About Hui-wen (Alina) Sato

Words are fascinating. They can be careless, careful, powerful, hurtful, transformative, destructive, clarifying, confusing, unifying, divisive, honest, deceiving, empty, meaningful, terrible, beautiful. I am a Christian, a wife, a daughter, a mother, a friend, a citizen, a nurse. I hope the words I share in this space will do justice to the dignity that each of these roles deserves.

NPR TED Radio Hour Podcast: What can grief provide us?

My NPR TED Radio Hour podcast episode has dropped! 🎙

In this podcast, Manoush explores a few TEDTalks connected to the topic of Heartache. Starting at 27:00, my interview with her explores some of my bittersweet experiences as a nurse and the hard-wrought lessons grief has brought about over the years in this profession.

I can think of no other time in our lives when we as an entire world have experienced sorrow, heartache and grief as a collective whole for over 1.5 years. I hope a bit of what I share here is an encouragement, a balm for our weary souls.

You can listen to just my segment alone here, find the entire episode here, or you can click below and listen through Spotify.

Grief and the Good and Hopeful Life


In my last blog post, I took a birds-eye view with some thoughts on why we don’t know what to do with grief. I’m not trying to talk us out of grief by rationalizing. It only makes sense that we don’t readily know what to do with grief. It can hurt like hell. Its existence means something has gone dreadfully wrong. There are moments where it feels completely dark; I’ve known those moments myself. But perhaps it’s for those very reasons that I think it’s important to look at it from more angles than the typical ones we come at it with.

In this blog post, I want to spend some more time on my final thought in the previous post: We struggle to see what a good and hopeful life can look like with grief always present.

This isn’t to deny the permanent wound a significant loss can leave on us; life will never be as we knew it. But with social media feeding into the rather narrow (read: curated) ways we define a good life which often include some version of lying carefree, young and beautiful on a luxury vacation, it is no wonder that we can feel almost doomed once significant suffering or loss find their way into our lives.

What are we doing to ourselves – and to each other – when we primarily define a good life as one that involves minimal heartache and tears?

What we do when we define a good life in a narrow, idealistic way

We live superficially and don’t allow ourselves to be challenged to consider what can make for a meaningful existence even when circumstances are deeply painful and far from ideal.

We miss out on a certain depth to our perspectives and our care for others that can really only come through wrestling with harder questions and circumstances.

We create a divide between perceived haves and have-nots, further isolating those who are suffering and compounding their sadness with despair.

We set our hope solely upon ideal circumstances that aren’t guaranteed to hold up, and this lays shaky ground for our long-term sense of well-being.

What we can do when we learn to broaden the definition of a good and hopeful life to one that includes grief

We can discover a different and more solid foundation for life – a process that is, quite frankly, work. It’s built through a process of dismantling old foundations that might’ve been easier to establish, ones that are sufficient for effortless days but can never hold up in the storm. It’s built with hammering, fire, sweat, tears, questioning if it’s worth all the cost and effort. But in the end, the new foundation holds solid, firm, unshakable when everything else is shaken. It can be terrifying to build and test, but it ends up providing the greatest sense of security we could find.

We develop an intimate understanding of hope beyond ideal circumstances where there was once ignorance.

We are less intimidated by people who are suffering and develop more capacity to share space with them without feeling desperate to sugar coat the conversation.

We discover deeper and more authentic community. Is it not true that when we are hurting, we gravitate more towards those who have been through similar heartache and less towards those who seem to have never tasted hardship? Our ability to truly know and be known by one another grows in new dimensions through shared suffering. My richest and most significant relationships are with those who have shared their grief with me and who have borne mine as well.

I wish grief upon no one, but we do ourselves such disservice when we pretend that we can or should avoid it throughout our lifetime. Its reality is sobering, but its reality also does not automatically mean a good and hopeful life becomes unattainable for all who experience it. Without discounting the very real pain that suffering brings, my years of being an ICU nurse and my own encounters with personal grief have taught me that in some ways, those who wrestle hard with grief are the ones who find a deeper understanding of what a good and hopeful life really mean.

