Facing cancer, most patients follow such a path: surgery first, spending tens of thousands of dollars; then chemotherapy, spending hundreds of thousands of dollars; then radiotherapy, spending hundreds of thousands of dollars; then turn to TCM treatment, spending tens of thousands of dollars, and finally they are both empty. In the face of cancer, most patients take such a path: first surgery, spending tens of thousands of dollars; then chemotherapy, spending hundreds of thousands of dollars; then radiotherapy, spending hundreds of thousands of dollars; then turn to Chinese medicine treatment, spending tens of thousands of dollars, and finally empty. After the death of a loved one, many people find that we do not know much about cancer and put too much emotion and expectation into the treatment, instead of having time to let the deceased enjoy the last affection. The United States is the country with the highest level of cancer treatment. When American doctors themselves face cancer attack and end-of-life, how do they face and choose? Many years ago, Charlie, a highly respected orthopedic surgeon who was also my mentor, was found to have a mass in his stomach. It was surgically explored and confirmed to be pancreatic cancer. The surgeon in charge of Charlie’s surgery was one of the best in the country, and he happened to have invented a surgical procedure for this type of pancreatic cancer that could increase the patient’s survival rate a full three times – from 5% to 15% (although the quality of life was still low). Charlie, however, was not the least bit impressed. He was discharged home the next day and never stepped foot in the hospital again. He spent all his time and energy with his family and was very happy. A few months later, he died at home. There was no chemotherapy, radiation or surgery. His insurance provider also saved a great deal of money. Some doctors have been known to wear a small “Do Not Resuscitate” sign around their necks after a serious illness to remind them not to be resuscitated when they are dying, and I have even seen people with this phrase tattooed on their bodies. is a human being, will also face terminal illness, death. But the way doctors die seems to be different from ordinary people. The difference is that, contrary to accepting every treatment possible, doctors hardly ever choose to be treated. Because they know how their condition will evolve and what treatment options are available to them, they choose “no” even though they usually have the opportunity and ability to receive any treatment. By “no,” I don’t mean that doctors are giving up on life. They want to live, too, but their deep knowledge of modern medicine makes them well aware of its limitations. By profession, they also understand that people are most afraid of dying in pain and loneliness. They will discuss this with their families to make sure that when that day does come, they will not be administered resuscitation – CPR and the ensuing broken ribs (which can also be caused by proper CPR). Almost all medical professionals have witnessed “ineffective treatment” in the course of their work. By ineffective treatment, we mean that all the most advanced techniques are used to keep a dying patient alive. The patient’s trachea will be cut open, a catheter will be inserted, a machine will be attached, and medication will be pumped in and out. These scenarios are played out every day in the ICU (Intensive Care Unit) and the cost of treatment can reach$10,000 a day. This torture is something we don’t even resort to when punishing terrorists. I have lost count of the number of physician colleagues who have told me, “Promise me that if I ever become like this, please kill me.” Some of my colleagues have even worn small “Do not resuscitate” signs around their necks to avoid such an end. After the death of my loved ones, many of us found that we did not know much about cancer and invested so much emotion and expectation in the treatment that we did not have time to let the deceased enjoy the last affection. The United States is the country with the highest level of cancer treatment. When American doctors themselves face cancer attack and end of life, how do they face and choose? Many years ago, Charlie, a highly respected orthopedic surgeon who was also my mentor, was found to have a mass in his stomach. It was surgically explored and confirmed to be pancreatic cancer. The surgeon in charge of Charlie’s surgery was one of the best in the country, and he happened to have invented a surgical procedure for this type of pancreatic cancer that could increase the patient’s survival rate a full three times – from 5% to 15% (although the quality of life was still low). Charlie, however, was not the least bit impressed. I’ve seen people with the words tattooed on their bodies. Sometimes what families mean by “all measures” is just taking “all reasonable measures,” but doctors try to do “everything they can,” whether it’s reasonable or not. Why do doctors pour so much effort and treatment into their patients, but are reluctant to give it to themselves? The answer is complex, or perhaps simple, and can be summed up in three words: patient, doctor, and system. First, let’s look at the role played by the patient. Suppose A loses consciousness and is brought to the emergency room: normally, when faced with such an emergency, A’s family is overwhelmed by the array of options that are suddenly available to them. When the doctor asks, “Do you agree to take all feasible resuscitation measures?”, the family members often immediately say, “Yes.” And so the nightmare begins. Sometimes what families mean by “all measures” is simply “all reasonable measures,” but the problem is that sometimes they may not know what is “reasonable”; because doctors In resuscitation, they will try to do “everything they can”, whether it is “reasonable” or not. It is easy to see that a lack of knowledge and false expectations are the main reasons for poor decisions. Of course, the patient is only one of the reasons. A few doctors do what they can with a “if you treat, you get paid” mindset, and many more simply have to treat doctors out of fear of being sued. The problem is that even if the doctor himself does not want to carry out “ineffective treatment”, but because of the system and the law in the restraint, he must also find a way to be worthy of the patient and the family. Imagine an emergency room full of grieving or even hysterical families – who