Looking for it for a long time, I can't find any other papers. . Recently, my tutor and respected plastic surgeon Charlie found a lump in his stomach. He went to see a surgeon and was diagnosed with pancreatic cancer. The surgeon is an authority on the treatment of pancreatic cancer. He invented a new surgical method, which tripled the five-year survival rate of patients, although there was no quality of life. The next day Charlie came home, closed the clinic and never set foot in the hospital again. He spent as much time with his family as possible and died at home a few months later. He didn't receive chemotherapy, radiotherapy, surgery and didn't use much medical insurance. Although it is not often said, doctors do die, and the way of death is completely different from others. They are different from ordinary people. They don't use some treatments more than most people. On the contrary, they seldom treat them. Although they are always helping others to resist death, they are often extremely calm in the face of death. They clearly know what will happen and what choices they have, but they usually get the medical care they want and just leave peacefully. Of course, doctors don't want to die, they want to live. However, they know modern medicine too well and know that modern medicine is not omnipotent. They will discuss all this with their families to make sure that when their time comes, their families will not try to take any exaggerated rescue measures-they don't want to have their ribs broken at the last moment of their lives for cardiopulmonary resuscitation. Almost all medical professionals have witnessed the "futile care" people receive. At the end of life, doctors apply cutting-edge technology to critically ill patients, making them endure unnecessary pain besides illness. The patient's body will be cut open, inserted into a catheter, connected to a machine, and filled with drugs. All this will be done in the intensive care unit, and the daily cost is as high as tens of thousands of yuan. What did you finally pay? Only pain, some pain that we don't even want to impose on terrorists. I don't know how many times my doctor colleagues whispered to me, "promise me that if you see me suffer this punishment, you will kill me." They're not kidding. Some medical staff carry badges with the words "No First Aid" and tell doctors not to perform CPR. I even saw a doctor tattoo it. Why don't doctors want to receive unique medical services? The reason is very complicated, and it has something to do with patients, doctors and medical system. To understand the role of patients, please imagine a scene: someone is unconscious and taken to the emergency room. The patient's family was frightened. When doctors asked if they wanted to "try their best", their answer was definitely yes. As a result, the patient's nightmare staged. In fact, family often just means "doing all reasonable efforts." The problem is that they don't know which measures are reasonable. In confusion and sadness, they don't ask the doctor questions or listen to what the doctor says. Doctors, of course, will "do their best", regardless of whether the measures are reasonable or not. The above situation is commonplace. The root of the problem lies in people's high expectations of doctors. Many people think that cardiopulmonary resuscitation is an effective first aid, but in fact, its effect is often minimal. I have treated countless patients who failed in CPR in the emergency room. If the patient is seriously ill, old or terminally ill, the effect of cardiopulmonary resuscitation will be even more insignificant and the pain will be unbearable. Lack of knowledge and wrong expectations will lead to a series of bad decisions. Of course, patients are not the only factors that cause problems, and doctors are also responsible. The trouble is that although doctors know that they are "wasting their brains", they still have to find ways to meet the wishes of patients and their families. Imagine that the emergency room is full of grief-stricken and possibly hysterical family members. They don't know the doctor. In this case, building trust and confidence is a very delicate matter. In order to save time, money or energy, people have long been ready to trust doctors. When doctors suggest that further treatment is needed, they will do as they say. Some doctors have better communication skills than others, and some doctors are stubborn, but they are all under similar pressure. In decades of medical practice, whenever the patient's family members make unreasonable demands at a critical moment, I will explain the risks from the perspective of a layman. If patients or their families still insist on using treatments that I think are meaningless or harmful, I will transfer them to other doctors or hospitals for treatment. But these transferred patients still make me nervous. One of my patients is a lawyer and comes from a famous politician's family. She suffers from severe diabetes, poor blood circulation and pain in her feet. Considering that hospitalization was unfavorable to her condition, I made every effort to make her avoid surgery, but she consulted experts outside the hospital, who had nothing to do with me. Experts are not as familiar with her condition as I am. In order to eliminate the long-standing thrombus, they decided to do vascular bypass surgery for her foot. The operation did not improve her blood circulation, and the incision never healed. The patient's foot was infected with gangrene and was eventually amputated. Two weeks later, in a famous medical center, the worst thing happened. She died because of ineffective rescue. In this story, it is obvious that both doctors and patients are responsible, but in many cases, both sides are just victims of a larger system-encouraging over-medical treatment. In some unfortunate cases, doctors use the mode of "reimbursement of medical expenses" and do whatever they want, no matter how meaningless, as long as they can make money. More commonly, doctors are afraid of being complained, listen to patients and rarely raise objections to avoid trouble. Even if people are prepared first, this system will still kill people. I once had a 78-year-old male patient named Jack, who was ill all the year round and had 15 major operations. He told me that under any circumstances, he didn't want to use the ventilator again. However, one Saturday, Jack suffered a severe stroke, lost consciousness and was taken to the emergency room. The doctors tried their best to revive him and put him on a ventilator in the intensive care unit. This is the last nightmare that Jack wants to experience. When I rushed to the hospital to take over the treatment, I talked with his wife and the hospital staff, and showed the nursing power of attorney left by Jack. Then, I unplugged the ventilator and sat beside his bed. Two hours later, he died. Honey. I hope it helps you, and remember to adopt it if possible. . .