The Cancer Patients Abandoned by Their Own Families

More than ten years ago, a cervical-cancer patient came to me for help. She was already critically ill: severe intestinal obstruction had left her unable to pass stool for over a week, and excruciating pain was more than she could bear. She was hospitalized in a provincial cancer hospital, where the attending physician recommended palliative surgery to relieve pain and improve quality of life. But she had no money, and she knew her time was short; surgery would help little, and would bring a host of postoperative problems that might not leave her better off than without it.

I used the Chinese medicine Zengye Chengqi Tang (Fluid-Enriching Qi-Coordinating Decoction)—boldly raising Dahuang (Rhei Radix et Rhizoma) to 30 g—to temporarily solve her problem. After dispensing it I remained anxious, fearing some accident. Fortunately, ten hours after taking the medicine her bowels moved, the obstruction resolved, and the severe pain eased.

Her fate was wretched. When cervical cancer was diagnosed, her mother was already dead; her father sent ten thousand yuan to the hospital where she was being treated and then vanished completely, even changing his phone number. Her relatives refused financial help, and she herself had almost no savings. So afterward she had no money for treatment, nor even for living.

I organized two fundraisers for her, covering continued treatment and temporarily her living expenses. Many people at the time criticized her family as cold-hearted; I too was displeased by what they did, but could do nothing. In the end she even asked me to raise one more fund to cover her funeral. I declined; that, I said, was the duty of her relatives, not of us online acquaintances, and we had no obligation to give endlessly.

More than ten years have passed; few now know her real story, and I think it can be told as a warning to other cancer patients. When she first asked for help, she gave me her complete medical records. In them I saw that besides cervical cancer she also had syphilis and two other sexually transmitted infections. Her cervical cancer had developed from HPV infection. A little embarrassed, she told me that when young she had kept bad company and caught STDs. She asked me to keep this confidential while she lived, but permitted me, after her death, to write her story as a warning to other women.

She had an honest occupation, but had had multiple sexual partners. One partner was a promiscuous man who had picked up several STDs and passed them to her, along with HPV. Her behavior was unacceptable to her relatives, who were worn out by her willfulness. Meanwhile her family environment was poor and relations among them cold, so when she fell ill she had no support at all; without our fundraiser she could not even have eaten.

I do not like using the moral cudgel on anyone, because I myself am no moral paragon and have no right to judge others. I felt understanding and compassion for both this patient and her family; I believe her hard fate must have had its unavoidable causes. Perhaps she had inborn genetic problems, or some psychological illness, that led to so much misfortune. At the end she too reflected on much of her life and began to repent.

Her case was typical. She was kind-hearted; after cancer she kept encouraging other patients to fight on, and made many friends. Some psychologically fragile fellow cancer patients benefited from her and were deeply grateful. I admired the good she did, and so did everyone who knew her, which is why we were glad to help her.

Human beings are very complex animals; judging a person by simple methods never yields a correct answer, and even comprehensive methods may not. She has been in her grave for years, yet I still will not pronounce any verdict on her. I do not think myself qualified to judge her; I can only say her fate was hard, and that she suffered from many physical and psychological illnesses, cancer among them. She did keep bad company; when she lay dying, not one of her former boyfriends came to see her or helped financially—they all stayed far away.

Another patient had the same disease and came to me while suffering massive bleeding. For such critical patients I usually follow closely; the day after writing the prescription I asked how she was responding. She told me she was waiting for a friend to repay a debt, and had no money for medicine; she also reported that day's bleeding, worse than the day before.

I asked: where are your relatives? Can you get no support from them? She said bitterly that all her relatives had cut her off years before. On the spot I transferred 500 yuan so she could buy medicine to stop the bleeding—otherwise her life was in danger. She was shocked and asked why I trusted her and helped her. She had no one trustworthy around her; she never trusted others, and others did not trust her; she thought the world cold and heartless.

I told her that from my clinical experience and from seeing, in a video, her weak and pale face, I knew she was telling the truth—her quilt was also stained with blood. At such a moment, if I had begrudged those 500 yuan and failed to help in time, and she had died, I would have felt deeply guilty, like someone who saw a life in peril and did nothing. I told her not to worry about money; I would use my own reputation to raise funds for her. She wept and promised to buy the medicine.

As I prepared the fundraiser, another medical master's student helping me said his gut feeling was that this patient was a sex worker, and asked whether it was worth raising money for such a person. I told him I personally did not care what kind of person she was, and would not pass moral judgment before deciding whether to save a life. Judging patients is the business of judges, not of medical workers. Physicians follow the spirit of humanitarian aid; before illness, anyone is forgivable. The master's student agreed and joined me in raising funds; in her final days we gave her some warmth.

Before she died she told me that if there were a next life and anyone dared to hurt me, she would give her own life to protect me. She even confessed to me that she had been a sex worker; her whole way of life had driven her relatives away, and she repented it. I told her that the master's student who raised funds with me had known all along, and I told him about our conversation at the time. I believe she had unavoidable reasons for the road she took; her fate was wretched enough, and I hoped she would forgive herself.

