In 2003 I met an unforgettable incidence.
Mr. Wang, 76 old, was a Hong Kong entrepreneur. In 1994 when his business was at its peak, he was diagnosed with liver cancer. He underwent surgery to remove tumors in his liver in Queen Mary Hospital, Hong Kong. Nine years later, he had liver cancer recurrence. There were two tumors, one at the right hepatic lobe near the diaphragm, and the other tumor was hanging below the liver like an eggplant surrounded by kidney, colon and duodenum. He was a diabetic. Although he had been given hypoglycemic agents, his blood glucose control had not been satisfactory. He also had prostatic hyperplasia and urinated once every hour. He had hypertension, too. His virtuous wife had consulted all the hospitals in Hong Kong and his sons in theUnited Stateshad also consulted many doctors in theUnited States. All the doctors concurred unanimously that while surgical resection was feasible, it was too risky.
On13th February 2003, The Oriental Daily of Hong Kong published the news on the treatment provided by our hospital to save the life of Ming Zai who suffered from malignant teratoma. Mr. Wang saw a ray of hope for survival. Early March2003, he came to our hospital and requested for cryoablation.
Two of Mr. Wang’s children lived in Hong Kong while another two of his children lived in theUnited States. All of them were very filial. They were very worried over their father’s illness. They were afraid that if their father was given inappropriate medical care, it would lead to irreparable consequences. They insisted their father to go back to Hong Kong for treatment. “Even if our father cannot be healed in Hong Kong, we will still be happy because Hong Kong provides one of the world’s best medical care services.” They said.
However, their father, Mr. Wang held a different view. He said, “I want to receive treatment in Guangzhou. I have faith in the doctors here. Even if I were to die, I would prefer to die here!”
Mr. Wang’s children looked for us; they came personally, they phoned, faxed and emailed us and all the contents were identical: “Our father is an old man and is seriously ill. Doctors in Hong Kong dare not provide him treatment. Do you dare to bear all the responsibilities?” Finally they sent us a note in English saying, “You must give up treating our father. We are determined to bring him back to Hong Kong immediately!”
Mr. Wang’s young wife accompanied him all day. She did not make her stand clear. She told us in private that she was caught in between, and torn by both sides. Mr. Wang lost his temper and said, “I will make the decision myself. No one is to decide for me!” He told me in Shanghai dialect “I am from Shanghai and you are from Jiangsu. We are village mates. I trust my own village mate.”
One evening at about 9 o’clock I was in my office. My mind was very confused and I was unable to think properly. I asked Dr. Niu Lizhi, the physician attending to Mr. Wang, to see me. He had just seen Mr. Wang in the ward. Before he could speak, I told him my views: 1.To discharge Mr. Wang, or 2. Advise him to go to another hospital and find a surgeon to do the operation. Dr. Niu did not object to my opinions on the spot, but his eyes revealed that he was probably disagreeable with my views.
That night I could not fall asleep. “Perhaps I am getting older, and become too conservative. Perhaps I give too much consideration for the sake of the hospital and I want to play safe!” I thought.
The next day when I had just arrived in my office, Dr. Niu came to see me. He said in a frankly manner, “President Xu, I do not agree to your ideas!” Then he gave me three reasons why he did not agree. Firstly, Mr. Wang cannot tolerate surgery. If he can, doctors in Hong Kong would have given him surgery. He has high blood pressure, diabetes, prostatic hypertrophy; postoperative survival is slim. Secondly, though Mr. Wang has liver cancer recurrence, there are two tumors only and their edges are quite clearly defined. Local treatment is not of much difficulty. Thirdly, besides liver cancer, there are no metastases of other organs. If liver cancer is kept under control, there is no problem for him to survive for another 10 years.”
Deep in my heart, I agreed with Dr. Niu. I asked him how were we to convince Mr. Wang’s children. He said with tears in his eyes, “By our sincerity and actions!” I calmed down my thoughts and said, “Dr. Niu, please work up the treatment plan and do according to your opinions. I will bear all the responsibilities!”
