Book Title: Gratitude Left Unsaid: Narrative Medicine Reflections and Writing

Synopsis:

Death is inevitable in life.

When the road comes to an end, one must eventually let go of everything.

Human life gradually withers, fades, and ultimately reaches its demise.

Yet, before a life vanishes,

there are always those touching moments

that leave an unforgettable mark on our hearts...

When I was little, Grandpa loved to hold my hand and take me to the nearest grocery store to pick out my favorite candies. The sweet powder on the candies inside the glass jars shimmered, making Grandpa feel like a bright little sun in my heart, forever radiating warmth. Back then, I had no concept of life and death, naively believing that such days would go on forever and that everything would proceed safely and uninterrupted. It never crossed my mind that Grandpa would age, fall ill, and die—that one day, he would let go of my hand and leave me for another world.

Grandpa was a staunch supporter of the Kuomintang (KMT). Whenever he saw news about the KMT on television, he would be all smiles. At those moments, I would wave a small flag adorned with the KMT emblem, stand high atop a round stool, and shout at the top of my lungs, "KMT, Dong-suan (get elected)!" Grandpa would let out a chuckle. Whenever I heard his laughter, my mood would instantly brighten.

One day, Grandpa felt discomfort in his abdomen and was rushed to the hospital. The nurse drew his blood, and a few hours later, the lab results were out. Grandpa was diagnosed with stage II colorectal cancer. A large tumor had grown inside his body, requiring urgent radiation therapy. From then on, he was hospitalized. He could no longer eat his favorite foods and had to go to the treatment room every day for a series of radiotherapy sessions. Every time he emerged from treatment, his face was deathly pale, his cheeks hollow, and sometimes he would even vomit and lose his hair... The warmth once radiated by the little sun in my heart seemed to have been cruelly extinguished by the relentless treatments.

After months of therapy, his body could no longer bear the daily grind of chemotherapy, and he finally lapsed into a coma, placed in the Intensive Care Unit (ICU). Looking at him hooked up to an oxygen mask, his weak breaths and steadily dropping blood pressure readings tugged at my heartstrings with every breath. When he woke up, he was unable to speak and relied entirely on Grandma for even the simplest everyday tasks, lying motionlessly in his hospital bed. Once, he craved beef soup, but due to the cancer, his digestive system had deteriorated, forcing him to eat brown rice which he detested. Accumulated from months of resentment over not being able to enjoy a single meal happily, he smashed his bowl onto the floor in a fit of rage, scattering rice everywhere. Grandma cleaned up everything without a single word as tears streamed down her cheeks. She swallowed all of Grandpa's frustrations, silently keeping vigil by his side throughout the grueling treatment process. Now older, I realize how agonizing it must have been for her back then, but as a naive child, I could only sit quietly by the side, utterly helpless.

That was my first time entering the unit to see him. Before stepping into the ICU, I had to put on an isolation gown and a mask. Pushing the door open and looking at Grandpa on his sickbed, my heart felt overcast, cloaked in a dismal gray. As a child, I didn't comprehend what heartache meant; now that I am grown, I know that feeling was heartbrokenness and profound reluctance to let go.

A few months later, in the dead of night, Grandpa embarked on the path to death, leaving nothing behind for us.

On the day of the funeral, the elders told us to wear black clothes and trousers, don burlap garments, pin on mourning badges, and stand straight before Grandpa's coffin. When the time came, everyone looked forward at Grandpa lying quietly in the cold coffin, and tears fell from every eye. My own eyes welled up with tears; though I didn't understand why I felt that way back then, I simply felt an overwhelming urge to weep. Growing up, I learned that people weep because sadness or deep emotion touches the bottom of their hearts. I suppose my tears back then were born of my reluctance to lose Grandpa. Even though a long time has passed and Grandpa's image has gradually blurred in my mind, I am certain that when I stood on that round stool shouting those playful words to make him happy, I did it solely to see him smile.

I often wonder: if he hadn't undergone those radiotherapies or chemotherapies, would his body have been spared that torture? He wouldn't have had to swallow countless pills of all sizes, nor spend his entire day confined to a sickbed waiting for nurses to draw blood and hang IV drips, repeating the exact same routine day after day. Perhaps, in his final days, Grandpa could have rediscovered some of life's simple pleasures, expressed his final wishes, and shared old stories with his beloved grandchildren for us to pass down. And we could have cherished the time spent with him to tell him how much we loved him, ensuring he didn't face the terror of death all alone. With us accompanying him on that journey, he could have quietly stepped toward death according to the laws of nature...

Grandpa is no longer in this world. His wishes rest silently within the cold urn, buried away beyond my reach or knowledge. All I can do now is touch his urn before every holiday, update him on my recent life, and pray for his blessings to keep our family safe and well.

Patient-centered, humanistic medical care has become a crucial topic of reflection in medical education in recent years. How to extend medical practices from biological care to psychological, social, and economic support poses a significant test for medical humanities education.

This book brings together numerous course works related to "Narrative Medicine Reflections and Writing"—a program dedicated to promoting medical humanities. Through reading and writing life stories, the author re-examines and understands the doctor-patient relationship. Simultaneously, by deconstructing (examining, analyzing) and reconstructing (understanding, interpreting) the process of narrative medicine, healthcare professionals learn how to extend care to others. By reflecting on and reviewing their own experiences, they rediscover themselves, ultimately finding their professional position and identity in the workplace.