system. That your father’s life is at risk is logical. That something could go wrong is obvious.

To me, it felt less like standard plumbing than flying: “Fasten your seatbelt, we got bumpy air ahead.” Sure, but that won’t help a whit if the plane goes down, and science knows that it could.

I had flown to Boston a week earlier from Tokyo, Japan, where I live and work for most of the year, to attend the surgery with my America-based Japanese mother and half-Japanese sister. It was April; the entire year had been full of disruptive feelings. Hasty emails of proactive hope (“only 1 to 3% chance of heart failure for men of dad’s age!”) silenced by nights of creeping dread. My family’s humorous optimism, partly an inheritance from my father’s small-town Pennsylvania roots, seemed to vacate us.

Months prior to surgery, when I visited my father at home in Massachusetts during the New Year’s holiday, his eyes would cast floorward in dismay at what was happening to him, to all of us. We used to crank up traditional jazz or swing albums from his lifelong record collection and sip a whiskey or three when I arrived at the house. But the diagnosis of imminent personal danger, the need for surgery, an invasion of his body, the risk and hospitalization meant dark, radical change to a future that long seemed immutable. That quietened him.

Before retiring at 70, he had been a marine biologist, a general ecologist, a botanist, an ornithologist, a professor, and an amateur jazz drummer and fan. The joys and assurances of being able to name the world’s natural wonders, to look at the veins of a leaf and identify the plant family and its history, parse the cadences of birdsong or the bone-chill terror of a wildcat screeching from the trees—his ability to decode all of this was at least one driver of my love of words, sounds, and language.

My mother, too, has always been an ardent reader and communicator. She speaks at least three languages with ease, has taught Spanish at several institutions, and takes visible pride in finding words for thoughts.

Yet the news of my father’s predicament rendered the three of us mute, or worse—cliché-addled and stupid. “We have to take it one day at a time,” I remember myself telling them in the still of their living room, wincing at the banality, fumbling on.

My immediate family’s negotiations with grief and pain were underway. Our track record had been lousy to begin with, so my expectations should have been low.

My paternal grandmother, I, died in a penthouse apartment at the Essex House Hotel in Manhattan in the 1960s. She was taking several antidepressants, and that night she was smoking in bed. She fell asleep and burned to death.

This sent my paternal grandfather, her husband, A, careening. A successful retired industrialist in a small town in Pennsylvania, he stopped playing golf and started drinking heavily, taking up with a young brunette ‘floozy,’ as they used to say, a gold-digger who drank so much that my father and his six siblings nicknamed her “wall-to-wall” to describe her nightly sways. The children and a doctor successfully talked my grandfather off the booze, but he was already damaged and grew ill. A heart attack killed him at 72.

After my grandfather died, my father suffered such severe migraines that he had to pull over onto highway shoulders and grip his temples until they went away. I was too young to understand the symptoms, but I sensed that grief of this intensity could be debilitating.

My Japanese grandparents lived a lot longer—my grandfather died at 94, my grandmother at 100. I lived in their home for a year with my mother when I attended kindergarten in their northern city of Morioka, Japan. They visited our American home several times when my sister and I were growing up, and to us, they were sweet-faced, generous, easy-to-please aliens: we couldn’t understand their native language and culture, but we got the message through smiles, giggles, pats on the head and back, and occasional stiff embraces.

But my mother attended neither of their funerals. Both times she issued terse, hardline excuses—not enough money to make the trip, too busy working right now. It was as if she couldn’t or wouldn’t or was unable to accept and honor their deaths. As a young woman who had left her homeland decades earlier and struggled to assimilate to American culture with an American husband and two US-born children, my mother might have felt that her parents were dead to her years ago. I don’t know.

After open-heart surgery, her husband, my father, was at sea in the ICU. The man who could recite the Latin scientific names for nearly every plant, bird, and furry in the New England forests looked at us blankly when we entered his room, reflexively pushing aside an untouched plate of paper-dry salad.

