The Top 5 Longreads of the Week

This week, we’re sharing stories from Mike Mariani, Emma Marris, Patrick Rosal, Susana Ferreira, and Scott Indrisek.
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This week, we’re sharing stories from Mike Mariani, Emma Marris, Patrick Rosal, Susana Ferreira, and Scott Indrisek.
Sign up to receive this list free every Friday in your inbox. Read more…

This week, we’re sharing stories from Roxane Gay, Katherine Heiny, Alexandra Starr, Dionne Searcey, and Anna Silman.
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I know what you’re thinking: Not another sexual harassment post. Bear with me.
I’ve spoken to many women over the past few weeks who feel exhausted by the current news cycle, I count myself among them: the endless onslaught of horrific stories, interspersed with the occasional, extremely bad non-apology.
I know it’s tempting to look away, and it’s fine if you have to; please take care of yourself. It doesn’t make you a bad person or a bad feminist. But it’s important the stories keep coming out, that the issue remains in the public discourse. It feels like we are in a moment of momentum, working our way towards something better, however clumsy, messy, and painful the process can be. It’s a little cheesy, but I keep thinking of the quote often misattributed to Winston Churchill: “If you’re going through hell, keep going.” This momentum feels like hell, and we have to keep going.

Who gets to decide if a disability is bad? This is one of the fundamental questions raised by a recent STAT feature on the genetic testing of embryos, which also looks at how that decision is reached. Andrew Joseph follows two women who knowingly pursue a pregnancy with an embryo that has a mutation that would put their child at a higher risk for certain cancers. It was the only viable embryo the couple had, so if they wanted a baby they didn’t have much of a choice.

Alex Mar’s cover story for Wired‘s November issue, “Love in the Time of Robots” is an epic look at the life and work of Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who has spent his life and career in pursuit of a more perfect android. He has made copies of his friends, family, and himself with his “Geminoid” project, and he delights in the moment when a human confronts its twin. What could have been a simple profile of Ishiguro goes much, much deeper — at nearly 12,000 words, it is one of the longest features that Wired has run in print — as Mar explores the origins of human nature and intimacy, and the desire to turn to a robot for comfort or companionship. “Most of us already allow technology to mediate what was once simple, direct human interaction,” Mar writes, “what really is the difference?” I spoke with Mar via email about her experience with Ishiguro and the freedom of writing at a length far beyond the typical magazine feature.
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How many times did you meet with Hiroshi Ishiguro? How did your understanding of him and his work change with each meeting?
I’ve been in touch with Hiroshi for over two years and we spent about three weeks in each other’s constant company in Japan, between Osaka and Tokyo. He was immediately forthcoming with me, very open and direct. We had a great, natural rapport from our first Skype chat, and that was a big part of why I decided to pursue the story. Almost immediately he announced himself as less of a roboticist and more of an artist, which I could relate to more than an engineer’s perspective — he was turned on by big concepts and risk-taking.
Over time he did become more open about his family, a subject that’s pretty verboten for him, as he’s always been a firm believer in keeping his family life separate from his public, professional life. (Ironic, considering his first major experiment was an android copy of his then 5-year-old daughter.) He’s a charismatic figure, and he and his work have gotten plenty of press coverage internationally over the years. It took a moment for him to realize I was also interested in very minute details about his life — his childhood, his personal habits — things that he at first dismissed as too boring to discuss. It’s funny how often people assume that the kind of minutia that really makes a story, the intimate stuff, isn’t worth mentioning.
Ishiguro closely studies the small physical cues involved in human interaction in order to build a better android. (He notices, for example, that people never sit completely still.) But you seem to think his understanding of humanity is lacking. How did your understanding of his work change over time?
I don’t know if Hiroshi’s understanding of humanity is lacking any more than yours or mine. It’s more that his project is immense and requires a lot of hubris. He’s studying, measuring, and trying to replicate something that remains pretty intangible: the human presence, which the Japanese call sonzai-kan. The ineffable thing that signals to us that we’re sitting across from a living, breathing, thinking, feeling person. Plenty of people would call that a soul — something that, by definition, is impossible to replicate. So I think the bigger question here is: Do you think that human-ness is something that we can measure and weigh and build from scratch? Hiroshi’s answer to that, at least in public, is a resounding yes. But in private, I think that Hiroshi is conflicted. Personally, he seems to be struggling with his own deep desire for human connection — he spoke to me repeatedly of his feelings of loneliness — and I don’t know if he’ll ever be able to reconcile that with his work.
When did you suspect you would have to be a part of this story? How did you decide how much of yourself to put in?
I consider myself a “literary” non-fiction writer, but not a particularly confessional one. I believe in using the first person sparingly in journalism; in my longform stories I’ve tended to use it more as a light-handed framing device. But with my first book, Witches of America, about the present-day witchcraft movement around the country, I was surprised and a little bit horrified when I realized I needed to go all-in and insert myself as a character. I needed to be honest with myself and the reader about my curiosity about witchcraft, and to be frank about how subjective my experience of these Pagan rituals was — there’s no “objective” way to take part in a religious ceremony. My approach to the book became very personal and immersive, and any other approach would have felt dishonest.
When I returned from my first reporting trip to Japan, I had that feeling again: The subject of the story required a writer who was also a stand-in for the audience. I had to be able to describe in a very immediate way the experience of being around those androids, of being immersed in Hiroshi’s world and his way of thinking about humanity. When events in my personal life began to get all tangled up with the ideas I was absorbing in Hiroshi’s labs, I felt the only honest way to write this story was to weave that in.
Do you think that inventors who work at the edge of what is technically possible — with artificial intelligence, virtual reality, and so on — lose sight of what humans actually want, what we actually need? It seems like much of what Silicon Valley provides serves the interests of a narrow subset of people in the name of helping humanity.
It seems to me that the goal of a lot of research and development is to anticipate a need, or perhaps to create a desire where previously there was none. Android development is less about a concrete need — a robot doesn’t have to have a human face to perform surgery, or rescue someone from a war zone — but it does seem like an extension of the parts of our lives technology has already colonized. So many of our relationships are already virtual or text-based: entire friendships with people we almost never see in person, interactions with avatars people have created to stand in for themselves online. I’m willing to bet that internet porn, for those who are more or less addicted to it, is rewiring their sexual instincts and, to a degree, eliminating the need for actual human contact. And what about the constant need for affirmation that Instagram or Facebook satisfies? Are we really interacting with humans when we’re interacting on social media, or would that shot of cortisol to the brain be just as satisfying coming from a bot? If you go down this rabbit hole, it becomes possible to imagine a market for android companions, whether platonic or sexual, that goes beyond a “narrow subset” of people.
But putting that longer-term apocalyptic talk aside, here’s something else to consider: AI, android science, VR, etc. — these are clearly male-dominated fields, whether we’re talking about Japan or the U.S. Therefore the needs and desires research and development is addressing are, for the most part, the needs and desires of men — the fantasies of men projected onto the not-so-distant future. When I learned that Hiroshi had produced some two dozen attractive female androids, I thought, of course they were female, young-looking, and pretty. He may be a radical, independent thinker, but he’s ultimately following the dictates of an industry built by men.
