The "Divine Doctor" You Heard of May Be Nothing but a Quack

A couple of days ago a patient came to see me. She is from Liaoning, and her whole family are intellectuals. After developing lung cancer, through an acquaintance she met a mysterious TCM doctor said to hold the status of a Tibetan-Buddhist lama. A web search turned up information on him too; his self-description is very miraculous—these days, putting up a few web pages about oneself is far too easy.

The patient was overjoyed, thinking she had found a brilliant divine doctor. The divine doctor also vowed confidently that he could cure her lung cancer in about three months. Delighted by this promise, she gave up standard treatment and patiently took the divine doctor's medicine for three months.

The medicine cost about 25,000 yuan a month (roughly what I spend on ten similar patients; of course, even prescribing two or three thousand yuan of medicine a month, many of my patients still complain bitterly—which I understand, after all, most Chinese people are poor). The divine doctor said his medicines were extremely precious and highly effective.

Three months later, having spent nearly 100,000 yuan on medicine, her condition worsened; a hospital recheck showed rapid progression. Only then did she wake up: the person she had met was perhaps not a divine doctor but a quack. But it was too late; her lung cancer had already metastasized to bone.

She then went to Peking Union Medical College Hospital, where the doctors gave her a thorough scolding for having delayed her own treatment. They put her on targeted therapy, finally controlling her clinical symptoms, and her tumor markers began to fall.

This patient has a fellow-sufferer who is a local medical worker. That fellow-sufferer has late-stage gallbladder cancer and, after surgery, has been treated by me for over two years with a fairly good survival status, so she referred this patient to me.

The patient then began following my official account and reading my articles, and her understanding of Chinese and Western medicine gradually grew rational. After starting targeted therapy, she hoped I could also help her with TCM.

I followed the principle that "when a treatment works, do not change it," requiring the patient to continue relying mainly on targeted drugs. While targeted therapy is effective, TCM serves only as an adjunct; once targeted therapy fails, TCM will take over.

The patient accepted my plan. Once bitten, twice shy; she no longer dares believe those miraculous "divine doctors." In her eyes now, such people are out-and-out fraudulent quacks.

Yesterday another patient came to see me: end-stage triple-negative breast cancer, already with bone, lung, brain and liver metastases, plus ascites and pelvic effusion. She is emaciated, with poor appetite and poor sleep, answers questions weakly, cannot walk, and is pushed around by her family in a wheelchair seeking help.

Her family had used the empirical effusion-resolving formula I publicly share, and her condition had improved—reportedly, before taking the medicine she had been at death's door, in a moribund state. So they felt I might have a way to work a miracle for her.

After examining her, I told the family that her condition was extremely grave; if Cancer Hospital Chinese Academy of Medical Sciences or the other two cancer hospitals in Beijing still had a suitable Western plan for her, it should be combined. I frankly admitted my ability was limited and I could do nothing for such a patient, only try to ease her suffering.

But in conversation the family told me they had read online some self-styled divine doctor saying Western doctors are all useless bunglers and there is no disease TCM cannot cure. From the conversation I roughly grasped the inflated expectations such remarks had created in them—expectations I could not meet. So I backed down, telling them my ability was limited and I could not help.

After a two-hour consultation, the family offered to pay—something I must commend them for, because they respected the physician's labor; after all, I had patiently seen them for nearly two hours and given them much advice.

But I refused their payment. This is a principle I have long held: for patients so severe that I have not the slightest confidence, I will not and dare not charge.

So I have always held to the principle of seeing the patient first and charging afterward; if the case is so severe that I am powerless, I will still see it through to completion but refuse payment. People come to me on reputation; even if I am powerless, I must offer what help I can. Coming from afar and going through all the trouble costs them a great deal.

In fact, for patients unwilling to pay after the consultation, I also charge nothing and politely see them out. It is just that over the years I have met few unwilling-to-pay patients. It must be acknowledged that although China has many doctor-patient disputes (over 600,000 a year), most patients and families are reasonable and know how to respect doctors.

This is an important reason I have almost no medical disputes, and an important reason TCM doctors rarely encounter them. Objectively, Western medicine bears a great deal of pressure for us. I read patients' lab reports too, and they are very helpful to me; but those tests were ordered by Western doctors, and the large fees patients pay have little to do with me, so I avoid many doctor-patient disputes.

I have always held that Chinese and Western medicine should not undermine each other. TCM attacking Western medicine, or Western medicine attacking TCM, only worsens an already tense doctor-patient relationship.

As for the so-called TCM divine doctors who casually dismiss modern medicine as worthless and brag that TCM is omnipotent, I personally do not believe them for a moment. But patients love to hear them—especially patients and families who cannot accept death, who are particularly easily taken in.

Their end is usually like the patient at the opening of this article: patients and families who believe such quack talk end only in bitter regret.

Hoping for a miracle is the natural reaction of every patient threatened by death and their families. Many films and works of literature also puff some divine doctors' skills up to the level of immortals, so that the public believes such miracles really exist.

In fact, any truly experienced clinician—whether TCM or Western—knows that medicine is powerless against many patients' diseases. Every doctor has especially successful cases, but there remain a great many problems he cannot solve.

On my official account and blog, divine doctors often turn up to post their lofty opinions as if challenging me. Once a "divine doctor" left a comment claiming that cancer simply does not exist in the world; so-called cancer is just a pack of swindlers fooling a pack of fools, and he treats cancer like a cold, curing it with a touch of the hand.

Of course, I block such comments outright. Such grand swindlers will say anything; I will not let them run wild on my patch.

Seek treatment rationally and choose your doctor carefully. A doctor should also be rational and cautious, able to control his material desires; facing irrational patients, or patients whose outcome is clearly doomed to lose both person and money, he should try to avoid causing them major financial loss. Otherwise our career is in danger.

A doctor can afford to take a loss. The Clinical Oncology Handbook compiled by the American physician Dennis A. Casciato notes in particular that about 15% of patients in clinical practice are "difficult patients" (troublemakers exist all over the world), and these difficult patients easily cause doctor-patient disputes. When seeing such patients, a doctor should tread carefully and act prudently, preferring to take a loss rather than leave himself future trouble. This is the inherent nature of the profession we chose; we can only adapt to it to be good doctors.

I also earnestly hope that my colleagues in medicine, whether speaking, writing, or lecturing, will not exaggerate. Patients' unrealistic expectations have much to do with the fondness of certain "divine doctors" for bombast.