Easing Suffering Is the Greatest Filial Piety
At noon today, I brought a middle-aged woman who had come from Xi an and her mother to my home, to help treat her mother and chat. This was the first time I had brought a patient to my own home. This woman father had lung cancer and had once sought my help; later her mother developed leukemia and also sought me out.I had treated her parents on and off for four years, and after four years of dealings we were considered very close friends. Since the COVID epidemic began, my studio was vacated and has not been re-rented. When such old friends come to see me, I can only bring them home.The woman mother had leukemia, and I had treated her for over three years. During these three years, the family was unwilling to accept the situation and often sought Western medicine, undergoing various treatments: chemotherapy, targeted therapy, antibody therapy. After each treatment, the elderly woman was always in an extremely dangerous state. Western medicine had no very good way and could only issue critical-illness notices to the family again and again. Each time the patient was in critical condition, her children would come to me for help; I would prescribe some TCM, and the elderly woman would always turn the corner.This time they came to Beijing to undergo a brand-new antibody therapy from the team of a certain professor who is authoritative in the leukemia field. This treatment was extremely alluring in theory, but after the treatment the elderly woman condition rapidly worsened, with very poor blood counts. First she had a high fever that would not abate, and the hospital used many antibiotics in vain.I prescribed her a decoction: Banlangen (Isatis root) 30 g, Daqingye (Isatis leaf) 30 g, Guanzhong (Wood Fern) 15 g, Baitouweng (Pulsatilla) 15 g, Chishao (Red Peony) 12 g, Shengdi (Raw Rehmannia) 12 g, Mudanpi (Moutan bark) 12 g, Zicao (Arnebia root) 12 g, Chanyi (Cicada slough) 10 g, Sheng Huaimi (raw Sophora bud) 30 g, Shengdiyu (Sanguisorba) 30 g, Xueyutan (hair charcoal) 10 g, Mohanlian (Eclipta) 30 g, Nüzhenzi (Ligustrum) 15 g, Cheqiancao (Plantago herb) 15 g, Digupi (Lycium bark) 15 g, Xiyangshen (American Ginseng) 10 g, Maidong (Ophiopogon) 10 g, Xiaoji (Cirsium) 15 g, Duzhong (Eucommia) 10 g, Jin yinhua (Honeysuckle) 30 g, Zihuadiding (Viola) 10 g, Yejuhua (Wild Chrysanthemum) 6 g, Pugongying (Dandelion) 30 g, Huangbai (Phellodendron) 10 g, Dilong (Earthworm) 10 g, Chao Maiya (fried Barley sprout) 30 g, Shengma (Cimicifuga) 6 g.This formula was large; after the elderly woman drank it, the fever came down. After continuing the hospital series of treatments, gradually she could not see with her eyes, could not hear with her ears, had very poor blood counts, was utterly weak, and was disoriented. The doctor could only talk to the family, telling them the elderly woman was in great danger, that they had no good way, and asking the family to prepare for the worst. The family had no choice but to arrange an ambulance to send the elderly woman from Beijing back to Xi an.After hearing the hospital doctor words, the woman broke down and called me on voice, weeping bitterly. I calmed her and told her not to panic. On the basis of my three years of intuition treating her mother, I knew this was not the elderly woman final moment; with some TCM, she had hope of improving, and likely would not be in life-threatening danger within three months. If lucky, she might still get through this year.So I prescribed her another large prescription: Banlangen 30 g, Daqingye 30 g, Guanzhong 30 g, Baitouweng 30 g, Zicao 30 g, Qiancao (Madder) 30 g, Chanyi 10 g, Sheng Huaimi 30 g, Shengdiyu 30 g, Xueyutan 15 g, Mohanlian 30 g, Nüzhenzi 15 g, Cheqiancao 15 g, Digupi 15 g, Xiyangshen 10 g, Maidong 10 g, Wuweizi (Schisandra) 10 g, Xiaoji 30 g, Duzhong 10 g, Jin yinhua 30 g, Zihuadiding 10 g, Yejuhua 6 g, Pugongying 30 g, Huangbai 10 g, Chao Maiya 30 g, Shengma 6 g, Sheng Huangqi (raw Astragalus) 90 g, Dangshen (Codonopsis) 30 g, Huangjing (Polygonatum) 30 g, Shudi (Prepared Rehmannia) 30 g, Zhi Shouwu (processed Polygonum) 30 g, Fengweicao (Pteris) 50 g, Xianhecao (Agrimonia) 100 g, Muzei (Horsetail) 15 g, Gujingcao (Eriocaulon) 10 g, Danggui (Angelica) 16 g, Shayuanzi (Astragalus complanatus seed) 10 g, Tusizi (Cuscuta) 10 g, Bajitian (Morinda) 10 g, Xianmao (Curculigo) 10 g, Cheqianzi (Plantago seed) 15 g, Huainiuxi (Achyranthes) 15 g. One dose daily, decocted in water, taken after meals.This formula had many herbs and a large dose; pharmacies in Beijing did not dare fill it for the patient. But a heavy dose cures a stubborn ailment; at such a moment, apart from prescribing such a large formula, there was no better way to bring the elderly woman back from the brink. The woman had no choice but to plead hard with the pharmacy, and finally the pharmacy steeled itself and, at some risk, filled the medicine.After the elderly woman took three doses of TCM, she could get out of bed and walk, her ears could hear, her eyes could see, her thinking was clear, her speech returned, her spirits markedly improved, and she was out of critical condition. After this fright, the family decided not to try various new treatments again and to take the elderly woman home as soon as possible.Before they prepared to go home, the woman asked to meet me, and I did not refuse. For three years of the