Appendix: by Wei li
Dad’s medical career
Dad didn’t have a chance to enter medical college, instead he went to a junior medical school. However, the achievements he has made in the past 40 years of medical practice are beyond the reach of most of his career peers from college.
The excellence in his amazing career depends on his being bold as well as meticulous, being diligent in practice and studying hard. I remember when we were young, we used to directly go to the operating room to look for our parents when we returned from school. Dad worked very long hours a day, and when he came home, he plunged into medical books preparing for the operations next day. It was rare for him to have time for a full rest. Over the years, Dad built his fame as surgery master. People seeking his medical treatment came in an endless stream. Even when the relatives of the surgical director of the hospital at the next higher level need surgery, he would send them to my father for the peace of mind.
Doctors were well respected, but they had a fixed salary, barely making the ends meet. In Mao’s time, wages and prices remained unchanged for decades. My dad’s monthly salary then was 46 yuan, and my mother 43 yuan, so our family income totaled 89 yuan, to maintain a family of six (us 3 children plus my grandmother) for basic food and clothing, it was difficult to have any savings for emergency. Most people lived a poor life in those days, so we never felt we also had a hard time then, although for every meal, the entire family only had one or two small dishes besides rice. Anyway, everyone was struggling, and there were still many people who did not have enough rice to feed the family. Some could only afford porridge or dried sweet potatoes. Dad’s problem is, where could he save the money for medical books he badly needed? Those big and thick professional books, such as Surgery and Osteology, are expensive, but they are must-have. Who would have thought that many medical books were actually bought by my father’s selling his blood without telling the family. 300cc at a time, the price then was 30 yuan (to save 30 yuan would otherwise take half a year with strict budget). Once, my mother was very angry when she found out my dad had donated blood for covering the cost of a book. Dad was very thin then, and Mom was worried that his blood donation would harm his health. But my father always argued that people have hematopoietic mechanism, and it’s okay to lose some blood. However, is there another way out? No matter how skilled you became, you simply had no way of making extra money. I remember that when the operation lasted long into late night, the subsidy for prolonged night work at that time was only 20 cents, or a bowl of free shredded pork noodles was provided (mom and dad would not consume the delicious noodles by themselves, but would always bring them home to feed us).
It is true that each era has its own way of life. However, it was still hardly imaginable that a medical doctor who enjoys a high reputation and well recognized medical skills could not afford his own medical books unless he exchanged them with his own blood. This kind of thing could only happen perhaps in the Mao’s China. It can’t be said that Dad didn’t catch up with good times. From the perspective of career pursuit and spiritual satisfaction, the specific conditions of that specific era gave Dad a rare platform for practicing his wisdom and skills to the fullest extent. The grass-root county hospital he served was like a blank sheet of paper for drawing, faced with a steady stream of endless rural patients who had always lacked medical care and facilities. These patients could not afford to be transferred for treatment in primary hospitals, so they had to try the county hospital at best, or quit any treatment leaving themselves to fate. Dad was one of the founding members of the county hospital. He had full autonomy and worked like crazy to cope with the endless incoming cases. For years, there were a series of operations almost non-stop every day. I knew a young doctor who was tired of practicing medicine because he could not see any career future limited in his rural clinic, and changed his career to become an English teacher after reentering a teachers’ college. However, when talking about my father’s medical skills, he was full of admiration: “Do you know your father is the greatest doctor in the world. Your father is able to perform major surgeries that are not commonly performed even in larger hospitals.” He explained to me some of the highly complex cases my dad has dealt with, which I did not fully understand, but I knew that for decades my father had been continuously challenging himself and mastering more and more complicated procedures. Recently, when I asked my father if there were any surgeries he wanted to perform but had not yet been able to, Dad told me that he had pretty much done everything that could be done in his practice, except for some types of operations that were out of reach, such as microsurgery and replantation of severed limbs, which require expensive equipment and facilities that a county hospital simply could not afford, there were no such conditions for pursuing these.
It is worth noticing that in many cases, even very poor farmers could also enjoy surgery services in grass-roots hospitals like the county hospital my father served. At that time, the fees for minor operations (e.g. appendectomy, etc.) were less than 10 yuan a surgery, those for medium-level operations (e.g. gastrectomy, etc.) cost tens of yuan, while those for major operations (e.g. surgeries involving heart, brain, etc.) were about a hundred yuan. Of course, it’s not easy to save enough money for such costs, but most people have come up with a way to manage that as emergency needs. For extremely poor households, there was a way to apply for government subsidies at the Civil Affairs Bureau. This part of the low-cost medical system with socialist subsidy policies in Mao’s time is worthy of praise. The fundamental reason for the low fees is, of course, the very limited basic cost for human resources: doctors and nurses were state employees, getting a modest fixed salary, with few extra expenses.