“I don’t know why they wouldn’t let your call go through!” he said when he saw my face. “I knew you were downstairs the whole time and I told them to let you come up. They were having a pizza party in here last night. Pizza and beer. Jesus.”

I had only just arrived with my mother and sister. We were told not to come until he’d regained consciousness that afternoon. A tall, long-faced nurse with her hair in a towering bun came into the room. Tell them about the pizza party, she said to my father.

“Oh, it went on all night, Roland,” he said. “You wouldn’t believe it.”

And please tell them, the nurse added, that among the very last things we’re allowed to have up here in ICU, besides cocaine and marijuana, are pizza and beer.

More than heartbreaking, the processes of pain are absurd and embarrassing, their nonsense humiliating.

My father recovered from his surgery well. There were a few harrowing days of patching up the infected gash in his left thigh, which had been cut to move the second bypass artery up to his heart, a la the surgeon’s Etch A Sketch. But he seemed to be regaining strength and appetite. He would never ‘be the same,’ the head surgeon had warned us, because open heart surgery ‘takes the starch out of you.’ But he was still here.

A few months later, after I had returned to my life in Tokyo, I got a late-night call from my sister. She was in a car driving to our parents’ home. Our mother had just flown to Canada for a two-week trip, and my sister was on her way to take care of our father. She had called him three times. He wouldn’t pick up the phone.

I called their number from Tokyo at what was midday in New England. No answer. More alarming: no answering machine, no beep.

After a few frantic overseas exchanges, I told her to call the local police. The region was experiencing a midsummer heat wave, with temperatures over 100 F. The cops broke into the house and found my father almost fully naked in a room at the back of the first floor, slumped on the hardwood, perspiring and passed out. TV on, AC off.

An ambulance rushed him to the Emergency Room at a nearby hospital while I scrambled to get a flight to Boston the next day. (Turns out that major airlines have contingency seats for grievance flights, at least if you are a repeat customer. Grief is status.)

When I arrived at his bedside, I recognized my father’s face atavistically: the death mask. He was gray and faded, his eyes hollow even when I could tell that he saw me. He wheezed a ‘hello.’ Speaking seemed Herculean.

He had been infected by a bacterium: Methicillin-resistant Staphylococcus Aureus, MRSA, a staph bacteria resistant to most antibiotics. That’s what the doctors told my sister and me that night, when my father looked already gone, or at least sidling toward the exit. The bacteria were in his spinal column, the neurologist said. They were in his knees.

Couldn’t we just do a little plumbing? I wondered. A little standard stuff?

But my father’s face said otherwise. You learn what dying is just as you learn about living: you confront it, stretch your muscles, learn to accommodate. You don’t learn from mistakes, I once read. You just learn what they feel like.

I learned the look of death in my American father’s face from my Japanese grandmother. I went to her funeral in my mother’s stead and arrived in Morioka from Tokyo at the end of her wake. She was laid out under sheets and bearing a tight kimono, something I’d never seen her wear, and she was horribly made-up but defined by her absence. In Japanese, it’s called the tsuya, the passing of night. I sat with my uncle and aunt and three cousins. We were listening to her silence.

Writing this now, I am embarrassed by my weak nerves and emotional incompetence. I took the Shinkansen bullet train from Tokyo to Morioka, and in the taxi from the station to the Buddhist temple where she would be cremated and memorialized, I couldn’t tie my tie. I mean: I forgot how to tie a tie.

I texted my girlfriend in Tokyo, and she pointed me to a step-by-step website on tie tying. I had to concentrate hard to figure it out. None of the folds made sense, and I was nearly choking myself with crooked knots. The driver eyed me in the rearview mirror. I called my girlfriend minutes before arriving at the temple, and she walked me through the basics. I had tied ties for three decades. Suddenly, I’d forgotten how to do it.

