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Home Our Volunteers Stories "Going Home": A Patient's Understanding and Mine

"Going Home": A Patient's Understanding and Mine

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When 50-year-old Min Xiao was transferred into the Heart Lotus Palliative Ward in the final stage of hypopharyngeal, he could not eat or speak. Just before New Year's Eve, he communicated by writing with a nurse his wish to visit his 84-year-old mother at home. He said he has never been home for New Year's Eve.

Although the nurse understood his yearning for his mother, the unstable condition of his health made it hard to realize this wish. Not wishing to disappoint him, the nurse brought up the question at the daily morning meeting. When he heard of it, Dr Wang Ying-Wei, director of the unit, decided to fulfill the wish of Mr Min. Preparing a patient in his fragile condition to leave hospital for a day is not an easy task. Because his condition may change, wheel chairs, oxygen, roll-away beds and other medical equipment are often needed during the trip. Extra care was needed because it was a long trip.

To fulfill his wish, the team chose a day when Mr Min was in good health. Instead of asking a hospital driver, Director Wang personally made the two-hour drive to his home.

During the ride, the patient was accompanied by medical staff and volunteers who treated him like members of their own family. When they arrived, they presented gifts to his mother and two married sisters. The whole house was full of joy. Although this may be Min Xiao’s first and the last New Year celebration at home, he had a warm and happy expression, with no hint of regret.

After the family reunion, Dr Wang brought Mr Min back to the hospital. Although it was tiring to be the driver for a day, he smiled and said: "this car is bigger and no-one else knows how to drive a stick shift car, so only I can drive".

Son of Medical Doctor Develops Passion for Helping Others

Dr Wang is gentle, warm and polite and talks fast with a slight Cantonese accent. He speaks fluent Taiwanese as well as Mandarin. He has the air of a scholar who loves books. When the Tzu Chi General Hospital in Hualien opened, he was the first doctor to help in ambulance driving.

He was born in China in 1956 and moved to Hong Kong during his childhood. Both his father and his grandfather were doctors. Grandfather Wang De-Guang was one of the first western doctors in Guangzhou, China. He opened a hospital where he worked as a very dedicated doctor; he often charged no fees from poor people

Although Wang Ying-Wei never met his grandfather, he was inspired by his example and that of his father. Most importantly, he was able to realize his wish to help others through interaction with a group of people. At that time, many students in Hong Kong wanted to study in Taiwan; he tried and succeeded in getting into National Taiwan University Department of Medicine.

Away from Home, He Understands the Meaning of Home

When he was young, Dr Wang studied abroad far away from home; so he understands a patient's desire and hope for their home. Whenever a patient talks about going home, he talks more slowly and says with feeling: "to a patient, going home is indeed an important thing. Home is an important place. It is often said that the Heart Lotus Palliative Ward is full of warmth, but, in reality, there is no place like home."

On one occasion, the Hospice Foundation of Taiwan brought 20-30 volunteers from South Korea to visit the ward. During the feedback, one of the volunteers shared her feeling that she had been inspired by Doctor Wang's words: "what we see is not important. The facility is not very important as well. No home is like a hospital and no hospital is like home. The most important thing is for one group of people to care with love and diligence for another group of people."

Patient is Priority, Medicine has no boundary

Dr Wang was one of the first to consider how to develop palliative care wards in the Tzu Chi Hospital. After discussions with Master Cheng Yen, his team started with home care. Then he went with other went to visit such facilities in Japan; in the group were Ms. Lin Bi-Yu, vice executive officer of Tzu Chi Foundation, Mrs. Du Chang Yao-Cheng, wife of the then superintendent, and Lai Hui-Ling, current Hualien Tzu Chi Hospital Nursing Director. Following a thorough observation of the palliative care wards in Japan, the team returned to Taiwan and drew up their plans.

The Heart Lotus Palliative Ward in the Tzu Chi hospital in Hualien has become a model in its field. Doctor Wang said that its guiding principle should be to complete the ‘five tasks’: diligence, individual, family, journey and team. He also established the practice of having a conference between doctors and nurses every morning. He pointed out the importance of each nurse in the conference, because they are the ones who have the most interaction with and understanding of the patients. 

In most wards, it is the doctors who discuss treatments. In the Heart Lotus Palliative Ward, they emphasize integrated care; the doctors have to understand the feelings of the patient and the reaction of society. Their goal is to understand a patient's thoughts, see things from his perspective and find ways to accomplish his wishes. The most important thing is to take care of the patient and his family.

On one occasion, a patient's cancer cell shifted into the bones, causing pain to the entire body during any movement. When he asked Doctor Wang how to co-ordinate with the doctors and nurses, he replied: "you put it wrongly. It is the doctors and nurses who need to coordinate with you."

Dr Wang is also in charge of writing the curriculum on medical ethics in the Tzu Chi University; in this, he included a theory: "help the patient speak their mind". Sometimes patients wish to speak but are afraid; or they are uninformed about their rights. Therefore, he hopes that all doctors and nurses allow their patients express their wishes and help them to realize them.  

Bringing medical services to rural areas

Dr Wang’s love not only covers the patients in his ward but also people who live in rural areas with poor medical services. He was one of the first participants in the plan to bring such services from the Hualien hospital to Xiulin Township and the Tianxiang clinic in the Taroko National Park. He always drives the team up the mountain.