This is one of the longest features Wired has ever run in print, over 12,000 words. Was having that kind of length helpful for this subject, or was it unwieldy at times to tell a story of that length?
My very first draft of the story was close to this length, and it felt natural. I’m very grateful that Wired was willing to give it that space, about twice their typical feature length. I think there was a consensus that this story needed that kind of room because of how it continues to evolve all the way to the last page. Hiroshi’s work has a breadth of scope that requires that much space if you’re going to push beyond “man who creates good-looking androids” terrain to get to something deeper. My editor Mark Robinson was a real believer in the piece and wanted to avoid any cuts that might subtract from what he thought made it different and strange and intimate.
There’s also the fact that, for whatever reason, 12,000 words is a sweet spot for me with magazine features. I like to hurl myself into the subject and write my way out of it, and it seems to land at that length nearly every time. But I believe that every story has a length that it naturally wants to land at, once you’re plugged into the writing process. That’s why it’s so valuable to have magazines that are willing to take this kind of risk and go long. This kind of freedom is the greatest gift an editor can give you.

Carey Purcell | Longreads | October 2017 | 4280 words (16 minutes)
Kasey Smith began gaining weight as a teenager. The numbers on the scale started increasing overnight, and no matter how few calories she consumed, they continued to go up. “It will even out,” she thought, crediting the change to puberty and hormones. But it didn’t, and her hair and skin began changing as well. “Something was definitely wrong.”
Each medical appointment, and there were many, concluded with doctors telling her to go on a diet. Smith (not her real name) remembers telling the endocrinologist about her frustrations with burning off the 900 calories she consumed each day and still gaining weight. “He looked at me and said, ‘Maybe you can cut back your McDonald’s to twice a week.’ I was stunned silent, and I went into the bathroom and broke down. ‘He doesn’t believe me. He thinks I’m just fucking with him.’”
As Smith’s weight went up, her food intake went down. Her mother signed her up for Nutrisystem, and her diet hung on the fridge for everyone in her family to see. Shame and humiliation narrowed her life down to three questions: what to eat, what not to eat, and how to burn more calories. She began to form dangerous habits, sometimes eating little more than lettuce.
Smith ultimately received a diagnosis of polycystic ovary syndrome, a hormonal disorder that can lead to excess male hormones, irregular menstrual cycles, and weight gain. She was prescribed Metformin and quickly began to lose weight, but the damage had been done. The 18-year-old developed anorexia, leaving for college at 130 pounds and coming back four months later and 30 pounds lighter, her hair falling out in clumps.
No one thought anything was wrong.
“I would go to the doctor, and there were no red flags. It was ‘You look fantastic!’ Not ‘This is alarming.’” Smith continued starving herself for another year until she ended up in the hospital, undergoing a colectomy to remove a foot and a half of her intestines, which had twisted as a result of her severe calorie restriction.
One year after the surgery, her worst nightmare returned: She was gaining weight. Celiac disease was the cause this time, but it wasn’t diagnosed until after Smith was in the habit of purging the little food she ate every day. She would regularly run in the park and pass out afterward. “I would starve all day, then I’d eat something at night, then I would purge it. In my head, I’m thinking, ‘I’m literally not consuming anything. The weight has to fall off.’”
She realized she needed professional help, and Smith found a therapist who specialized in eating disorders and began treatment at The Renfrew Center, a residential facility in Pennsylvania. She continues to struggle with discussing her weight at medical appointments. After she told her endocrinologist about her treatment at Renfrew, his reply was “I see you need to lose some weight.”
* * *
According to the National Association to Advance Fat Acceptance, one out of three doctors responds to obesity negatively and associates it with poor hygiene, hostility, dishonesty, and noncompliance, viewing fat patients as “lazy, lacking in self-control, non-compliant, unintelligent, weak-willed and dishonest.”
“Doctors may think they are doing their jobs by focusing on patients’ weights,” said Dr. Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Obesity. But the effects of weight discrimination, both physical and mental, can be harmful to patients. “I do see this in health providers just as much as the general population, which is that maybe stigma isn’t such a bad thing. Maybe it will motivate people to lose weight. Maybe it will provide incentives for weight loss. But that is not what we see in research. We see the opposite — that in fact, stigmatizing people about their weight actually reinforces behaviors in health that increase body weight and obesity.”
The doctor looked at me and said, ‘Maybe you can cut back your McDonald’s to twice a week.’
As weight discrimination has increased in recent years — roughly 40 percent of adults report having experienced some form of weight stigma — so have obesity rates. A positive correlation between experiencing weight bias and developing eating disorders has been documented, and two studies have reported that overweight children are more likely to binge after being teased about their weight. Nor do these habits change as we age. In a 2006 study of more than 2,000 overweight and obese women who were part of a weight loss support group, 79 percent said they turned to food after experiencing weight stigma. Another common response: refusing to diet.
Johanna Tan encountered that stigma when she gained 80 pounds in three months after beginning the hormonal birth control Depo-Provera. Her doctor suggested weight loss, and she chose a weight loss clinic. In the weeks after undergoing her doctor-mediated diet of 500 to 800 calories a day, Tan began experiencing episodes of chest pain so severe she made more than one trip to the emergency room. Her general practitioner blamed her symptoms on her large breasts. “Never mind that my boobs have always been this big, and this was a new symptom,” Tan said, laughing wryly as she explained she had been performing special exercises and getting massage treatments to help ease the symptoms. But it wasn’t her breasts that were causing the pain, it was her gallbladder. Gallstones had blocked her common bile duct, and if left untreated it could cause acute liver failure. The cause of the gallstones? Rapid weight loss. Neither Tan’s weight gain nor her loss had been correctly assessed by her doctors. (Depo-Provera lists weight gain as a common side effect. When Tan voiced concerns to one doctor, she was told, “Everyone gets more hungry. You just need to not eat more.”)
The assumption that any health issues a fat person experiences can be chalked up to weight has not gone unnoticed by the fat community. Marilyn Wann was motivated to pursue fat activism after what she describes as her Really Bad Day, when a man she was dating told her he was embarrassed to introduce her to his friends because of her weight, and she was denied health insurance because Blue Shield of California deemed her morbidly obese.
“This double whammy of social and institutional exclusion based on my weight woke me up,” she said. “Until then, I had hoped to avoid the impact of anti-fat attitudes by avoiding the whole topic. But hiding and silence and avoidance didn’t keep the yuck from finding me. So I recognized that I had to come out as a fat person. The next day, I went to a copy store and made up business cards for my new print zine, which I decided to call FAT!SO? — ‘For People Who Don’t Apologize for Their Size!’ Immediately, my life became less stressful. Of course, I still encounter anti-fat attitudes and weight-based exclusions, but I have drawn a line between me and the hatefulness. It makes a huge difference.”
Wann still experiences bias, especially at the doctor. “I know before I enter the door that the whole system prioritizes its prejudice over my well-being,” she said. “The prejudice is what’s necessary to the institution as it stands. The medical establishment, the insurance agencies, public health agencies that are government-based have always advanced their agenda on the back of fat people. … The institutions of our supposed health systems — in the government agencies, in the insurance companies, in all of the medical practices — are saturated or have deeply ingrained anti-fat bigotry.”
