The Healer Is Only a Bridge

"It is God who heals you; I am only a bridge that brings you before God."

— A Korean physician

While I was working at an international outpatient clinic in Beijing, a senior colleague once told me that a famous Korean doctor had said the words above. They left a deep impression on me, and from time to time they come back to mind. The older I grow and the more I experience, the more I endorse the metaphor of the physician as a bridge leading to God.

This morning, when I went to the local police station to handle household-registration procedures, I encountered a young woman in a hysterical outburst there. During her transaction she apparently felt that the officer on duty was rude and that the written statement she was being asked to sign was far too cumbersome; angered, she clashed with the officer.

The officer on duty was a woman. At first she dared to defend herself a little, but her defense was like pouring oil on the fire, and the woman's emotions kept escalating. Furious, she roared while filming with her camera, threatening to preserve the evidence. Her emotional display was so intimidating that none of the officers or security guards in the station dared say another word to her, for fear of being drawn into the blaze.

The civility of police officers in the capital is among the best in the country, so in such a situation the officer was actually the vulnerable party. The duty officer was later too frightened to say a word, letting the woman vent her rage at will. The agitated woman repeatedly demanded that the station chief come out so she could lodge a complaint in person. Accompanying her was her mother, who looked utterly at a loss. Evidently, such irritable outbursts by the daughter had occurred more than once at home; the mother was frightened too.

Irritability is a prominent feature of mental disorder. I cannot judge from a single incident whether this woman has a mental disorder, but years of working with a great many patients made me realize that she needed someone to help her calm down.

So I stepped forward to talk with her, hoping she would be more forgiving—and the crossfire was promptly turned onto me. The woman at once raised her phone to film me. I told her that front-desk staff in any industry have a hard job, and asked her to be more tolerant and understanding toward this older officer; some of the cumbersome procedures were uniform regulations, and the officer could not change a single character of them. Besides, her outburst in the station was blocking other people's business and wasting everyone's time.

These words did not fully calm the woman's agitation, but they at least eased the awkward standoff. Under my soothing and persuasion, she cooled down a little from her explosive state and went off on her own to "complain" to the station chief, allowing everyone else's business to proceed.

The officers in the station took a liking to me for this and voluntarily asked what procedures I needed to handle, offering to help. The female officer who had been complained about was especially grateful; in fact, the business I came to handle was her responsibility, and she treated me very well while processing it.

Few people can deal with irritable (overly emotional) individuals; communicating with them requires special ability, and sometimes only a psychiatrist or a professional psychological counselor can reach them, because only such professionals can read their logic. In fact, most irritable people also live in torment. Their irritability has long made daily life miserable for them; they are in constant conflict with the outside world, and their relationships are terrible as a result—which pains them too, though in the moment of an outburst they cannot control themselves.

Ordinary people cannot enter these people's inner world, and irritable people cannot make ordinary people understand what they feel. Between them and the outside world lies a thick wall, and they struggle behind it. Very often irritable people deeply regret their impulsive behavior, yet they are powerless against their own irritable physiology. Their high sensitivity and low tolerance may be innate; their physiological makeup differs somewhat from that of ordinary people. At the moment of rage, they are undergoing a biochemical reaction that even they themselves cannot bear, and the world in their eyes is different from that of ordinary people.

Ordinary people and irritable people need a bridge, through which each can better understand the other. This is precisely the value of psychiatry: the psychiatrist or psychological counselor is the one who builds that bridge. Human differences are objective, and in most cases innate and hard to change by one's own effort. The combination of genes is diverse; from the moment a person becomes a fertilized egg, the lottery ticket in hand is already different. The lucky win the jackpot, while the unlucky are fated to live their whole lives alongside physical and mental illness.

One great social responsibility of physicians is continually to educate the public, explaining the biological basis and pathological features of these differences, and promoting mutual understanding and communication between special populations (many of whom do not even qualify as mentally disordered) and the general population, so as to improve everyone's quality of life. The world can never eradicate conflict between people; perhaps recognizing that most human conflict arises from physiological or pathological reactions people cannot overcome on their own will make everyone feel a little better.

In the afternoon I took a taxi to a hospital, and on the way back the taxi was driven by a woman. After picking me up at the hospital gate, she said she had just come from another nearby hospital with her own physical examination report and had then received my ride on the Didi app. Her mind was greatly unsettled, and she needed someone to talk to—even an ordinary passenger.

She told me that last November her checkup had shown a small nodule in her lung, and that this April the nodule had grown rapidly to just over one centimeter. She was currently taking Chinese medicine for her lung nodule. I asked her several very professional questions about it: Was the border well-defined? Were there spiculated margins? Was it a ground-glass opacity or a solid nodule? Realizing she was talking to a specialist, she poured out her whole situation at once and asked me to analyze it and give her some advice.

After hearing her account, I told her that her lung nodule was most likely a high-risk nodule. One criterion we use to judge whether a nodule is benign or malignant is its doubling time; a high-risk nodule may more than double in size within 30–400 days. A high-risk lung nodule may be either benign or malignant. Even if malignant, at the present stage it is most likely early-stage, in which case the treatment of choice is surgical resection followed by pathological analysis of the nodule. She asked which Beijing hospitals would suit her; I recommended Peking University Cancer Hospital, the Cancer Hospital of the Chinese Academy of Medical Sciences, Chaoyang Hospital, and the former 307 Hospital.

The female driver told me the nodule had been detected at a health screening center, and that she had recently been trying to register, but appointments at good hospitals were impossible to get. Opening the booking app, every slot for the next half month was snapped up instantly; she was utterly frustrated and helpless. The lung nodule weighed heavily on her, so in the end I taught her some special ways of seeking care, such as first getting admitted through the night emergency department to a respiratory or thoracic-surgery ward, undergoing comprehensive examinations during hospitalization, and then deciding on the next medical step based on the results.

My most important advice was to find a hospital and operate as early as possible, because if malignancy were present, early surgery would greatly extend her survival. By the time I got out of the car, I had given her the medical common sense and next-step guidance she wanted. The female driver was deeply grateful but also anxious. At this moment she needed one—or even several—bridges to safety. Every physician who appears by her side is such a bridge; each ferries her across a stage, and together they may carry her to the far shore of recovery.

These past two years I have loved my profession more than ever and cherished my reputation more carefully—careful in words and deeds, yet sincerely and actively communicating with people. Because I know that in this lifetime I can still be a bridge for many people, helping them reach the far shore. I dare not risk myself, nor dare I damage my reputation, for to do so would remove from this world one bridge that does some small good.

For those of us who love medicine, perhaps one day we will understand that we have a great influence on others, yet can rarely play a decisive role. The role we ought best to fulfill is that of a bridge: building bridges between special populations and normal people, and building bridges for patients leading to safety. We should know where we ought to stand and what role we ought to play—neither overstepping our office nor doing nothing. Get this balance right and we fulfill our patients and ourselves; get it wrong and we make a complete mess of things.