Should a stage 3b to stage 4 terminal cancer patient be rescued?

"Should a stage 3b to stage 4 terminal cancer patient be rescued?" 

Before my father passed away, my dad hospital doctor in charge clutched a hospital receipt: That 1.2 million China reminbi yuan drug, in exchange for his father living another twenty one days, had bankrupted our entire family.

The year my father was diagnosed with late-stage lymphoma, I was thirty two years old, having just finished paying off a house.

For the previous seven years, my dad endured twelve rounds of chemotherapy and experienced two relapses. His body was like a city repeatedly bombed, utterly deteriorated, yet it never truly broke down. I naively believed that as long as we did not give up, he would keep fighting.

Until the doctor brought out a sheet of paper with a color diagram, pointing to the text on it: "This is a brand-new immunotherapy, specifically for your father's difficult-to-treat type. It is the most likely effective option currently available. However, it is entirely out-of-pocket, 1.2 million yuan."

1.2 million China reminbi yuan. Our family of seven, without spending a penny, would need to save for four years.

My father was very weak, lying on the edge of the bed. After listening to the doctor's explanation, he remained silent for a long time. His first words were, "It is really too expensive, let us  not get treatment."

I did not respond. That day, I went back and signed the sales agreement for the apartment. It was an old building we had lived in for twenty years. The balcony had a flower bed my father had built himself, and the roses bloomed especially beautifully in spring.

I thought I was buying time. Actually, I was just buying a "possibility" that could bankrupt the whole family.

The treatment itself was calm. The afternoon the cells were infused, my father slept in the laminar flow ward and gave me an "OK" sign through the glass window. We both held our breath, as if waiting for a miracle to launch.

The miracle really happened.

On the fourteenth day, a PET-CT scan showed that the lesions that had once been densely packed like sparks all over his body had almost completely lost their metabolic activity. The attending physician said with restraint, "Currently, the assessment is that he has achieved complete remission."

We hugged each other and cried. One million two hundred thousand, the outcome was really worth the cost. 

But we did not know that this victory would only last seven days.

On the morning of the twenty-first day, Dad started to have a high fever. At first, we thought it was just a normal fluctuation in cytokines, but after the mercury thermometer reached forty degrees Celsius, it stopped rising. Then came severe diarrhea, from three times a day to ten times a day, and after that, he could not get out of bed. My dad had bloody stools. His vomit contained bile and streaks of blood.

"Immune-associated colitis, stage four, very serious." The doctor lowered his voice considerably. "His intestinal mucosa is almost completely eroded; he can not absorb any food or water now. We are using the strongest inhibitors to control his immune system, but this process is extremely dangerous."

We felt like we were on a runaway roller coaster, watching helplessly as our father bobbed up and down in the ICU. My dad had lost weight so quickly; his cheekbones were so sharp they looked like knives, his eyes were sunken, and his lips were cracked from the high fever. His hands, which had once helped me fix my bicycle, were now swollen like pig's feet, pressed against the bedside, covered in needle marks and bruises.

On the thirty-fifth day, our father regained consciousness briefly.

My dad struggled to move his eyes, saw me and my mother watching over my dad by the bedside, and then my dad slowly looked towards the bedside table. I knew what my dad was looking for, so I handed my dad the crumpled hospital receipt.

My dad looked down, staring at the hospital receipt for a long, long time. The numbers on the receipt were glaringly obvious under the stark white light. Then, in an almost inaudible breath, he uttered four words:

"...Ugh...not worth it..."

I knelt beside my dad bed, unable to utter a sound. At that moment, I did not know how to tell him—the apartment had already been sold, and the day the real estate agent brought strangers to view the property, my mother had hidden in the kitchen and cried all afternoon.

On the forty-second day, my father passed away in a deep sleep under the influence of sedatives.

From the infusion of cells to the cessation of his heartbeat, twenty-one days. One million two hundred thousand, twenty-one days. On average, it cost fifty seven thousand dollars per day. In those twenty one  days, the total time he was truly conscious and able to talk to us was less than forty eight hours. The rest of the time, he struggled with high fever, excruciating pain, diarrhea, and delirium.

And our family, we lost our father and our lifelong home. My younger brother, who had just been accepted into graduate school, voluntarily applied for a leave of absence, saying he needed to work to pay off debts. My mother's hair turned white overnight, and to this day she still does not dare to pass over or even walk by the real estate agency windows.

I am not a doctor, I am not qualified to judge the value of that drug. Medical science is progressing rapidly, scientists are working hard to pave the way for future generations, I understand. But as a woman, I still can not forgive myself.

I spent 1.2 million to buy my father twenty one days of "survival." But in those twenty-one days, my dad did not eat a single meal, did not hold his grand child once, and did not  even look at the roses outside the window. He was just a lone figure in a collapsing immune system, bearing the brunt of a battle I stubbornly initiated, a battle I could never win.

Before she passed away, she clutched that receipt—not for the money she paid for herself, but for me.

Her last complete sentence was a denial of her own worth, a desire to alleviate her daughter's guilt about "going bankrupt to save her father."

That was the final straw that broke the camel's back.

If I could turn back time, I would have sat beside his bed on the day I signed the papers and listened carefully to her words, "It is too expensive, I am  not getting treatment." I would hold his hand and say, "Dad, let us make good use of our remaining time and not get treatment."

We can not go to America, but we can go to Sanya to see the sea. You can not hold your grand children, but you can sit in the yard basking in the sun and watch the roses bloom. We will not have to borrow money, Mom will not have to do cleaning, and the little guy will not have to drop out of school. In our final days, we will be a family, all together, quietly, and properly saying goodbye.

Unfortunately, there are no "what if". 

I am writing this not to deny any cutting-edge medical technology, nor to advise people "not to get treatment." I just want every family facing the same choice to know: between 1.2 million and twenty one  days, what separates us is not just money, but also the patient's final quality of life, the future of their entire family, and the irreplaceable guilt towards their loved ones. Before signing any consent form for exorbitant out-of-pocket treatments, please, absolutely must, ask these three questions:

1. Given the patient's current physical condition and organ function, can they withstand the potential for serious complications?

2. Even if the treatment is effective in the short term, will they have a sufficient quality of life to enjoy this "won-back" time?

3. If the outcome is still the same—no money, no life—can we, the entire family—including the patient—bear the cost?

The sharper the spear of medicine, the more we need to protect the clear-headed compassion within humanity. Sometimes, the highest level of treatment is not about buying a few more days of intensive care for a loved one, but about preserving their final dignity and ensuring the family's future is not being crushed.

The second month after Dad passed away, the demolition office issued a notice that a subway line was going to be built in the area of ​​the old building, and property prices rose by thirty percent.

I locked that crumpled hospital receipt and his last old jacket, still warm from his body, together in the deepest part of the box.

Dad, I am sorry. In the next life, I will not sign any operation for you; I will just listen to what you had really say first.