Medicine is a science with a temperature. A doctor with a warm heart should be a kind and loving person who respects life and has deep compassion for the pain of his patients. Pain is a very unpleasant experience for people, especially when they suffer from illness, a situation that everyone avoids. The pain is in the patient, but the pain is in my heart. I have been helping patients with their pain for more than ten years. During the process of contact with patients, there are many warm moments vividly. There was an old lady, a retired university professor, who came to me for treatment of osteoarthritis pain in the National Pain Treatment Center of China-Japan Friendship Hospital. When she came, her leg was limping, and she was talking with a sigh and a heavy heart. When I understood her condition, I mentioned that elderly people should have a hobby after retirement. At this point, she immediately came to life and said, “I’m a veteran Beijing opera singer, I often perform on stage, and I’m the leading actress in my circle. But lately, my knees have been hurting so badly that I can hardly walk, and I haven’t been able to perform for months. As people get older, their joints will naturally deteriorate. I will try my best to help you return to the stage.” I looked at her test results, which were not yet ready for artificial joint replacement, and suggested she perform joint cavity injection therapy, once a week. Three weeks later, the old lady’s joint pain was significantly better and she walked with much more energy. She happily said to me, “Dr. Sima, you are welcome to come see our performance sometime, the tickets are on me.” “Thank you, my work is really too busy, you can record a video for me to see.” To be honest, in addition to seeing patients in outpatient clinics and managing ward patients every day, I do hardly have time to spare. The speaker has no intention, but the listener has an intention. Some time later, the old lady came again. The number she registered was very close to the front, but she let other patients see her first, and sat on a chair at the door and waited. At 12 noon, I was washing my hands after seeing the last patient when she came in with a DV. “Dr. Sima, let’s not delay your lunch. I recently starred in “Mu Guiying hangs the marshal” and asked my partner to record a segment, see how well I performed?” I was stunned to hear that the old lady had waited outside the door for more than 3 hours just to let me watch a performance of her Peking Opera! The old lady pointed at the screen and said proudly, “I played Mu Guiying, my stance and singing skills are pretty good, right? I owe this knee to you!” “Hearing the golden drums and the sound of the horns, I was reminded of my ambition to break through the gates of heaven. I want to think of the year when the peach blossom horse majestic, enemy blood splashed pomegranate skirt ……” look at the old lady’s energy, just like a professional actor. My eyes are a little moist. As a doctor, what is more moving to me than the trust between doctors and patients …… A bouquet of flowers One morning in early summer 2011, the sun was shining. I was changing my white coat and preparing to leave the clinic when a nurse’s crisp voice came: “Dr. Sima, a patient’s family is looking for you.” In came a middle-aged woman of about 40 years old, holding a bouquet of flowers with a refreshing fragrance. “Aren’t you Auntie Sun’s daughter, why are you carrying a bouquet of flowers so early in the morning?” I asked. “Dr. Sima, this is a small token of my appreciation. Thank you for your efforts to relieve my mother’s cancer pain, she had a very happy life these years. She left the day before yesterday and left a last wish for me to make sure I came to the hospital to thank you in person.” First, I felt a warmth in my heart, and a sense of professional sanctity arose. But there was also some inexplicable sadness inside, in front of the disease, doctors often encounter “helpless pain”. I have received flowers from patients or family members many times, but it was the first time I received flowers from a grateful patient after he or she passed away. With the flowers in my hand, I could see the kind and gentle old lady in my mind. It was a day in 2008 when 65-year-old Auntie Sun came to me with a painful bone metastasis from breast cancer. She came in a wheelchair, her face was haggard and painful, her white hair at the temples was a bit messy, and she looked gloomy and did not say a word. “The cancer pain made her want to commit suicide several times. You must find a way to help her.” Auntie Sun’s daughter begged with tears in her eyes. “Bone metastasis pain is the most intense cancer pain, I can understand.” I clutched Auntie Sun’s hand and said to her with a smile and determination, “Auntie Sun, don’t