It was Saturday, 19th December 2009 in the afternoon. We were at the out-patient square of the Zhangjiang People’s Hospital. Though located at the southernmost tip of mainland China and it was near winter solstice, the temperature at Zhangjiang was as low as 11°C. I could still feel the chill even though I had put on a long coat with a woolen scarf wrapped around my neck. We were taking part in a charity medical consultation programme organized by the Digestive Diseases and Cancer Division of Guangdong Province’s Association of Integrative Medicine. Six doctors from several hospitals in Guangzhou including the Second Affiliated Hospital Zhongsan University, the Second Affiliated Hospital of Guangzhou Medical University, and Southern Hospital were giving consultation to patients coming from the different parts of the province.
Around 3pm came a young lady. She was thin and pale. As she sat down in a half-leaning position, I noticed that she had an extraordinary, or rather humongous abdomen; her legs were badly swollen like elephant’s legs with was dry and purplish skin. I examined her and was astonished to see she was not wearing any underwear. The swelling of the legs extended all the way to her lower abdomen area, the skin was tight and the blood vessels below the skin were clearly visible. The abdomen was tense and inelastic.
She was Peng Ximei, 28 years old. She came from Fu Lian Bo, Guangqiao Village, Guangdong Province Town, Maoming City. There was no telephone contact at home. When I asked her why she came to Zhanjiang, her answer was she was sick, penniless and her family members had abandoned her. As to questions on how she came to Zhanjiang or who sent her there, she did not want to reveal. I asked if she would like the village head to arrange for her to get back to the village, she revealed that the former village headman was no one else but her father.
The nurse who was with me told me that Ximei had been seen in the vicinity for the past two months. The nurses thought that she was a pregnant woman, and therefore took little notice of her. I asked Ximei what she was doing in the hospital, she told me that she used the lobby area as a shelter and survived on food given by others. She had great difficulty to go to the toilet and hence she would choose a place very near to the toilet. She did not go to see any doctor because she had no money.
She did not have any medical record with her. I asked Chen Juan, a staff nurse, to bring her for ultrasound and wanted to give her 200 Yuan as fee. However Chen Juan refused money. She asked me to fill a requisition form for ultrasound. I later discovered that in fact Chen Juan paid the bill of 140Yuan for the ultrasound herself.
Half an hour later, I did not see them back, so I went to the ultrasound room. The doctor in charge, Dr. Wu Ge gave me a warm welcome and upon my request, Dr. Wu did another scan on Ximei. The ultrasound showed that there was a huge cystic lesion filled with liquid; no abnormality was seen in the kidney, liver and spleen.
The sight of Ximei brought back the memories of those ultimate challenges we had faced before in treating some cancer patients. Three things came across my mind: firstly, to save her life, secondly, it was likely we could save her, and thirdly, it was an opportunity for us to further sharpen our skill in the process of treating her.
I told Ximei that I was willing to provide the treatment but her family members or local government officers at the province had to send her to our hospital in Guangzhou. I gave her all the cash I had with me (200 Yuan) for her to take a cab home. She did not give a definite answer but wept instead.
I tried to get the trainee nurses to send Ximei back but they could not get leave to do it. I asked Mdm. Chen, the head nurse, for help. She said that they could not send her back as her family was in Hua Zhou under the jurisdiction of Maoming; due to its social complexity, if we were to send Ximei back, people there might falsely accuse us of her abduction.
I believed that Ximei was suffering from ovarian cancer. I consulted a few veteran physicians who had more than 40 years of practice. All of them agreed that it must be a tumor except that they had never seen such a big abdominal tumor before. We could not tell for sure if we could cure her as none of us had the experience of treating tumor of this size before; however, intuitively we felt that if immediate treatment was given, the outcome would be good.
I noted down the telephone numbers of Mdm. Chen, the head nurse and four trainee nurses. I hoped that they would continue to show care and to find ways of getting Ximei to be treated at their hospital. If that could no be done, our hospital would take her in.