When Ahn Kihong was diagnosed with cancer about two years ago, the disease was spreading to his liver, large intestine and lungs.

At 67, he yearned for his only daughter, his eldest, to be at his side in Seoul, South Korea. But Anita Ahn was far away in Hawai'i with a visa situation that meant if she left, she'd risk not being allowed back to work. (In Korea, the family name goes first, but Anita Ahn, who lives here, uses the Americanized configuration.)

A bout of chemotherapy extended the father's life for about a year, but by August, he was failing fast. Just minutes before he died, he woke from his illness-induced stupor and had Anita Ahn's brother phone her. Speaking into the phone's receiver, the daughter told her father: "Please come to me, I'll take care of you."

He would oblige, but not in the traditional sense.

After her father died, Anita Ahn invited several people to join her as she performed Je Sa, a Korean ancestral rite, for Ahn Kihong.

It was as if his spirit filled the room, she said.

"Energy, bright lights came down," Ahn recalled.

As the tears flowed, she said, she knew her father — like her, a holistic healer — really wanted to see her. "He knew I couldn't go there, (so he) tried to extend his stay on this planet."

LESSONS IN UNDERSTANDING

South Korea is a land where Christianity, Islam, Buddhism, Confucianism and other religions mesh with indigenous practices such as shamanism to create a rich tapestry of cultural practices, often confusing to those trying to care for the dying here. Understanding the vast array of religious and cultural practices of Korean-Americans is helping those in the medical and social work fields minister to the needs of this portion of Hawai'i's diverse cultural pie.

To that end, doctors, nurses, social workers and an array of other professionals heard firsthand from members of the Korean-American community in Hawai'i what they should — and shouldn't — do when death comes knocking for someone in their midst at a discussion of end-of-life cultural differences held by St. Francis Hospice last month.

Ken Lee, a lifelong Hawai'i resident who now is director of disaster case management training programs at the University of Hawai'i School of Social Work, told how as a teenager, he observed as his auntie, normally a strong professional woman, wailed the most plaintive of cries when her husband died.

When the family went to visit her immediately after the loss, she wrapped her nephew in her arms. Then she cried like Lee had never heard her cry before.

Taken aback by this side of his aunt, Lee responded the way boys who are surprised often do — he began to laugh.

Of course, that brought on much consternation from his family. It reminds Lee to try to tailor the message to the audience.

"Here, Koreans come from so many different experiences," said Lee, whose family goes back to the first days of Korean-Americans in Hawai'i. "Some are westernized; some follow the cultural practices."

BLENDING BELIEFS

Assimilation isn't the only thing taking a toll on cultural practices: Time itself brings variations, as Korean culture evolves both here and in the homeland.

"Different generations may have different sets of beliefs," Lee said.

In South Korea, for example, Maryknoll Sister Yoo Soo Kim kept her mother's body in the house for three days after she had died. It was a time during which the family performed rituals and set up a special room for visitors to pay their respects. A car covered in flowers took the body to the funeral, where four priests said Mass, and along the route people came out of their homes to bow.

But these days, whether in Korea or in the Islands, more funerals incorporate western touches, said Sister Kim, who now lives in Hawai'i. That's because Christianity has become a religious force in Korea, though many still mix and blend different religious practices like Confucianism or Buddhism with their Christianity.

Still, religious concepts overlap or intertwine from Korean tradition. One common belief is acceptance of some form of an afterlife. "For Koreans, dying isn't the end of being," said Sister Kim, a Roman Catholic nun.

Anita Ahn, Lee and Sister Kim showed the group gathered at Borthwick Mortuary the beginnings of a Je Sa ancestral rite ceremony, which calls upon the ancestors.

For the demonstration, the trio wore the traditional hanbok in white, and the altar was set with sweet rice cookies and Korean-style mochi as well as Korean wine, an offering for the ancestors' spirits when they return to the earthly realm.

Ahn said her father's spirit has returned to her when she has felt the most troubled. About six months after Ahn Kihong's death, she held another rite and was comforted by his spirit once again.

"It was really powerful. I received a message and felt Father's presence," Ahn said.