Such Is Life

Yesterday, the son of one of my gastric-cancer patients sent me his own physical examination report, asking what he should do next. The color Doppler showed multiple thyroid nodules, the largest already over 1 cm, with irregular morphology, considered C-TIRADS category 4b. I told him this requires a biopsy to determine first whether the nodule is benign or malignant, and then decide what to do.

TI-RADS grading is a classification based on the size of thyroid nodules and the risk of thyroid malignancy. Category 3 and below is benign; category 3 has a 2% chance of malignancy. Category 4 is sensitive, and is divided into 4a, 4b and 4c: 4a nodules have a 10% chance of being malignant, 4b about 10-50%, and 4c about 50-90%. Therefore TIRADS 4b thyroid nodules require biopsy to determine benign vs. malignant by pathology. If malignant, a comprehensive anti-cancer plan should be made as early as possible.

This patient's family member is only two years older than me; on February 19 of this year he had brought his mother to Beijing to see me. His former colleague's father, diagnosed with gastric cancer four years ago, had been unwilling to undergo Western treatment (because the patient's wife, diagnosed with colorectal cancer, survived less than half a year on Western treatment, which greatly affected the family's medical decisions thereafter), and had come to me for treatment. The effect was very good; on follow-up the tumor could no longer be found, and he remains in good shape today. So he and his mother trusted me greatly and had traveled a long way from Dandong to Beijing to see me.

No one could have imagined that two months later his own physical exam would turn out like this. He is only two years older than me; he is very filial to his mother. His mother was diagnosed with gastric cancer in 2018, and all these years he has taken her seeking doctors everywhere. Although we did not talk in detail about his experiences over the past five years, from his mother's stack of examination and hospitalization reports I could tell what kind of life these mother and son, dependent on each other, had lived over the past five years.

Because everything he is going through, I have also been through. Only I was a bit luckier: when caring for my mother, although I was also under enormous pressure and broke my own health, it was not as severe as his. He and I, two middle-aged men of similar age, really did not know what to say to each other at such a moment. After guiding him on what to do next, I wanted to say a few words to comfort him, but felt words were too pale. I could only express regret for the misfortune of him and his mother; his reply was also brief, only the two words "life." A thousand words and endless feelings were all condensed into those two characters.

Such is life. What the words "life" contain, only we ourselves know. Especially for cancer patients and their families, the sweetness and bitterness of life truly cannot be explained to outsiders; and even if explained, how many could understand?

I have met too many cancer families in distress. Before the pandemic, the wife and daughter of one of my lung-cancer patients were successively diagnosed with bladder cancer and a brain tumor-the whole family fell. When their examination reports were all laid before me, my heart was heavy and wretched. I used my personal influence to raise several hundred thousand RMB for this family, and personally donated several thousand yuan to them in installments. Though only a drop in the bucket, it brought some practical help to this family in great misfortune; more importantly, this despairing family pulled itself together at that moment.

Misfortunes often strike the same family one after another. Not long ago, the mother of a neuroblastoma child who sought my help herself developed renal failure. She asked me to help solve the renal failure; I did not have that ability and could only suggest she go to the nephrology department. Seeing the examination reports of her and her child, my heart ached too. I offered to waive all her child's consultation and medication fees, and proposed using my personal influence to raise funds for her family.

When I encounter families in especially dire straits, I occasionally raise funds through my personal influence; I can still raise several hundred thousand in donations at a time, but I seldom readily use the trust readers and fellow patients place in me. Many patients deserve sympathy, but my time and ability are very limited, so I can only prioritize those who truly have nowhere else to turn. All my offers were politely declined by her; this is a very strong mother. She only accepted a partial fee reduction, saying that if I charged her nothing at all, she would never be able to ask me for help in the future. As for fundraising, she did not want to accept it for now. Some cancer families, though in distress, remain self-reliant and strong, which I admire greatly.

In the world of tumor patients and their families, what we see is truly the most tragic life. Terminal illness is the verdict the god of fate hands down to humanity; since receiving that verdict, the vast majority of patients and their families fall into depression, despair and suffering. The oncologist's duty is not only to prolong their lives but also to rescue them from this depression, despair and suffering.

I am now in an almost full-time study state, which will last for more than five years, perhaps until 2028-2030. I am not satisfied with my current level and ability; I hope through several years of full-time study to improve myself, master more comprehensive medical knowledge, and bring greater help to cancer families. Too many cancer families are trapped not only in health difficulties but also in economic and spiritual distress; they need the most economical and effective anti-cancer plan. Only a physician who masters the most comprehensive oncology knowledge can formulate for cancer patients a truly valuable, most economical anti-cancer plan; therefore we must constantly improve ourselves.

The vast majority of cancers are incurable; the future life road of patients living with cancer and their families is an important question doctors should consider. A good doctor-patient relationship is built on mutual trust and understanding. If a doctor wants the patient's understanding and trust, he must first have professional technical competence and the professional conscience to think for the patient and the patient's family. When a person's life has become gloomy because of illness, if the doctors dealing with them lack sympathy and empathy, serious doctor-patient disputes can easily brew; many tragedies of doctor-patient disputes arise in just this way.

My son is not very interested in studying medicine, and I understand and support his choice. When I was young, because my family was poor and my relatives were weak and often ill, I wandered the streets, slept under bridge arches and in waiting rooms, and even begged; I know deeply the suffering of the disadvantaged. This life experience helps me, in medical practice, to have natural sympathy and empathy for cancer patients and cancer families in distress.

So I often tell my family that my taking the medical road was fate. My son lives in a middle-class family and cannot experience what I have experienced. Without similar life experience, how can one produce spiritual resonance with the people we serve? For the same reason, I do not believe the currently booming AI technology can replace doctors-especially doctors who feel patients' lives in their bones-because medical care will never be a dry technical matter.