One in seven to eight people will die of cancer. A typical 4 +2 +2 family has just eight people. Except for a few lucky people, most people will face an encounter with cancer at some point in their lives.
Ten years after being defined by the World Health Organization as a chronic disease that can be treated, controlled or even cured, the word cancer still has destructive power.
A daughter who died of her father’s cancer wrote in an article, “I think every family should prepare potassium cyanide. If I have cancer, I will eat it immediately. I cannot accept being the cancer patient who tortures my relatives.”
The question is no longer whether we will encounter this eternal disease, but when we will encounter it. When this inevitable encounter comes, can we still do some what?
We visited many families, cancer surgeons, cancer physicians, psychologists and palliative care experts.
This is not a story of victory or failure after fighting against the disease one by one, but a story of how patients, their families and doctors make choices according to their own philosophy of life, economic situation and disease progress in the face of great uncertainty in medicine. It is a story of how to maintain peace, dignity and life value after making choices.
In these stories, there is hope, fear, sadness, tears, regret, but there is no failure.
1. Guidance and people
Gu Jin, an advocate of death with dignity and the leader of China’s first colorectal cancer diagnosis and treatment standard, decided to carry out a radical operation for Li Xiao, a patient with advanced cancer, in violation of various medical standards and guidelines that he has been practicing medicine for 30 years.
Li Xiao is not suitable for surgery-from a biomedical point of view.
This is the largest recurrent tumor at the stoma site seen by Gu Jin, China’s top colorectal cancer surgeon. The vegetable-like tumor covers one third of the skin in the abdomen and has suspected metastasis in the liver.
At the beginning, Gu Jin only looked at the medical records and image data, and he denied the possibility of the operation-high operation cost, no hope of cure, and fatal operation complications at any time.
This is also the unanimous reply that Li Xiao’s wife got after visiting all the 3A hospitals in Beijing.
At that time, Gu Jin had not seen Li Xiao, After rectal cancer surgery two years ago, The intestinal tract is no longer connected to the anus, so a part of the intestinal tract is placed outside the abdominal surface to form an ostomy, which is wrapped in protective equipment to replace the original anal function. The biggest difference is that the artificial new anus has no ability to control itself-a dilemma that more than 50% of patients with low rectal cancer have to face.
Because of weakness and embarrassment, Li Xiao did not go out. Throughout the winter of 2016, Li Xiao lay in a small hotel in the western suburbs of Beijing, waiting for the bad news his wife Guo Guo brought back every day.
On those cold and long winter days, Guoguo will take a stack of medical records, jump on the morning bus, go to the hospital delineated the night before, and wait for a few hours to see if any doctor is willing to take over Li Xiao.
After being rejected countless times, Guo Guo will take the bus for another hour to return to the small hotel and change to another hospital the next day, repeating the same process. Like Sisyphus in Homer’s epic, he is hopeless but persistent in fulfilling his responsibilities.
Li Xiao and Guo Guo agreed that this was the last attempt.
Guo Guo rented a wheelchair and took Li Xiao to Gu Jin’s clinic in Shougang Hospital of Peking University (he is the president of the hospital). Gu Jin became stunned. Reading black-and-white film, numbers on pathological reports and directly facing a young cancer patient who was consumed were two completely different psychological shocks.
At the end of March in Beijing, the heating supply had just stopped, and what was brought into the clinic was not only the cold air outside the door, but also a faint stench of excrement.
The young man in the wheelchair looked pale and, like most guests who came to the clinic, tried to pull out a smile at the doctor opposite although he was in the darkest day of his life.
When Gu Jin asked Li Xiao to lie down for examination, he shrank back and said wryly, “Doctor, it’s a little dirty.”
Only one corner of the clothes was lifted, and the stench spread in the small clinic.
The tumor recurred at the stoma on the abdominal surface, which was clearly visible to the naked eye. The vegetable-like tumor began to fester. Compared with the photos and medical records seen last time, the blood-red lump on the abdominal wall seemed to have grown up a lot, and there was no protective equipment to cover it. Purulent blood and feces poured out from the fester.
