This is my only published short story, “Dress in White,” in Zyzzyva in the early 2000s. I read it again and many of the themes in it—the refugee experience, sexual identity, lack of Asian representation in the movies—still work today for me. There are references to CDs and VCRs, so it is dated. In a way, this piece was part of my mental health work, as I was trying to work through the trauma of the refugee experience and being a doctor in the AIDS epidemic.
Why this is “Reflections without Mirrors”
This is the post excerpt.
Life goes on and goes by. We often do not have the time, or take the time, to think what it is about. Or, what we are about. So people sometimes say, we should take a look in the mirror. But mirrors are themselves a fiction, pieces of glass with silver backing that supposedly show us ourselves, but do they? And is that the most important thing, to see ourselves? We are about what we do, what we create, what we love, what we stand for and what we stand against. I want to reflect not only myself, but also the world I live in and try to change.
The Endless Mirror Room – by Yayoi Kusama
Rise of the Cats
Last month, the city of San Jose broke ground on a building called the Vietnamese-American Service Center, to serve the community that is still living in downtown San Jose. That part of the city was where the few Vietnamese American refugees congregated in the 1970s after the end of the Vietnam War. As companies like Apple and Hewlett Packard build Silicon Valley at the same time, these refugees, living their second and sometimes third lives, rebuilt downtown San Jose.
My parents were a part of the rise of both Silicon Valley and downtown San Jose. My father worked as an assembler for Shugart Associates, a disk drive manufacturer, in the late 1970s and early 80s while my mother ran a small grocery store owned by her friend on 6th and Santa Clara, a dilapidated downtown area.
Sick of getting up early to work for little pay, my father went to a jeans store on Santa Clara and 5th and asked if it was for sale. With rudimentary English, he worked his way through the store owner and the bank until he found the building owner. With a little gold we brought from Vietnam and the savings from 5 years of working jobs like assembly and grocery stores, my parents put a down payment on that place. The price was ridiculously low by our current standards. My parents then started their own grocery store.
According to my father, the purchase made a big splash among the very small Vietnamese American business world in San Jose. Everyone was renting, but when they realized that a small fish like my parents were able to buy property, that changed the approach. The refugees started to buy properties, and Vietnamese American businesses quickly transformed that part of San Jose.
The boom lasted five years. The rise of Silicon Valley brought more investors, including Chinese investors who had a lot more money. The end of the small mom and pop Vietnamese grocery stores and downtown scene came the day a Chinese investor bought a supermarket on Tully Road in southeast San Jose and started Lion Plaza. Suddenly, the business center for the Vietnamese American community shifted there, where Little Saigon was formed.
The death blow for my parents’ dreams came when the city of San Jose decided to build its new city hall in the area that the Vietnamese Americans had revitalized. I recently found some papers from the lawyers who helped those businesses vainly fight back against eminent domain. The city claimed that the block where my parents’ store was would be turned into some kind of performing arts center. Instead, it became a parking lot across the street from the huge gleaming city hall run by mostly white politicians.
The performing arts center was never built, and the parking lot has been sold to a private developer for about 10 times what they paid my parents, to be turned into a giant condo building.
The story of how my parents coped with these changes is for another day. Suffice it to say, after being refugees twice in their lives, they learned how to land like cats and thrived even more. Like cats, my parents seemed to have nine lives until Death caught up with my Mom, on this day last year. The building of the new Vietnamese-American Service Center feels like a Phoenix rising from the ashes of the downtown scene that refugees built.
Fathers and Children
My first son was born on a late fall evening in New England. Outside the window, the sun was almost gone from the sky, but its presence remained in hues of red and orange. The river, from my view up high, was flat, a silvery highway cutting through the city. I had seen this sunset, this river, this city thousands of times. But that evening, my newborn eyes teared at the sight of the setting sun.
I thought my heart was a four-room house filled with love, for my parents, my wife, and my patients. The arrival of this other life blew that house outward. The windows that supposedly allowed me to feel the world but really served to keep people out were gone. I felt that the skin had been stripped from my body. The world became a dangerous place, and I knew that the rest of my life would be spent thinking about how to make it safe for my child.
That was when I began to understand my own father. All of the advice began to make sense as well as why he felt like he had to give them over and over again. The stories about how people died from doing every day thing like driving a car behind a truck were his lessons and anxiety relief. I remembered how I had always wanted him to treat me not as a child but an adult ever since I came to America. And for the first time, I wondered what it felt like to be separated from my child during wartime. To send him off to school in a strange new land with a strange new language to be teased by strange new kids. To stay up nights wondering how to support that child when one had no skills, knew no one, and did not speak the language.
