#健康夜话 #
Every day before going to bed, I have a habit of looking at the circle of friends and paying attention to my group of "special patients". I'm always happy to see themselves or a friend or family post some heartwarming photos of their lives, because it shows that they're still alive and well.
Am I a somewhat emotional doctor? Some people will ask, what kind of "special patients" is this? Speaking of which, they got the disease that I used to "dislike": lung cancer soft meningeal metastasis.
Lung cancer leptomeningal metastases are one of the serious complications of malignant tumors, and the incidence is relatively low, but once it occurs, the treatment effect is far inferior to that of lung cancer brain metastases. The patient is in pain and the family is heartbroken. So five or six years ago, as long as the patient in front of me was lung cancer soft meningeal metastases, I would say fiercely and helplessly: "Go home." ”
Affection
However, a family relationship changed my attitude. That year, my cousin came to me and said that her lover had just been found out to be lung cancer, and that my cousin had a severe headache and was mentally abnormal.
After I examined my cousin, I found that he was a leptomeningal metastase of lung cancer. I had to say to my cousin, "Go home, what to do." "After my cousin's aunt left, another colleague from my cousin's unit came to me and said, such a good individual, how can I give up treatment like this." I told them that with a survival period of two or three months, is it still necessary to adhere to treatment? My cousin said to me very sincerely, "No matter how difficult it is, we must try something." Otherwise, how can I give it up? ”
It was affection that touched me. So I tried to get my cousin to do a genetic test for cerebrospinal fluid. The test results suggested that he was not suitable for targeted therapy, so chemotherapy was chosen for him.
Unexpectedly, after 3 weeks, the miracle appeared, and the headache of the cousin and uncle disappeared. After 3 months, he actually achieved complete self-care in life.
camaraderie
Because my cousin's effect was so unexpected to me, I began to pay attention to the disease, from "disgusting" it to trying to understand it, as if starting to establish a friendship. I consulted the relevant materials and discussed with my brother departments to improve the existing diagnostic methods, establish a process for genetic testing of cerebrospinal fluid, and began to actively admit patients with lung cancer with leptomeningal metastases.
Every year, I will tell my cousin's story at the "Multidisciplinary Diagnosis and Treatment Forum for Tumor Brain Metastasis" in the Oncology Department of Huashan Hospital. Each time, experts from all over the country would nod their heads and exclaim, "It's a miracle!" ”
1 year, 2 years, 3 years, 3 and a half years, 4 times! You know, this is a patient with tumor cells in the cerebrospinal fluid. At 3 and a half years, my cousin's colleague even came to me and said, "Doctor, didn't you say he could only live for 3 months?" You see, it's been 3 and a half years now! ”
I can only explain: "In the past, the general survival time of lung cancer leptomeningal metastases was about 3 months. The oncology department of our hospital conducted a statistic on patients who were clearly diagnosed with lung cancer meningeal metastases in the past 3 years and found that the median survival was about 10 months. Of course, this patient belongs to the one who has a particularly good effect. ”
"Love"
As a result of the continuous admission of patients with leptomeningal metastases for lung cancer, I began to focus my clinical attention on this disease. Slowly, I developed a "love" in the diagnosis and treatment of this disease: I introduced my experience in various academic conferences in China and on the platform of the Brain Metastases Committee of the Shanghai Anti-Cancer Association, collated the data for clinical summary, and conducted in-depth research with relevant scientific research units, and collated the relevant results into documents...
Step by step, from family affection and friendship to "love". Sometimes I ask myself, if it were not for my feelings for my cousin and aunt, would I have paid attention to this critical illness until I later gained a little in clinical work?
Thinking back to that year, if it were not for the tedious medical experience of my father who suffered from kidney colic, which made me determined to make patients no longer cumbersome, would I stick to this profession that sometimes feels a bit "chicken ribs" until now?
We often say that doctors can't be emotional, and emotional things can go wrong. I remember that there is a passage in the TV series "Latent", to the effect that the organization said to Yu Zecheng that he hoped that he would join the organization not only out of love for Comrade Zuo Lan, but also out of the heart's identification with ideals and beliefs. I wondered, if it weren't for that "love", would Yu Zecheng have access to advanced ideals and beliefs?
Similarly, doctors do not reject sensibility, do not reject feelings for relatives and friends. Sensibility gives me the privilege of stepping into the sacred temple of saving lives and helping the injured, allowing us to go further in the thorns of the earth, allowing us to make unremitting quests and absorb the knowledge and strength of rational practice of medicine.
Author: Department of Oncology, Huashan Hospital, Fudan University
Deputy Chief Physician Huang Ruofan
Planner: Tan Jia Yu Yunxi
Anchor: Liang Jing
Editor: Yu Yunxi