Hektoen International

A Journal of Medical Humanities

Unfinished business: End of life care and regrets in the films of Akira Kurosawa

X.M. Griffiths
Tuckahoe, NY, USA

Director Akira Kurosawa (center) with actors Takashi and Miki Odagiri on the set of Ikiru (1952). Billy Rose Theatre Division, The New York Public Library.

Death and mortality were recurrent themes in Akira Kurosawa’s works but the director examined the issues most acutely in the films Ikiru (1952) and Madadayo (1993). Though the two films hail from different periods of his career, in each the main character is forced to face their own mortality, which provides the narrative thrust of their plots. Death is presented as both something to fear and an impetus for further action. Kurosawa expresses these dueling dimensions of death through many repeated elements in these films including flashbacks, dream sequences, and references to youth and childhood. Despite these similarities there are also drastic differences between how the characters are medically prepared to face death by their physicians and how this affects the outlook of the respective films.

The opening shot of Ikiru is that of an x-ray showing a tumor growing in a stomach. We are told dispassionately by the film’s narrator that it belongs to Kenji Watanabe (Takashi Shimura), a Tokyo bureaucrat. With no history or character yet established, the knowledge of this cancer and impending death still holds little meaning for the audience. The omniscient narrator agrees as he deadpans, “But what a bore would it be to describe his life now. Why? Because he is only killing time. He hasn’t actually lived. You can’t call this living.”1 The dramatic irony presented so early on in the film is palpable, as the title Ikiru literally translates as “to live.”

Watanabe takes his first day off in thirty years to visit his doctor about his stomach pains. The doctor tells Watanabe that he has nothing to worry about and that he can eat any foods that he likes as long as they are easy to digest. Watanabe knows the diagnosis is false and resorts to begging, “Be honest with me . . . Tell me the truth . . . tell me it is cancer.”2 In private the doctor rationalizes that it is better to treat his patients in this paternalistic manner rather than burden them with the knowledge of impending death. The doctor’s subordinate and nurse silently express their guilt when he asks, “If you were like him, with only half a year to live, what would you do?”3 This ethical conundrum has plagued both sides of the doctor-patient relationship from ancient times to the present. In the words of gastroenterologist Seamus O’Mahony, “the dying very often have not accepted or understood their situation, the truth denied them by well-intentioned relatives and doctors. Their death has been stolen from them.”4 Watanabe finds himself facing this dilemma and his challenge is not to recover but to reclaim his life (and death).

Kurosawa explained that the idea for Ikiru sprang from his ruminations on death: “. . . I think – how could I bear to take a final breath? While living this life, how could I bear to leave it? There is, I feel, so much for me to do. I keep feeling I have lived so little. Then I become thoughtful, but not sad.”5 Watanabe must reckon with this sentiment and it leads to two conflicting desires. The first, a desire to reclaim youth and live life all over again and the second, to make the most of what time is left.

During his nightlong sojourn into bacchanalia, Watanabe sings a song that was popular in his youth. This callback to youth and childhood reveals a deeper psychological understanding of what it means to face death head on. As a child the concept of death is foreign and difficult to understand. Coming to terms with the idea of death is a major milestone on the road to adulthood. Watanabe recalls that pivotal moment from his childhood and relates it to his current predicament, “Now I remember: I nearly drowned in a pond once when I was a child. I felt exactly the same way then.”6

The two seemingly incongruent reactions to death converge as Watanabe resolves to tackle the bureaucracy he knows so intricately in order to build a park for the community children. This leads to his rebirth as symbolized in the scene where he descends a staircase with a chorus of young people singing “Happy Birthday” behind him as their friend ascends unbeknownst to Watanabe. Death is more manageable if he can set his affairs in order and he finds the goodness in creation. In the most iconic scene of the film Watanabe sits on the swings of the playground he helped build while singing in the snow. In the final shot of the film the swing is vacant yet still in motion as if occupied by Watanabe’s spirit.

In Madadayo, Kurosawa takes the long view of death. We meet its subject, Professor Hyakken Uchida (Tatsuo Matsumura), on the first day of his retirement. Like Watanabe in Ikiru he too has spent thirty years at his profession. Unlike the weary bureaucrat, the professor has had a fulfilling career as evidenced by his many generations of admiring students. Madadayo translates into English as “Not Yet.” Every year his students throw him a Mahadakai party. The theme of the party is a callback to the childhood game of hide and seek; the seekers would ask Mahadakai? (Are you ready yet?), to which the hider would reply either Mooiyou (Ready) or Madadayo (Not Yet).7 Every year his students ask him this same question and every year he responds “Madadayo.” This ritual of self-affirmation reflects a desire for a long life, if not immortality.

