在生命尽头遇见的那位暖心医生（五）

父亲最后的时光里，因为中药治疗未见效果，癌症病情持续恶化，出现了腹水和黄疸症状。到了这一步，意味着肿瘤已经侵蚀了相当一部分肝脏，肝功能已经无法维持身体的正常运转。这也表明父亲已经无法耐受任何积极治疗，只能进行减轻症状的对症治疗。

从这个时候开始，父亲的心态发生了变化。在控制病情无望的情况下，他只想尽快解脱，拒绝任何形式的治疗，包括缓解腹水引起的腹胀的腹水引流，以及通过胆管引流排出被堵塞胆汁、降低黄疸的手术。他签署了放弃治疗的同意书，中途出院了几天。

但是出院在家的这几天，没有任何治疗，加上他本身肝功能被肿瘤破坏，几乎无法进食。我们看到这种情况也很无奈，在医院里还能输液补充营养，在家恐怕会活活饿死、渴死，只能再次回到医院。

这次回到医院，医生告诉我们有一位和父亲相同病症的老太太做了胆管引流，建议我们去和她交流。那位老太太是两年前确诊的，当时还可以做手术，所以又多活了两年，虽然现在复发情况也很严重。她体内植入了胆汁引流管已经两个月，胆汁可以顺利排出体外。老太太说，做了这个手术会舒服一些。

这终于说动了父亲同意做胆管引流。如果不将堵塞的胆汁排出，胆汁会回流进肝脏，进一步损害肝脏功能，缩短父亲的生存期。接诊我们的是医院超声科的主任。这个手术需要在超声引导下进行。他非常热心地进行了检查，但发现父亲有腹水，这种情况下不能做手术，需要先排除腹水。而且从超声检查来看，父亲的情况相当严峻，肝脏已经长满了转移性肿瘤。肿瘤的一个特性就是能够吸引产生新的血管来自我供养，所以很多胆管上面都覆盖着肿瘤引来的血管。

这位超声科主任非常热心，和我们谈了很久，告诉我们这个治疗并非针对肿瘤本身，而且按父亲现在的情况来说，手术难度很大。他还提到父亲的病症和一位副国级领导人得的病一样，即便拥有雄厚的医疗资源，最终也没能救回来。这位主任可以说是我们这次看病以来碰到的最热心的医生了，让我们头一次感受到了医生的同情心，因为在其他医生眼里，父亲的病情已经和死亡没什么区别了。面对癌王这种让人绝望的疾病，我们从其他医生那里收获的只有冷漠。

这次父亲的想法改变了，他说这次来住院就是要做这个手术，不管怎样都要做。我们向主任转达了父亲的意愿，主任说好，那就先排几天腹水再做手术。几天后，我们又去找那位主任，尽管这个手术很有挑战，而且能否起到作用都不是很确定，主任还是认真地做了一次检查，并和助手仔细讨论了手术方案，没有因为父亲是一个癌症晚期的病人而有任何敷衍懈怠。和这位主任医生的交谈中得知，他的父亲也因为癌症去世。也许是这一点让他和我产生了共情。

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In the last days of my father's life, because the Chinese medicine treatment did not work, the cancer continued to deteriorate, and there were ascites and jaundice symptoms. At this stage, it means that the tumor has eroded a considerable part of the liver, and the liver function has been unable to maintain the normal operation of the body. This also indicates that the father can no longer tolerate any active treatment, only symptomatic treatment to reduce symptoms.

From this time on, my father's mentality changed. With no hope of controlling the condition, he just wanted to get out as soon as possible, refusing any form of treatment, including ascites drainage to relieve abdominal distension caused by ascites, and surgery to drain blocked bile and reduce jaundice through bile duct drainage. He signed a waiver and was discharged for a few days.

However, in the days when he was discharged from the hospital, there was no treatment, and his liver function was destroyed by the tumor, and he could hardly eat. We see this situation is also very helpless, in the hospital can also infusion nutrition, at home I am afraid will starve to death, die of thirst, can only return to the hospital again.

Back at the hospital this time, the doctor told us that an old lady with the same condition as my father had a biliary drainage, and suggested that we go to communicate with her. The woman was diagnosed two years ago, when she could still have surgery, so she lived two more years, although now the recurrence is very serious. She has had a bile drain implanted in her body for two months, and the bile is flowing out of her body smoothly. The old lady said the operation would make her feel better.

That finally got my father to agree to a biliary drain. If the blocked bile is not removed, the bile will flow back into the liver, further damaging liver function and shortening the father's survival. We were treated by the head of the ultrasound department at the hospital. The procedure is performed under ultrasound guidance. He was very enthusiastic to carry out the examination, but found that the father had ascites, in this case can not be performed surgery, need to rule out ascites first. And from the ultrasound examination, the father's condition is quite serious, the liver has been overgrown with metastatic tumors. One of the properties of a tumor is that it attracts new blood vessels to feed itself, so many bile ducts are covered with blood vessels from the tumor.

The director of the ultrasound department was very helpful and had a long talk with us, telling us that the treatment was not specific to the tumor itself, and that the surgery would be difficult given my father's current condition. He also mentioned that his father's illness and a vice leader's disease, even with strong medical resources, ultimately could not be saved. The director was the most enthusiastic doctor we had seen since the visit, because in the eyes of other doctors, my father's illness was no different from death.

This time the father's idea changed, he said that this time to the hospital is to do this operation, no matter what. We conveyed the wishes of our father to the director, and the director said, let's first discharge ascites for a few days and then do surgery. A few days later, we went back to see the director, who did a serious examination and discussed the surgical plan with the surgeon.