Another patient, while asking for my help, accidentally discovered her husband's affair. His lover was impatiently asking when the patient would die so they could be together. Seeing these messages on her husband's phone, she burst into tears, with no one to talk to; late at night she texted me, hoping for some guidance and comfort.

I did not know how to comfort her. Her husband was, in fact, still conscientious; he had stayed by her, actively searching for every kind of treatment, some of it very expensive. They shared a child and a deep emotional foundation. I could not judge his extramarital behavior at such a moment; condemning a person morally is easy, but the reasons behind events are usually complex. Why a marriage reaches the point where one partner strays is surely not the husband's fault alone.

In her final stage she was anxious and depressed over both the disease and her betrayed fate, always feeling abandoned and in great pain. I could only comfort her occasionally; there was little more I could do. Life in this world is always full of challenges, and marriage needs both spouses to tend it well. I hoped she could move past the pain, but sadly she never could.

Many patients do not grow enough psychologically; this is a deep lesson from my practice. Patients often come to me weeping, tears throughout the visit. They pour out their misfortunes, complain that the world is unfair, accuse their families of hurting and abandoning them.

Once, an advanced colorectal-cancer patient came to me; after the consultation she spent nearly two more hours pouring out her lifelong unhappiness. She told of her miserable marriage, convinced that her disease was entirely caused by her husband and in-laws' mistreatment. She said she was deeply unhappy in marriage, with constant quarrels and no peace at home.

She furiously accused her in-laws and husband in vicious terms. I asked: do you usually speak to your husband and in-laws like this? She said arguments were even worse. I asked further: if you have quarreled like this until there is no affection left, how can you finally expect their help?

The conversation was very hard, but by the end she began to realize she too needed to repent. She finally understood that the fault was not entirely others'; she too was at fault. She was an emotional rather than rational patient, making every decision on feeling—including decisions about treating her cancer. At first diagnosis her stage was not late, but because she trusted an article by a TCM PhD that exaggerated the side effects of surgery, she refused the operation and chose treatment from that PhD. She had come to me early on; I strongly urged surgery first, then other treatment, but she did not take it. When she returned to me, nothing could be done. She deeply regretted not listening; at the time she was searching the world over for that PhD to take revenge, but he had fled overseas and she could not find him.

This was a typical patient with emotional disorder; treating her disease should from the start have involved a psychiatrist. Sadly, medical care in our large developing country has not reached that point.

I also saw a male cancer patient who, at the end, relied entirely on support from his church congregation to cover treatment and living costs. He had family and children, but they gave him no support and even hated him. From contact with him I learned that even when others gave him great help, he never said a word of thanks. That explained why his family abandoned him: he lacked gratitude, taking others' efforts as his due, even from people he had met only once.

I have long urged oncologists to study psychiatry and psychology, because many of our patients already have psychiatric or psychological illness before diagnosis; others develop it after receiving the diagnosis. We call the latter secondary psychiatric or psychological illness.

We must help identify these and give professional advice, so that with medication or counseling—mild cases can self-help by reading books—they can escape the comorbid conditions accompanying cancer. These conditions greatly worsen quality of life, accelerate tumor progression, and substantially shorten survival.

I also urge patients to broaden their hearts, repent their faults, forgive others' wrongs, and make peace with themselves and the world. If we want to receive care and support from others, we must first give ours. If we want others to stop hurting us, we must stop hurting them. Everyone should know that we ourselves have problems; many seeming external troubles are really the product of our own character flaws interacting with the environment.

Spiritual growth is a lifelong task. If a person cannot reflect and only blames the outside, he or she will never build reliable, close bonds with others. Gibran famously said he would not make friends with people who always think they are right. Many people lose support at critical moments in life for their own reasons.

Of course, while repenting and forgiving others, we should also forgive ourselves. But before forgiving ourselves we must first repent our faults, build inner self-discipline, and earn others' forgiveness. Good relationships are built on mutual understanding and tolerance; only on that foundation is care acceptable and returned.

I am past the age of one-sided accusation, so I am reluctant to moralize about anything. In my position I am trusted by many patients and their families, who hope to find answers in every problem they meet. In truth I can only write essays, urging them to reflect quietly and find answers for themselves.

Loss of social support, plus a patient's high emotionality, undoubtedly accelerates disease and hastens death. But suffering is often also an opening for spiritual growth; if we seize it and grow, we elevate our lives. No one in this world—not even our closest kin or dearest partner—is obligated to give to us unconditionally, especially when we keep hurting them.

Frequent self-reflection and caring for others are the two keys to redemptive relationships. If both sides practice them, the bond grows strong; at critical moments, our family and beloved will stand by us and give us their greatest support. Humanitarian relief from society matters, but the help and warmth we get from our own people matter more.