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Kazuo Ishiguro's Never Let Me Go: a model of ‘completion’ for the end of life
  1. Robert C Abrams
  1. Correspondence to Dr Robert C Abrams, Department of Psychiatry and Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, Box 140, 525 East 68th Street, New York, NY 10065, USA; rabrams{at}


Kazuo Ishiguro's remarkable novel, Never Let Me Go, is a potent critique of societal and medical inhumanity. However, it can also read as a study of psychosocial development across the life span, featuring age-specific milestones and acceptance of death as the fixed point towards which humans advance through the stages of maturation. Emphasising a developmental perspective based on Eriksonian and Jaquesian theory, Ishiguro's storyline is followed closely and retold in this article. At each critical point in the novel, the differing styles of preparation for death are considered.

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Never Let Me Go, first published 10 years ago by Kazuo Ishiguro,1 is set in a dystopia in which humans are cloned to harvest organs for medical science.2 ,3 Since the time of its initial publication, Never Let Me Go has struck a deep, if multidirectional, chord, setting off a conversation from a range of perspectives, particularly social and bioethical.4 ,5 Never Let Me Go has also been considered in the Bildung tradition of intellectual and spiritual growth within, or in opposition to, the tenets of the larger society.6 As science fiction, the novel's strangeness recedes quickly, abetted by its narrator, Kathy, who addresses an audience of other clones in a believable 1990s-era British slang. In this article, Never Let Me Go will be depicted as a disturbing yet insightful allegory, an Eriksonian developmental saga in which the clones, proxies for ourselves, traverse the stages of psychosocial development in a condensed preparation for death.

Ishiguro's principal themes include the notion that a satisfactory death, individually defined, requires a lifetime of emotional maturation; dealing effectively with the end of life must, therefore, commence near the beginning of life. That a ‘good’ death requires psychological maturity refers to the scheme in which humans navigate a lifelong sequence of psychosocial hurdles.7 ,8 Never Let Me Go, embracing this developmental principle, is organised around a succession of stages leading to a final encounter with death.

Never Let Me Go takes place in England in the 1990s, in an eerie yet plausible milieu. Scientific advances and the public demand for organs have outpaced the creation of consensual ethical norms, leaving the society to impose an ethos of eugenics as a quid pro quo for its citizens’ health.5 To this end, the clones are doubly exploited: approaching adulthood, they become carers for other clones, slightly older, who have already become donors of their vital organs. ‘Donors’ is an evil euphemism, since there is nothing voluntary about the process. After a third or fourth donation, usually before their 30s, the clones ‘complete’, that is, they die.

The clones’ life-cycles are abbreviated variants of our own. Clone infancy and early childhood are sketchily presented, while the later stages are delineated more clearly. In middle childhood, the individuals are innocent, unaware of how limited their life spans will be and what horrors await. In adolescence, the characters, en route to the establishment of coherent identities,8 dream and drift and pair off (by now they know more about the sacrifices they are later to endure, but they retain a youthful feeling of invulnerability). Next is adulthood, where the clones, adhering to the Eriksonian sequence, apply themselves to productive work as carers; that phase is succeeded by the period of organ donations and declining health, corresponding to ageing and senescence; and lastly there is ‘completion’, or death itself.

As the story opens, we meet Kathy H, a 31-year-old clone woman who is a carer driving around England to coordinate the management of her assigned donors at their care centres, that is, nursing homes. (The clones have only initials in lieu of family names, befitting their dehumanised status.) Kathy H has been a carer for 12 years, a period of unprecedented length. She has survived to see most of her peers finish their cycles of donation and completion. Kathy has been so efficient in her work that the authorities have kept her on as a carer, but soon this is to stop, and Kathy will herself become a donor and ultimately complete.

Never Let Me Go is an ideal vehicle for considering the experience of death, its characters having been brought into the world primarily to die, technically to sustain the lives of others, but to do so through their own deaths. So, in the opening passages, we find Kathy looking back, reflecting on how fortunate she has been—she and her friend Ruth and her great love, Tommy—to have been raised at Hailsham, an elite school for clones. Kathy cites the critical influence of happy memories in the face of imminent death. If you do not have good memories on which to reflect as you die, you must invent or borrow them.

Kathy goes on to describe life at Hailsham, which seems much like any privileged co-ed English boarding school. Her classmates Tommy and Ruth are described in detail. The former was a mostly ordinary boy prone to seemingly unprovoked rages, Ruth a bossy know-it-all. Tommy and Kathy began at an early age to have secretive tête-à-têtes, in which they tried to decipher the still-mysterious augurs for their futures.