Japanese funerals are largely Buddhist in ritual, though it’s a very distinct version of the religion that arrived from 6th century East Asia, colored by Japan’s polytheistic and animistic national faith, Shinto. The emphasis is on daily presence in nature, not scripture, ritual versus study. Japan can be simultaneously rigid in its behavioral norms and deeply sentimental.

In the temple, I fingered my juzu (prayer beads) during the chanting of the monks, which sounded like humans trying to be cicadas. It was a buzz, a gravelly buzz, and I tried to take comfort in what felt like urgent sadness. My grandmother, this woman, this soul, was gone, it seemed to say, and death is present. Stay alert. Pay attention.

And then came the closest encounter with the realms of both passage and presence that I could imagine: kotsuage. This is a ritual that makes death feel like it’s inside you. What happens: You and your family, in my case, me and my Japanese uncle, aunt and three cousins, retrieve from the ashes of cremation, the bone fragments of your relative—in this case, our grandmother, our mother.

The fire is still burning in the far corner. The ashes are freshly deposited. I am using chopsticks. I am connecting those chopsticks with my cousins, my uncle, and aunt, to my grandmother’s bones. In Japan, this is the only occasion on which two people are supposed to clasp the same item with their chopsticks. To do so in any other setting is sacrilege.

We are delivering her bones to an urn.

When I first learned of this ritual from my cousin, I begged out. I lacked the requisite physical delicacy, I’d told him, picturing my fat American fingers squeezing too hard, sending a bone fragment flicking through the air, knocking an urn to the floor. I couldn’t do it, I’d said. I can’t.

But the experience stirred feelings that grew peaceful and intensely intimate. I was touching my grandmother, participating in her transformation less from something into nothing, but from something into a something else. There was just us: me, my family, grandmother.

My grandparents lived most of their lives and died in Tohoku, the mountainous territory of northern Japan, years before its Pacific coastline was severely and in many cases irrevocably damaged by the earthquake, tsunami and nuclear disasters of 2011. My grandmother’s family were farmers, once-wealthy landowners from Akita, a city on the main island of Honshu’s west coast, at the Sea of Japan. My grandfather was the son of a Bushido samurai family from Esashi, a mountain village just south of Morioka, the capital city of Iwate, on Japan’s eastern Pacific coast.

In the five years since the triple disasters, over 18,000 are officially tallied as perished, some two to three-thousand of whose bodies have not yet been found. Tohoku and Iwate, its northeastern prefecture, are Japanese place names I once associated with my year in a local kindergarten and the rural roots of my Japanese family. Now they are destinations for relief workers, demolition crews and journalists like me.

Last year, I visited Fukushima Prefecture’s Minami-soma, one of the most brutally devastated of Tohoku’s coastal towns, to meet Takayuki Ueno, a 43-year-old farmer-turned-victims’ advocate and local educator. The Ueno family’s presence on the land dates back generations. Standing at sunset beside his new home (built three years ago and ten yards from where his old one was destroyed), at the edge of puddled rice paddies wedged between leafy hills to the west and the sea to the east, it’s not hard to understand why he is staying.

Like many in constant trauma, he recounts the tragic events hour-by-hour, sometimes minute-to-minute—the calm after the earthquake, the sirens warning of a wave 9-feet high that rose 60 feet, the water surrounding and blocking his return home—as if they happened just yesterday, despite the five years of recovery and debris cleanup, his spacious and very modern new home, and a cherubic 4-year-old daughter, Sally, born five months after the disasters. Ueno is seated across from me on the floor at a low coffee table, a lean man with an athletic build who chain-smokes aggressively, as if in competition. “I started doing this after the tsunami,” he says, half grinning as he stubs out one cigarette and reflexively lights another. “Now I can’t stop.”

The bodies of his father and son remain missing. On select monthly Sundays, Ueno searches on a beach near the town of Okuma, a few miles south of Fukushima Daiichi, the most badly damaged of the area’s nuclear reactors. Local residents and government-hired construction workers often join him (the latter illegally using government-issued bulldozers and mining shovels), helping him dig through heaps of natural and man-made wreckage on the seashore for a fragment of bone, teeth, or tuft of hair that might be DNA-tested and verified.