Li Xiao put his head to one side. [Look at me now. I can’t go out. I have no dignity at all! ]
At one end is the eager eyes and dignity of a 32-year-old young man for the rest of his life, and at the other end is a guide compiled by bringing together the most reliable medical evidence and the opinions of top clinicians.
Gu Jin, who has always been decisive, hesitated for a while.
2. Only God knows
Medicine is a science full of uncertainties.
As a top surgeon, Gu Jin faces countless choices, large and small, every day:
The 75-year-old suffers from emphysema, hypertension and coronary heart disease at the same time. Can he have surgery? Is it to expand the scope of the operation to avoid future troubles, or to try to keep the anus of the 20-year-old young girl? Patients from rural Hebei come from poor families. Is it direct surgery or a round of neoadjuvant radiotherapy first?
Even if we have entered the era of precision medicine, doctors’ efforts to intervene in diseases may not necessarily lead to a definite and good result, especially cancer.
For a specific person, will this expensive targeted drug definitely work? Will the tumor relapse after the operation? Only God knows.
After many defeats and wars, mankind briefly found some weapons against cancer:
Large-scale surgical resection may reduce the recurrence rate, but patients will lose breast, anus, esophagus and other important organs. There is also a certain chance that fertility and sexual function will be irreversibly damaged. In some operations for brain and spinal tumors, patients may even be paralyzed.
Some chemotherapy drugs, while killing cancer cells, also kill normal cells, bringing nausea, allergy, bleeding and other side effects, as well as high costs.
After all, cure is a small probability event. After exhausting all means of modern medicine, the 5-year survival rate of cancer in China is only 30.9%.
At the moment of suffering from the disease, the opportunity to choose the best choice (cure for most people) is lost. It is just a compromise of the lesser of the two, and it is to find a relatively less bad result among the numerous uncertainties.
Risks and opportunities coexist, darkness and hope coexist.
If the best option does not exist, the good or bad results are often the patient’s subjective feelings, and more importantly, find a future path that he feels valuable.
Li talked to Gu about his daughter and his frustration as a father. When his daughter was half a year old, Li Xiao was found to have colon cancer, and the whole family was dragged into the track of cancer. He and his wife frequently commuted between their homes in Beijing and Shijiazhuang. They did not work any more, and their daughter was entrusted to the care of the elderly.
Tumors, pus and blood, enterostomy, and the stench wrapping around the body prevented Li Xiao from appearing in places where there were people. He gradually lost all his social roles as father, husband, subordinate, son and friend.
Susan Sontag wrote in “Metaphor of Disease” that cancer is not only a biological disease, but also a huge, social and political disease, a disease full of punishment.
Daily life has been obliterated one by one: one cannot dress, the rough fibers of clothes will rub and stimulate the surface of the tumor, afraid of being rejected and afraid to go out, even afraid to give a hug to his daughter.
[You don’t refuse me, we have gone to many hospitals, if you don’t do it for me, I can only die, no, this is better than death…]
Gu Jin decided to operate on Li Xiao. He hoped that the young father could live his life with dignity-no matter how long or short it was. Can no longer feel guilty when hugging their daughter; Can get out of the sojourn hut and find their social status as father, husband and son.
31 million to buy 10 months of life, buy?
In the complex data model on cancer treatment, besides the puzzling permutation and combination of survival time, effective rate, cure rate, paralysis probability and possibility of complications, there are more cruel variables-money.
According to data from Hermes, a global medical information provider, in 2015, the average annual cost of cancer patients with private insurance was 58,000 US dollars, equivalent to nearly 400,000 yuan.
In the past five years, more than 70 new anti-tumor drugs have been put on the market, which can prolong the lives of patients originally believed to suffer from the most deadly cancers, such as advanced melanoma and squamous non-small cell lung cancer.
The price is also high. In 2014, the average annual cost of anti-tumor drugs approved by FDA was as high as 120,000 US dollars, equivalent to more than 800,000 yuan.
Try an expensive new drug to prolong your life or that of your family for several to more than ten months at a cost of hundreds of thousands. How do you choose?
