Warrant

Why did it feel like i was signing away a warrant...? A death warrant was what came to my mind when I put down the pen. Perhaps it's a "life" warrant, for it's supposed to remove remaining traces of mum's cancer on the spine. But it felt so heavy, so very burdensome, as if the responsibility, the outcome is all resting on my shoulders. Just one little push, and I could have burst out in tears at the doctor's office.

The entire morning I rang back and forth between home and hospitals. I needed to deliver the latest whole-body bone scan results to the new doctor at the hospital we were referred to. Out of curiosity, I went home first to take a look at the images. And lucky I did that, because the lady who copied the images gave me those from last year, so I had to go back to the hospital where mum is still staying and get the correct images. Plus, I had to make sure mum has some thing substantial and nutritious to eat, for she has been complaining of terrible fatigue and lack of energy. The surgery had really taken away much of her "energy", or chi, as we say here. And a person lacking. "chi" is like a deflated tire... Tired, drained, utterly listless and mentally and physically eroded...

I rushed to meet the doctor's assistant at the hospital mum is about to be transferred to. A long journey across the entire city of Taipei on the bus and metro... Outside, the sky was so gratuitous, so heavy with rain ad fog, and I found myself having to lift myself up and tell myself that the sun is just behind the clouds...

The doctor's assistant was extremely friendly and patiently explained to me the entire procedure. She said it could all be arranged by tomorrow, and treatment could all be completed by the Lunar New Year, which is coming Sunday (With all the rushing around and time at the hospital, the festivities have escaped me, and I am only reminded of it by the changing of shop windows and signs and red lanterns...). But at mum's request, I rescheduled the procedure to be after the New Year, for she is already so weak and energyless.

So on the 30th of January a more precise scan will be made of the two (or more?) tumours on the spine. The next two days are planned for treatment, and on the 4th of February, a post-procedure consultation with the neurosurgeon is planned. I was again taken aback by the efficiency and speed of the entire process.

The doctor's assistant kindly explained to me the procedure, side-effects, and costs. Over two hundred thousand New Taiwan Dollars (approx. CAD 7000), as this form of radiotherapy is very advanced, and still undergoing clinical testing, so is not covered by the national health insurance.
I gasped quietly when the costs were revealed, for earlier an estimate (by her current physician) was half that amount... And I was specifically told also that as the cancer has metastasised, the next treatment can only contain, not fully eradicate mum's cancer. As precise and effective the treatment is, it can only detect and destroy tumour cells over 1.25mm. Anything smaller will go unnoticed, thus there remains the possibility of not a completely "clean" treatment.

I listened the to list of side-effects... Nausea, vomiting, swelling of the oesophagus, lung fibrosis, possible bronchitis, diahrea, localised damage to the intestines... As new and advanced as the treatment is, it is still a form, albeit much improved form that is much less destructive of surrounding organs and cells, of radiotherapy. The list of side-effects may be daunting, but the doctor's assistant said there was a duty to tell me all that so we are aware of the risks.

But what price tag can you put on health? What risks can possibly outweigh the possibility of living for another day with less pain, with more hope? Mum may never get better, may never completely be free from cancer, but for now, the new treatment is the best that is on offer and best way to deal with the spreading on her spine.

We cannot give up now. Not after we have come so far...

I signed the documents, and found myself trembling as I did.

My name was on the form...

I am my mum's representative. In a way, I somehow found myself determining mum's health and illness, life and death. Mum could not be there, for she is hospitalised. Brother could not be there, because he's gone home to spend time at the mother-in-law's.

And I am the only one who has to shoulder all this and decide right there, right then...

" I understand the cyberknife treatment, its necessity, its procedure, its risks and success rate.

I understand alternative treatments and their risks.

I understand the sideeffects and possible risks of the cyberknife treatment.

I have been able to ask questions and enquire dieter about the cyberknife treatment.

I understand the cyberknife treatment is currently the best option, but it cannot guarantee an improvement in the condition.

I agree to proceed with the cyberknife treatment.

Signed in agreement with the above,

XXXXXX , son of the patient,
Taipei,
2012/1/16 at 14.26.