Fijian Oldies

Dr. Andrew Kim shares a deeply moving story of unspoken reconciliation between a patient and his estranged mother. As they navigate the complexities of family estrangement, Dr. Kim reflects on the powerful moments of connection and forgiveness that transcend words. Join us as we explore the themes of love, acceptance, and the healing power of presence in the face of life's most challenging circumstances. 

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Transcript

Prelude

Andrew Kim (00:00)

The embrace was short, it couldn't have been more than 5 or 10 seconds. We didn't exchange any words again, but there was within that embrace this implicit acknowledgement, this silent and deep knowing that the answer to that question, no, we were not too late.

Show Introduction

Nate Houchens (00:44)

Hi and welcome to Boundless Moments, the storytelling podcast that brings sacred moments to life through the voices of those who lived them. I'm Nathan Houchens. Support for Boundless Moments comes from the Sacred Moments Initiative. 

At Boundless Moments, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality.

All views expressed are those of the person speaking and not their employer.

Some stories featured on Boundless Moments may contain themes or content that could be upsetting for some listeners. We encourage you to use discretion and take care of yourself while listening.

Introduction: Andrew Kim

Nate Houchens (01:28)

Andrew Ikhyun Kim (he/they) is a physician, peacebuilder, and chaplain-in-training at Upaya Zen Center who is planting the seeds for his dreams of creating a nature-based hospice. He was the director of policy in the UCSF Center for Global Health Diplomacy, where he coordinated global health policy engagements for the UN High Level Meetings on Tuberculosis, and he served as the co-secretariat for the Lancet Commission on TB. Prior to that he served as a White House Fellow at the Office of Management and Budget and the White House COVID-19 Response Team. He earned his Medical Doctorate from Harvard Medical School, his Master of Philosophy in International Development at the University of Cambridge, and Bachelor of Arts from Brown University. As an integral balance to his professional work, Andrew enjoys thru-hiking, trail running, volunteering as an adaptive ski instructor for skiers with disabilities, and exploring mysticalcontemplative traditions across world religions.

Introduction: Fijian Oldies

Nate Houchens (02:37)

Here Dr. Kim shares a deeply moving story of unspoken reconciliation between a patient and his estranged mother. As they navigate the complexities of family estrangement, Dr. Kim reflects on the powerful moments of connection and forgiveness that transcend words. Join us as we explore the themes of love, acceptance, and the healing power of presence in the face of life's most challenging circumstances.

The Story: Fijian Oldies

Andrew Kim (03:19)

When I was an intern during my residency at the San Francisco General Hospital, I cared for a young man from the Pacific Islands who had moved to San Francisco back in his late 20s because he was estranged from his family for his sexuality. And it was one of those encounters where I saw reflected back to me in someone I was caring for so much similarity with my own circumstance that there was almost this bond. ⁓ Immediate bond of, wow, this could be my life. And ⁓ he had moved to the Bay Area in his late 20s. ⁓ He had come out to his parents, been rejected, completely estranged, flew over, knew nobody ⁓ in San Francisco, but had been embraced by a beautiful community. I met him when he was in his mid 30s, about the same age as me at the time.

And I met him in the intensive care unit where he was being treated for brain complications of an opportunistic infection from his HIV/AIDS. I had not personally come out to my parents yet at that time for my own, about my own gender and sexuality. And hearing his story of being a young Asian man who was rejected by his family for his identity and sexuality really stirred something, deep fear within me. 

But over the next few days, we ended up becoming quite close. I spent a lot of time in his room. I learned that he loved Fijian oldies, which I did not even know was a genre. He played them on his guitar and ukulele, and he missed the islands. He hadn't gone back since he had left. 

I remember I once asked him if he wanted, if he missed his family and wanted to go back and wanted to see them again, and his usually bright figure kind of dampened a little bit. He turned his gaze downward and shrugged a shy yes, but he said he wouldn't really know what to say to them right now. 

