Sunday, January 12, 2025

Tao of K-drama: The Cornered Stone

In Season 2 of Dr. Romantic, one of the young doctors, Seo Woo-jin, pushes teacher Kim Sabu. He knows something is wrong with Dr. Kim. Dr. Kim loves this young man and accepts his rather desperate need to know. But, of course, he is Kim Sabu, so he shoves armsful of notebooks filled with journal articles at Seo Woo-jin. "You can ask one question," Dr. Kim barks. 

Seo Woo-jin wonders what he's going to do -- all the notebooks are named "The Cornered Stone Project." does he have to read every article in every book? Fortunately, by this time in his work in Doldam Hospital, he has connected with three others, and together they start to work on the problem. One points out that the notebooks have different annotations, "GS" for General Surgery, "CS" for Cardiovascular Surgery, etc. "Dr. Kim said it didn't involve surgery, so we can eliminate those," the colleague suggests. This boils it down to one notebook -- Neurology -- and it is almost immediately obvious what Dr. Kim's diagnosis is -- I'm so indoctrinated in HIPPA that I feel like I can't say it here. But Seo Woo-jin goes back to Dr. Kim and shares what he's found, which is, indeed correct. 

We also learn what "The Cornered Stone Project" is -- it is the effort of the hospital to reflect on every case, learning from experience what succeeded and what might be done better. Throughout the series Dr. Kim has "known" things that others didn't -- he says it's not intuition, it's unceasing study. Young Dr. Seo is invited to join the project, helping the hospital perfect its ability to serve. 

I don't know anything about Go, called "Baduk" in Korea, but I have seen baduk played in a number of K-dramas. I know that a "cornered stone" is one that is surrounded by the opposition. In Captivating the King, the fate of a Cornered Stone is a point of contention between the King and his gidaeryeong, Kang Mong-woo. The position of gidaeryeong is that of personal baduk opponent for the king. While the King is willing to sacrifice the cornered stone, Kang Mong-woo says that the cornered stone can always be saved, if you pay attention, and that this is the surer road to victory. 

I feel deep kinship with Dr. Kim in this -- we are all cornered stones at this moment, and finding solutions requires unceasing study and practice, a constant iterative search for what can work. As a psychiatrist, I have been engaged in similar work, watching the constantly changing landscape of poor and working class communities, and searching for interventions that can stabilize us. While the threats I've been watching over the years yield pride of place to climate change, the scale of terror and inertia grow. Can we find a way to get people to give up carbon? I don't know, but I know that my colleagues and I will continue our own "cornered stone project" in a search for answers. 


Tuesday, January 7, 2025

Tao of K-drama: Under My Skin

On January 1, 2025, Professor Emeritus Rhonda J. Hughes, who has read a draft of my book, The Tao of K-drama, wrote to me: 

I find myself returning often to your book, to check whether you have watched a particular drama or to reread your ideas on one I'm watching. I don't see Dr. Romantic on your list [of all the shows on which the book is based]. I can't recommend this highly enough. Kim Sabu is one of the great characters. You know I always lack words, but this drama, which I watched right before Hospital Playlist, is phenomenal. I found myself needing something to write on nearby, there were so many pearls of wisdom from Kim Sabu and others around him who narrate.  I had a hard time with the graphic surgeries, but found a way to cover the screen so I could still read subtitles. This one was a real gift.  So much about class and the way health care works or does not, how people come to terms with the [system].

There was a certainty urgency to this email that pushed Dr. Romantic to the top of my watchlist. Although I've instituted a "one hour of K-drama a day" practice, Dr. Romantic slipped those constraints -- I barely remembered to eat or do chores. I am regularly entranced by K-drama, but this was a whole new level of engagement. I was enthralled. It is no surprise that a medical drama would hold great interest -- it was Live Up to Your Name, Dr. Heo that first pulled me in. But Dr. Romantic got under my skin -- perhaps because it is the ethical issues that are at the heart of the show. While ethics might seem dry and distant, the show played them as the agonizing and life-changing decisions they really are. 

