Thursday, December 5, 2019

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Disclosures

The Farewell, directed by Lulu Wang, tells the story of a Chinese family that decides to withhold the diagnosis of lung cancer stage IV to their matriarch, the grandmother Nai Nai. They spare her the troubles of dealing with terminal illness, dismissing her complaints of cough as prolonged infection, and going out of their way to create fake X-ray results. I must say that I enjoyed the film immensely, as it deals with the question of how to best approach the family's decision against disclosure versus the patient's need to be informed of the illness.


This issue resonates with my daily experiences, but I've come to realize that patients know a whole a lot more about their illness than we give them credit for. How do I deal with this issue? It's still on a case-to-case basis. I tell the family it's hard to conceal a cancer diagnosis if we plan to give palliative chemotherapy or some other treatments with concerning side effects. Disclosure is a complicated issue for which no pat solutions can be offered. Here lies the art of medicine—something I keep working to be good at so that one day it becomes second-nature to me.

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