Over the next several days, his prognosis grew worse and the brain infections started to cause seizures and a lot of confusion. And the previously really talkative and smiling young man ended up growing more and more confused, sleeping more and more each day. And we were afraid that we were coming to his last few days. 

Somehow our social worker at the county hospital ended up getting in touch with his mother back on the islands and was working in the background on somehow getting her flown into San Francisco. But only 18 or so hours before his mother's arrival to San Francisco into the hospital, this young man lost consciousness. And I remember when his mother arrived to the San Francisco General to the Intensive Care Unit, she walked into her son's room, saw her comatose son, and there was almost no expression on her face. She softly approached him, put her hand on his hand and then suddenly she just wept. She knelt over him and wept.

I remember giving them some space and then softly approaching his mother and placing my hand on her shoulder. We didn't really speak many words, but I could sense within both of our hearts this deep and heavy burden. And internally, this question of “were we too late?” If she had just arrived a day before, if he had stayed awake even just a day longer, could there have been some sort of reconciliation moment, a moment of forgiveness?

I stepped out eventually to give them some one-on-one time and give her some time to process. And I felt heavy. I wondered if I were to have this happen with my own family, what would this be like? And I wondered why, you know, why did she finally get to see her son after almost a decade, but only to find him comatose? I was even half expecting when she knelt over him and started weeping that there would be some sort of grand religious spiritual moment or some sort of miracle. Like his vital signs would change, like in the movies, or he would blink his eyes open or he would twitch his hand.

But there really was nothing. It was just her in the room with her son, no longer conscious, and her weeping over the son she has always loved. And over the next two or so days, we transitioned towards a more comfort-focused approach to his care. We kept him as comfortable as possible. We played on a little Bluetooth speaker some of his favorite Fijiian oldies that his mother had mentioned and brought in.

And he passed. I was called in to pronounce his death. I gave his mother a hug. And it was one of those rare times in my medical training and in my medical career so far where I felt like time stopped. The embrace was short, it couldn't have been more than five or 10 seconds. And we didn't exchange any words again, but there was within that embrace this implicit acknowledgement, this silent and deep knowing that the answer to that question, no, we were not too late. That somehow in her arriving there 18 hours after he went comatose… the very fact of her arriving, of her being able to hold her son's hand. That in that very act, there was a deep love and forgiveness and reconciliation that was beyond words.

She didn't stay long. And I never saw her again. She flew back to the islands. And I went on with my training.

Since then, a few years later, I've since come out to my parents and I still go through different difficulties around my identity with my family, with many of my spiritual communities, many of my traditional Korean communities. 

I still think back to this moment, just that embrace and this knowing that even if there isn't some sort of Hollywood movie resolution, even if there are no neat moments of, oh deep acceptance that comes in words, that there's never a too late. And that in the very imperfect way in which our differences with our family and our loved ones gets played out, in whatever incompleteness there is, that that contains within it, somehow, the seeds of a resolution that comes in this lifetime or the next, in words or in silence.

Yeah, that's a sacred moment in medicine that I'll continue to cherish in my life.

Interview

Nate Houchens (12:40)

I’m here with Dr. Andrew Kim, who just relayed this powerful story of unspoken reconciliation between his patient and his mother and the relationships that often mirror our lives as we're taking care of people. Thank you, Andrew, for sharing that story with us. 

I wonder if you could start by sharing what you recall about the patient, what struck you most. Not just about his medical condition, about what you were treating and helping to improve about his health, but about his presence, about his spirit.

Andrew Kim (13:22)

You know, in some ways he reminded me of some of my own family members in this just completely easygoing and bright and optimistic countenance, even while he was, you know, he had in his MRI, you could see these large cavitations, these holes in his brain from this infection. And he was clearly suffering. And he hadn't had an easy life, even though he was embraced by the gay community in San Francisco upon arrival, you know, he went through financial suffering. He went through many periods of being unhoused, going through his AIDS diagnosis and the challenges of treatment and stigma around that.

