The 'Masters' Manufactured by Consumption
Recent news reports about various "masters" have set me thinking: what is the deep reason for their existence? The exposed masters have almost all been concentrated in traditional Chinese culture—Chinese medicine, qigong, even fortune-telling—areas in which I myself am now quite interested. Taking others as a mirror shows one's own gains and losses; reflecting deeply on others' successes and failures can educate oneself.
China has always produced "masters." Yu Ji, recorded in Romance of the Three Kingdoms as killed by Sun Ce, and the founders of the countless large and small sects that have surged through the dynasties, all originally beguiled the masses with healing and fortune-telling, becoming revered "masters."
Wandering charlatans have always been looked down on, yet there has never been a shortage of them. Among magicians and soothsayers the fish and dragons are mixed: some were China's earliest natural scientists, but more were probably swindlers. Hence among the nine callings, the magician was placed in the lowest tier and held in little esteem. Medicine, shamanism, and fraud are tangled together and very hard to distinguish.
Without a market there are no masters. The appearance of a master presupposes a market that consumes masters. Take the qigong masters who surged in China in recent decades: they became famous only after being fawned on by senior officials and military generals. Most masters began as nobodies; as nobodies they would never have imagined that one day they would become masters. But chance opportunities brought them to light, and then by fate they met their "patrons," and so, naturally enough, they became dazzling masters.
Birth, old age, illness, and death are the four sufferings the human body must endure; the Creator is fair in this. Few escape them; rich or poor, none is exempt. A stubborn illness wears down a person's will to the greatest degree; once ill, the well-to-do panic more than the destitute. Because the wealthy have means, they seek doctors everywhere, and when regular medicine fails they mostly pin their hopes on miraculous masters.
The demand for masters thus arises from human nature itself. To put it bluntly, people need masters as a lustful man needs a prostitute under the torture of desire—both are driven by natural appetite. Relatively speaking, those driven into despair by stubborn illness crave masters even more than the client craves the prostitute, because sexual desire is a passing urge that can be suppressed, while the terminal patient's longing to live cannot be laid aside so lightly.
The path of the master is highly dangerous. Whether or not he has power over life and death, patients want to believe he holds the keys; failure to rescue easily breeds resentment in the family. Not only was Yu Ji, the heretical magician, beheaded; even Hua Tuo, hailed by later ages as a divine physician, was beheaded. Chunyu Yi, ranked with Hua Tuo and Bian Que, was also nearly killed by the powerful because his skill was great yet he would not run in and out of the mansions of the influential to serve them. Had his daughter Tiying not petitioned the throne to die in his place, finally moving Emperor Wen of Han to pardon him, Cang Gong would hardly have escaped death. "Tiying rescuing her father" became one of China's most moving idioms; behind it lies a physician's hair-raising life.
I often face patients and families directly; after seeing some severe cases I tell them plainly that they cannot be saved. But these patients and families believe in my skill even more than I do; they fantasize that I will succeed. Their longing for a miracle is understandable but not rational. The psychology of patients and families is most fragile; at such a time, a little draught of flattery is enough to make the family willing to give everything. Patients and families are only too ready to believe that divine doctors and masters exist in this world. Rather than being produced, the divine doctors are expected into being.
Recently the son of a patient often tells me, you TCM people must know very well that curing cancer is only one layer of paper away; that paper is about to be punctured, and cancer will be conquered. I understand this fellow's longing for a miracle, but his reasoning makes me laugh and cry. Through the dynasties, how many clever and talented people have struggled on this road for a lifetime and ended with nothing; to this day the successful are few, and those who have succeeded consistently are none at all.
Without such eager, irrational expectations, where would be the market for divine doctors? Precisely because of this consumer demand, one miracle doctor after another appears out of nowhere. Although in the end every one of them comes to a bad end, the next batch of new miracle doctors is already thriving—crowds are good at selective forgetting, and the market is always there.
The fate of these masters puts me on high alert. When I decided to sign the formal apprenticeship-in-heritage agreement promulgated by the Ministry of Health, through a former teacher I found a master willing to take me as a disciple so that I could lawfully sit for the medical licensing exam. On the very first day my master told me: in practice, be vigilant about risk at every moment.