Some people have so much empathy that they do not need shared experience to care. But many have to live through a trauma to see the human connection. Thus, cancer patients become cancer advocates. I found myself smiling at other people’s children. I could not read the news about any tragedy that afflicted a child. It got to the point where I was unable to fully appreciate the good things that happened to my children. When my son did well in school, I wondered what went on in the lives of the kids who struggled. When my daughter’s school held a school trip to Birmingham to study the civil rights movement, I thought about all the kids who went hungry during the summer when there was no school lunch.
This Father’s Day has been hard even though I have the greatest gifts a father can have, three healthy children and a loving father. Children are being separated from their fathers—at the border, through deportations, by the prison system, deployment in wars that kill fathers and children. In the philosophical conundrum of the shining city on a hill, the question was whether utopia was worth the suffering of one child locked away in a basement. A Father’s Day with millions of children suffering from hunger, poverty, and separation is not a celebratory occasion. All children should give their fathers the gift that their fathers gave them. Save the children.
Whether It Is the End of the World
This collage consists of a poem by Anna Akhmatova, a Russian, a song by Yo La Tengo, an American band, and pictures of Vietnamese refugees, as a representation of the end of the Vietnam War.
This land, although not my native land,
Will be remembered forever.
And the sea’s lightly iced,
Unsalty water.
The sand on the bottom is whiter than chalk,
The air is heady, like wine,
And the rosy body of the pines
Is naked in the sunset hour.
And the sunset itself on such waves of ether
That I just can’t comprehend
Whether it is the end of the day,
the end of the world,
Or the mystery of mysteries in me again.
Anna Akhmatova
The Unbearable Lightness of Being a Refugee
My life has been separated by a clear line—a childhood in wartime in Vietnam, an adulthood as a refugee in America. For many years, I have listened to stories, read books, and watched shows and movies about the war and what happened afterward. I think that many of these histories and stories are true. But to me, they are true in the way that a blind man’s description of the world based on what he can touch is true. I myself have no pretense of knowing the truths about something that costs millions their lives and weighs heavily on millions of survivors. I can only tell you what I have touched, and what has touched me. So here are some memories.
I remember a woman lying on top of a fresh mound of earth and weeping. And the boy whom I knew under that earth, put there by a bomb dropped by an American plane.
I remember as a child woken by the rumbling of Russian tanks over the paved streets of Ban Me Thuot in March 1975. I remember the piles of army uniforms left at the corner in front of my house. I remember watching the North Vietnamese soldier marching by, many barely older than I was. And how scary they were with the rocket launchers on their shoulders.
I remember my mother waking me up one morning and quietly hustling us to a car to escape. I remember asking her why my adopted older sister was not with us. My mother said that we would be back. It will be decades before she went back.
I remember that on the road from Ban Me Thuot to Nha Trang, I only carried the clothes I wore and the belts of gold around my waist and my ankles. Every single bridge was blown up, so we had to go down before we could climb up. My mother hired men to carry my younger brother. In the distance, dead paratroopers hung in trees.
We met my father in Saigon, and then looked for a way out. I remember crowds. At Tan Son Nhut airport. At the U.S. Embassy. At the docks. Along the way, we were separated from my father. My mother said, jump. The three of us ended up on a barge. It’s a floating piece of wood with sandbags around the side with no engine. We were tugged out to the ocean and left there. It rained. Grown men wept. My brother and I were hungry and thirsty. My mother had a look on her face that I did not understand until I was 33 years old, when my first child was born.
We were picked up by an American freighter. Within hours, we found my father among the thousands of people on the ship. I stopped worrying. My brother and I were hungry and thirsty. My parents brought some gold but no food.
The only memory I had about landing in Manila and being there was that someone gave us a piece of hot chicken before the ship docked. It was the best meal I ever had.
I remember living in Pennsylvania with a white family with 2 kids my age and another Vietnamese boy not my brother. White kids stole my Halloween candy. I failed a True/False test because I did not understand how there were only 2 answers to all the math questions.
I remember my mother disappearing for several months after we got the news that her mother had died in Vietnam.
I remember never seeing my parents during daytime after we moved to San Jose because they were at their Vietnamese grocery store 363 days a year. I remember doing the bank deposit after homework every night. Stacks of dollar bills and checks. And the biggest stacks of all, the food stamps.