Even doctors have no answer. Zhang Xiaodong, chief physician of digestive tract oncology department of Peking University Oncology Hospital, remembers that a young man took his mother with advanced cancer to seek medical treatment everywhere. Although his family was not rich, he still asked about expensive targeted therapy.
[I don’t know how to say to him, targeted drugs are not 100% effective, the beneficiary population is about 20%, if I say I can try, if he has no money, then the regret and guilt in his heart will accompany him for life in the future.]
At the most desperate time, Yang Yang thought about divorce, selling the property he shared with his husband and using his half of the property to cure his father.
In July 2013, his father was found to have liver metastasis from colon cancer. After discussing with doctors, Yang Yang decided to adopt the treatment plan of targeted drug cetuximab plus chemotherapy drug irinotecan to strive for a glimmer of hope for surgery.
A 20 ml targeted drug costs 4,698 yuan and is not covered by medical insurance. However, it is indeed effective for patients with advanced metastasis of wild-type colon cancer with K-ras gene such as Yang Yang’s father.
A clinical study by the German Medical Oncology Association shows that the median survival time of advanced colon cancer patients using this targeted drug plus chemotherapy drug is 28 months-more than half of the patients have survived 28 months, which is an encouraging data for advanced patients.
In the first three months of treatment, Yang Yang’s father spent 300,000 yuan, which was also the total treatment cost previously estimated by the attending doctor.
Yang Yang is a reporter from a magazine, while her husband works in a state-owned enterprise and his family’s monthly income is 25,000. The two made up a down payment to buy a new house with a monthly payment of 3,500 before Beijing’s housing prices jumped. Rao is so, facing the medical expenses of six or seven figures, Yang Yang still feels dizzy.
My parents have already sold their clothing shops in their hometown and borrowed 200,000 yuan. Yang Yang lost sleep every night and lay in bed thinking, [1 million yuan can only buy my father’s life for 10 months, where can I collect the money? ]
Yang Yang asked a nearby intermediary that she and her husband bought a duplex two-bedroom apartment outside the North Fifth Ring Road two years ago at an hourly price of 2.8 million yuan. In despair, she tried to mention divorce to her husband, [we sold the house, I took half of the money with my parents, and when I could reach what, it was what, and it would not drag you down.]
Relatives and friends in their hometown tactfully persuaded Yang Yang and his mother to give up and not to run out of money. However, the latest CT results show that targeted drugs are indeed effective for their father. The number of tumors has been reduced from more than a dozen to six. Although surgery cannot be performed immediately, hope seems to be just around the corner.
Is your philosophy of life what?
Facing the multiple-choice question of cancer, when medicine cannot give you the best solution, which solution to choose is a contest between different philosophies of life. It is related to which kind of life you and your family want in the future, and there is no difference between right and wrong.
There are always some people who are full of fighting spirit. They don’t want to stare at the survival statistics, but want to try their best to [actively respond to] the diagnosis results. Perhaps their greatest happiness is that hospitals are willing to admit them, surgery can be done, and medicine can be used.
There are also plans that others [obviously] want to give up, which may be the best choice for this person and his family.
Zhang Xiaodong talked about a friend of hers, low-grade malignant lymphoma, but she did not want chemotherapy and certainly did not use various Jianghu folk remedies. She died five years later.
[She doesn’t regret] As an oncologist, Zhang Xiaodong thinks that this is also a great choice.
Four years ago, Chen Zuobing, an emergency department doctor and medical doctor of Zhejiang First Hospital, gave up chemotherapy and radiotherapy after his father was diagnosed with advanced malignant peritoneal stromal tumor and sent him back to his hometown in Zhuji, Zhejiang Province.
This is Chen Zuobing’s father’s own choice. Chen Fuxi reads < < Zhuangzi > > and < < Lao Zi > > and has his own views on life. He said that people are like streams, beginning with drops of water, then streams. In his youth, his voice will become louder and louder, magnificent, and finally he will return to the sea silently.