In another sharp contrast with Ikiru, the professor’s relationship with his physician in this film is friendly. At his first Mahadakai party he sits with his doctor at his right hand side and the priest that will perform his funeral rights on his left. Candidly he asks how long he should expect to live. The doctor responds that he has fifteen or sixteen years if he continues to follow his advice. The prospect of old age is met with humor. He waits as if greeting death as an old friend.

There are constant callbacks to childhood besides the yearly Mahadakai parties. Most of these are not presented to us on screen but recounted by the wizened professor to his adoring audience of former pupils. He recalls fears of the dark and robbers, he cowers under blankets as thunder strikes outside, he is reduced to tears over the disappearance of his beloved cat. Youth is not only a period of life characterized by ignorance of death but also a natural unconcern for work. It is a time when play and leisure are the most important objectives. In his retirement the professor finds his life operating in much the same way. His life’s work is already complete. He can live comfortably on the income of his published works. The only requirement left is to enjoy life to its fullest. He expresses this by drinking a large glass of beer in one gulp with the blessing and under the supervision of his attendant physician (though the glass seemingly shrinks every year).

As the final film of his storied career, comparisons of Kurosawa to the subject and treatment of this film are inevitable and often discussed. Kurosawa was not always appreciated by his native film industry in the manner that the students treat their professor in this film. Nevertheless, Madadayo retains many of his stylistic elements while providing an optimistic bookend to his fifty year career. Though the theme of mortality remained a substantial concern throughout his career, Madadayo was not made as a definitive statement on the matter. We do not see the professor expire but rather be put to bed after a frightful episode. True to Kurosawa’s expressed outlook, it is a thoughtful but not sad film.

To emphasize this point the final sequence of Madadayo is both a dream sequence and a callback to youth, depicting the professor as a young boy hiding amongst stacks of hay. The other children ask him “Mahadakai?” to which he repeats the common refrain of “Madadayo.” Just as it looks as if he had found his ideal hiding spot and is about to declare his readiness he is instead captivated by the beauty of the clouds.

Akira Kurosawa stated in his autobiography that he always wanted to die at work, collapsing on a film set.8 This opportunity was denied him. After the release of Madadayo he was already hard at work at what he thought would be his next picture. Unfortunately, bedridden and secluded from his film crew by his family, Kurosowa passed away from a stroke before he could see the picture through to production. It would become one of a number of unfinished or abandoned projects that would amass over his lengthy career. Interest in Kurowsawa has not waned since his death. Nor can it be said that his career has truly ended. At the 2017 Cannes Film Festival it was announced that a Chinese-Japanese production partnership will collaborate to release up to nine of the filmmaker’s unproduced screenplays and other uncompleted projects with the authorization of his grandsons.9 Much like the last shot of Ikiru, signs of Kurosawa’s career, legacy, and influence are still in motion.


  1. Ikiru. DVD. Directed by Akira Kurosawa. 1952. Toho. Criterion Collection, 2015.
  2. Ibid.
  3. Ibid.
  4. O’Mahony, Seamus. “Prologue.” The Way We Die Now: the View from Medicine’s Front Line. (New York: Thomas Dunne Books, 2017), xi.
  5. Richie, Donald. The Films of Akira Kurosawa. 3rd ed. (Berkeley, CA: U of California, 1998), 95.
  6. Ikiru.
  7. Madadayo. DVD. Directed by Akira Kurosawa. 1993. DAIEI Co., 2006.
  8. Richie.
  9. Frater, Patrick. “Chinese-Japanese Partnership to Complete Akira Kurosawa’s Unfinished Movies.” Variety, May 18, 2017. http://www.variety.com/2017/film/asia/china-japan-pair-to-complete-akira-kurosawas-unfinished-movies-1202432044/.

X.M. GRIFFITHS studied English and Communications (with a concentration in film) at Fordham University in the Bronx, New York. At Fordham he received awards for his creative writing and criticism. He spent a semester abroad at Sophia University in Tokyo, Japan where he studied Japanese language and literature. After graduation he returned to Tokyo as a high school English teacher through the JET Program. He works in the editorial department of a publishing company in New York.

Winter 2018



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