Reiko’s first mental breakdown began when the left little finger she depended on as a pianist abruptly stopped moving. No physical cause could be found, yet the failure shattered the future she had been raised to expect: after piano had shaped her life since childhood, its threatened loss left her without a stable sense of what remained. Her account connects that private collapse to the sanatorium’s later ethic of accepting, rather than forcibly correcting, human differences.

The finger that stopped

Reiko recalls that she was in her final year at the conservatoire, preparing intensively for an important competition. Her prospects appeared assured: she had won competitions, received top marks, and expected to study in Germany after graduation. Then her left little finger stopped moving. Massage, hot water, and time away from practice made no difference.

The doctors found nothing wrong with the finger or its nerves, and could identify no physical reason for the loss of movement. A psychiatrist suggested pre-competition stress and advised her to leave the piano for a while. The mismatch between the clear bodily failure and the absence of a medical explanation intensified the uncertainty: piano was both her vocation and the frame through which she understood her life, while the cause of its sudden interruption remained obscure.

A life organized around piano

Reiko went to her grandmother’s home on the coast in Izu to recuperate, intending to spend a few weeks away from practice. Instead, she found herself unable to stop thinking about the piano or the possibility that her finger would never move again. She had begun playing at four, had built her days around music, and had even avoided housework so as not to injure her fingers. She understood that people had valued her for her talent, and feared that without piano she would have nothing to offer.

The crisis became a mental collapse she describes as a complete jumble and total darkness. Her dream of becoming a concert pianist ended. After two months in hospital, the finger began moving again, allowing her to return to the conservatoire and graduate. But physical recovery did not restore what had been lost: Reiko says that some inner energy had vanished, and a doctor advised her that she lacked the mental strength to become a professional pianist.

She taught piano pupils at home after graduating, but the work did not resolve her grief over the career she had imagined. Hearing of less talented musicians winning competitions or giving recitals brought the loss back into focus. The breakdown therefore outlasted the period when her finger was immobile: the immediate bodily symptom receded, but the collapse of her former future remained a source of pain.

From crisis to the sanatorium

Years later, Reiko describes herself as a music teacher and office helper at the sanatorium, where she has lived for seven years. Other residents sometimes call her “The Music Doctor” or “Doctor Ishida,” but she clarifies that she is a patient, not a doctor. The ambiguity of her daily role reflects the community’s less sharply divided arrangement of care: patients and staff can work and take part in activities together, even though their positions are not identical.

Reiko explains that the place is not an ordinary hospital. It has doctors who check residents’ conditions, but its purpose is more convalescence than intensive treatment; there are no bars on the windows, its gate remains open, and people enter and leave voluntarily. Admission depends on being suited to that form of recovery. People needing specialized therapy may instead be sent to a specialized hospital. The distinction matters to Reiko’s story: the sanatorium provides a setting for living with vulnerability, but it is not presented as a substitute for every kind of treatment.

Acceptance rather than correction

The sanatorium’s doctor tells Reiko that residents are not there simply to have their deformities corrected, but to become accustomed to them. Differences in how people think, feel, and see the world cannot necessarily be altered on command; trying to force a correction may create other problems. The explanation does not deny the pain these differences cause. Rather, it describes the community as a place to get away from some of that suffering and make room for it.

Reiko links this idea to the way residents live together. They know themselves to be “deformed,” she says, whereas people outside may go through life unaware of their own differences. The residents wear their deformities openly and live quietly so as not to hurt one another. Her history makes that principle concrete: the return of finger movement did not make her former ambition recoverable, and simply telling her to resume her old life could not undo the devastation attached to its loss.

Care, its limits, and Reiko’s later role

The novel later shows the boundary of this mutual-support model through Reiko’s account of Naoko’s condition. Reiko writes that Naoko is usually well, but can become so emotionally unstable that the residents must watch her constantly; during intense episodes of hearing voices, she shuts down and withdraws inside herself. After a long discussion involving Naoko’s mother, the doctor, and Reiko, they conclude that Naoko should move to a proper hospital for intensive treatment, with the possibility of returning to the sanatorium depending on the results.

This later decision does not erase the sanatorium’s value; it clarifies its limits. Reiko’s account of her first breakdown is set against a form of care based on patience and accommodation, while Naoko’s worsening condition requires a different level of treatment. Reiko’s own experience—from a finger that began moving again to a future in music that did not return—keeps recovery from meaning a simple restoration of the past. In her history, learning to live with a changed life is distinct from being cured of what caused the change.