Although it is very tiring to do clinics after such a drive in a large vehicle, he insists on sitting on the driver's seat to serve his fellow colleagues. He gave a good reason: "if we hire a driver, he will have to drive us up to the mountain, go back down and back to pick us up. It is dangerous for someone to drive alone in the mountain. Why put one more person in danger?"

When he first started working in the Hualien Tzu Chi Hospital, he asked Master Cheng Yen what he should do. She said that she wished him to serve Aboriginal people and those who live in remote areas. In that case, Dr Wang said, we need a car, ideally a four-wheel drive. After a while, the Tzu Chi volunteers provided an ambulance but they did not have a driver. So Ying-wei learned to drive himself to the rural areas and villages, serving the patients there or visiting care-recipients to evaluate their medical needs.

Although the trips are arduous, he laughed and said that he is a part-time driver who is often complained by the other volunteers for speeding. Even the Master started paying attention to this. He often jokes about it with her, saying: “I abide by the speed limits. On average, each of my wheels never went above 60km an hour!” Even a gentleman like him cannot help but reveal his humor and naughty side.

Because he has spent years serving the sick in the rural areas of Eastern Taiwan, he has deeply experienced and observed their difficulties. He hopes that he can further improve his ability to help them. He said, because tropical medicine is part of a specialization for the poorer communities in Public Health, it is very relevant to his care-recipients. So he went to the US and earned a Master's degree in tropical medicine and a Ph.D. in International Public Health Education. After he completed these courses in 1993, he returned to the Hualien Tzu Chi hospital.

Overcome Science and Live in the Present

In 1994, civil unrest started in Rwanda and Tzu Chi began its international medical outreach. They needed doctors who specialized in tropical medicine and public health; Dr Wang volunteered and collaborated with the Doctors of the World (Medicins du Monde); he went to the disaster area, making history as the second doctor from the Tzu Chi Foundation to serve abroad.

When he reached Rwanda and Congo in Africa, he saw 200,000-300,000 refugees in camps; many were suffering and receiving intravenous drips as they were lying on the floor. Many of them were told to go home. The journey was long and arduous, so that only the healthy could make it on foot. So Ying-wei and the Tzu Chi volunteers set up pit stops on the road to provide food and medical services.

It was Ying-wei's childhood dream to serve in Africa; but, after this trip, he realized how limited his help was. To help, passion alone is not enough; you must consider transportation, barriers of culture and language and having a proper support system. At the same time, he started discussions with Dr Lin Jun-long, then head of the Tzu Chi Hospital in Dalin and now CEO of the foundation’s medical mission, on the establishment of the Tzu Chi International Medicine Association (TIMA), so that many countries could start local health clinics and the foundation could extend its medical mission far and wide.

After that, Ying-wei went to the Philippines and the Inner Mongolia region of the mainland to serve. He confessed that, when he started to give free health services, he doubted that one or two treatments could sufficiently help the patients or their community; it did not seem possible to change their destiny. But, whenever he interacted with the patients, he realized that, even though he could not make a huge difference, he should not underestimate his ability. Everything he did had a unique and significant meaning behind it.

“I heard a story many times -- a father and a son were walking on the beach where there were countless sea stars washed up. The father picked up a few and threw them back into the ocean. The son asked: ‘there are so many sea stars and you can never finish picking them up, so what difference does it make?’ The father replied: ‘maybe it doesn't mean much to the other sea stars but it makes a difference to this one.’”

The free clinics have changed much of the thinking he learnt from his objective, scientific training. He used to doubt the use of such services that focus on helping the desperate, not the poor. But, after he started working on them in person, he realized that it was significant for the patients and doctors at every moment. Compared to his time in Taiwan National University, serving the rural areas was the experience in which he gained the most.

Learn from role models, tell true stories

In Ying-wei's opinions, when you teach medical ethics, most important is the role model. But being a good role model is no simple feat. In the medical field in Taiwan, doctors are doing a brilliant job only in certain areas. Even Albert Schweitzer, his role model when he was young, had his flaws and many of the perfection he strives for are only ideals for the medical students. 

In Tzu Chi University, the role model teaching is using a student's observation to see what great things can be done in practice through not a person, but stories. All the stories have a lesson -- through true interactions between a doctor and the patient. When the students experience these in person, they can learn at first hand and change themselves.

Ying-wei has received inspiring feedback from his students for the doctors or teachers. These doctors were just patiently listening to the patients, giving a warm smile or helping them. When a teacher does these, the students learned from them first hand and realized their importance. The cycle of kindness continues. 

Ying-wei jokes that the soil in Hualien is really sticky, so it will be the place where he will be laid to rest. After working in medicine for 30 years, every patient is his reward and family medicine is a branch that is centered on the person. So, for him, the patient's happiness is his own. And it is natural that he serves every patient. He has finally reached the fourth stage of practicing medicine -- returning to the reality of seeing the mountain as a mountain and seeing the trees as the forests and the trees. 

(Article by Wu Wan-lin, Excerpt from the Medical Journal 2013 January)

Translated by Lily Kang and Huiying Chin
Edited by Joanne Chang and Mark O'Neill
 

" Those who have great wisdom must all the more be humble and unassuming, just like the rice stalk that bows under the weight of ripe grain. "
Jing-Si Aphorism

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