What Illness Does Tozawa Have in Tokyo Vice?

Image Credit: James Lisle/HBO Max

Based on the 2009 memoir by real-life investigative journalist Jake Adelstein and created by Tony-Award-winner J.T. Rogers, ‘Tokyo Vice’ is a crime-drama series. It revolves around Adelstein (Ansel Elgort), who is an American expatriate in Japan, and his experience as a beat reporter for a Japanese-language newspaper. While pursuing one of his stories, Jake inevitably comes face to face with one of the most ruthless yakuza leaders — Shinzo Tozawa (Ayumi Tanida). In his introductory scene, Tozawa is shown to be suffering from a severe illness. As the story progresses and Tozawa emerges as the main antagonist of the season, the yet unexplained illness continues to play an important role in the narrative. If you are wondering what it is, we got you covered. SPOILERS AHEAD.

What Illness Does Tozawa Have?

The very first sequence of ‘Tokyo Vice’ has references to Tozawa’s illness, but the audience doesn’t necessarily realize it at the time. In 2001, with the police detective and mentor Hiroto Katagiri (Ken Watanabe) accompanying him, Jake sits down for a formal meeting with Yabuki and other high-ranking members of Tozawa-gumi. Yabuki warns Jake against publishing an article on Tozawa and threatens him and his family. The story then shifts two years back to 1999 and begins to proceed forward from there.

As mentioned above, Tozawa makes his first physical appearance in episode 3. He has been sent to Tokyo by the head of the western faction of the yakuza to take Tokyo from their rival, Chihara-Kai. Not many know about his illness, save for his doctor, Yabuki and some other trusted underlings, and his mistress Misaki. The answer to the mystery of Tozawa’s illness lies in the identity of the real-life yakuza leader Tozawa is modeled after. Rogers told The New York Times that no character in the show is based on Tadamasa Goto, the alleged former affiliate of the Yamaguchi-gumi and the founder and leader of the Goto-gumi. However, the fictional Tozawa seems to share multiple similarities with Goto.

Image Credit: James Lisle/HBO Max

Goto was referred to as “the John Gotti of Japan.” In 2008, the real Adelstein wrote an exposé in The Washington Post, claiming that the FBI had let Goto enter the US in 2001 for surgery at UCLA. In exchange, Goto promised to provide an extensive list of Yamaguchi-gumi mobsters and front companies in the US. The FBI reportedly received only a fraction of what Goto originally agreed, but they considered it better than nothing. Adelstein also wrote about Goto in his memoir.

According to Adelstein, Goto went to UCLA for a liver transplant. In one of the last scenes of the first season of ‘Tokyo Vice,’ Tozawa meets Misaki on an airfield and ominously tells her that he will be in this world for a long, long time, dashing her hope for freedom after his imminent death. Although the series has taken much creative liberty, we can assume that this sequence is a dramatization of Goto’s travel to the US for surgery. Considering this, we can say that Tozawa has some type of liver disease, perhaps cirrhosis. And what we see of the illness throughout the season — from erectile dysfunction to the appearance of the spider angioma on his face — seems to corroborate with this theory.

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