U mạch chủ bào trung thất. That was how the diagnosis result sheet wrote. I don’t know what that word mean, I don’t even know how to pronounce it. I just know that the patient’s name was my mom’s.
It was quite a long time since I last wrote a blog post. But mom has carry that tumor inside her mediastinal for even longer than that
No one know for sure when did it start, but a few years back, after decades of battling diabetes, her respiratory and cardiovascular system started deteriorating too fast. A bunch of trips to the local hospital and back yielded no meaningful result. Then in 2023, the local hospital finally found something in her chest X-ray and suggested a following checkup at the Heart Institute1. Following checkup at Heart Institute suggested that the problem was lung related so we were referred to Phạm Ngọc Thạch Hospital2, the most notorious tertiary hospital in the city for lung disease in southern Việt Nam. It was never a good sign when you got referred to such hospital, and this was not my fist beef with this hospital either.
That hospital was not particularly crowded, given its status, but everything at its clinic was slow. A whole day of waiting just for chest X-Ray and ultrasound, another day for CT Scan and it revealed a small lung tumor, and they immediately suggested surgery. Mom was terrified. She did not admit it at first and try her best to put on a straight face but the word ‘tumor’ carry an immense weight. She tried her best to fight the doctor, asking for other course of treatment and other delay tactic. Finally, agreeing on an CT scan-guided endoscopy biopsy. When the result found no sign of invasive malignancy, yet, she dismissed all notion of an surgery. Declaring that she would rather live with an benign big tumor than risk dying on the surgery table.
All effort to persuade her went fruitless. She was rightfully to be scared, it’s common knowledge that lung cancer was among the deadliest 3 and in her mind our family can not afford a battle with such disease anyway. But she was too proud to admit fear. She was the eldest child, the corner stone of the family, and for all her life, she was the care giver, not receiver. She put on a strong face fearing that things would fall apart the moment she show weakness. She will herself to be strong, tumor or not. And thus she went beyond reason, resorting to faith, concealing her symptoms and invoking her rights to her own body any time she was about to lose an argument. All my critical thinking and debating skills fall flat. I disproved crap load of conspiracy theory about modern medicine, dismissed bullshit “traditional cancer remedy”. But I couldn’t do anything when she simply refused to go for treatment.
Fast forward another year and she agree to go for another checkup, this time University Medical Center HCMC4. I thought it was on the pretext that I have a cousin studying nursery and midwifery at this university that she choose this hospital. But it turned out that she went alone, only inform everyone when she was about to step out of the house. She was desperately looking for a second opinion, and try to avoid Phạm Ngọc Thạch hospital at all cost. But the results came quick, but grim. A contrast-enhanced CT scan shown the tumor had grown (almost twice the size I reckon). It was now beyond the capability of UMC surgeon, but they suggest immediate hospitalization nonetheless.
Mom would hear none of that though. She simply refused treatment and left the hospital. Claiming that she was fine, and should remain an outpatient, if no course of outpatient treatments was available then it was fated. She refused to even talk her conditions with family or anyone else. Just full blown denial, no question asked.
Last year was hell. Mom tried everything to hide her deteriorating health from family. She always tried looking for all other reasons on earth to blame for her condition, as long as that condition stay away from the word ‘tumor’. She shut down conversation and even reacted angrily when pressed about the real elephant in the chest. All the while, that tumor grew.
This year, things got so bad that even mom could not keep denying. She could run out of breath just by keeping a wrong posture. Her strong face could not be hold up anymore now that she ran the risk of fainting from asphyxiation. So mom decided to get another checkup, but this time back at Heart Institute because she would refuse to blame the lung or anything close to it. Just like last time, she went alone, only inform family when she was about to step out.
But then hell erupted.
It was only now that mom confesses she fainted while getting an ECG. She woke up in the emergency room with oxygen tube and the Heart Institute strongly refused to release her without family member present. So she had to call me, finally out of denials we went back to Phạm Ngọc Thạnh hospital. She was hospitalized quickly after a Blood Oxygen level measurement, now bound to bed by oxygen tube, unable to venture just outside the emergency room without panting for air. Mom finally got out of the denial phase and contemplated on what to do next. Though it still took another heated argument, she finally agree to treatment but reality hit us pretty hard.
Things at Phạm Ngọc Thach was as slow as ever. We spent 3 days in emergency room because other department was ‘crowded’. During that time mom got a chest X-Ray and an ultra sound, none of which reveal anything new. Then we got a bed in the department of palliative care????
After another 2 days just to get a CECT, the department head herself come to mom’s room to convince her she was too weak to undergone treatment now, and we should come home to rest to prevent cross-contamination. Now that we are ready to take any risks necessary, we receive no explanation of mom’s condition, no plan on going forward, just a simple surrender.
The week that follow was dreaded. I rushed to by oxygen concentrator and learn how to care for mom but she simply won’t get better. She no longer be able to hide her suffering, despite the whole family trying to put up the most optimistic notes. Despite telling the guest and relatives that mom was gathering strength we really don’t have any clue what to do next.
Then my cousin’s boyfriend introduced to Doctor Đặng Đình Minh Thanh. He believed the tumor was of Mediastinal, not lung, and thus the survival chance was higher. And that was the only hope. But getting there was not easy. Mom still too weak to do MRI scan to confirm the diagnose. The only course of action was to just go in the operation room and hope for the best, and that course of action wouldn’t sit well in a consultation of big public hospital. So the doctor suggested we go to a private hospital5 that he has good relationship with, where he can find an operation room with surgical team. Such a suggestion sure would raise some eyebrows but in the end I choose to believe. I believed in the surgeon I’ve only met once but moreover, I believed in the introduction that was motivated by love.
And that belief seemed to checked out.
The pre-op assessment took two days, mom was hospitalized waiting for the operation. The wait itself was just shy of a week but that was heavy enough. Then come the operation day.
I didn’t expect the operation to finish in less than 2 hours. Still getting my morning coffee to prepare for the wait when Dr. Thanh call me and show me those pictures. Such massive tumor. I still didn’t dare to raise hope when he said mom would recover within a week.
Then 2 more days in ICU and another week of recovering in hospital, we booked our taxi home.
The successful operation brought mom back the ability to breath freely. Everything was so surreal. Now Let’s hope that I would overcome my laziness for another blog post when the Immunohistochemistry result arrived.
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