My brother asked, "You know what he said? 'Son, I'm sorry…, hope you prepare for your old age better than I did…so that you won't burden your children…like I did.' What has he ever done to burden me…?" My brother's voice trailed off over the phone. I knew that he was in tears, but I just couldn't picture him over the phone. Hojin, 6 years older than me, the rock of my Korean immigrant family, has never shed tears in front of me. Today, however, was a very unusual day. Hojin had had to drive Dad to a nursing home in Seattle. I diagnosed Dad with dementia 4 years ago, but I live across the continent in Baltimore. As has always been the case, it fell on Hojin to take the steering wheel to drive Dad to the nursing home for Dad's final journey away from home.

A low-level civil servant throughout his life in Korea, Dad decided to move our family to the United States at the late age of 52, when most of his co-workers were preparing for retirement. It is still a mystery to me what led this meek, shy man to make such an audacious decision against Mom's bitter opposition. Several years before my family's move, Dad had taken a business trip to the United States, and it must have made quite an impression on this lifelong salary man. A seed of the American dream planted during the trip must have kept on growing. Meanwhile, Hosun, my eldest brother, received a scholarship offer from a Ph.D. physics program in Boston. Dad reasoned, Why not have the younger ones educated in the U.S. as well? He cajoled Mom, quit his job, sold our house, packed up all our belongings, and had our family depart for the United States on Thanksgiving Day in 1982.

The day before we were to leave Korea, he took me to a fancy shoe store in downtown Seoul and bought me a pair of trendy leather shoes that I had seen on television commercials. His eyes twinkled as he talked about how I should walk in the new country with a new pair of shoes. He excitedly described our new life in the new country across the Pacific Ocean. How we would live in a bigger house with green lawns and our own cars in the two-car garage. How I would study in much better schools and go to world-famous universities in the United States. I think he even asked me what I thought about all this. I don't remember how I answered; I was just a 12-year-old kid with a new pair of leather shoes.

Like most immigrant families, my family also struggled in the beginning. Dad could not find a regular job for over a year, Mom cleaned motel rooms to make ends meet, and Hojin dropped out of college to get a job as a data entry technician to help out the family. I got into some fights at school while I learned to read the alphabet and speak English, but I was largely shielded from whatever troubles my family was going through during those years. Eventually, it worked out as Dad had dreamed. By the time I left home for college, my family had saved enough to make a down payment on a modest house with a two-car garage and a green lawn. Hojin went back to college and got a job as an accountant near my parents' home. Ironically, Hosun, who had provided the initial impetus for our immigration, went back to Korea for a faculty position after getting his doctorate degree. I went to a medical school on the East Coast and became a geriatric psychiatrist specializing in dementia care.

A few years ago, Mom called me at work and told me that Dad had fallen and injured his face. She had been worried about Dad's frequent falls and his increasing memory problems. Dreading what sounded like a familiar story in my clinic, I went back to Seattle and took him to see a local neurologist. Since Dad could not speak English, I had to serve as an interpreter and provide a detailed cognitive examination in Korean for the neurologist, who kept deferring to me. I found this annoying. It was hard enough for me to demonstrate Dad's deficits in several cognitive domains, but did I even have to blurt out the dementia diagnosis for him? Later that day, I also saw the MRI film of Dad's brain, which had shrunken pitifully. I had viewed such an appearance many times before in my clinic with the smug assurance of an expert clinician at a tertiary medical center. This time I felt every groove and fissure that was curling away into the darkness of the cranial cavity. Dad asked me if everything was OK with him, and I just smiled at him without saying anything. Dad smiled back and told me that he knew that his doctor son would take care of him.

Last summer I made my annual trip to my parents' house and noticed Dad's beat-up, dusty canvas shoes on the shoe rack. By then he could not walk without a walker. Even with a walker, he would struggle to keep his shuffling steps moving forward and drag the front of his shoes on the ground to keep his balance. When I picked up the shoes and looked at the bottoms of the soles, I saw several deep holes in them and treads that were all but gone. That afternoon I took Dad to a shopping mall and bought him a pair of sturdy leather shoes. He kept fussing about how expensive the shoes were, but I could see that he was having a good time. Unsolicited, in his broken English, he kept telling everyone at the shoe store that I, his youngest son, was a doctor. As the kind shoe salesman humored Dad by pretending to look impressed, I saw the same twinkle in Dad's eyes that I'd seen a long time ago but had forgotten. At that time, however, I didn't know that I was buying him a pair of shoes for a journey on which I couldn't accompany him. I am sorry, Dad.