epidemic, I had been helping the elderly woman with various problems by video. Such a high-trust patient and family (indeed no longer just patient and family, but friends), happening to be in Beijing, I was willing to make an exception and bring her to my home to chat, as if in everyday talk, about the future treatment approach.I persuaded them from then on not to pay attention to any blood indicators, and that there was no need even to go to the hospital for tests. From then on, use only pure TCM symptomatic treatment. As long as the elderly woman lived well and was not in great pain, that was enough. No need to focus on survival time; only focus on quality of life. Because over these three years they had been through plenty of upheaval and spent a great deal of money (Western medicine treatment is far more expensive than TCM, especially far more expensive than the medicine I prescribe, because I rarely prescribe expensive drugs), and each treatment also made the elderly woman suffer terribly, with the family suffering alongside.The woman and her mother both agreed. After three years of upheaval, especially this time nearly dying away from home, they finally understood that late-stage leukemia cannot be cured; that obsessively watching blood indicators, apart from making their own hearts race, does no good. Now they can accept the elderly woman living with leukemia. Many late-stage cancer patients and their families harbor fantasies of cure, and end up having spent everything, with body and mind utterly exhausted; some cancer families even go from being comfortable to poverty-stricken, truly impoverished because of illness.For terminal patients, my advice is basically always the same: tell the family and patient to stop the upheaval and abandon all tests and traumatic treatment. Accept reality, use TCM symptomatic treatment to ease pain, build up strength, live this last period of days relatively comfortably, and as far as possible lower treatment costs. One must change the mindset: not seeking cure, only seeking to ease suffering; easing suffering is itself filial piety.We always cannot accept the reality of death, and this breeds much suffering and prevents us from making rational choices at the final moment. Sometimes I need to do a great deal of emotional work to make the patient family accept reality and stop the upheaval. Quite a few patients come to me only at the final moment of life; I take the last leg, which is essentially giving the patient hospice care.In this process I must first heal the grieving patient family, listening to them unburden themselves (and sometimes listening to them weep), comforting them. At the same time I persuade them to accept reality, reduce the patient suffering, and also reduce the whole family financial loss — this is actually very important; at the final moment of a terminal illness, there is no need to drag the whole family into a financial pit because of that unrealistic fantasy in one heart.I have previously seen a patient whose family was not well-off spend over five million yuan treating himself (about equal to what I spend treating 100-200 cancer patients in a year), dragging his family into a financial quagmire, and then beginning to raise funds online. I did not donate to him; this kind of unreasonable behavior cannot save his life. On the contrary, if he had not treated so aggressively, he could have lived longer and suffered less.I often tell patients and their families with trepidation that I only have some symptomatic-treatment skill, and it does not work for every patient. My success with some cancer patients was purely luck. And what terminal cancer patients need most is precisely symptomatic supportive care.If the patient suffering is easing little by little, if ascites is gradually receding in those who have it, if appetite is gradually returning in those who had none, if strength is coming back in those who had none, that is already quite good. These are enough to make the patient suffer less and moderately prolong life; lucky patients may even live with their disease for many years. Many terminal patients have no need for repeat testing; apart from wasting money, the greatest effect of repeat testing is to make the family suffer.One ovarian cancer patient I treated adopted exactly this strategy; nearly five years on, she still lives in good condition. Over the past five years she has used only pure TCM; her CA125 rises a little every month, but not by much.I had them gradually reduce attention to CA125; their testing frequency grew lower and lower, and now they basically test once every six months. Each time, this tumor marker is still rising. But the patient herself has little discomfort, and continues in the countryside eating, drinking and enjoying herself like a normal person; most of the patients treated aggressively at the same time as her are now a handful of earth, with grass high on their graves.How long one survives after cancer, and how good the quality of life, depend on the patient and family mindset. The more impatient for success, the more likely the opposite result, because patients and families with too-high psychological expectations often adopt over-treatment plans, which promote rapid patient death. Perhaps only when we accept the idea that easing suffering is filial piety can we make more rational choices.