Take One Step at a Time

After supper, the hospital seemed to loosen its grip on everyone. The corridors were quieter. Patients who had spent the day going between examinations, infusions, scans, and consultations began drifting downstairs. Along the edge of the sidewalk, people sat wherever there was room, legs stretched out or crossed, talking to strangers as though they had known each other for years. Cancer was no longer a private subject. Someone would ask where you were from. Someone else would ask what you were being treated for. Then, before long, people were comparing hospitals, doctors, chemotherapy, scans, food, and whatever else had happened to them that day.

Among them was a fifty-three-year-old man from Zhongxiang County. He had once worked in Wenzhou as a painter. When he first came to the hospital, he was told almost immediately that his rectal cancer had already spread. There was no long period in which the family could pretend that the diagnosis might be something else. It was undeniably advanced cancer. And, yet, as he sat on the roadside after dinner, he was one of the liveliest people in the group. His hands never seemed to stop moving as he talked. He gestured toward the hospital, toward his chest, toward the people around him. He laughed. He interrupted himself. He shifted from one story to another. Most strikingly, he did not speak like someone waiting for death. He spoke like someone who had decided that worrying about it would not help. “When you get sick, you have to take things easier,” he firmly stated like he could not stress it more.

Before he became ill, he explained, he cared about appearances. He wanted to make money. He worried about the things people normally worry about. “Now that you're sick, what else matters?” he laughed, “Nothing.” There was something almost blunt about his life philosophy, which was not even philosophical. If he spent the day worrying about what might happen, the cancer would not become easier to treat. So why worry? “想那么多没用了.” Thinking too much would not change anything. He had already completed five rounds of chemotherapy. And, according to his latest scan, the tumors had become smaller. This fact seemed to give him even more confidence. “I've actually gained a few jin since the last round.” He laughed when he said it. Chemotherapy had not destroyed his appetite. Quite the opposite. “I eat a lot during chemo,” he repeated as though this were an accomplishment. “You have to eat.” For two or three days after treatment, his appetite might suffer. Then it came back. His sleep was good too. He could fall asleep and stay asleep until morning. His physical condition, he believed, was helping him tolerate treatment. But he also believed that his mind mattered just as much. “Don't think about it too much. If your mindset is good, treatment goes better. If your mindset is bad, you make yourself worse.”

Another woman sitting nearby agreed, “Seventy percent is your mental state,” she said. “Thirty percent is treatment.” The numbers were not medical statistics. Nobody was presenting them as such. They were simply the language people used to explain what they had observed among fellow patients. Some people became frightened as soon as they heard the word cancer. Others became so consumed by anxiety that they seemed unable to think about anything else. He had chosen another way.

His family had initially been frightened too. At one point, they had even wondered whether spending six hundred thousand yuan on treatment would be worthwhile. They asked a doctor a blunt question: “If we put six hundred thousand yuan into this, can you cure him?” The doctor did not give them false hope. No. There was no guarantee. The possibility of losing both the money and the person was real. So the family could only take it one step at a time, and that was exactly what he intended to do: 走一步，看一步, take one step and look around before taking another.

His story had already given him reason to believe in improbable outcomes.He told us about a relative by marriage who had developed cervical cancer years earlier. The cancer had spread to her bones. Doctors had told her there was little more they could do. She went home. But she continued treatment. Years later, she was still alive. When he talked about her, his expression brightened. She had apparently continued living almost normally. She worked in the fields, and she even played mahjong. “She had a good mindset.” That, he felt, was part of the explanation. Maybe medicine was responsible. Maybe luck was responsible. He did not pretend to know. He only knew what he had seen. And what he had seen made him less willing to believe that an advanced diagnosis automatically meant the end was near.

He also had a complicated relationship with his own illness. He knew it had spread. He knew that made surgery more difficult. Nevertheless, he refused to spend his days mentally rehearsing the worst possibility. “There are things you can't control.” So he focused on the things he could: eating well, sleeping a lot, talking to people downstairs, taking the pills, sitting beside his wife. That last part seemed especially important. He had a wife who came to the hospital with him. And, according to him, a patient's mental state depended partly on the people waiting at home. “You can have a good mindset,” he explained, “but if you go back every day to someone who is constantly worrying and looking miserable, it still affects you.” The family mattered. They could change what it felt like to live with it. He understood that children could not stay beside their parents forever. They had jobs, their own families, their own responsibilities. Brothers and sisters could help. But spouses were different. A wife was the person who went home with you and had to help you put yourself back together after a difficult day. She was not simply another caregiver. She was part of the emotional treatment plan.

I asked him whether the cancer patients had a WeChat group where they could talk to one another. “No.” There was no formal patient community. More often, people talked in the ward. Then they talked downstairs. Then they met again during the next admission. People came and went. The people in a room could be completely different from one treatment cycle to the next. Yet there was a strange continuity. Everyone had been through some version of the same thing. “Those are the old customers,” he joked. Cancer treatment was rarely a single visit. Unlike appendicitis, where an operation might solve the immediate problem and allow someone to leave, cancer patients return again and again. They became familiar with the hospital, the people, and, eventually, familiar with the uncertainty itself.

He was scheduled to leave the hospital soon. Another chemotherapy cycle was nearly complete. After several days of treatment, he would go home. Then, eventually, he would return again. I asked him whether there was anything he had changed since becoming ill. He admitted it forthright. He used to smoke two packs a day, but now he smoked only occasionally. He knew he should probably stop altogether. He had also changed the way he ate. He had less spicy food and heavy food, but he still wanted his food to taste like food. Sometimes, when cooking, he would cut just two or three tiny slices of chili and put them into the dish. “Otherwise it doesn't taste good.” Everyone laughed. It was perhaps the most ordinary thing he had said all evening. After all the conversations about cancer, chemotherapy, recurrence, survival, and death, what he wanted was still something remarkably simple. For dinner to taste good. For his wife to be beside him. For his stomach to feel well.

As the evening darkened, people gradually began returning upstairs. The sidewalk emptied. The conversations faded. The man from Zhongxiang still looked energetic, talking with his hands and laughing at something someone had said. He had been told he had advanced cancer almost as soon as he was examined. Five rounds of chemotherapy later, the tumors were smaller. No one could tell him exactly what would happen next, and perhaps that was precisely why he had chosen not to spend the time he had been given trying to predict it. “命是有的,” he said. Life had its own timing. He could not control the ending, but he could still choose what to do before it arrived, and, whenever he was asked how he was doing, laugh and say that he was doing just fine.