‘The Farewell’ : Culture, Democracy and Cancer

Is there an Asian American who hasn’t heard “go back home,” particularly in these Trumpian times? Is there an East Asian who hasn’t heard, “Go back to China/Japan/Korea”? Sure, some West Asians may be white passing, but that’s like being a secret Asian agent. Undercover, undiscovered, but not understood. Lulu Wang’s “The Farewell” warmly depicts what might seem like a distinctly East Asian problem in a way that is universally relatable.

A whole family–three generations–goes back to China and in doing so they must perpetuate a lie. The paternal grandmother, Nai Nai (Zhao Zhuzhen), is terminally ill with cancer. The doctor tells her younger sister (Lu Hong), and that sister, Little Nai Nai arranges for Nai Nai’s two sons to return–one from Japan and the other from the US.

The eldest son, Haibin (Yongbo Jiang), who has been living in Japan, has a son, Haohao (Han Chen),  and that son, a sweetly shy lad, is marrying a Japanese woman, Aiko (Aoi Mizuhara). The wedding in China is the pretext for the gathering. The other son, Haiyan (Tzi Ma) and his wife, Jian (Diana Lin), had immigrated to the US when their daughter Billi was very young. They now fly to China, leaving behind their only child, the now thirty-something Billi (Awkwafina). Billi shows her feelings too plainly on her face, not having carefully cultivated the artifice of self-effacing Chinese manners nor, it seems, the emotionally controlled poker face infamously employed in Western movies. Determined to see her Nai Nai one last time, Billi follows her parents, arriving during a family meal, much to the chagrin of her parents. What follows is both a tragedy wrapped in ceremony and a comedy of circumstances. People wishing to say something, but can’t in order to keep the secret.

Seen through Billi’s point of view, the secret is unethical and possibly immoral. This isn’t a role one might expect from someone known for more broad and comedic tones like Awkwafina.  In 2018 “Ocean’s 8,” Awkafina was Constance, a loud street hustler and pickpocket. She was loose and confident, streetwise, but brazen enough to be hip chic for an upscale party. In last year’s “Crazy Rich Asians,” as the protagonist Rachel Chu’s BFF, Goh Peik Lin, she had the air of careless confidence with a heavy perfume of privilege but she was merely rich and not crazy rich even though she lived in a house modeled after the Versailles Hall of Mirrors.

In “The Farewell,” Awkwafina’s Billi slumps over, even in the US. She is in her thirties and the precariousness of her finances (often alluded to by her parents) and the yet-to-be-obtained success (having been turned down for a genius grant) weighs upon her in the US. In China, she takes on the whine of a child unable to get what she wants, unable to express her feelings and opinions adequately and deeply saddened that the China of her childhood has disappeared.

Awkwafina’s Billi was born in China; Awkwafina was not. Yet the New York-born and Queens-raised Awkwafina has been told to “go back to China.” Awkwafina’s father, Wally Lum is Chinese-American. Her mother, who died when Awkwafina was four, was from South Korea. Awkwafina was raised by her paternal grandmother and in an interview, she emphasized that she was extremely close to her grandmother.  She also noted that not being fluent in Chinese, but having studied in Beijing, she understands ways of showing affection beyond words because, lacking fluency, words most definitely fail to convey more abstract ideas and concept that she might be able to express in English.

Shuzhen Zhao as Nai Nai and Lu Hong as Little Nai Nai can be different people at different times. They both use a matriarchal sweet tone and overly enunciated words when addressing Billi, emphasizing that Billi is still a child, not because of her age or her position in the family, but also because of her limited knowledge of the Chinese language and culture.

Toward the end, Awkwafina’s Billi makes it clear that while she has gone back to China, in this case Changchun, it is not the China of her childhood memories. People are gone. Living situations have changed.

From interviews with Hong Kong-born Tzi Ma and and China-born Diana Lin, it is clear that for them and their characters as well fit somewhere in between China and their chosen countries. Lin thought she understood her character completely, having left China at about the same time and having made a new life for herself in Australia. She compared Billi’s mother to a boat, drifting between two countries. That message is particularly important in these times where the sentiment similar to the “go back to China” insult has been taken off the rude streets and turned into the political chant:  “Send her back.”

Culture or Democracy?

What you might miss in “The Farewell”  is the contrast between the two brothers and their families. Haohao was raised in a country that also has a tradition of non-disclosure. In a 1994 study on “Japanese Attitudes Towards Truth Disclosure in Cancer,” researcher Noritoshi Tanida found that “most cancer patients are not told the truth about their disease in Japan.”

