By Tang Jing & He Xin

Talking about death involves great courage and determination.Even a person like me will often feel uneasy when a patient, sitting in front of me,starts to talk about the death—the unknown realm. I used to avoid the horrible word, lest it might affect the already sensitive mind of the patient and dwindle their hard-earned peace of mind. But gradually I found that they are actually willing to talk about it.After all, they have been facing it alone for so long, and the long and lonely spell of pondering upon death is quite a tortuous experience.

For those who suffer from cancer, loneliness is the most painful twin of the death.

In most cases, the patients are eager to tell the people around them how they feel,but no one bothers to listen for they don’t know how to comfort them. Even family members distract them from the topic—worrying it would disturb them.They might encourage them to be more optimistic, distract them from thinking of unhappy things, or even define their worries as overreacting. In such circumstances, the patients are compelled to be strong and optimistic, and forced to be cheered up. They do not wish to instill their fear or sorrow in others, so that they are the only ones left to face the music. Yet the more they do so, the more lonely they become.

As a matter of fact, talking out a problem of any sort can really reduce one’s fear. When one speaks out, fear is shared by the person who hears and understands. Thus, the silent wall of loneliness is shattered.Such companionship can help the patient jump out of the dilemma, making them feel warm,supported, and hopeful.

Sometimes, the fear a patient has does not coincide with the condition. They are more likely to engage in such thought as the inevitability of a horrible end in one form or another. I once observed a lady suffering from breast cancer (stage I) who was constantly in tears, and even wrote her will down. She worried about osseous metastasis every day and night, yet in fact, the cancer could be removed with a simple operation.

Another man in the early stages of lung cancer searched on Baidu.com everyday about the development stages of the cancer.He was told after a medical examination that he had three tiny lung adenocarcinomas. The man kept imagining his painful death scene of many tubes inserted in his lungs.

“Help me conquer the fear,please,” he told me,“do me a favor, and I will give you all I have.”

The fact is that lung cancer at that stage is unlikely to threaten life.

I often ask these types of patients a question.“Please think of it. Do you fear the truth, or do you fear your imagination?”

Imagination is a precious gift God blesses humans with.However, it can bring countless fears if it is used negatively. As doctors, we should not try to deceive the patients, but instead,tell them the truth. Doctors should assure the patients that they are safe and that their condition is not dire. What they fear is usually just a possibility that is not a reality for now—and probably will never be.

Many patients fear the pains over the course of their death. So,helping them to know more about the process of dying is equally essential.

One of my patients who had pancreatic cancer was told that she had only 6 months or so.Knowing the fact that pancreatic cancer was the most ferocious and painful among all cancers,she was seized with anxiety and fear. We discussed and exchanged ideas over it. Finally,she realized that the quality of life was more important than the length. I talked with her doctor and focused more on pain control in the treatment than the use of targeted drugs (to which the patient was insensitive), the formerly scheduled operation was canceled. Instead, palliative care,more effective analgesics, painkilling measures and life quality were given priority in the last phase of her life.

She felt more in control of her own health and the stress and anxiety were greatly reduced.Eleven months later, she left the world in peace, with the companionship of her family.

We are all doomed to death.But when it comes, may we not be so lonely, not be tortured by our own imagination, and be prepared to withstand the pain. In this way,we’ll make a good end to our life journey.