Because I Understand, I Will Stay With You All the Way

Every day I witness the deaths of roughly 3–10 cancer patients. This is because my articles carry considerable influence among cancer patients, so many cancer patients and their families add me on WeChat. I often see obituaries posted in my Moments; each obituary means a life slipping away. A few people added me on WeChat but have never spoken with me; some I know well. Sometimes I comfort the families of familiar deceased, urging them to "mourn with restraint and accept what cannot be changed."

My Moments are also full of medical crowdfunding appeals like Shuidichou; every time I open Moments there is a pile of such pleas. Because the great majority of my WeChat contacts are cancer patients or their families, I almost never forward these. The reason is simple: cancer families all have it hard. If I forwarded these every day, it would exhaust and anxiety my WeChat friends.

Many patient families are in dire financial straits, and I can only help some of them to the extent I am able. Cancer is a bottomless pit; several people together rescuing one cancer family still feel the strain, and I face tens of thousands of cancer families, so I can only harden my heart.

Not only that, I also charge fees to some inquirers who can pay; otherwise I cannot survive myself and cannot continue the related research. Occasionally I treat a familiar difficult case of a patient who can pay well, and the fees I receive from them add to my income. I do not lack money, but I need money to do what I want to do; I am very grateful for their trust and help.

After the pandemic I gradually declined the help of other friends who had been co-funding some extremely needy families, because their own lives had also grown hard. In July, when I received the final donation from my old classmate, I learned he had had another son this year. He runs a small company of his own, working more than ten hours a day with almost no days off. I had my wife send him a generous gift. In August he insisted on continuing to fund some especially needy patients through me, until he could no longer manage and would tell me himself. I declined his kindness; he has it hard enough already, and I could not wait until my old friend was truly exhausted before he complained to me—that would make me uneasy. The value of a close friend lies in mutual empathy. The patients he used to help I now bear myself.

Several old patients whose disease is well controlled, and whose family income has been affected, I have quietly given what help I could. I can only do things for patients I already know inside out, because I understand their condition. Their treatment plans are mine; I have been caring for their bodies all along, and I know their efficacy—as long as they do not stop their medicine, they can survive. My ability is limited, so I can only apply my limited ability where it cuts the most.

I know my articles have become a daily spiritual necessity for some cancer patients and their families; my existence reassures them. This is my social responsibility and my mission, and I dare not slacken in the least. Some patients have passed away, yet their families still read my articles; this is because the pain in their hearts has not yet healed, and they need to find comfort in my writing.

There are also people, at the moment of life-and-death parting, who need to draw some strength from me. People are in the greatest pain at parting; the dams of emotion and reason both collapse, and they truly need someone who has gone through the same thing to give them spiritual support. Only the families of cancer patients understand this feeling; my articles are written for them as well. Although not everyone likes my articles—some even hate every word I write and curse me—as long as there are people who need me, I will not stop. Those who resent my words will have to continue suffering in hatred and anger.

What cancer families are going through, I have been through; and I seem to be a bit mentally stronger than most—only seem, though. After my mother died, I hid in a corner and licked my wounds for three years. During that time I stopped most of my work; and because the grief of losing my mother left me dazed, I lost my phone, and for three years I did not buy another, living a life cut off from the world. Only my family knew how grief-stricken I was as I occasionally lost control. What helped me come out of the grief of losing my mother was time, nothing else.

A few days ago, the mother of a junior-high classmate of my son told me she hoped I could keep her alive until her daughter finished the college entrance exam. This is indeed difficult, because she had a liver transplant and her tumor has recurred many times—it is very tricky—but I still decided to bite the bullet and try. At this moment her daughter, like my son, is in the second year of high school; I cannot bear to see a child so young go through the grief of losing a mother that I went through in my thirties. Every cancer patient's family endures each day in torment; when a patient leaves this world, some among their close relatives are always sunk in grief they cannot escape.

In fact there are many people even harder off than she: some patients' children are just born, some patients are themselves children, and their will to live is very strong. In their earnest gaze I can read the suffering of "separation from the beloved" in their hearts. Yesterday a patient's family member asked me in a Zen way: what is my suffering? And what is joy? He of course felt the answer should be emptiness. Actually, for a physician who mainly treats late-stage cancer, daily life is standing at the gate of hell witnessing parting; suffering and joy are clear and real, by no means empty. Saving one person brings universal joy; losing one, who does not grieve?

My WeChat often has people deleted, because too many people add me; if I do not delete some who are unrelated to cancer or no longer need my help, new people who want to add me cannot. Some have urged me to apply for several WeChat accounts, but I refused. A person's energy is very limited; I have no assistant and do everything myself. American family doctors serve at most six hundred patients; we live in a developing country and cannot compare with them, so it is normal for Chinese doctors to be tired. But I can serve at most 1,000–2,000 people at once; beyond that my body would collapse. The WeChat friend limit is 5,000; serving more than 5,000 would be a disaster for any doctor. So I firmly use only one WeChat account and keep my friends around 3,000; once over 3,500, I cull a batch. One more person means one more burden.

I also set a fee threshold for consultations; without it, no fewer than three hundred people would consult me each day. That workload means I could not possibly have the energy to offer anyone genuinely meaningful help, and my body could not sustain such a load. Even with the threshold, my workload is still heavy. I try to guarantee time for exercise every day, but often cannot manage it. I treat cycling to the vegetable garden as my exercise, but this year my vegetables have done poorly, because after the pandemic eased I have not had much time to tend my little garden.

Many patients I have refused, because their condition is too severe for me to help them, and I could not even provide comforting hospice care; it would only bring financial loss to their families. Waiting for death is cruel, but it is one of the realities of life that must be faced; making a patient's family recognize this reality and avoid losing both the person and their money is itself a way of helping.

Some patients with obvious trust issues I have also politely declined. Treating cancer patients—and most who come to me are late-stage—is something of great responsibility, risk, and pressure. When the patient and family have not yet decided to trust me completely, I will not rashly agree to serve them.

Many people are striving to extend their survival, waiting for medical technology to advance, hoping new technology will let them live. I too am trying every way to extend patients' lives, but this wish is not easily fulfilled. Every patient whose survival exceeds expectations lifts me up. Some patients I have kept alive for over ten years after cancer; the hardships along the way are beyond words. The doctors treating them are also pouring out their hearts and souls. In peacetime, only doctors face life-and-death daily; those without enough spiritual strength cannot be oncologists.

Medicine and religion are closely linked. The Mayo Clinic, one of the best medical institutions in the world, was co-founded by Dr. Mayo and a nun in wartime. Most contemporary doctors undoubtedly believe in science, but they are not prejudiced against religion the way professional scientists are, dismissing it as superstition. For doctors know very well that many people have religious needs at the end of life, and religious faith can help them leave this world peacefully and lessen their physical and mental suffering. Likewise, religious faith can give some believing patients extraordinary spiritual strength to help them overcome illness and create miracles. The compassion of religion and the humanitarian care of medicine reach the same destination by different paths.

I will keep walking this road; perhaps I will never retire in this life. I just watched one of my patients, a teacher, retire; I envied her for a second, then immediately knew I will probably never have such a moment. In this world, no normal person can truly exist independently of society, let alone someone as diligent as I. As long as society continues to need us, we should keep working hard. It is just that, between people, mutual understanding and consideration would make things better.