Typhoon clouds churned across Tokyo's September skies. Beneath the clouds, down in the unfashionable northern prefecture of Toshima, workers at Otsuka General Hospital struggled through the gathering noontime dusk to clear the sidewalks of the sick and dying before the torrential rains began to fall.
Hundreds of the sickest lay scattered about like cordwood, blanketed by a miasmic stench that rose from suppurating skin abscesses and bloody diarrhea. Some were silent, others moaned in high-pitched whines as loudly as their weakened bodies would allow. The rotting stumps of arms, legs, and fingers attracted flies and showed bare bones.
Those in earlier stages of what the newspapers were calling "the Korean Leprosy" sat in stained trousers and skirts, hung their heads between their knees, moaning and coughing. Here and there, entire families gathered, creating microcosms of the crowd with their dead, dying and walking wounded. Mothers and fathers cradled their children in futile attempts to protect them from a horror that attacked from within.
They covered the sidewalks, the lawns, the ambulance loading ramps; they filled the empty parts of the parking lot, even the spaces between vehicles. The truly fortunate lay thick in the hallways of the emergency room, where medics from the Self Defense Forces pumped them with antibiotics and intravenous drips.
At the perimeter of the hospital grounds, SDF soldiers garbed in disposable overalls, masks and rubber gloves worked away at the crowd, loading the live ones onto litters and into olive-drab transports. The dead were carried out of sight of the crowd and stacked on flatbed trailers.
Among the carnage walked three men. A white-haired Japanese man, about seventy, of average height. He wore a white physician's coat. Two tall, blond Caucasians in jeans and sweatshirts towered over him, each carrying a large duffel. All three wore sterile masks that left only their eyes showing.
The two Caucasians wiped steadily at their eyes which watered against the sharp caustic mist hanging over the hospital grounds. Around them, scores of SDF soldiers walked about spraying a disinfectant solution from large backpack pump applicators normally used for applying lawn chemicals.
The trio moved in lurches , a few steps in one direction and then a stop as the white-coated figure stepped ahead of the two others, turned to them and blocked their way. They exchanged words, then one of the Caucasians would start off in another direction, leaving the Japanese man scurrying to catch up and repeat the process.
"We really have things well in hand," said the white-coated Japanese man as he stepped into the path of the other two once again. Dr. Yoshichika Iwamoto was chief administrator of Otsuka Hospital, professor at Tokyo University and former member of the Diet. "You really didn't need to come." he insisted. "It is very kind of you, but so very unnecessary." Like most Japanese doctors, Iwamoto spoke English. Like many of them, he considered it a barbaric tongue.
Iwamoto's face showed none of the internal turmoil stirred up half an hour before when the two U.S. Army doctors had arrived unexpectedly. He wore his shiran kao -- his nonchalant face -- and tried to explain to them that this was an epidemic, a matter for specialists, that they would only be in the way. To his dismay, they had demonstrated that they were, indeed, experts in this sort of medical emergency, even pulling out published papers the two had co-authored.
What Iwamoto really wanted to explain to these ill-mannered intruders was that this was a Japanese situation, something like a family emergency to be dealt with as discreetly as possible. That NHK, then other television stations, had broadcast stories since the outbreak of Korean Leprosy a week ago was intolerable. To air one's own dirty linen was disgraceful, unacceptable. He shook his head now as he thought about the broadcasts and the newspaper articles that followed. Soon, there had been attention from foreign journalists -- more gaijin. Whatever happened to Japan for the Japanese?
The news reports had brought these gaijin doctors, evidence of a lack of faith in his ability, in the ability of the entire Japanese race. Big white racist bullies who automatically assumed that little wheat-colored people couldn't handle things by themselves and so forced their filthy "help" on them. Iwamoto seethed inside. And their bad manners! They had arrived unannounced; it embarrassed him that they had given him no opportunity to welcome them properly.
They were so arrogant these ketojin, these Americans.
He said a small prayer of thanksgiving that at least they weren't Japanese forcing their help on him. That would create an on, an obligation, a debt that he and the hospital would be duty bound to repay. Fortunately, gaijin were without virtue, without value. Those without virtue could not create on, nor were they to be afforded the courtesy or protection due true sons of Yamato. Iwamoto knew his only obligation was to rid himself of these two pests as quickly as possible, to keep them from hindering the removal process that was proceeding so efficiently.
