Chapter 110 A Doctor and the Pharmacopoeia

A tense consultation falls silent.

The room was utterly silent. Evan had stunned them all.

Even Professor He could find nothing to say for a long while. The young man beside him no longer seemed like the modest student he had known.

Evan was still young and had not been practicing long.

Only a few people in the room were younger than he was. Everyone else was older.

Several department heads were there—the Chinese medicine hospital's leading clinicians, people with real authority.

And then there was Professor He, a university professor and a provincial-level specialist.

Yet Evan alone had intimidated the entire room.

No one even dared speak.

Who could blame him for being angry? He could barely contain it.

A patient like this should never have been allowed to deteriorate so far. If someone had dared use strongly acrid, hot-natured medicines early on—to break the ice and thaw the cold, open the doors and drive out the thieves, draw the latent pathogenic factors out—he could have been cured when he first fell ill ten years ago.

Even after all that delay, large doses of wutou and fuzi when he entered the provincial hospital seven months ago could still have broken through that ice.^[1]

Why let it drag on until now, until he was critically ill and close to death?

The patient had been tormented beyond endurance.

His family was suffering just as terribly.

Wasn't that the doctors' responsibility?

Evan's anger spilled over. His face grim, he looked at them one by one. In the real world, he had little seniority. But his outlook had long since ceased to be that of an inexperienced young doctor.

Once his temper rose, he stopped worrying about the consequences. It wasn't as though he had never berated an expert to his face before.

“Don't imagine that critical illness has nothing to do with Chinese medicine,” he said, staring at them. “I'm telling you, it is our responsibility!

“When the doctors practicing Western medicine invite you to a consultation, don't think you're just there to go through the motions. You have to take responsibility. Chinese medicine has never lagged behind in treating acute, critical illness.

“If you won't shoulder that responsibility, patients will lie in bed waiting to die. If you won't shoulder it, people will keep dismissing Chinese medicine as slow to work, fit for nothing but keeping people healthy!

“If you won't shoulder it, all the experience in emergency treatment that generations of great physicians struggled to accumulate will be wasted. If you won't shoulder it, Chinese medicine will go on barely clinging to life!”

He gave them a thorough dressing-down.

The room remained fearfully silent.

Marcus and the patient's wife stared at the young doctor, dazed. He was so young and had so little seniority, yet his rebuke frightened them so deeply that, for the moment, no one dared argue with him.

Even Professor He felt uneasy. He suddenly remembered a Chinese medicine conference he had attended years before. An old physician there had berated his colleagues in exactly this way.

He had accused today's practitioners of caring only about protecting themselves, prescribing cautiously and being content with a reputation for slow-acting medicine. They had surrendered the entire field of acute and critical illness and become mere adjuncts to Western medicine.

“This is a terrible disgrace to three generations of Chinese medicine practitioners—old, middle-aged, and young!” the old doctor had thundered at the conference.

Yes. That old doctor's name was Li Ke.^[2]

Looking at Evan, Professor He could almost see that physician's figure superimposed on him.

The same tone of voice.

The same look in his eyes.

The same anger.

…

After a long silence, a timid voice came from the group. “Are you sure nothing will go wrong?”

“Once the medicine is ready, I'll drink it first,” Evan said, his face expressionless.

Everyone was startled.

Professor He was astonished too.

No one had anything to say.

“That wouldn't be right,” the patient's wife said. “Write the prescription, prepare the medicine, and give it straight to him.”

“Ma'am, you…” Marcus was taken aback.^[3]

“Qingyan, you…” Leo didn't know what to say either.

The patient's wife raised her head and looked at Evan. “I agree to use your prescription,” she said calmly.

“Ma'am, please think this through,” Marcus urged.

A trace of despair appeared on her numb face. “Do I have any other choice?”

Their hearts grew heavier still.

Evan looked at her and solemnly promised, “Please don't worry. I'll do everything I can.”

This reproduction traces to , where the author publishes the chapter, but it was copied without consent.

“Evan!” Professor He snapped again. “With an illness this serious, nobody can guarantee a cure, whether they practice Chinese medicine or Western medicine. If you fail, the pharmacopoeia is the law. You'll be held responsible! Have you forgotten the five million yuan Yong'antang had to pay in compensation?”^[4]

Every Chinese medicine practitioner's expression darkened.

Even Evan froze. He really had forgotten. It had happened only a few years before. He had remembered it clearly before going back to study under his mentors, but he had spent so long inside the system that it had slipped from his mind.

For a moment, he was at a loss.

The other practitioners sighed. After that case, everyone in Chinese medicine had feared for themselves. What did it matter how effective Zhongjing's classical formulas were? What did it matter that they had been used for a thousand years and saved countless lives? Who the hell still dared prescribe above the doses in the pharmacopoeia?

Professor He frowned deeply and knocked his fist against the desk. “Evan, you mustn't be reckless,” he urged earnestly.

Evan lowered his head. Memories flashed before his eyes…

After a little while, he looked up at Professor He, smiling at the memories.

“Professor, the truth is… I've been through a great deal lately.

“I've studied with many older physicians of Chinese medicine. But I learned more than how to treat illness and save lives. I learned what it means to give yourself entirely to saving a patient, without regard for your own reputation or what you stand to gain or lose.

