I remember the last time I met Mdm Lee clearly. She was crying in my clinic, but refusing admission for her paroxysmal vomiting and headaches. I knew her symptoms were due to brain metastases arising from her breast cancer. This malignancy had already eaten away one breast, leaving behind raw and weeping chest wall.
It had been a frantic year for her, since I diagnosed her with metastatic breast cancer at age thirty seven. She had declined all conventional treatment involving chemotherapy and hormonal manipulation, instead, preferring to visit me on a regular basis to demand reassurance that her cancer was improving on alternative medications. This was a reassurance that I would have loved to give, but could not.
Alone here in Singapore, things took a further downturn when her husband back home in Malaysia left her abruptly. She did not want to return to Perak, where her family awaited her anxiously. Gradually, whatever little money she had saved over her ten years as a factory worker here in Singapore evaporated in the quest for a miracle cure. It was a bumpy, and ultimately downhill road, through colon cleansing, vegetarian diets, ozone therapy and more.
I did whatever I could – what fortified milk samples I could persuade her to accept in hopes of adding some weight to an increasingly cachectic body, the quietly waived consultation fees, my rejected attempts to find an oncologist in Peninsular Malaysia who could continue her care, the fruitless consultations with social workers.
I wish I could say that there was a happy ending.
I still remember that last consultation – she was alternately angry, tearful, needy. No, there was no way palliative radiation to control her symptoms was an option – she was too fearful of radiation damaging her constitution. Eventually, she stumbled outside, blind and heedless to our entreaties, and I never saw her again. Her mobile phone line was terminated – I couldn’t contact her subsequently, and I hope she returned home safely.
These are the stories that we do not hear about, that doctors prefer not to recount except in reflection. Sometimes, the misery can be almost enough to blunt hopeful oncologists, but not quite enough.
Much more inspiring and positive, the stories of heroism and cure and grateful patients.
as a spider the web it has made for itself.
Wise people when they have cut this,
go on free from care leaving all sorrow behind.
