Dr. Xu: A Chinese Medicine Novel
Chapter 124 Checking the Answers on the Spot
Alex has plenty to say about other people's medical advice.
“I don't know whether they're real doctors,” Clara said. “I've never seen any of them treat a patient.
“They spend all day posting myth-busting videos and putting Chinese medicine down to make themselves look good. I had a look. They sell all kinds of merchandise. They've even made a calendar out of their myth-busting tips—one for every day—and sell it online. They have an online medical discussion platform too.”
Evan's frown deepened.
Alex put it more bluntly. “So they make money by attacking Chinese medicine, getting attention, and building a following?”
Clara nodded. “Exactly. I've been doing online publicity for a while now. Most people who attack Chinese medicine don't know anything about it. Some of the others do it to get traffic and attention.”
“Fine, chase your traffic,” Alex said indignantly. “Take shots at Chinese medicine, even. But you can't go spreading health advice like that, telling women they can eat whatever cold foods they like during their periods.
“Shit, where's their company? I'll go there, find a few women whose period pain comes from cold congealing, and have them eat as much crab, persimmon, and other cold food as they can. Let's see whether they're doubled over in agony! Hey, could we go there and show them up?”[1]
Clara glanced cautiously at Evan. That was it. Alex was definitely going to get yelled at.
Alex noticed her look and turned to see what she was looking at. “What's wrong?”
He found Evan staring at him, his face dark.
Alex drew in a small, sharp breath. He was getting nervous. “Wh… what's wrong, Dr… Dr. Xu?”
Evan's expression was stern. “If you ever joke about treating patients again, you can stop coming here to learn medicine from me!”
Clara shook her head. He'd walked straight into it again.
Alex was mortified, his expression strained. “Dr. Xu… that's not what I meant. I wasn't saying we should deliberately leave them ill and make them worse by feeding them those things.
“It's just… they insist on talking nonsense and misleading people. Besides, you can do a medical experiment that way. You need a comparison.”
Evan stared at him, delivering the reprimand word by word. “Treating patients is one thing. An experiment is another! How can a doctor have no respect for the responsibility he carries? Treating illness and saving lives are a doctor's duty. How can you let your own anger and resentment make you careless with patients?”[2]
Alex could hardly have been more embarrassed. He'd only got carried away and blurted it out, and now he was getting this lecture!
Clara shook her head helplessly. Evan had always taken treating patients and saving lives this seriously. Show the slightest carelessness in front of him, and he'd scold you mercilessly.
She changed the subject. “Besides, they've already got two trending search topics: ‘Dr. Cinnamon Debunks Incompatible Foods’ and ‘Kicked Out of the Family Group Chat for Sharing Dr. Cinnamon's Article Debunking Incompatible Foods.’
“The second one has reached number two. They're gaining followers fast, and that video's getting plenty of views. Evan, should we respond?”
Beep… Respond to those mistaken views with accurate knowledge of Chinese medicine to receive a reward.
Evan paused. This system really wasn't very smart. It worked when it felt like it. He'd almost forgotten the thing existed.
“Of course we'll respond,” he told Clara.
“They've got nearly forty million followers across all their platforms,” she said. “And they're riding high right now. Number two in trending searches. Plenty of major accounts have shared it.”
“We didn't start doing online publicity to chase fame and money,” Evan said. “Or to manufacture hype, pull publicity stunts, and sell people anxiety. We did it to pass on accurate knowledge, so more people could learn about Chinese medicine and understand it.
“He's not just smearing Chinese medicine. He's misleading a great many people. The more attention he gets, the more people he misleads, and the greater our responsibility to tell them what's right. How can we be afraid to offend him just because he has more followers? That was never what we set out to do.”
Clara nodded. “All right. I'll start writing the article.”
Evan gave a slight nod, then glanced at the embarrassed Alex. “Come on. Let's go downstairs.”
“Yes.” Alex answered glumly, his head lowered, and followed him down.
This copy was made from a NovelPhoenix chapter without permission; the author's published version helps sustain the writer.
Clara stayed home to look after her father and boil his herbal medicine, while working on her article against the clock. She was going to war with a major account.
Evan took Alex downstairs to Mingxin Clinic and began seeing patients.
Evan sat in his usual place. Alex stood obediently beside him, taking careful notes.
Evan took teaching his students as seriously as treating his patients. He knew Alex had the basics, so there was no need to start from the beginning. After examining a patient's pulse and tongue, he kept the findings to himself and wrote them down, along with his analysis of the underlying pathomechanism.[3]
Once Evan had written the prescription and sent the patient to collect the medicine, Alex used the interval to ask the patient to let him make his own assessment.
