There Are Countable Paths in Medicine—Why Rush to Surgery?

Last year, after a cold, my mother-in-law suddenly developed deafness. Because I was at school, and the elderly woman did not want to disturb my studies, she did not tell me; she went on her own to our local People’s Hospital and was treated for over a week, without effect. The doctors demanded that she undergo surgery. By then she could no longer keep it hidden and told my wife, and that was how I learned about it. I immediately called to ask about her symptoms, judged that this was a sequela caused by the cold—in TCM terms, a lung-heat cough pattern—and bought her Lianhua Qingwen capsules and Erlong Zuoci pills. Within less than a week of taking them, her hearing recovered.

When the local hospital doctor suggested my mother-in-law have surgery, my wife and her siblings were deeply worried; my wife even prepared to go home and take her mother for the operation. If a condition like my mother-in-law’s could be resolved with a few Chinese patent medicines, then the original diagnosis might not even have been correct. Operating on the basis of a wrong diagnosis would not only have been useless to her but harmful.

Also last year, a friend of mine in Guangdong had a child under ten with a toothache. The local doctor actually recommended root canal treatment—removing the relevant nerve of that tooth—on such a young child. My friend asked me what to do; I told the child to first take Niuhuang Metronidazole plus a cephalosporin, and not to rush into tooth extraction or nerve removal, because the child still had a long life ahead and such treatment would create endless future problems. After following my approach, the child was well within three days and never relapsed.

Last weekend I took a niece of my uncle’s to Peking Union Medical College Hospital. This cousin had just been advised by a very famous surgeon to undergo pancreatic removal surgery as soon as possible. After reviewing her records, I strongly opposed it. Fortunately, after reading the records, the PUMCH doctor’s diagnosis and attitude toward surgery were highly consistent with mine, which is what stopped the operation.

Previously I had not felt much about the medical situation outside Beijing, because we usually seek care in Beijing, where few doctors readily propose surgery. But in recent years, as health problems have successively arisen among the elderly and relatives in my family, and I have personally experienced their treatment, I have come to realize how surprisingly rash some medical institutions are toward surgery.

China’s cardiovascular expert Professor Hu Dayi wrote an article more than ten years ago mentioning the issue of stenting for Chinese heart-disease patients. He said China’s practice is very unusual: in the preceding five years (when he wrote), nearly 100% of stents used were drug-eluting stents—something not seen in any country, from Cuba to the United States to India.

Professor Hu went on to point out that drug-eluting stents have an advanced side—reducing restenosis—but also the “double-edged sword” side: they are a therapeutic tool with hidden risks of causing thrombosis, even very late thrombosis. China’s stent use has been increasing by 30% annually, has already surpassed 300,000, and may soon become the country (outside the United States) using the most stents—and all of the most expensive stents carrying thrombosis risk.

Data from the United States and Britain found that in patients with stable coronary heart disease receiving stents, 12% did not need them at all; 38% had unclear benefit and medication alone would have sufficed; only half had stents done appropriately, bringing benefit and value to patients. When I read Professor Hu Dayi’s article, I decided not to follow the doctor’s recommendation to operate on my father, who had just been diagnosed with coronary heart disease. The doctor had told me that if my father did not have surgery, he might have only three to five good years. It has now been nearly twenty years. My father has not taken even a single conventional coronary heart disease medication, yet his physical condition remains good.

These figures cited by Professor Hu have not been taken seriously by Chinese medical workers, and the Chinese medical community has never conducted similar statistics like those in the US and UK. Surgical operations have nearly become rampant. Of course, in recent years, under the advocacy of top experts like Professor Hu Dayi, the situation has improved somewhat, and the state is now increasing efforts to restrict surgical overuse.

Many diseases absolutely do not need to be rushed into these future-burdened surgeries. But unfortunately, from the experiences of relatives and friends around me, I have learned that this kind of surgical overuse—and overuse of invasive examinations—is now far too common, while conventional internal medicine treatment is no longer valued.

Over time, this not only harms patients but also causes the overall level of internal medicine treatment to decline. Behind this there is both the driving force of economic interests and the reason for inadequate routine medical care. In recent years, the treatment outcomes for my relatives at hospitals around the country have been unsatisfactory. Their diseases are actually not hard to treat, because most of the time I have been the one who resolves their problems.

I am now studying surgery myself. We operate on experimental animals and have mastered some basic anesthesia and surgical skills. It is indeed easy to cut open the abdomen with those sharp scalpels, but after surgery it is very hard to restore the subject’s good state of being.

China now advocates the parallel development of Chinese and Western medicine and emphasizes the building of grassroots TCM medical institutions, which is a very good direction for health-care reform. Common diseases that are not immediately life-threatening should first be given a trial of various non-surgical treatments, providing patients with more options; surgery can be considered later if nothing else works.

I also hope that everyone will protect their bodies when seeking medical care and not readily agree to surgery, unless the disease is truly life-threatening. After being told you need surgery, visit several hospitals and consult several doctors, judge comprehensively whether surgery is really necessary; if there is no urgent surgical need, do not casually destroy your own body.