My aunt, my mother (1942–2016)
My aunt was an intensely private woman. She did not want a funeral. There was to be no memorial service. Even a tombstone was out of the question. At the end of her life, she had only two desires. She wanted to meet her Lord and for all of us to grow closer as a family.
On the day she died, I felt the world lose a symbol of love and selflessness. For those friends and family fortunate enough to have known her, she will continue to live on in their memories. For me, this written account will be my memorial for her and a reminder for how to live a life with integrity. For everyone else, I hope to provide a glimpse into her life, the final days I spent with her, and the way she epitomized those virtues so rarely found in our society today.
This is my aunt.
No. Rather, this is my mother.
“Dagu,” as we called her in Chinese, was born in 1942. She was only one year older than my father and growing up they were siblings that looked out for one another while their single mother was busy working to put food on the table. Their adolescence, like many other children in Taiwan, was marked with days of school, play, and going to church. Although my father was the more studious one, Dagu sure knew how to play.
After my father immigrated to the United States for his graduate studies, Dagu decided to come along as well. Even when they were well into adulthood they stuck together and looked out for each other. Dagu was raising her own daughter (my cousin) as a single mother and when my father got married, he and my mother looked after my cousin as if she was their own daughter.
Eventually Dagu moved to Maryland (where many of her friends were living) while my family stayed in the Bay Area. However, a few years after I was born my mother was struck ill with breast cancer. Dagu had decided to come home to help take care of my mother and it was under these circumstances that she promised my mother that she would look after me and my brother. Despite having established her own life elsewhere for many years, Dagu never questioned what her priorities were. She respected my mother to such a degree that she knew what she was going to do: she was going to quit her job, sell her house, and move back to be with us.
I was six years old when my mother died. My brother was ten years old. It was not until only after I had grown up that I began to understand what Dagu sacrificed in order to raise us as her own children. She may not have seen it this way, but I know that with her own daughter already having graduated from college, she was placing an enormous responsibility on herself to begin raising two children all over again. None of this was made easier by the fact that my own father was traveling for his job much of the year. Dagu took us to school and to extracurricular activities. She cooked meals for us. She stayed with us during those nights when there was no one but me and my brother. I do not know how much stress she faced during those times, but if she was stressed, she did not let it show.
It is easy in retrospect to make sense of those life-changing events and to form a coherent narrative out of them. However, when I was growing up, I was the typical ignorant child, driven by compulsion and selfish interests, and these symptoms of immaturity blinded me from seeing the sacrifices Dagu made. Whenever our family faced a bump in the road, she was there alongside us to absorb the impact. Whenever things were going well, she kept our heads screwed on our shoulders in a way only a mother could.
Much time has passed since those days and I admit the details of my upbringing by her appear now like stars veiled by the nighttime fog. But they are there and they will continue to shine in the years ahead.
Roughly three years ago, I had returned home after a seven year layover in the land of young adulthood. I was 25 years old, ready to begin my medical studies, and yet to be honest, I was ambivalent about my return. In my mind, I was confined to an all-too-familiar city at an age where the world was supposed to be my ‘oyster’ (Do people actually still say this or I am getting old here?). My hometown seemed utterly pale in comparison to the novelty proffered by foreign lands.
Why did I come back home? What is my true purpose here?
On a superficial level, I appreciated the proximity of my parents and Dagu because it allowed me to spend more time with them. I was also the only son or daughter nearby and therefore felt the obligation to see them more often. However, this was all an implied understanding that still allowed me to go on searching for a purpose that revolved around my interests.
And then one year ago, everything changed.
It started with her loss of appetite. Then her weight loss. In medical school, you are taught to instantly recognize these symptoms as a red siren for the big ‘C’ word. Cancer. While the symptoms can arise from any number of causes, physicians are instilled with the habit of always keeping cancer on their differential diagnosis. I remember spending many a days with other medical students dreary from reciting cancer as a potential cause for whatever symptom we were interpreting that day. And now here I sat in the doctor’s office with Dagu nervously waiting to hear the physician confirm that most dreaded of maladies: metastatic pancreatic cancer.
“I’m not afraid of dying,” Dagu said without skipping a beat. That was her first response to her physician. Perhaps we had all prepared to be delivered this news ahead of time and therefore went in with a level of composure. However, she still impressed me. She clearly wanted the physician to understand her resolve. Her faith and ultimately her devotion to God had prepared her for this moment.
I wish I could claim to have been equally stoic when all of this happened. But as I took her to more and more hospital appointments, I became saddened by what I felt to be the unfortunate timing of her disease’s arrival. She had only retired from her career few years prior and was just beginning to adjust to retirement life. She had kept busy volunteering for her community, spending time with decades-old friends, and traveling the world when she had the time to do so. There was still so much to look forward to. But she trusted the Lord and gave herself to His plan. Whatever He had in store for her, she gladly accepted. It was this example she set that helped me understand why I also ended up returning home. I did not return home to pursue my own agenda. I was sent home to be by her side.
Dignity and Conviction
Pancreatic cancer leaves many patients in a state of confusion. No definitive cure exists and yet patients are expected to carry on with their lives until the inevitable occurs. Physicians are also loathe to spend too much time detailing the survival rates — every patient is different. The long tail of survival can extend to five years, while most patients do not live more than one year after being diagnosed. When faced with this paradoxical certainty that there is so much that will remain unanswered, how is one supposed to determine how to best spend the remaining time?