K-dramas show us many perspectives -- in that way, they constitute "situation analysis." This strategy illuminates the dynamic forces and limited choices that protagonists face. If one is old enough, one has been in many roles: student, teacher, leader, patient. I have certainly reached that age. It was bewildering to watch a scene between an angry young doctor and the wise mentor and, having been in both roles, to feel so deeply what each of them was trying to communicate. 

Many of the sequences were jarring. I'll tackle two that show the "Big Picture." The first had to do with three people who potentially had MERS (Middle Eastern Respiratory Syndrome) which is caused by a coronavirus. The emergency room in which the people were seeking care had to go on lockdown to contain potential spread, but there was minimal protective equipment available to those inside. This resonated so strongly with the our experiences with COVID-19, when hospital personnel were using garbage bags as protective gear and people all over were sewing cloth masks for them.

The second sequence had to do with a threat to close Doldam Hospital, where the story is taking place. It is not the modern, no-expense-spared hospital in Seoul, but rather a rundown country hospital which operates with just enough equipment, much of it ancient and barely functional. Emblematic of the state of affairs is the ultrasound, which people bang to get a clear image. As part of a power struggle, the director of the main hospital threatens to close Doldam and make it into a retirement community. He shrugs when people point out that it's a busy area with many highways and an acute need for trauma services. He doesn't hear or care about the people who will lose their jobs. All of this brought home to me the 2006 loss of Orange Memorial Hospital, the hospital that served my hometown, which was closed, like many community hospitals, to "save money." The costs to Orange were not relevant to the calculations, as many jobs were lost, ancillary businesses failed or relocated, and the buildings were left, to this day, a hulking eyesore in the city. 

Many of sequences that got under my skin were those that depicted the young physicians doing the wrong thing and getting their heads handed to them. This happened to me a lot. Watching the show, I had a new appreciation for the tender care of the many mentors who got me through those tangles. When I was wrong, they helped me see my error. When I was right (or right-ish), they helped me manage the difficulties I faced. A part of the struggle of the main Young Doctor, Kang Dong-joo, is that he holds a resentment against his mentor, Kim Sabu. Kang Dong-joo knows, as a physician, that the resentment is unfounded, but he doesn't know how to let go. It is not until he learns that Kim Sabu protected him from his youthful acting out that he can fully accept Kim Sabu's mentorship. I am deeply touched by the opportunity to see mentorship in action -- it actually lifted decades of old remorse and resentment that lingered from my own growing up in medicine. 

The bottom line of the show -- and the reason it got under my skin -- is that growing up in medicine is extremely difficult. On the one hand, young doctors live with the extreme beauty of caring for patients. Dr. Hughes, who is a mathematician, covered her television to block the surgery scenes. I adored them. The room for surgery is a called a "theater" and it is indeed the setting for great drama, the incredible beauty of the human interior, and the heroic actions that patch people back together to give them a new lease on life. It is different in psychiatry -- my specialty -- but no less dramatic, as the alcoholic person gets sober, the suicidal person finds new reasons to live or the person who is hearing voices gets back in touch with our shared reality. It is an extraordinary experience.

BUT the glory of caring-for-people is constantly in tension with the reality of medicine-as-business: hospitals that have to "make money," care that must be "paid for," choices about life and death because there isn't enough fill-in-the-blank to go around. Thus, the simple mistakes of not asking the right questions or seeing the right symptoms are only the beginning of the getting of wisdom. What is one supposed to do about the tortured care one is obligated to give? What about the exchange of fame and money for compliance with the rotten system? 

Medicine is a path paved with painful choices, all at great cost not only to the self, but also to others. 