Before that I had been seeking masters around Beijing. When I wished to become a disciple of an old TCM doctor, he asked what I wanted to learn. I answered that I wanted to learn to treat cancer in order to save my own mother. That answer led directly to rejection, for no other reason than that the master said he himself did not know how, and so had nothing to teach.
For someone who studies medicine and enters the field of terminal disease, the greatest risk is being unable to master his own heart. If you cannot steer yourself, one slip and you become a watered-down "divine doctor." In the short term you may win fame and fortune; in the long term your life may become a tragedy. Facing patients' expectations, facing the lure of fame and gain, even facing the moment when the patients you treat begin to deify you—can we remain clear-headed, and rein in runaway vanity?
After so many years of study, my long-term outcomes remain to be seen, but my short-term results do have something exceptional: there are often moments when one or two doses bring the dying back, which excites patients and families enormously. Sometimes they spontaneously promote me; at first I myself was excited too. But now I constantly restrain these patients and families, forbidding any promotion. Whom God would destroy, he first makes mad. The fanatical adulation and superstition thus unleashed are enough to ruin a physician.
Short-term effect and long-term effect are entirely different things. Hua Tuo once said, "Your servant can make them rise, but cannot make them live again." A physician's embarrassment is that when a patient is at death's door, he can sometimes give a near-terminal-rebound effect yet cannot finally save the life. But that rebound effect is enough to fill patients and families with hope, and on that hope they trust the doctor boundlessly. Survival is human instinct; driven by it, human irrationality is magnified without limit. Such moments are truly the most dangerous pass for the clinician. If one cannot overcome oneself, one is sure to seize the chance to rake in profits, damaging hidden virtue and sowing endless future trouble.
In this world there simply is no doctor who never makes a mistake; however careful, every physician will inevitably make medication errors in a lifetime. The Drug King Sun Simiao frankly admitted countless patients died under his treatment. How many reach Sun Simiao's level? A so-called divine doctor, through over-promotion, raises patients' and families' expectations too high; a few mistakes in a lifetime and trouble is likely immense.
To grow into a great physician of a generation, a medical student must weather countless storms; the greatest storm comes from within. In an age of rampant materialism, whether we have the reason to steer our own hearts, whether we can soberly maintain basic honesty and conscience, whether we can overcome the evil desires in our own hearts—all directly determine our life choices.
The Drug King Sun Simiao said: "(The physician) must also range widely among the classics. Why? If he does not read the Five Classics, he will not know the way of benevolence and righteousness; if he does not read the Three Histories, he will not know the affairs of past and present; if he does not read the masters, he will not, on encountering events, comprehend them in silence; if he does not read the Buddhist canon, he will not know the virtue of compassion, joy, and giving; if he does not read Zhuangzi and Laozi, he will not embody nature and accord with fate, and inauspicious restraints will arise at every step; as for the waxing and waning of the five phases and the astronomy of the seven luminaries, all must be probed deeply. If he can study all these, he will be unobstructed in the Way of medicine and attain the utmost excellence."
Broad learning and careful reflection governed Sun Simiao's whole life. He wrote of himself that "in the years of his green collar (youth) he honored these classics, and in the white-haired years never let the volumes leave his hands"—truly growing old in study, never unrolling a book all his life. Precisely because he was so broadly learned and upheld through his life the principle of the great physician's sincerity, he not only enjoyed a long life of over a hundred years, dying in peace, but also left medical writings that have benefited the people and endure forever.
In the works that famous physicians of the dynasties wrote in their declining years, they all stress that studying and practicing medicine must be guided by a principle far from utility; otherwise trouble is endless. If one would study medicine, one must first understand human hearts, be versed in the ways of the world, and transcend oneself; otherwise the Way of medicine can itself bury one without a grave.
Seeing the worthy, strive to equal him; seeing the unworthy, examine oneself inwardly. Others' today may be my tomorrow. With reason and caution, maintaining at every hour the self-reliance and preventive vigilance urged in the Book of Changes—"in the morning as vigorous, in the evening as wary"—not seeking blessings but seeking to avoid calamity, one may perhaps live a life in peace.