He chose to return to the place where he was born and planted pumpkins and amaranth in the mountains of Zhuji. Take a winter’s time to say goodbye to relatives and friends; I spent a very lively New Year’s Eve with my grandchildren and took many family photos.
In March of the following year, Chen Zuobing’s father died in peace.
Chen Zuobing said that there is no right or wrong choice. Any choice, as long as it is made with one’s own rationality and thinking after fully understanding the disease condition, is correct.
Having been a cancer specialist for more than 20 years, Zhang Xiaodong believes that tumor treatment often stands at the crossroads and makes sense to which side to go. The advantages and disadvantages are the same. Patients and their families need to choose according to their own wishes. The important thing is, don’t turn back, the treatment window is fleeting, only one way to go to the end, otherwise it is psychological torture for patients and their families.
The beauty of medicine is that there is always uncertainty. Those high-spirited people hope to take active fighting methods and last long enough. There is always a slim possibility until new and better therapies come out.
Yang Yang’s mother condensed her husband’s life in one sentence-he is a person who loves life.
When living at his daughter’s house for treatment, chemotherapy made him feel groggy. One day, he threw up on the sink. Yang Yang brought back two tickets for Peking Opera from work and asked, “Dad, I have two tickets for the performance here. Will you go or not?” ]
Hearing this, Yang Fu rushed to say, go, go.
When the mother came back to complain to her daughter, your father refused to leave after the performance. He kept applauding and cheering around the orchestra pit.
A misconception about cancer treatment is that treatment, especially chemotherapy, will destroy the patient’s body, not only causing pain, but also causing the patient to die faster.
As a cancer physician, Zhang Xiaodong’s most frequently asked question from patients and their families is, [Will chemotherapy die faster? The side effects of chemotherapy are so great, can he bear it? ]
In Zhang Xiaodong’s view, Whether there is the possibility of chemotherapy, It is the doctor’s judgment. Patients and their families can decide whether to accept it or not according to their wishes and financial situation. However, due to the limited effective rate of chemotherapy, In some patients, after chemotherapy fails, the tumor grows uncontrollably, causing the symptoms to become more and more serious and eventually leading to death. Family members mistakenly believe that chemotherapy is the cause, but it is actually the cause of disease progression. However, the quality of life of patients with effective chemotherapy will be improved.
Yang Yang’s father was lucky. At the beginning, the side effects of chemotherapy and targeted therapy were not too big, with some rashes and nausea. Except for those days when chemotherapy was more painful, [but after it was time to eat and play, there was no what in my heart.]
After the phased treatment, Yang Yang will take his father and mother to have a meal of Haidilao or Korean barbecue as a celebration.
Father likes to stand under the window of his daughter’s house facing east. When the weather is fine, he can see the planes taking off and landing at Shunyi Airport. Father who has not been on a plane will ask his daughter many questions about the plane. For example, why do you think the plane pulls a white line in the sky?
More often than not, the father goes to the supermarket for a stroll every day to buy vegetables and cook delicious food for his daughter and son-in-law, just like all ordinary fathers. Summer is coming, and there is an old man playing flute downstairs in the community. The father can play erhu, and the two always play a song < < Liang Zhu > > in the evening.
The 6-month combination of targeted plus chemotherapy has provided Yang Yang’s father with an opportunity for surgery, which means the possibility of radical cure.
If I could still eat chocolate and watch live football, I would like to live.
There is no end to choice. The process of disease is a continuous process of choice. Just after one choice is made, the next choice follows.
Yang Yang’s father went to Beijing Tumor Hospital, one of the two best tumor hospitals in China, and the hospital had already made full preparations: the attending doctor in his prime watched the film over and over again, and the doctors in the whole department held a general meeting to study the operation plan.
Yang Yang was propped up. She was already 30 weeks pregnant and was waiting anxiously outside the operating room with her mother and aunt.
After half an hour of operation, the surgeon found a tumor in the liver that was not shown on CT. This is a blind area in imaging and the limitation of modern medicine. It is impossible to detect all corners before laparotomy.