After a lifetime of choices, one lives with the consequences. This is particularly what the show gets right about Kim Sabu's mentorship. He is not "kind" to his young mentees. He does not coddle them or express his affection. He sets the choices before them and lets them live with the consequences. This is the part that people like to overlook, me included. The easy choice that leads to cash and prizes seems great, but the high cost is often hidden behind the sparkle. 

For sure, there is a wide spectrum of ways in which physicians experience these challenges. Nonetheless, the current arrangements of medicine have created a very high rate of burnout: according to the American Medical Association, it skyrocketed to 62% in 2022 and dropped to "only" 48% in 2024.  One-third of physicians are considering retirement, including many young and mid-career physicians. 

Towards the end of Season 1, two storylines converge. One was that the wealthy chairman of the board, who trusted Kim Sabu above all others, finds a way to say why he feels that way. And a young artist, who can't afford the healthcare he needs to live, gets an offer from the chairman who wants to buy his talent in exchange for his surgery. We soon see what is meant by this puzzling offer. Kim Sabu finds a book on his desk. He opens it to see a short graphic story about a rich miser who was hated by everyone. When he fell ill in the street, no one came to his aid, except one good Samaritan. The book ends with the question, "Do you remember who that was, Kim Sabu?" 

The struggle to live an ethical life is not an easy one and there are many reasons for leaving the path. Happily, patients, friends, lovers, mentors, tragic reality -- there is so much to help us find our way again. We are the lucky ones, as Michael Lally always reminds me. 

Tuesday, December 31, 2024

Tao of K-drama: Wait a Bit

In order to write The Tao of K-drama, I thought I should pay close attention to the Tao Te Ching. I got really hung up in the process. The five English translations I read emphasized the concept "Do nothing." According to the translations, successful people do nothing and things turn out well. I found this incomprehensible both because there was lots of doing in the Tao, and because it's literally impossible to "do nothing," right? To explain, "do nothing," people would start to talk about "go with the flow," which is not at all the same thing. 

Furthermore, it was clear to me that nothing about modern South Korea, including what is shown in its popular television, involves people doing nothing. They are always doing something. Now, it was nobody's fault but my own that I had linked K-drama with the Tao, but I was really committed to that proposition. To salvage that, and to link the busy-ness of K-drama with the "do nothing" of the Tao, I came up with this saying:

Heart of the Tao

"Do nothing" means "Wait a bit and see what comes along, while cheerfully doing your chores and cleaning all the neglected corners of your house."

My friend, the poet Michael Lally, liked it so much he suggested I make a tee shirt, which he proudly wears. Thank you, Michael!

But about the time the tee shirts arrived, I got a whole new perspective. I came across Roger Ames and David Hall's Dao Je Jing: "Making This Life Significant" A Philosophical Translation. They make the point that the correct translation is "do nothing coercive" and the common "do nothing" is simply an  unfortunate translation. This makes total sense to me -- suddenly the text is entirely coherent and I feel that I have been offered a real direction for living a good life -- do nothing coercive. AND it totally works for the message of K-drama, which made me so very happy!!!

I did have a new problem -- if "do nothing" is out the window, what do I do with my saying? The rest of it is rather perfect, as anybody who has seen even a little K-drama can tell you. Might I rephrase it???? 

And I might add, this is an excellent prescription for people with burnout! I'm going to try it myself!




Monday, December 30, 2024

Tao of K-drama: Where were you?

In the show, Because This Is My First Life, Yoon Ji-ho, the K-drama-writing heroine, needs to reset her relationship with Nam Se-hee, the man she loves -- she needs him to open up his "Room 19," And so she goes away for a few months. He develops the idea that she has gone to Mongolia and he suffers with longing for her. She reappears, ready to woo him on a new basis. He is shocked to see her suddenly and demands to know where she has been. 

"Insadong," she says.

"Insadong????" he replies. 

If I hadn't been to Seoul, I wouldn't have understood the shock of this. Insadong is a lively neighborhood near the historic center of the city, largely frequented by tourists. He would never have gone there, but it was literally a stone's throw away. It is NOT Mongolia. 

