Hunchback by Saou Ichikawa

Published in Japan in 2023; published in translation by Hogarth on March 18, 2025

One gift that authors give readers is the opportunity to exercise empathy. By reading about lives that are not their own, readers gain an understanding of people that extends beyond the knowledge they gain from personal contacts. Reading the first-person narrator’s account of her life in Hunchback opens a window on the life that a Japanese woman might live when she is physically impaired by a severe disability.

Shaka Izawa (like the author) suffers from myotubular myopathy, a rare genetic disorder that causes severe muscle weakness. The condition has affected the curvature of her spine, leaving it “twisted so as to crush my right lung.” As the novel’s title suggests, her body has taken the form of a hunchback. “As a consequence, my way of walking was sufficiently imbalanced to make the word ‘limp’ seem an understatement, and whenever I lost focus, I’d strike my head on the left-hand side of the door frame.

Shaka had a tracheostomy to ease her breathing. She needs the assistance of a ventilator to breathe when she lies on her back. She uses a suction catheter to drain mucus from her windpipe. She needs to cover the hole in her throat to speak, but she doesn’t do so often because speaking increases her mucus production.

Shaka is fortunate to have been born to financially secure parents who assured that she would receive the lifelong care she needs. Shaka owns a building that her parents converted into a group home. She has lived there for since her early teens. Caregivers prepare her meals and help her bathe, as they do for the other disabled residents.

For nearly thirty years, Shaka has not set foot outside the building where she lives. She never has visitors, apart from healthcare professionals and the people who service her ventilator. Saou Ichikawa makes the point that Japanese culture relegates the disabled to the status of nonpersons. Japan, she tells the reader, “works on the understanding that disabled people don’t exist within society.” Keeping the disabled out of sight spares the abled members of society the discomfort of recognizing that some people do not share abilities that they take for granted. The American push for inclusion of the disabled (which will likely be set back by deliberate misunderstandings of what DEI means) has evidently not taken root in Japan.

To help pass the time, Shaka takes remote classes at a university. She’s working on her second degree. She also writes porn. She donates her earnings from porn production to food banks, shelters for homeless girls, and charities for orphans.

Shaka’s focus on sexual pleasure in her part-time work provides another opportunity for Ichikawa to contrast the lives of “normal” people in Japan with the lives of the disabled. Sexual desire is normal, no less so for the disabled, but Japanese society isn’t prepared to accept the notion of a severely disabled individual having a sexual encounter. Hunchback may be an attempt to provoke change in society’s willingness to accept that disabled individuals may be just as interested in sex as the nondisabled.

The novel opens with one of Shaka’s porn stories, an account of a woman visiting a sex club. Her date and another couple adjourn to a private room where they engage in sex acts while patrons on the other side of the glass walls masturbate. We later learn that on the site for which she writes, the greatest demand “among male users is first-hand accounts of various adult entertainment venues or lists of top-twenty pickup spots, together with adverts for dating and hook-up apps, while among women, it’s lists of the top-twenty shrines to pray at for rekindling romance, together with adverts for psychic hotlines.”

Shaka is a virgin, but her “ultimate dream” is to get pregnant and have an abortion. The shape of her skeleton would prevent her from giving birth, but she has the biological ability to conceive an embryo. She sees pregnancy and abortion as a means of living “like a normal woman.”

Shaka tweets her thoughts and fantasies (including working as a high-end prostitute) with the assumption that nobody reads them. She’s surprised to learn that one of her male caretakers has, in fact, followed them. For a price, he seems willing to make her fantasy come true. At the same time, his distaste for Shaka is evident. Shaka realizes that the “appropriate distance between us was one that allowed him to pity me.” Their abbreviated sexual encounter leaves the reader wondering which of them was more affected by the experience.

The novel is filled with insights into the life experiences of a severely disabled woman. The discussion of abortion is particularly telling. Shaka tells the reader that Japanese women routinely abort fetuses to avoid giving birth to a disabled child. Shaka’s fetus could be genetically unimpaired, so she sees an intentional pregnancy for the purpose of having an abortion as an attempt to “balance the scales.”

The story ends by transitioning back to the world of porn, this time featuring Shaka playing out her fantasy life as a prostitute. Yet this time Shaka is not the porn’s creator but a character imagined by the creator, a character who writes porn as “a way for her to survive in society.” The narrator considers that “maybe I myself don’t exist,” circling back to the earlier theme of disabled people living invisible lives, hidden from a society that prefers not to be disturbed by knowledge that some lives are less fortunate than their own.

Hunchback is a powerful and sometimes disturbing work. Readers who are willing to move outside their comfort zones to consider experiences that they cannot easily imagine will find ample opportunities to exercise their compassion in Saou Ichikawa’s semi-autobiographical novel.

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