The following is a reflection on my home visit in my Family Medicine rotation:

I gained a lot from my home visit experience because I chose the right patient. I chose a patient that I can relate to and, at the same time, learn from. She is a 62-year-old Filipina woman who was diagnosed with metastatic lung cancer last November. She came to her office visit with her husband and her sister, and I knew this was a patient I wanted to know more about. I'm Chinese, but I dated a Filipino man for over 6 years and one of my best friends is Filipina, so that influenced my decision in choosing her. I expected that I would feel comfortable in her home since I've spent so much time in the homes of Filipino families. I admit that I stereotyped her based on my life experience - I assumed she would be happy to open her home to me. And with that assumption, it was easy to ask if I could do a home visit with her. All three of them said yes, like they were a collective.

She is a former dialysis social worker with a BA and masters from Sacramento State. I was really impressed with her level of education since she was an immigrant. Her former occupation gave her a lot of insight with her current struggle, but it's still so different when you are the patient. Her husband also retired when she was diagnosed, which is financially straining. With her work experience, she knew they wouldn't qualify for IHS income because they don't qualify for Medi-Cal.

She is not able to walk because the cancer metastasized to her spinal cord. Her lower extremities were atrophic, but they still had sensation. I was happy to give her a foot rub. She sleeps on a hospital bed in the living room and her husband sleeps on a twin bed beside her. She doesn't sleep well and gets anxious, which means her husband doesn't sleep well either. Fortunately, she has a great family support system, and she has siblings who relieve her husband so he can rest. Her siblings also cook for them.

She is Catholic and uses prayer to help cope. She takes it "one day at a time." I'm not a particularly religious person, but I really respect the fact that religion helps people be appreciative of their blessings despite their tribulations. It helps people find peace.

At 24 years old, I'm not familiar with death and dying. But every year I'm in medical school, I learn to accept it as a part of life a little more. This patient is going through something very awful, but she is lucky that she is not alone. As she approaches the end of her life, she is surrounded by people who love and care for her. Not everyone has that.

Dear Dad,

While I'm on my way to being the best me I can be, I now truly understand that you're on your way to being the worst you you can be. You've been on your way...for as long as I've been alive, and I think for as long as you've been alive. I'm no longer a kid, but you somehow manage to bring me back to angry outbursts filled with disrespect and cursing. I pity you, but at the same time, I'm extremely annoyed by you. I pity you for being who you are, and I'm annoyed by who you are. I don't consider you a man. I cannot think of any other example besides the one I'm about to give that would make you a man.

You are kind to me. You love me. You are patient with me. And I am blessed. In this way, you are a man who loves his daughters.

But in every other way, you are not. You are a child...desperate for attention. You want to be heard, but you have no worthwhile thing to say and no credibility behind your words.

You are a child...needing to be taken care of. You think you deserve a life of luxury, but you don't think you need to earn it yourself. You take advantage of family, because you can and because we let you. You should be homeless. You didn't pay for the roof over your head or the food you put in your mouth. You don't contribute to your life.

You are a child...hurting people to make you feel better. You like to hurt with your words because that's the only way you can feel powerful. Mom is such a sensitive soul and you know it...you manipulate it.

I know you're my dad and I know you love me. And that is all I need between us.

There will not be peace between us until you leave mom in peace. The way you hurt her is almost evil. It makes me hate you. It disgusts me. You disgust me.

And I'll never say these words to you in the depth I have written them here. Language barrier affects my relationship with my family so dramatically. But I had to write it down. Because one day, I will have to make the decision whether or not to take care of you. I probably will, but it won't be with open arms. It will be with resentment and obligation.

Your Daughter