The only reason I didn't give this book a one-star rating is that it starts off with some beautiful writing -- spare, lovely descriptions of beauty and Japanese traditions such as calligraphy and incense. There are also some interesting takes on Japanese society and life.
That said, the book relies too heavily on this and not enough on plot and character. I'm not a fan of totally plot-driven writing, but the conceit of this book -- that the author is in a coma, looking over her life -- is difficult to carry off even in the hands of a seasoned novelist. It's not impossible; I think of the biographical novel of Chang and Eng Bunker, the original "Siamese Twins," which starts with one of the twins waiting for his death. That, though, relays the events of their lives in a lively way, as if they are just happening, so you forget that the entire book is a flashback. In this case, though, the writing style is all reminiscent, a style that works all right for the first 40 pages but then becomes unremittingly flat. The main character never gets out of her own head, and the book never really comes alive.
Neither do most of the characters, most of whom are cardboard cutouts: distant husband (disposed of in three pages from marriage to divorce), evil uncle, saintly mother. We don't see what motivates the uncle to do what he does, even though it's pivotal to the book; and even though the character suddenly has enough spine to stand up to her uncle and husband, we don't see where it came from in her life.
And the ending! It's such a quickie, tacked-on ending that it almost makes me think the author had a page limit and had to end the book within that. She badly needed a discerning editor, or good reader, one who wasn't overly charmed by her (often) well-done descriptions of Japan into mistaking them for successful fiction.
As a long-term resident of Japan, I also became irritated by the book's tedious focus on depicting modern Japanese life, often heavy-handed and frequently cliche. It was nearly possible to check off every modern cliche about Japan, especially towards the end: Hello Kitty, train suicides, gropers. The author was using these images to substitute for those essential building blocks of a real novel: plot, character development, resolution.
Some very beautiful writing here, almost painfully lovely. If the author could match them up with a bit more action and more complex characters, she'd probably have a best-seller.