And a lot of the patients I treated at the county hospital, because of those similar experiences, would have a certain sort of almost gruffness or jadedness or a cynicism about life. Life is there to, I don't know, screw us over or to get us, right? But this young man, I don't know, maybe it was his couple decades of growing up in the islands and having that sort of easygoing nature, but he would always have a smile, always say, how are you doc? You know, when we walked in and yeah, up until he was starting to have seizures and getting confused, he was always this bright and positive self.

Nate Houchens (15:03)

I'm struck by how the people with the most adversity so often are the ones with the most uplifting, warm, generous, positive spirits. When I meet them in some of the worst moments of their lives, that positivity and that kindness really shine through despite the challenges that they face.

Andrew Kim (15:26)

Yes.

Nate Houchens (15:29)

I'm going to credit the strings. The ukulele, the guitar. I think that is, there's just something about that that is life-giving. Stringed instruments. 

You described feeling a deep sense of kinship, if I'll use the term. In what ways did his story mirror parts of your own that you hadn't fully faced?

Andrew Kim (15:55)

Yeah, I mean, certainly we come from different cultures, the Pacific Islands versus East Asia. I come from Korea. I think there are some stark differences. And of course, the life paths that we had and the privilege that I had of being a physician in training at the time. But even, you know, even having grown up in Korea and then come to the United States and being received by new friends, by a strange community, and being fully accepted for certain ways of being, not just my gender and sexuality. I'm pansexual and genderqueer. This young man was cisgender and gay. And yet these… Back in our own home cultures, there was either outright rejection or just sometimes a complete not understanding of what that even is, right? And then to come to a new place, a new country where we know very few people and suddenly with strangers, we could be fully ourselves and fully accepted, right? And not just even fully accepted, but fully celebrated.

I remember going to a Department of Medicine holiday party at UCSF, the University of California San Francisco, in a dress. And I was so nervous going there because I thought if I did this in Korea, it would be complete and utter rejection. And our chair of medicine came up to me and just was, you know it was like, you look beautiful tonight. Gave me a hug, and we just talked about something that we had talked about the week before. Seeing many professors, seeing friends who had just unconditional acceptance was so healing for me. And I know that this young man had found that kind of community in the Bay Area as well. 

And so this kind of tension between finding love and acceptance in a new culture but also having these familial roots and this loyalty and the dissonance that causes, especially when there's estrangement or separation or distance. I think that really resonated in both of our experiences.

Nate Houchens (18:34)

Having some version of belonging sounds so light. And by light, I mean not just brightness, but also the lifting of weight, I would imagine. Having that acceptance sounds like it's very light.

Andrew Kim (18:56)

Yeah, yes.

Nate Houchens (19:20)

I wanna stay with that theme for just a moment. Because of the rejection that you may have experienced in your own life and perhaps in your patient’s experiences, tell me about that moment when you asked him if he wanted to see his family again. First of all, what gave you the courage to kind of ask that? And second of all, what did his response, that kind of quiet, a little bit reserved, yes, stir in you?

Andrew Kim (19:55)

I’m not sure if courage was what was required for me, but rather just discernment. I'm currently training as a Buddhist chaplain and there's these teachings of the five gates of speech. And they're questions we ask ourselves before we speak any words. Is it true? Is it kind? Is it beneficial? Is it the right time? And is it skillful?

And by that time, I had known him several days and spent quite a bit of time in his room. And I felt like there was this trust that I could ask him anything and he wouldn't take offense. He wouldn't think I was crossing boundaries. I think there was a sense of, ok, we know each other and we trust each other. And there was this also at the same time, this sense of urgency with the progression of his infection in his brain.

And even though I didn't know much medically at the time and there's still so much for me to learn about the condition he had, he could tell that he didn't have that much time left. And so it was almost this sense of, if we want to try for some sort of reconnection with the family, we have to know now in order for this to happen. And it just felt right. It felt like the right moment. You know, those times in the conversation where there's suddenly a soft pause and something comes over us and we know to ask, this is the right time. I think that's what came.

