Mrs. CHANG LAY IN THE EMERGENCY WARD, fighting. She was fighting terminal cancer, pain, and despair, and as her oncologist, I was called to see her. Just back from a farewell visit to her parents in Taiwan, she lay on her gurney behind a green curtain, her son beside her. Her knees were drawn up, her arms crossed, her eyes closed. When I said hello and touched her frail shoulder through the worn hospital gown, she turned, her body stiff beyond her years. She fought to sit up, to smile, to regain the politeness and grace that were second nature to
her. But fighting took everything she had. She grimaced and fell back against her plastic pillow.
I can’t, was all she said. I can’t.
Mrs. Chang had cervical cancer and it was killing her. She was not yet 50, and because of her cancer she never would be. Her life—as immigrant, wife, mother, waitress, daughter—had been full of struggles. She had survived them all, but now she was struggling with things she could not overcome. I could not cure her, only help her to be more comfortable.
Nearly two and a half years had passed since she first came to see me, the gynecologic oncologist at Chicago’s Cook County Hospital. At the time of diagnosis, her cancer had spread beyond the cervix, the opening from the vagina into the uterus, and into surrounding tissue. Although the cancer was advanced, it was not yet hopeless. I had told her of the odds and outlined her options. And at first she did well. Radiation treatments shrank her tumor. Then a hysterectomy removed the residual growth. For two and a half years, she was healthy. On visits to the clinic every few months, I examined her. I was looking for signs that cancerous cells remained in her reproductive tract. I also asked her about new pain, weight loss, leg swelling, and cough—all signs that cancer has recurred.
