The Painful and Profound "I and the Temple of Earth"

I had long heard of the great fame of Shi Tiesheng's "I and the Temple of Earth (Wo yu Ditan)," but I had never read it. Recently, while buying books for my child, I bought his essay collection *I and the Temple of Earth*. I took the opportunity to read Shi Tiesheng's famous piece "I and the Temple of Earth." As I read, grief rose up in my heart beyond words; by the end, perhaps thinking of my own mother, who had once been tormented by illness just as Shi Tiesheng was, I could not help but burst into tears.

Although I too have suffered many misfortunes, I have never lost the ability to walk, and to this day I remain hale and vigorous. At the age of twenty-one, Shi Tiesheng was permanently paralyzed because of illness. After his paralysis, Shi Tiesheng's movement was greatly restricted, so he spent most of his time in the Temple of Earth Park. He spent many springs, summers, autumns, and winters there, contemplating life and writing his novels and articles.

His mother suffered terribly at the loss of her beloved son's legs; watching her child in pain, fearing he might take his own life, and yet unable to say anything, she could only watch over him silently. Each time he stayed in the Temple of Earth Park too long, his mother would go there to look for him, and on several occasions, not finding him, she would be utterly anxious. This loving mother lived only to the age of forty-nine before she too passed away from illness.

The life Shi Tiesheng experienced was utterly different from the life most people experience. What I face is precisely countless Shi Tieshengs—people whose fates have been rewritten by disease. Fate, to them, is cruel and merciless.

In another of his essays, "The Year I Was Twenty-One," Shi Tiesheng recounts his and his fellow patients' experiences hospitalized in the neurology ward of Friendship Hospital. These experiences are all too familiar to a doctor. Everything in the ward is, for us, our daily work and life. But for the patients, it is quite another matter. The suffering they endure after being stricken by disease is truly beyond words.

After reading Shi Tiesheng's "I and the Temple of Earth" and "The Year I Was Twenty-One," I suddenly felt ashamed. Reflecting on my own doings over these years, I asked myself: With what wish did I come to study medicine? Or what was it that inspired me to study medicine? In the course of studying and practicing medicine, have I forgotten my original intention? Is my care for patients a heartfelt love and compassion? What is my present motivation for studying and practicing medicine? Am I pressing on under the drive of fame and profit?

These questions left me feeling wretched. The cost of living in the capital is high, and the cost of educating a son is high. To say that there is no element of fame or profit at all in my present work would be dishonest. In the eyes of some patients, I might even count as a greedy physician. Many patients belong to that impoverished group Shi Tiesheng described, crushed day after day by exorbitant medical bills; I once vowed to provide them with warm, non-greedy medical care, but frankly, I have not done as well as I originally hoped.

Shi Tiesheng's writing makes me feel a little ashamed before my own conscience. The enormous, unproductive workload brought by steadily growing fame, the tedious and exhausting work, the pessimism and despair when I cannot solve a patient's problem—all these are distorting my original intention. I have also been impatient with patients, and have even turned away some patients whose conduct was improper; for these actions I repent from the bottom of my heart.

Disease tormented a twenty-one-year-old young man like Shi Tiesheng beyond endurance; he spent his bitter years in the Temple of Earth Park, again and again contemplating the question of death there, and in the depths of his depressed and somber soul, he asked himself what was the meaning of going on living.

I also take long walks in Purple Bamboo Park all year round, and have thought about the meaning of life while walking, but I have never experienced Shi Tiesheng's depressed and somber state of mind. He took the Temple of Earth Park as his spiritual home; I too take Purple Bamboo Park—or, more precisely, the National Library, separated from Purple Bamboo Park by only a wall—as my spiritual home; Purple Bamboo Park is in my heart merely a place for walking connected to the National Library.

Deep down I always feel that a doctor who does not commit his soul to the medical profession is shameful, and that in practicing medicine, considering first any question unrelated to saving lives and healing the wounded violates the professional ethics of a doctor; but I also inevitably consider those factors that might endanger the safety of me and my family. Especially every time I see news in society of a patient or a patient's family murdering a doctor, this worry is further reinforced. The whole society's general lack of understanding of the nature of medicine also makes me realize that those of us who study medicine bear a heavy social responsibility to popularize medical knowledge to the public.

Perhaps thinking that goes deep into the soul is always dangerous. Shi Tiesheng's thinking left him in agony; after reading his essays, my own soul-searching likewise left me embarrassed and in pain. More than twenty years ago, when I always thought and wrote with a compassionate feeling for suffering humanity, my teacher said to me: "Zhiyuan, do not think of yourself as a savior." Perhaps my teacher had already seen that, on many questions, I was too hard on myself. More than twenty years have passed, and I still, from time to time, prompted by certain things, cannot help thinking this way.