The topic of cancer diagnosis disclosure came up in the autumn of 1988 because of the death of Emperor Hirohito. The Los Angeles Times reported in “Emperor Not Told: Cancer Still Taboo Word for Japanese,” that “the palace lied to the public” in case “reports should filter back to him (the 87-year-old Hirohito).”  The LA Times wrote that “cancer patients are routinely denied the right to know the cause of their suffering, to participate in decisions about their treatment and, if necessary, to prepare to meet their death.”

While the article blames the culture where the “belief that physicians are lofty savants whose judgment.” Additionally, “malpractice suits are extremely rare here, particularly the kind that forced U.S. doctors to begin disclosing cancer diagnoses about 25 years ago.”  According to a New York Times article, the doctor quoted in the LA Times article, Makoto Kondo, is a radiologist who “returned from a year in the United States determined to tell patients bad news, and his campaign for radical change — for pulling doctors down a notch and injecting democracy into the Japanese medical system — is provoking such outrage among fellow physicians that they refuse to refer patients to him. He is scarcely more polite about them.”

Kondo told the LA Times that in Japan “We have all the technology of the 21st Century, but the relationship between doctor and patient is still decades behind the times. The patient is simply supposed to shut up and let the doctor make all the decisions.” He also notes that in the early stages some forms of cancer are treatable.

Yet the NY Times article notes that a 50-year-old woman decided not to have the surgery recommend by her doctor who told her she had gallstones, but suspected she had cancer. She did have cancer and died, but the courts dismissed her lawsuit. The doctor thus is not necessarily a “lofty savant,” and perhaps the problem is not democracy.

Kondo comments in the NY Times article that, “The present system is like the medical experiments on prisoners during World War II.” Kondo’s quote seems to be about Japan. While the experiments on prisoners of the Japanese Imperial Army are well known in the US, less well known are the unethical US medical experiments carried out on mental patients and prisoners. The University of Chicago with the US Army and the State Department carried out malaria experiments at Statesville Penitentiary in Joliet, Illinois.  The experiments, however, were not unknown outside of the US. German doctors cited the experiments during the Nuremberg trials.

US researchers experimented on people in Guatemala from 1946-1948 in order to study STDs. Similar studies were carried out in Tuskegee from 1932 to 1972. Biological warfare studies in 1950 prompted the US Navy to spray a bacteria over San Francisco in Operation Sea-Spray. These studies put the Japanese medical experiments in context, but do not answer the question about non-disclosure for cancer patients.

China and Japan are not the only countries that practice non-disclosure and according to another study, this isn’t a case of East Asia versus the so-called West. A 2016 study of Chinese doctors notes that “Withholding information from cancer patients is a common practice in many Asian countries, including China, Japan, and Singapore, as well as in some Western countries, such as Spain, Greece, and Italy.” A 2006 Italian study looked at the “paternalistic approach” in Italy and found that “The probability to be informed was higher for patients living in the north of Italy, young, well educated, with longer survival, and with breast or head and neck tumor.”

A 1994 study of clinical practice asked,  “What do gastroenterologists in Europe tell cancer patients?” From a survey with 260 replies, the researchers found that “Gastroenterologists in northern Europe would usually reveal the diagnosis to both the patient and the patient’s spouse, but some would inform only the spouse with the patient’s permission. They would sometimes embellish the truth if the cancer had metastasised. Gastroenterologists in southern and eastern Europe would usually conceal the diagnosis from the patient, in many cases even when the patient asked to be told the truth. Most, however, would tell the spouse the full truth about both diagnosis and prognosis. The variation probably reflects differences in both doctors’ attitudes and patients’ expectations.”

A clash between cultures was studied in Australia. “All oncologists felt that the family request for nondisclosure was difficult, with many cultural and emotional nuances to take into consideration. Some immigrant Australian oncologists who had a similar cultural background as the patient/family, felt they could better understand the desire for nondisclosure.”

Democracy doesn’t seem to be the problem in this kind of medical dilemma. Of course, mainland China remains communist and this is the unspoken reason that the two sons have left China. In “The Farewell,” the secret nature of the diagnosis is presented as something cultural and not a matter of democracy.

To Live and to Say Farewell

While “The Farewell” shows Billi’s dilemma as a woman caught between her US upbringing and the Chinese traditions of her family when she returns to China, Akira Kurosawa’s 1952 “Ikiru” looks at the problems a terminally ill cancer patient faces in a changing Japan and indicates the important role women have within the family.

Before we see the patient, we see the x-ray that indicates his condition to his doctor. When we see him, he, Kanji Watanabe (Takashi Shimura),  is a man who shuffles papers. The narration tells us that he is only man passing the time and he has done well enough to become the chief of his division. The narrator twice uses the verb in the title to describe Kanji. He is a man who hasn’t lived (ikita jikan wa nai) and one could say he isn’t really living (ikite iru to wa ienai kara desu). There was a time (1930), when he tried to do something, writing up an efficiency report, but now that report serves as scratch paper. He looks at his pocket watch and when women complaining about a cesspool come, he tells his subordinate to send them to another department.