On the face of Yang Yang, there is another thorny multiple-choice question: the tumor in the liver is in a very poor position, and three quarters of the liver needs to be cut off. Do you want to cut off?
[Doctor, does this mean what? ]
[He may stay in bed for a long time.]
[Can chemotherapy be carried out after surgery? ]
[If most of the liver is cut off, the patient will be very weak and unable for the time being.]
[Will it relapse? ]
[Probably.]
[What about recurrence? ]
[Cut Again.]
The dialogue went on so fast that the decision had to be made in an instant.
As a daughter, Yang Yang understands how strong his father wants to live, but he also understands where his father’s bottom line is.
Before the operation, Yang Yang and his father had a semi-formal conversation. He talked about the fistula operation of one of his father’s patients. He reconstructed an artificial anus in his abdomen, wrapped the excrement in a bag and replaced it regularly. His father said firmly at that time that he would never accept it. If he were allowed to hang such a bag, he would rather die.
Yang Yang heard his voice trembling a little, [not cut.]
The surgeon agreed that the liver would not be done and only the tumor on the colon would be cut off.
[If active treatment cannot be selected, it is more important to determine the bottom line that patients can accept and that patients do not want what,] Liu Wei said.
Liu Wei is the director of the Palliative Treatment Center of beijing tumor hospital. Before giving his own opinions, Liu Wei always asks: Are you most afraid of what? Do you want the treatment to give you what effect? In order to achieve this goal, are you willing to accept what? Can’t we give up what? If you wish, we can’t do it for the time being, is there a sub-optimal choice?
Artu Gavender, a professor at Harvard Medical School, wrote in “The Best Farewell” that sometimes we can provide healing and sometimes we can only provide comfort. But whether we can provide what, our intervention and the risks and sacrifices it brings are only reasonable if the larger goal of the patient’s personal life is satisfied.
Artu’s colleague Susan Bullock, a palliative care expert at Harvard Medical School, had such a conversation with his father before surgery for spinal cord tumor-in order to gain a chance to survive, are you willing to bear what?
The honorary professor of the University of California, Berkeley, surprised her daughter by saying, “If I can eat chocolate ice cream and watch live football, then I would like to live. If I can have such an opportunity, I would like to suffer a lot.”
This conversation is very important, because after the operation, his spinal cord hemorrhage is in danger, and there are two choices before his daughter: let go and let his father leave; Another operation, but he may be permanently disabled.
Susan asked the surgeon if he could still eat chocolate ice cream and watch live football if his father survived. After receiving a positive reply, Susan asked the surgeon to perform another operation. [Thanks to the conversation, I don’t need to make what’s choice, he has already made a decision.]
After the operation, Susan’s father lived for another ten years. Although he needed help bathing and dressing, he was able to walk a short distance and completed two books and more than a dozen academic papers.
6. Medicine treats diseases as well as people.
Marked by the rise of palliative medicine, modern medical practice centered on diseases has begun to pay attention to human needs.
As a medical branch that focuses on symptom relief and quality of life, palliative treatment does not take curing diseases as its value orientation, but focuses on various physiological and psychological feelings of patients in diseases.
Take the elevator from the outpatient hall to the fourth floor, pass through the long corridor, and walk down 10 steps. A row of rooms on the left is Liu Wei’s palliative care center.
Not many people pass through the hustle and bustle of people in the hospital and eventually come to the palliative care center. Liu Wei sees about 10 patients in the clinic every morning. Her clinic time is usually very long because she needs to reserve not less than half an hour for everyone.
First of all, sometimes patients or their families will fall into the story of failed treatment and vent their emotions more, but Liu Wei seldom interrupts.
A middle-aged daughter described her sick mother’s heavy heart, fear of spending money and dragging down her children. Liu Wei gave her a warm response, [I guess your mother must love you and say hello to her for me.]
[They have pain, and talking is also a cure.]
After the clinic was over, Liu Wei’s student Xue Lu stopped the patient or his family and handed over a business card with the clinic’s phone number and WeChat service number on it. [No one can be found 24 hours a day, but 8 hours of work are fine.]
