Pursue Simplicity, Keep Reason

Pursue simplicity, and keep reason.

— Alfred North Whitehead, British mathematician and philosopher

The biologist Hermann Muller said: "If you regard 'academic life' as a way of escaping reality, then do not study biology. Through this discipline, human beings can approach the mystery of life." The reason Hermann Muller said this was that he had witnessed a group of politicians (including Hitler) using biology's eugenics theories as a pretext for racial cleansing; the cruel reality made him realize that science, too, could be so dirty.

Replace "biology" in Hermann Muller's words with "medicine," and it still holds true. Having practiced in the medical profession for many years, I am no longer the brash young man I once was. I constantly use Whitehead's eight-character maxim—"pursue simplicity, keep reason"—to remind myself to stay clear-headed.

We should strive to be simple people, but always keep reason, keep a clear head, and not be lulled by slogans—slogans like "the healer's benevolent heart" and "benevolent heart and benevolent skill" can easily become a pretext for some people to morally coerce us. Some people endlessly take up doctors' time, paying not a cent, using only such slogans as payment; but if something goes wrong, they immediately hold the doctor responsible. The world is far more complex than the "simplicity" we pursue; if we wallow in the vanity of being praised and cannot extricate ourselves, then one small slip and we will take a great fall.

The world is like a kaleidoscope; at any time we must recognize that the ideal that all sentient beings are equal is a fine one, and we should firmly uphold it and adhere to the principle of the equality of all beings, not discriminating against anyone. But treating all sentient beings exactly the same is quite wrong; people differ too greatly from one another. Equal treatment and a great unified world may be looked forward to as a future ideal, but in reality we should treat different people in different ways according to their characteristics.

For example, we cannot treat a murderer in the same way and let him kill and set fires; nor can we treat Hitler in the same way and let him enslave and slaughter innocent people. Likewise, we need to keep our eyes open and be cautious toward those who may bring us danger.

I believe most doctors can understand these words of mine, because at work we need to deal with all sorts of people. Some people do not trust us from the bottom of their hearts; they think they have hidden this distrust well, but to a senior doctor, just hearing a patient and the patient's family speak a few words is enough for us to see through the degree of the patient's trust in us. There are others who have a deeply entrenched hatred of medical staff; if we are sufficiently sharp, we can catch this attitude in their every gesture. Regarding such patients and families, one of my teachers gave me a piece of advice: see them politely to the door, decline to see them again; next time you meet, be on high alert.

I am very grateful to this teacher of mine. When I studied medicine under her, I did not quite agree with this advice; I held the ideal of treating everyone equally and thought I should strive to communicate well with every patient. But in practice I realized that my teacher, after all, had practiced medicine her whole life and was far more experienced than I. I myself was somewhat utopian, and this advice of hers could help me avoid a great deal of trouble.

Nowadays there are often news reports of doctors being assaulted; I sometimes wonder, why do those doctors fail to recognize these problems and risks in their profession? Why can they not avoid these risks? Perhaps many helpless rules and beliefs stand in the way of their becoming medical workers who "pursue simplicity and keep reason," but we cannot rule out that some doctors are indeed not sharp enough.

When a patient repeatedly breaks trust, or when the patient's words show little respect or trust for medical workers, or even rude and unmannerly behavior, we should become alert, realizing that they may be among that 15% of difficult patients in the medical profession (according to statistics from some institutions in the United States, difficult, unreasonable patients encountered by medical workers in real clinical work account for about 15%; over 90% of doctors have been attacked or threatened at work, and these attacks and threats come almost entirely from this 15% of difficult patients). Be on guard against them and protect ourselves. Rational precaution is not the same as discriminating against patients; preventing medical disputes should be treated as a technical rather than a moral problem.

The real world is imperfect, even torn; even a society that looks very harmonious has undercurrents. If we do not realize this, it shows that our minds are not yet mature enough. I used to be a perfectionist, but medical work shattered my perfectionist complex. There is no perfect medicine in the world; medicine inherently carries many uncertainties. We cannot make definite promises to patients; in fact we cannot predict what outcome the treatment we give a patient will produce. So medical workers must always have a risk awareness. If the string of risk control goes slack, trouble will follow.

I once had a deep conversation at the dinner table with an elderly Chinese-American doctor who had practiced in the United States for many years. He said that in his whole career, his rate of doctor-patient disputes and medical accidents was zero. This was because his family had practiced medicine for generations; from childhood, in the family education he absorbed by osmosis, he learned caution and reason. So although throughout his life he advocated a simple style in dealing with people and things, he also always kept reason. He said to us: we who study medicine always talk about how preventing disease is more important than treating disease; in fact we ourselves must also realize that preventing doctor-patient disputes and medical accidents is more important than handling them. If we care too much about our own reputation and value face projects while neglecting precaution, accidents will happen.

His words struck me deeply. Up to now, I too have never encountered a doctor-patient dispute or a medical accident; at most, I have met with some venting-style abuse from unknown inquirers—which is unavoidable for the great majority of medical workers. I hope that in my own life I, too, can be like that elderly Chinese-American doctor, keeping a zero record in medical accidents and doctor-patient disputes, and striving not to break that record.