When, out of the needs of life, I have to charge patients a fee, I always feel a deep sense of guilt. These are people who truly need social assistance; I stand on the front line of this rescue, yet I cannot provide help to them free of charge. Morally speaking, the ultimate model of medical services in human society should be free. Among our own kind, there is a group of people who, tormented by disease, have already lost the ability to create wealth and at the same time face the threat to their lives; we healthy people should lend them a hand.

But the investment needed for the medical enterprise is enormous. Who will pay for the funds needed to develop medical services? Who will pay the research and development costs for new drugs? Who will pay the expensive costs of doctors' medical training? And who will pay for the living expenses and education of doctors' parents and children? Perhaps these questions can only be more perfectly resolved when human society develops into a more advanced state of civilization.

I once had the good fortune to know the daughter of a family friend of the renowned leader of China's medical community, Professor Lin Qiaozhi. She told me that for a time, because of social upheaval, everyone was in difficulty; yet Doctor Lin, contrary to her usual way, suddenly raised her consultation fees very high. Someone asked Doctor Lin why she did this—was she not making things hard for the patients? The lifelong compassionate Doctor Lin said that if she did not do this, all the patients would come to her, and those young doctors would have no livelihood; if they had no livelihood, the medical profession would have no successors. Disease is common, but a good doctor is not common; the medical profession having no successors would be an even greater humanitarian disaster.

In my family there was no lack of ancestors who practiced medicine free of charge, but their medical skills have all been lost. When I was a child, two great-uncles of mine had hoped to pass their skills on to the younger generation of nephews, but no one was willing to inherit. The reason was none other than that, in those days, being a doctor was a thankless task. They lived lives of noble integrity, practicing medicine free at night or in the slack farming season, and at other times they had to till the fields or run a small business to make a living like everyone else. One of my great-uncles supported his family by selling tofu while practicing medicine on the side. Neither of these two great-uncles lived to old age; both passed away early from overwork.

I still remember that great-uncle, who was skilled both in bone-setting and in acupuncture, always wearing a smile; every evening many people would come to his house carrying thermos flasks (filled with ginger-and-scallion water used for tuina and bone-setting) and queue up, waiting for him to set bones and heal injuries free of charge. Villagers near and far praised him without end, considering him a living Bodhisattva. No one ever thought to pay; no one realized that this great-uncle of mine also needed to feed his family.

He once intended to pass his medical skills to my father, but my father had neither the time nor the energy to study medicine with him in earnest, only occasionally going to lend him a hand. This great-uncle died before reaching sixty; the villagers knew full well that he had worked himself to death. He had four biological sons and many nephews who loved him, but not one was willing to inherit his medical skills, so his craft has been completely lost. If doctors have no security in life, this profession is, for them, an inhumane occupation.

Many people think that the loss of medical skills among Chinese doctors is because doctors are too conservative, but I, born into such a family, have personal experience and know that part of the reason for the loss of Chinese medical skills is economic. The medical careers of doctors who are too compassionate are unsustainable. My son studied medicine with me, but in the end chose mathematics as his lifelong goal; more or less, this was also part of the reason. Those who study medicine are ashamed to charge for medical services—I practiced medicine free for many years (back then I had other income); in recent years, because I am already too stretched and unable to do other part-time work, I have had to charge, but I do indeed carry a psychological burden when charging. At least someone who studies mathematics can find a position where they do not have to bear a psychological burden when receiving payment.

I do not want my students to imitate me; I hope they can calmly accept the reasonable compensation they deserve for their work, and keep their compassion within a limited range. Otherwise they, too, will, like me, feel deeply shaken and ashamed when reading an article like "I and the Temple of Earth."

I also hope that our society can develop further, becoming prosperous and civilized enough that people are willing to pool their strength to build a medical system that provides free rescue and care for all patients. By then, perhaps even if there are again people as tragically fated as Shi Tiesheng, the pain in their hearts will be much lighter!

I am also very grateful for the respect and gratitude toward medical staff that Mr. Shi Tiesheng expressed in his essay; although disease tormented him, he was still full of gratitude to the medical workers who helped him overcome the god of death. Although he also knew that his daily bed fee and treatment costs were deducted from his parents' wages, he expressed understanding of this. He was even deeply saddened by the early death from overwork of Doctor Tang, who had once treated him; Mr. Shi Tiesheng was a kind person.

I also feel helpless and regretful that this medical cause, which ought to be kinder and more beautiful, has to carry a nature that most doctors do not wish to see—one that adds to the financial burden of these tragically fated patients. Du Fu once made this appeal in poetry: "Would that I had a myriad broad mansions, to shelter all the poor scholars of the world with joyous faces!" I too hope that human civilization will soon advance to an era when it can "shelter all the patients of the world with joyous faces." Building such a beautiful society is the common responsibility of all members of society; no one can shirk the share of responsibility they owe in it. I hope that, through the joint efforts of us all, the future of human society can be better.