I remember flying across the country to college and being surprised that everyone else was moving in with their parents. I remember standing in the balcony at a major meeting on the Vietnam War, ironically enough in the John F. Kennedy Center, and shouting at the panelists, all white men, “Where is the Vietnamese perspective in all of this?”
I remember sitting among Americans who said that the Vietnam War protests made them felt like they were making a difference. And I thought to myself, I’m so glad we helped you.
I remember taking care of Vietnamese American veterans who were dying from cancer and still smoked. One said, “I smoke because it reminds me of the men I fought with.” I understood, because by then I had learned about survivor guilt.
I remember a Vietnamese woman saying to me, “I had so many hardships to bring my son to this country, and he said to me, my life is so hard now, I wish I had never been born.”
I remember a college student who said to me, yes, I came over as a refugee without my father, who was shot and pushed off the boat by pirates in front of me.
I still have a fear of forests. I believe it comes from repeated admonitions by my parents when I was young in Vietnam not to wander off because of mines.
I watch leaders of our community urging us not to forget our roots and where we came from and not to ignore the sufferings and oppression of our people in Vietnam now. And some say now we should vote for people who oppress minorities, immigrants, the sick, and the poor.
I ask myself, what is the use of remembering our history, culture, language and suffering, when we will not use those memories to help people like us. Many Americans, including Vietnamese Americans, are poor, have health problems, and have families they want to bring here.
Here is my truth from what I have touched and what has touched me. I am special, just like all Vietnamese Americans are special, but I am not different, just like all Vietnamese Americans are not different from all the other people who suffer in the world.
And the burden of being a refugee? It gets lighter if we did not keep it to ourselves but share it with as many others as we can.
A Sanctuary is a Refuge
A Sanctuary is a Refuge
A sanctuary is a place where people can find safety from persecution for their families. In many countries, churches and temples have often served as sanctuaries against oppressive governments. This is because protecting other people from harm is a fundamental tenet of morality. As refugees, Vietnamese Americans know the value of a refuge. Most Vietnamese Americans are here because humanitarians in the U.S. government made America a safe place for us.
When the Trump Administration drastically increased ICE raids to round up undocumented immigrants, the state of California passed three laws, for humanitarian reasons:
- SB 54, the sanctuary law, prevents law enforcement officials in California from using public resources for immigration enforcement, such as detaining immigrants on behalf of ICE when immigrants are being released from jailor transferring them to federal custody except in narrow circumstances.
- AB 450, the workplace-raid law, prevents employers from collaborating with ICE agents during workplace raids by refusing access to nonpublic areas or records without a warrant.
- AB 103, the detention review law, requires the California Attorney General to review any detention facility conditions, requiring such facilities where immigrants are being held pending immigration hearings, removal, or unaccompanied minors, to maintain a standard of care.
Jeff Sessions, the U.S. Attorney General, has filed a lawsuit against these California laws. The Sessions lawsuit is unlikely to succeed because the Tenth Amendment of the U.S. Constitution protects states’ rights. A federal judge has ruled in favor of California’s position in a prior lawsuit. Nonetheless, cities such as Westminster have voted to support the Sessions lawsuit.
Disappointingly, two Vietnamese American Westminster city council members voted to support the lawsuit. This is despite the fact that many Vietnamese Americans had suffered greatly in Vietnam from oppression by the government and its security agents. Many Vietnamese American small businesses are at risk of disruptions to their business and possible loss of their employees. Most notably, many Vietnamese Americans are currently held in ICE detention centers with inhumane conditions, such as the Theo Lacy Facility in Orange County, where immigrants are often held in solitary confinement, forced to use moldy showers and eat spoiled food.
Some Vietnamese Americans justify the federal government’s position by stating that they came to the U.S. legally as refugees, not as undocumented immigrants. They have conveniently forgotten that in the 1980s, many of us lingered for years in the refugee camps because Americans were arguing whether we counted as political refugees or economic immigrants. Vietnamese refugees argued that our people be let into the U.S. for humanitarian reasons.
At the Westminster City Council meeting to discuss this vote, many Vietnamese Americans came to support the sanctuary laws but were prevented from speaking or even entering the meeting room. This is a tactic from the kind of authoritarian regimes that Vietnamese refugees seeked to escape. Disturbingly, many people who opposed the sanctuary laws revealed their racist side by telling Vietnamese Americans who supported the laws to go back to Vietnam. Sadly, the Vietnamese American City Council members chose to align themselves with these racists. The large turnout of young Vietnamese Americans in support of the law showed what these Council members stand for is not the future of our community.