Dr. Niu gathered several physicians to discuss Mr. Wang’s case. They worked out a three-step treatment plan. Mr. Wang strongly supported the plan. His children forwarded the treatment plan to their friends who were doctors in theUnited States. The reply they got back was: “This plan is probably the best option.” Mr. Wang’s children reluctantly agreed but they wanted to wait till the return of Wang’s eldest son from theUnited States.
A week later, treatment commenced. The first step was to treat the recurrent intrahepatic tumor lesions. Cryosurgical probes were inserted into the tumor percutaneously under ultrasound guidance and two cycles of freezing and thawing were done. There was no general anesthesia during the course of treatment. Throughout the operation, Mr. Wang kept telling the doctors doing the operation about how he was feeling.
That day, by special permission, Mr. Wang’s children, about 5 or 6 of them, were allowed to stay outside of the CT room to have a clear view of the entire treatment process through the glass window. For those psychologically venerable, the scene must be unbearable. For members of the Wang’s family, every treatment procedure brought pain to their heart. For our medical staff carrying out the operation, it was the thought of responsibility, risks and expectation of a successful operation that occupied their mind. At last, the operation was a success; there was a sigh of relief in everyone. Throughout the treatment process, the screen of the ECG monitor showed that the heart rate was around 70 and the blood pressure about 140/90.
That night at 10 p.m. when I went to the ward, I noticed that Dr. Niu, after a day of intense hard work, was still at his desk with the medical report of Mr. Wang in front of him and a half-eaten meal box by his side. Perhaps he was thinking of the next step of treatment or perhaps he was recalling the course of treatment that afternoon. I left without disturbing him.
A few days later, the second step of treatment began. The focus was on the tumor hanging on the liver. The operation was conducted under the guidance of CT. It was different from the previous operation which used very fine cryosurgical probes. This time the probe used was 5mm in diameter. Any slightest negligence or if the probe was slightly off course it would pierce through the intestine. Furthermore the frozen area must be just right, neither too big nor too small. If it was too small, it would not achieve the desired therapeutic purposes. If it was too big, the ice crystals formed would burst leading to profuse bleeding and other related complications. First, Dr. Niu used the tip of the probe to puncture the skin and pushed the probe in very slowly at to a pre-determined angle until it was inserted into the centre of the tumor. Two cycles of freezing and thawing were performed.
A month later, Mr. Wang sent us his CT review from Hong Kong. It showed the tumor at the upper part of the liver was dead while the one hanging from the lower part of the liver had shrunk to 2cm size. The liver function test showed the liver functions had improved significantly.
Later, Mr. Wang came to our hospital for the third treatment successfully. He, her wife, children and our medical staff finally reached a complete consensus.
One morning two months later while I was resting at my home in Shenzhen, Mr. Wang phoned and requested me to meet him in a hotel in Shenzhen as one of his son had come all the way from theUnited Statesspecifically to see me. When we met, his son, a burly middle-aged man, hugged me with tears in his eyes. He did not come back when his father was treated in our hospital. He thanked me repeatedly and asked me to forgive him saying, “President Xu, I am sorry that as a junior, I have wronged you!” It was he who sent me the email from the States asking me to “Stop treatment” for his father. Being a father myself, I fully understood and knew his thoughts and feelings at that time. It was out of his love and concern over his father. I must not blame him for the chaos he had caused by being filial.
On 3rd May 2003, the Oriental Daily of Hong Kong carried the headline “King of Bleaching Agents” in recognition of the donation of a big quantity of bleaching agents to the community by Mr. Wang and his wife in the fight against SARS in Hong Kong. Some time in May 2004, I met Mr. Wang and his wife in their Hong Kong’s office. From his CT report, Mr. Wang’s liver cancer condition had stabilized. I told him to take good care of his heart. A year later, he passed away suddenly. In her letter, Mrs. Wang told me that her husband was “inobedient” and was too occupied with his business everyday that finally he died of a heart attack.