Ten years had passed since Sadaharu Nobeji had found a bit of land where he could build his obstetrics and gynecology clinic. The place was as close as he could get to the ocean. He'd been born where the scent of the Pacific Ocean was always in the wind, even though one could not actually see the water. As though he had the instincts of some amphibious creature, when it came to build his own home he sought a place where he could hear the sound of the sea.
Summary: In fact, Sadaharu cannot get such a place; people do not go to see obstetricians and gynecologists in remote places, so he settles for some land high enough that he can just see the ocean in the distance. It is likely, though, that this given-up hope is a factor in Sadaharu's regular visits to his old friend, Yoko Kakei, who does live in precisely such a place. It is through Yoko, who is Catholic, that he meets Father Munechika, a priest, who becomes a common friend.
Sadaharu's clinic sees a continual and routine stream of the ordinary things. There are plenty of births, check-ups, and health emergencies. He also does quite a few abortions; as it is Japan in the mid-twentieth century, they too are rather routine. He tries to do well by his patients, but he also tries to remain detached and clinical, and often does not even remember his patients' faces. However, a series of events lead him to be more reflective about what he is doing. He is a person of fairly stable temperament and his personal philosophy is to take everything a bit lightly, so there is not a great deal of drama about it, but it does raise a great many questions for him. The most significant of these, although not the only one, is when he happens to run into a woman who had come to him for an early abortion and who had discovered that it had failed. She was still pregnant, and has decided to keep the baby. Failed abortions occasionally happen, particularly with the technology of the day when doing such an early-term abortion, and certain medical conditions can increase the chances -- Sadaharu thinks that in this case it was bicornuate uterus, a condition in which a woman's is forked, thus misleading him into thinking that the uterus had been emptied. Other cases, of unwanted children and deformed babies and yet other difficult cases, will intensify the reflection. Sadaharu will not change his views or ways, but one can hardly deal with matters of life and death in the context of birth and not come face to face with questions about the value of human life and the inconsistencies in practice with which which we express, and fail to express, that value. If you actually deal with the actual problems of actual people, with all their difficult decisions, with all their follies and worries, you find yourself in messes. It is not avoidable.
The Japanese title for the work, The Dirty Hand of God, refers to a painting that Sadaharu that Father Munechika shows him not long after Sadaharu learns about his failed operation and discusses it with the priest. Sadaharu had remarked that, while in the priest's view of things his bringing life into the world made him an instrument of God, he is a rather dirty instrument. It is a picture of Jesus as a carpenter in Nazareth, repairing a broken cart amidst all the mess of a real carpenter in the middle of a job. It is a somewhat simple painting, like one might find in a children's book, but what strikes Sadaharu most, and pleases him most, about the painting is that Jesus' hands are dirty. When Sadaharu points it out, Father Munechika remarks (p. 148), "But even the hand of God is dirty when He is at work. If His hands are not dirty, then He is not actually working."
The English title for the work, Watcher from the Shore, connects to another image threading through the work. He happens to get into a discussion with Yoko and Father Munechika about the Flood, and reads some of the flood story in the Epic of Gilgamesh. Given his lifelong love of the sea, it is perhaps not surprising that he likes the story; he thinks of himself as a sort of Utnapishtim. One of the things that puzzles him, however, about both the story of Noah and the story of Utnapishtim is that there is no indication of people trying to get onto the ark. Noah has nothing but his family, Unapishtim's ark includes the families of the craftsmen as well, but there is no fight and chaos as people fight to get onto the ark. It is puzzling; it should be there.
The irony, though, is that, later in the work, when Sadaharu thinks of his own situation in terms of the ark, while he does imagine people struggling to get on, he does not imagine himself as one of them. Sadaharu is one of the people not on the ark. Yoko and Father Munechkin, and the little deformed babies dying after two days in the world, and his patients, and others, but Sadaharu imagines himself outside the ark, on the shore, just watching the ship depart. Sadaharu has no answers for the moral difficulties he faces through his work. He does not believe in any overarching standard; he just tries to help as he can, and is well aware that this does not solve the problems into which it gets him. He does not, however, have any desire to believe, or any thirst for salvation. He finds the viewpoint of Yoko and Father Munechika interesting, and admires the good it leads them to do, but it is not his own. When the ship departs, he will not struggle to get on board but simply stand there as the wind beats around him, watching from the shore.
He hung up the phone and wished this was a case he could be spared from dealing with. If examination of the amniotic fluid was done properly, one could tell beforehand whether there was a chromosome or metabolic abnormality in the fetus. And if the shoot was bad, it could be plucked early. In the old days, out of natural selection, people were born indiscriminately, mysteriously, but now parents and doctor could participate in the child's right to life. Strangely enough, even pacifists who agonized over the deaths of common people and prime ministers who spoke of the sacredness of human life whenever there was a hijacking--all these humanistic voices were silent regarding this kind of situation. It came down to a conspiracy of silence, a kind of passive participation in the idea that somehow there exists a mechanism of selection that ought to eliminate persons who are not well made.
Sadaharu himself was one of those people. But more precisely, in his mind he found himself saying to people in the same position as his: Can't we at least admit it to ourselves when we kill someone? (pp. 308-309)
Ayako Sono, Watcher from the Shore, Putzar, tr. Kodansha International (New York: 1990).