I was on his shoulders, my hands holding my father’s hair and my toes curled up trying to hang on to my oversized sandals. It was dark out; I do not remember the moonlight, but I remember he was barefoot walking on the shoulder of a dark road. I remember asking him why he did not put his shoes on and offering my too-large-for-me-but-too-small-for-him sandals. We walked for what felt like all night but, in reality, was probably a mile or two to a convenience store. He bought me bubble gum and a soda, and we walked some more; this time I was piggyback on him. We slept overnight on the floor of his friend’s house, and the next morning, my dad called my mom on a pay phone to say that he would return me safely if she did not press charges.
Growing up in a Vietnamese refugee apartment complex, I saw addiction tear apart my family and terrorize my father’s life. Partly induced by the trauma of the Vietnam War and the pressures of acculturation, my father became a chain smoker and was addicted to alcohol by his early teens which continued into adulthood. Although he never physically hurt his children, the alcohol sent him into violent rages toward my mother.
On one horrible night, when his overconsumption drove my mother to call the police, she and my sister jumped from our second-story balcony to escape to the neighbors. My mother made the hard decision to not take me with her, and my father chose to run from the police. She always told me it was because she knew he would never hurt me. He grabbed me and we scaled a cinderblock wall, ran across a dark parking lot, and hid behind a large, brown dumpster. I remember the loud police helicopter overhead. After it disappeared, he put me on his shoulders and we walked in the darkness.
I was concerned that my father was not wearing shoes. My young, naive self was so happy to have spent that time with my father. Over 20 years later, I still have vivid memories of that night.
After my parents' divorce, I grew up seeing my dad weekly. He suffered from substance use disorder and his lifelong stutter made it frustrating for him to communicate, but he loved me and my sister deeply. I always looked forward to our visits. He spoiled my sister and me with outings and desserts, and he taught me how to draw calligraphy. Having completed up to high school in Vietnam, his handwriting was elegant. By the time I started high school, my father was diagnosed with renal failure and placed on dialysis for the next four years. During that time, he finally quit smoking cigarettes. His drinking lessened. My sister and I were often in the hospital with him helping to translate or to bring him noodle soup.
Four years ago, I received a call that he was going in for a kidney transplant. I was ecstatic for him, but I also felt a pang of guilt. I worried that an alcoholic may have received a renal transplant over a young, ambitious college student. In these last four years, he has gained weight and looks healthy. He drinks little and only raises his voice when he laughs too hard.
My own childhood experiences with addiction informed my adult experiences. I spent five years as a registered nurse before entering medical school. I saw
young people put on opioids for a surgical procedure and become endlessly addicted. I saw their desperation for freedom from drugs. I saw a healthcare system that often did not take addiction seriously. I remember receiving handoff reports from fellow nurses who warned me about the patient who will ask for more pain medications.
These experiences sparked my interest in addiction medicine. During my first summer of medical school, I completed an internship with an addiction treatment center. I was exposed to various treatment options for those with substance use disorder. There are individual and group therapy sessions, self-reflections, journaling, and psychiatry available. The treatment program is holistic, and it draws upon a community of engaged people in recovery to help each other quit using. A jarring realization for me during my internship is that rehabilitation may be life-changing but would not have been a feasible option for my father, whose primary language is Vietnamese.
My vision is to expand rehabilitation programs for non-English speakers. Rehabilitation is unheard of in my culture as it demands serious discussions about past trauma, emotional drives toward addictions, and uncomfortable dialogue about feelings. My father can be pretty stoic, and getting him to acknowledge these things can be challenging.
I envision the first step would be to create a program that addresses the first barrier of language, which has the power to connect people. In the words of Trevor Noah, “When you make the effort to speak someone else's language . . . you are saying to them, ‘I understand that you have a culture and identity that exists beyond me. I see you as a human being.'” By acknowledging a person’s cultural identity, we can create effective relationships that promote mutual trust and respect. People need to be able to understand the language before they can dive into the deeper emotional layers of addiction. After the language barrier is addressed, then culturally-sensitive approaches like Buddhism, seeking forgiveness from ancestors and within families, and utilizing East-Asian medical practices can be incorporated. These approaches would appeal to Asian patients in a way that makes sense to them—and bridges the rehabilitation culture gap.
These days, I see my father radiate joy by spending time cooking extravagant buffet-style meals for his family to enjoy, pruning the leaves from his backyard vegetable garden, or feeding the growing number of fish in his small aquarium. I am grateful that he found it within himself to wean his substance use. I cannot say for certain that he would have chosen rehab, but I would have liked to know that the opportunity was available to him. I hope to devote my future career to creating rehabilitation options for non-English speakers.