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???????? ????? National Taiwan University Hospital ???????????
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Episode today

Today I am going to share Anglena Baby’s story.

#medical podcasts in Taiwanese # We do not choose to be born nor do we choose the time and condition of the death

I am a medical staff in the hospice for the terminally ill patients of all kinds of cancer. During the development of conditions, the hospice takes care of the patients’ body-mind-spirit well-beings by the means of providing holistic care and helping the patients’ family with our comprehensive care team throughout the nursing process, hoping to console both the family and the patient in the last stage of life.
One day, while I was serving a sleepy elder man and massaging his dropsy legs, his daughter stood aside looked apprehensive, and her furrowed brows were like a dead knot. She sighed and said, “do you know anything about death? Do you know how cruel it is for a patient like him who is still conscious but getting weaker and weaker day by day until the Death comes?”

“This is for you,” a cleaning lady aside gave her tissue paper.

I did not say anything then but listen to her quietly. I recalled the whole thing after work and started to think what could I respond to her question.

I walked on the red-brick road by myself and thought if there is anyone asks me the same question again, I would answer, “I know what death is, but I have not yet fully explored it. I know it is difficult to explicit the feelings of patients who still have consciousness to aware their lives are fading away. I might only understand how it feels until this happens to me. But before that, I want the patients to tell me what else do they want to do and say, so I can help them. This is my job of being here.”

I remember while I was stammering out my answer to her, several phone calls interrupted. Now I have practiced how to answer this question several times hoping I can express it by a way of closing to one’s heart if anyone asks me again.

By the way, I really want to praise the cleaning lady who gave the patient’s daughter a pile of tissue paper. It is warmhearted.

A few old sayings in Taiwanese: “We do not choose to be born nor do we choose the time and condition of our death. (Taiwanese: Sen bô tiun-tî?sí bô kíng sî)” “If Death have you die at midnight, nobody dares to hold you till the daytime.” Those who want to live cannot get enough time; those who want to die have no way to find.


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The article is wrote by Li,Bao-luo, deputy director of intelligence medicine of National Taiwan University Hospital. Extracted from: https://www.facebook.com/chnchng.lee.5?locale=tw_TW

Polycystic kidney disease and aortic dissection lead to the death of Alien Huang

The sudden death of Alien Huang, a 36-year-old famous Taiwanese celebrity, shocks Taiwan’s society. The pathology report pointed out the cause of death is aortic dissection, a condition mostly happens to patients aged more than 50 years old with long-term high blood pressure. Alien Huang was diagnosed with “three types of highness” (high blood pressure, high blood sugar, and hyperlipidemia), but, supposedly, his condition would not have deteriorated to aortic dissection within one year. If aortic dissection occurs to a young person, it is mostly caused by genetic disorder, particularly patients with Marfan syndrome. Patients with Marfan syndrome have longer arms and legs than normal, and their joints are softer than usual. To tell whether a person has Marfan syndrome, the best way is to see if his/her arms are longer than his/her height. However, Alien Huang is apparently not in this case, so he does not look like having Marfan syndrome.

If Alien Huang does have polycystic kidney as the report said, does this disease associate with aortic dissection?

It reminds me a night 16 years ago, during that time I worked as a chief physician of emergency room in National Taiwan University Hospital. An adult around 40-year-old was sent to the emergency room after losing consciousness during an argument with his friend. Before he lost his consciousness, he yelled: “my chest hurts” and then he fell down. His heart stopped beating when he was sent to the hospital. We immediately did CPR on him. The ultrasound exhibited that he had pericardial effusion as well as cardiac tamponade. Without any hesitation we underwent pericardiocentesis and his heart started to beat, but because the body fluid was red while undergoing the procedure, we assumed it was aortic dissection led to pericardium. Then we arranged computer tomography right away and found out he did have aortic dissection; meanwhile, we also discovered he had numerous kidney cysts in different sizes which indicated he had polycystic kidney disease. An emergent surgery was performed immediately afterwards. Unfortunately, we failed to save his life after a 6-hour operation.

This case lingered in my mind. Is polycystic kidney related to aortic dissection? I read some papers and only one of them has case report. There is no clear link to it. Although there is a relation shown in the animal experiment that genetic polycystic kidney might associate with abnormal formation of fibrin, patients with polycystic kidney disease are easier to have severe high blood pressure, which is a vital risk factor causing aortic dissection. Still, there was no conclusion in academia on whether polycystic kidney will trigger aortic dissection in humans. Because of the surgery 16 years ago, we were able to access the patient’s aortic specimen and studied it with pathologists. It is proved later on that the pathological change of aortic dissection occurs to patients who have congenital polycystic kidney disease is similar to the inherited abnormalities of fibrin, but not the pathological change of hypertension atherosclerosis. I published the findings on the journal, Resuscitation.

From these researches, the most possible reason of Alien Huang’s sudden death is that his congenital polycystic kidney disease was complicated by abnormality in elastic fiber as well as high blood pressure and led to acute aortic dissection.

There are numerous patients in Taiwan suffer from congenital polycystic kidney disease which might not only trigger aortic dissection but also ruptured cerebral hemorrhage. To prevent sudden death, patients with such disease should go for a physical examination regularly to checkup the condition of cardiovascular disease, watch out the level of blood pressure, blood sugar, and blood lipids, avoid strenuous exercise, and avoid moving heavy stuffs.

#polycystic kidney disease
#aortic dissection
#Huang, Hong-sheng
#Alien Huang



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