The symbols in “The Case of Isobe” include the TV game show, the house, and the volunteer nurse.

In the hospital, Isobe watches a “vapid game show” where young married couples compete to win a vacation to Hawaii. The joyful exuberance of the show symbolizes the misery of Isobe and his situation. The show represents feelings and emotions denied to Isobe because his wife Keiko is dying and because he’s “embarrassed to reveal his own feelings.” Through the symbolism of the game show, Shūsaku Endō explores themes of emotion and married life.

The house, too, acts as a symbol. It seems to represent Keiko. With Keiko in the hospital, the house is empty. When she dies, Isobe stays late at work or has dinner and drinks with friends to avoid being home since the vacant house reminds him of Keiko. With the symbolism of the house, Endō addresses the theme of loss and absence.

Another symbol is in the character of the volunteer nurse, Miss Naruse. She appears to symbolize reality, as Isobe worries she will tell Keiko the truth about her dire condition. The ginkgo tree and the flowers might also serve as symbols—representing Keiko’s ability to form supernatural connections, which might relate to the theme of reincarnation.