How We Ought to Treat the Sick Among Us

There is an old Chinese saying: "Long at the sickbed, no filial son; long in poverty, no worthy wife." Lately, caring for my father, I have come to feel some truth in it.

My father has a mild tendency toward late-life depression, stubborn constipation, and coronary heart disease; he has always been short-tempered, so caring for him is no easy task.

For decades he has practiced a qigong system called Zhenqi Yunxing Fa (True Qi Circulation). When he came to stay with me he still believed this qigong could solve his constipation. Although I repeatedly told him that such qigong does little to promote intestinal peristalsis and would only worsen, not improve, his constipation, he obstinately believed in himself. Only after he practiced it and his recently eased constipation did indeed worsen again would he believe me.

I had him switch his exercise to slow jogging, though he had never jogged in his life. He has always believed that boxing and qigong build strength. Coming from a martial-arts family myself, I have watched my father and my fourth uncle practice martial arts and qigong their whole lives without ever achieving good health, so I do not recommend such unscientific ways of keeping fit.

No matter how busy I was, I insisted on taking him jogging to fix his constipation, and I insisted forcefully. A tiger grows old and fears the cat; a father grows old and fears his son. Perhaps he was a little afraid of my forcefulness, so he stopped being so stubborn. That was the most obedient period of his life I have ever seen.

Slow jogging, plus probiotics and more fruit and vegetables, improved his constipation a great deal. But he still has not formed a jogging habit; even when very busy I keep running with him in the park every day.

That my father has to fear my moods makes me deeply ashamed. But as a caregiver I have no better way to change a father who has been tough and stubborn his whole life.

Nor can I change the stubborn bad habits of many of my patients. At least a third of my lung-cancer patients keep smoking even as I treat them; quitting is harder for them than death. Several liver-cancer and cirrhosis patients, even while seeking treatment everywhere, stubbornly keep up a daily life of fine wine and rich food.

I once treated a patient with cirrhotic ascites; with great difficulty I brought the ascites under control, but she never skipped wine at any of her three daily meals, and it soon recurred. Her relatives said: Doctor, just go along with her; when she is unhappy and not drinking she feels even worse. Please think of another way with the medicine; let her not give up the wine.

Disease and bad habits are twin sisters: disease is hard to cure, bad habits are hard to change, and the human heart is harder still to change. It is also very hard for those around a patient to strike the right attitude and measure. But in general there are bottom lines that must not be crossed. I have met family who abandoned their relatives in hospital; though such people are few, it truly violates human ethics.

Most of the time, though, we are not that cruel to the sick. It is just that sometimes society's attitude toward patients is truly heartbreaking. Recently a suspected bipolar-disorder patient of Air China's became involved in a fierce altercation on a flight when he stopped a passenger who would not switch off his phone; the incident was then posted online by one rather brash passenger and blew up. Society at large gawked at this bipolar patient, and not a few jeered. To this day the online harassment against him continues.

Similar incidents are not rare. Last year an irritable mental-disorder patient on a high-speed train had a clash with others and was live-streamed, then subjected to online abuse by a crowd lacking even basic medical common sense.

I have seen some editorials crudely demanding that airlines and railway companies bar such patients from flying or taking trains; among these writers are not a few so-called big Vs and opinion leaders.

These writers, so eager to display their hot-blooded sense of justice, do not know that China has more than a hundred million potential mental-disorder patients. According to WHO figures, about a quarter of global health spending is on people with mental illness. Of the ten diseases causing the heaviest social burden, four are mental disorders.

Expand the circle again and we have many tuberculosis patients, hepatitis-B patients, STD patients, and cancer patients. By these gentlemen's satisfyingly simple methods, at least 30–40% of the population would be discriminated against and segregated. If that were really done, honestly, our public would be more extreme and dictatorial than Hitler.

Locking people up like this achieves nothing but provoking war and violence. Society itself is imperfect; many of our fellow citizens are ill or defective. We should exhaust every means to improve this, but the one measure we must not even consider is isolation and discrimination. Especially when these patients show no serious violent tendency, to wall them off at the drop of a hat would make for a truly terrifying society.

Improving the social environment benefits everyone. Who can guarantee he will never be ill? And who can escape aging? When these gentlemen themselves fall ill and the public treats them as they treat others, I wonder how sour, sweet, bitter, or hot it will taste.

Foucault, in Madness and Civilization, already gave a very thorough critique of this social phenomenon. Again and again humankind is ruthless: we build a "ship of fools" to cast out people we find unbearable, much as past leper colonies isolated lepers from the world.

A closer analogy: in backward regions of old, after some disaster struck, people would decide that a certain widow or other ill-fated person in the village was unlucky, and collectively burn her to sacrifice to the gods, begging their forgiveness.

Many people's self-righteous outcry is strikingly similar. In that age, those who burned the so-called unlucky ones were equally full of confidence that they represented justice.

People feel that medical staff treat patients poorly, yet when they themselves join in such online mobs, they are wholly unaware that they are behaving like a rioting crowd, besieging a patient who ought to be cared for. Their conduct is nastier beyond measure than that of the medical staff they criticize.

Few realize that such mobbing is an act of corruption, deliberate or not; most feel they are raising a just voice. This brutality laced with ignorance is chilling, because it shows that our society is barbaric rather than civilized; we see in it no light of friendship, tolerance, patience, or reason.

Caring for patients demands enormous patience. Even the filial son by a long sickbed eventually defects; a medically literate person like me, caring for his own father, sometimes grows impatient. The indifference of the public, who are not close to the patient, is understandable.

Moreover, many patients themselves have problems; quite a few have bad habits hard to shake and a certain aggressiveness—though by no means rising to the level of murder or arson.

I write a lot, and I am often abused by all sorts of readers and patients I have never met. Some call me an idiot, some a fraud, some a hypocrite; a few go so far as to curse my mother.

I have written online for twenty years and long since take this in my stride; I can understand that some people's behavior is nasty. Still, it has never reached the point where I would drag people out to make them a target for all and to suffer online mobbing.

None of us has it easy living on this earth; it is hard to say who is perfectly healthy. Asking one group to be tolerant and forbearing toward another may seem a grievance, but there must be a bottom line that sustains civilization. We cannot, as Pascal put it, prove ourselves normal by accusing our neighbors of being madmen and fools; such behavior is too base.

Society needs reason, tolerance, patience, and restraint in order to evolve into a more civilized state; only then can people have peace.

Each such collective event is a mirror. We should see our own shortcomings in it, reflect on where we fall short, and strive to improve.

I pray that all of us may learn as much as possible, help ourselves out of ignorance, and shed our own barbarism and rudeness.

I also pray that none of us, merely because we have a little money or social standing and can afford first class on a plane, will be swollen with superiority and flout the rules of society; or loudly broadcast to the world another's private fact of mental illness. Such conduct is pure nouveau-riche bluster.

Honestly, the day you yourself fall ill you are nothing but a poor creature wagging its tail for life. Being well today is just luck, not proof of superiority. No need to show off; some day misfortune will come, and the sick one will be yourself or your family. Rather than calling on others to understand you then, understand others more now.

In these people's conduct I see no trace of civilization or breeding; I see only restlessness and brutality. If the whole society is like this, then no matter how much material wealth we create, no matter how advanced our technology, no matter how rich our art, there will be no decency or dignity—only ignorance, hypocrisy, ugliness, and barbarism.