At age 11, Kathy acquired a cherished object, a cassette tape of songs performed by a Judy Collins-esque pop-culture figure: Songs After Dark, by Judy ‘Bridgewater’. She became transfixed by one track, ‘Never Let Me Go’, which she realised was a typical romantic ballad, but reimagined as the story of a woman who had thought she would never have a child, then miraculously did so and clung to it fiercely. One reviewer has seen this fantasy as providing Kathy, via the device of a ‘replica’, her imagined baby, a compensation for both her motherlessness and future childlessness.5 If among the tasks of adolescence are separation and individuation, then, having had no single maternal bond, most of the Hailsham classmates were compelled to seek substitutes, in fantasy or among each other, before moving on alone.

The passing of time clinches the nomination of Kathy, the most evolved of Ishiguro's clones, as the candidate best suited for the deepest and richest encounter with death. That Kathy most closely achieved the Eriksonian ideal of end-of-life integrity is unsurprising, as from her earliest days she had displayed an independence of judgement and capacity for tolerance, in, for example, her defence of Tommy who had been ostracised by his Hailsham peers for his mystifying rages. As an adult carer, Kathy interacts smoothly with the outside world. The emotional strength that Kathy derived from maternal substitutes was, for her, sufficient to favourably affect the outcome of ‘basic trust over basic mistrust’, the conundrum proposed by Erikson to be the first and most fundamental of the challenges in psychosocial development.8 Kathy's self-confidence and her abiding sense of ‘all-rightness’ stemming from this early advantage will sustain her throughout her short life.

Meanwhile, Kathy and Tommy continued to speculate on the meaning of things. Ruth and Tommy became an official couple, even though it was Tommy and Kathy who had a more natural affinity and deeper ties of affection. At this stage, the clones were still, in adolescent fashion, preoccupied with sex and fantasies of the future, but they were also beginning to realise that their lives would be unnaturally shortened. This burgeoning awareness can be considered in the context of the mid-life crisis, a phenomenon described by Jaques as that time when one begins to have an adult appreciation that death follows life.9 Until that pivotal moment (the timing of which varies according to individual circumstances), death is abstract—known, yet too remote to feel real; and before that point, one's options in life seem boundless. So, with only a superficial understanding that they will die young, these clone-students at about the age of 15 remained in ‘pre-crisis’ mode.

At 16, Kathy, Tommy and Ruth were transferred from Hailsham to the Cottages, a ramshackle cluster of farm buildings. There they spent several structureless late-adolescent years, a pause before moving on to their training as carers. During this time, many continued to dream about careers they could never have. The awareness of limited time oppresses the reader, but not these adolescent clones. The Eriksonian explanation for this phenomenon is derived from the diffusion of time perspective that ‘in its milder form belongs to the psychopathology of everyday adolescence’.8 For adolescents there is a ‘disbelief in the possibility that time might bring change’.

As teenagers, Kathy and Tommy were ahead of most of their peers in their appreciation of what the future would hold, but they, too, were caught up in reparative fantasies. Tommy developed the improbable but compelling theory that if a couple could show that they were in love, the authorities would grant them a deferral that would set back the training and the donations by several years.

Eventually the clones, implicitly accepting their fates and abandoning their aspirations, started separately to leave the Cottages to begin their training as carers. The Hailsham ties that had bound them together were weakening. Actually, the first awareness of limited options and the loosening of ties to one's family of origin, two permutations on the theme of ‘letting go’, were both cited by Jaques as precursors of the mid-life mindset.9 Starting now, Kathy and her peers confronted an unceasing process of ‘letting go’; by adulthood this would become a relentless relinquishing of dreams, goals, friends, bodily integrity and finally, existence.

Back to the present, 12 years later: Kathy, still a carer, learns that Hailsham has closed. Ruth and Tommy have both weathered donations. Facing death, Ruth is now determined to atone for having kept Kathy and Tommy, the natural lovers, apart. To make amends, she pleads with Kathy and Tommy to appeal to the former Hailsham administrators for a deferral. Surely, a deferral would be granted to these two, Ruth believes, since they have loved each other all of their lives. But in a sardonic sidebar on medical arrogance, Kathy at first demurs; co-opted or blinded, she defends the systemic medical cruelty to which the clones have been subjected because, as the sole member of her group who has not undergone a donation, she has never been ill. Like many a young doctor, she is unable to empathise beyond her experience, even as she insists that she can.