Establishing the balance of information and compassion while discussing a patient’s weight is constantly on Rebecca Zuckerman’s mind. “It puts medical professionals in a weird catch-22,” said Zuckerman, a fourth-year medical student at the Pritzker School of Medicine at the University of Chicago, who understands the motivation of fat activists but whose education includes the negative medical impacts of obesity. “It’s something I’ve struggled with personally. You can only explain it and tell people their options. You can ask if it’s OK to talk about weight loss or give more information. If they say, ‘No, I don’t want to hear it,’ you have to respect that.”
Still, the intense schedule of medical professionals, who are often allotted only 15 to 20 minutes per patient, often results in less-than-ideal communication. It’s easier to reach for the quickest conclusion: telling the patient to lose weight. Says Zuckerman, “A lot of doctors and nurses experience burnout, and they start losing empathy and don’t view the patients as people anymore. Your hands are tied to stay within those 20 minutes. Everyone’s trying to make more money, and the doctors are a cog in the wheel.”
That’s along with pervasive stereotyping about fat people in the medical community. In a study of 318 family physicians, two-thirds reported that their obese patients lacked self-control, and 39 percent stated that their obese patients were lazy. Even health care professionals specializing in nutrition thought poorly of their obese patients: “Attitudes toward obesity and the obese among professionals,” a study in the Journal of the American Dietetic Association, reports that 87 percent of health care professionals specializing in nutrition believe that obese persons are indulgent, 74 percent believe that they have family problems, and 32 percent believe that they lack willpower. In 2013, the American Medical Association labeled obesity a disease.
The misdiagnoses that occur lead directly to poor health outcomes. Johanna Tan ultimately spent three years in pain, leading to four weeks of hospitalization, a series of invasive surgical procedures, and lengthy rehab — procedures that wouldn’t have been necessary had the gallstones been caught earlier. While she was enduring severe pain following her first surgery and struggling to complete her postsurgical rehab, the hospital staff accused her of being lazy. “I spent two weeks in hospital post-surgery,” she said, “copping abuse for being lazy and not participating in my own rehab, before they realized they fucked up.” Tan said the nurses were condescending, saying, “I know it hurts. It’s major surgery. You still have to get up.” The pain didn’t ease until her doctors realized they had missed some gallstones and had to perform a second surgery. Tan wasn’t able to walk more than 10 feet at a time for the first month following her surgeries. It took six months for her to be able to walk further than a block.
* * *
Fat patients also often find themselves facing off with doctors who refuse to write prescriptions or referrals until patients lose an arbitrary amount of weight, a common scenario for those seeking joint replacement surgery. Despite being in “crazy amounts of pain,” Melinda Belles-Preston was required to lose 30 pounds before receiving an operation on her hips. Losing between one and two pounds a week, a healthy pace according to the Centers for Disease Control, would delay her surgery by several months. Heavier patients see longer lags. A required loss of 50 to 100 pounds can postpone a procedure for months or even years unless the patient undergoes weight loss surgery. Without surgery, the time spent in pain is prolonged, opening the door to painkiller dependence. It took Belles-Preston roughly six months to lose the weight, and she was in pain the entire time.
“Going in nutrient-deprived and starved is probably not a good way to send someone into heart surgery or major any surgery,” Wann said; her tone made it clear she was stating what she thought should be obvious. “Someone who’s been losing weight may have worse outcomes than someone who’s stayed the same weight. … It’s amazing how someone can just look at you and decide how a random number of pounds can shift you from someone who doesn’t deserve care to someone who does.”
Pain management was barely discussed when Virgie Tovar, activist and author of Hot & Heavy: Fierce Fat Girls on Life, Love & Fashion, went to the doctor after being injured on an amusement park ride. Suffering what she described as “debilitating back spasms” that made movement “electrifyingly painful,” she was told she had to lose weight before anything could be done for her. “It was like this dogged commitment to not helping me until I was at a different weight,” she recalled. “Let’s say I lose weight at what is considered a normal pace that doesn’t endanger a person’s life. For me to get to the weight you’re talking about is like 10 years. So I just get to be in pain until I’m at that weight. And if I’m still in pain after a decade of weight loss, then you’ll think about taking care of this?”
Ideally, preventive care helps patients avoid catastrophic health problems, but it’s not always accessible to fat patients, whether because of issues with doctors, issues with technology, or both. Fat patients have been refused medical screenings, such as Pap smears, mammograms, and colonoscopies, that are considered routine and vital for thin patients. The American Cancer Society advises women to get mammograms yearly beginning at age 45 and colonoscopies every 10 years beginning at age 50, but fat people often struggle to find facilities that will perform the screenings and are told they cannot fit in the machines.
A required loss of 50 to 100 pounds can postpone a procedure for months or even years… It took Belles-Preston roughly six months to lose the weight, and she was in pain the entire time.
The importance of an MRI comes from its ability to provide higher-quality images. But the machines that provide those images are small, and other options, like CAT scans or ultrasound, don’t provide a comparable alternative. “All those scans need to penetrate the body to create an image. If a body is larger and has more fat tissue to penetrate, the image quality is poorer and blurrier, and it’s harder to make out structures,” Zuckerman explained. “It’s harder for skilled radiologists to diagnose things in patients who are larger for that reason. … The fact is, MRI machines are tiny. Some people literally cannot fit in them. So we do something else like an ultrasound or CT that is not quite as good. It’s better than nothing, but it doesn’t give us the image quality that an MRI does. You run the risk of missing something because the picture that you’re getting is not clear.”
The need for hospital equipment that can accommodate fat people has grown, and imaging devices are now available. This equipment is not available everywhere, however, and sometimes patients are referred to their local zoos. When Wann called the San Francisco Zoo’s medical department to ask about accessing its technology, the person on the phone sighed and said, “I wish people would stop saying that,” referring to requests to use the department’s CT and MRI scanners. While vet schools and zoos have larger-capacity devices, they can’t allow human subjects, and scanning humans in machines intended for animal subjects is banned by formal policies in most facilities. “That’s really beyond their certification,” explained Wann. They’re not licensed as an institution to practice medicine on people. Their entire institutional certification is being put on the line because our human medical system refuses to accommodate people above a certain size. It draws an arbitrary line and says, ‘Go beyond this line, and they’re monsters.’”
Without being properly screened, patients can’t be diagnosed. A 2008 review of previously published studies, 32 in total, reported that white, female, obese patients were less likely to be screened for breast and cervical cancer. A study from 2006 reported that only 68 percent of women with a BMI of greater than 55 were given Pap tests, while 86 percent of other women were tested.
In some cases, this is a result of fat patients opting out of health care entirely, even if they otherwise have the ability to access health care facilities and are insured: According to the International Journal of Obesity, 19 percent of participants reported that if they felt stigmatized about their weight by their doctor, they would avoid future medical appointments, and 21 percent said they would seek a new doctor.
