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Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.

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Kristina X. Duan

It was a Monday morning in Chengdu, the capital city of China's Sichuan province. I was a premedical student who had traveled here from the U.S. to do a six-week summer term abroad at People's Hospital, one of Chengdu's largest cancer centers.

As the child of Chinese-born parents, I'd always felt a special fascination for my parents' strange, captivating homeland. In college, I seized the first opportunity to pursue medical studies in China alongside native students. I'd found myself immersed in a healthcare system that was fragmented, corrupt and riddled with problems stemming from overpopulation and limited resources. 

This morning, as always, the hospital's outpatient clinic held a jumbled mass of anxious people. Before daybreak they'd gathered outside by the hundreds: frail elders supported by their children; exhausted mothers cradling sleeping newborns; gaunt men with half-smoked cigarettes dangling from their lips. 

Now, only minutes after the clinic opened, they thronged the modest waiting room with its worn, grimy cobblestone floor and plastic benches, awaiting a chance to receive a treatment number. 

Even after several weeks here, I found the noisy, chaotic scene disturbing. 

I pushed through the crowd amid angry glares, reached the front desk and smiled at the sour-faced receptionist.

"Zao shang hao, lao shi (Good morning, teacher)--I'm a student," I shouted above the din. 

Slipping through the splintered wooden doorway, I walked down the narrow hall, which was lined with open examination rooms, until I reached the office of my mentor.

My mentor was one of the hospital's chief physicians. I admired him greatly: a calm, composed teacher whose wisdom and knowledge reflected decades of experience, he had spent hours explaining the hospital's byzantine workings to me when I'd first arrived. A bit later, when a former student's mother was diagnosed with cancer, my mentor had recruited his very best staff to care for her. 

The quality I admired most in him, though, was his refreshing candor. He did not tolerate laziness or noncompliance in his patients: I vividly remembered how he'd scolded an elderly gentleman for not eating nutritiously while on chemotherapy. 

As I entered his room, my mentor lifted his dark eyes from the papers piled neatly on his desk and nodded slightly, every movement radiating authority and dignity. 

Bowing respectfully, I thought, as I often had, This man is a true professional...I only hope that I can be that kind of doctor one day. 

Moments later, his first visitor arrived. 

I recognized him immediately: Mr. Chen. 

The prior week, Mr. Chen had disrupted my mentor's daily rounds with the medical team. He'd appeared seemingly out of nowhere and had stood in the hallway, blocking our path. 

A fortysomething man, he was financially successful, as attested by his rumpled button-down shirt, half-tied Nike sneakers and gold Rolex watch. But his weary slouch was one I'd seen in those facing the loss of a loved one. His wife had been on chemotherapy, but, as we all knew, it had had no effect. 

"Please--you have to save my wife!" Mr. Chen yelled at my mentor. 

The team members froze. Along the hallway, heads popped out of the wooden door frames. Instinctively I recoiled, then cowered behind another medical student as Mr. Chen kept on shouting.

Our medical team struggled to find the words to quell the raging, incoherent tirade.

"Mr. Chen, please try to calm down. There is nothing else we can do--" 

Mr. Chen brandished a crinkled envelope stuffed with red 100-yuan notes. 

"You can save her...you have to save her," he gulped in a trembling, tear-choked voice. "I can't...I can't go on without her. I can pay. I have money!" 

I felt as if I'd been punched in the gut. This was my first encounter with such desperation and denial. 

With gentle hands and soothing words, some of the medical team had finally drawn Mr. Chen away, and my mentor had continued with our interrupted rounds.

That had been a week ago. Now Mr. Chen was back.

"Yi shen (Doctor), my wife... my wife...put her back on chemotherapy," he stuttered, wringing his hands. "She's ready...she feels a lot better now." 

His sunken black eyes darted to and fro, scouring my mentor's face for any sign of encouragement. 

I too studied my my mentor's face, hoping that he would say something that would help this man. But when he spoke, his voice was acid and impatient.

"I've told you," he said."There is nothing I can do for her."

I felt stunned.

My mentor had spoken the truth. There was no wisdom in continuing Mrs. Chen's chemotherapy; the adverse side effects would only spoil the small amount of time she had left. 

My mentor could have told Mr. Chen this, but for some reason he did not. 

Instead, he peered down at his silver timepiece, brows furrowed in annoyance. Then he abruptly motioned to me to fetch the next patient. 

For his part, Mr. Chen slouched dejectedly and walked out ahead of me.

That evening, as I scurried along the sidewalks to the bus stop, the passing faces blended into a blur. In my mind's eye, all I could see was Mr. Chen's broad back disappearing through the doorway. 

I remembered a medical oncologist saying to me, "A physician must always be willing to remove his aloof, professional mask in front of patients, or he will lose his greatest, most valuable quality: empathy."

My mentor seemed to have forgotten this. In Mr. Chen's moment of need, he had offered no comfort--instead, he had crushed the one hope that Mr. Chen had been clutching. 

Not only had he hurt Mr. Chen; he had shattered my admiration and my trust in his kindness and competence. Seeing this consummately skilled physician trade his usual caring for brutal frankness and irritability--the ultimate time-savers--had taught me a bitter lesson: how fragile compassion can be. 

Now, two years later, part of me fears that when I face the demands of medical training, I too will succumb to self-protective callousness. 

So I've promised myself that, wherever my life journey takes me, I'll keep this memory as a reminder to approach all of my professional dealings with integrity, compassion and consideration.. 

This resolution may not change the world, but it's one step that I can take--a step in the right direction. 


About the author:

Kristina Duan is a junior at Wellesley College. Upon graduation, she hopes to pursue an MD, with specialty training in oncology. She greatly enjoys writing in her free time. "I find it a deeply valuable form of self-expression. I would like to express my appreciation toPulse's editors and staff for their invaluable help in improving this piece. With their enthusiasm and dedication, they've inspired me to continue developing and refining my writing skills."

Story editor:

Diane Guernsey

 

Comments   

# joyce fish 2013-10-04 16:55
You and your mentors did a marvelous job of writing.

I'm grateful that the doctors and staff at Calvary Hospital during my second husband's final illness were more than compassionate, and even sought out his advice!

. However, there was one during my first husband's final illness who upbraided me for following a consulting doctor's advice when I couldn't reach him!
Joyce
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