Meeting a Kindred Spirit in Words — My Heart Trembles
This Spring Festival I have been reading extensively, mainly the latest works in brain science and psychiatry. I would not claim to have fully integrated Chinese and Western medicine, biology, and psychiatry, but many questions I did not understand before I now genuinely grasp, and I have built a bridge between Chinese and Western medicine, psychiatry, and biology. All along, my goal has been to thoroughly master existing medical knowledge and apply it comprehensively, seeking the optimal and most cost-effective solutions to minimize patients' mind-body suffering and financial burden.
Last night I was reading Depression by the American psychology masters Aaron T. Beck and Brad A. Alford. I came upon a sentence: "According to Klein's research, depression causes greater suffering in humans than any other disease that afflicts mankind." Precisely because depression is so agonizing, the great majority of people who die by suicide do so because of depression. When I read that sentence, my tears could no longer be held back. Because my mother was once tormented by secondary depression, and at the time I did not understand this disease; I did not know how deep her physical and mental suffering ran, and could not find a better way to relieve it.
Fortunately, at the time my brother extensively searched English literature (he graduated in English), and found an antidepressant effective against the hemisensory disturbance following cerebral hemorrhage. He went to the neurology department of Xuanwu Hospital to ask doctors to prescribe it; at that time the doctors at Xuanwu did not know about this and hesitated to prescribe. My brother showed them the relevant literature, and only then did they believe there was indeed a basis and agreed to prescribe for my mother. Sometimes it is indeed family members who guide doctors in how to treat; this is not strange, because family members care more than doctors. This drug did relieve my mother's suffering at the time, though the effect was still limited.
Li Zicheng once issued a military order forbidding his troops from killing innocent civilians: "Killing one man is like killing my father; dishonoring one woman is like dishonoring my mother." For me it is: "Treating one patient is like treating my mother; saving one patient is like saving my father." When treating cancer patients, there are always moments that touch my heart and make me think of my mother.
Cancer is a complex of diseases, closely tied to a person's genes, psychology, life circumstances, and habits. To truly understand this disease, one must delve into the depths of Chinese medicine, Western medicine, psychiatry, biology, and even philosophy and religion, to understand the deep mystery of what it means to be human. Why can we multicellular organisms not escape the doom of cancer? What diseases go hand in hand with cancer? What methods can alleviate the mind-body suffering of cancer patients?
On the road of seeking medical help for my mother, I encountered too many people who made rash promises, only to reveal themselves as after nothing but a little money. Now I am skeptical of any promise about cancer treatment efficacy, and I dare not make any promises to patients or their families. Medicine is a science full of uncertainty, and at the same time an art full of hope. Perhaps we can indeed help patients, perhaps not. As physicians, even knowing our limited effect, we must not abandon the pursuit of healing; the sacredness of the medical profession lies in being able to bring hope of life to those desperate patients.
Life is most precious, weightier than gold. If we cannot feel empathy for the mind-body suffering of patients and their families, and cannot treat those who sincerely seek our help as we would our own loved ones, how can we face our own hearts?
Today I read Living Beautifully: How I Lived to 105, a book published after the Japanese doctor Shigeaki Hinohara was interviewed at the age of 105. I was deeply moved after reading it.
His upbringing, personality, and views on life all resonated strongly with me. His parents gave him enough freedom to grow on his own; as a child he was naughty, even a bit mischievous. But after growing up to become a doctor, he developed in his daily work and life a deep understanding and appreciation of love, respect, and tolerance. He was the first person to introduce preventive medicine to Japan; his life, marked by bold innovation, was full of controversy, and he devoted himself entirely to the medical cause. He said that love is the ultimate purpose of human life, and that a person's self-worth is realized in love.
That there are people in this world who can fully resonate with us is a deeply comforting thing. It shows that in the future there will be others who share the same vision and walk the road we are walking now. To love someone is to wish them well, not to force them to change so that they meet our own need to be loved. Loving all beings is wishing all beings well, not making them satisfy our own need to be respected and adored by them. Even if our reputation might be damaged by a treatment with uncertain odds, we must not abandon a patient's hope of survival for the sake of protecting our reputation. Love requires using one's own soft, warm heart to heal others' wounds.