“Fat people don’t go to the doctor often. They tend to avoid it,” writer and activist Kitty Stryker said. “A lot of fat people are ashamed of being naked. They don’t want to be touched. When I say I have a lower-back problem, I know they’re going to say, ‘Lose some weight, and that will go away.’ So what’s the point? Why bother continuing to try to get to the root of my health problems when I know the only thing they will ever tell me is ‘Lose weight’?”
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Patients often face added risk beyond concerns of being dismissed or the necessary treatment being denied: the possibility of weight loss treatments and procedures being strenuously suggested at inopportune or irrelevant moments. While the American Academy of Family Physicians recommends screening for obesity along with monthly sessions of counseling and behavioral interventions, the timing of these suggestions is crucial to the impact of motivational interviewing — and execution is often poor. Tan was mid-Pap smear when her doctor asked if she wanted a Weight Watchers pamphlet.
“The speculum’s already in and open. And she says, ‘I can tell you’re getting upset. Do you want me to continue?’” Tan recalled in disbelief. “I said yes because I didn’t want to have to make another appointment for my Pap smear. I was so mad, I was crying at this point. I couldn’t move. I couldn’t yell. She said, ‘I can tell I’ve made you upset, but weight is a serious issue.’”
Although familiar with the prejudice that came with her weight, Belles-Preston was still shocked when her general practitioner recommended weight loss surgery — while she was pregnant. “I walked out of the room. It was so incredibly offensive to me. I’m coming to you for medical advice about my pregnancy, and you’re talking to me about weight loss surgery, which is the furthest thing from my mind.”
“I have tons of resources and attitudes for confronting this kind of stuff, and it can still kill me,” Wann said as I marveled at her calm approach to discussing prejudice so severe it can result in death. “I understand not going [to the doctor]. I think it’s self-protective to some extent.… Every time I go to any kind of medical appointment I anticipate facing weight bias. I anticipate being denied the sort of services thin people would receive with no problem or being targeted for weight-based treatments that I don’t want and could harm me. I’m not interested in stomach amputation or stomach squeezing. I don’t think those are therapeutic practices in any sense. Every time I go see a doctor I’m aware they may casually say the only thing they want me to do is have my stomach cut off.”
* * *
The effects of that bias were traumatizing and long-lasting for Tan. Triggered by her uncomfortable experiences in hospital environments, Tan’s first job as an audiologist after graduate school provoked frequent panic attacks because of its location at a hospital. “I used to have to go to work early so that I could tamp down the panic associated with being in a hospital at all,” she said. “This fear of hospitals hasn’t quite gone away. Most recently, a few months ago, we had to spend a few days in ICU as my partner’s dad passed, and just being back in ICU rattled me so badly it was a month before I could stop popping several Valium a day.”
It was the adversarial relationship she had developed with doctors and nurses that contributed to Tan’s panic. And she’s not alone. For many, thin means healthy and fat means unhealthy. So small and slender equates with good health and is encouraged by medical providers, often resulting in strained relationships with their patients.
The idea that the lower the weight, the healthier the person, escalated into life-threatening conditions for Smith, who was frequently complimented on how healthy she looked while she was starving herself. “When you’re restricting [calories] you can brag about it,” she said, recalling her preparation for the colectomy. “[Doctors] asked, ‘Are you eating well and exercising?’ I said, ‘I’m very healthy. I exercise all the time. I only eat vegetables.’ It’s a funny dichotomy. Just because the scale is low does not mean that you’re healthy. A lot of doctors forget to be careful of that.”
But as the number on the scale climbs, the less flattering characteristics — greed, lack of control, messiness, lack of self-care, laziness, automatic unhealthiness — are associated with fat people, only to be furthered by the media’s portrayal of fat characters, who are typically the butt of jokes or seen as slovenly and undesirable. Women are often the punch lines, much more than men. BMI standards also are more harsh for women than for men, which is apparent in the statistics regarding weight loss surgery: Obesity rates in America are split fifty-fifty between genders, but 80 percent of bariatric surgeries are performed on women. In a 2014 study from Kansas State University, 72.8 percent to 94 percent of overweight and obese men were satisfied with their health as compared with 56.7 percent to 85 percent of overweight and obese women. There’s a reason all the stories and sources here are about and told by women.
“The truth is that there are reasons why fit people live longer, better lives,” Tovar said. “It’s because the entire culture is constructed to benefit them.” Weight discrimination is associated with an increase in mortality risk of nearly 60 percent for both women and men.
Fat activists are working to provide recourse at the community level; patients share the names of fat-friendly doctors or establishments, and Wann uses her social networks to help people get referrals for doctors and other medical providers. She also assists people with planning responses to doctors and providers who inflict weight bias. Fat activist Stef Maruch maintains a list of doctors who do not inflict bias or are fat positive, and Wann encourages people to update it whenever they can. NAAFA also publishes brochures and tool kits to assist fat people in navigating bias and fighting anti-fat legislation. A monthly newsletter updates recipients with the latest research and provides referrals to practical tools like products made for people of size. After Hurricane Harvey devastated Texas, NAAFA released a special-edition newsletter and sent plus-size clothing and supplies.
Obesity rates in America are split fifty-fifty between genders, but 80 percent of bariatric surgeries are performed on women.
The organization has also updated the brochure it gives health care providers treating fat patients. It was last updated in 2011, and per the recommendation of one of NAAFA’s advisers, its language is being revised to be much more aggressive when discussing weight bias with medical professionals. “Up until this point we’ve been trying to inform and be a little bit gentle,” explained Peggy Howell, NAAFA’s vice chairman and public relations director, citing the research scientists, Ph.D.s, and professors in medicine, law, nutrition, social work and more who serve on NAAFA’s advisory board. “The advisers came back and said, ‘I think we need to take a different approach. I think we need to be more assertive about this. There are lots of studies that support that this bias does more harm than good to the patients.’” The nonprofit’s 2011 brochure states, “NAAFA is working to help ensure that health care providers provide the best possible care by keeping in mind the special needs of their fat patients.” The new brochure reads, “We currently live in an environment that stigmatizes anyone who does not meet the aesthetic or medically defined categories of an ‘attractive’ or ‘healthy’ weight… [it] creates and sustains fat phobia and oppression, which includes weight bias, prejudice, stigma, discrimination, bullying, violence, and cultural imperialism. … Sometimes the internalized biases of health care providers directly contribute to further stigmatization of fat people.”
There is some movement on the medical end as well, driven by health care providers seeking training and resources. The Rudd Center has developed educational videos, which have been tested and found to reduce weight bias. Viewing the two 17-minute films — “Weight Prejudice: Myths and Facts” and “Weight Bias in Health Care” — resulted in improvement in attitudes toward obese people. The Rudd Center has also created a media repository of 400-plus photos and more than 80 B-roll videos that portray children and adults with obesity in non-stigmatizing ways, intended as a resource of respectful, rather than stereotypical, images for the media as well as scientists and health professionals to use when making educational presentations.
“We’ve created online courses and all different kinds of resources to use to try to increase awareness about this issue and educate providers that this is more than a social justice issue,” Puhl said. “This is a full public health issue. The stigma is making their patients’ health worse.”
