Kate Hoepke and Dr. Wayne Pan: A conversation about community and belonging

00:04 Okay. Hi. Hi, wayne. Today is August 4, 2022, and I am Kate Hoepke and I'm the executive director of San Francisco Village, and I've been with San Francisco Village a little over 10 years.

00:24 Hi, Kate. My name is Wayne Pan. I'm on the board of San Francisco Village, and I've been on the board since January of this year, so about eight months.

00:34 Yeah. We're happy to have you. I'm proud to say that I recruited you.

00:38 Yes, yes.

00:40 That was very smart of me. Yeah. So really happy to have you. So I'm going to start with a few questions just to find out a little bit more about you. So you started with San Francisco Village on the board earlier this year. Can I ask you what attracted you to San Francisco Village?

01:02 Yes. I've been always interested in how community groups can help older adults live in their neighborhood, live in their houses. I was originally involved in a startup earlier in my career where we tried to do exactly that by using tablets and devices that were, you know, before the iPad. And it was a learning experience to understand that this or these types of organizations are across the country and actually help older adults be able to live in the place where they like to live the most, which is their home.

01:40 You're a physician? Yes. Yeah. So why is that important? Why is it important for people to be able to live in the places they call home?

01:49 Part of my background is also in managed care, and I realized that the cost of healthcare for older adults obviously increases exponentially, and part of that cost is associated with living in an institution. If people don't need to live in an institution and can be supported at home, that can obviously increase their quality of life as well as reduce total healthcare costs. My interest has been from an economic and social standpoint, but also from a cultural heritage standpoint. The Chinese culture is very reverent to older adults, and we as a culture have always lived in multigenerational families which supported people as they age and they aged in place. So that's where I came from.

02:38 Yeah. And then you joined the healthcare industry, which is. It doesn't seem to pay very much attention to culture or to the social determinants of health, to things that really influence a person's life. Have you found that to be true, too?

02:54 Yeah, that, unfortunately, is something that. It's an afterthought because most people are trained on focusing on the clinical issues, but of course, the patient or person doesn't live in just the clinical setting. They live in their world and life dealing with the other Pieces, which we now know is 80% of. Of the contributions of healthcare cost variability is the social determinants.

03:20 80% of cost variability is dependent upon social determinants of health.

03:25 Yeah, exactly.

03:26 Wow.

03:27 Which is amazing. Right? Yeah. We try all these other things and those other things don't really matter as much as social determinants.

03:36 Right. It makes sense when you say it, because our lives are not lived within health medical institutions. Right. They're out here in the world.

03:47 Right?

03:47 Yeah. Wow. So you're a physician.

03:52 Yep.

03:52 Yeah. So what got you interested in medicine?

03:56 So I'm not really sure exactly when that happened, but it probably was implanted into my head when I was a baby, you know, because as a, as an Asian immigrant family, you know, they tell you either be a doctor or a lawyer or if you have to be an engineer. I think that's where it started. And I just felt, I just looked up to doctors. I thought they were cool, they knew what they were doing, they were well respected in the community. That's how it happened.

04:27 Was it a good choice? Are you happy as being a physician?

04:31 Yeah, I think ultimately it was the right thing to do. The special diapic was helpful to me. Now, probably debatable as an orthopedic surgeon, you don't typically deal with this type of stuff, but as you know, I've migrated away from clinical practice and moved into more business and other issues associated with health. And that being a primary care doctor probably would have given me a little bit more insights into that slide, but definitely learned a lot in my travels.

05:05 Yeah. Your background is really interesting. There's a lot of intersections in your background. Right. So there's medicine and there's technology and there's business and an interest in culture and an interest in older adults. And so it's very wide ranging. Yeah.

05:24 And I'm also gay, so that throws another different perspective into how I see things and what I see.

05:33 And your first generation born here in the United States.

05:36 Yeah, exactly.

05:37 Yeah. And you have a couple of kids?

05:40 I do. I have a four year old son and a seven year old daughter. So.

05:44 Yeah. Good for you. Congratulations. My heart goes out to you. It's challenging times to raise a child and you're a member of the sandwich generation. We were talking earlier about child care and elder care. Right. Your parents are older.