Why We Don’t Know What to do With Grief

(Taken from my nursing blog, http://heartofnursing.blog)

In my recent interview for an upcoming NPR TED Radio Hour podcast (9/17) on “Heartbreak,” the host, Manoush Zomorodi, asked a series of insightful questions from many angles about my experiences with grief over the years as a pediatric ICU nurse. Those questions have sparked many thoughts that I believe are worth exploring and sharing in a series here on grief, with hopes that we can take a closer, courageous look at grief and reframe our perspective on it during a time when we are all feeling it perhaps more than ever.

Unfortunately, recent world events give us countless issues to grieve on many levels. Please note this blog series will primarily focus on grief and loss more on the individual/personal level, though I think some of these ideas will be pertinent to broader societal issues.

And with that, the first thought I want to tackle is: Why we don’t know what to do with grief.

Before we tackle some reframing of grief, I think it’s important to consider why we run for the hills from it before we even give it a chance to just be a normal part of our lives.

Denial of its possibility is ingrained into our culture from day one.

I’ve lost track of the number of times I’ve heard or said myself, “I just thought that happens to other people in other places, not to me, not to us here.” Our blind spots to the assumptions we make about life as people in a wealthy, powerful nation profoundly shape our shaky personal response to real suffering, loss and grief.

We are a culture obsessed with convenience and easy fixes. Any ICU nurse (that’s me) can tell you how much we love our easy fixes to life’s pains and problems (hello, all the medical interventions), but also how powerless and detrimental some presumed fixes can actually be (again hello, all the medical interventions). We just keep assuming we can always find a way out of our grief, if not avoid it altogether.

Grief is too closely associated with negativity.

This is a tricky statement because there is obviously some connection between the two. But sometimes “toxic positivity” is completely out of touch with reality, and grief is more in touch with reality than we care to admit. You can have days of intense grief and intense negativity, but they don’t necessarily go hand-in-hand. You can also have days of intense grief and also have solid hope. Because we have such a hard time recognizing this, and we are a fix-it culture addicted to “positive vibes only,” we are strongly tempted to reply to someone’s healthy, normal grief with “At least you…(can still have another child),” or “You should just be thankful that x, y, and z.” This actually ends up invalidating and somewhat shaming what is actually a normal, healthy response of grief to a real loss. We think it’s necessary (and even possible) to somehow cancel out the grief by diverting attention to some more “positive” thing over there, instead of giving healthy space and permission to cultivate and process normal grief.

In other words, we only know how to battle negativity by trying to shut it down, which in most cases is probably wise to not indulge it too much. Unfortunately, because we almost automatically associate grief with negativity, this means we typically respond to grief by trying to squash it as well, even when its manifestation is actually a very healthy thing.

We struggle to be quiet and patient with hard questions.

With Google Search at our fingertips, we are more accustomed than we realize to having all the seemingly hard answers so readily accessible. Will my children growing up in this Internet age really even learn to think for themselves? It is in many ways a gift to crowdsource knowledge and have others do so much of this hard work for us. But when it comes to grief and loss, which are so intensely personal and complicated, we have to do the work ourselves of wrestling with the hard questions grief often raises, and this feels daunting because we simply don’t practice it much day to day. We deeply resist the discomfort of having our worldview and our assumptions of how life “should” operate be so profoundly challenged, and often prefer relief and escape from that discomfort over working towards the building of a different, deeper life foundation.

We don’t know what to do with things that cannot be explained.

Even as we work through hard questions, there remain some things that cannot be fully explained. There may be a medical explanation, coroner’s cause of death, but there are other types of answers we often search for that we simply won’t find in their entirety. Our need for control and power chafes against this. But when I’m suffering, it’s usually not clear and specific answers that actually soothe my soul. As the wise singer/songwriter Rich Mullins once sang, “And I know that it would not hurt any less…even if it could be explained.” When I’m suffering acutely, I find the most comfort in having space to lament, being accepted and embraced as I am by safe loved ones, and being helped to just take the next step forward when everything else about the future seems too murky or overwhelming.

We struggle to see what a good and hopeful life can look like with grief always present.

This, I think, is key, and will be the topic of a future blog post. (Note: it won’t be a blog post with answers, per se, but an exploration of what we do to ourselves and each other when we only define a good life in a narrow way – and what we can do for ourselves and each other when we learn to broaden that definition of a good and hopeful life.)

Thanks for reading this far. I would love to hear thoughts, comments, disagreements, as long as they stay civil and productive.