For many fat people, the response is too little, too late. “I would rather doctors have signs on their door saying, ‘I don’t treat fat people,’” Wann said. “It would save everyone time and money if they had a sign on their door that said, ‘No fatties.’ At least they would be honest and own their bias.”
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Carey Purcell is a New-York based writer who covers culture, politics and current events from a feminist perspective. She has been published in The New York Times, Vanity Fair, Politico and other publications. She has been a featured guest on AM Joy and Good Morning America, and her writing can be read at CareyPurcell.com.
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Editor: Michelle Weber
Illustrator: Hannah Perry
Fact checker: Matt Giles
Copy-editor: Sylvia Tan

At Proximity, Blaire Briody brings us an essay adapted from her book, The New Wild West: Black Gold, Fracking, and Life in a North Dakota Boomtown. Briody profiles female fracker Cindy Marchello, who left Utah to work the oil fields of North Dakota after her 28-year marriage collapsed and the bank foreclosed on her house. At age 56, Marchello was the only woman on her crew, working rigs where six-figure salaries and hefty bonuses attract those without college degrees and few job prospects. Marchello worked hours upon hours at a stretch in an environment rampant with misogyny, living in a camp with 200 men where every six weeks, one of their coworkers died a violent and premature death in service of big American companies thirsty for oil.
Most of Marchello’s 12-person crew regularly clocked 120 hours a week—with some logging an occasional 140- or 160-hour week. That meant they worked, ate, and slept while on the well site, though sleep was never a priority. Most workers took catnaps in an 18-wheeler’s sleeper cabin. “When you’re out in the field, there’s not much sleep,” said Marchello. “You get used to it.”
The long hours, sleep deprivation, lack of training, extreme weather, and dangerous work were a particularly lethal mix. In 2011, North Dakota became the most dangerous state to work in, with the fatality rate nearly doubling since 2007. By 2012, the state job fatality rate was 17.7 deaths per 100,000 workers, more than five times the national average and one of the highest rates ever reported for a U.S. state.
Many workers I met said they saw a limit to the number of years they could stay in the oil field. They witnessed what happened to those who stayed too long—divorce, estrangement from their children, health problems, debilitating injuries, or early death. People often said oil field years were like dog years—for every year you worked in oil, you aged about seven years. Marchello estimated that with her oil field years, she was 92. “Mine quadrupled because I was so old when I started,” she said. But pulling herself away from the high paycheck and transitioning to a slower pace of life was easier said than done.

Sexual harassment and abuse existed in our institutions long before recent allegations against men in power like Harvey Weinstein, Bill O’Reilly, and Roy Price came to light. How do institutions protect and enable these predators, and say things like, “Honestly, it was not on my radar,” when abuse surfaces? This is the question Alexandra Starr tackles in her Harper’s Magazine story examining how the U.S. Olympic Committee inadequately addressed sexual abuse in youth athletics. Institutions like the U.S.O.C. have often turned a blind eye to allegations of abuse until they’re forced to address them in court:
Marci Hamilton — the head of Child U.S.A., an organization that works to prevent child abuse and neglect — travels the country drafting legislation and testifying in statehouses on behalf of sexual assault survivors. She told me that, beyond money for therapy, window provisions help provide victims with recognition from the state that a wrong has occurred. “It is validating,” she said. “It can quiet the voices in their heads telling them they were somehow at fault.” For others reticent to come forward, watching people publicly hold their perpetrator accountable is key.
Hamilton has observed that child abuse at the Catholic Church has generated the most attention, but she finds youth athletics to be no less hazardous. “We have reports of abuse in every possible sports organization — whether peewee or little league or high school,” she said. “The extreme power imbalance between a coach and an athlete — not just an adult and child but a coach and an athlete — creates conditions for keeping secrets. And so long as secrets are kept, the perpetrators are protected.” Lawsuits, she added, “are the only way to force these institutions to disclose what’s in their files.” When SafeSport launched, she wrote that “the U.S.O.C. has moved at a glacial pace,” grappling with allegations of assault over the past fifteen years; “its actions have more often protected problematic coaches than children.” She told me, “What always comes out in the end is that the institution knew more about abuse than just about anybody else. They are also the ones most dedicated to silence.”

Richard Lloyd Parry | Ghosts of the Tsunami | Farrar, Straus and Giroux | October 2017 | 19 minutes (5,224 words)
I met a priest in northern Japan who exorcised the spirits of people who had drowned in the tsunami. The ghosts did not appear in large numbers until autumn of that year, but Reverend Kaneta’s first case of possession came to him after less than a fortnight. He was the chief priest at a Zen temple in the inland town of Kurihara. The earthquake on March 11 was the most violent that he or anyone he knew had ever experienced. The great wooden beams of the temple’s halls had flexed and groaned with the strain. Power, water, and telephone lines were fractured for days; deprived of electricity, people in Kurihara, thirty miles from the coast, had a dimmer idea of what was going on there than television viewers on the other side of the world. But it became clear enough when first a handful of families, and then a mass of them, began arriving at Reverend Kaneta’s temple with corpses to bury.
More than eighteen thousand people had died at a stroke. In the space of a month, Reverend Kaneta performed funeral services for two hundred of them. More appalling than the scale of death was the spectacle of the bereaved survivors. “They cry,” Kaneta said. “There was no emotion at all. The loss was so profound, and death had come so suddenly. They understood the facts of their situation individually — that they had lost their homes, lost their livelihoods, and lost their families. They understood each piece, but they couldn’t see it as a whole, and they couldn’t understand what they should do, or sometimes even where they were. I couldn’t really talk to them, to be honest. All I could do was stay with them, and read the sutras and conduct the ceremonies. That was the thing I could do.”
Amid this numbness and horror, Reverend Kaneta received a visit from a man he knew, a local builder whom I will call Takeshi Ono.
***
Ono was ashamed of what had happened, and didn’t want his real name to be published. It was difficult at first to understand the reason for this shame. He was a strong, stocky man in his late thirties, the kind of man most comfortable in blue overalls, with a head of youthfully dense and tousled hair. “He’s such an innocent person,” Reverend Kaneta said to me. “He takes everything at face value. You’re from England, aren’t you? He’s like your Mr. Bean.” I wouldn’t have gone so far because there was nothing ridiculous about Ono. But there was a dreamy ingenuousness about him, which made the story he told all the more believable.
He had been at work on a house when the earthquake struck. He clung to the ground for as long as it lasted; even his truck shook as if it was about to topple over. The drive home, along roads without traffic lights, was alarming, but the physical damage was remarkably slight: a few telegraph poles lolling at an angle, toppled garden walls. As the owner of a small building firm, he was perfectly equipped to deal with the practical inconveniences inflicted by the earthquake. Ono spent the next few days busying himself with camping stoves, generators, and jerrycans, and paying little attention to the news.
But once television was restored, it was impossible to be unaware of what had happened. Ono watched the endlessly replayed image of the explosive plume above the nuclear reactor, and the mobile-phone films of the black wave crunching up ports, houses, shopping centers, cars, and human figures. These were places he had known all his life, fishing towns and beaches just over the hills, an hour’s drive away. And the spectacle of their destruction produced in Ono a sensation of glassy detachment, a feeling common at that time, even among those most directly stricken by displacement and bereavement.