As people who have benefited from humanitarian policies and as human beings, Vietnamese Americans are obligated to do the same for others. When the bullets were flying, the Communists were imprisoning, and the pirates were robbing, all we wanted was food, shelter, freedom, and safety for our families. What we wanted was a sanctuary, a refuge. That is all that undocumented immigrants want, too.
The United States of America
I have been thinking about what it means to be an American. We are clearly a divided country, and it is important for us to work together to sustain what, in my opinion, has been the most important social undertaking ever conducted. Can a country that arose out of revolution against oppression not regress into it? Can people of different races and ethnicities co-exist without killing each other? Can human beings truly have an equal society? Can we celebrate what makes each of us unique and yet maintain respect for or even support each other’s humanity? These questions have not been resolved. Really, they can never be resolved because such a society will have to be constantly evolving. But are we still trying?
I was both angered and saddened by Donald Trump’s recent statements about people from El Salvador, Haiti, and African countries. More importantly, his actions in ending DACA and now Temporary Protected Status for the Salvadorans, among other policies, show that this is not just talk. It is indisputable that Trump’s statements and actions come from an ugly place, full of racism, xenophobia, and elitism. Many of us–of all races, ethnicities, genders, class, and other identities—have always known that this place exists in America. It exists in geographic locations. It exists in institutions of power. It exists in the hearts of men and women. It even exists in the original Constitution of the United States, which denied full personhood and citizenship to all but white men of means.
As a physician, I have seen that stress of all kinds brings out the ugliness in all of us. I have seen good people hurt anyone under their power through words and through actions when they are stressed. People abuse children and elders. People commit acts of sexual abuse. People abuse themselves, through substance use and degradation of their self-esteem. I do not mean that these acts are justified, nor that people who do wrong should not be punished. I mean that we should expect people to do bad things sometimes when they are put under bad situations, and we should do all that we can to prevent those conditions. And one way to know good people is to see what they do, when things go badly, and one way to know bad people is to see what they do, when things are good.
Donald Trump is a bad person, because he has been given all of the advantages in life—being male, white, and wealthy—and yet, he chooses to believe the worst in people who are not like him and to abuse those under his power. People who are doing well and support Trump are bad people, for the same reason. But many of Trump supporters are suffering. Things are going badly for poor and middle-class white people, those living in rural areas, and those who have been left behind by the changing economy. As a healer, I do care for them, and I will continue to care for them no matter what their actions are. But my question for them is how they define the good in themselves. In a bad situation, do they care for others or do they abuse those who need their help? And I believe that everyone is capable of learning and changing. So, as they see for themselves how bad Trump and his wealthy supporters are, can those who have supported Trump in the past stop supporting him?
Because here is the fundamental problem. We can be united, if we are good and have good intentions. When the dividing line between good and evil has been drawn, such as in slavery, there is no union. Having lived through a war during my childhood, I know that we do not want actual wars. The leader of our government has in words and in deed declared war on the poor, minorities of all kinds, and immigrants. The duty of all good people in the United States of America is to resist him, peacefully but forcefully and with all of our hearts, minds, and actions.
SOAP Opera
I was the first person in my family to attend college, and so when I went to medical school, I had no one to tell me what to expect. What I did know, however, was the way some doctors treated people like my mother, a Vietnamese refugee. As a teenager, I often translated for her when she went to the doctor.
So, for the first 6 months of medical school, I prayed every night before I went to bed. Not to pass my classes, although in retrospect I should have, because it took me five years to get through medical school. No, I prayed that I would not lose myself while undergoing the training process.
One of the goals of medical training is to create clinical detachment. Through that process, the hope is that the trained physician knows how to separate the facts from everything else with the purpose of making the correct diagnosis and choosing the right treatment. Or, to put it another way, physicians need to separate the subjective from the objective.
One way that we are trained to do this is to write SOAP progress notes. As a medical student, I heard the phrase “SOAP” notes a few times before I knew what it stood for. Perhaps because English was not my first language, I thought that I was missing something important. Why were they telling me about soap? Was I supposed to wash my hands before I wrote my notes? Later, I found out that SOAP stands for “Subjective, Objective, Assessment, and Plan.” The “subjective” information, that came from the patients—what they told us. The “objective” consisted of the physical exam and the laboratory data. And even though I now know that the physical exam is fairly subjective, nonetheless, the objective information is the object of desire. I am not kidding. Read a typical physician note now, and it usually consists of a few sentences from the patient’s perspective and pages upon pages of lab results.
