Patients' Understanding and Trust in Their Doctor Matter Greatly

I still remember that when I had just achieved complete remission (the tumor had completely disappeared and cancer markers normalized), I shared in a group chat: "Don't look at the fact that I recovered on Chinese medicine—that doesn't mean you can too." I said that during my treatment I had also experienced pain, bleeding, and even tumor growth, but I never once suspected that the problem lay with the doctor or the medication. Instead I actively contacted the doctor to find the right approach, and whenever a problem arose I communicated actively to find a solution. I said I could entrust my life to Dr. Zhou, which is why our collaboration (between doctor and patient) achieved such good results. If you took Chinese medicine, could you do the same? So don't just look at how many people take Chinese medicine; look at how they take it."

— Ma, a late-stage cervical cancer patient from Shaanxi

These are words spoken to me once by Ma, a late-stage cervical cancer patient I treated (her case has been published; see my article "The Treatment Case of Late-Stage Cervical Cancer Patient Ma"). I excerpt them because they are so well put. Only when patients understand and trust their doctor can treatment achieve the best possible result.

I have seen people online discussing TCM, claiming that patients who believe in TCM are paying an "IQ tax," and choosing not to trust it themselves. Such "shrewd" patients and families do not hold this attitude only toward TCM; they may hold it toward all doctors. Because a person's character is consistent, "shrewd" people stay "shrewd." Many Western-medicine friends tell me they likewise encounter large numbers of distrustful patients, some of whom even record video during consultations, ready at any moment to make trouble, leaving them terrified.

On the question of doctor–patient cooperation, there is a line in Dream of the Red Chamber that hits the nail on the head: "He who schemes too cleverly and overreaches only ruins his own life." Most patients and families are not "shrewd" enough to think that trusting a doctor is paying an IQ tax, but a few are always full of self-importance, refuse to trust the doctor, and ultimately harm themselves.

I cite this patient's example not to persuade anyone to come to me for treatment—frankly, my level is not high, especially since most of my patients are late-stage cancer patients whom hospitals have given up on, which makes my success rate even lower. I often give my all treating a patient and am still hit by harsh reality, ending in failure most of the time; success is only an occasional event.

I cite this patient to make a point through her words: treating disease requires close cooperation between doctor and patient on a foundation of mutual understanding and trust. Our common enemy is the disease, not each other. If a patient distrusts the doctor from the start, they are better off seeking someone more skilled rather than delaying themselves. In the past, when questioned by patients I would feel a little sad; now, when I encounter patient distrust, I take a step back before the patient does, do no persuading, and instead try to talk them out of treatment.

Cancer remains a worldwide medical problem, and no doctor can cure it easily—except, of course, for certain fraudsters, in whose mouths cancer is as easy to treat as the common cold. Such scams can be seen through with common sense. During cancer treatment, if a patient blames the doctor at the first sign of trouble, no doctor will dare to treat such a patient or family with peace of mind.

Objectively speaking, treating disease involves a process of trial and error, because many regimens that work for patient A may not work for patient B. Clinical statistics are probabilistic data; they cannot infallibly guide a doctor in solving one specific patient's problem. This feature of clinical work means risk for both doctor and patient; doctors must be clearly aware of it, and patients and families must understand this common sense.

A few of my patients did see their tumors disappear completely or their disease remit after taking medicine, but no patient's treatment went smoothly. During treatment they all experienced side effects, or tumor growth mid-course, or rising tumor markers. But because of the strong trust between doctor and patient, we always faced everything together, looked for solutions, and—with the patient's luck—finally achieved good results.

Regarding luck, I must say it plays a large role in cancer treatment. Last night a cancer patient who had survived for more than twenty years told me that he now deeply feels that how long a cancer patient survives depends largely on luck; I fully agree.

A few years ago I was more enthusiastic about taking patients; in those days my mind was simpler, and I thought every patient who came to me was kind and trusted me. But in recent years I have become less enthusiastic; before taking a patient I first observe coldly what mindset the patient and family hold. If some patients and families are not so kind and sincere, I will not easily establish a doctor–patient relationship with them. I have two reasons: first, because I know that unkind and insincere help-seekers will surely retreat mid-treatment and achieve no good result, so it is better not to waste their precious time seeking someone they truly trust; second, to avoid doctor–patient disputes.

Because medical problems are complex, treating disease is one of the hardest things in the world. Patients' understanding and trust cannot guarantee the doctor can solve their problem, but without understanding and trust the doctor certainly cannot. Without the patient's support and cooperation, a doctor can do little. My more successful patients over the years seem a bit "foolish" to many people; they seem to be exactly the kind of people who supposedly pay the IQ tax.

But I think such patients possess great wisdom: they are good at building a mutually trusting doctor–patient relationship rather than being overly shrewd and suspicious of everyone. Overly shrewd people are rarely truly clever; most are merely smug. If a patient guards the doctor like a thief and questions the doctor like a fraud, the doctor will not dare to treat them. Because doctors are not foolish either; they can tell from the words and demeanor of patients and families the risk of treating a given patient. These truths are simple, yet not every patient and family understands them, which is why I must emphasize them again and again.