Black Jack: The Manga Osamu Tezuka Wrote When He Stopped Caring About Being Acceptable

By 1973, Osamu Tezuka was in trouble. His studio, Mushi Production, had gone bankrupt the previous year, taking his personal finances and professional infrastructure down with it. His reputation as the dominant figure in Japanese manga had been challenged by a new generation of artists — the gekiga movement, the underground comics scene — who considered his style naive and his morality simplistic. He was 45 years old and felt, by his own account, like a figure the medium was moving past. Then the editor of Shonen Champion asked him to produce a new serialized manga, and he pitched a story about an unlicensed surgeon who charged impossible prices for impossible operations. The series ran for ten years and is now considered his most fully realized work.

"Black Jack" follows a scarred, mysterious physician who performs surgeries that licensed doctors refuse or cannot accomplish — reattaching severed heads, removing inoperable tumors, saving patients who have been declared terminal — and charges fees that are beyond any reasonable client's ability to pay. The ethical situations this creates are the series' engine: does he take the case? Does the patient deserve saving? What does the patient's life cost, and who should decide? These are not children's questions, and Shonen Champion was a children's magazine, and Tezuka published them there anyway for a decade.

Each chapter of "Black Jack" functions as a moral case study: a dying yakuza who wants to live long enough to see his daughter graduate; a brilliant surgeon who operated on Black Jack's own scarred face and failed; a child born without pain receptors who does not understand why anyone would want to feel pain. Tezuka was working through questions he had carried since his medical school training — he held a medical degree, though he never practiced — and questions about mortality, professional ethics, and the value of a human life that his earlier, more optimistic work had not asked directly.

The character of Black Jack himself is Tezuka's most complex protagonist: a man of absolute technical competence and unclear moral motivation, who charges enormous fees partly because he resents a medical establishment that ostracized him and partly because he believes that people who want to live should be willing to pay for that desire. He is not a villain; he saves lives that no one else will save. He is not a hero; he sometimes makes choices that are deliberately cruel. He is, in the way of the best literary characters, simply a person — comprehensible but not reducible to a single moral category.

The series' influence on Japanese medical drama as a genre — on everything from "Dr. Koto's Clinic" to "Team Medical Dragon" to the entire subgenre of medical manga that has flourished since the 1980s — is direct and acknowledged. Tezuka proved that medicine could sustain dramatic serialization, and that the ethical questions raised by medical practice were available to manga in ways that made the subject richer than any other thriller premise. He was not the first to notice this, but he was the first to do it at scale, in a mass-market magazine, and to make it work brilliantly enough that the genre it spawned has never exhausted the territory he opened.