About 15 years ago, I met Mrs. S. I was in my mid 30s, married, and had a 3-year old at home. Mrs. S. was in her mid 70s. Tall, thin, gray hair, with lots of wrinkles. A Latina, she spoke English well, but with an accent that I found charming. At first, I did the usual things. Worked with her on her blood pressure. Got her to do the cancer screenings. As a primary care physicians, the work gets easier and more rewarding once I know the patients’ chronic conditions and how they approached their health and healthcare. This usually occur after about three or four visits over several years. I suspect this timing is one of the reasons why primary care specialties have trouble attracting medical students and residents. The hardest part of the relationship comes early, when one has to meet the patients, learn their history, figure out their knowledge, beliefs, and preferences, and understand what best motivates them to take care of their health. By the time our trainees get close to the good part, they have to leave their patients.
Mrs. S was easy. She did what we discussed. She came every 3 to 4 months regularly without any major surprises. For a primary care physician, the best visit begins with “no chief complaint”! There was one catch though. Every visit, she talked about her son. She had two, but only talked about one. He had died of pancreatic cancer in his late 40s. Mrs. S thought that he was misdiagnosed and blamed his doctor for not listening, for not picking up on the signs, for not doing the tests. It was hard for me to hear this without thinking that she was criticizing medicine in general, and me in particular. At first, I wanted to defend the doctor. Pancreatic cancer is hard to detect early, and often it did not matter anyway. Perhaps I also wanted to defend myself, because a similar case happened to me, and the patient’s wife never forgave me.
But then I would think about my own son. So, I said nothing except that I was sorry. Mrs. S would go on for about 5 minutes, and then we would say good-bye until the next time. The first few times, I did not write down in the note what she said about her son. Eventually, in my objective assessment, I wrote that perhaps her grieving had gone on too long, that perhaps I should think about her mood and the possibility of depression. At the following visit, I asked her about her mood. Whether she ever thought about anything else besides her son. That I was worried, that she was staying at home alone and not going out. She looked at me as if I were stupid. What do I need to go out for? I am happy, she said. I said, you don’t seem like you are. Oh, I am, she said. Especially when I sit in my living room and play my operas on the stereo.
I was taken aback. Opera? It was not something I associated with her. I did not know much about operas. Unlike in America, where opera seemed to be a taste of the upper class, only hicks listened to old-style Vietnamese operas where I came from. And in America, the only operas I ever saw were soap operas on TV. The Young and the Restless. General Hospital. Over the course of several years, Mrs. S told me about opera plots, or particular arias that she really liked. By then, I had 3 kids all under 8. I barely had time to think, much less listen to music. I wish that I had written these conversations in my notes, and it does not matter if they were in the subjective or objective sections. Because I would like to go back and listen to the arias that she liked.
This story ends more or less like all medical stories end. I received a call from the admitting resident one winter. Mrs. S was admitted for pneumonia. During the evaluation, he found she had widespread lung cancer. I thought, what did I miss? She had no symptoms for me to evaluate her lungs. No reason to screen for lung cancer. Still filled with doubts and regrets, I went to see her in the ICU. She was intubated. Definitely not what she ever wanted. She had said to me that death was nothing to her. She said I’m not afraid of it. I will get to see my son.
I set up a meeting with her remaining son. I knew it was going to be hard, it always was when it was someone’s mother. I explained to him the clinical situation. And told him that Mrs. S said she never wanted to be on machines. And he agreed, that was what she told him too.
I thought, this is going rather well. He asked me, what should we do? And I wanted to say, based on what I know about your mother, she would want us to turn off the machine. And as I was saying that, I had a vision. Of Mrs. S. sitting on a sofa. An aria was playing, I couldn’t tell which one. Everything was dark, except for her wrinkled face. And what came out of my mouth were the words that I wanted to say, but I also heard crying. It came from me. Then I had an out of body experience. I was standing there watching myself and thinking, this is rather unprofessional. What must the son think, when his mother’s doctor is bawling? How does he have any confidence in you? Does this crying mean that your prayers not to lose yourself were fulfilled or a sign that you have failed to be a good doctor?
I think about Mrs. S. Sometimes when I chart, I listen to an aria. Even though I don’t understand the words, the music makes me kinder when I write my assessment. And whenever I write or read SOAP notes or go to San Francisco General Hospital, a part of my brain thinks “General Hospital is a SOAP opera”. I no longer think that the objective is the objective. For me, the subjective is the objective. The goal is to get the patient’s story. Oh, and one more thing I am thankful for that Mrs. S gave me. That it is o.k. to cry, even if you are a doctor. After all, tears are often a part of operas, soap and otherwise.
Reflections without Mirrors 