Medical Backdrop in “Monster”

In Monster, Naoki Urasawa uses medical ethics not as a setting but as an anchor to the story. Deep interrogations into ethical debates about triage, neuroscience and institutional ethics are woven throughout this psychological thriller, exploring what happens when medicine becomes entangled with the production of harm. 1/11

Monster opens with Tenma growing increasingly disillusioned by the hospital’s corrupt politics. After being pulled from operating on a Turkish construction worker who arrived first, to work on a renowned opera singer instead, his faith and contentment in the system begins to crack. 2/11

After listening to Tenma recount this incident, Eva, Tenma’s then-fiancee, told him that “some lives are worth more than others”, worsening Tenma’s internal conflict. When presented with the same decision again, to operate on a child that came first or the city mayor, he defied orders to save the child. 3/11

Medical discrimination is not novel. Nakao et al. (2017) detail how early military triage dating back to 19th-century military medicine, prioritized officers over foot soldiers. It was later reformed but Urasawa highlights a conflict that has existed for centuries. 4/11

What makes Monster so compelling is Tenma’s willingness to abandon status and the life he had worked so hard for to uphold his values. His choice was one that was correct by every standard of modern medical ethics, yet it still produced devastating consequences. 5/11

The decision to save the child, Johan Liebert, carries consequences that form the backbone of this story. Johan’s gunshot wound is no narrative accident either, as it hit regions near his frontal lobe that are linked to empathy, moral reasoning, and impulse control. 6/11

The question Urasawa subtly raises is whether the surgery further awakened something already present within Johan. It would be inaccurate however, to attribute his psychopathy to the gunshot wound due to his turbulent childhood and several characters’ attest to an “evil” within him. 7/11

In the portrayal of 511 Kinderheim and its aftermath, Urasawa provides a stark contrast to Tenma’s philosophy. Where Tenma feels a duty to heal, Kinderheim is defined but the complete absence of ethics where medicine and psychology are weaponized to break children like Johan, not save them. 8/11

511 Kinderheim, Monster’s fictional East German orphanage where children were psychologically broken and “engineered into ultimate soldiers” has disturbing real-world parallels. During the Cold War, institutionalized children were subjected to psychological and medical experimentation (Hornblum, Newman & Dober, 2013). 9/11

These were not fringe operations either. Orphans and children with disabilities were exposed to electroshock, radiation, and untested drugs at facilities backed by prestigious universities and government agencies. Children were stripped of names and autonomy like the children of Kinderheim. 10/11

Urasawa created an interesting exploration of medical ethics with the use of surprising medical accuracy as well as historical references embedded within it. Medicine is not treated as a backdrop but rather as a central architecture of Monster. 11/11