A Belated Mourning

A patient recently came to consult me; her name was the same as a former long-term patient of mine. Because of her, I suddenly realized that, shaken by this year's pandemic, I had not been in touch with my old patient for eight or nine months. So last night I searched her out on WeChat and glanced at her Moments. At the very top were three obituary notices posted by her family in June; she had passed away on June 25.

Seeing these notices grieved me deeply, because this patient and I had shared a bond for ten years, and our relationship had long outgrown the doctor-patient frame—we were already like family.

Once, when my own mother died of cancer, it struck me a heavy blow; her death made me doubt for a time whether medicine had any reason to exist, and whether I had chosen the wrong path in studying it. Back then, this older sister of mine, a late-stage breast-cancer patient, together with some of my early loyal readers and patients, was what sustained me spiritually. They never doubted at all that I could help extend their survival.

For three years after my mother's death I was immersed in grief and could hardly climb out. This older sister, whose WeChat nickname was Elm Catkins, often comforted me; every time she came to Beijing to see me, after the consultation we would chat for a while.

Once, invited by the sister of a late-stage liver-cirrhosis patient to go to Shenyang to treat her, I happened to visit Elm Catkins's hometown. She was overjoyed and insisted on treating me to a meal.

We shared a meal of large-dumpling jiaozi, a Northeastern specialty. In those days I was often traveling away from home, worn out by the road. Seeing how weary I looked, she even had her husband give me a massage. Her husband's technique was excellent; after a short while my fatigue lifted considerably.

We may have spent more time together than she did with most of her own relatives. She kept saying that, with me as her guardian, she hoped to live past sixty. She was born in 1972, and when we first met she already had late-stage breast cancer with lung and bone metastases. From her diagnosis to her death this year, she fought the disease for nearly twenty years.

Cancer changed her whole life. She was a certified public accountant and kept working even after cancer, only going half-on, half-off work when her condition worsened. Her husband was a man of deep feeling and loyalty; though they had no children, ever since her breast-cancer diagnosis he had kept working hard to carry the family forward. The older sister actually loved children and often worried over the studies of her nephews and nieces. A few years ago her father also developed intestinal cancer, and she turned to me for help with his illness.

I knew all her joys and sorrows, just as she knew mine. Sometimes we talked seriously about her condition; sometimes we joked together. Ten years slipped by in a flash—who could have foreseen we would keep each other company so long?

Yesterday I looked at her Moments and saw a post she made on June 3: "It's not as if palliative care is the end of it—all sorts of side effects: cough, vomiting, constipation. Where is the palliative hospital, and palliative care costs no less than treatment. Coming into this world for a while isn't all moonlight and flowers. The last road is the hardest; now I understand why Buddhists seek liberation rather than rebirth. I only hope kindness brings them the reward they want." This was a voice from her final days. Another of her voices said: "If there is a next life, I must become one of them (the doctors)—even a barefoot doctor."

I truly feel ashamed. Because of the pandemic, WeChat Moments were filled with foul, nauseating disinformation, and for a long time I did nothing but post links to my own articles and stopped reading other people's Moments. As a result I could not learn in time how things were for the older sister in her final period.

I have nearly five thousand WeChat contacts—which is why I so often have to prune my friends list; there is no way to read everything. In an ordinary year, the older sister would already have come to Beijing to see me. This year, because of the pandemic, many patients who used to come to me at least once every three months have not come for ten months. So I no longer keep as timely a grasp on their situation as in past years. Many patients, in this special year, had their treatment delayed by the pandemic and became victims of the secondary disaster of COVID-19.

Between a doctor and patient who have spent more than three years together, the relationship is no longer the ordinary doctor-patient one. I do not like or excel at socializing, so I have few friends; but these long-term patients are my true friends, and these patients and their families feel deeply toward their doctors. On fees I also look after these patients as much as I can; I have a rule in my heart: for cancer patients ill beyond five years, I waive or reduce my charges whenever possible, because we know all too well what it is to be impoverished by illness. Doctor-patient disputes never happen between such patients and doctors, because we understand one another.

I often feel heartened by the existence of these long-term patients, because their prolonged lives prove the value of our profession. The longer patients live, the more I feel that holding on to this work is something both ordinary and great. After all, we are fighting cancer, called an incurable disease, and we are also keeping affection and happiness alive for one family after another.

The older sister slipped away so quietly, without even a chance to say goodbye to me before she left. This had much to do with this year's pandemic, and also with her own kind nature.

We had a mutual friend—another late-stage breast-cancer patient who also survived for over a decade under my care. In her last year, she enrolled in a new clinical trial at the cancer hospital (weekly low-dose chemotherapy); to obtain clean clinical data, the hospital forbade enrolled patients from using adjunctive Chinese medicine. As a result, within a year she lost over 30 kg, her condition rapidly worsened, and she died.

Her death saddened me for a long while. At the time, Elm Catkins said to me: "If one day I have to go, I won't let you know, because I'm afraid you'll grieve for me too. Having this disease, one day we will leave because of it. I only hope you won't be too brokenhearted, won't be crushed by our passing—you must keep walking this road, because many people need your help."

Who would have thought she would really do exactly that.

When she was first diagnosed with breast cancer, many people urged her to seek famous specialists; in the end she chose a Western-medicine doctor at the local cancer hospital who had only just graduated. Over the course of treatment, that young doctor who first operated on her has today himself become a famous specialist. When she came to me for TCM treatment, I too was unknown; as we walked forward together, my own reputation grew day by day.

She told me she was glad to be a "guinea pig" for us beginners, short on clinical experience but strong in responsibility; and in fact her choice was the right one. Her survival time was exceptionally long among late-stage breast-cancer patients. She was so rational and gentle that I regarded her as an elder sister and a kindred spirit. I never once thought she would die of cancer; I always felt that, with integrated Chinese-Western medicine, she might live to a natural death.

Rest in peace, sister. This belated mourning, half a year on, can no longer reach you beneath the nine springs, yet it is something I cannot omit. However much you hoped your leaving would not affect me, how can ten years of friendship be wiped out with one stroke?

Only I will, just as you hoped, not let your departure plunge me into such gloom that I once again doubt the value of medicine. I will keep walking this road, seeking ways to prolong life for other patients. In this way I remember you, fulfill you, and also fulfill the wish my mother made on her deathbed—that for the rest of my life I be a doctor who saves the dying and heals the wounded, though in practice we must so often face failure.