Classic and Contemporary Poetry: Explained

Janice Mirikitani’s "Hospitals Are to Die In" is a deeply intimate and sorrowful reflection on loss, displacement, and the dehumanizing aspects of institutional care. Centered on the experience of an elderly woman, Obachan (a term of endearment for grandmother in Japanese), the poem explores themes of dignity, memory, and the cultural and emotional dissonance surrounding death in modern settings. Through stark imagery and an understated yet powerful tone, Mirikitani confronts the tension between the personal, sacred act of dying and the impersonal, transactional nature of institutional spaces like hospitals.

The poem begins with an unvarnished declaration of inevitability: “They finally had to take Obachan she was dying.” This line sets the stage for the painful reality that unfolds, where the necessity of hospitalization conflicts with Obachan’s desire for a more intimate, familiar death at home. Her whispered protest, “hospitals takai takai” (expensive), underscores her resistance not only to the financial burden of medical care but also to the alienation and coldness she associates with the hospital environment. Her dying wish—to remain in the house “that was like a body / wrapping her in smells she knew”—reflects a profound connection to place, memory, and sensory familiarity as sources of comfort and identity.

Mirikitani contrasts the warmth of Obachan’s home, imbued with “breathing memories,” with the cold, sterile atmosphere of the hospital. The attendants, described as rushing from their coffee break and “irritated,” embody the impersonal and indifferent nature of institutional care. Their mishandling of Obachan—dropping her on the stretcher and bumping her against the door—serves as a visceral reminder of the loss of dignity that can accompany the dying process when it is removed from familiar, loving hands. This moment of physical violation echoes the broader emotional and cultural displacement experienced by Obachan as she is forced to leave the home that represents her identity and history.

The speaker’s emotional connection to Obachan is palpable throughout the poem. When the attendants carry her “body barely breathing,” the speaker feels as though they are “carrying my soul / wrapped in the thin sheath of her skin.” This intimate identification with Obachan’s frailty and impending death underscores the deep generational and familial bond between them. It also reflects a shared sense of vulnerability and loss, as the speaker confronts not only the impending death of a loved one but also the cultural and emotional erasures that accompany it.

The poem’s tone is understated yet charged with quiet rage and sorrow. The attendants’ casual conversations—complaints about the “high cost of living” and one mentioning he had to “buy a side of beef to hang in his freezer”—create a jarring juxtaposition to the gravity of the situation. These mundane, self-centered remarks highlight the disconnection and lack of reverence that characterize the institutional handling of death. The irony of discussing “the high cost of living” while transporting a dying woman adds a bitter layer to the poem’s critique of societal priorities and values.

Mirikitani’s imagery is both spare and evocative, capturing the stark contrasts between warmth and cold, care and indifference, life and its inevitable end. The house, described as “breathing memories,” becomes a living entity, a space of belonging and solace, while the hospital represents a void—cold, white, and alienating. The thinness of Obachan’s skin, repeatedly emphasized, symbolizes the fragility of life and the delicate boundary between the living and the dead.

“Hospitals Are to Die In”  is a powerful meditation on the intersections of cultural identity, familial love, and the dehumanization of institutional systems. Through her portrayal of Obachan’s resistance to leaving her home and the speaker’s visceral sense of loss, Mirikitani critiques a society that prioritizes efficiency and cost over dignity and emotional connection. The poem ultimately serves as a call to honor the dying process, to recognize the importance of place, memory, and human care in moments of profound vulnerability. It is a deeply moving testament to the enduring bond between generations and the quiet resilience of those who seek to preserve their humanity in the face of loss.

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