Nate Houchens (21:33)

I love how you describe that. I am thinking of all of the times when I myself have been distracted or burdened with other thoughts or feelings or whatever else is going on in my own life. And I have to imagine that so many of those soft pauses and opportunities to explore those connections further… I wonder how many I've let pass me by. 

And I am so appreciative of the way that people describe and people embrace these opportunities to perhaps delve into topics that… both are needed, of course, but also that might be challenging in one way or another.

Andrew Kim (22:26)

Yes. And it's so hard to, even when we notice those soft pauses, or even when they occur, the state in which we enter the space affects so much our ability to attune to those pauses or to respond to those pauses, right? And I feel like so much of the high pace of medicine, the fast pace, makes it such that even when we notice it, there's this... If we know that there's four other patients to round on next, it's hard to pick up on those and respond to those pauses. And that's been something that I question is, do we allow and cultivate that kind of opportunity for connection the way we've designed so many of our systems?

Nate Houchens (23:16)

I'll have to learn more from you about the ways in which to ask questions effectively. As someone who's just starting out in the podcast world… boy, that would be wonderful. Your tips and tricks. 

I want to talk a little bit more about after the patient's mother arrived. 

I can't say enough great things about the amazing work that social workers do in our teams, in the health care system in general. They are often relied on so much to be the liaison between other members of the medical team and patients and their families. And they just do incredible work. 

So that social worker who eventually got in contact with the patient's mother and coordinated sort of her visit. Tell me more about that. You mentioned you half expected this sort of cinematic awakening, this sort of moment that never came. I would love to know what roller coaster, what sort of evolution of emotions, if any, did you sort of experience when you half expected this cinematic moment to occur and it didn't?

Andrew Kim (24:33)

Yeah, I think that was my ego coming in. There were other patients I've had where, at the moment of death, right, or as one of my palliative care mentors says, when death makes the slightest approach, all pettiness falls away. I've seen these, by that time, I'd seen a few stories and patient cases where long estranged family members would come back and there would be reconciliation because of a terminal cancer diagnosis or because their loved one was close to death. My ego was wanting that so badly for this young man. Not just for the young man, but in some ways for us too, right? As the medical team, for the social worker who put in hours of work trying to like hunt down people in the Pacific, you know, like, make calls to different agencies in the Pacific Islands to figure out how do we do this, how do we get the flights over for the medical team too, right? This man had charmed all of us, the nurses, the doctors, the CNAs, and we wanted something beautiful for him. And for me, it was this ego of, oh, I have this conception from my past experiences from these other patient cases of what a beautiful reconciliation looks like, and I want that for this situation. Rather than this coming into this situation, this scenario with a sense of not knowing or a sense of mystery or a sense of openness of, I wonder what might happen here. I wonder what might be possible here. And just being fully present for that. So that disappointment, that roller coaster that you mentioned of, oh I want this cinematic reconciliation and it not coming. I think that was just my internal work not yet done.

Nate Houchens (26:32)

I think so often, and I can speak personally, we want to steer the course of events. We want to have it the way we think others want it. And we think the way it should be. This is the way it should be. This should not have happened. And I think so often that that mind frame, that approach just feels limiting when it doesn't unfold in the ways that we hope or expect.

Andrew Kim (27:02)

Mmhmm. And that mind frame can steal the sacredness of the moment. If I had stayed in that attachment to that particular form of reconciliation and outcome, that last hug that I shared with his mother and the sacredness of that moment could not have arisen.

Nate Houchens (27:21)

Right, it will just be diluted. It will be, it will pass you by, for lack of a better term.

Andrew Kim (27:27)

Yes.

Nate Houchens (27:49)

I'm reflecting on your words about, were we too late and exchanging through that unspoken embrace with the patient's mother, this silent and deep knowing that we were not too late. There is no such thing as too late when it comes to love and reconciliation.