In another digression, Tommy asserts that the only way a couple can convince the ‘Donations Programme’ authorities that they are genuinely in love is through the art they created at Hailsham, and since he himself had done little art during his student years, he now steels himself to make up for his earlier failing. Here, Ishiguro underscores the futility of trying to achieve by will without feeling; art created for advantage is subtractive and meaningless.

After Ruth's death, Kathy comes around to fulfilling her friend's wish—she and Tommy become a couple and ‘apply’ for the deferral. All good; and yet, as lovers, Kathy and Tommy are haunted by an autumnal feeling. They are out of phase. Their sense that it is ‘too late’ for them, that their moment has passed, is itself a Jaquesian corollary: the perception of time as finite was considered by Jaques to be a prodrome of the mid-life crisis.9

When the pair finally see their former schoolmistress and sponsor, now two frail elderly spinsters, they are stunned, as they had always envisioned them as ageless. Here, we have another Jaquesian mid-life milestone. Now, it is the recognition of ageing in the generation proximate to one's own, and the awareness that senior figures of authority, assumed to be buffers against one's own death in the natural order of things, will soon be gone. All adults must discover at some point that parental figures can no longer protect them.

These two women—the headmistress Miss Emily, and the sponsor, ‘Madame’—forced into retirement since the demise of Hailsham, have become an eccentric elderly couple, perseveratively rehashing their careers as pioneers in the ethical care of clones. They are presented as servants of the prevailing oppression even though they have dedicated their lives to winning concessions from it.

Miss Emily now breaks the shattering news to Tommy and Kathy: there are no deferrals. Their hopes had been unfounded, and their preparations, including the latest of Tommy's painfully wrought drawings, futile. Kathy and Tommy then seek explanations of the deceptions that had been fostered at Hailsham. They are told that the curriculum had been designed to shield them from awareness of the grim reality they would face in adulthood, while at the same time subtly preparing them for the same. But however central to any educational enterprise is the measured withholding of unpalatable truths, tied to the developmental levels of the students, therein also lay the ‘sham’ in Hailsham's model. Just as Kathy's defence of the ‘Donations Programme’ revealed the susceptibility to corruption of even the most dutiful citizens, Ishiguro is warning that the demands of the larger society have the potential to subvert the best intentions of individuals. But throughout Miss Emily's self-justifying explanations, the reader also wonders whether all educational efforts, however conceived, are not also, at their core, distractions from the most terrible truth about human life, its transience?

Madame, who had witnessed the 11-year-old Kathy dancing to Never Let Me Go years earlier, becomes overwhelmed with emotion. The sadness is Madame's Eriksonian tragedy, too; the interview with Tommy and Kathy has forced her to revisit the ruins of her life's work, confirming, towards the end of her life, the failure of her own productive adult years. Madame's tears now are shed for the vulnerable 11-year-old Kathy whom she saw dancing many years before and also for herself, recognising that her vision of a kinder, more compassionate world will not endure, and that she will have left behind nothing of lasting value.8 ,10

Driving back to Tommy's care centre, he and Kathy are crushed and subdued. Suddenly, Tommy runs from the car to a field at the side of the road, raging and cursing, just as he had done as a boy. Kathy says that she clung to him…until he stopped shouting and I felt the fight go out of him… And so we stood together like that… just holding each other, while the wind kept blowing… it seemed like we were holding onto each other because that was the only way to stop us being swept away into the night.

In that moment, another connection, a mature one between Kathy and Tommy derived from their mutual loss of hope, was forged, then released. Here, the ‘letting go’ was predicated on the clones’ understanding that they must face death separately and alone. The poignant sequence of coming together and ‘letting go’ in that desolate field could be viewed as a cathartic mourning, a rehearsal for their imminent separation as a couple and for the definitive separation to follow—death.

When Tommy is calm again, Kathy tells him that she believes that when he used to go bonkers like that at Hailsham, at some intuitive preconscious level he must have known. But weighed down by the futility of their plight, or inured to it, Ishiguro's clones drive freely about the country and never speak of rebellion or escape. Only the book's title hints at any serious resistance.4 In fact, Tommy has been the sole character to express anger, an emotion absent in the stoic, reliable Kathy and the devious, yet fearful, Ruth. The reader next learns that Tommy has completed—died—following his fourth donation, and Kathy is facing the beginning of her own donations.