“Perhaps everyone thinks I didn't have to insist on saving that patient who was dying of heart failure. I could have given him some Suxiao Jiuxin Wan pills and done my duty as a doctor, without ruining my whole career. But, Professor, I've never regretted it.”^[5]

Professor He was stunned.

Evan gave his teacher an easy smile. “Perhaps I'm still a fool. Everyone may think Chinese medicine should stick to chronic illness and keeping people healthy. But I really can't watch a patient lying in front of me without doing everything I can to save him. I can do more.

“After all… I'm a doctor.”

Every Chinese medicine practitioner in the room was moved.

Marcus stared at Evan too.

The patient's wife looked at him differently now.

Even Professor He could not speak for a long while. He sighed, then gave a rueful smile. More than six months had passed. Despite such a devastating setback, Evan was still Evan.

But Dr. Shi, the head of the ICU, frowned. “We can't give a patient a decoction that exceeds the specified doses. If something goes wrong, it isn't you who'll have to answer for it. It's our hospital.”

“I can sign a liability waiver,” the patient's wife said.

Evan looked at her in surprise.

Dr. Shi was taken aback too.

She looked at Evan and spoke slowly. “I'm not an unreasonable person. We're not the sort of family that harasses doctors or makes a scene at the hospital. I don't know whether you really can cure him. But I can feel your sincerity and your integrity as a doctor, and that's enough. Whatever happens, we'll only be grateful.”^[6]

She rose from her chair and bowed to Evan.

That bow moved him deeply.

It moved every doctor there even more.

Reader Notes

1. ↩︎ Warming medicines and latent pathogenic factors. “Acrid” and “hot” describe properties in Chinese medicine, rather than the temperature of the drink. Wutou and fuzi are related aconite medicines; their names do not identify one interchangeable material. The ice and thieves are treatment metaphors. “Latent pathogenic factors” refers to a harmful influence understood within traditional theory as remaining hidden in the body and causing illness later, not necessarily an identified microorganism. The claims that earlier treatment would have cured this patient belong to Evan's reasoning. These metaphors do not establish the safety of aconite medicines, which contain toxic alkaloids. Sources: WHO — International Standard Terminologies on Traditional Chinese Medicine, entries 367 and 2639–2643; Hong Kong Department of Health — Aconitum Alkaloids (in Chinese).
2. ↩︎ Li Ke. Li Ke was a real physician of Chinese medicine associated with the use of classical formulas in acute and critical illness. His work and teaching have been discussed earlier in the novel. Here, Professor He remembers a conference speech and recognizes the same anger in Evan. The university source describes Li's teaching legacy and clinical interests; it does not supply a verified transcript of this particular speech. Source: Guangzhou University of Chinese Medicine — Li Ke Memorial Meeting (in Chinese).
3. ↩︎ A familiar form of respect. Marcus uses saozi, literally “elder brother's wife,” which can also respectfully address a friend's wife. “Ma'am” conveys respect here without telling an English reader that she is married to Marcus's brother. She is the patient's wife; the address does not change that relationship. Leo, Marcus's older brother, calls her Qingyan, the same name used earlier in this consultation. Source: Ministry of Education — Saozi, Revised Mandarin Chinese Dictionary (in Chinese).
4. ↩︎ Dose standards and liability. The pharmacopoeia is the drug-standard reference invoked in this argument; no edition is named. “The pharmacopoeia is the law” expresses Professor He's warning, rather than establishing an automatic legal outcome. China's 2007 prescription rules address exceptional use above usual labeled doses, requiring a reason and another signature; that alone does not establish that this proposed treatment is permissible. The five-million-yuan Yong'antang payment is preserved as the story reports it. A matching court judgment and its grounds have not been verified for this edition. Source: National Health Commission — Prescription Management Measures, Article 6(9), p. 4 (PDF, in Chinese).
5. ↩︎ Medical ethics and the named pills. Evan's account of learning to rescue patients without regard to personal gain recalls the ethical language of Sun Simiao's Dayi Jingcheng, “The Sincerity and Skill of the Great Physician.” This is an ethical ideal, not a guarantee that a treatment will work. Suxiao Jiuxin Wan is a named Chinese patent medicine in pill form, discussed earlier in the novel; it is distinct from an aconite decoction. Evan is referring to an earlier heart-failure emergency and his damaged career, not treating or giving pills to the present patient. Sources: Sun Simiao — Beiji Qianjin Yaofang, Book 1, Dayi Jingcheng (Chinese transcription); Jinyao Darentang — Suxiao Jiuxin Wan History (in Chinese).
6. ↩︎ A waiver and a family's promise. She offers to waive liability; the chapter does not show an agreement being signed or the hospital accepting it. That offer is distinct from consent to treatment and does not establish that the hospital can be freed of responsibility. As a modern legal comparison, China's Civil Code distinguishes consent and medical liability and invalidates contractual exclusions for personal injury (Articles 506, 1218–1219). The story supplies no exact year. Her reference to making trouble translates yinao, disruptive hospital conflict or harassment, without equating every patient complaint with misconduct. Sources: Supreme People's Court — Civil Code of the People's Republic of China (in Chinese); National Health Commission — Maintaining Order in Medical Institutions, sections 2–3 (in Chinese).