One is that I will often encounter such problems in the clinic, and the other is that recently my own loved ones have experienced such risks. First of all, my aunt was 88 years old, and one day I suddenly received a call from her children saying that the hospital had told me that she was critically ill, and when I went over there, I saw that she had a perforated gallbladder stone, was in infectious shock, and her blood pressure was maintained by medication. I remembered that some time ago she was hospitalized because of gallbladder stones and cholecystitis, I went to see her and suggested surgery at that time, but her family felt that they were too old to do so, and I was usually too busy and forgot to ask about it. They wanted to be transferred to my side, but the hospital she was in was afraid that the patient would die in transit, so they had to call me over. I made it very clear that she would die of infection without surgery, and that she might not even pass the anesthesia, but there was hope if she survived, because after all, she was her own relative, and I had more guts in this critical situation). After the surgery, he went through bleeding, infection, nutrition (nearly a year of living on ration, afraid to eat a little greasy because of the pain), and finally recovered successfully after two repeated discharges. When we summarized this case, we thought that if we had been a day later, even if the patient had been operated on, he might not have passed, and now he would have lived for another 10 years. I am in no way bragging about how good our technology is when I tell this story. To be honest, at that time I was not sure that the 88-year-old would have survived in such a critical situation, and even if she had, I wouldn’t have been able to guarantee that I could save the next patient in a similar situation. What I want to say is: she actually missed the right time to choose the surgery! In my clinical work, I often encounter elderly patients who have gallbladder stones and need to be removed, especially some elderly patients who also have diabetes and hypertension, and these patients refuse surgery because of their age, poor health, and high surgical risk. I usually explain to the patient: I know what you are talking about, and the doctor will put safety first when deciding whether to operate. If the pain is recurrent, even if you get better for a while with conservative treatment now, it will almost certainly come back later. Even if you are now 70 years old, your life expectancy in terms of current living conditions will certainly not be only 71,72,73 …. The first thing you need to do is to live until you are 80 years old, then well, wait until you are 80 years old and you are in pain again, and the pain is very bad, no surgery can not do? At that time, the risk is not greater than now, and then how to choose it? Older people’s health will only get worse every year, that is, the risk of surgery is greater than a year, often the current time may be the least risky surgery, or even you open a few years earlier, the risk is less than now (older people are often known to suffer from stones for many years before they will come to the clinic). The core point of all this is to look at all aspects of risk when considering it: including the risk of surgery, the risk of not having surgery for this disease, the risk of aging, and the risk of other co-morbidities worsening with age. The right way to reduce risk is not to avoid it, but to exchange it for a greater benefit at a minimal cost. There are two sides to the story, and I am not in any way encouraging elderly patients to go ahead with surgery regardless, but rather suggesting that you listen carefully to your doctor’s advice rather than drawing a line in the sand before you see him or her. Everyone values their life, and doctors would never take it for granted. Surgery has risks, and everyone on earth knows that. If you read what I wrote and have a different opinion, feel free to leave a comment and discuss it together.