Dr. Xu: A Chinese Medicine Novel

A difficult conversation brings Evan back to the consequences of an earlier rescue.

Evan let out a heavy sigh. For a moment, he felt helpless.

“Evan, this time you really were lucky,” Professor He said. “I don’t mean you cured this patient through luck. I mean you were lucky enough to meet a kind family member, Chinese medicine doctors willing to support you, and hospital leaders willing to take responsibility.”

He gave a helpless smile.

“Sometimes you really mustn’t underestimate how malicious people can be. Especially after you’ve spent years in a hospital. You see far too many bad people.

“Chinese medicine has it a little easier. Hardly anyone makes trouble for Chinese medicine doctors. But on the Western medicine side, it’s happened over and over. Some people deliberately manufacture grounds for compensation claims against hospitals and doctors.

“Take this patient. Suppose his wife were more ruthless. His condition has improved now, hasn’t it? But if she stopped giving him the next few batches of medicine, he’d certainly deteriorate again.

“Then suppose she reported you for improper prescribing, or took you to court. You’d be in serious trouble, and so would the hospital. Don’t think things like that never happen. People can be very cruel.”[1]

Evan frowned.

He had practiced medicine for many years in the countryside, in the time and place the system had taken him to. He had never traveled beyond the county town. Perhaps it was because he had gone back to an earlier era. The farmers hadn’t yet become so malicious.

Those farmers had little education and no knowledge of the law. They knew nothing about the pharmacopoeia’s rules, much less that they could use a lawsuit to go after the doctors working so hard to save them.

And there was Dr. Li’s reputation, earned over all those years of saving lives in the county. Evan was his disciple. Evan himself had saved many people, and their hospital director was willing to protect him and take responsibility for him. In that county, very few people could touch him.

So, despite all his years of practice in that time, Evan had rarely faced harassment over his medical work.

Now it was different. People had changed. And Evan no longer held the same position.

…

His brow tightly furrowed, Evan sighed softly.

“All I want to do is treat people and save lives. Why is it so hard?”

Professor He sighed too, full of helplessness.

“Evan, there’s something I lied to you about.”

“What?”

“The prescription you used to save that earlier heart-failure patient. I persuaded your hospital’s leaders to stand behind you, but none of us was sure it would pass a medical assessment.”[2]

Evan was taken aback.

Professor He gave a bitter smile.

“If you’d decocted the fuzi for an hour before giving it to him, then perhaps, with us vouching for you and giving evidence on your behalf, you might have passed.

“But you brewed it rapidly over high heat and gave it to him as it brewed. That is precisely when the toxic substances in fuzi are breaking down most rapidly. Dr. Li says that, when saving a heart-failure patient on the verge of death, the poison in fuzi is the wonder drug itself—the key to bringing the patient back.

“But no matter how they run the pharmacological tests, the toxins in fuzi are still very potent at that point. Modern medicine hasn’t shown that those toxins are useful in the emergency treatment of heart failure.[3]

“Dr. Li proved it long ago through his experience, but as long as modern medicine doesn’t recognize it, none of that counts. The authority to interpret Chinese herbal medicines doesn’t lie with Chinese medicine doctors.”

Evan’s brow tightened further.

“After that incident, you were fired,” Professor He continued. “That actually reduced the hospital’s responsibility considerably. After all, you were practicing outside the hospital. You weren’t on hospital premises, the patient hadn’t registered there, and the medicine hadn’t come from the hospital pharmacy. The hospital knew nothing about it.

“Once you were fired, things settled down for the hospital. Looking back now, perhaps being fired was a good thing. If you’d stayed, they would have had to test the medicine, and the result would most likely have been what I predicted.

“Then you really would have been finished. You might even have lost your license and been banned from practicing medicine for life. At least the hospital leaders did me the favor of keeping this out of your file, and you kept your license. Your record is clean now.”

Evan stared at the ground, dazed.

It took a long time before he gradually recovered. He turned his head.

A small source note: the NovelPhoenix site publishes this chapter for its author, while this version was reproduced without approval.

“Then… Ryan’s family…”

For a moment, Professor He was silent too.

“What happened to Ryan’s family?” Evan asked again.

Professor He frowned deeply and shook his head a little.

“They… ended up paying a substantial sum to settle privately. But word had spread, and their reputation suffered. Business fell off badly.”

Evan went pale. He had thought that, by being fired, he could take all the responsibility himself. He had wanted to bear the whole thing. He hadn’t expected the patient’s family to keep pursuing it. In the end, he had dragged Ryan’s family into it after all.

He looked stricken. Even his voice shook.

“I’ve hurt them…”

Professor He let out a long sigh.

“Evan, you didn’t do anything wrong. You’re a truly good doctor. It’s the world that’s wrong! If you practiced Western medicine instead of Chinese medicine, things might have gone much better. At least you might have had a chance to explain.

“Take digitalis drugs. They’re poisonous too, but they’re allowed to use them for heart failure. They’re also allowed to use drugs above the dose limits in emergencies. There’s no such provision for Chinese medicine. It’s as if nobody ever considered that Chinese medicine could treat serious and critical illnesses. This really isn’t your fault.”[4]

Evan noticed his hands were trembling. He slowly covered his face with them.