“My life had returned to normal,” he told me. “I had gasoline, I had an electricity generator, no one I knew was dead or hurt. I hadn’t seen the tsunami myself, not with my own eyes, so I felt as if I was in a kind of dream.”
Ten days after the disaster, Ono, his wife, and his widowed mother drove over the mountains to see for themselves.
They left in the morning in good spirits, stopped on the way to go shopping, and reached the coast in time for lunch. For most of the way, the scene was familiar: brown rice fields, villages of wood and tile, bridges over wide, slow rivers. Once they had climbed into the hills, they passed more and more emergency vehicles, not only those of the police and fire services, but the green trucks of the Self-Defense Forces. As the road descended towards the coast, their jaunty mood began to evaporate. Suddenly, before they understood where they were, they had entered the tsunami zone.
There was no advance warning, no marginal area of incremental damage. The wave had come in with full force, spent itself, and stopped at a point as clearly defined as the reach of a high tide. Above it, nothing had been touched; below it, everything was changed.
This was the point at which shame entered Ono’s narrative, and he became reluctant to describe in detail what he did or where he went. “I saw the rubble, I saw the sea,” he said. “I saw buildings damaged by the tsunami. It wasn’t just the things themselves, but the atmosphere. It was a place I used to go so often. It was such a shock to see it. And all the police and soldiers there. It’s difficult to describe. It felt dangerous. My first thought was that this is terrible. My next feeling was ‘Is it real?’”
***
Ono, his wife, and his mother sat down for dinner as usual that evening. He remembered that he drank two small cans of beer with the meal. Afterward, and for no obvious reason, he began calling friends on his mobile phone. “I’d just ring and say, ‘Hi, how are you?’ — that kind of thing,” he told me. “It wasn’t that I had much to say. I don’t know why, but I was starting to feel very lonely.”
His wife had already left the house when he woke the next morning. Ono had no particular work of his own and passed an idle day at home. His mother bustled in and out, but she seemed mysteriously upset, even angry. When his wife returned from her office, she was similarly tense.
“Is something wrong?” Ono asked.
“I’m divorcing you!” she replied.
“Divorce? But why? Why?”
And so his wife and mother described the events of the night before, after the round of needy phone calls. How Ono had jumped down onto all fours and begun licking the tatami mats and futon and squirmed on them like a beast. How at first they had nervously laughed at his tomfoolery, but had been silenced when he began snarling, “You must die. You must die. Everyone must die. Everything must die and be lost.” In front of the house was an unsown field, and Ono had run out into it and rolled over and over in the mud, as if he was being tumbled by a wave, shouting, “There, over there! They’re all over there — look!” Then he had stood up and walked out into the field, calling, “I’m coming to you. I’m coming over to that side,” before his wife physically wrestled him back into the house. The writhing and bellowing went on all night until, around five in the morning, Ono cried out, “There’s something on top of me,” collapsed, and fell asleep.
“My wife and my mother were so anxious and upset,” he said. “Of course, I told them how sorry I was. But I had no memory of what I did or why.”
It went on for three nights.
The next evening, as darkness fell, he saw figures walking past the house: parents and children, a group of young friends, a grandfather and a child. “The people were covered in mud,” he said. “They were no more than twenty feet away, and they stared at me, but I wasn’t afraid. I just thought, ‘Why are they in those muddy things? Why don’t they change their clothes? Perhaps their washing machine’s broken.’ They were like people I might have known once or seen before somewhere. The scene was flickering, like a film. But I felt perfectly normal, and I thought that they were just ordinary people.”
The next day, Ono was lethargic and inert. At night, he would lie down, sleep heavily for ten minutes, then wake up as lively and refreshed as if eight hours had passed. He staggered when he walked, glared at his wife and mother, and even waved a knife. “Drop dead!” he would snarl. “Everyone else is dead, so die!”
After three days of pleading by his family, he went to Reverend Kaneta at the temple. “His eyes were dull,” Kaneta said. “Like a person with depression after taking their medication. I knew at a glance that something was wrong.” Ono recounted the visit to the coast, and his wife and mother described his behavior in the days since. “The Reverend was looking hard at me as I spoke,” Ono said, “and in part of my mind, I was saying, ‘Don’t look at me like that, you bastard. I hate your guts! Why are you looking at me?’”
Kaneta took Ono by the hand and led him, tottering, into the main hall of the temple. “He told me to sit down. I was not myself. I still remember that strong feeling of resistance. But part of me was also relieved — I wanted to be helped and to believe in the priest. The part of me that was still me wanted to be saved.”
Kaneta beat the temple drum as he chanted the Heart Sutra:
There are no eyes, no ears, no nose, no tongue,
no body, mind; no color, sound, or smell;
no taste, no touch, no thing; no realm of sight,
no realm of thoughts; no ignorance, no end
to ignorance; no old age and no death;
no end to age and death; no suffering,
nor any cause of suffering, nor end
to suffering, no path, no wisdom
and no fulfillment.
Ono’s wife told him later how he pressed his hands together in prayer and how, as the priest’s recitation continued, they rose high above his head as if being pulled from above.
gone gone gone beyond
gone altogether beyond
O what an awakening
— all hail!
The priest splashed him with holy water, and then abruptly Ono returned to his senses and found himself with wet hair and shirt, filled with a sensation of tranquility and release. “My head was light,” he said. “In a moment, the thing that had been there had gone. I felt fine physically, but my nose was blocked as if I’d come down with a heavy cold.”
Kaneta spoke sternly to him; both understood what had happened. “Ono told me that he’d walked along the beach in that devastated area, eating an ice cream,” the priest said. “He even put up a sign in the car against the windshield saying disaster relief, so that no one would stop him. He went there flippantly, without giving it any thought at all. I told him, ‘You fool. If you go to a place like that where many people have died, you must go with a feeling of respect. That’s common sense. You have suffered a kind of punishment for what you did. Something got hold of you, perhaps the dead who cannot accept yet that they are dead. They have been trying to express their regret and their resentment through you.’” Kaneta suddenly smiled as he remembered it. “Mr. Bean!” he said indulgently. “He’s so innocent and open. That’s another reason why they were able to possess him.”
Ono recognized all of this and more. It was not just the spirits of men and women that had possessed him, he saw now, but also animals — cats and dogs and other beasts that had drowned with their masters.
He thanked the priest and drove home. His nose was streaming as if with catarrh, but what came out was not mucus, but a pink jelly-like nothing he had seen before.
The wave penetrated no more than a few miles inland, but over the hills in Kurihara it transformed the life of Reverend Taio Kaneta. He had inherited the temple from his father, and the task of dealing with the survivors of the tsunami tested him in ways for which he was unprepared. It had been the greatest disaster of postwar Japan. And yet the pain did not announce itself; it dug underground and burrowed deep. Once the immediate emergency had abated, once the bodies were cremated, the memorial services held, and the homeless sheltered, Reverend Kaneta set about trying to gain entry into the dungeon of silence in which he saw so many of the survivors languishing.