06:02 Yep, my parents are older and now need more attention and more help. Some of them are starting to have declines in cognition and mental issues and so that is challenging, particularly since they're immigrants and need specific cultural and language Care. Language. Affiliated care.

06:23 Yeah, That's a conundrum. And good that you're in the Bay Area. I think there's a lot of resources in the Bay Area for monolingual speaking people.

06:34 Yep, exactly.

06:35 And for the families that love them.

06:37 Yeah, yep, exactly.

06:38 Yeah.

06:39 That's what's interesting about San Francisco Village as well. Right. Because it is community based. And so as we're trying to expand our reach into other communities, I think that will provide a better base for membership as well as a base to reach out to. To families in need that could see the value of having San Francisco Village as part of their lives.

07:04 It's really true. You and I, we chatted a little bit earlier about some of the questions that we were thinking of asking each other. One of them that we landed on was this question. What has been the most significant experience in your adult life? I don't know if it needs to be the most, but a significant experience in your adult life, and how has that experience shaped or guided your choices? Do you want to talk about that a little bit?

07:33 Yeah. I think the most significant experience in my adult life was the birth of my daughter. Obviously, we couldn't have children ourselves. My partner, Steven and I wouldn't. Obviously that wouldn't work. The process of identifying a surrogate in which. And we decided to do it outside the US and also required an egg donor. And then the whole process of following the pregnancy remotely and then having. Then obviously going to the country to be able to be there at her birth. And I was actually in the operating room where it happened. So that, by far is the most impactful thing. And the way that it changes you, as anybody, any parent that has kids knows your world changes completely once you have a child, because it's no longer just about you and your partner and your friends and family, but it's this human being that you brought into the world and making sure that the world is a safe place. Right?

08:44 Yeah. Yeah. I get chills listening to tell that story. We actually have that in common. The birth of our children was a very significant time in my life as well. But, you know, the other thing I'm aware of is that when we become parents, when we bring a child into the world, it changes the whole family system. Yes, right.

09:04 Yep, it definitely does.

09:06 So from an ancestral point of view, you know, or from an evolutionary point of view, bringing a new person into the world, it's like, whoa. Kind of just blew the walls out a little bit here.

09:17 Yeah, it becomes. Yeah, it really becomes. You have a totally different perspective, because it's not. You're now one level up right now. You have a level below you, and you have this responsibility. It's no longer just how I function or I deal with things, but it's how your children will live out their lives. And you're very concerned that things that may not be as pertinent for your lifetime will certainly be relevant in their lifetime. And so your perspective, your longitudinal view becomes much more focused. Right. So things like safety and peace and pollution and environment and climate change and all that kind of stuff, it doesn't really matter, but it now becomes. I got to make sure that this doesn't get worse, because that will impact my children.

10:16 Yeah. It's huge. That ethic of care that we must.

10:21 Care for, not optional.

10:25 Right. We must care for future generations. That's our job. I think we have lost sight of that in our American culture.

10:34 Yeah. I think there are other things that interfere with that line of thought, and I think we need to get back to that. And it's very basic. Right. It's not. You just have to leave the world a better place, or at least not make it a worse place. And I think that's an obligation for each succeeding generation. Otherwise we'll all go extinct.

10:58 Yeah, absolutely. So it's really clear how becoming a parent has impacted all of your life choices at this point.

11:07 Yeah. Yeah. I mean, it. Yeah. It definitely has changed the way that I think about things and how I go about trying to pick problems to solve, so.

11:17 And your kids are now watching you in how you care for your parents.

11:22 Yes. They're also seeing that, too.

11:25 Yeah. It's really deeply embedded, I think, in all of us when we're young, how our grandparents age and how our families care for them. I think we carry that with us.

11:39 Yeah, I agree. I think the connection between generations is very important. And I think that. That, you know, I think nature made that happen. Right. I think if we didn't have that, if we basically left our parents when we were two years old, like some species, you wouldn't have that connection that you have as humans. And so I think we could look at that as that's a sign that we should be doing something better.

12:06 Yeah. Well, Wayne, it's been really fun talking to you and getting your perspective on a few things, so thank you.

12:15 Sure. Thank you.

