Kobo Abe, Japan's foremost novelist, is a trained physician, and yet he disavows any comparison with Chekhov, William Carlos Williams or any other author in the long line of literary MDs. "There's a big difference," he says. "If you were to break your arm on your way out of this room, I'm afraid I wouldn't be able to do a thing for you. I'd probably just make you worse."

Abe (pronounced Ah-bay) was a skilled mathematician as a young man, and his fascination with all the sciences infuses his imagination and language in such novels as "Secret Rendezvous," "The Face of Another," "Inter Ice Age 4" and "The Ruined Map." But as a medical student at Tokyo University in the '40s specializing in gynecology, he was bored. Bored and lazy. He flunked his exams and his teachers demanded he take them again.

"The truth is," Abe told his elders, "I don't really intend to practice medicine."

"Oh," one professor said. "Why didn't you say so? If I'd known that earlier, I'd have passed you." The two men cut a deal. Abe was granted the title of "doctor" under the condition he never practice medicine.

"You see," says Abe, "Chekhov was the real thing. I am a fake. So please, do not break your arm."

The organizers of last week's PEN International Congress did not, of course, invite Abe here to mend snapped limbs. He was here for the strength and strangeness of his work -- a body of prose fiction that stands far outside Japanese traditions in both subject and form. His books sell widely not only in Japan, but in the United States, the Soviet Union and Eastern Europe.

"Japanese readers don't understand me better or worse than anyone else," he says. "Place has no role for me. I am rootless."

Abe has always refused to be a strictly Japanese novelist. Yukio Mishima ("The Sailor Who Fell From Grace With the Sea") and Japan's first literary Nobelist, Yasunari Kawabata, differed vastly in tone and politics, but both men venerated versions of the Japanese pastoral, the traditional ways of life, and mourned the encroaching industrialization and westernization. (And both were suicides in the early '70s.) Abe's tales are universal, dark, ironic. His best-known novel, "The Woman in the Dunes," a mythic story of a man held captive in a remote sand pit, rings more of Kafka than Kawabata. There are no samurai warriors, as in Mishima, no tea ceremonies, as in Kawabata.

"I get a little tired of hearing about tea ceremonies," Abe says through a translator, the Japanese literature scholar Donald Keene. "I think tea ceremonies are for tourist brochures and the propaganda put out by Japan Air Lines." Abe's laugh is not the sort of tittering giggle that one hears often in the streets of Tokyo. It is a belly laugh, a New York sort of laugh.

Abe studied Chinese, English and German and is the most cosmopolitan of writers, but cannot read or speak any foreign language. "It's ironic that Abe is such an internationalist," says Keene, "but he has to rely on a translator like me." During an interview Abe's eyes blink wildly, at times causing his thick glasses to bounce up and down on his nose. Other times he seems far away, the English of his interrogator and translator become a kind of white noise.

Abe is 62, an age when a literary figure of his accomplishment normally would generate endless tributes from his colleagues and followers. But he is aloof from the universities, media and organizations that constitute the Japanese literary establishment. Abe not only looks far younger than he is, he has also avoided the "grand old man" status accorded to Kawabata. He lives with his wife Machi in a house just a few miles outside Tokyo, but he may as well be a thousand miles from the official cultural life of the city. He despises the mail, refuses invitations and rarely answers the phone.

"I get angry when I meet new people," he says with a weird smile.

"Abe is a kind of special case in Japan," says Keene. "He was close to Mishima but he really doesn't have any writer friends now. And he has an unusual audience. The people who buy literary books in Japan tend to be young women who, I think, read them as a kind of last intellectual fling before settling into marriage. The lack of Japanese content to Abe's books makes him different. Even though 'The Woman in the Dunes' was published more than 20 years ago and was made into a popular art film, he still has an avant-garde reputation. Most of his readers are men."

No living Japanese novelist has achieved an international reputation as great as Abe's, but within the country there are more traditionalist figures, such as Yasushi Inoue, a writer of historical novels, and Kenzaburo Oe, author of "A Personal Matter," who dominate the literary scene. Shusaku Endo, author of "The Samurai" and the president of Japanese PEN, writes mainly about the Christian period in Japan and is more popular in the West than in his own country.

Abe is a figure apart -- appreciated but not adored.

"I think another, less literary reason Abe is so far outside the establishment is that he never writes articles or editorials for popular papers and magazines," says Keene. "The only thing he writes are his novels, and they are difficult, dense in the best sense of the word.

"The Japanese think that if anyone is going to win the Nobel from their country, it will be someone like Inoue, who is working in modes similar to Kawabata."

Asked what Japanese writers have influenced his work, Abe has a simple answer: "None." He first acquired a taste for literature through the tales of Lewis Carroll and Edgar Allan Poe. Such an answer does little to ingratiate him to the admirers of tradition at home.