He began traveling around the coast with a group of fellow priests, organizing a mobile event that he called “Café de Monku” — a bilingual pun. As well as being the Japanese pronunciation of the English word “monk,” monku means “complaint.” “We think it will take a long time to get back to a calm, quiet, ordinary life,” read the flyer that he distributed. “Why don’t you come and join us — take a break and have a little moan? The monks will listen to your complaint — and have a monku of their own too.”
Under this pretext — a casual cup of tea and a friendly chat — people came to the temples and community centers where Café de Monku was held. Many were living in “temporary residences,” the grim prefabricated huts, freezing in winter and sweltering in summer, where those who could afford nothing better ended up. The priests listened sympathetically and made a point of not asking too many questions. “People don’t like to cry,” said Kaneta. “They see it as selfish. Among those who are living in the temporary homes, there’s hardly anyone who has not lost a member of their family. Everyone’s in the same boat, so they don’t like to seem self-indulgent. But when they start talking, and when you listen to them, and sense their gritted teeth and their suffering, all the suffering they can’t and won’t express, in time the tears come, and they flow without end.”
Haltingly, apologetically, then with increasing fluency, the survivors spoke of the terror of the wave, the pain of bereavement, and their fears for the future. They also talked about encounters with the supernatural.
They described sightings of ghostly strangers, friends and neighbors, and dead loved ones. They reported hauntings at home, at work, in offices and public places, on the beaches and in the ruined towns. The experiences ranged from eerie dreams and feelings of vague unease to cases, like that of Takeshi Ono, of outright possession.
It was not just the spirits of men and women that had possessed him, but also animals — cats and dogs and other beasts that had drowned with their masters.
A young man complained of pressure on his chest at night, as if some creature was straddling him as he slept. A teenage girl spoke of a fearful figure who squatted in her house. A middle-aged man hated to go out in the rain, because of the eyes of the dead, which stared out at him from puddles.
A civil servant in Soma visited a devastated stretch of coast and saw a solitary woman in a scarlet dress far from the nearest road or house, with no means of transport in sight. When he looked for her again, she had disappeared.
A fire station in Tagajo received calls to places where all the houses had been destroyed by the tsunami. The crews went out to the ruins anyway, prayed for the spirits of those who had died — and the ghostly calls ceased.
A taxi in the city of Sendai picked up a sad-faced man who asked to be taken to an address that no longer existed. Halfway through the journey, the driver looked into his mirror to see that the rear seat was empty. He drove on anyway, stopped in front of the leveled foundations of a destroyed house, and politely opened the door to allow the invisible passenger out at his former home.
At a refugee community in Onagawa, an old neighbor would appear in the living rooms of the temporary houses and sit down for a cup of tea with their startled occupants. No one had the heart to tell her that she was dead; the cushion on which she had sat was wet with seawater.
Such stories came from all over the devastated area. Priests — Christian and Shinto, as well as Buddhist — found themselves called on repeatedly to quell unhappy spirits. A Buddhist monk wrote an article in a learned journal about “the ghost problem,” and academics at Tohoku University began to catalog the stories. In Kyoto, the matter was debated at a scholarly symposium.
“Religious people all argue about whether these are really the spirits of the dead,” Kaneta told me. “I don’t get into it, because what matters is that people are seeing them, and in these circumstances, after this disaster, it is perfectly natural. So many died, and all at once. At home, at work, at school — the wave came in and they were gone. The dead had no time to prepare themselves. The people left behind had no time to say goodbye. Those who lost their families, and those who died — they have strong feelings of attachment. The dead are attached to the living, and those who have lost them are attached to the dead. It’s inevitable that there are ghosts.”
He said: “So many people are having these experiences. It’s impossible to identify who and where they all are. But there are countless such people, and their number is going to increase. And all we do is treat the symptoms.”
When opinion polls put the question “How religious are you?,” Japanese rank among the most ungodly people in the world. It took a catastrophe for me to understand how misleading this self-assessment is. It is true that the organized religions, Buddhism and Shinto, have little influence on private or national life. But over the centuries both have been pressed into the service of the true faith of Japan: the cult of the ancestors.
I knew about the household altars, or butsudan, which are still seen in most homes and on which the memorial tablets of dead ancestors — the ihai — are displayed. The butsudan are cabinets of lacquer and gilt, with openwork carvings of flowers and trees; the ihai are upright tablets of black lacquered wood, vertically inscribed in gold. Offerings of flowers, incense, food, fruit, and drinks are placed before them; at the summer Festival of the Dead, families light lanterns to welcome home the ancestral spirits. I had taken these picturesque practices to be matters of symbolism and custom, attended to in the same way that people in the West will participate in a Christian funeral without any literal belief in the words of the liturgy. But in Japan spiritual beliefs are regarded less as expressions of faith than as simple common sense, so lightly and casually worn that it is easy to miss them altogether. “The dead are not as dead there as they are in our own society,” wrote the religious scholar Herman Ooms. “It has always made perfect sense in Japan as far back as history goes to treat the dead as more alive than we do . . . even to the extent that death becomes a variant, not a negation of life.”
At the heart of ancestor worship is a contract. The food, drink, prayers, and rituals offered by their descendants gratify the dead, who in turn bestow good fortune on the living. Families vary in how seriously they take these ceremonies, but even for the unobservant, the dead play a continuing part in domestic life. For much of the time, their status is something like that of beloved, deaf, and slightly batty old folk who cannot expect to be at the center of the family, but who are made to feel included on important occasions. Young people who have passed important entrance examinations, gotten a job, or made a good marriage kneel before the butsudan to report their success. Victory or defeat in an important legal case, for example, is shared with the ancestors in the same way.
When grief is raw, the presence of the deceased is overwhelming. In households that had lost children in the tsunami, it became routine, after half an hour of tea and chat, to be asked if I would like to “meet” the dead sons and daughters. I would be led to a shrine covered with framed photographs, with toys, favorite drinks and snacks, letters, drawings, and school exercise books. One mother commissioned carefully Photoshopped portraits of her children, showing them as they would have been had they lived — a boy who died in elementary school smiling proudly in high-school uniform, an eighteen-year-old girl as she should have looked in kimono at her coming-of-age ceremony. Another decked the altar with makeup and acrylic fingernails that her daughter would have worn if she had lived to become a teenager. Here, every morning, they began the day by talking to their dead children, weeping love and apology, as unselfconsciously as if they were speaking over a long-distance telephone line.
The tsunami did appalling violence to the religion of the ancestors.
Along with walls, roofs, and people, the water carried away household altars, memorial tablets, and family photographs. Cemetery vaults were ripped open by the wave, and the bones of the dead scattered. Temples were destroyed, along with memorial books, listing the names of ancestors over generations. “The memorial tablets — it’s difficult to exaggerate their importance,” Yozo Taniyama, a priest friend of Kaneta’s, told me. “When there’s a fire or an earthquake, the ihai are the first thing that many people will save, before money or documents. I think that people died in the tsunami because they went home for the ihai. It’s life, the life of the ancestors. It’s like saving your late father’s life.”
