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"Grandma, what do YOU want to do?"

When we realized that my mother could no longer make the trip to Japan regularly as she had done for years we faced a tough decision because Obaachan couldn't live alone. So we brought my grandmother to the U.S. to spend her last years, and to die. No one actually said that but we all knew it was true. After all, grandma was 99 and how many more years could she possibly live? Better to die among those she loved the most, we reasoned. She could pass her few remaining years in peace and would be able to die surrounded by her only child and grandchildren.

Since she had never actually lived in the U.S. we decided it would be best to call it a trial and tell her that she could return to Japan if she decided that it was the best thing to do. But since she could no longer live alone, should she decide to go back she would have to enter a nursing home there. She moved in with my mother and older sister in Massachusetts. I was in Tokyo.

Days passed and tensions mounted. As the time approached for a decision to be made I received a phone call from my older sister who does not speak Japanese, requesting that I ask Obaachan what she wants to do.

“Okay,” I said, and when the phone was passed, asked, “What do you want to do Obaachan?”

“I think I should go back.”

She gave the phone to my sister and I translated into English.

"She thinks she should go back.”

This answer did not satisfy my sister who insisted, “I want to know what she wants to do, not what she thinks she should do.”

“Okay, let me ask her again.”

“Big sister wants to know what you want to do Obaachan.”

“Well, I think your mother wants me to go back.”

I translated this too.

My sister said, “That might be true but I want to know what she wants to do.”

“Okay, I’ll try again.”

“Obaachan, don’t worry about what you think mom wants, what do YOU want to do?”

“I think your sister’s husband is not comfortable with me here.”

I translated this too, but my sister said, “Tom would love for her to stay here; he’s fine with whatever we decide. What does she want to do?”

“Sister says her husband is fine with you here. She wants to know what YOU want to do.”

“It’s probably better for everyone if I go back.”

My sister was getting a little frustrated. “I’m not asking her that. I want to know what she wants. Tell her that if she wants to stay, I will take care of her.”

“Big sister says if you want to stay she will take care of you.”

“I appreciate it, but I should probably go back.”

"She thinks she should go back,” I told sister, realizing we were back where we started.

She replied, “I just want to know what SHE wants to do.”

I was also exasperated, “I know you do, but maybe she just can’t answer your question in the way you want her to.”

There was a silence, then my sister said, “Okay, I understand.”

Obaachan went back to Japan a month later. She moved into the nursing home without complaint. She stayed there till she passed away at 111. Would she have been happier in the U.S.? I don’t know. There was overwhelming stress on my mother, the only person to whom she could speak and be understood. There could have been incredible problems with health insurance that would have exhausted all her savings before the bills were passed on to us. And how would she have communicated with doctors, nurses and caregivers?

Though I feel sad and imagine that she is lonely this is the way she is living out her last years. And though it seemed ideal to be surrounded by family the reality was that she was debilitating rapidly in a strange environment in which she was as helpless and dependent as a little child. While they are not family in the sense of blood ties, she has had the same doctor and nurse for years and I can sense their care and affection for her.

Maybe she really did want to come home to Japan, where she was born, where her mother died, where she herself wanted to die. Perhaps she could never express her desire, but perhaps she needed to be where things were familiar—the way things looked, smelled, the natural world of home. Maybe she couldn’t stand losing memories. It was her choice, I say to comfort myself. But what does this mean? Could she ever really choose what she wants—a woman raised at a time in which a girl's and woman’s desires did not matter, a woman raised in a society in which she could only see herself in a contextual web of relationships? When we asked her “What do you want to do?” could she possibly see her wishes simply as personal, individualistic desires?

What Obaachan wanted is what is best for all her loved ones. Japanese culture, even in the language, shows how humans are deeply connected to others. Characters for self, JIBUN, show how the self is part of something larger. Even the character for person, HITO, shows how we are connected to another. My grandmother always reminds me that who I am is connected to others, most notably my parents and other ancestors.

Obaachan was born in Meiji Japan, 1903 and grew up in a house with her grandfather, a former hatamoto, a samurai who was a direct retainer for the Shogun. She was deeply impressed by his character and dignity. One of the great virtues of Bushido, the samurai code of moral principles, is Chugi, or loyalty. Bushido held that the interest of the family, and the members thereof, is intact – one and inseparable. This interest is bound up with affection—natural, instinctive, irresistible; we can die for one we love with natural love. It is the opposite of individualism which puts self-interest first, seeing one’s own pain, pleasure and existence as our greatest concern. In contrast to individualistic Western culture, which puts the burden on the individual to initiate and accomplish change, Japanese culture pushes you to reach beyond yourself to build your network of connection that will feed and sustain you as you change. This network will include family, friends, and community, as well as connection with your own spirit and a source of meaning and purpose in your life.

While loyalty is fundamental in Asian cultures, it is an intrinsic human need to seek a cause beyond ourselves. It might be large, like family, country, religion, or it might be small, like a project, a garden or a pet. We give our lives meaning by ascribing value to the cause and seeing it as worth sacrificing for. Loyalty also enhances the quality of life, especially for those struggling to find meaning in their existence in illness or aging. It may not produce happiness and may even be painful and lonely but it may make life endurable.

I believe that Obaachan decided to sacrifice what she may have felt were her own individual desires, for the greater good of all in the family. Seeing the hardship it would impose on everyone, she determined that the best course of action was to leave the warm nest of family affection and retire to the group home in Japan. Perhaps she considered her sacrifice and death as meaningful when she saw herself as part of something greater, in this case, a family. Loyalty to the value of the well-being of all in the family and sacrificing for it, gave her life meaning. Obaachan may not have been happy in the sense of having individual desires met, but she may have felt her life was meaningful as she was contributing to the happiness of others who loved her but could only care for her at great personal expense.

The individualistic emphasis on finding the self and following the heart that American culture advocates is important for us. The collectivistic emphasis on Self of my grandmother is also important. When we think about who we are and how to follow our heart both dimensions must be considered, and we all must care for ourselves as well as for others. Discovering our unique purpose in life is a difficult, challenging task because we are all both individuals and part of something larger than ourselves. Our purpose will be to honor the inner voice and follow our heart in fulfilling both our needs as individuals and as members of broader circles. We are part of a larger whole and can see ourselves in this complexity.

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