The actors play the scene brilliantly and I laugh out loud every time I see it. 

I once read The Tenth Month by Laura Z. Hobson, a novel about Theodora Gray, a woman who gets pregnant from an affair and decides to keep the baby. Because it is a decision unthinkable at that time, she plots to protect the baby from the stain of illegitimacy. She moves from the East Side of New York City to the West Side and after its birth "adopts" her own child. My mother Maggie Brown had the same predicament and moved from Jersey City, NJ, to Newark, eventually settling in Orange, where I grew up. 

In each case the woman -- Yoon Ji-ho, Theodora Gray, Maggie Brown -- was empowered by a reset of the situation. Yoon Ji-ho's thoughtful exploration of her own situation, and her clever solution, is heartwarming. At the same time, by showing her self-awareness and intellectualism, the show illuminates the writing of K-drama itself. It confirmed my hypothesis that the writers of these shows are literate and psychologically-minded, often with a very good sense of humor. 

The ancient Chinese philosopher Xunzi proposed that people have the agency to put new patterns on the world. By her reset, Yoon Ji-ho and Nam Se-hee are freed to define their own terms for love and marriage. "It's OK to make it your way," she tells us in a voiceover at the end. 

And that is lovely message as we stand at the threshold of 2025. 



Tuesday, December 3, 2024

Tao of K-drama: How DO you handle the truth?

I love K-drama because it teaches me so many things about the life. On November 30th, I posted the revelation of truth in the K-drama She Would Never Know.  Then, on Sunday, December 1st, I read the  Sunday Opinion section of the NY Times, which had a number of pieces on the challenge of facing the truth. At the heart of that problem is Jack Nicholson's famous line in A Few Good Men, "You don't want the truth -- you can't handle the truth." 

The cover story of the Times' section is Sarah Wildman's magnificent, "If my dying daughter could face her mortality, why couldn't we?" Wildman describes the long journey of the family as her daughter died of an incurable cancer. Doctors kept talking of "hope" to the exclusion of time and space to talk about that other thing -- dying -- which shouldn't be but does get conflated with "no hope." It reminded me of the conversation I had with a friend who worked in palliative care. I told her doctors had said there were no more treatments for my nephew's leukemia. She said, "You know that means he's dying, don't you?" I would have to say I didn't know that, and I didn't want to know that -- but it put us in the bind that Wildman is describing, with the dying child left alone with the truth because we don't know how to handle it. 

Nathaniel Rich's "A place that looks death in the face, and keeps living," was almost a counterpoint to Wildman's story of bewilderment and isolation. Rich talked about New Orleans and climate change, arguing that everyone in the city knew that the city might be swallowed by sea. They weren't in denial about this, but rather in active conversation, planning and action. He wrote, "New Orleans has a striking competitive advantage. It knows that every hurricane season poses an existential threat." 

He continues:

I've never met a New Orleanian who feels safe from climate change. Living here, rather, engenders hurricane expertise -- and hurricane fatalism. Yo become your own disaster planner, insurance adjuster, land surveyor and roofer. You know how many feet your neighborhood is above or below sea level, which storm drain on the block must be cleared by hand before the rain starts, which door sill needs to be bolstered with a rolled-up towel and where water is most likely to pool, with what appalling consequences.

The essay arrives at the conclusion that finite lives -- whether of a person or a city -- are not worthless. Learning to live with acceptance of limits -- taking joy in what we have, rather than thinking it has to last forever -- is the great challenge. 

The truth is hard all the time. Even small truths -- we have to floss, eat green leafy vegetables and exercise are truths that many of us (me included) fall flat in accepting. In a way these are stand-ins for the bigger trrouble-makers -- the knowledge that it's all finite. How can it be that this beautiful, wonderful world and the lives we live here won't go on forever? 