“But… Ryan’s family suffered because of me. I’ve wronged them…”

Professor He reached out and patted his shoulder.

“The clinic was badly affected, yes. But for the past six months, I’ve spent one of my days off there every week, seeing patients. Over those six months, business has picked up a great deal.”

“Professor…” Evan’s voice trembled again.

Professor He patted his shoulder once more.

“It’s all right. Ryan’s my student too. Neither of you did anything wrong. As your teacher, I’m glad I can do something to help.”

All his gratitude, all the words he wanted to say, lodged in Evan’s chest. He couldn’t make a sound.

“Evan, when I first arrived, I made a promise,” Professor He said. “If you could prove your medical skills were good now, I wouldn’t make you come to the provincial Chinese medicine hospital with me.

“Now I can see that your skills really are excellent. Far better than I expected. By rights, I shouldn’t force you to come back. But… this time I’m going to break my promise.”

Evan looked at him, stunned.

Professor He met his gaze.

“The better you become, the bolder you’ll get, and the more likely you are to run into trouble.

“You’d be much better off staying by my side, where I can keep an eye on you.

“The provincial Chinese medicine hospital is a Grade A tertiary hospital, after all. There are rules and procedures. You can’t simply do whatever you want. And if anything does happen, a large hospital can protect you. A little independent clinic like this is powerless.”[5]

Professor He spoke earnestly.

“Evan, you’re an excellent doctor. You could even be called the future hope of Chinese medicine. I truly don’t want to see you get into trouble. Still less do I want to see you ruined.

“So even if you don’t want to come, I have to do this. For my sake, Evan—I’m swallowing my pride and asking you: will you come back to the provincial Chinese medicine hospital with me?”

Reader Notes

Reader Notes

↩︎ Harassment and compensation claims. Yinao refers here to disruptive pressure or harassment surrounding medical care. Pengci, literally “touching porcelain,” describes deliberately contriving grounds for a claim. Professor He is warning about bad faith; these terms do not make every complaint or lawsuit fraudulent. For comparison, China’s Civil Code separately addresses medical fault, a patient’s failure to cooperate with appropriate treatment, and interference with medical work. The novel leaves its year unstated, so this comparison does not decide the hypothetical wife’s rights or the hospital’s liability. Sources: Supreme People’s Court — Guidance on contrived compensation claims, opening definition (in Chinese); Supreme People’s Court — Civil Code, articles 1218, 1224, and 1228 (in Chinese).↩︎ Medical assessment. The assessment discussed here concerns responsibility for medical treatment, rather than an examination Evan must pass to qualify as a doctor. China’s 2018 medical-dispute regulations distinguish findings about harm, fault, causation, and the degree of responsibility, and provide for relevant medical or forensic expertise. That offers a comparison for the term, not a ruling on Evan’s case. The professor’s predictions about testing, dismissal, licensing, and the hospital’s exposure remain his account; no assessment report or disciplinary decision is supplied in the story. Source: State Council — Medical Dispute Prevention and Handling Regulations, articles 34–36 (in Chinese).↩︎ Fuzi and decoction time. Fuzi is an aconite medicinal material. Processing the root before dispensing and decocting it afterward are different stages. Hong Kong’s health authority identifies excessive amounts, insufficient boiling, and improper processing among causes of aconite poisoning, and specifies preliminary, prolonged decoction for processed fuzi. This supports the importance of preparation, not a universal one-hour safety threshold. The dialogue’s “peak” concerns the breakdown of toxic substances, rather than a stated peak concentration. Neither that kinetic claim nor the claim that the poison itself rescues heart-failure patients is established by this source. Source: Hong Kong Department of Health — Aconite medicines: preparation and toxicity (in Chinese).↩︎ Digitalis and dosing. Digitalis medicines include cardiac glycosides such as digoxin; the dialogue does not name a particular drug or dose. Digoxin’s prescribing information includes heart failure among its indications and distinguishes an initial loading regimen from later maintenance dosing. It also emphasizes how close toxic concentrations are to therapeutic ones. A loading dose within a specified regimen is different from permission to exceed dose limits. Professor He’s broad contrast between Western and Chinese medicine is retained as his statement; the drug label does not establish the legal exception he describes. Source: DailyMed — Digoxin injection prescribing information, sections 1.1 and 2.1–2.3.↩︎ A Grade A tertiary hospital. Sanjia abbreviates “tertiary, Grade A”: a hospital’s institutional level and assessment grade, rather than a doctor’s personal rank. The National Health Commission’s 2022 assessment rules illustrate this distinction by setting different standards for grades within tertiary hospitals. They are cited as an example, without assigning that edition to the novel’s unspecified year. The professor’s argument is that a large institution offers supervision and support; the designation itself does not establish immunity from medical liability. Source: National Health Commission — Tertiary Hospital Assessment Rules, 2022, PDF p. 1 (in Chinese).