Shuttling Between Two Worlds
Shuttling Between Two Worlds
The first night back home from a holiday is always a restless one. There are many reasons for this. Usually, after wrapping up seven or eight classes at school, I rush to catch the high-speed train home. By the time I arrive, it is already late; getting there before ten o'clock counts as good fortune, and after washing up and settling in, it is often past eleven.
Once everything is ready and I finally get into bed, I still have to readjust. It sounds a little funny, but it is no exaggeration. Since I spend most of my time at school once the term is on, the bed at home feels somewhat unfamiliar when I return, and it takes a while to get used to it again.
The same goes for the return trip. After spending just two days at home over a weekend, I need a little readjustment when I get back to school. And after a long holiday, even the campus feels a bit unfamiliar, so the readjustment process begins all over again. One's ability to adapt to such changes of environment is simply not what it was in one's youth; for a middle-aged person it is clearly no match for that of a teenager.
What demands adaptation is not only the change of environment, but also the leap between medical philosophies, which is another great challenge.
For various reasons, I studied Traditional Chinese Medicine (TCM) first, and I daresay I did reasonably well with it. My clinical level is probably a little above the societal average—at least that is the feedback most of the patients I have treated have given me. Of course, I cannot rule out the possibility that they were flattering me to save my face, for courtesy is second nature to all of us here in China.
Now I am studying Western medicine, and my grasp of its theory is fairly solid. There is a more objective standard for judging this: my scores in professional courses each semester stay consistently above ninety out of a hundred, with some even approaching full marks. Many students cheat in exams, but I never do; and I have managed to build a well-connected chain of knowledge across the various subjects of my clinical-medicine program.
All this has left me having lost confidence in both TCM and Western medicine, frequently plunging me into self-doubt. When I face a patient and prepare to adopt a TCM approach, a host of Western medical concepts pop into my mind, and I begin to doubt the TCM method I am about to use. Likewise, when I prepare to treat with Western medicine, I find myself questioning it from a TCM perspective. In the end I even come to doubt medicine as a whole, wondering whether studying medicine truly helps patients at all.
Many diseases seem formidable, and their very names sound solemn, yet in reality patients with such conditions have an average life expectancy no lower than that of healthy people; treatment can relieve their suffering, but going without it is not a great matter either—chronic enteritis running in my own family is a case in point. Other illnesses do affect a patient's lifespan, yet at the same time medicine is powerless against them.
I know that the state I am in now is merely a transitional one—a phase that anyone straddling two medical systems must pass through in order to grow further in the field of medicine. Perhaps once I cross this stage my medical skill will make a great leap forward. But at the present stage the discomfort is real, and it does not deceive.
Occasionally what pulls me back from this self-doubt is the feedback from patients and their families. When they tell me that their symptoms have improved, I feel a little better. After all, a person who lives for long in a state of doubting his own worth cannot be comfortable either.
This feeling resurfaces whenever I take my family to see a doctor. The doctors at a top-tier (Grade 3A) hospital are usually hurried, and the consultation is extremely cursory. I believe these doctors are certainly competent, yet I cannot help doubting their clinical procedures. When they studied medicine they were surely trained under the same educational philosophy I was, but in actual practice very few manage to follow it. Omitting a patient's past medical history, family history or allergy history during a consultation has become routine.
To the heart of someone who has studied medicine, this instantly drives a thorn in. For such carelessness usually means a high probability of missed or misdiagnosed conditions, and the treatment plan built upon such a basis is usually risky. Let alone spanning both TCM and Western mindsets to serve patients—many doctors cannot even till their own small plot of land with careful diligence.
Yet if I were to put myself in those doctors' shoes, having to see so many patients in a single day, I might find it hard to be truly meticulous as well. But we are not ordinary patients or family members: we understand the risks of such diagnostic and therapeutic practices, and we know what iatrogenic harm means—so how could we dare to gamble with the lives and health of ourselves and our families?
Not long ago one of my teachers was chatting with me, and when he spoke of the treatment of a relative of his, he dwelt especially on many regrettable details that had not been done properly, which is why that relative of his is now in a vegetative state.
Medicine is such a discipline that it concerns human lives. The more a doctor learns and understands, the more cautious and careful he becomes, never daring to let his guard down. In a state of ignorance, people are usually fearless—but that fearlessness is not courage; it is recklessness.
Choosing for a patient a treatment plan that is the safest, most effective, most economical, most standardized and with the fewest side effects has always been the ultimate pursuit of every doctor. But how far from easy it is to realize this goal!