How much love can be fooled

What came in was a family member of the patient. She consulted on her behalf for the future of the patient himself.

This is a middle-aged patient with cervical cancer stage I, who did radical cervical cancer surgery and pelvic lymphadenectomy in a hospital outside the country, preserving the ovary. This is the standard treatment for cervical cancer stage I patients, in line with the treatment guidelines. Surgical pathology indicates lymph node metastasis cancer, and radiotherapy should be given according to the treatment guidelines.

However, the patient adopted traditional Chinese medicine chemotherapy without evidence-based basis. After that, the tumor recurrence-chemotherapy-various toxic and side effects-was hopeless, and the patient came to Concorde.

I am familiar with the hospital on the medical record, and I am also familiar with several doctors in the hospital. They are all engaged in tumors. How can they be so irregular?

Therefore, I offered to take photos of the medical records to my family members, promising to take only the parts that did not contain privacy. The family members readily agreed. After filming, I showed the family members that there was no part that contained privacy, and the family members expressed their approval.

I intend to send medical records to gynecologists to criticize this irregular treatment. Of course, I don’t want to say this to my family to avoid unhelpful disputes.

Then, I began to try to explain the patient’s current situation and suggestions to my family: [the treatment of such patients usually requires radiotherapy after surgery in our hospital…]

My family interrupted me: [The doctor told us to get radiotherapy, We were afraid that the patient could not stand it. She didn’t know she was suffering from the disease at all, and we told her it was benign. We were afraid that radiotherapy would cause too much damage, and she would know it was malignant, and bad mood would aggravate the disease. We didn’t agree to radiotherapy. Later, a patient said that HC, a traditional Chinese medicine, was effective in chemotherapy, so we went to have 4 courses of HC].

Well, I almost misjudged my local counterparts.

This kind of family is really too common. From the very beginning of seeing a doctor, we tried every means to deceive the patient, so that the patient was ignorant of his own illness, excluded the patient from his own treatment decisions, and miserably deprived the patient of some assurance of his own fate.

They regard this as love for patients. But what a foolish love it is.

Do you want to inform your family if they are seriously ill?

Suffering from malignant tumor is a major stress event encountered by patients, and the care of family members is of course very important. Specific to the condition notification, it really needs certain skills, step by step, cooperate with doctors to let patients understand the condition without panic or even complete pessimism and despair.

However, in any case, patients cannot be deprived of their right to know and decision-making. How can patients overcome pain, understand and cooperate with anti-tumor therapy, which is often more intense, if they do not know the disease condition?

As a person of sound mind, patients have the right to make decisions that meet their wishes for their own treatment and give informed consent, instead of being made by deceiving the patient’s family members, even in the name of love.

Recently, Richard Smith, former editor-in-chief of < >, wrote that [cancer is the best way to die], because [you have time to say goodbye, have time to reflect on your life, leave your last words to your family and friends, and perhaps have time to go to the place you want to go most, read some favorite poems, listen to favorite music, and make all preparations for the coming of the last moment].

He certainly did not know that for many Chinese patients, this is not the case: their illness is concealed and treatment decisions are made by others, so they cannot effectively cooperate with treatment and cannot refuse treatment.

For those patients who cannot be cured, because their illness is concealed, they cannot plan their destined life with few days to come, and have no chance to make up for the defects in this life that could have been made up for. Some of them even do not understand what disease they are until they die, leaving the world full of doubts, regrets and even resentment…

Therefore, for patients who come to see me, I will always tell their families that patients must know, otherwise please ask for another expert. I cannot tolerate my patients being concealed.

Of course, I will cooperate with my family members to inform the patient’s condition skillfully and step by step according to the specific situation of the patient, so that the patient can make an informed choice.

For the treatment of patients who have no hope of running out of water, I will tell her the truth skillfully, She is not encouraged to unnecessarily accept painful, ineffective or even harmful drastic measures. Instead, she carries out palliative measures focusing on reducing pain and improving the quality of life. She takes the last leg of her life well, meets the people she wants to see, says what she wants to say, walks the way she wants to go, does what she wants to do, and minimizes the defects in this life.

I imagine that if the patient is informed and can communicate well with the doctor, maybe she will choose evidence-based treatment, maybe the outcome will be completely different, at least she can choose her own life.

Although this is only possible, there is no reason why we should not work hard.