12:16 I really enjoy getting to know you.

12:18 Yeah, same here. Thanks. So it's my turn to ask you some questions. When in life have you felt most alone? I know that's out of the blue. But we've talked about this before. When have you felt most alone and when have you most connected or known?

12:35 Yeah, well, we did talk about this, and I identified that as a question that I would like to talk about. Because my work at San Francisco Village is all about community building and about the recognition of social isolation and loneliness as a threat to our well being, not just as we get, not just for older people, but for all people. And so I think that my sense of belonging to something bigger than myself has been so dominant in my life since I was a child. And there have been many times in my life when I felt alone. And there's sort of. It can be kind of an alarming state to be in, you know, and one time in particular had to do with the birth of my children. So I am originally from Detroit, Michigan, and my husband, I was married for 27 years. I've been divorced for 15 years. But at the time when we were having children, we lived in Southern California and he was from Germany. And so we had no family, we had no extended family, no network. We were new to California. And here I was, had two children, two years apart. And I felt extremely isolated. I didn't have a babysitter, I didn't have friends, I didn't have a job to go to because I was a stay at home mom. And it was really a frightening time. And so fortunately, the universe intervened or the stars aligned or whatever, and I discovered something called the Huntington Beach Mother's Club in Orange County, California. And I called this number and I connected with these women who were going through pretty much the same thing I was. They were having children, and whether they had family nearby or not, it didn't seem to matter. That what I discovered later was that it was a developmental thing in our lives. When we become parents, we're going through this whole identity shift. Who am I now? And how do I relate to my previous life and how do I discover my life going forward? And so it became a journey that I could embark on with connection and with friends and with accompaniment, which really changed everything for me. And so it rooted me in community building, which became my field of study. And so I've been studying community building for the last 40 years.

15:32 Wow.

15:33 And I took that experience and I turned it into a project. I started Mother's Clubs all over the Bay area. I started 40 of them.

15:45 Wow.

15:46 And they have served somewhere between a million and a half and 2 million families over the last 25, 30 years.

15:53 Wow.

15:54 And that was. Yeah. And we started that before the Internet, you know. So I was teaching classes at park and rec departments and stuff like that to inspire other women who I knew were going through what I went through. And clearly the numbers speak to a need. It's part of our human development cycle. And I think that increasingly we've become a lonelier population. And so there was really a defining moment in my life.

16:31 Wow, that's really cool. Have you helped, I guess, or connected what you did in the community with the healthcare sector, talk to OB GYNs who obviously have patients who will be delivering to help them prepare and then afterwards so that they could find these clubs a lot easier. Was that difficult to do?

16:58 It was very difficult to do, Wayne. And of course it was a strategy that I identified early on when I was starting all these clubs. And I thought, where's that central hub? Where's that point of connection? Right. And I was dismissed at every level. I was told, you don't know, we don't need that. We're a very service rich Bay area or whatever. We don't need anymore. I said, it's not a service, it's community, it's life. It's like breathing. And I was dismissed. So it's a good thing. I have a rather rebellious nature and I said, okay, forget it, I'll do it myself. And I did.

17:39 Wow.

17:40 And so my attempts to connect with sort of the institutional support that I thought would be a natural fit, it didn't work. But it prepared me for the work that I do now. So as the executive director of San Francisco Village, we kind of operate on the periphery.

18:01 Right.

18:02 We're not part of the mainstream infrastructure. We created our own infrastructure because it was so desperately needed. And the benefit of that, of course, is that we've got great agility and the ability to pivot and do what we need to do because we're not beholden to an institution. The downside, of course, is that for many years we struggled to get the kind of support we needed to sustain ourselves. But we're there now, I think.

18:31 Right, that's great.

18:33 Yeah.

18:34 So what has been the most significant experience in your adult life now that you've talked about the Mothers Clubs and starting, you know, being executive director of the San Francisco Village. And what has this experience shaped or guided your choices?

