Five Medical Notes
1
A patient with a skin leiomyoma, long after surgery, suddenly grew a growth near the original surgical scar; every tumor patient inevitably grows anxious at the sight of a mass. The patient was terrified it was a recurrence; I saw its shape was still regular and thought the possibility of malignancy was low. It being summer, a growth on the skin is fairly common anyway, so I suggested first taking Pifuxue Du Wan for about a week to observe whether the growth would shrink or change color.
The patient followed my advice; after several days on Pifuxue Du Wan, the growth clearly shrank and its color changed. Malignancy could basically be ruled out; the patient set her mind at ease and continued taking Pifuxue Du Wan.
This morning, the patient suddenly told me the growth had burst; she had pulled out a black thread suture from it, it bled a little, and it had healed on its own. It turned out this growth had been caused by a suture left in during surgery; the patient added that she had not gone to have the stitches removed after the operation. That makes it easy to understand why there was a foreign-body-induced growth. Interestingly, Pifuxue Du Wan also had an effect on this situation; probably because Pifuxue Du Wan has an anti-inflammatory and antibacterial effect!
The world is full of oddities; strange diseases and bizarre symptoms are innumerable. The longer one practices medicine and the more one sees, the fewer misjudgments one makes.
2
I have a patient who is very wealthy, with no children of his own; after seeking treatment from me, he quite wanted to fund my research. Later, wanting to cure his cancer once and for all, he went to the United States for treatment; treatment in the US was ineffective and his condition rapidly deteriorated. Knowing he did not have long to live, one day he video-called me, wanting to give me a large sum of his fortune to fund my research.
I politely declined. For one thing, my research and life do not require much money; for another, he still had living relatives in the world who would hope to inherit his estate, and I did not want to be drawn into his inheritance battle. Later he died; at the funeral I went to see him off, and in the mourning hall I heard his ex-wife say that they would audit his financial accounts down to the last cent, track down everyone who had improperly benefited from him, sue whoever should be sued, and absolutely not let those who had cheated him out of his money get away.
I was very glad I had not coveted his money; to this day I remain good friends with his relatives. When his mother and sisters fall ill and seek a doctor, they also come to me first. The ancients said that in conduct one should be "as level as water in money matters, and as straight as a steelyard among people"; this old precept contains profound philosophy, and who knows how many people have stumbled for not following this rule.
Many doctors stumble over money matters; the risks of medical practice and of worldly human relations both cannot be underestimated. A person practicing medicine who cannot curb his own desires is very likely to fall. Over the years, many kind-hearted people have wanted to fund my research, and I have declined them all; only occasionally do I join acquaintances in supporting impoverished patients.
Those willing to fund us are all people full of goodwill toward us. But once money enters a person's goodwill toward another, it may turn sour; over time, good friends can become enemies. My beloved teacher has always insisted that I not lose out financially, often telling me that even close brothers should keep clear accounts, and asking me to trust his life experience and follow his arrangements. More than twenty years on, our bond has deepened and no conflict has ever arisen. By his own example he taught me how to conduct myself; a good teacher matters a great deal.
As she ate them, the bleeding grew worse and worse; the sellers told her this was "detoxification," a stage the body must pass through before improving. The patient believed it; on top of that, the sellers vividly exaggerated how severe the side effects of regular Chinese and Western cancer treatment were, frightening her into not seeking medical care.
The patient recently had frequent massive bleeding and finally could no longer keep going, so she consulted me. I demanded that she immediately stop this foolish behavior, promptly have some repeat examinations to see how the condition had progressed, and seek proper treatment as soon as possible. Unexpectedly, the patient did not last a few more days before passing away; her family posted an obituary on social media.
A few days ago the news reported that a black-hearted entrepreneur had passed off candy as health supplements, exaggerating their efficacy, and amassed over 200 million yuan. The health-product market is a mishmash of good and bad, mostly exaggerated and untrue; many sellers use pyramid-scheme methods, and these people are silver-tongued and quite adept at bewitching people—truly impossible to guard against.
Every health supplement advertised as anti-cancer is deceptive; this is a golden rule. I hope cancer patients will be less gullible and not miss the best treatment window.
4
A breast cancer patient came to consult me about her condition. She had already seen TCM doctors for over a year, and every TCM physician who saw her had used the side effects of modern breast-cancer treatment to scare her off; she herself had rejected Western medicine for years and hit it off perfectly with these doctors.
But over this past year her body had gone from bad to worse and her tumor had grown day by day; yet this woman remained obstinately deluded, still seeking better and better TCM doctors. When she reached me, I looked into her situation and thought that although her body was worsening, the disease might not be progressing so fast; she should go to the hospital for repeat evaluation to see how far the tumor had progressed, and then decide.
Fortunately, the examination showed that although her tumor had grown, there was no distant metastasis yet, so a radical operation could be performed. Postoperative findings were somewhat better than expected; her tumor was still an early-stage cancer—some cancer types stay in the early stage for several years, and the radical cure rate for early cancer surgery can reach over 90%, so missing the window brings regret too late.
In Singapore, when TCM doctors see cancer patients, if they dare to use all sorts of scare tactics and mislead patients into missing the best surgical opportunity, the doctor will be sentenced. Such laws are set precisely to protect people's lives. The first choice for early cancer is radical surgery; this is experience summarized globally by legitimate Chinese and Western physicians from vast numbers of cases. Yet still many people, for various reasons, scare and mislead patients so they dare not operate.
We who practice medicine must have upright hearts, broad minds and horizons, and follow the principle that the patient's life comes first; we must not, out of self-interest or out of our own ignorance and prejudice, delay the patient's treatment window. If we flout this principle and mislead enough patients, we will eventually run into serious trouble.
5
A few days ago I published an article mentioning that during endocrine therapy for breast cancer one might consider combining Erzhi Wan with Ermiao Wan. Immediately a TCM student left a comment saying that Xiaoyao Wan should also be added. I told him to go first and learn what endocrine therapy actually is; this regimen of suppressing estrogen is completely opposed to a medicine like Xiaoyao Wan, which unblocks the channels and regulates estrogen secretion—adding it would only harm people, wouldn't it?
In reality, there are often people who have read little literature and rely on guesswork and personal opinion to guide patients' choices or medication; this is a sloppy style that must be firmly guarded against. I urged this TCM student to learn more and broaden his knowledge; it was also meant to push him to grow, since in the future he too may become the support on whom many patients depend—if, out of his own ignorance and assumptions, he harms patients, would that not be a shame?
Life weighs more than a thousand pieces of gold; before life, every physician should be careful and cautious, diligent and conscientious, learn and broaden oneself, and strive to improve, so as to injure fewer lives! With so many doctor-patient disputes now, if one does not hold such a sense of awe, one should not practice medicine, otherwise in the end one will inevitably mislead others and harm oneself.
The medical profession is high-risk and being a doctor is not easy. Insufficient insight and experience, or deviations in temperament, can all make us stumble. From antiquity to the present, doctors have always walked as if treading on thin ice; after all, we are dealing with life, so no amount of caution is excessive.