Now, we come full circle to that point where Kathy is putting the finishing touches on her model for acceptance of death. For Kathy, there is in the anticipation of death an almost paradoxical relief from the frustration and sadness that pervade Never Let Me Go. At the book's beginning, she had asserted that if at the end of life, you do not have good memories on which to reflect, then it is acceptable to invent or borrow them. To this, she now adds that even if your memories are painful, there is still consolation to be gleaned from their uniqueness, falling back on the bedrock fact that they are indisputably your own and cannot be taken from you. Kathy's is thus a more rigorous, but more rewarding approach to the end of life than Ruth's, which had been characterised by the unidimensional wish to ‘set right’ her own misdeeds. But before Tommy's death, Kathy tells him that she regrets that Ruth did not survive to see the collapse of her plans—words spoken not vindictively but with compassion for her friend who died with an incomplete understanding of their lives.

The book concludes with a striking image. Kathy, in one of her last drives before becoming a donor, parks in front of an empty field and gazes at rubbish blown by the wind and caught in a fence. Then, Tommy enters the frame in the far distance:…All along the fence…all sorts of rubbish had caught and tangled…I imagined this was the spot where everything I'd ever lost since my childhood had washed up, and…if I waited… a tiny figure would appear on the horizon… I'd see it was Tommy…. The fantasy never got beyond that…and although the tears rolled down my face, I wasn't sobbing or out of control. I just waited a bit, then turned back to the car, to drive off to wherever it was I was supposed to be.

This closing passage describes a small moment yet also hints at a larger process of grieving for Kathy, for the loss of Tommy and for her own death. All of the objects that Kathy had ever lost, or more accurately, their mental representations as discarded everyday objects, are disgorged. Remarkably, the images are of trash, yet they are movingly sad and elegiac. It is entirely in-character for Kathy to be a disciplined soldier, to bravely confront her powerlessness and carry on with her tasks—even if partially taken in by the propaganda of the shadowy figures that have controlled her life. As in Ishiguro's other novels, restraint may be the very source of a character's emotional impact.11 ,12

Kathy's brand of tolerance may be the best that can be achieved; yet one still hopes for something better at the end of life. Ishiguro is reaching here to define the perennially elusive components of a ‘good’ death: he concludes that under perfect conditions, a lifetime of accumulated experience could at the end yield a heightened understanding. This achievement might be akin to an Anglican choral descant in which the melodic theme is magnificently enhanced in the closing bars, producing an effect more complex, balanced and beautiful than the original. In a similar vein, Oliver Sacks wrote about the potential for one's last days to be a joyful ‘sabbath’ of rest and reflection.13

In a less Eurocentric context, this exemplary final phase of life might be compared with the time of material renunciation in the Hindu cycle, where life culminates in introspection and a search for meaning. But Kathy has no spiritual example to follow, and is poised to face death alone. Her courage is a bold rejoinder to the morally compromised society that spawned her, the culture that needed to look to the Hailsham students’ artwork to determine if clones ‘had souls’, and where individuals whose lives were saved by the donated organs did not ask hard questions about the provenance of those organs.

In Kathy's model of dying, one would expect her to engage in a process whereby fresh new aspects of people and events, and of oneself, are revealed. All of this may recall the defensive glossing-over of failures, the convenient forgetting of disappointments, that Erikson described as a normative defence in the last stages of life.10 The power and meaning of forgetting are in fact central in Ishiguro's most recent work.12 But Never Let Me Go resonates precisely because its characters do not indulge in wishful post-hoc revisions of their lives, even as they are about to be disposed of as so much medical waste. Instead, the goals are clarity and integrity; at the end of life, one aims ‘to face down despair with faith and appropriate humility’.10

However, Kathy's wish for her days in the care centre, that they should be spent recalling and reliving her memories, and the prospect of a truthful, meaningful last look at one's life before the final ‘letting go’, should be considered ideal scenarios. Such processes can easily fail in the cold medical settings in which most of us will die. Dying with insight may prove as much of a remote abstract goal as ‘living fully’.

As one colleague told me: ‘Never Let Me Go is the saddest book ever written’. But Kathy's demise and our own deaths as well can also become triumphs of personal integrity over societal cruelty and historical accident. In a few felicitous phrases, as if with Ishiguro's Kathy in mind, Erikson offers transcendent hope for the human journey when he asserts that at the end of life:8…the possessor of integrity is ready to defend the dignity of his own life…. For he knows that an individual life is the accidental coincidence of but one life cycle with but one segment of history; and that for him all human integrity stands and falls with the one style of integrity of which he partakes.


The author wishes to acknowledge the assistance of Rosalie Wohlstatter, Esq. in the preparation of this manuscript.


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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.