18:51 Yeah, you know. Oh, there's so many. I would say that my ex husband was in the hotel business and so when in. We were living in Orange county and we had a three year old and a one year old and he wanted to take a job in New Jersey, across the country. And so I agreed because I wasn't that happy in Orange county. And. But I got there, to New Jersey, and I was like, wait a minute. I know. I know what it's like to be the member of a community that really cares for me and is curious about me and knows me and how much that contributed to my health and well being. And there was nothing like it in New Jersey. So I started my own. And so what that taught me, taught me so many things. It taught me that I had. I had a chutzpah. I think I already knew, but it confirmed it for me. I learned that I had leadership capacity, that I had managerial skill, that I was a good public speaker. So all of this came together in that experience, which then fed the community building drive in me. From that experience, I studied community building. I'm still studying it. That's been about a 35, 40 year journey of learning what it means to become myself in the reflection of other people. So that's a sociological concept, right? That we become who we are in the reflection of other people. That's really been true for me. And so I'm really grateful. It was difficult. Those were difficult times. Then we relocated back to San Francisco four years later. My kids remind me that I was depressed at that point, which I think I probably was because I had left this wonderful community of women that I had basically created the structure for. But you know, oftentimes out of those woundings, I've discovered is where my medicine is like, I can take that wounding, I can take that difficult experience and I can turn it into something that not only heals me, but heals other people.

21:18 Right.

21:19 So I kind of have to learn to ride that wave.

21:23 Right?

21:24 Yeah.

21:25 That's great. That's a really important lesson to learn. If you were going to do it again, is there anything that you would do differently? Or is everything sort of you're satisfied with the way things have turned out?

21:41 There's a million things that would do differently. A million. When I talk to old people and they say I don't have any regrets, I say, are you kidding me? I have mine and yours, then you know, yes, there are plenty of things I would do differently. But then at the same time, you know that old adage about, well, I've become who I've become and I'm happy with that. Yeah, that's true too. But I know that I could have made some better choices in my life and for whatever reason, I didn't have the capacity at the time to do that. You know, one thing I've learned a lot about Wayne is forgiveness.

22:23 Right.

22:23 I recently became a grandmother for the first time.

22:26 Congratulations.

22:28 Thank you. And when visiting my daughter and my son in law during that first month of my grandson's life, we were in a conversation about something where my son in law felt as though he had made a big mistake, you know, he had done something, you know, that might have harmed the baby. He didn't.

22:47 Right.

22:48 But I remember saying to him, you know, Christian, for me becoming a parent, as a parent, I find that I need to forgive myself nearly every day. There are a lot of, a lot of mistakes and we're flying by the seat of our pants a lot of times and we do the best we can. All those, all those platitudes, you know? But yeah, learning to forgive myself has been really important.

23:16 Right.

23:17 Yeah.

23:18 Is there any. So for generations listening to this conversation, years from now, is there any wisdom other than what you just said, which is, I think, very important and very wise that you want to pass on to them? And what would you want them to know?

23:32 Yeah. I'm reading a book right now, and one of the statements in the book is really something that has guided my life for a long time. And that is, it's not so important what I decide to do. It's more important who I decide to become. And so I love to share that with younger people that in their different stages in our lives, we make choices about who we're going to become. That's one of the beauties of working with older people the last 25 years, is that I get to interact with people and I'm listening to their stories and they may be really happy and light and carefree, or they might be really dragged down by memories and unresolved business. And I often say to myself, I wonder what choices she made when she was my age, you know, and I wonder how she's gotten here to this point. Either her happiness or her depression or whatever that is. And I take that on seriously, like, I am the master of my own life. I am making choices every day about am I acting in line with my values or am I acting in line of pursuing something consumer like consumerism or fame or, you know, ambition, or am I, you know, taking a step every day towards something that really matters to me. So I do, I do hope that young people realize that it's. We create our own reality and we create our own life. Yeah. It's not accidental.

25:28 Right. I think you bring up a good point about the fact it's the journey and the process within the journey that matters the most and not necessarily the immediate outcome or the immediate consequences. It's really the longer view, which I think is helpful to understand and. And working with older adults, you get to see that, because the ones that are generally happier are ones that have made peace with that and understand that it's the journey, not the destination, and it's all the things that made up that journey that makes that person.

26:11 Yeah, right. Well said.

26:14 That's cool.