In his book Being Mortal, surgeon Atul Gawande writes of his own revelation on the role of medicine at the end of people’s lives. He discovers the human need for autonomy and how medicine has failed to respect this aspect of human being during end of life care. We provide endless treatments yet patients do not survive longer than if they had foregone these ‘options.’ In fact, patients often end up suffering more under medical care. It is vital to understand, as Dr. Gawande would learn from many of his patients, that living out one’s final days with dignity is sometimes all one desires.
Dagu was determined not to live out her last days thinking about the next pill to take or the next hospital visit. She only agreed to undergo the usual protocol of chemotherapy treatment under the condition that she could maintain her independence and a semblance of normality. Never did a day go by where she did not make all of us also feel as if life were still normal. When I stopped by after work, her only concern was whether I had something to eat. No matter how much I discouraged her from getting out of bed, she would get up and bring me some food. And when her friends came to visit, she made sure they ate first.
After a year of this life of being confined to her house, following the doctor’s orders and keeping a meticulously organized medical record (better than I could ever do even as a medical student), her body finally gave in. She could not walk nor feed herself anymore. Yet in those final few days before she died she still mustered enough energy to tell everyone to save me some food for when I came to visit. Throughout this whole process of confronting her mortality, all she really cared about was how her children were going to carry on. Whenever we told her to stop worrying about us children and worry about her own condition, she seemed not to have heard what we said and instead told us how we ought to be living.
Sometimes I wish I could have helped her more. I could not even offer to buy her food; if I did, she would not let me go home without paying me back. She treated her friends all the same. She was serving others even in her final days.
In some respects, Dagu led a complicated life. She was human after all. But her convictions were simple: Trust in God. Be honest. Give more than you receive. Treat your friends and family well. Career and recognition do not define who you are — God does. Live simply. You do not need much to be happy.
Dagu’s medical team: Her physicians and care team were exemplars of their chosen specialties. She respected her oncologist very much. Her oncologist also happened to have studied under the tutelage of the professor who treated my mother many years ago. These physicians both represented what the primary role of medicine in treating the terminally ill should be, which is to respect every individual’s dignity and autonomy. The medical field is only beginning to learn how to achieve this and there is no doubt that Dagu’s oncologist is a leader in this new territory. I appreciate all that the medical team has done for her.
Dagu’s friends and family: To them I am eternally grateful. Many of them travelled from across and even out of the country just to live with her and take care of her. Local friends and family visited her almost every day to deliver the food they made and to chit-chat. They helped sustain her dignity and morale. In reality though, Dagu and her friends were simply putting into practice what they were taught to do as Christians, and the sacrifices her friends made in both time and money reflect what she meant to them. I will consider myself lucky if I experience but a fraction of the love they had for each other.
Dagu’s brother: My father and Dagu were like two peas in a pod. He would visit her everyday after work to check on her health. Through all their years together, they bickered, they took on each other’s responsibilities, and they were both there for each other when it mattered the most. They understood each other like no one else did. I was fortunate to have observed this special bond, and several days before she passed away, I selfishly took a photo of my father comforting his sister because it captured how close they were to each other. I wanted to remember that moment for myself.
Dagu’s daughter: My cousin took on most of the responsibility of looking after her mother. She did this while also working and living far apart from all of us. It would be an understatement to say that she navigated the difficult terrain of decision making extremely well. The pressures she faced along the way (and there were many) did not stop her from fulfilling her duties as a daughter. Dagu’s death certainly affected her the most. But she can move on knowing Dagu was proud of her.
Dagu: You will be sorely missed. I will miss passing by your home every day during my commute to work. I will miss the meals you cooked for me. I will miss you dropping by the house just to give me some delicious pastries you discovered. I will miss the random emails you sent me about the dangers of common household appliances. I will miss the trips we took together. I will miss you nagging at me to go to church. I will miss you reminding me to have a generous heart. I will miss those rare occasions you revealed your inner child. I will miss how poorly you took photos with your camera. I will miss your love for my mother. Most of all, I will miss what you stood for: unrelenting integrity and an unwavering love for God. I may never be able to live up to the standard you set for how to love, but I am only the man I am today precisely because of your love. It was an honor and privilege to have been with you and served you over the past year. May you rest in peace with the Lord.
Dagu did not leave much behind on this Earth aside from her daughter and two nephews. She led a simple, quaint life. Material belongings did not attract her attention. Being in the spotlight was not her thing (she probably would not even comprehend the idea of me writing about her). What she enjoyed the most was spending time with her friends, family and church. She made sure that if I learned one or two things from her example, it was that material wealth is unimportant. Her friends were all wealthier than her, she would remind me, but they were her friends because of their shared spiritual bond. They adorned each other through endless back and forth giving. In my eyes, Dagu may have been the least wealthy, but she had the most to offer. She was the widow whom Jesus praised:
‘Jesus looked up and saw the rich putting their gifts into the offering box, and he saw a poor widow put in two small copper coins. And he said, “Truly, I tell you, this poor widow has put in more than all of them. For they all contributed out of their abundance, but she out of her poverty put in all she had to live on.”’ — Luke 21:1–4
Thank you Dagu for being who you were all the way until the end.