The Nocturnists: Sharing my Story as a Nurse and Mom in a Pandemic


The Nocturnists is a podcast that has done incredible work documenting the experiences of healthcare workers from many angles, and in current times capturing this phenomenal moment in history as we endure this COVID pandemic.

I had the opportunity to reflect on the early days of the pandemic as we all began to realize that this coronavirus was to be taken very, very seriously. What was it that made me realize it wasn’t like other coronaviruses I’ve seen in our ICU? My sharing in Stories from a Pandemic: Part II – Episode 7: Remembering a Pandemic starts at 5:57.

In the next Episode 8: A Call to Arms, I share about what it was like to be a pediatric ICU nurse, a new (and overwhelmed) homeschooling mother to two young elementary age children, and a wife of a health inspector before – and then just after – the vaccine finally becomes available. What was it like to go from hoping for the best with only external protection, to finally having some internal protection on board? My sharing in this episode starts at 18:19.

We are living in such crucial moments in history, and as intensely stressful as they have been, I am grateful to be alive. I am grateful for the vaccine. I am grateful we have ways to share our stories.

On Updating my Professional Headshot

Photo Credit: Tracy Kumono

Having slowly grown in my platform and public opportunities with both writing and speaking professionally as a nurse over the past four years, one of the greatest learning curves has been with navigating this idea of a public image. Looking to see what other people in the public eye do can be both inspiring and, well, nauseating. There are a lot of voices that come at you about how you should present yourself, how you should play the game of developing a public persona and voice.

I started this journey with a desire to speak from my heart, and if I was fortunate enough to connect effectively, speak to hearts as well. My fear is that without realizing what’s happening, I’ll begin listening to the siren song that says developing a strong voice with the things I write and speak about is for the sake of cultivating my own image as someone “up there.”

This is not to say I never struggle with pride. I wish I didn’t. But I hope to make choices in every step that continually help me remember what the point of this all really is, including my choice of a professional headshot. I don’t judge people who do the arms-crossed pose; I think it can be effective and even friendly when done right, when matched with real character. But my personal comfort level shies away pretty intensely from the corporate look; it simply doesn’t suit me at this stage. I don’t think leadership that talks eloquently all the time without ever truly listening is real leadership. My hope is to always be to others, both in real life and in a headshot, someone who listens, watches, and cares for them more than I care for myself. Introverted as I am, I want to lean in, connect, be with people where their hearts are at.

Because at the end of the day, I follow the model of Christ. He was with all of us in the trenches, loved, served and taught us from that heart. I follow Him and hope to be more and more like Him and only Him. 

Finding God in the Wild Crash between Motherhood and PICU Nursing

I needed to walk the dog, and the kids were reluctant to join me. I had to sternly remind them that if they wanted this dog, then they needed to fully participate in taking care of him. I was annoyed.

The demands of and feelings about motherhood this past year have crashed wildly with the demands of and feelings about pediatric ICU nursing. I have at times despaired of the intensity of home life in a pandemic only to wildly swing the other direction and hold these mundane, annoying moments of motherhood in precious light when I crouch as a nurse next to a mother crumpled to the ground over losing her child, longing for just one more mundane moment with her beloved.

Doing what I do and seeing what I see at work gives me a certain perspective of what it means to say God is always good, and God is always with us. It holds space for really, really big messes in life, and big messes in my own heart. He’s not just good to me in my smiling, happy, healthy moments with my children. He’s good because He gives hope for the long perspective, one that recognizes we all suffer certain ways and we are all mortal, and yet He has not forsaken us. He has joined us in those messy realities. In one moment Jesus said Father take this cup from me, in the next He said Your will be done.

I am not always as thankful as I should be for the mundane moments with my kids but still He gives them to me. I’m trying to be more intentional about capturing these #proofofmom moments in photograph and story, so when I find myself one day looking back and yearning for them, I can remember all the expressions of His grace and then look ahead with hope for the Day there is no more suffering, sorrow, death or pain.

New Blog Post for AJN: How I Would Prepare My Daughter to Become a Nurse

My kids have been asking me surprisingly specific questions about my work as a nurse lately. I really enjoyed writing this blog post for American Journal of Nursing because God knows the two occupations that have consumed my days and thoughts this past year have been nursing and motherhood.

