This novel and The Doctor's Wife (see this database) offer rich detail about life in Japanese families, where the women shoulder most of the burdens. Akiko exemplifies a society in transition from a feudal parent-child relationship to a a modern world where married women and men both work full-time. In addition to her job, Akiko is also responsible for her housekeeping, bills, cooking, and the care of her parents-in-law. She assumes the care for her rude and then whining father-in-law as her husband becomes depressed and continues to absent himself from the home.

When her father-in-law becomes too demented to go to the elder center and starts to wander about town, Akiko decides to bed next to him in order to help him use the toilet at night. She changes Shigezo's diapers and bathes him like a baby though revolted by his eighty-four-year-old genitals. He regresses further, and Akiko finds him smeared with his own feces. When he dies, no one sheds a tear.

Akiko's suffering is terrible; but she, her marriage and her son survive thanks to this woman's strong sense of duty and her conscientious housekeeping. Ariyoshi's detailed story of ordinary life raises important issues about the quality of life at the end of life, caregiving for the old, and the dilemma of women who have both career and family obligations. The work gives us believable characters and home situations that reach beyond Asian experience. Anyone interested in geriatrics would benefit from reading Ariyoshi.