In Liu Wei’s view, palliative treatment is a positive intervention in the overall process of cancer and a complete set of treatment systems involving many fields and huge systems: support for physical symptoms such as fatigue and pain; The reflection of fear, anxiety, insomnia and other emotions; Intervention in the drastic changes in the patient’s life and social role. [To enable the patient to die peacefully, peacefully and with dignity, even including funeral service.]
Palliative treatment is not only an independent discipline, but also an idea-the idea of paying attention to the patient himself runs through the whole cancer process.
Gu Jin said that as a tumor surgeon, most people pay attention to the tumor in the patient’s body, whether it can be removed, whether it metastases, whether it will relapse and whether it will be resistant to drugs. But how do people feel? What do they think about surgery and chemotherapy? Are there any unspeakable difficulties?
When I first saw Li Xiao, it was the fourth month after Gu Jin operated on him. In the aisle of the surgical ward on the 9th floor of Shougang Hospital, he and his wife leaned gently on the stool in the aisle. I was afraid of mistaken people and did not dare to greet them.
The young man in front of him was slightly yellow in skin, with a well-defined face, not thin. He looked too different from the weak and undignified patient in the doctor’s mouth, but more like the family members who came to the hospital to visit the patient. He grinned and waved to me, “I’m Li Xiao.”
I knew that there was a metastasis in his liver, and this time I came to find Gu Jin to find a way. I was a little unable to open my mouth for fear of revealing people’s scars, but he had no scruples and easily talked to me about the operation 4 months ago.
It was a technically successful operation, After the huge abdominal lesion was removed, Li Xiao unloaded a huge burden. Two weeks later, Li Xiao was discharged from the hospital. He was wearing a light-colored hoodie and walked back into the crowd. In the huge crowd at Beijing West Railway Station, no one paid attention to Li Xiao and his wife, as if they were an ordinary young couple visiting Beijing. When he returned home, Li Xiao gave his daughter a big hug.
Recently, the MRI results of the liver showed that there was a suspicious transfer. Li Xiao does not seem very worried. He plans to get together with two friends from Beijing first today and invite Gu Jin to watch the film the next day to see if there is any what method.
Gu Jin is China’s top colorectal cancer surgeon, He has served as vice-president of Peking University Cancer Hospital and president of Peking University Shougang Hospital. His title is too long to write a line of documents. He has published articles in the top academic journals and has not received less research funds. However, when Li Xiao walked into the clinic with a smile, it was still the best moment for Gu Jin to practice medicine for more than 30 years.
[I don’t know how long he can live. The road ahead is not easy, but he has gained the dignity of being a human being. He wears daily clothes and walks in the corridor outside the clinic. No one pays attention to him and no one dislikes the smell on him. For me, it is the greatest sense of accomplishment.]
Medicine treats not only diseases but also people.
Under the biomedical model, the focus of medicine is on the biological factors that lead to diseases, and the pain of patients is difficult to respond to.
Tang Lili, director of the rehabilitation department of Peking University Cancer Hospital, still remembers a patient saying to her, “I am not a breathing tumor”.
Many years ago, Tang Lili was somewhat surprised to see a patient with breast cancer in the first stage who attempted to commit suicide by cutting his wrists due to severe depression. You know, the 5-year survival rate of breast cancer in the early stage is as high as 90%.
Tang Lili said that we have good methods for treatment and treatment, such as surgery, chemotherapy, etc. Therapy means nursing and maintenance. Have we treated it? Pain, disease is a word, many of our diseases cannot be cured, pain, anxiety, vomiting, insomnia, we can give relief and relief.
Tang Lili later learned from Jimmy Holland, founder of psychosocial oncology, and translated “The Human Side of Cancer”. He introduced the concept of psychosocial oncology into cancer diagnosis and treatment to provide psychosocial care for more cancer patients and relieve their psychological pain.
[The doctor is not a cold white coat. Can the hospital smell coffee, sound music and see the piano in the hall? ]
Tang Lili pointed to a piano outside the door. Last year, she collected a grand piano and placed it in the lobby on the first floor of the surgery building, leaning against her rehabilitation clinic, avoiding the treatment time of patients. Volunteers play it every morning and afternoon for two hours.
