As Dr. SreyRam Kuy describes her work as a surgeon caring for the nation’s veterans, and the closeness and fun she shares today with her mother and sister, she repeatedly interrupts herself with the spontaneous laughter of a person whose spirit will not be contained. It’s easy to forget that she was born in a Cambodian death camp during one of the worst genocides in human history, and that she was almost killed by a grenade before she was three.
Kuy, 37, graduated from Oregon State in 2000 with bachelor’s degrees in philosophy and science. She earned her medical degree at Oregon Health & Science University in Portland in 2005, and a master’s in health services from Yale in 2009. She works in Shreveport, Louisiana, at Overton Brooks Veterans Administration Medical Center, which handles nearly half a million patient visits a year.
“I’m a general surgeon, which means I do everything that’s not cool or pretty,” she said. Her patients have ailments ranging from hernias and appendicitis to life-threatening abdominal cancers. “It’s like the family practice of surgery. You do it all.
“I think it is such a privilege to serve these veterans. It can be a difficult population to work with, because there’s a lot of poverty and a lot of the residual effects of having gone through warfare — PTSD, depression, anxiety … but they are also grateful. They are almost always appreciative of the care they get.”
Kuy knows about gratitude. Her mother, Sovanna Soeung, instilled it in her daughters as she taught them how they survived Cambodia’s Killing Fields and Thailand’s crowded, dangerous refugee camps to make it to a new life in the United States, where both SreyRam and her big sister SreyReath — a 1998 OSU grad who works as a podiatrist in Houston — would live lives beyond what they could imagine as children.
“When we were young, working with our mother in the strawberry fields in Oregon — we worked alongside migrant workers from Mexico and elsewhere, picking berries, beans, onions and anything else you can pick — she’d always tell us stories of our time in Cambodia.
“Even when she talked about the Killing Fields, she’d try to find the good stories about how someone saved our lives, or about how she was resourceful as she sneaked away at night to find food for us, digging up bamboo shoots in the forest. There was always a miracle in there. Those stories became a part of me.”
Early on, the Kuy family lived a reasonably comfortable life in Phnom Penh, Cambodia’s capital. Mom was a teacher, Dad a mid-level government official. They had a baby daughter, SreyReath.
Then, in April 1975, Khmer Rouge rebels led by the ruthless Pol Pot toppled the government.
Everything changed. Pot tried to impose his vision of a perfect communist society by taking Cambodia back to what he called “Year Zero.” Khmer Rouge fighters, many of them still children themselves, marched millions of Cambodians out of the cities and into primitive work camps.
Anyone found to have an education could be summarily executed or taken to a special facility — the most infamous of which was a converted high school — for more systematic annihilation.
Bodies were stacked and left in the open, leading to the designation of much of the Cambodian countryside as the Killing Fields.
Like most educated Cambodians, the Kuys posed as illiterate peasants to avoid execution. They struggled to survive years of hard labor on a starvation diet.
At one point, someone told the Khmer Rouge that SreyRam’s mother had been a teacher, and soldiers dragged her away to kill her. She reminded the young fighters of a Cambodian folk tale in which some men paid a terrible price for mistakenly punishing a powerful man’s dog for something the dog hadn’t done. She convinced them she was like a lowly, stupid dog — no threat to the revolution.
In 1978, in a place and at a time when anyone found to have medical training was deemed to be too educated and was marked for death, future surgeon SreyRam Kuy was born at the edge of the Killing Fields.
Vietnamese soldiers toppled the Khmer Rouge regime the next year. An estimated 2 to 3 million Cambodians — about one-fifth of the population — had been murdered, starved to death or had died of disease. Guerrilla warfare would continue for another dozen years.
The Kuy family was free to return to Phnom Penh but their home had been destroyed and Cambodia remained an extremely dangerous place. Seeking a better life elsewhere, they joined hundreds of thousand of fellow refugees in a harrowing, often deadly trek toward makeshift aid camps in Thailand.
The Thai government was overwhelmed and displeased by the massive exodus from its neighbor to the east.
“We were basically illegal immigrants,” Kuy said. “They didn’t want us there.”
Two weeks after her family reached Thailand and settled into a squalid camp, someone attacked it with grenades, presumably to discourage more immigrants from coming.
SreyRam sustained a head wound that almost detached her left ear, and her sister had an arm injury, but their mother — who had tried to shield the girls with her body — took the brunt of the blast and received seemingly fatal wounds to her torso. Medical workers on the scene assumed she would die and focused at first on helping her daughters.