don’t know anything about medicine. Trying to build mutual trust and confidence at a time like this can be delicate and difficult to grasp. If the doctor recommends no aggressive treatment, the family is likely to assume that he is making this recommendation to save time, money, etc. Some doctors are eloquent, some are firm, but either way, they are under equal pressure. When it comes to matters involving “end-of-life treatment options,” I list what I think is reasonable as early as possible (in all cases). If a patient or family member makes an unreasonable request, I will explain the potential negative consequences of the request in easy-to-understand language. But in many cases, both patients and doctors are simply victims of a vast system that promotes “overmedication. In some unfortunate cases, a few doctors do what they can with the mindset of “if you treat, you get paid,” doing whatever they can for money. In more cases, doctors are forced to perform treatments simply out of fear of being sued. Doctors still don’t overtreat themselves, and studies have found that terminally ill patients living in hospices live longer than patients with the same illness who actively seek treatment. Because of this he was discharged home the next day and never took another step into the hospital. He devoted all his time and energy to spending time with his family and was very happy. A few months later he died at home. There was no chemotherapy, radiation or surgery. His insurance provider also saved him a great deal of money. It’s not often that people think about the fact that – doctors are human beings too and can face terminal illness and death. But doctors seem to die in a different way than ordinary people. They have seen the end of treatment so many times that almost all of them can stay at home and pass away in peace, and the accompanying pain can be better relieved. More importantly he understands the advances in medicine and only has to take responsibility for himself. Hospice care is more focused on providing patients with a sense of comfort and dignity than overmedication, so they can live their final days in peace. It is worth noting that studies have found that terminal patients living in hospices live longer than patients with the same illness but actively seeking treatment. Many years ago, my cousin had an illness that was later found to be lung cancer and had spread to his brain. I took him to various specialist clinics and finally understood: in his case, with aggressive treatment, he would need to go to the hospital for chemotherapy 3 to 5 times a week, and even then he would only live for 4 months at most. In the end, my cousin decided to refuse any treatment and just take medication to prevent brain edema and go home to recuperate. We spent the next 8 months having fun together and doing many of the things we loved to do as children. Finally he fell asleep for three days and passed away quietly. If there were an art form to death, it would be: dying with dignity. As for me, I had clearly explained my wishes to my doctor. When death finally came, I could not be resuscitated, but sleep peacefully, just like my mentor Charlie, my cousin. After reading? That’s one doctor’s view of life and death. Don’t think that doctors are gods, or that they are heartless! This article is not made by me, it is the Health Times 2012.05.17 KenMurray article, a salt translation. Understood, relaxed and harmonious. The difference is this: contrary to accepting every treatment possible, doctors hardly choose to be treated. Because they know how the condition will evolve and what treatment options are available to them, they choose “no” even though they usually have the opportunity and ability to receive any treatment. By “no,” I don’t mean that doctors are giving up on life. They want to live, too, but their deep knowledge of modern medicine makes them well aware of its limitations. By profession, they also understand that people are most afraid of dying in pain and loneliness. They will discuss this with their families to be sure that when that day does come, they will not be administered resuscitation – CPR and the ensuing broken ribs (which can also be caused by proper CPR). They have seen the end of treatment all too often, and almost all of them stay at home and pass away peacefully, and the accompanying pain can be better relieved. More importantly he understands the advances in medicine and only has to take responsibility for himself. Hospice care is more focused on providing patients with a sense of comfort and dignity than overmedication, so they can live their final days in peace. Notably, studies have found that terminally ill patients living in hospices live longer than patients with the same illness but actively seeking treatment. Many years ago, my cousin had an illness that was later found to be lung cancer and had spread to his brain. I took him to various specialist clinics and finally understood: in his case, with aggressive treatment, he would need to go to the hospital for chemotherapy 3 to 5 times a week, and even then he would only live for 4 months at most. In the end, my cousin decided to refuse any treatment and just take medication to prevent brain edema and go home to recuperate. We spent the next 8 months having fun together and doing many of the things we loved to do as children. Finally he fell asleep for three days and passed away quietly. If there were an art form to death, it would be: dying with dignity. As for me, I had clearly explained my wishes to my doctor. When death finally came, I could not be resuscitated, but sleep peacefully, just like my mentor Charlie, my cousin. After reading? That’s one doctor’s view of life and death. Don’t think that doctors are gods, or that they are heartless! This article is not made by me, it is the Health Times 2012.05.17 KenMurray article, a salt translation. Understood, relaxed, harmonious. This torture is a tactic we don’t even resort to when punishing terrorists. I have lost count of the number of physician colleagues who have said to me, “Promise me that if I ever become like this, please kill me.” Some of my colleagues have even worn small “Do Not Resuscitate” signs around their necks to avoid such an end. I’ve even seen people with these words tattooed on their bodies. Sometimes what families mean by “all measures” is just to take “all reasonable measures”, but doctors will try to do “everything they can”, whether it is reasonable or not.