Alex wrote down his diagnosis too, then compared it with Evan's to see whether he'd identified the pattern correctly.
Evan had required him to do this, partly to develop his skills in the four diagnostic methods. He also wanted to use the test to see which areas Alex was weak in, so he could target his teaching later.
Mingxin was a small private clinic, devoted entirely to Chinese medicine. Every diagnosis relied on the combined findings of the four diagnostic methods. Although Alex was a doctor of Chinese medicine, at the hospital he often sent patients for tests and consulted those Western medical test results too.
With all of that taken away, he felt immense pressure. Sweat appeared on his forehead. What if he got the pattern wrong?
Evan left him to it. Mingxin was doing quite well now, with patients arriving one after another.
For a doctor, it all came down to results. Word spread. If your treatments worked, people would keep coming to you for help.
Not much time had passed in the present-day world, but Mingxin had gone from almost deserted to bustling, with patients often lining up. Before long, they might have to follow the hospitals' example and have people register in advance, then call them in by number.
Alex didn't dare dawdle. He had to make his assessments as quickly as he could.
The more patients he examined, the closer he came to breaking out in a cold sweat.
There was an old saying in medicine: after three years of studying medicine, you think there is no illness you cannot cure; after three years of practicing, you begin to believe there is no prescription you can use.
Once you actually started seeing patients, you discovered how lost you could be. Patients didn't get ill according to the textbook. Identifying their patterns correctly was difficult, and the medicines you chose were often inappropriate.
That was why Alex often referred to Western medical diagnoses and test reports. Plenty of other doctors of Chinese medicine did the same. It wasn't necessarily that they treated people according to the reports. Without the reports, they simply didn't feel sure of themselves.
After all, those results were objective; his own judgment was subjective. Chinese medicine textbooks at the universities listed corresponding Western medical diagnoses and test findings for every Chinese medicine disease category. In clinical practice, senior doctors taught students to identify patterns that way too.[4]
Now he had none of that. Only the methods of Chinese medicine.
His nerves reminded him of a math final he'd taken years ago, when his calculator had suddenly broken and he had to do everything by hand.
He felt just as anxious and uncertain now.
No. More anxious.
At least after a final exam, you had a few days before you got your grade. Treating patients in the hospital was much the same: they had to take the medicine, and you had to wait a few days to see whether it worked, whether you'd been right. Here, they checked the answers on the spot. The grade came out on the spot too.
“Alex, come here.” Evan had called him over again.
Reader Notes
Reader Notes
- ↩︎ A cold-congealing pattern. Alex is continuing the preceding chapter's traditional explanation of menstrual pain. “Cold” here includes a Chinese medicine classification of foods and a proposed pattern of illness, rather than simply their measured temperature. The WHO terminology describes cold congealing with blood stasis as a pattern that may include pain relieved by warmth. That definition does not establish how particular women would respond to eating crab or persimmons. Alex's line expresses an angry proposal. Source: WHO — TCM terminology, entry 1030.
- ↩︎ Care and research. Alex invokes a comparison to defend an angry suggestion. The distinction Evan insists on is ethical as well as practical: caring for a patient and conducting a study are different responsibilities. The World Medical Association's Declaration of Helsinki requires a scientifically justified research design, assessment and reduction of risks, independent ethics review, and informed consent. Calling an activity an experiment, or including a comparison, does not supply those protections. This note provides external ethical background; Evan does not cite the declaration. Source: World Medical Association — Declaration of Helsinki, research risks, protocols, review, and consent.
- ↩︎ Findings, patterns, and the four methods. Chinese medicine traditionally gathers information through inspection, listening and smelling, inquiry, and palpation, which includes feeling the pulse. Tongue observation belongs to inspection. “Pattern differentiation” means interpreting the collected findings within that traditional framework. A “pathomechanism” is its account of how an illness develops. Here Evan keeps his findings and reasoning to himself for the teaching exercise. The passage supplies no individual patient's findings or final diagnosis. Sources: Hong Kong Department of Health — Diagnostic Methods and Features of Chinese Medicine Practitioners; WHO — TCM terminology, entries 364, 550, and 552.
- ↩︎ Diagnostic classifications and test reports. A traditional disease name, a Chinese medicine pattern, and a biomedical diagnosis are distinct kinds of classification. Hong Kong's Health Bureau describes traditional assessment and also arrangements for consultation with Western doctors, including laboratory and imaging investigations when clinically indicated. The novel describes Alex's training and his dependence on those reports. Its contrast between objective tests and subjective judgment does not establish that every test is conclusive, or independently validate either doctor's written answer in this teaching exercise. Sources: WHO — TCM terminology, entries 546–554; Hong Kong Health Bureau — Consultation and diagnosis.
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