Fijian Oldies

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.

Andrew Kim, MD, MPhil

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.