Speaking of surgery, I myself still have my father’s “magic work” on me. It was the time when I was about ten years old. One day, shortly after breakfast, I suddenly had a terrible stomachache. Dad came to check, pressed his hand on my right lower abdomen and asked if it hurt. I said, “It hurts”. He suddenly pulled his hand back, and I immediately felt a sharp pain, and could not help with tears out. Dad told me that this is called “rebound pain”, which is a typical symptom of acute appendicitis. He told me that I needed an immediate surgery and soon brought me to the operating room before noon. I had been used to seeing operations since I was a small child, knowing that appendectomy is a minor operation, and I should not be afraid of it at all. But when I was really sent to the operating table, I felt I should not be rushed to it. What if it was a mis-diagnosis? In that case , would I undergo an open operation for nothing? I felt just fine in the morning before breakfast. After drinking half a bowl of porridge, I suddenly had a strike of stomachache. I did not even have a blood test or other clinical tests. All diagnosis was based on my father’s checking my lower abdomen with hands, was that sufficient? I simply could not drive my suspicion away and was very reluctant to face the coming surgery. Of course, all these were my over-anxiety. My appendix extracted in the surgery was swollen like a carrot head. Because the operation was timely, it hadn’t festered yet. Many surgeons don’t operate on their loved ones for fear of being too nervous. But dad would not trust others, so he insisted on doing it himself, with my mother as his assistant. Usually, if conventional spinal anesthesia or epidural anesthesia were used, he could take his time, but dad insisted on using only local anesthesia for the sake of small postoperative response and fast recovery. So I was conscious of every process of the operation clearly. Most similar operations then often left a few inches of incision on the skin, but my father only gave me a small incision of one or two centimeters (only two stitches used after closing my abdomen), barely enough to insert a finger through. Moreover, unlike most incisions, Dad used crosscutting, which makes the operation more difficult to operate. Dad said that cross-cutting conforms to the natural lines of human abdomen, and the scar would not show up after healing (indeed, I have seen the scars of other vertical cutting operations, and they stand out there thick and red, long after healing, which looks really ugly. In contrast, mine was hardly noticeable). Of course, this operation was very successful. I went home the same day, and the next day I was able to get out of bed and slowly walk around. However, there was a real pain during the operation with only local anesthesia, and I cried and shouted, which put a lot of pressure on my father. The pain was most serious when Dad’s finger tried to get to the inflamed appendix, which hurt even if it was not touched, not to say being pressed. Fortunately, it didn’t hurt for a long time before my father caught it and quickly made up for some additional anesthetic. My father reflected the procedure later on, and said that despite all his efforts, the place where he cut the knife in was slightly off the target, which unfortunately made me suffer more pains. Local anesthesia should have been fine if the incision were enlarged, an easy way to go, but Dad insisted on making the incision as small as possible, and did not want me to leave a permanent big scar for life. Year later, I told my daughter this story, and she tried to spot my almost invisible surgery scar and exclaimed, “Grandpa did a terrific job! Grandpa’s craftsmanship is out of the world! ” From then on, when she had a stomachache, she often shouted, suspecting that she had appendicitis. I felt relieved when I found that there was no “rebound pain”. She also said that if she had appendicitis, she would fly back to Grandpa, because the doctors in the United States couldn’t be trusted: they had only operated a limited number of cases, and my grandpa had operated tens of thousands of surgeries in his life!
Dad often paid on-call visits to rural clinics and farmers’ homes (as director of obstetrics and gynecology, so did my mother). Many cases needed emergency surgeries on the spot, no matter what the conditions were, they had to be carried out to save lives. Many rural areas had no electricity, so flashlights were collected together over the an operating table. In the second year of the Cultural Revolution (1967), the two factions of grass roots organizations were divided into conflicting groups, often with friction, sometimes using fire arms. In the beginning, it was street fighting, using steel knives and the like, and at the later stage, they used real guns. Our county town became a war zone. The county hospital was in a semi-paralyzed state, and it was located in the area controlled by the group named “Sweeping the Black Line” (a more radical mass organization). Mom and Dad were closer to the less extreme group so-called royalists (“royalist” means opposing the struggle against veteran cadres), but they would not participate in their ideological and political activities. The commander-in-chief of this group used to be the uncle next door, tall and robust. In my memory, after serving as the commander, he often wore a wide belt around his waist, carrying a box gun, and staged to be very heroic. One day, he sent someone to our home, quietly inviting our whole family to the base camp of his faction as they urgently needed medical experts to treat the wounded in the warfare. When we were settled down, my father set up a wartime operating table in the camp, just like Bethune’s battlefield hospital, which also saved many lives.