26:16 Yeah, that is cool. So the good news, the other really great thing that I love to share with younger generations is that I love what I do. And I've been saying that to people for, you know, everything. Actually. When I got in the field of Aging 22 years ago, I knew I was home. I had. I really could feel the resonance in my body, like, oh, this is what I've been meant to do. And so in all my engagements with people, they would maybe compliment me on something that I was doing or saying, and I'd say, yeah, well, I love what I do. And people often say it shows. And I think that's the highest compliment, that it's like, okay, it's evident. So my inner life matches my outer life. That's congruence for me. There's just nothing better. Yeah, that. There's that congruence in my life.

27:16 That's great. Yeah. I think it's hard for younger people to achieve that because there's so many other things going on. And I think you get to a point in your life later on, unfortunately not earlier, that you realize that congruence is actually the key to happiness. Right. The dissonance that happens as you're. When you're younger contributes to a lot of the angst that you have, and the sooner you're able to resolve that and step back. Right. Not to be always on that edge trying to figure out what to do next, but sitting back a little bit, that perspective helps. And then you become grounded and centered, as people say, and then you become happier. Right?

28:04 Yeah. Yeah.

28:06 That's really cool.

28:07 It is very cool. Yeah.

28:10 I want to ask you a question about the board and how you. How you see the board as an extension of the work that you do and how you. What's your philosophy on how to manage a board? Because I think there might be some people listening to this conversation later on that will want to understand how you approach a board and especially for nonprofit. And what you look for and how do you deal with it.

28:40 Great question. We're a very Small team here at San Francisco Village. We're so excited. We have six employees. We manage a community of over 800 people. People with six employees. We have a lot of volunteers. And so I've always looked at the board of directors as my partners and as somewhat of a management team, because I don't have a management team necessarily. You know, we've all got our work to do. But I look at the board as a brain trust and this body of resource for the organization. So when I am looking to ask, you know, to recruit people to come on our board, I'm looking for people that have a really deep connection to what they do, that there's that congruence, and I can feel it in other people, and I can feel the opposite. So I want people that are really, you know, deeply committed and inspired by their own life and by the work they do, and they're going to bring that to us. I'm also. I look to our board of directors as a team of ambassadors. So you're all out in the world, and you're interacting in a number of venues with a number of different people, and you're a representative of San Francisco Village. Now, the village model is relatively new, and there are a lot of people that do not know who we are or what we do or why it's important. And so you're like a brand ambassador in a way, where you're representing us and you're thinking about, how can I make a connection between this person I just met and San Francisco Village? How can I bring resource to San Francisco Village? It might be money, but oftentimes it's connections with other people. It's partnership potential. It's new ideas, it's new technology. It's a way to help us think bigger. You know, in business, we all. Everybody talks about scale. That's the buzzword. And there's a lot of value in that, and I understand it. But I also think about expansiveness, and that's more of a centered heart centered. And we expand out. How do we include more people? How do we bring in new ideas? How do we challenge ourselves? And those things all lead to growth. So every new board member brings this potential for that kind of growth.

31:27 Yeah, that's great advice. I think looking at a board as. As an extension of your team allows them to participate more and want to do more for the organization and feel like they have something to contribute. So I think that's a great approach.

31:48 Yeah, absolutely. I think people join a board because they want to make a contribution and for me. Like I said, financial contribution is great, but usually it has to do with talent and ideation and this willingness to kind of get creative with us.

32:10 Yeah.

32:12 Because, you know, the San Francisco Village has grown so much in the 10 years that I've been here, and that is due to some really creative people who've been on our team or been members of the community or, you know, the different volunteers. It's all so dynamic.

32:29 Right.

32:31 That keeps me interested after all these years.

32:34 Right. That's great.

32:37 Yeah. Yeah. Because I'm lucky.

32:39 I love what I do and it shows. That's cool.

32:44 Thank you. Well, Wayne, thank you.

32:49 Yeah, no, thank you, Kate.

32:51 Yeah.

32:52 Appreciate this conversation and definitely am looking forward to many, many more years on the board serving with you.

33:01 Thank you. We're so happy to have you. You're a wonderful addition. Thanks, Wayne.

33:07 Thank you, Kate.

33:07 Okay.

33:08 All right. Stop recording.