I don't even know if I have a specific question about that. I just wanted to underscore it again, because it is again, maybe not expected, but certainly sacred in its own way. And what a, I would imagine, what a privilege to be able to bear witness to.

Andrew Kim (28:35)

Yeah, really a privilege. And a lesson for my own life, right? Because I think as doctors or chaplains or whatever other professions where we are facing the sort of suffering and drama of life on a regular basis, there can be a sense of, oh of course it is that way, right? Like it's easier to apply these teachings of our wisdom traditions when it's not our own lives and it's our professional calling, but then reflecting it back to my own life. And even with my own family, with our own families, without going into details to protect privacy, I think there are many situations in the family where someone passes away without that sort of reconciliation. And from the outside, there can be this sense of despondency of what a shame that this could not happen before they died. But the fact is that healing, whether we're physicalists or whether we believe in a spiritual realm or whatnot, healing can occur after the fact too. And that is this work that many of our mental health providers, psychologists, spiritual healers do of intergenerational healing. Even if the unreconciled and unhealed traumas and wounds of past generations were not healed by them, that it can be done by subsequent generations. Even if there is not a pure knowledge of the details or the experiences, that the healing can continue to occur in some manner. Whether we believe that on a spiritual level or on the level of, you know, methylation of DNA, it happens.

Nate Houchens (30:32)

What a comforting thought. One of my final questions will be about how you think about this patient and his family when you are approaching or grappling with your own communities and your own lived experience.

Andrew Kim (30:51)

I'm not a parent yet, and I hope to be. But as a child, that patient's mother gave me such a deep appreciation for what a mother's love, for what a parent's love looks like. I don't know her story, right? I knew her son's story to some extent, but her story I have no idea, right? And I don't know what generations of indoctrination or whatever, what other things were getting in the way of her reaching out to her son during those years of estrangement. 

And yet for her to come across such distances, across the oceans, right? But also not just the oceans of physical distance, but the oceans of emotional distance, the oceans of possibly shame or guilt or the sense of regret. And to just reach out across all of that, to be with her son, her beloved son in the last moments… It gives me a sense of thankfulness and awe at the parents' love. And no matter where I am with my own family, to have that deep appreciation for my mother, my father, my grandmother.

Nate Houchens (32:17)

And that this kind of love can exist between others outside of a parent-child relationship. This kind of love can be seen in all sorts of relationships. 

Andrew, I just want to thank you for sharing so much of yourself, for so much of your patient and their family's stories. It has been an honor to learn from you and to talk with you today. Thank you.

Andrew Kim (32:47)

Thanks, Nate. Appreciate you holding the space and for your beautiful, thoughtful questions.

Nate Houchens (32:54)

Always. I'd love to know more about how to ask them. We’ll be in touch. We'll be in touch for sure. Be well, Andrew.

Andrew Kim (33:03)

Thank you.

Postlude

Nate Houchens (33:17)

We would love for you to be a part of this movement, and we would be honored to hear your story. If you have experienced a moment of grace, connection, or empathy that changed you, we invite you to submit it for consideration to be shared on Boundless Moments by sharing, you not only contribute to a collective celebration of human connection, you may also inspire others to recognize and cherish the sacred moments in their own lives. To discover more about sacred moments and to share your own story, please visit sacredmomentsinitiative.org.

This episode of boundless moments was produced, edited, and mixed by Nathan Houchens. Our program manager is Jessica Ameling, and our publishing and social media manager is Rachel Ehrlinger. Our podcast is made possible by the Sacred Moments Initiative, a humanistic project whose aim is to study, catalog, and share sacred moments. Learn more at sacredmomentsinitiative.org. Boundless Moments is also made possible by donations from listeners like you. Thank you so much for supporting our work in sharing sacred moment stories. If you enjoyed this episode, please subscribe to the show wherever you get your podcasts and drop us a rating or review to help others connect with us. I'm your host, Nathan Houchens. Thank you for joining and until next time, be well.