The Way Home

&quotSide By Side,&quot Emily Malec, Daegu.

By Bijou Nguyen ETA ’14-’15 / Photograph by Emily Malec

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How do you return home if home is an ocean, language, and world away?

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I met Mrs. Lee in my third year of medical school, three years out from my time living as a Fulbright English Teaching Assistant in Korea. I’ve met a lot of different patients during my clinical year, but Mrs. Lee is one of those patients I will never forget. Mrs. Lee was small and stout with disheveled hair, white peppered with grey. Her skin was both soft and wrinkled like fragile parchment paper. Her face was like a dried persimmon, creased and wise with years of experience. Her eyes formed tiny crescent moons, and there were only two teeth teetering in her mouth. She was one hundred years old and had called the ambulance because she was having trouble breathing. She was one hundred years old, and her seventy-year old niece could no longer care for her. Mrs. Lee said she was sorry she had called the ambulance, but that she was scared. She had no wish to be resuscitated or for us to do anything for her really because she felt like she had lived on this earth long enough.

At our low-income, inner-city county hospital, patients were often admitted because they did not have a place to go. Mrs. Lee may have had a touch of heart failure, but her labs were nearly pristine. She did not have a medical reason to be placed in our hospital, but was completely bed-bound, and did not have a place to go. Her niece had cared for her many, many years but was unable to pick up her aunt when Mrs. Lee would fall out of bed.

With my limited Korean, I visited Mrs. Lee in the mornings and checked in on her. I asked her the basic orientation questions: “What is your name? Where are you? Why are you here? Who is the president?” Mrs. Lee would reply correctly to all of them, with the exception of answering President Moon Jae-In, rather than the American one.

She would sit in the hospital bed, smiling gently, and appearing quite out of place. In a place where patients had IVs and chest tubes and ventilators, Mrs. Lee did not need anything medically. She would sit in the hospital bed, snacking on the tteok her niece would bring for her, her hand clasped to her radio that played familiar Korean songs. She would tell me, “Be careful. Don’t walk too fast or you’ll fall down.” During my time in Korea, I learned about the concept of jeong, an inherent closeness and connection that Korean people often develop toward strangers and loved ones alike. I feel that I was able to experience jeong with Mrs. Lee. Though our interactions were somewhat limited by language and time, I also felt a strange closeness between us I could not quite put into words.

Mrs. Lee, because of her kind and grateful personality, became a very beloved patient on the list. In the midst of rounding as we talked about patients who refused dialysis for their kidney failure or refused labs, Mrs. Lee was a patient who made every member of the team smile.

One day I came in and found Mrs. Lee shifting in bed with her head nearly off the rail. Her sitter said she hadn’t been able to calm Mrs. Lee. Mrs. Lee mumbled incoherently, and looked– for the first time that I had seen her in the hospital–very sad. When I asked where she was, she told me she was home. I corrected her, telling her she was in the hospital, but she continued to say (home) longingly.

Worried, I called a phone translator to ask her, “Where are you going?”

“I’m trying to get home, but I don’t know how,” the interpreter translated, and something physically hurt in my chest.

I ached, for Mrs. Lee was indeed thousands of miles away from the place she called her home. She was in a place she didn’t know, away from her family members. Her typical meals were oatmeal, green jello, a ripe banana, mashed potatoes—the hospital’s mechanical soft diet, a sorry excuse for her usual sticky grains of white jasmine rice and ripe kimchi. Having spent a year in Korea myself, I remembered so viscerally the beauty of the country, the respect shown towards elders, the smell of cherry blossoms in the spring. The plain hospital room blaring a TV in a language that Mrs. Lee could not understand suddenly felt so limiting, so small.

In the days to come, Mrs. Lee grew increasingly confused. At times she thought she was in Daegu, back in her familiar hometown in Korea. Other times, she fell out of bed or wound up upside down, trying her hardest to go home. A yellow “FALL RISK” band was eventually placed onto her arm, and my chest couldn’t help but ache for the impossibility of ending up back where she wanted–no needed–to be regardless of how much she struggled.

The medical term for this condition is delirium– the waxing and waning of attention in conjunction with intermittent confusion. Untreated, it increases the likelihood of mortality. My team addressed Mrs. Lee’s symptoms with the so-called delirium precautions: lights on, windows open during the day to discourage sleeping during the day. Frequent re-orientation. Encourage visits from family members. Provide a one-on-one sitter. However, being awake more frequently during regular hours only would make the time alone in the hospital that much more isolating, as there was limited staff–let alone Korean-speaking staff–to interact with her.

Working with Mrs. Lee reminded me of my life in Korea three years ago which now feels like a lifetime ago. At times, I miss Korea so much that I dream of it. For a period of time during my first year back, I would wake up from a dream about Korea with tears on my face, without quite understanding why. I miss nodding my head in greeting, extending both hands to receive something, eating 김밥 (kimbap rolls) with my friends. Other times, Korea is like the pages of an old book that have been soaked in water—filmy and blurry in front of me. I remember not knowing how to communicate. I remember trying to find pieces of my home in a place that I was trying to make my home. I remember first coming back to America and feeling like I had lost something very precious, something very dear, that others could not understand.

In Korea, (though I look back on the time fondly now), I often felt alone, like a stranger in an unfamiliar place. I looked Korean, but I was not. I didn’t speak the language as well as I wanted to, and I was constantly reminded of how “other” I was. I can’t pretend to know how Mrs. Lee felt, but I wonder if we shared similar feelings.

When I went into medicine, I wanted to help people reclaim their lives. I wanted to help them find the best way to live. I didn’t realize that sometimes, in medicine, it’s about helping people move on. Sometimes the hospital is a transition place. It’s about helping people die.

I wish I had a good answer for what happened to Mrs. Lee because in all honesty, I don’t know. I ended my time on Internal Medicine, when I next checked her chart, she had been placed at a skilled nursing facility. I imagine, if she has moved on, her last days were hard. She shared with me her fears about going to a place where the caretakers would not be able to speak Korean, where she would spend the rest of her days alone. In medicine, our straightforward goal is often treatment, and with Mrs. Lee, the ending wasn’t necessarily happy. I’m not sure that she found the peace that my team was hoping she would achieve. There was an inherent calm in Mrs. Lee, in her steadfast approach and acceptance of death. There was something beautiful yet so sad in her knowledge that though she was surrounded by caretakers, she was very much alone.

I still remember her gentle smile, her resilience, her spirit. Meeting Mrs. Lee brought back memories from my time in Korea that I had unknowingly tucked away in the creases of my heart, making me long for the past in a way I never expected. Mrs. Lee came to me in a place where I had so little time to think about anything other than the road ahead, not to mention feelings and longings from before. In my interactions with her, I found a beautiful duality of patient and provider coming together through threads linked by the same culture, country, home–although in completely different timelines. In imagining a happy ending for Mrs. Lee, I still don’t know if it was my way of creating a happy ending for her. Or perhaps, something that is more for me.




Bijou Nguyen was a 2014-2015 ETA at Janggi Elementary School and Uirang Elementary School in Sejong-si.

 

*Patient’s name has been changed for privacy reasons