“There was a German surgeon volunteering in the camp that day, and he operated on us and saved my life and then my mother’s life,” SreyRam said. “I’ve always thought that was amazing and miraculous. It’s just incredible that people will leave their comfortable lives and go to a place that’s dirty and dangerous and work to help people who don’t look like them, don’t speak their language and have nothing to give back to them. I think that has just been ingrained in me. I think it’s why I’ve wanted to be a doctor since I was in third grade.”
As the family recovered from its wounds, the Kuys were deemed fit for emigration to the United States and were flown to a new camp in the Philippines. There, a group of Seventh-day Adventists from a faraway placed called Corvallis agreed to sponsor them.
Once in Oregon, SreyRam’s parents could not find work close to what they’d had in Cambodia. Her mother took a position cleaning hospital rooms and supplemented her income by cleaning doctors’ houses and taking on other jobs.
“I’m just so proud of her, of all she did for us,” SreyRam said. “Everything that is good or praiseworthy about me, I owe to my mom.”
(She does not speak in detail about her late father, except to say she loved him and that he had an especially hard time with life after the family was forced out of Phnom Penh.)
SreyRam’s mother made sure her daughters remembered that she had almost died for being educated in Cambodia. She insisted that they study hard so they could enjoy the tremendous opportunities available to educated people in the U.S.
Both girls were good students; SreyRam was valedictorian at Crescent Valley High School. Harvard offered her a generous scholarship at almost the same time her father was diagnosed with terminal stomach cancer. In what she calls a “spur-of-the-moment choice,” she decided she needed to stay and help her mother, rejecting Harvard in favor of the local university.
“The day I decided to come to OSU, I came over to the campus to fill out paperwork and then I sat on the steps of Strand Ag Hall with a paper pad and a pen and I wrote down everything I was going to do for the next four years,” she said, adding that she has no regrets about her decision.
“I am by nature a planner. For every single step I have a plan A, a plan B and a plan C. In college I was going to win these awards and be in these student groups and have these experiences. Some of those I did accomplish and some I didn’t, but what I’ve realized since then is that none of that really matters.
“Those things are just pieces of paper. What really matters is that we’ve been given one day in our lives to live. This day. We can’t control tomorrow and the past is over already.
“There were three million people with us in Cambodia who didn’t get this day. They were murdered or they died from starvation or illness in the Killing Fields. I’m alive, and I did nothing to deserve to be alive while they are not.
“Who I am is directly shaped by the experience I had at OSU. … Where else would I have gotten so much love and support? I had endless opportunities. I had incredible teachers.
“I got to know President Paul Risser. I would go to these awards dinners and events they had for presidential scholars and he’d know me by name. That felt so amazing to me. You come from where I came from and the president of your university knows your name!
“When it was time to graduate, I was in Washington D.C., working for Sen. Tom Harkin, and I hadn’t planned to came back for the ceremony. But Les Risser, President Risser’s wife, sent my mom a bunch of tickets and said we were sitting next to her at graduation, so I had to come back.
“I had so much help. I’m grateful to all the people and foundations who enabled me to get an education at OSU. I couldn’t thank them enough. I was supported by the Ford Family Foundation, the Earle Chiles Presidential Scholarship, the Marilyn Koski Memorial Foundation, the Tom and Faith Norris Foundation, and the Oregon Academy of Family Physicians, among many other incredibly generous people and organizations.”
Today, in addition to having a full-time surgical practice, Kuy directs the Overton Brooks Center for Innovations and Quality Outcomes in Patient Safety. One of a handful of such programs across the nation, the center researches ways to better care for surgical patients, and seeks to teach the new approaches across the VA system.
“When you look back over 100 years or so of surgical training, it’s ingrained deep in the culture that the surgeon is the captain of the ship and you don’t question him,” she said. “But communication is the key to preventing what we call these ‘never’ events — things that just can’t happen, like retained sponges and allergic reactions and people bleeding to death. We train the entire surgical staff to react in terms of ‘What I see, what concerns me and what I need to do.’
“We’ve reduced our adverse outcomes, and when we’ve presented this at national conferences of VA surgeons, we’ve had people lining up in the aisles to say good things about what we’re doing.”
A self-described workaholic, Kuy spends almost of all of her free time hanging out with her mother and sister, who live together in Houston. The sisters are seeking a publisher for their account of the family’s experiences, and their mother still makes trips to Cambodia to do missionary work.
Kuy said that while she doesn’t know if she’ll always work for the VA, she loves the service aspect of caring for a population that sacrificed so much and often has nowhere else to turn for care.
“I know that wherever I go, I will always be in some sort of service medicine,” she said. “I have to do something that shows my gratitude for this life.”
Photos by Hannah O’Leary; story by Kevin Miller. Originally appeared in the fall 2015 Oregon Stater magazine.