The Patient Is Far Harder to Treat Than the Disease

Having treated disease for a long time and dealt with many patients, I sometimes cannot help but sigh: the patient is far harder to treat than the disease. It is especially difficult when treating patients who come to Chinese medicine.

The biggest hurdle is that patients find it hard to build confidence in TCM treatment. Patients often abandon TCM treatment halfway. Sometimes, having poured my heart into planning to treat a patient to a more ideal outcome, the patient quietly slips away, and a well-intentioned expectation vanishes in an instant. After long clinical experience, I can sense it from a patient's few words and small actions.

Although some patients still put on a polite front, I can keenly detect that they have already engaged someone else; the reason they still exchange pleasantries is merely to keep a spare option handy, just in case.

Patients' personalities vary. Some are extremely impatient, holding unrealistic expectations for serious diseases like tumors—hoping to cure it within a month. Though I myself pursue rapid results, I really cannot meet such an expectation. Some patients have only taken medicine a few days yet watch the tumor's every move; at the slightest change their emotions immediately surge. Such unrealistic expectations often lead patients to grasp at results and advance recklessly.

Over ninety percent of patients who come to Chinese medicine for tumors have already reached a point where Western medicine can no longer manage. Nine out of ten such patients will die in the short term, yet once they start TCM treatment they expect to be cured immediately. Young patients are especially like this: they underestimate the difficulty of treating a tumor. Doctors fighting cancer often exert their utmost yet achieve only modest results, which obviously cannot satisfy the patient's expectations.

And so patients rotate through doctors and treatment regimens like a revolving door. Nine out of ten such patients die quickly. There is no other reason: every doctor or therapy needs a period of trial and error, and the little bits of time add up until the patient's time to die has arrived.

I know full well the pitfalls of this. But facing the patient I choose silence. Because I can say with certainty that over ninety percent of the patients who come to me cannot be cured by me; all I can do is improve their quality of life and prolong their survival. In my lifetime I may cure a small number of patients, but that probability is absolutely a once-in-a-blue-moon occurrence. That being so, why block the patient's other choices for survival?

Cancer patients are a very special group, and their rationality is limited. Some patients have clearly achieved remarkably good results, but as soon as a few other patients come along and say some other therapy is wonderful, their hearts are stirred at once. With such patients, I now politely see them out immediately. Because I myself cannot guarantee them a cure, but others are different—they like to tell patients with great confidence that so-and-so has been cured by them. Such words are the most intoxicating for patients. Let them go whomever they like! If I stand in the way and then the other treatment fails, how do I explain myself? The patient will say I delayed them from trying other methods.

There are also patients who treat doctors' orders as worthless, ignorantly expecting rapid results, and recklessly altering the treatment course on their own. This has made me realize that treating the disease and treating the patient are two different things. Treating the disease is much easier than treating the patient; patients or their families are not nearly as easy to handle as the disease.

I like to seek out rational cancer patients or family members and form a doctor-patient bond with them. Because they are mature in thought and highly rational, matching my own temperament. Treating them doesn't make me feel pressured, and in fact such patients have the best outcomes. They cooperate remarkably well with the doctor; sometimes although the situation looks dangerous, they turn from peril to safety. Other irrational patients may show excellent short-term results, but because the patient or family is flighty and impetuous, a single rash action is enough to waste all previous effort.

Sometimes I write medical orders until my hand aches, only to see the patient treat those orders as worthless; I cannot help but feel disappointed. After treating such patients for a while I inevitably become disheartened and no longer want to continue. Medical orders matter as much as the medicine itself, because they are the most important supporting measures for treatment. If the patient does not follow the orders, the doctor's treatment is immediately wasted and the course becomes especially erratic.

For example, in a bleeding patient, the doctor will instruct them not to eat chili and not to strain during bowel movements; if the patient doesn't take it seriously, bleeding may recur immediately. In a bloated patient, the doctor warns them not to eat foods that easily cause constipation; if the patient cannot control their mouth, the organs that were just unblocked will clog up again before long. A doctor's course of treatment has a comprehensive plan, but patients mistakenly believe that curing disease depends on the medicine alone, thinking that just taking pills will cure them. Little do they know that the medicine's effect is limited while the disease's power is boundless; there are some behaviors one should barely escape, yet the patient runs headlong toward them—isn't that making things difficult for the doctor?

My original wish was to be a good doctor, helping patients escape from the clutches of cancer. But gradually, that expectation of mine has shrunk considerably. As the old saying goes, a doctor does not knock on the patient's door; a physician should not beg patients to come.

Between doctor and patient, once a trust crisis arises, the doctor should be the first to step aside and yield. In truth, for cancer patients there is only one golden rule of survival: once a treatment regimen is working, stick with it! Follow the arrangement of a professional doctor, not your own assumptions.

I gradually understand why some doctors begin with burning passion but gradually grow numb. It is lamentable that many patients' deaths are not really due to their disease, but due to their own personalities.