Ueno believes that his son’s body, in particular, may have drifted down the coastline in the aftermath of the tsunami waves and washed up on one of the beaches. But at the time, he was prohibited from searching those beaches by local police and government authorities, because they were inside the zone designated most radioactive.

“It was a time of extreme effort,” he says after a long pause and exhalation of smoke. “The priority of a parent is to defend the child from anything and everything. I couldn’t save or protect my kids, so I thought I was the worst parent for a long time. I could’ve saved them, I kept telling myself, but the fact was, I couldn’t. When I found Erika’s body, I held her in my arms, and I apologized to her. I still need to apologize to Kotaro. I think if I had found Kotaro at the time, and if I’d looked into his face, I would have killed myself.”

The butsudan (family altar) in his house bears four football-sized ceramic urns, one for his mother, father, daughter, and son, arranged in a horizontal line behind portraits of each. Two of the urns are filled with cremated ashes from a kotsuage Buddhist ritual, in which the larger bones are separated from the ash by surviving family, like the one I experienced at my grandmother’s funeral, held at a nearby temple exactly one year after the tsunami. The other two remain empty.

Ueno is still angry. First, he had to get over the initial spike of rage he felt toward his parents.

Immediately after the magnitude 9.0 earthquake, at 2:46 p.m., they called their grandchildren’s hillside school and were told that all were safe. But since the building might have sustained structural damage, the children should be picked up and returned to their homes immediately.

Ueno was working at a farm cooperative a few miles inland. His wife, Kiho, was a nurse at a local hospital, also miles from the sea and nestled in the hills. His parents were told to get the children out of the precarious school building and bring them to his home, less than a mile from the coast. Fifty minutes later, at 3:38 p.m., when his wife was on the phone with his mother to confirm their safety, a 60-foot wave swept through that home, washing away its first floor and most of its second, making them all tsunami casualties.

(To this day, Kiho believes she heard a female scream, but she’s not sure who it was—her mother-in-law, or her daughter, before the line went dead.)

“At first I just blamed them,“ Ueno says. “I felt a kind of hatred. Why did you let my children die? But later I thought that Erika loved her grandma so much, and Kotaro loved his grandpa. My wife and I were working that day, so my parents were helping us raise them. They were doing what they were supposed to do. So one time I thought: well, my kids are with their grandparents now, so maybe my parents are still taking care of my kids.”

But his anger toward the Japanese government, the nuclear industry, and Tokyo Electric Power Company (TEPCO), the operators of the power plant, is inconsolable. That the energy generated by the facility was used to power Tokyo’s moneyed and what he calls “wasteful” residents, and not the people of Tohoku and Fukushima, who continue to suffer its poisons, is “offensive and humiliating.” That their officially sanctioned incompetence prevented him from searching for the bodies of his son and father in the crucial days after the catastrophe, he finds unforgivable.

“It was their nuclear plant that caused the 12-mile exclusion zone,” he says, shaking his head. “I still imagine how many bodies may have been on those beaches.”

During our conversation, Kiho has been weeding the local grounds—something she does when they are unable to farm, when nothing is growing. But suddenly the door opens, and Kiho enters with their daughter, Sally, who has just returned from school.

Ueno is getting tired, smoking a little more slowly, his eyes blinking against emotional fatigue. “I know for certain that if my wife wasn’t pregnant then, and if my daughter hadn’t been born that October, we wouldn’t have a family now. Maybe I wouldn’t be here.”

Sally brushes past her mother and pauses in the living room to take in the scene, nods her quick acknowledgment of me, the foreign journalist, then swiftly turns toward the family altar. There, she bows low before each urn and portrait, pausing to greet the four members of her family that she’s never met. “Hello, grandpa. Hello, grandma. Hello, sister. Hello, brother.”

Then she takes a few steps back and shouts, “Tadaima!” “I’m home!”