When people die violently or prematurely, in anger or anguish, they are at risk of becoming gaki: “hungry ghosts,” who wander between worlds, propagating curses and mischief. There are rituals for placating unhappy spirits, but in the aftermath of the disaster, few families were in a position to perform these. And then there were those ancestors who lost all their living descendants to the wave. Their well-being in the afterlife depended entirely on the reverence of living families, which was permanently and irrevocably cut off: their situation was as helpless as that of orphaned children.
Tsunamis anywhere destroy property and kill the living, but in Japan they inflict a third kind of injury, unique and invisible, on the dead. At a stroke, thousands of spirits had passed from life to death; countless others were cut loose from their moorings in the afterlife. How could they all be cared for? Who was to honor the compact between the living and the dead? In such circumstances, how could there fail to be a swarm of ghosts?
It was in the summer after the tsunami that Naomi Hiratsuka began to speak to her dead daughter, Koharu. At first, and unlike most people she knew, she had hesitated. Shamanism, and varieties of mediumship, were deeply established in Tohoku, and many of the bereaved were turning to those who practiced them. Naomi had her doubts about the existence of such gifts, but above all she detested the way in which some people, especially in the media, treated the subject, in an effort to squeeze spooky entertainment out of tragedy. She had been especially sickened by an article in a Japanese magazine about teenagers daring one another to make nighttime visits to the site of Okawa Elementary School, in the hope of encountering its ghosts.
But the search for Koharu and the other missing children was going so badly, bogged down both in the literal mud and in a morass of bureaucratic complication. Naomi was in close touch with the police unit, which was carrying out its own search, and got to know its commanders. One day they made a suggestion that surprised her at the time — that if she knew of any mediums or psychics who had advice to offer, particularly about specific places to direct the search, she should pass it on.
A friend introduced her to a young man in his twenties who was known to have the ability to see and hear the dead. Recently, people said, he had heard a voice in a dense bamboo thicket by the Fuji lake — and when it was searched, bones were indeed found, and identified as the remains of a missing woman. Naomi arranged to meet the young psychic late one evening at the ruin of the school. It was the summer festival of Tanabata, the star festival, when people hang trees with handwritten poems and prayers, and with delicate paper decorations: streamers, purses, birds, dolls. They walked side by side in the humid darkness, between the shell of the school and the hill behind it. At a small shrine on the hill, Naomi tied decorations of her own around the bamboo and prayed for Koharu’s return. It was a hot, windless night, but the colored paper danced and shivered strangely in the motionless air. “It is the children who are moving the decorations,” the psychic said. “They are delighted with them.”
They walked past a long line of rubble, roughly heaped up into great mounds. Hundreds of people had died in this small area. It was possible that bodies were still contained within the heaps. The psychic said, “I can hear a voice. I think it is the voice of a woman, not a child.” And Naomi, straining, also heard it, although too faintly for the words to be distinguishable. “It was just an ordinary voice,” she said. “It sounded as if she was having an ordinary conversation. But when I looked around, there was nobody there.”
Naomi said, “I didn’t used to believe in such things, and I’d never had an experience like that before. But having lived through the disaster, having been through what I had, perhaps it’s quite natural that I would hear such a voice.”
She spent a lot of time with the young man. They walked together for hours through the wide environs of the school — around the Fuji lake, and as far in the other direction as the Nagatsuura lagoon. He gave Naomi a crystal on a length of cord, which she would hold suspended over a large-scale map in the hope of divining Koharu’s whereabouts. She told the police about the voice she had heard at the rubble mounds, and they were thoroughly sifted. But no human remains were found.
During their long walks, the young psychic would describe to Naomi the invisible scene surrounding them. One might have expected a consoling picture of life after death, but the vision he described was appalling. Naomi compared it to a famous Japanese horror film, Ring, which itself drew on the hell imagery of medieval art. “He said that there were pale figures like the ghosts in that film, many, many of them crawling on the ground. Some of them were stuck in the water, covered in mud, and swallowing the dirty water in terrible suffering. Some of them were trapped and trying to get out. But he couldn’t tell which of them were the spirits of people who had already been found, and which of them were those like my daughter, who were still missing.”
Naomi began to seek out other means of reaching the dead. The introductions were easily made — many of the Okawa mothers were consulting one psychic or another. Having started out a skeptic, she found herself holding conversations with Koharu herself.
The medium, whose name was Sumi, ran a small coffee shop in the city. Sometimes Naomi and Shinichiro went to see her in person; sometimes Koharu’s utterances were conveyed over the telephone, and even by e-mail and text message. But Naomi was quickly persuaded of their authenticity. Sumi conveyed so perfectly the tone and character of the Koharu that her family remembered — the chattiness, bossiness, and sweetness of a girl about to become a teenager. Through Sumi, Koharu dictated a detailed list of presents that were to be given in her name to members of the family — a particular kind of drawing pad and pencils for her brother, a pink bag for her little sister. She instructed Naomi to serve the family with powdered green-tea sweets, which she had always loved. But apart from the convincing childishness, there was an unexpected maturity in much of what she said, which might have been that of the medium, but which seemed at times to be the authority acquired by those, even in their young years, who have passed through death.
Koharu asked in detail about the well-being of her family, especially her siblings, and showed great concern about her mother’s career. “She seemed to think that Sae, the baby, would be okay,” Naomi said. “But she wanted me to give a lot more attention to Toma, who was older. And she told me to finish my maternity leave and go back to work. All of this helped, it helped us so much to carry on with an ordinary life, even after death. It was so welcome.”
What neither the medium nor the spirit ever seemed able to say was the thing Naomi most wanted to know: the resting place of Koharu, or her bodily remnant. “Sumi told us that finding the remains is not everything. She said, ‘You might think that the kids want their parents to find them, that they are desperate to go back home. But they are already home. They are already in a very good place. And the more you bury yourselves in the search, the more desperate you will become.’”
Naomi’s friend Miho visited another medium and drew the deepest consolation from her conversations with her missing daughter, Hana. “It was just like talking to her,” Miho said. “It was just as if Hana was standing there, at my side. She said that she was in heaven and that she was very happy. The woman knew all about our daily life, how Hana talked, the kinds of expressions she used. If she said that she was suffering, if she’d been crying for help, and saying, ‘Mum, get me out of here!’ I wouldn’t have been able to bear it. But the words I heard always made me feel calmer.”
Sometimes the messages from the dead contradicted one another. One of the first things Hana told her mother, Miho, was that she should not harbor any blame or resentment towards the teachers at the school. “The teachers are crying in heaven, and that is hard for us,” she said through the medium. “They are suffering, and watching them makes us children feel sad.” But another psychic, at another time, told Miho the opposite: that the children were bitter and angry towards the teachers for letting them die so needlessly, for failing to lead them to the obvious places of safety and survival.
* * *
From Ghosts of the Tsunami: Death and Life in Japan’s Disaster Zone by Richard Lloyd Parry. Published by MCD / Farrar, Straus and Giroux. © 2017 by Richard Lloyd Parry.

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