Despite our wish to hide or dissemble or steer away the truth, it will come to us. And when that happens we need our communities to hold us close, to talk with us about answers, to go through it together. 


Saturday, November 30, 2024

Tao of K-drama: She comes to know

The K-drama, known in English as She Would Never Know, is, of course, about women coming to know. The name in Koran is 선배, 그 립스틱 바르지 마요, which literally means Senior, Don't Put on That Lipstick. The translation is a bit awkward. "Senior" in this context does not mean last year of high school or elderly person -- the word is "seonbae," a title for someone who is ahead of one in school and/or work. It is a term of respect. The command here is uttered by the junior -- hoobae -- to his seonbae, a woman having an affair with a man who, unbeknownst to her, is about to marry someone else. She puts on bright red lipstick to go meet him in the stairwell. The hoobae hates the color on her, and hates what is about to happen when she finds out the truth. 

The show doesn't stop at one of these -- a wife doesn't know her husband is quiet and unexpressive because he is repressing his same-sex desire, and their child doesn't know divorce is looming; a woman doesn't know she can survive without the man of her dreams; a mother doesn't know her daughter was aware of the husband's infidelity, nor does the mother know she can survive the growth in her uterus because she's afraid to find out. All of these secrets will come out in time, and people will weather the storms they create. 

This being K-drama, people come into relationship, and by the time we reach the end, a much larger group is helping to manage the trauma and recovery. One recapper said that this was predictable K-drama and not that interesting. I thought he must have missed the careful way in which the show allowed people to get closer to the truth and closer to other people so they could manage the truth. Because that is the secret of the truth -- things are hidden because they will be hard to digest, they are frightening, they force us to go against the established order. 

This is perhaps clearest in the case of the husband who has to face "who he really is" -- that is, accepting his same-sex attraction. In one scene he goes to tell his parents he wants to divorce his wife. His father surges to his feet and smacks him hard in the face and then does it again and again. "You will not get a divorce," the parents shout. Imaging if he were there on his knees saying, "I am getting a divorce and marrying another man." His wife, who knows the violence of the in-laws, tells him that she will stay by his side until he can accept himself -- that she loves him as he is. He later says that that was the first time anyone had said that to him and it was freeing. 

Which brings us back to the red lipstick -- it is not her color. This show takes place in a cosmetics company and she was working on the color cosmetics team. So wrong color is a big no no. The hoobae wipes it off her lips. By the end, when she wants to win his love (back), she puts on an excellent color. Perhaps the deeper allusion is to the Police song, Roxanne -- "You don't have to put on the red light" -- or to the source of that song. No need for the red light -- you are OK just the way you are. 

Tuesday, November 26, 2024

Main Street: What bothering a friend reminded me of

My friend Dr. Reggie Shareef lives in Roanoke, VA, and I met him while studying the urban renewal program there. He has looked at that process from the economic perspective and this has given him unique -- even dazzling -- insights. I was bothering him about pulling his pieces together into a book. He said no, he is retired (and maybe tired?) and didn't want to do that. 

This reminded me of Zora Neale Hurston getting to know Cudjo Lewis, a man who arrived in the Americas on the last slave ship. She sat with him and ate watermelon and listened to his extraordinary story. This encounter was published in Barracoon: The Story of the Last Black Cargo. Alice Walker wrote the profound introduction, in which she says:

Here is the medicine:

That though the heart is breaking, happiness can exist in a moment, also. And because the moment in which we live is all the time there really is, we can keep going. It may be true, and often is, that every person we hold dear is taken from us. Still. From moment to moment, we watch our beans and our watermelons grow. We plant. We hoe. We harvest. We share with neighbors. If a young anthropologist appears with two hams and gives us one, we look forward to enjoying it.

I was imagining the young anthropologist with two hams who might wander by Dr. Shareef's house and listen intently to his wisdom! Maybe collect the papers into a book?