UNCLE BUCK'S

Yesterday, my brother invited us to go bowling in Round Rock, Texas, the suburb of Austin where I went to grade school. We met at Uncle Buck's Fishbowl & Grill Restaurant, which is an entertainment offshoot of the Bass Pro Shops outdoor chain. In fact, this Uncle Buck's was located immediately adjacent to the Round Rock Bass Pro Shop.

I am not a bowler, having only bowled once in my life back in medical school, but I was happy to go along and give the kids a chance to have fun with their cousins. We were assigned a seating section shared by those using the first and second lanes. Our group entered our names on the sign board above our lane and began to play. A few minutes later, a family of four arrived, and we shared our area with them.

The couple we shared the space with was in their thirties with two sons - one who must have been seven or eight and another who was probably fourteen. The older son had a knife strapped to his belt, and the younger one appeared to be much less of an immediate threat. Because they entered their names on the signboard, I came to know that the kids were Asher and Hayden and that the parents were Peter and Mel. They bowled one game together and shared a cheese pizza. We did not directly talk with them, but they were cordial and polite as our groups took turns bowling on our adjacent lanes. After the first game, Mel and Asher went off to play video games in the adjacent arcade while Peter and Hayden stayed to bowl a second round. What struck me most was just how normal and down to earth they were - just out for a family get-together with mom in her jeans with holes in the knees (presumably for fashion reasons, rather than poverty) and the kids not seeming to have a care in the world.

In the next lane, a biracial African-American/Caucasian family was seated. They, too, seemed quite at ease. At one point, the infant began crying, and one of the women attempted to comfort the child by showing the baby a video on the phone. It would not have been my parenting choice, but who am I to judge?

As I took in the events at Uncle Buck's over the two or so hours I was there, I came to realize that this was not just an anthropological adventure. This was a view into the heart and soul of "the real America" - hard-working people trying to live within their means and do right by their families.

It is with men and women and boys and girls like those at Uncle Buck's that our country's future will be decided. The decency and humanity I saw in those individuals gives me hope for 2020, even if they chose a different path than I would have preferred in 2016 and 2018 - if they chose at all.  I do hope that whomever emerges as the front runner in 2020 finds a way to address these families' concerns as well as they attempt to address core Democratic voters like me. For it is only by finding common ground that we will be able to make progress and re-connect the frayed ties that used to bind us. That afternoon at Uncle Buck's was just one small step in that direction.

THE SYMPATHIZER

In recent years, the Vietnamese-American writer Viet Thanh-Nguyen has written several wonderful books about his experiences in Vietnam and coming to America during the war, including The Sympathizer and The Refugees. The former is about a Vietnamese General who is caught between two worlds, and I could not help thinking about this book when I meet Mr. D, who was a former Vietnamese General, himself.

The General was in his mid-60s and had been living in America with his son for several years when he was first diagnosed with prostate cancer about 5 years ago. Despite surgery, his cancer had returned, and he was referred to my care. He spoke very little English, and so we always arranged for a translator at his visits. However, at the end of each visit, the General always said, "You are MY doctor. Thank you, MY doctor." It was his way of showing me his gratitude and the respect that he thought I deserved.

Unfortunately, Mr. D's cancer was quite resistant to treatment, and it morphed into an even more aggressive form called neuroendocrine prostate cancer. Despite our best efforts to slow the cancer down with chemo, it continued to grow and left him weak and in pain.

Because of his deterioration, I asked him to bring his son, who worked as a mechanic and who had not attended previous appointments, the next time he came in. It was at this visit, that I gave them both the bad news that his cancer was no longer treatable and that I thought we should focus on maximizing his comfort and quality of life at home with hospice.

The General was obviously upset about this, but not for the reasons you might have suspected. He said he had lived a long life for which he was thankful, but he also recounted many of the hardships from that life including a gun shot wound during the war and seeing his country come apart. He fanned his arms to describe how we are all connected and said he had one final wish - to go home again to Vietnam.

I sympathized with him and his son and explained that I was concerned about his ability to make it home to Vietnam safely. He was insistent, however, and I said I would do anything I could to help him. For his pain, we called in strong narcotics, and we arranged for equipment at home.

The day of his trip, I received an urgent page from my nurse. The General had arrived at the airport, and his weak and cachectic appearance had startled the airline staff at the check-in desk. They were concerned that the General might not make it to Vietnam without experiencing a medical emergency - a concern I, too, shared. However, I knew that getting home was the General's final wish - a wish I knew I had to do everything in my power to help grant.

My nurse Pam helped to draft a letter to the airline, to which I affixed my signature. Pam somehow got the letter into the right hands at the airport, and the General was permitted to fly home.

Last week, Pam reached out the General's son to see how he was doing. His son said that they had made it to Vietnam two months ago without needing to divert the plane. Upon landing in Vietnam, the General was taken directly to the hospital to treat his uncontrolled pain. He died there in the hospital a few days later.

There are many definitions of home. Certainly, a sterile hospital bed does not generally meet that definition. However, the General was no usual man. It was home that we were able to get him and where he took his last breath.

IF YOU SEE ME, DON'T SAY HI

If you See Me, Don't Say Hi is my pick for favorite book of 2018. While there may have been better written or well-received books this year, none resonated with me as much as this debut collection of short stories by Neel Patel. While comparisons with the Indian-American writer Jhumpa Lahiri have no doubt been made, Patel's focus is not on the Indian diaspora. Rather, Patel gives voice and life to the offspring of that diaspora - first generation Indian-Americans like me.

In a recent interview entitled, "This Indian American Life," Patel recounted his experiences growing up as a first generation Indian-American in rural Illinois. It is the experience of an outsider - an experience with which I could easily identify from my own upbringing in rural Canada and suburban Oklahoma and Texas - that made this book so powerful for me.

Whether describing the angst of an Indian-American teen who realizes he is gay, a young, recently divorced Indian-American women whose community casts her out, or Indian-American brothers who  fall out of love, the desire for acceptance and community is a theme woven throughout the eleven stories in this collection.

My favorite of the bunch revolves around a young man named Krishna and his experiences growing up in Illinois in the penultimate story of the book. He is a character who is always on the outside looking in, which creates blind spots about navigating adolescence and adulthood. That Krishna's story comes full circle so powerfully in the book's final chapter- in the most tender and heartbreaking of ways - is a tribute to Patel's ability to capture his characters' humanity and their complexity.

Keep an eye on Neel Patel! He is a writer who is just getting started, and I hope he has many more tales to tell!