When Nicole Chung was growing up in a heavily white town in southern Oregon, she dreamed of escape.

She "felt like an anomaly" as a Korean American adoptee, an experience she explores in her 2018 debut All You Can Ever Know. In that memoir, Chung breaks down the simplistic origin story her white adoptive parents told her about how she came to be theirs, while tracing her search for her birth family.

Chung eventually staked out a new life for herself far from her adoptive parents, both in physical distance and social class. Her new memoir A Living Remedy grapples with the guilt and grief that accompany that distance, and the pain of not being able to help her parents when they needed her most. In the process, Chung crafts a deeply personal reckoning with our country's entrenched inequalities and an elegy for her parents.

As a child, Chung had considered her family middle-class, but work was often unsteady. When Chung was in high school, her mother had a mastectomy to treat breast cancer and a hysterectomy to treat endometriosis — costly medical crises that brushed up against periods of unemployment for her parents, who often didn't have health insurance. During this time, Chung realized her family's financial situation was in fact precarious. "I had sensed that we no longer lived paycheck to paycheck, as my mother had once told me, but emergency to emergency," she writes, distilling the insecurity her parents faced. "What had seemed like stability proved to be a flimsy, shallow facsimile of it, a version known to so many American families, dependent on absolutely everything going right."

Attending college on financial aid was Chung's first opportunity to build a more stable economic foundation, but her ascension up the class ladder was not seamless. She and her husband experienced times when money was tight as they were building their careers and family on the East Coast. Still, as she takes pains to acknowledge, she was better off than her parents ever would be: "Our 'broke' bore no resemblance to my parents' 'broke,' because ours was finite and because we always had other options: we could have quit our graduate programs, avoided having children, tried to pursue more lucrative careers."

Not taking those other options led to self-reproach. For years, Chung couldn't afford to help her parents financially; worse, she could "barely afford to visit them." Her situation is not uncommon, as she points out in one of the book's sharpest passages: "In this country, unless you attain extraordinary wealth, you will likely be unable to help your loved ones in all the ways you'd hoped. You will learn to live with the specific, hollow guilt of those who leave hardship behind, yet are unable to bring anyone else with them."

Chung was already struggling with this guilt when her father was belatedly diagnosed with late-stage kidney failure, his condition compounded by the diabetes he couldn't afford to adequately treat for decades. He died a few years later, at 67 — nine months before the publication of All You Can Ever Know, which would change Chung's finances in a way that might have allowed her to help him.

When Chung sold the proposal for A Living Remedy in 2019, she had intended to focus on her father's illness and death, and how it embodies America's uneven burden of healthcare inequality. For about half the book, which proceeds linearly from her upbringing in Oregon to the present, this is indeed the shape the memoir takes — and where it is at its strongest. That her father wasn't approved for Medicaid or Social Security Disability Insurance until he was "gravely ill" speaks to the system's dysfunction. "It is still hard for me not to think of my father's death as a kind of negligent homicide, facilitated and sped by the state's failure to fulfill its most basic responsibilities to him and others like him," Chung writes, nailing how her father's "common American death" evidences how easy it is to slip through the gaping holes in our safety net.

But as Chung was writing A Living Remedy, a new emergency would complicate her project. Within a year of her father's death, Chung's mother was diagnosed with cancer. Amid her grief for her father, she struggled with how best she could help her mother — like many, she was pulled between the needs of the family she had started across the country and the one she had been raised within. And then the pandemic shut down the country, and Chung could not be there as her mother took her last breath in May 2020.

Chung could have decided to leave her mother's cancer and death out of A Living Remedy. But in bringing the reader along as she grieves and travels back and forth to her mother's house, her finances now allowing more visits, Chung provides a rare record of the difficulty of supporting a parent through end-of-life care. "This first. Then you can fall apart," Chung tells herself as she struggles to talk with her mother about treating a brain metastasis, capturing the devastation of needing to make decisions no one wants to have to make. A similar pain suffuses the chapters about calculating the risk to her mother, her family, and herself if she were to fly out to be with her mother after the pandemic hits.

The last several chapters of A Living Remedy feel loose as Chung wades through grief for both her parents. At times I wished she would return to some of the argumentation that grounded the chapters about her father's experience, especially when she mentions subjects like overwork without bereavement leave.

But these chapters also contain striking reflections on living with absence. "How do you learn to cherish yourself, your life, when grief has made it unrecognizable?" Chung writes. "I am starting to feel that we do so not by trying to fill a void that can never be filled but by living as best as we can in this strange, yawning terrain our loved ones have left behind, exploring its jagged boundaries and learning to see it as something new." It's a line that recalls the book's title, borrowed from a phrase in a Marie Howe poem called "For Three Days": "...because even grief provides a living remedy." This book does not fill the void left behind by Chung's parents and others lost to our broken systems, but it provides a powerful remembrance and a path forward.

Kristen Martin is working on a book on American orphanhood for Bold Type Books. Her writing has also appeared in The New York Times Magazine, The Believer, The Baffler, and elsewhere. She tweets at @kwistent.

Copyright 2023 NPR. To see more, visit https://www.npr.org.