Film / Reviews

'Koko no Mesu'

Hospital drama about Japan's first liver transplant makes cut

by Mark Schilling

Hollywood once used permanent sets for the dozens of Westerns it cranked out annually — the frontier town, ranch house and corral all in one convenient location, built to last. I sometimes imagine something similar for Japan’s endless procession of hospital dramas. They all seem to use one generic set, populated by full-time extras dressed as doctors, nurses and patients.

Izuru Narushima’s medical drama, “Koko no Mesu” (“The Lone Scalpel”), may unfold almost entirely in a hospital, but it is not a bland, antiseptic, standard-issue set. Instead it looks like the hospitals and clinics most of us encounter here: Scruffy and grimy, as though it has been a stranger to the paint can since it opened its doors decades ago.

This realism extends to the entire production, including operation scenes that could serve as instructional videos. The story, about the first liver transplant in Japan, is based on an actual incident, while the medico hero, played by the always excellent Shinichi Tsutsumi (“Climber’s High,” “Always”), is exactly the type to make such a breakthrough: Skilled, dedicated — and more than a little unworldly. That is, he doggedly presses on without making the usual calculations to advance his interests, personal and professional — or simply guard his back.

Koko no Mesu
Director Izuru Narushima
Run Time 126 minutes
Language Japanese

Based on a novel by Toshihiko Ogane, a veteran surgeon, the film is on the serious, methodical side, reflecting the temperament of its no-drama, results- oriented hero. What saves it from dullness and sterility is its angle of approach. We view the hero, Dr. Toma (Tsutsumi), through the eyes of an operating-room nurse, Ryoko Nakamura (Yui Natsukawa), who faithfully records his exploits in her journal — and silently carries a blazing torch for him.

The story begins in the present, with Nakamura’s doctor son (Hiroki Narimiya) witnessing his mother’s cremation and voicing his anger at the fumbling response to her illness. Going through her possessions later, he comes across her journals from the 1980s and reads her outraged accounts of incompetent doctors killing patients in front of her eyes.

In 1989, Dr. Toma arrives at her hospital, fresh from his study of liver- transplant surgery at the University of Pittsburgh. Toma proves himself to be superbly skilled and Nakamura starts to see her profession — and him — in a new light.

His miracle-worker reputation, however, does not endear him to his colleagues at a nearby medical-school hospital, who have been handling difficult operations for Toma’s lower-status city hospital, while accepting its deference as their lordly due. Toma is not only upstaging but outclassing them and they don’t like it one bit.

Then Toma decides to perform Japan’s first-ever liver transplant to save the life of the town’s crusty but lovable mayor (Akira Emoto). To do that, however, he must end the life of a young man, brain dead after a traffic accident. But he is the beloved son of nurse Takei (Kimiko Yo), a member of his operating team. Meanwhile, Toma’s rivals are conspiring to have him roasted by the media and arrested by the police if the operation fails.

Most directors — and certainly nearly all working for television — would use this story to pump audience tear ducts hard. Narushima, who made the mordantly funny crime comedy “Yudan Taiteki” (“The Hunter and the Hunted,” 2004) and the tiresomely hokey thriller “Midnight Eagle,” 2007) doesn’t completely avoid cliched theatrics, as exemplified by Katsuhisa Namase’s slithery turn as the unscrupulous leader of the enemy camp.

The film’s main focus, though, is squarely on Toma and his life-or-death work, which he self-deprecatingly compares to knitting. After seeing dozens of hyped on-screen operations, it was a revelation to witness Toma in low-key, closeup action, with enka singer Harumi Miyako warbling in the background. My first thought was, “So this is what a liver operation is really like.” My second was, “I want this guy to work on me.”

Tsutsumi plays Toma as humanly likable, if saintly selfless. Instead of relying on showy effect — the flashing eyes and jutting jaw — he drills down to the character’s essence. That is, his total concentration on the patient in front of him. Everything else, including his love life, comes a distant, distracted second.

Playing nurse Nakamura, Natsukawa is similarly shy and dedicated, but capable of emotion in a way that Toma is not. She is the quietly passionate sun to his workaholic moon, though he only sees her as a colleague, not a woman.

Do these soul mates finally connect? You may think you know the answer, but this small gem, so matter-of-fact in its telling, so moving in its conclusion, doesn’t play by conventional rules. Something like Toma himself.