And at the end of the day, I realize this was a reflection for myself as well – what I have learned and continue to need to learn as both a nurse and simply as a human and as a Christian looking to live faithfully and well in a complicated world.

You can read the entire post here.

anchor for the years

Ten years into being a pediatric ICU nurse, I find I still grieve the saddest patient cases the same way I did from day one. It hits the day after with unpredictable tears, and I’m discombobulated as I try to reorient myself to my “normal” life and all its demands on me as mama, while still feeling haunted by the harsh reality of the story I bore witness to for 12+ hours just the day before and all its demands on me as nurse.

It’s like having this bittersweet privilege to pass through a blackout curtain where one side cannot see the other. Normal healthy families cannot imagine the agony of critically ill ones. Critically ill ones ache to remember what normal life felt like as it now feels too out of reach. I am the witness between the two sides that pull in opposite directions. On one side, I am playful, silly and tempted to be dismissive. On the other side, I am heavy, somber and sometimes over-responsible. Sometimes they collide inside me and that too is disorienting.

But in this particular moment in history, normal life is also not quite normal. Sands continue to shift, kids’ schedules continue to change, and I am looking for the anchor when I feel unmoored.

I am fighting today to remember that one of the best things I can do is carry the lessons from the darker, heavier side into the lighter spaces where I can see through the layers of all “normal” life’s demands and find what really matters for today. Loving God, loving my neighbor, my children…and being loved.

New blog post for AJN: The Bittersweet Reality of a Nurse’s Limits in Providing End-of-Life Care

My latest blog post for American Journal of Nursing is up.

Working in pediatrics means I didn’t see the kind of mass casualty COVID deaths that adult hospitals saw, but death and dying are still a regular experience in our unit.

While sobering, it’s important to think about death because it’s then important to think about life and the way we are with one another while we still have breath and opportunities. Caring for these patients at very different points in their end-of-life trajectory left an impact on me, and I hope I too was able to make some impact on them as well.

You can read the entire post here.

COVID Vaccine: Dose #1

We are living the most wild time in recent history with this COVID pandemic, so I find it important to document our experience as nurses. Here are my reflections on the day of, and day immediately following, receiving dose #1 of the COVID vaccine.

Saturday, December 19, 2020: I received the first dose of the COVID vaccine at my hospital at 0630 before my shift started at 0700. This was written later that morning.

***

Who could’ve imagined a year like this. We are still in dark, dark times. Just last night I broke down and cried out “I quit!!” re: all things about this madness. But I didn’t mean it. I’m just worn down like we’re all worn down – by a mean virus, awful politics, heartache and anxiety. I grieve that we have lost so many lives to date. It didn’t have to be this way and I grieve that deeply.

But still His mercies are new every morning. The sun rises, hope comes. So I got up in the darkness to get to my 6:30am vaccine appointment on time before my work shift. And this smile is one of deep gratitude for the scientists and workers and yes even the politicians who cut through the red tape and all the bickering to get this vaccine to us.

It didn’t hurt at all. 2.5 hrs in and I feel great, just the most negligible soreness in my arm, but I’m roaming the ICU as Resource Nurse with a grateful confidence that I finally have some protection on board, and more is coming with the second dose. I understand the fears, I do. But let me be your “guinea pig,” I don’t mind. I will be so happy to be a living and grateful example of the relief we can all begin to find from this awful virus. We can rise up in the darkness. We can. The sun rises, and hope comes.

Sunday, December 20, 2020 11:30AM

A day and some change after receiving the 1st dose of the vaccine:

– Arm soreness is mostly gone, some tenderness at the injection site remains. *I will say that after I got the shot yesterday morning, the arm soreness increased throughout the course of the day, to about a level 4/10 for me which is more than I’ve experienced with other vaccines, but I was still fully functional at work.

– Maybe (?) some mild body aches but I’ve been carrying a lot of stress in tense shoulders for weeks so it’s really indistinguishable from my usual.

– Otherwise normal.

I will not sugar coat any side effects I feel, particularly after the 2nd dose when I fully expect to feel worse for a couple days. People deserve a fully informed choice about this vaccine, but they also then need to face up to hard realities of the risks of opting out of it when it becomes available to them, which I will speak up about in future posts.

For now, it is time for hope, and I am glad to be the public’s guinea pig.