Nakoshi, the homeless main character who lives in his car, was approached by Manabu, a medical student, and offered him a large sum of money in exchange for undergoing trepanation. Trepanation is an ancient and debunked medical practice of drilling a hole on a person’s skull. It was believed that the imbalance of bodily fluids such as yellow bile, black bile, phlegm and blood (then called the “four humors”) causes mental disorders.

Manabu stated that through this method, Nakoshi can achieve ESP. He’ll be able to see Homunculi, which in this manga is depicted as physical manifestations of people’s inner thoughts. Nakoshi, having been recently fired and buried in debt, thought he has nothing else to lose, and agreed to do the procedure.

A few days after the operation, Nakoshi does begin to see people as deformed and abstract. What he called their “heart” would be something Manabu would later on admit as Placebo Effect. Placebo Effect is a phenomenon of wherein someone feels the manifestation of something without it actually physically affecting the body. Now was Nakoshi just imagining the existence of Homunculi? I personally think not. It would be too much of a coincidence that he just guessed all the pasts of the people he encountered throughout the manga. Maybe they are Yokai? Or maybe he actually became an empathy (someone who can see through people’s emotions and memories). Or maybe a little bit of both.

Collective Unconscious is what psychologist Carl Jung would describe certain ideals that are universally accepted. Such examples include mother figures, people’s dark side, and the belief in ancient wisdom. In psychology though, some abstract ideas cannot be easily be categorized as one thing or another. That’s why psychology tests require repetitive questions asked in different ways. Or in terms of projective tests, we try and detect consistent drawing patterns to confirm certain traits.

Having said these, there are instances in the manga where Nakoshi or other characters would have multiple interpretations of what a certain person’s Homunculi indicates about them. This is because what a symbol may mean to one person, may not be so for another.

Body dysmorphia is a psychological disorder wherein a person is so dissatisfied with his looks that he/she would often undergo surgery to change his/her appearance. A famous example of this is Michael Jackson. His problematic childhood caused him to be so insecure with himself that he constantly tries to change himself physically.

Throughout the manga, we have seen Nakoshi’s willingness (and later on, regret) to change his appearance. And we have been given multiple reasons as to why he did this – from feeling of rejection by his parents, to an extreme desire for beauty. The former is further reinforced by the way he sleeps. To sleep in a fetal position, accompanied by thumb sucking, is a classic psychological sign of profound insecurity towards the self.

But the sense of numbness that Nakoshi felt after the surgery can be interpreted both literally and metaphorically. One can say that the surgery has accidentally damaged some of his facial nerves. But the other is that feeling of dissatisfaction, thinking that he could achieve happiness through altering his appearance. Due to his aforementioned sense of insecurity, he was unable to form actual emotional connections.

Finally, what are my thoughts on the ending? I found it tragic yet satisfying at the same time. Having accidentally killed Nanako, his former lover, due to him misguidedly performing trepanation, he was arrested. Manabu blamed himself for introducing Nakoshi into this concept of Homunculi. Nakoshi himself has given up to search for people who can see his inner self, mainly because he doesn’t know himself either.