They walked along in silence for several steps, making a wide detour around a man who retched convulsively at the edge of the street.
"I'm afraid you will not be comfortable," Iwamoto said hopefully as he stepped ahead of them and stopped their progress once again. "Our sanitary facilities are quite overstressed."
"No problem," said one of the gaijin. "We're Army. We're used to being uncomfortable."
"It's part of regulations," joked the second as he headed off in another direction.
Iwamoto cringed inside as he scurried to catch up with him. How could they be so insensitive as to ignore his distress? How could they miss such obvious communication?
Blocking their path, Iwamoto marshaled his resolve and tried again. "Ah, you see, we have limited supplies and equipment. I am afraid that--"
"Brought our own," the gaijin said almost simultaneously. One slapped the big duffel bag for emphasis, then turned and continued walking in yet another direction.
Desperation welled up hot and sour in Iwamoto's throat as he set out after them again.
In the distance, thunder rolled; stiff winds tore at the trees and rolled off the massive hospital building in chaotic gusts. Looking hopefully at the sky, Iwamoto maneuvered himself in front of them again and stopped. Instead of speaking immediately, he made a point of studying the weather carefully. The two Caucasians looked upward for a moment, then back at him as he spoke.
"These very early typhoons can be serious," he said. "It could be dangerous for you here." He looked expectantly from one white face to the other. "Perhaps you will be needed by your own people at Camp Zama."
The gaijin shook their heads synchronously, as if their necks were linked by gears. Almost as precisely, they turned and resumed their stroll.
Iwamoto made an audible hissing sound as he sucked in wind through pursed lips; he pursued them yet again. The older physician was winded by the time he stopped them again, this time just yards from the entrance to the hospital.
"It's a disgusting disease," Iwamoto said. "The soiling, the rotting, the bloody discharges -- the odors."
Pungent antiseptic now masked most of the nauseating stench that earlier had hit the Caucasians like a squirming fist in their bellies as soon as they had stepped off the train at the Shin-Otsuka rail station.
"Look, doctor, we've been through it before," said Lt. Col. Michael Davis, M.D., infectious disease specialist with the U.S. Army 9th Corps, stationed at nearby Camp Zama in Kanagawa Prefecture. "We're big boys." This won't be the first time we've gotten shit on our nice white coats. We happen to think this is a pretty important situation, and we'd like very much to help you to get to the bottom of this weird strain of glanders -- if that's really what it is -- but if you don't want us here, then why don't you just come out and tell us that?"
I have been, Iwamoto thought to himself. But you are too thick to hear me.
"Calm down, Mike," cautioned Anthony Mills, M.D. Mills was another Army light colonel, an epidemiologist and internal medicine specialist whose offices adjoined Davis' at Zama's Medical Corps facility.
They had come -- in violation of specific orders for all of Zama's physicians to stay clear of the area -- as volunteers, partly because they wanted to help and partly because Davis hoped to snag a sample that could be turned into a publishable paper.
Iwamoto fought to control his anger. When he spoke, it was formally, stiffly. "I am quite aware what you see may remind you first of typhoid fever, mycotic infection or even acute staphylococcal septicemia. We of course eliminated those possibilities immediately. Indeed, we successfully cultured the Malleomyces mallei bacteria from blood and sputum cultures. You are aware -- are you not -- that glanders is endemic among peoples on the mainland in China, India, Indochina, Korea?" He gave them a challenging look.
"Accordingly, we began aggressive use of tetracycline, chloramphenicol and a number of sulfonamides." He paused. "But, as you are undoubtedly unaware, there have developed over the past decade more potent varieties of this and other pathogens. None of the patients have survived so far."
Mills and Davis thought they saw a faint look of satisfaction.
"We have genotyped this variant and found that its DNA is that of Malleomyces mallei variant 087 that killed all the inhabitants of that small settlement on the northeast coast Cheju-do."
Davis nodded his head. Mills saw his colleague's eyes glitter. Just six months before, more than nine hundred people on Cheju-do -- a small island in the South Sea some fifty miles south of the tip of the Korean Peninsula -- had been wiped out before help could arrive from the mainland. Nobody knew where the disease had come from, but it ravaged the settlement and then, ten days later, seemed to self destruct.
