Are you alone?
Are you alone?
This was just a very ordinary admission originally. Mr. KWONG was diagnosed to have Liver Cancer (HCC) since 1997. The tumor was told to be inoperable and he had undergone Transarterial Oily Chemoembolization (TOCE) for 20 times in one of the hospital. Unfortunately he was found to have lung metastasis in 04 and since then he was given tamoxifen. He has suffered from the stress and burden of the malignancy for many years. Admission, OPD visit or even seeing a new doctor will not bring any new excitement to him. While taking 2 tablets daily, he also counts his days daily. When he is able to swallow the pills. he knows that he IS SURVIVING.
Actually he is not that dependent in the society. He walks unaided, can go there and go where. He does not suffer from any ascites nor pleural effusion, however he complained of bilateral lower limb edema few weeks ago. He has consulted the hospital and was prescribed with Lasix for diuresis. However, for some reasons unknown the lasix tablet was prescribed BUT NOT dispended in last
discharge. He carried his heavy legs and realized that it impaired his walking, therefore he consulted our AED one night, hoping he can "get some stock of Lasix from the AED directly". His wish was later turned down, because as you guess correctly, he was admitted to the ward instead of discharged with medication supplement.
He has no other complaint, he was not in distress, actually he was fully ambulatory in the ward, while he first saw us having morning round in front of him, he immediately requested discharge with medication.
Being a case doctor it is the happiest news in the world -- it is the best way to minimize the workload and the bed number. In fact his vital sign was too stable and he got very good control over his symptoms except the bilateral lower limb edema. He still enjoyed active social life with outdoor activity. He claimed he can manage himself at home. Examination was unremarkable except hepatomegaly and bilateral lower limb edema, but they did not hinder his functional status. He was happy to be discharged, and I was happy to discharge him also. All he needed was the LASIX tablets.
While we were preparing his discharge issue, one of our nurse colleauge asked him if someone will leave with him. It is a very very usual question, but the answer is so unusual that I cannot sleep well for many nights because of his response.
He told us, 'I come here alone, and I will leave here alone...' 我一個人來，都係一個去…
Yes. It is not a full stop, the air was totally frozen for few seconds. I felt that my brain has just received ECT after this very short and shocking sentence.
According to the patient, he lives alone and there was no close relative in Hong Kong. He still have some sociable friends but the contact was minimum. In these 8 years while he was fighting with the cancer, it is him and only him to run this uneasy road. Not much people is going to share his worry, no one will care whether he survives or died.
'I come here alone, and I will leave here alone...' can be interpeted as 'I come to this ward alone and I will leave this ward alone.' If the answer is yes, it will be good because he can leave at anytime and 1 more extra bed can be avaliable for new admission.
How about if this means, ' I come to the earth alone, and I will leave the earth alone?'
...
...
.....
The patient finally left the ward happily, knowing that he will get enough stock of Lasix until his follow up. He was discahrged uneventfully, but his sentence cannot be discharged from my brain gyrus. Everynight when I was sleeping (except those tired post call night), his shout always come from the deepest floor of my mind. I don't know what the underlying aspiration, and I feel regret for not having a full talk with him. (Nevertheless he requested early discahrge so that he can go back into his normal life, we won't do something to stop the earth turning...) Is it just an aspiration asking us for earlier discharge from the ward, or earlier discharge from the earth? Does he feel lonesome during the final part of journey?
I come here alone, and I will leave here alone. If I survive but be alone, is surviving meaningful or painful?
(Rewrite from a story of a patient, name has been changed, details of disease has been changed)
This was just a very ordinary admission originally. Mr. KWONG was diagnosed to have Liver Cancer (HCC) since 1997. The tumor was told to be inoperable and he had undergone Transarterial Oily Chemoembolization (TOCE) for 20 times in one of the hospital. Unfortunately he was found to have lung metastasis in 04 and since then he was given tamoxifen. He has suffered from the stress and burden of the malignancy for many years. Admission, OPD visit or even seeing a new doctor will not bring any new excitement to him. While taking 2 tablets daily, he also counts his days daily. When he is able to swallow the pills. he knows that he IS SURVIVING.
Actually he is not that dependent in the society. He walks unaided, can go there and go where. He does not suffer from any ascites nor pleural effusion, however he complained of bilateral lower limb edema few weeks ago. He has consulted the hospital and was prescribed with Lasix for diuresis. However, for some reasons unknown the lasix tablet was prescribed BUT NOT dispended in last
discharge. He carried his heavy legs and realized that it impaired his walking, therefore he consulted our AED one night, hoping he can "get some stock of Lasix from the AED directly". His wish was later turned down, because as you guess correctly, he was admitted to the ward instead of discharged with medication supplement.
He has no other complaint, he was not in distress, actually he was fully ambulatory in the ward, while he first saw us having morning round in front of him, he immediately requested discharge with medication.
Being a case doctor it is the happiest news in the world -- it is the best way to minimize the workload and the bed number. In fact his vital sign was too stable and he got very good control over his symptoms except the bilateral lower limb edema. He still enjoyed active social life with outdoor activity. He claimed he can manage himself at home. Examination was unremarkable except hepatomegaly and bilateral lower limb edema, but they did not hinder his functional status. He was happy to be discharged, and I was happy to discharge him also. All he needed was the LASIX tablets.
While we were preparing his discharge issue, one of our nurse colleauge asked him if someone will leave with him. It is a very very usual question, but the answer is so unusual that I cannot sleep well for many nights because of his response.
He told us, 'I come here alone, and I will leave here alone...' 我一個人來，都係一個去…
Yes. It is not a full stop, the air was totally frozen for few seconds. I felt that my brain has just received ECT after this very short and shocking sentence.
According to the patient, he lives alone and there was no close relative in Hong Kong. He still have some sociable friends but the contact was minimum. In these 8 years while he was fighting with the cancer, it is him and only him to run this uneasy road. Not much people is going to share his worry, no one will care whether he survives or died.
'I come here alone, and I will leave here alone...' can be interpeted as 'I come to this ward alone and I will leave this ward alone.' If the answer is yes, it will be good because he can leave at anytime and 1 more extra bed can be avaliable for new admission.
How about if this means, ' I come to the earth alone, and I will leave the earth alone?'
...
...
.....
The patient finally left the ward happily, knowing that he will get enough stock of Lasix until his follow up. He was discahrged uneventfully, but his sentence cannot be discharged from my brain gyrus. Everynight when I was sleeping (except those tired post call night), his shout always come from the deepest floor of my mind. I don't know what the underlying aspiration, and I feel regret for not having a full talk with him. (Nevertheless he requested early discahrge so that he can go back into his normal life, we won't do something to stop the earth turning...) Is it just an aspiration asking us for earlier discharge from the ward, or earlier discharge from the earth? Does he feel lonesome during the final part of journey?
I come here alone, and I will leave here alone. If I survive but be alone, is surviving meaningful or painful?
(Rewrite from a story of a patient, name has been changed, details of disease has been changed)