worry, I have a way to relieve your pain!” I first chose the right dose and type of narcotic analgesic for her, and the effect was immediate. The next time she came in, her pain was significantly reduced and she was not in a wheelchair. I re-evaluated her condition and suggested palliative low-dose chemotherapy, which would relieve pain and slow the spread of the tumor. Auntie Sun and her daughter gladly accepted this plan. After 4 courses of treatment, Auntie Sun’s condition was well controlled and pain medication was no longer needed, and she was only maintained with endocrine therapy and osteoprotective agents. She can go out for walks and do household chores, no different from normal elderly people. I remember once she came to the clinic and was happy to see me, saying that her life was full of sunshine again and teasing herself, “Dr. Sima, I don’t want to commit suicide anymore, I want to live well.” This went on for 3 years, and every time she came to the clinic, she would use a short time to talk to me about happy things. When she left, she would always say, “Dr. Sima, take care of your health!” Three years later, Auntie Sun’s condition began to worsen, and she tried palliative chemotherapy, but the effect was no longer very satisfactory, so she stopped using it. As the pain worsened, I gave her another adjustment of analgesics and adjuvant medications to alleviate advanced symptoms to try to make her feel better, which lasted almost half a year or so. “Mom was very peaceful when she left, and she talked about you many times during those days. The doctor said she wouldn’t live more than a year, but you gave her confidence and hope, and she was happy for the past three years.” The words of Auntie Sun’s daughter made me think a lot. Patients with advanced cancer rely on doctors more than their relatives and friends. If doctors do not give them confidence, they will lose the last straw of life. Any doctor with a sense of responsibility will try his best to “remove the pain of human diseases and help the perfection of health”, especially at the end of life, what we should do most is to respect the patient’s feelings and wishes, and help them finish their last journey with dignity. A prescription Not long ago, I saw an old man, 70 years old, with a malignant fibroid tumor in his left lower extremity, suffering from unbearable pain and limping, and using a large dose of painkillers, but with poor results. He was agitated when he came in, and his partner cried and cried when he talked about his condition. I first comforted him and helped him build up his confidence to overcome the disease, but he immediately interrupted me and said, “I am not a 3-year-old child, it’s useless for you to talk about this, you have to find a way to help me relieve the pain and let me sleep peacefully.” The patient was obviously well aware of his condition and already had significant anxiety. I immediately changed my strategy and first asked him about the characteristics of his pain, his medication history and side effects, and then told him, “Mr. Lao, don’t worry, I have a solution for you. On the other hand, there are many nerve fibers on the surface of the periosteum, if not treated effectively, it will develop into neuropathic pain, which will be more complicated when intertwined with cancer pain. I will add a neuromodulatory drug to you, so that you can get twice the result with half the effort.” When the old man saw that I was not “talking about the same old thing” but had a treatment strategy, his anxiety was immediately relieved and he said, “Okay, I will try.” One day, a week later, when Beijing was on red alert for haze, the old man came into the clinic and said to me cheerfully, “Doctor Sima, your medicine really works, my pain is much lighter all of a sudden.” My partner said, “He trusts you so much that he said he must give you personal feedback on his medication and listen to your advice. Knowing that you have a specialist clinic this morning, the old man insisted on coming. At that time, my heart trembled, how much trust and dependence the patients had on us! “Old man, next time you choose a sunny day to come over, consider it as exercise.” After hearing my words, the old man left the clinic happily. Before he left, his partner told me, “He hadn’t been so happy for more than half a year since his illness was diagnosed. We have been to many hospitals and all of them said there was no hope. Only you not only encouraged him, but also talked to him so patiently, which gave us hope.” “I feel your pain.” We face painful patients every day, and from the perspective of humanistic medicine, the patient’s feelings come first and are respected. Read the disease, more read the person; focus on the disease, more focus on the heart, this is the highest level of the doctor!