Nothing to Envy: Chapter 7 Summary & Analysis

That July, the hospital in central Chongjin where Kim Ji-eun worked received many patients who sustained injuries or collapsed while mourning Kim Il-sung at his statue in the city. Rooms were crammed due to a recent typhoid outbreak and dark due to electricity failures. The 28-year-old Dr. Kim hardly ever left the hospital, as she was always the first to volunteer for extra shifts in hopes of being chosen to join the Workers’ Party one day soon. Dr. Kim’s father, an ethnic Korean from Manchuria, moved to North Korea in the 1960s and expressed extreme devotion to the regime right away, grateful to have fled Mao’s China. Dr. Kim always mirrored her father’s enthusiasm for the regime and sought to impress her father with her loyalty and hard work.

Dr. Kim gave herself to her patients body and soul. From making house calls in poor neighborhoods to donating her own blood to gathering medicinal herbs to supplement the hospital’s paltry treatments, Dr. Kim managed to meet the unique demands of being a doctor in  resource-strapped North Korea. By the early 1990s, however, medical equipment continued to break, yet no new supplies or machines arrived from abroad; pharmaceutical factories shut down, leading to a shortage of medicine. When Dr. Kim’s higher-ups started rationing painkillers and antibiotics based on their personal preferences for different patients, Dr. Kim began experiencing tension with her superiors. She asked to be transferred to pediatrics. Dr. Kim was already divorced and living with her parents—the struggles in her personal and professional lives were compounded by the sudden misery of Kim Il-sung’s death.

Dr. Kim was devastated when she learned of Kim Il-sung’s death. She and her colleagues, deep in denial, traded conspiracy theories about how Kim Il-sung had been assassinated. She was so wrapped up in the response at work that by the time she realized her father was intentionally starving himself to death, it was too late for her to do much of anything. Though Dr. Kim begged her father to eat and even gave him intravenous fluids, her father’s condition worsened. He grew delirious and began railing against the Great Leader. One night, he scrawled a strange pyramid labeled with names and numbers on a piece of scrap paper. He handed it to Dr. Kim and told her that he had written down the names of relatives in China who would help her when she needed them. Dr. Kim locked the paper away in a box, confused and upset.

After her father died, Dr. Kim threw herself into her work with even more gusto. Summer turned to winter, and the normal rhythms of life in North Korea resumed—but when the weather once again warmed and rains flooded the rice paddies, the government admitted publicly, at last, that the nation was enduring a food shortage. Dr. Kim began to notice that her patients in the pediatric unit were skinny and weak, with heads too large for their bodies and strange pains in their stomachs. Fed on wild grasses foraged in the woods and the husks of corncobs, the children were unable to digest or receive any nourishment from the scraps they were eating.

Other patients began coming in with devastating, strange symptoms. Rashes around the neck and hands indicated pellagra, caused by a lack of niacin in the diet, and many women came in unable to produce milk for their newborns due to their own malnourishment. Many came to the hospital looking for food, but the hospital had no rations, either. Dr. Kim watched many of her pediatric patients die, unable to do anything to relieve what ailed them: starvation and wasting.

By 1995, North Korea’s economy had come to a total standstill. Exports dropped from $2 billion to $800 million; factories began to rust, Chongjiin’s ports were empty, and even the ubiquitous propaganda signs began to chip and fade. Demick notes that Kim Il-sung died at a “convenient” time—his legacy, in the eyes of his people, would be protected from association with the immense destruction that was just beginning.