Hektoen International

A Journal of Medical Humanities

The smartest vampire story

Alice Theibault
Rochester, New York, United States


Japanese grave markers like those which may be seen in the show Shiki
181. Silhouette of traditional Japanese grave markers, found on Flickr Creative Commons. Nachans, June 28, 2011.

There is something uniquely terrifying about vampires. The concept of a nocturnal creature showing up at one’s home to suck their blood is enough to make just about anyone uneasy, and so vampires have been mined as a horror device for generations. Bram Stoker’s Dracula, which is arguably the most famous and influential vampire novel, attempted to apply scientific reasoning to the titular vampire based on what was then known about the human body. For instance, in one scene characters attempt to save a young woman named Lucy from vampires by giving her a blood transfusion, which at the time would have been relatively new technology.1 Since then, most vampire fiction has veered into the realm of the purely fantastical. One modern vampire story, however, attempts to link medical science to fighting vampires yet again: a Japanese animated series known simply as Shiki.

Shiki tells the story of a rural village in the mountains of Japan that is invaded by vampires. Eventually, the vampires reveal that they want to take over the village and make it their own, so they can live a normal life.2-3 In addition to being a fascinating exploration of human cruelty and what makes someone a monster this story is also dedicated to scientific accuracy, particularly in its treatment of blood diseases and the medical profession.

The plot of Shiki begins when a young teenage girl, Megumi Shimizu, is found collapsed in the woods near the mysterious Kanemasa mansion. The town doctor, Toshio Ozaki, examines her and discovers that she has anemia. Just a few days later, he pronounces her dead of acute heart failure.4 At first Dr. Ozaki suspects that Megumi had iron-deficiency anemia because it is common in young women; but he is forced to abandon this theory when he draws a blood sample and realizes that her blood cells are normal. After this incident, more people show up at the Ozaki Clinic with similar symptoms. Dr. Ozaki starts methodically running tests and, with the help of his nursing staff, compiling records of their symptoms and the progression of their illness. Some patients—especially young ones—die of heart failure, while others die of kidney, liver, or multisystem organ failure. Some patients are cyanotic and all are sleepy and have a rapid pulse. At the first round-table meeting Dr. Ozaki calls with his staff, he maps out the syndrome:

The only thing we have to go on is that it starts with anemia. And according to the blood tests it’s normocytic normochromic anemia.[…] It progresses from anemia to MOF [multiple organ failure] and takes about three to four days.5

He and the staff speculate on what could be killing their patients, and whether it’s some kind of new illness.

The medical jargon flows thick and fast in the early segments of the story, and most of the terms are not explained because they are being discussed among medical professionals. However, the series provides enough context clues that even viewers without a medical background can probably make sense of at least some of the terms used. When a young mother named Nao Yasumori gets sick, Dr. Ozaki inspects her blood and, after noticing an increase in reticulocytes, wonders: “Could it be that hematopoiesis is accelerating because large amounts of red blood cells are being consumed?”6 In this way, even a viewer who is not familiar with the term “hematopoiesis” can probably discern that it has something to do with making new red blood cells.

While all this medical terminology may seem rather technical, it is never boring because it occurs in such an engaging and well-paced series, and concerns characters the audience genuinely cares about. Dr. Ozaki himself, who is arguably the closest thing the series has to a central protagonist, is a case in point. He is a gruff, tough-talking doctor with a deep voice and stubble, who smokes and shows a macho disdain for the folk legends and remedies many of the village women swear by. However, he genuinely cares about his patients and the villagers more generally, and will do anything he can to help them. This particular combination of traits makes him almost instantly likable, and the hard decisions he makes as he gets more desperate seem much more tragic as a consequence. He does all this while acting and talking, consistently and throughout, like a real man of science. When a tipoff from a local teenager leads him to suspect that vampires are behind the village deaths, he attempts to observe the vampires and take action based on what they do, rather than simply assuming all the legends about them are true.7 Even when his own wife becomes a vampire and he attempts to dissect her to determine her weaknesses, he keeps a meticulous log of everything he does. Eventually he discovers that the vampires have all the weaknesses they do in old legends—including a fear of holy objects and the ability to be killed with a wooden stake through the heart—but he does so scientifically.8