At the time, both Mills and Davis had been astonished that neither had been included in the U.S. Army's response team sent to the island. They were senior physicians and had, between them, conducted more years of research into infectious diseases than anyone else in the Orient. U.S. authorities had sent a team from the States comprised of people neither doctor had ever heard of. Mills put it down to a bureaucratic screw-up; Davis took it as a professional insult. It made both men even more determined to get up close and personal with the outbreak in their own backyards, orders to the contrary notwithstanding.
"You should also know," Iwamoto said, "that this is a biotype that is more likely to exist in a carrier state."
Carriers: the word had wreaked havoc in Japan's Korean community. The implications were impossible to miss. Koreans were carriers of the dirty Korean Leprosy, not a true leprosy, but more quickly disfiguring and fatal. It was as if the gods had invented the perfect disease to personify a race of people despised almost universally by the Japanese. The more than 700,000 Koreans in Japan were discriminated against and forced to carry internal passports, much like blacks in the old South Africa.
Many of the Koreans had been brought to Japan as virtual slaves during the Japanese occupation of Korea from 1905 until the end of World War II. Millions had been conscripted to fight Japanese colonial wars against China. Countless Korean women were locked into Army-run brothels as "comfort girls" that soldiers raped day after day. Koreans had been used as convenient laboratory animals for Japanese medical experiments.
In later years, Koreans came to Japan -- especially from the poverty-stricken communist North -- to better their economic lot and send money back home. Next to weapons sales to such countries as Iraq and Iran, North Korea's largest source of foreign currency was from immigrants in Japan. From the n and even for those who had become Japanese citizens, life was difficult. Police harassed them, arrested them for minor technical irregularities in their documents.
Despite scientific evidence that the Japanese themselves were descended from Koreans who migrated during an ice age that created a land bridge between the Korean Peninsula and the Japanese islands, Koreans -- and their threat to the purity of the Japanese race -- were the focus of a hot political issue, especially with the rise of new ultra-right-wing neonationalist parties.
The Korean Leprosy had inflamed the general population, propelled the Korean issue beyond its narrow ultranationalist constituency. The concept of Koreans as carriers of a messy, disgusting disease had been present in the news stories from the very beginning and had wreaked economic and social disaster. Korean workers were fired or furloughed; Japanese refused to buy merchandise from Korean clerks, boycotted restaurants in which Koreans worked. Even the pachinko parlors, homes of a pinball-like gambling game that was a Japanese mania, were closed. Most pachinko parlors were owned by Koreans.
The backlash had spread to anyone with dark skin -- Filipinos, Thais, Indians -- as a racial mania spread through most of the population, fed by graphic television news reports and members of the Diet who said this was the inevitable consequence of allowing gaijin to live among them. The mere thought of foreigners as carriers of disease inflamed the xenophobia that had been part of the Japanese culture for a millennium or more.
"None of that has much relevance if this truly is only a Korean disease, does it, doctor?" Davis asked. "Why should we be concerned?"
Iwamoto flushed with anger. He closed his eyes for a moment, trying to center his emotions. He looked deep inside to avoid being provoked by the keto, but it was to no avail; he would later offer prayers to remove the shame of losing control.
"Of course it is Korean! We have the genotype. That is why this should mean nothing to you, nothing at all. These are Koreans! The dogs that these animals eat have more value, don't you understand? Treating them is beneath the dignity of the medical profession."
Mills and Davis reacted to Iwamoto's outburst as if he had slapped them.
"You're a real asshole, pal," Davis said as he dropped his duffel bag and stepped toward Iwamoto with clenched fists.
The small doctor looked defiantly upward at Davis; Mills grabbed his colleague by the arm. "Chill. He's not worth it. That's not why we're here."
Davis towered over Iwamoto, as if deciding whether or not to take his buddy's advice.
"In our country, even dogs get care from veterinarians," Mills said finally.
"In your country, you also sleep with the kurombo -- niggers -- so what more is it necessary to say?" Iwamoto spat as if the words themselves had contaminated his mouth.
Mills hauled back on his friend's arm before Davis could deliver the haymaker intended for Iwamoto.
"Mike, we've got business. " Mills turned to Iwamoto. "Thank you so very much for your enlightened views. My experience indicates you are wonderfully representative of your culture, but we, doctor, are here to figure out how to cure the dogs."
Davis was still quivering with anger. Mills turned him around, handed him the duffel he had dropped, and lead him toward a family of six sprawled on an old tarp some ten yards away.
"There is no cure; there is
only death!" They heard Iwamoto screaming after them. Suit
yourself! You are wasting your time! Only death! Only Death!"