Reports in the newspapers that young singer Hsueh Yueh is suffering from liver cancer shocked and saddened many people around the country recently, whether they had heard of him before or not. At the same time that he continues cutting records, the singer was quoted as saying calmly, "I hope I can die lucidly and with dignity ... I know that at the end I won't be able to breathe, I'll feel a lot of pain and I'll have a body full of tubes ... but when that time comes I've asked my family to give me morphine to ease the pain, to pull out the tubes and to let me die with dignity. I don't want to rely on a bunch of tubes to stretch out a life without life."
His words in fact represent the heart-felt wishes of most dying patients. It was with those wishes in mind that Dr. Cicely Saundens of Great Britain developed the latest field of medical service--hospices.
Moved by the suffering of the terminally ill cancer and tuberculosis patients she cared for as a nurse, she went on to become a doctor and to found, in June 1967 on the outskirts of London, the St. Christopher Hospice, which provides medical, emotional and spiritual assistance to dying patients who are suffering in both mind and body.
"Vice Premier Chung brought up the idea nine years ago, but there were all kinds of difficulties," says Dr. Lai Yun-liang, a specialist in tumor pathology. From a hospital's point of view, hospices certainly aren't moneymakers, because the rules of medical insurance require checkups and treatment, and the principle of hospices is not to use chemotherapy, cobalt injections and the like.
From a doctor's standpoint, most physicians are more interested in--and gain a greater sense of accomplishment--treating standard acute diseases rather than chronic diseases like cancer, which are difficult to care for and entail expensive equipment and costly treatment.
Also, one of the principles of hospices--that family members and patients must understand the full severity of the disease--runs counter to ordinary ways of thinking in society. "A lot of people aren't willing to mention death," Dr. Chung Ch'ang-hung says. Family members don't want to let patients know they are dying, and the patients themselves don't want to accept the fact, yet each of them grieves in secret.
In addition, popular belief maintains that those who die away from home may turn into "lonely spirits and ghosts of the wild." As soon as they learn that a patient is terminal, many families abandon treatment at the hospital and have the patient brought home at once--they're not about to head off to a hospice.
For these and other reasons, it took nine long years of communication and waiting for such a good idea to be realized.
One of the characteristic features of hospices is group therapy with a doctor, nurse, volunteer, social worker and clergyman on hand to provide morale support.
Doctors and nurses are on the front line, of course, and nurses interface with the patients most often. "The nurses take care of around three patients each, which isn't easy. They chat with the patients as much as possible, but the nurses need to relax and readjust sometimes too," says Wu Wen-chin, ex-director of nursing at Mackay Memorial Hospital. Nurses are sworn to curing people, but at a hospice they know that the patients are steadily deteriorating. "It's hard to adjust to that way of thinking," she adds.
Doctors and nurses alike are afraid of facing death, which is one of the reasons that terminal patients don't often receive close, personalized care at regular hospitals. But at the hospice there are other people to share the burden.
"Love hath no fear," the Rev. Ts'ai Hung-ming says, explaining his feelings. "A patient in a coma kept calling for me, and I hurried over in the middle of the night to pray for him. He was weeping," he says. It's clear that people in a coma are still conscious.
But his kind of love has its limits. "Christianity isn't suited for us," says a native-born Taiwanese woman who would rather listen to Buddhist sermons on the radio. At the hospice you can see patients clutching images of Kuan-yin and eight-trigram mirrors hung on the wall.
The volunteer workers, specially screened and trained, are all loving and caring individuals.
"My father was a surgeon. I watched him perform an operation when I was little, and I can still picture my mother comforting patients in my mind," so it was natural for Kuo Ch'un-mei to become a volunteer after her son reached school age. And Ch'en Chin-luan came for religious reasons: "I want to work for the Lord." As for Liao Mei-hsi, she had cancer herself, and when she tells patients, "Don't be afraid, I've lived more than ten years now," it's often more helpful than anyone else can say.
"The director calls us the wish squad," Ms. Liao says. The things they ask for are simple things like eating chopped ice, seeing the sunset, writing a letter to an old flame, looking at the flowers in the garden or watching children at play. And the volunteers are the people who fulfill their dreams. "A patient wanted to eat something chilled once, but he had a cough and I thought he'd better wait a couple of days," Ch'en Chin-luan says with red eyes. He passed away the next day.
Helping to make funeral arrangements also falls within the scope of services. "A family wanted to hire a tour bus once for us to attend the funeral," Ms. Ch'en says, but to save the family money they just crammed together into a hearse. The family kept exclaiming that they had never come across anything like it.
All the consideration and attention to details is aimed at realizing a single ideal--caring for the fear, helplessness and grief that are often neglected in terminally ill patients.
[Picture Caption]
Chinese avoid the subject of death, not to mention psychologically preparing for it. If they should have to face it some day, they have only their faith to fall back on.
Medical science can now control the pain of cancer in its final stages, which is another reason for hospices.
Aimed at serving the terminally ill, hospices are a severe trial for most medical personnel, who are vowed to cure people.
It took nine years of effort before a hospice was set up in Taiwan, and there is still plenty of room for development.
Pouring out their grief to one another in the meeting room is a way for family members to ease some of the emotional pressure they are under.
The morning prayer meeting is one of the more formal religious activities at the hospice.
Volunteer workers often use hymns to console and comfort patients' anxieties.
Medical science can now control the pain of cancer in its final stages, which is another reason for hospices.
Aimed at serving the terminally ill, hospices are a severe trial for most medical personnel, who are vowed to cure people.
It took nine years of effort before a hospice was set up in Taiwan, and there is still plenty of room for development.
Pouring out their grief to one another in the meeting room is a way for family members to ease some of the emotional pressure they are under.
The morning prayer meeting is one of the more formal religious activities at the hospice.
Volunteer workers often use hymns to console and comfort patients' anxieties.