The mission of a physician is love. I admit I am not yet good enough in this regard; sometimes I keep people at a distance, sometimes my manner is not soft enough. All this is because my cultivation is still insufficient, my mind not broad enough, and there is much to improve. I am grateful to Dr. Hinohara for showing me my shortcomings and giving me the chance to see the worthy and emulate them, so that I may improve in the years I have left. Mr. Hinohara's writing has taught me a great deal; whether toward the loved one or toward patients, I am not as selfless as he is.
A physician should have lifelong, boundless pursuit. Only by remaining dissatisfied with one's knowledge and personal cultivation can one "abide in the highest good" at the final moment. A physician like me may endure much criticism, but as long as patients need my help, I am willing to bear any criticism. When I set out to integrate the various branches of medicine and offer cancer patients what help I can, some mocked me for overreaching, others scoffed at the branch of medicine I studied as beneath them — the TCM fans mocking Western medicine, the TCM detractors mocking Chinese medicine. I could only follow the Buddhist principle that "non-rebuttal of right and wrong is liberation" and respond in silence. Because, seeing patients tormented by disease like my mother, seeing the suffering of those pitiful people, I cannot remain unmoved, cannot be complacent, and cannot be satisfied with any art that does not fully resolve their mind-body suffering. Compared with these, what are misunderstanding, censure, and ridicule?
I venture to say that those who hold sectarian prejudices are merely people who cannot overcome their own inertia, cannot surmount their own shortcomings and narrowness, and are making excuses for not working hard enough. When other methods exist to treat patients, should we not learn about them and honestly compare their efficacy with what we now know? When one method fails, should we not strive to explore other potentially effective methods for patients? Can we simply look on at their mind-body suffering?
Serving patients is a long road, and Dr. Hinohara walked it past the age of a hundred. He too was a person who loved using writing to express his care for the world; he said that a person's life does not end with the death of the body, and he hoped his writing would continue to help others after his death. Yes, that is the shared wish of every writer. What flows through his writing is sincerity, open-mindedness, peace, tolerance, and love — these are indeed medicines that can heal the world.
The means by which we heal patients have never been limited to medicine or to fee-charging consultations; words are also one of our therapeutic tools. For patients tormented by mind-body suffering, a passage of writing that brings them relief is also a good medicine. And it can reduce their financial burden as well — why would we not do it? When a patient's mind-body suffering is relieved, should we not feel genuinely happy for them? Was not our original purpose in studying medicine to help patients?
Just today, one of my breast cancer patients continued discussing her sister's psychiatric disorder with me. Her sister is trapped in anxiety and phobia from which she cannot extricate herself, and my patient is herself exhausted in body and mind. Both she and her sister are younger than I, both are pillars of their families, yet they have suddenly been struck by cancer and mental illness.
Faced with such a family, I find it hard to remain unmoved, yet I am helpless, because the methods we have tried have not solved their problems. Medicine exists to solve real-world disease problems, not to satisfy vanity or score debating points. Whenever I encounter such an awkward moment, I know I still need to learn more. I could write articles lightly and luxuriate in a false air of ease — that would be easy for me, because few people write as well as I do. But I cannot deceive myself; I can only, like Dr. Hinohara, learn and walk on endlessly, striving to improve my ability to solve more problems.
On love, friendship, and kindred spirits, this centenarian also had penetrating insights. He said love is complete acceptance of the other and uncompensated giving for them, not demanding love from the other or asking them to change to satisfy oneself. True love and friendship need not be many; as long as one person in this world has deeply understood us, we are no longer alone. Even if one day this person leaves before us or is separated from us for whatever reason, we can still spend the rest of our days with their image in our minds. The best love is not thunderous and earth-shaking, but being able to eat at the same table — this is one of the best interpretations of love and friendship I have ever read.
Dr. Hinohara had wide-ranging interests. He was passionate about medicine, but in his spare time he loved music, even writing his own lyrics and conducting an orchestra; in his later years he took up painting. About the things he loved, this centenarian said: even taking the first step alone is already a remarkable thing. Indeed, life is so precious; while we cherish others' lives, we should also cherish our own, enjoying to the full the joy life brings rather than living in sorrow. His attitude toward life and death — "ready to die at any moment, yet striving to live with every step" — is both open-minded and sincere; the old man's wisdom had reached the realm of returning to simplicity, so he needed no hypocritical words to adorn it.