Just as Dr. Ozaki and his nursing staff show the scientific side of vampires, other characters provide an up-close and personal look at the lived reality of a village under siege, and how the vampires manage their everyday affairs. It is one thing to hear Dr. Ozaki list the symptoms experienced by vampire victims in a cool, clinical way, but quite another to watch them unfold. The seventh episode, “Seventh Killing Spirit,” contains a particularly disturbing sequence in which a teenager named Masao Murasako slowly dies as a vampire drinks his blood night after night.7 In that very same episode, a werewolf named Tatsumi reveals that vampires can be killed by a wooden stake to the heart—something Dr. Ozaki discovers later, though he calls it “severing the connection between the aorta and the vena cava.”8 Meanwhile, the villagers spread rumors of a deadly epidemic, even as Dr. Ozaki attempts to avoid creating a panic while he performs his research, just as any good doctor would.

Attention to scientific accuracy appears in other ways, too. Most notably, the series contains far more realistic violence than many vampire stories, particularly once the villagers start hunting the vampires down. Vampires exposed to the sunlight develop oozing blisters and sores similar to those of a real second-degree burn victim.9-10 Dead bodies become infested with insects and fall apart in much the way they would in real life.4,11 The vampires’ aversion to religious objects and festivities, meanwhile, is depicted as a phobia,8 and there is some indication that this phobia can be overcome by fairly conventional means. At one point, when Dr. Ozaki suggests the vampire known as Chizuru accompany him to a religious-themed festival, he attempts a form of exposure therapy to get her used to the idea,12 even asking outright: “Would going to the festival really harm you?”13 In all these ways, the series commits to answering the question of what vampires would be like if they existed in real life.

All in all, Shiki’s attention to scientific detail serves as a welcome addition to an already complex, intelligent, riveting series. That the narrative is in many ways quite conventional and fantastical, just like in most vampire stories, makes the accuracy of the science all the more remarkable. Perhaps moreso than any other vampire horror story, Shiki drives home what it would be like to live in a village that was invaded by vampires—or to become one. Following its twists and turns is guaranteed to provide hours of fascination to laypeople and medical professionals alike.



  1. Davis, Sara, “The Science of Bram Stoker’s Dracula.” The Rosenbach. November 3, 2017. https://rosenbach.org/blog/the-science-of-bram-stokers-dracula/
  2. Shiki, Blu Ray, directed by Mike McFarland (2002; USA: Funimation, 2012) (Note: this is the American license for the series. The citation for the original Japanese version is below)
  3. Directed by Tetsuro Amino. Written by Kenji Sugihara. Studio Daume, 2010.
  4. Shiki, “First Blood.”
  5. Shiki, “Fourth Fatality.”
  6. Shiki, “Third Tragedy.”
  7. Shiki, “Seventh Killing Spirit.”
  8. Shiki, “Fourteenth Death.”
  9. Shiki, “Twentieth Mourning and Offense.”
  10. “Second-Degree Burns (Partial Thickness Burns).” Children’s Hospital of Philadelphia. Accessed January 13, 2020. https://www.chop.edu/conditions-diseases/second-degree-burns-partial-thickness-burns
  11. “Stages of decomposition.” Australian Museum. Last modified November 12, 2018. https://australianmuseum.net.au/learn/science/stages-of-decomposition/
  12. “What Is Exposure Therapy?” American Psychological Association. Accessed January 13, 2020. https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
  13. Shiki, “Eighteenth Death.”



ALICE THEIBAULT is a graduate student in the Bioinformatics Masters program at Rochester Institute of Technology. She has been interested in biology and science communication for most of her life, and received an undergraduate degree in Biology and Environmental Studies from Hobart and William Smith Colleges. She also served for two years as an AmeriCorps, educating the public about environmental health and protection. One of her greatest passions is for stories, which she often reads, writes, and thinks about all day long.


Submitted for the 2019–2020 Blood Writing Contest

Winter 2020  |  Sections  |  Blood

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