"Doctor, all right, let me euthanize!"
This is the most plea I have heard from terminally ill patients in my years of practicing medicine. As normal people, we can't appreciate the pain of terminally ill patients, and we can't imagine the misery and pain of being tormented by pain in advanced cancer.
This pain doesn't just come from physical pain, because pain can be relieved, but the fear of the unknown can never be relieved.
For example, terminally ill patients know that they are running out of time, but they still have many worries and many unfulfilled wishes. For example, the terminally ill patient does not know how his death came to be, is it painful death? Or is it a mouthful of phlegm that chokes and suffocates to death?
Although we are afraid of death, we have to accept the fact that all life will eventually pass away. Maybe this is life, and we have to learn to accept the arrival of strangers, and we must also accept that familiar people leave us forever.
01.
I want to tell the story of Mr. Barkin first, as a doctor, I like Mr. Barkin's work immensely. But his story, I can't bear to read.
It was 1999, and Barkin was hospitalized for a serious illness.
After the rescue, he saved his life, but his life has since plummeted. He had a gastric tube in his nose, and he could only eat through the stomach tube, which was injected into the stomach 6 times a day.
Imagine the pain of a tube running from the nose to the stomach.
More painfully, because of the long-term gastric tube, his mouth could not be closed, and his jaw was dislocated.
Later, only the trachea can be cut open and breathing can be maintained through a ventilator.
As a party, Ba Jin does not have any quality of life, not to mention, and the physical torture is even more painful. It is not that he did not think of giving up treatment, but he did not have the right to choose, because all the family members and leaders did not agree with him to give up treatment.
Coma, inability to take care of oneself, or unable to eat, as long as the heartbeat is still there.
Mr. Barkin's words are still fresh in my memory: "Longevity is the greatest torture for me!" ”
02.
Whether it is cancer or other diseases, what patients and families are most afraid of hearing is "advanced". In our perception, the late stage is equivalent to being sentenced to death.
There is a saying that "it is better to die than to live", and everyone understands what it means. It is precisely because of this concept that many of us lack a correct understanding of death.
So that in the end, we ignore the consideration of the patient's feelings and regard "trying our best to rescue" as a manifestation of "filial piety".
So, put on a ventilator, use a nutrient solution, find a nurse... Tens of thousands of dollars, all at once spent.
This is the current situation of many sick families, not only at the end of life spent all the savings of the first half of life, but also suffered all kinds of pain, and finally left this world with both people and money.
What many people don't know is that when suffering from terminal illness or advanced cancer, whether there is any need for treatment depends entirely on the following aspects.
First, whether there is money or not
Poverty limits not only imagination, but life. Imagine that the same cancer patients, rich families and poor families, who has greater hope of survival?
Second, whether it can be cured
In fact, advanced cancer does not mean death, some cancers really do not need to be treated, but some cancers still have great hope, such as lymphoma and testicular cancer. There are also some common cancers, such as lung cancer and breast cancer, even if they are advanced, but with the increasingly advanced medical technology, we can also achieve long-term tumor survival.
Third, the attitude towards death
Everyone has a different attitude toward death, and some people are afraid of death, so even if they suffer all kinds of pain, they must do their best to live. Some people are more comfortable, they may be more concerned about the quality of life than the length of life, they want to leave with dignity.
03.
There is a word called Futile Treatment, which means ineffective treatment.
Ineffective treatment refers to the use of all external technical means to intervene in life when human life is about to come to an end, the most common in the hospital is to cut open the throat tube and insert a ventilator, inject cardiac injections and epinephrine, and constantly inject drugs and so on.
As a doctor, I personally feel that this is not to save lives and help the injured, but to detract from the dignity of a living individual.
So, when the doctor has his own cancer, how to choose?
In 2011, Mu Yourui, an associate professor at the University of Southern California, published an article titled "How Do Doctors Choose to Leave the World?" - It's different from the average person, but that's the way we should choose! article.
This article caused a great sensation in the United States.
In the article, Charlie is a very famous doctor, and suddenly one day he finds out that he has the most headache of pancreatic cancer.
Charlie found a specialist who could improve the 5-year survival rate of pancreatic cancer patients by a full 3 times. However, treatment also comes at a cost, that is, patients may lose a large part of their quality of life in the process.
After much deliberation, Charlie refused the surgery and all treatment. When he got home, Charlie put down his career and put all his mind and time into enjoying his last days with his family.
Charlie had no chemotherapy or radiation therapy, and for Charlie, the length and breadth of life, he chose the width.
"In a dying patient, a knife is fired here, a knife is fired there, with all kinds of tubes inserted in the body, and it is hung on a life-sustaining machine..."
Muyuri said it was a tactic that would not even be used to punish terrorists.
In the United States, many seriously ill doctors will hang a "do not rescue" sign around their necks. At the last moments of life, they tend to collectively choose the quality of life.
Because doctors can better appreciate that "being alive" has no meaning except pain!
04.
I think of a story about an 80-year-old man who was hospitalized for cerebral hemorrhage.
After four hours of rescue, the old man finally survived. However, the trachea was cut open and the throat was punched.
The old man is sometimes unconscious and sometimes awake, and whenever he wakes up, the old man behaves in pain.
The old man's family took turns to take care of him, and whenever they saw a change in the monitor, they would immediately run to the doctor.
Later, the condition of the old man began to deteriorate, and his body swelled up. The head is like a balloon, and the airway is still bleeding.
At this time, the only thing that can be done is to constantly clean the airway for the elderly, and almost every time a tube of blood clots and secretions will be cleared.
Being able to clearly feel the pain of the old man, the doctor couldn't help it: "Drag it out or give up?" ”
The family members persevered, even though they could no longer look directly at the distressed old man.
This lasted for more than ten days, and the old man was still gone.
On the day he left, the old man's complexion became translucent. There is not a single piece of intact skin on the body, and needle holes and intubations can be seen everywhere. The head is even more edematous, and the facial features become extremely distorted.
Dare to ask, if the old man can express, is he really willing to take these ten days?
In the only time left, he did not enjoy any right to life, so what is the meaning of life?
Can he really prove that he loves him for ten more days in such pain? Is love so superficial?
Finally, hopefully, each of us will learn to respect death. Because we have come into this world crying and finally just want to leave with dignity.