The women, who are dressed in simple kimonos with their straight hair, simply and practically arranged, are poor, but determined. They get sent to one place after another with no department willing to handle their request. The uncaring bureaucracy, run by men has defeated them.

After the women leave, the young woman in Kanji’s office, Toyo Odagiri, laughs out loud about a joke someone is passing around. Her hair is short and curled–likely permed and that would be significant to the Japanese who traditionally did not approve of curly hair.

Kanji has experienced stomach troubles, something that Toyo notices while the other coworkers, all men, do not. The actual diagnosis is not confirmed by his doctor, but Kanji learns from an astute fellow patient in the waiting room that certain phrases and vague instructions are signs of terminal stomach cancer. Even though Kanji asks his doctor to tell him the truth (shoujiki ni honto no koto oshatte kudasai), the doctor doesn’t tell him. After Kanji leaves, an intern asks how long Kanji has and the doctor estimates only six months. The doctor asks what the intern and his nurse would do if they knew they only had six months to live. The intern doesn’t answer, but the nurse says she would go to the cabinet and take Veronal, a barbituate named after Verona.

This, of course, suggests suicide. Suicide is certainly a problem in Japan with people killing themselves to avoid being a burden to their family or because they have brought dishonor to their families. Suicide is not a sin in Buddhism or Shintoism. Suicide is considered a sin in Judeo-Christian society and yet in a predominately Christian society like the US, suicide is a problem for cancer patients. One study suggest that a diagnosis of cancer increased the odds of suicide four times.

A depressed Kanji returns home and forgets to lock the door. Sitting in the dark, he hears his son and daughter-in-law return. His daughter-in-law, Kazue (Kyoko Seki) complains about living in a traditional Japanese house because it is as cold inside as it is outside. She begins counting the money that her father-in-law has and her husband, Mitsuo (Nobuo Kaneko),  joins in. Turning on the lamp in their quarters, they are surprised to find Kanji sitting in the dark. Kanji likely intended to tell his son about his cancer, but decides against it after hearing this conversation. Instead, Kanji goes to his room and looks at the smiling photo of his deceased wife.

The tacit comparison is made between two women–Kanji’s unseen and long dead wife and Kazue, a woman with a taste for modern things. Like Toyo, she has short hair that has been curled or permed. She wears a dress. She complains about the coldness in the house, but there’s an implicit accusation that she is to blame.  Women are the source of the warmth in the home. While Kanji misses his wife, the daughter-in-law does not rise to the occasion. As the wife of the eldest and only son, traditionally it would be her responsibility to take care of her in-laws, particularly as the live in the same house–a very different situation from the 1953 “Tokyo Story” (東京物語 Tōkyō Monogatari) where the children have all left home (Onomichi in the Hiroshima prefecture) for life in Tokyo.

How does one keep warm in a traditional Japanese house? Not by wearing a dress. Yet even with a dress, the traditional means would be gathering around a kotatsu. A kotatsu is a low, wooden table frame which is covered by a futon or thick blanket. The table is set on top of the blanket. A heat source is built in below the frame–originally charcoal but not electric. In a Japanese home, people gather around the kotatsu at night and on weekends for meals and other shared activities.

Kanji remembers the death of his wife when his child was young, and we see in flashback that later  his older brother, Kiichi (Makoto Kobori), advised him to remarry but although Kanji insisted that he couldn’t because of his son, he was often too busy or too afraid to be of comfort to Mitsuo. Depressed Kanji stops going to work although he leaves the house regularly, fooling his housekeeper.

Worried about his father, Mitsuo consults with Kiichi and Kiichi’s wife, Tatsu (Kumeko Urabe). Tatsu has noticed some changes, but Kiichi dismisses them. Again, we are reminded that women often notice things before men do and Kazue, who despite living with Kanji, has failed to pick up the signs that Tatsu and Toyo do. When we first meet Mitsuo and Kazue, the soundtrack plays a Western tune: “Too Young.”

They try to tell us we’re too young
Too young to really be in love
They say that love’s a word
A word we’ve only heard
But can’t begin to know the meaning of

Kanji withdraws a sizable amount of money and with a novelist as his guide he attempts to find joy in life through non-traditional things: couple dancing, a jazz house where he first sings “Gondola no Uta” (The Gondola Song), and by watching a stripper. The stripper is performing a Western interpretation of Middle Eastern dance. At the jazz club, the women are swing dancing. At the crowded ballroom, the people are dancing together–something that never developed in traditional Japan but was brought to Japan when it was forced open by the US.

