Mr. Mikami is a doctor in a rural village governed by the tradition of ubasute. This custom demands elderly citizens be carried into the mountains to die once they reach a designated age. He confronts the personal obligation of fulfilling this ritual with his own mother, Orin, who has reached that age. Despite his respected position as a physician, he adheres strictly to this societal duty.

His character embodies the conflict between familial love and cultural obligation. He tries to persuade his mother to accept her fate, stressing the necessity of upholding village traditions for the community's perceived stability. This highlights his internal struggle, balancing filial devotion against his perceived responsibility to enforce the harsh practice.

In a significant act of sacrifice, Mr. Mikami abandons his medical practice to personally carry his mother to Mount Narayama. This decision emphasizes his commitment to tradition, placing cultural expectations above his professional identity and personal comfort. His actions on this journey underscore the weight of societal pressure and the personal cost of conformity.

The narrative positions him as a representation of filial piety reinterpreted through sacrifice. His choice to leave his profession behind to fulfill the ritual demonstrates the extreme measures taken to honor ancestral customs, even when they demand profound personal loss. His story explores themes of duty, the cyclical nature of life and death, and the tension between individual compassion and collective tradition.