In years of peace after that “civil war”, the white ambulance in the county hospital used to carry mom and dad often together with us children for on-call emergency visits, having run around every corner of the county. If the call was from a nearby village, the visit was also on foot or by bike. I still remember when I was six or seven years old, my whole family moved to Hewan, a remote small mountain town, to support a rural hospital for one year. Dad often rode his bike in the night for home visits and sometimes he took me with him on the bike. It was always so dark, often passing one or two cemeteries, with a cold wind blowing overhead. When we entered a village, there were always dogs barking one after another. I hid in my father’s arms in the front seat of the bike, too afraid to dare open my eyes. After treatment, under the dim oil lamp, the host often boiled two eggs with brown sugar, and served them steaming hot to entertain us for appreciation. Then, they would use flashlights to send us out of the village, and I was often fast asleep on the way back before we got home.
Dad has always hoped that we children study medicine and follow his footsteps. If nothing else, wouldn’t it be a pity that the shelves full of medical books accumulated over the years have no one to carry on? Unfortunately, none of us four children ended up following this path. My elder brother and I were the first college students after the Cultural Revolution (Class 1977). In that year before the entrance exam, following the wishes of our parents, we both placed “Anhui Medical College” as our second choice. As for the first choice, my brother took the initiative to apply for “Nanjing Aviation Institute”. At that time, I didn’t have my own opinion, so long as I would enter a first-class university to study the then popular physics. So I followed my father’s advice, set a popular physics major plasma as top choice for the top school “University of Science and Technology of China”. We were in an age when we were convinced that “good knowledge of maths and physics would carry us all over the world to achieve anything we want”. I don’t know what plasma was, but I always felt that only such an unfathomable major would be qualified to surpass my father’s career of medicine practice. As a result, my brother got his first wish honored and went to pursue his dream of aviation with satisfaction. But all my choices failed to bear fruits, and I was forcibly “assigned” to the English Department of Anqing Normal University. What a disappointment and shock to me! Although I didn’t do very well in the college entrance examination, I later learned that my scores had reached the standard set by “Anhui Medical College” and I should be qualified for my second choice. The bad thing is that I “added” foreign language in the test list in the hope for enhancing my college competition. But in the first college entrance examination after the Cultural Revolution, foreign languages were not a compulsory test item, nor were they included in the total score that determined their destiny. The reason was simple: although college had shut down for nearly ten years to have accumulated 10 times of candidates competing for colleges at the same time, many people never learned any foreign languages in school. If colleges insisted on testing foreign language as compulsory, more than half of the candidates would be excluded from the radar. So it was decided to be an elective test item. I myself would not have dared to take the English test if I hadn’t followed the English learning programs of Anhui and Jiangsu radio stations for many years. I had hoped that given the same conditions, my additional test on English would help me to be admitted first for my choices. Who would have thought that after the Cultural Revolution, there was a serious shortage of foreign language major candidates in the liberal arts, so some science and engineering students who took additional foreign language tests were simply transferred to the liberal arts pool. That is how foreign language which should simply be a tool for other specialization became my major subject. In those days, the popular mentality favored science majors. After being forced to enter the liberal arts foreign language department, I always felt that I had “strayed into the wrong side door”. With that, I decided to insist on further self-study of advanced mathematics and Linear Algebra for another two years after entering college, which unexpectedly laid a foundation for my future interdisciplinary development of arts and sciences in my master’s program computational linguistics. Looking back, I think it was fortunate that I didn’t get into medical school as I had hoped, otherwise there would only be one more mediocre doctor trained in the world. I do have some perseverance in studying, but I lack my father’s courage, ingenuity and boldness which are required to be an outstanding physician. I would not have been able to be even close to Dad. I have seen many admirable elders and newcomers in my life and career, but I always admire my father the most. He set up an example of excellence way beyond our reach.
Dad is now semi-retired at home, still living a very simple life, in an orderly and healthy way. Unlike most other old men around 70 years old, he still keeps a keen interest in new things, and is more familiar with computers than many young people. He enjoys a solid knowledge of professional English for many years, and his general vocabulary is comparable to that of myself whose major is English. The development of all of us children is his greatest comfort. The little stories of his grandchildren’s growth brings him great joy.
The previous work is a debriefing report written by my father ten years ago for applying for the promotion as chief physician. Between the lines of many medical terms and figures, many past events of Dad’s medical practice and life come back to my mind, as if it were yesterday.