Later, he attaches himself to Toyo, who has sought him out to get him to sign off on her resignation. Here Shimura’s Kanji teeters on the edge of being a stereotypical “dirty old man.” He leans forward and intrudes on Toyo’s space. She has decided to work at a job where she’s making mechanical bunnies, saying over a meal with Kanji that by making them she feels that she is playing with all the children of Japan. That’s a rather romantic view of life in a factory, but it makes Kanji realize that he can possibly help children play by getting them a playground in his district. He departs as another group in the background are singing a Western tune, “Happy Birthday.” In Japan, that traditionally would have mean sekihan (literally “red rice” but it is rice with Azuki beans) and the word for birthday, tanjobi (誕生日) includes the kanji or Chinese character for “to live” (生きる).

The second half of the movie deals with people at Kanji’s funeral and during the flashbacks of various mourners we learn that Kanji was fearless in his pursuit of the playground, but also there were signs of the deterioration of his physical condition and that the poor women of the district who had wanted the playground clearly knew he was dying and that he was their benefactor. And still, Mitsuo didn’t notice nor did his wife.

Between 1930 and 1950, Japan went hard economic times, first during World War II when food was not plentiful and then again post-war under the American Occupation. Hard work and thriftiness were a matter of survival and this likely shaped Kanji Watanabe’s generation and the work ethic of today’s Japan. Prior to World War I, Japan was determined to become a modern country in order to be equal to Western nations in hopes of ending the so-called unequal treaties. This was, in the end, a hopeless crusade, but the measures taken as a result of those desperate times still made an imprint on the Japanese workplace.

There are other things in “Ikiru” that the Japanese would be more likely to catch than someone unfamiliar with the culture or language. Kanji (勘治) is not a common name in Japan like Kenji. Although the characters used mean “feeling,” or “intuition” (the “Kan” 勘) and “healing” or “cure” (the “ji” 治), Kanji is a homophone for kanji (感じ)to mean “feeling” and the verb kanjiru (感じる)means “to feel” or “to experience.” The son’s name literally means “light man” (光男), but Mitsu is a homophone for “intimate” or “close.”  In contrast, the daughter-in-law’s name, Kazue literally means “one branch” (一枝), Kazu also suggests kazu (数) or “number” and the verb kazuru (数る) or “to count.” 

In the end, Kanji lives by feeling, and women fulfilling traditional roles are the ones who understand him best toward the end. In contrast, “The Farewell” is about Billi (Awkwafina) accepting or at least understanding traditional Chinese values as they are explained to her by first her parents (Tzi Ma and Diana Lin), then her grandmother’s younger sister, Little Nai Nai  (Lu Hong) and then her uncle (Jiang Yongbo). In China, a cancer diagnosis is not disclosed to the patient, but to the patient’s relatives.

In this case the patient is Billi’s grandmother, Nai Nai. Nai Nai’s younger sister, Little Nai Nai, is the one who is informed and decides to keep the secret and thus perpetuate a lie about her elder sister’s health. Knowing that her sister has terminal cancer, she contacts her nephews and arranges for them to come home with the pretext of the marriage of the eldest’s son only child for the gathering.

The connections and the foundation of the family are the women. Little Nai Nai has left her husband to take care of her older sister, Nai Nai, who is widowed. Nai Nai has a male in residence, but he is almost oblivious to the family events and it is Nai Nai who takes charge of the wedding arrangements. The swiftness of the move from meeting to marriage suggests that Hao Hao (Chen Han) and Aiko (Aoi Mizuhara) might have been an arranged match. The sweetly awkward photo shoots in China would not seem out of place in Japan.

Billi sees this non-disclosure as an East versus West conundrum, but it is actually an approach that is taken not only in places like China, Japan and Singapore, but also in Italy, Greece and Spain. While in “Ikiru” the protagonist is able to rally and, in his final days, achieve something as a result of his position at work, Nai Nai is not working, if she ever did. She is the matriarch of the family, but a loving one. Her achievements are in forming a warm family connection, giving Billi a better understanding of the Chinese culture and even of living positively. Billi is also given a chance to achieve something with the help of a hongbao (red envelope with a gift of money) from her grandmother.

Where Kanji was caught in between the traditional Japan and the transitioning Japan, Billi’s family is also caught between Chinese tradition and US values. The mistake is to believe that modernization and Westernization are synonymous. We know that the film “The Farewell,” is “based on an actual lie” and that the director Lulu Wang has achieved something as well–an award-winning movie that has opened a conversation about East-versus-West and the importance of family as well as approaching traditional values with due respect and an open mind.

 

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