LITMIR.BIZ

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from seeing patients pending a hearing. Two months later—long and stressful months—I had my hearing. The whole thing lasted less than an hour, the conclusion pre-determined. In exchange for accepting blame, I was offered a new posting through the government agency, Physicians in Service to Rural Japan, with an added perk: my medical school loans would be paid after four years of service.

      A few weeks after the sentencing, I arrived at my assigned post—Marui-jima, a dust mote of an island, one of a chain dribbling off Japan far into the Pacific. The trip involved flying in a small plane from Tokyo to the largest of the islands, where I got on a hydrofoil ferry. Except for an older couple who disembarked at the first stop, the other passengers were in their late twenties or early thirties. By age alone, I could have been one of them. But they were on their way to scuba diving excursions, while I was heading toward banishment in one of the most remote corners of Japan. A visceral grip of envy made me woozy. Or was it the beginning of seasickness?

      When Marui-jima finally poked out of the horizon, it looked too small to be inhabited. And as the ferry skimmed closer, the island repeatedly grew large, then shrank. Perhaps some mid-ocean optical illusion was disrupting my perception. Focusing on the horizon past the island, I discovered the action of the waves raised and lowered my perspective. The sensation increased when the ferry slowed and its hull lowered onto the sea. We were then at the mercy of the smallest waves, and the island became a restless bobbing cork.

      Four derelict fishing boats were in the island’s pocket of a harbor. Two had foundered against the rocks of the jetty, one of them completely submerged except for the tip of its prow and a peek of its rotted decking. The other foundered boat leaned on the rocks; a jagged hole gaped in its hull. A seagull balancing on the edge of the prow squawked aimlessly. Of the two boats still floating, one had apparently been stripped of all usable parts and was now merely a hull and deck. The fourth boat appeared to be complete but floated low in the water.

      As the ferry skirted around the boats and pulled up to the pier, the captain announced we would be docked for only a quarter of an hour. Passengers continuing on were welcome to go ashore but were warned to be back on time. I was the only passenger who stood to get off. The others stared at me, undoubtedly wondering why I’d be so foolish to risk being left on this wreck of an island. I wanted them to put me out of my misery.

      Standing on the decaying wood-and-concrete pier on the brink of collapsing and sinking into the water, I watched the sweating crew toss out boxes and bags from the cargo hold. When I regained some of my equilibrium, I found my bags on the pile of cargo and hoisted them over my shoulders. I walked with a slight wobble down the pier to a ramp leading up to a ridge etched into the steep, eroded slope of the extinct volcano that formed the island. Cut into the slope was a rough-looking road. Both upper and lower sides of the road were crowded with houses and shops, most clearly abandoned.

      A compact delivery truck with rust-pocked doors bounced down the road, then skidded to a stop at the bottom of the ramp. I guessed the driver, an elderly man wearing a stained and frayed floppy hat, was waiting for me to pass. Obliging him, I hurried off the pier as quickly as I could with my heavy bags and sea legs. When I reached the truck, I gave the driver a nod. I could now see another elderly man in the truck. Both men returned my greeting with stiff-necked nods.

      At the open window of the cab, I said, “Sorry to hold you up, but could you tell me how to get to the inn?”

      The driver mumbled something I didn’t catch. Whatever the driver said made the passenger hack dryly in a laugh. I apologized for not understanding and repeated my question. This time the driver leaned out the window and pointed to a building straight ahead, not more than forty or fifty steps away.

      I thanked him then stepped aside. The little truck made an inelegant, jerky U-turn and backed down the pier, weaving from side to side so much I watched in fear that it would crash over the side. When the truck safely reached the pile of cargo, the two men crawled out of the cab so laboriously it looked like they’d been driving for days.

      The truck driver talked with the ferry crew members while the other man, who had an extreme case of genu varum—bowed legs—marked a piece of paper as he inspected the cargo. Apparently satisfied, the two men began loading the boxes onto the bed of the truck.

      I turned away from the pier and walked toward the inn. The fresh tropical air and solid ground dissipated my residual seasickness, only to be replaced by the crush of claustrophobia.

      The ferry engines roared when I reached the inn. I nearly dropped my bags and ran after it. Instead, I watched it pull out of the harbor like a spurned lover driving away. With a sigh, I stepped inside the cool, shadowy quiet of the old inn. Like an old Buddhist temple, the inn smelled of desiccated cedar and incense.

      comfort and coercion

      to continue

      A tiny elderly woman appeared out of the shadows. She glanced at me, then looked behind me for a long moment as if expecting someone else. I told her I was Endo, the new doctor. She didn’t acknowledge my pronouncement, perhaps already knowing who I was. Or maybe she simply didn’t care.

      Carrying one of my bags despite my vehement objections, the inn’s owner, Yoko Takahashi, led me across plank floors worn to a dull smoothness that chirped like crickets with each step. She told me the four-room dormitory her grandfather built at the turn of the twentieth century housed itinerant fishing boat crews when the island was a popular stop for the Pacific fleets. As the ships became larger and more powerful, they bypassed the island, and the inn rarely had visitors until the years before and during the war when the island assumed some strategic importance.

      At least that’s what I pieced together. She spoke in the same rough dialect as the truck driver.

      Several years after the war, she told me, the islanders attempted to attract tourists. But with the spotty transportation to the island and not much in the way of activities and amenities, especially the lack of a good beach, not many came. The last tourist visited in 1989, she said with a lilt of reminiscence. A swarm of earthquakes which began a decade ago scared away anyone else thinking about the island as a vacation spot. Now only government officials visit, she said in a thin, suspicious voice.

      I was about to tell her I wasn’t a government official and really was a doctor, when she entered one of the rooms and hefted my bag onto a stand. She gave me a nod then left me alone in the room, the scent of incense trailing after her. After I unpacked my bag and hung up my clothes in the free-standing closet, I stared out the window. The room overlooked the harbor and the southeastern arc of the island. A dull haze obscured the horizon making it impossible to tell where the ocean ended and the sky began.

      The stale, inert air in the room depressed me and caused a relapse of my claustrophobia. I tried to open the window but the panel stuck, probably jammed closed by a window frame out of square. I pulled harder and the flimsy frame splintered in my hands.

      The poor old innkeeper, still standing in the doorway, cried out as if I’d stabbed her.

      The island’s two-room health clinic overlooked the pier. Its wood siding was cracked, insect-ravaged, and weathered in some spots as thin as paper. The building leaned visibly toward the ocean-side of the ledge on which it was built. Inside, the clinic was permeated with a lingering odor of mildew, maybe severe foot fungus.

      Squeezed in the front room were two chairs, a desk, a filing cabinet, and a small table. On the table sat a bulky, obsolete combination phone and fax machine. On the wall near the door someone had thumb-tacked a calendar advertising easy-to-swallow heartburn tablets. Posters from pharmaceutical companies added splashes of color to the room: one advertised iron supplements, one a cream for skin rash, another an asthma inhaler. Each poster was illustrated with a photograph of a smiling young model holding the company’s product or in a relaxed pose on a stylish sofa. The previous doctor must have desperately needed something to remind him of civilization. I imagined relationships with the models. All ended badly.

      In the tiny examination room, I rested on the exam table and waited for a patient to visit me. What I knew

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