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Personal Stories: Dying to Know

Published in the Hepatitis B Foundation newsletter B Informed (Winter 2003)

Tragic End for Young American Asian Doctor
with Hepatitis B

By Joel P. Engardio 

From our table at a sidewalk cafe in August 2000, my partner Mark and I took turns pointing out things that made us smile. Our mood was sublime, like the day, as we headed to an open-air jazz festival. Until a sharp stomach pain made Mark wince and double over. Was it the ulcer he feared? At 30, Mark Lim was a young doctor saddled with debt and the challenge of building a career after eight sleepless years of medical school and training.

Mark didn't have an ulcer. An ultrasound of his abdomen showed an ominously patchy liver. A biopsy confirmed the worst: cancer. His liver was riddled with so many out-of-control cancerous lesions that neither surgery nor transplant was possible. Chemotherapy would only slow his inevitable, insufferable demise 14 months later. But the question remained, how did such an otherwise perfectly healthy young man, who had a gym-toned body and never drank, end up with the organ of a hard-living alcoholic twice his age? The answer was chronic hepatitis B, a virus that can silently harbor in a healthy liver for decades before unleashing its destructive power.

Mark knew about his hepatitis. He discovered it from blood tests required by his medical internship. But experts at the prestigious Midwestern hospital where Mark did his residency told the 26-year-old not to worry. He was a "healthy" carrier, they said. His symptom-free kind of hepatitis wouldn't have to be monitored for liver cancer until he was in his 50s or 60s. Good advice, if Mark were not an Asian man. Had he or his doctors been trained to know that Asians are at accelerated risk because they are typically infected as children, he would have immediately gotten regular ultrasounds and blood tests to catch the cancer that killed him at 31.

Liver cancer is rampant in Asia. The main culprit is chronic hepatitis B, a virus transmitted by blood or semen. Exposure to it at childbirth is the real problem, because that's when the risk of chronic or lifelong infection is greatest. Since it can take 30 years to manifest, all adult children of Asian immigrants -- even those born in the United States -- are at risk.
Before Mark died last October, he became a spokesperson for the Jade Ribbon Campaign, urging all Asians to check their hepatitis status. As a doctor -- and a victim -- Mark felt it was his duty to speak up about what has become the greatest health disparity between Asians and Caucasians. He was moved not only to fight the disease that was killing him, but to wipe out the ignorance that had allowed the problem to get so out of hand. Jade Ribbon is just one voice trying to sound the alarm of a health crisis to come.

Confronting his own mortality wasn't easy for him. "It's scary to think of your life in months, instead of years," he told me as his death approached, our dreams of that day at the sidewalk cafe shattered. His life was so short, and his death so horrible.

Mark was dedicated to saving lives as a doctor. He can't do that anymore, but his story can. In the end, the most he could do was hope his words might inspire his medical colleagues to offer -- and his Asian peers to seek -- the information that can save thousands like him from his fate. If only they listen.

Excerpted from articles by Joel Engardio that were originally printed in the San Francisco Weekly 5/1/02 and San Francisco Chronicle 1/3/03.

Editor's Note: The Hepatitis B Foundation thanks Joel Engardio for graciously sharing his story so that others can learn from Mark Lim's tragic death: it is important that those who may be at high risk for hepatitis B are tested as soon as possible. Re-testing may be necessary. Be sure to ask for copies of all hepatitis B blood tests and confirm the results with your doctor.

For further assistance, please feel free to email the Hepatitis B Foundation at info@hepb.org
or call 215-489-4900


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