Abe's dissatisfaction with tradition in general has increased with the decades. For 20 years he divided his time between writing novels and directing plays written by himself and others, including his friends Arthur Miller and Harold Pinter. Abe's lifelong friend Seiji Tsutsumi, head of the Seibu department store chain in Japan, was his patron in the theater. For Abe's drama company Tsutsumi spent more than a million dollars building a horseshoe-shaped theater on the ninth floor of the Parco department store in the Shibuya district of Tokyo.

Abe gave up directing and writing plays about five years ago. He says one reason "is that there is no country on earth less interested in the theater than Japan." He also says he has come to despise "ceremonies of all sorts," and the theater, to Abe, is the most ceremonial of arts.

"I've felt for a few years that the increase around the world of ceremony is the mark of a new nationalism," he says. "I've rejected ceremony as much as I can. I didn't attend my daughter's wedding. I don't wear a necktie. The Japanese language is filled with layers of ceremony, but I avoid that as much as I can. I believe my mother may die soon, but I am completely opposed to funeral ceremonies and I don't want to go. I don't think my brothers and sisters feel the same way, and I'm expecting an unpleasant confrontation."

Abe's distaste for nationalism and its attendant ceremonies is rooted in the scenes and politics of his youth. He grew up in the ancient walled city of Mukden (or Shenyang) in Manchuria, which the Japanese had seized from China in 1931. He was fascinated by the Chinese quality of the town and was appalled by the behavior of the Japanese army during occupation. As a testament to his ambivalence about Japan, he changed his name from Kimifusa to the more Chinese rendering, Kobo.

Abe was in high school during the war and though he once said, "I longed to be a little fascist," he never accepted the perverse nationalism of his country in the '40s. When he heard of Japan's imminent defeat in late 1944, he was "overjoyed."

After completing his dubious medical school career, Abe wrote his first serious stories, including "Dendrocacalia" about a "Mr. Everyman" who turns into a plant. He married, and he and Machi moved from place to place. They lived in friends' homes and in a shack on a burned field.

Like many Japanese intellectuals of the postwar period, Abe joined the Communist Party. He was an active member from 1950 to 1956, but became disillusioned after a visit to Budapest just before the Hungarian uprising. Abe drifted away from the party until he was formally expelled in 1962.

Abe consistently says in interviews that he is opposed to "obsessive" nationalism and the growth of government interference in private lives. He plays no part in left-wing politics, and Mishima's right-wing politics made Abe feel his friend had sunk to "plain madness." Yet because of his communist affiliations, the U.S. State Department deals harshly with Abe. Like Graham Greene and Gabriel Garcia Marquez, he has "excludability" status under the 1952 McCarran-Walter act. If he is allowed a tourist visa, it is severely restricted. He must report his whereabouts at all times.

Abe does not belong to Japanese PEN and only came to the congress here because he was intrigued by the theme of "the imagination and the state." Some writers, Norman Mailer especially, proposed the idea last week that the state has an imagination, evil or kind. Abe sees the state and the imagination as constant opponents.

He told a panel he saw the juxtaposition of the two elements vividly while watching a television newscast of the Iraqi-Iranian war. Amid the wreckage, the camera spotted a charred copy of one of Dostoevski's novels.

"It had the same impact on me as if I had seen a copy of Kafka in an Israeli army camp," says Abe. "It expressed perfectly my dread of nationalism. Dostoevski, Kafka, these were writers who denied that sick sort of nationalism and particularism that has begun to rise not only in Iran, but in Japan and the United States."

Abe is revolted too by the obsession, especially in Japan, with one's national origins. At New Year's the Japanese make a special pilgrimage to the town of their birth, but Abe will have no part of that. He sees Nazi Germany as the manifestation of an emphasis on roots: "The Nazi persecution of urbanized Jewry was a corollary of Hitler's elevation of German peasant virtues. The peasants were tied to the soil. The Jews were not."

Rootlessness and loneliness are, for Abe, not sources of despair. They are the natural conditions and sources of hope.

Abe has come a long way since living in shacks and selling rice balls for a living. He has a passion for expensive machines -- Moog synthesizers, expensive sports cars, stereo equipment. For years, however, he was a traditionalist when it came to the equipment of his craft.

He wandered from room to room writing sentences on scraps of paper. He could not, for some reason, just erase a word and keep working on the same sheet. Instead the house would be as littered with leaves as a maple grove in late October. Eventually Abe's wife got into the habit of picking up her husband's scraps and ironing them out, for Abe has occasionally found valuable lines among his crumpled dross.

"You see, I think the fundamental attitude of a writer should be a stoic one," he says. "Rather than putting everything I know into a novel, I try to eliminate everything that is not indispensable. It is all a process of erasure, an expression only of the necessary, not of loose memories and thoughts. And it's important for me to make sure I have made all the right choices."

These days Abe has a somewhat more efficient writing system. One cannot imagine Kawabata or Mishima or their literary progeny making the same move:

"I use a word processor now," Abe says.