[Cancer, music and coffee should not be the only thing in life.] Tang Lili said.
7. Best Farewell
Accepting the limitation of the life cycle and understanding the inevitability of aging and death is a process, not an epiphany.
Just learned that his father had cancer, Yang Yang did not accept this reality, [I don’t recognize it, I want to make a blog.]
After 6 cycles of targeted drugs, multiple rounds of chemotherapy, 2 interventional treatments and 1 laparotomy, like most patients with advanced cancer, Yang Yang’s father’s tumor inevitably recurred and spread.
The father hoped to have another interventional therapy, but the mother did not agree. During the last interventional therapy, the father gushed out a mouthful of blood. The mother was still concerned when she remembered the notice of critical illness issued by the doctor.
[Do you love money, or what? Father was somewhat dissatisfied.
My father did not know that the previous operation did not remove the tumor in his liver. It was only a palliative operation. He felt that his wife and daughter were both strange and did not want to give him a good treatment.
This will also lead to the plight of most Chinese families when facing cancer, hiding it for as long as they can. Until those things that should be said have not been said and those important things have not been done.
Yang Yang felt it was time to talk to his father. Artugwend called it a breakpoint discussion in “The Best Farewell”. Through a series of talks, he considered that what time would change from fighting for survival time to fighting for other cherished foods-spending time with family, traveling or enjoying chocolate ice cream.
Sometimes, this series of discussions is initiated by doctors.
Tang Lili is often asked by patients, so shall I die?
As a psychologist and palliative care expert, Tang Lili has her own speech skills:
[The doctor’s failure to treat is also a kind of treatment, not giving up you. Failure to treat is to give the body a recovery process and let him mobilize his potential to recover.]
[Sometimes, if we can’t do anything about the length of life, at least we can expand the width of life.]
Tang Lili will encourage patients to spend more time with their families instead of rushing around the hospital and home, cooking a meal for their families and going out to watch a concert when their physical conditions permit.
If there is pain, don’t endure it and seek the help of a doctor. [When the quality of life deteriorates irreversibly, this society can still give the dying the possibility of avoiding pain and fear. Hospice care is the best protection a civilized society can provide to its members.]
Yang Yang chose to have this difficult conversation with his mother and father.
My father asked after learning about my illness [what did I look like in the end? Before his daughter could answer, he added, “Liver cirrhosis.”
This sentence made Yang Yang sad for a long time.
Yang Yang said, Dad, if you really want to do interventional therapy, I will give the money. But you still have a choice. Take out the money and the three of us will go out for a trip. I’m afraid we won’t have a chance after you do intervention.
Although rising tumor markers indicate the deterioration rate of cancer, the father’s physical quality is still good. The family decided to go to Yunnan. Twenty-four years ago, when Yang Yang was 9 years old, he went to Yunnan with his parents.
Twenty-four years later, my father still regarded himself as the backbone of his family. When he arrived in Dali, his father drove his rented car all the way along Erhai Highway to Shuanglang Ancient Town.
Yang Yang remembered that it was still not bright that day, the stars in the sky were shining and the road was not very good, but his father’s car was still driving steadily. At night in the ancient city, his father pointed to the three bright stars in the middle of Orion and said that he had always thought it was a family of three.
This is Yang Yang’s first and last trip with his parents as an adult. Shortly after returning home, his father’s health deteriorated and he could no longer travel far away.
At the end of the day, Yang Yang did not carry out any invasive rescue and even withdrew the infusion. When he woke up for the last time, his father told his daughter that he was not afraid or sorry. He did not need to bring his African drum and erhu stereo. When he hit the tomb, he leveled the bottom.
From the discovery of cancer to his death, it took 2 years and 10 months and cost 1 million yuan for treatment. Yang Yang thanked his father for his persistence and waited until his granddaughter was born with joy. [He hugged joy and remembered grandpa with joy.]
(Some of the interviewees in this article are pseudonyms)