Communist director Satsuo Yamamoto’s scathing indictment of Japanese medical ethics remains gripping even today, after almost 50 years…
Since Donald Richie’s and Joseph L. Anderson’s legendary The Japanese film: Arts and Industry (1959) introduced Satsuo Yamamoto with the words, “He uses an axe where he should use a scalpel” to the West, the director’s work has been considered polemical, driven by a didactically formulated, leftist ideology.
Nevertheless, one also has to admire the integrity of this director and convinced communist: Yamamoto dedicated himself to the dark underbelly of Japanese society and exposed its deficiencies and problems – this at a time when the euphoria over the massive economic boom had swept Japan.
In The Ivory Tower he examines the lack of medical ethics at Japanese hospitals and achieved international critical acclaim. After its release, Yamamoto’s work not only won three Kinema Junpo awards, then Japan’s most respected cinema award, but also the “Silver Price” at the International Film Festival of Moskow.
Even today, a doctor enjoys the highest respect in Japan, his word is law, his authority rarely questioned. This respect is precisely the fatal mistake of many patients in this film: As Yamamoto shows, the well being of the patient has long ceased to be the top priority of the “angels in white”.
Goro Zaizen (Jiro Tamiya) is a talented young surgeon with big ambitions: With the help of his wealthy stepfather (Kenjiro Ishiyama), he wants to elected as the next head of his department and eagerly buys supporters of his campaign. Repelled by Goro’s arrogant demeanour, his supervisor Professor Azuma (Eijiro Tono) tries to prevent Goro’s advancement, proposing doctor Kikukawa (Eiji Funakoshi) as the successor to his position instead. While Goro and Azuma gather supporters, the idealistic doctor Satomi (Takahiro Tamura) harbours doubts about Goro’s integrity as doctor and tries to reveal his corrupt scheme to the public…
In The Ivory Tower, the deceptive practices of the medical faculties turn into a microcosm of Japanese society. Not only the maltreated patients at the hospitals suffer, it is the state itself, which is slowly consumed by the tumour of a neo-feudalistic social model.
For the doctors the well being of their patients has become secondary. After all, it’s not longer their talent, but their social standing leading to professional success. Thus, a pharmacist votes for the favourite of a doctor in an election, in turn, the doctor will vote for the introduction of a particular drug. A cronyism in which relations outweigh personal integrity.
Yamamoto’s refusal to hide this bad state of affairs before the eyes of the public is already symbolized in the first few minutes, when we are to witness stock footage of a real stomach operation presented in detailed close-ups. Just as the stomach of the patient is cut open, Yamamoto then dissects his subject: Meticulously, uncompromising and radical, without ever averting his gaze.
While Yamamoto uncompromisingly reveals the survival of feudalistic ideologies, he also exposes his own pro-communist stance in some places, for example when he contrasts the deviousness of the main character with the hard and honest work of his mother, a humble farmer’s wife, honest and straightforward, thus, an exemplary proletarian according to the book.
Therein lies the problem of ideological filmmaking. The moment when the ideology, theoretic and bookish in nature, overshadows social realities. In a less successful “shakai-mono” (“problem film”), the subject of critical examination is reduced to a mere tool of purpose to celebrate a particular political stance and thus, the film is rendered pure propaganda.
It is the excellent screenplay by the masterful Shinobu Hashimoto, which ultimately frees the films of exuberant didactics. He gives the corruptibility of each of the many characters believable motives, small nuances that make each character stand out, but nonetheless presents their deeds as the symptom of a larger context.
Not only the doctors’s corrupt practices are blamed, but especially their antiquated system, which not only tolerates, but encourages these deeds. In this institutional web of hierarchy and relations, the few honest doctors, Yoshi Kato’s sincere physician or Takahiro Tamura’s courageous assistant professor, seem to be foreign objects desperately clinging to the illusion of the Hippocratic oath.
An outstanding ensemble cast supports the filmmaker’s verdict with solid performances. Jiro Tamiya, a star of Daiei’s crime films, embodies his Goro Zaizen with spiteful arrogance, Takahiro Tamura can be seen in his signature role as honest remnant of a depraved world and veterans like Eijiro Tono, Eitaro Ozawa or Kenjiro Ishiyama convince as devious physicians.
Visually, Yamamoto follows the example of similar Daiei shakai-mono by directors like Yasuzo Masumura. Carefully constructed, moody black-and-white images plus a roaring, often dissonant soundtrack. Not very original perhaps, but in his exaggerated reference to the visual style of the film noir extremely effective.
It probably true that Yamamoto’s anger at the Japanese feudalism and its social injustice was the central force behind his more personal films. In his best works, however, Yamamoto maintained documentary objectivity and analysed his theories with the means of thrilling plots and fascinating protagonists.
The Ivory Tower belongs to this category. With a running time of more than two hours, the film is perhaps a tad overlong and not entirely free of a tendentious observation of its theme, but it avoids ideological overload with strong characters, a gripping plot and – above all – a precise examination of its theme whose radical approach still deserves respect, even after almost 40 years.