Dr. Xu: A Chinese Medicine Novel

At closing time, a visitor invites Evan to dinner to discuss medicine.

Clara had been quick to slip away. She didn’t dare come back, even by closing time.

But another visitor arrived as the workday ended.

Dr. Simon Liu.

“Dr. Liu!” Ben’s eyes lit up. “What brings you here?” Simon was quite well known—certainly better known than Leo Cao, and a better doctor too. No wonder Ben was delighted to see him.

“Please, have a seat!” Ben hurried to welcome him.

“I’m here to see Dr. Xu,” Simon said politely.

“Huh?” Ben stared. Why did everyone want Evan? Patients were one thing, but Dr. Liu too? What did he want with him?

Simon came in and gave Evan a small smile. “Dr. Xu, I… I got your address from Leo. I hope you don’t mind my dropping in unannounced.”

Ben was astonished. Why was he being so polite?

Evan’s expression was hard to read. He had mixed feelings about Simon. This was a conscientious doctor.

But… there had been two misdiagnoses that day, both involving the wrong medicines from Simon. Instead of getting better, the patients had grown worse. In fact, he had made the same mistake with both of them.

Evan sighed softly. “What can I do for you, Dr. Liu?”

“There are some medical questions I’d like to ask you. Are you free this evening? I’d like to take you to dinner.”

Ben was stunned. Damn! Even Simon Liu wanted Evan’s medical advice?

Evan paused, then nodded. “All right. Let’s go.”

“Good.” Simon smiled and held out a hand. “After you.”

Evan went out with him, leaving Ben looking utterly baffled. How was Evan getting to know more and more important people?

Simon drove Evan to the new town development zone. He found a fairly nice restaurant and asked for a private dining room.

Once inside, Evan looked around. “Any particular reason you chose this place?”

Simon looked surprised. “Uh… no. Everyone says the food’s good, and it’s a pleasant place. I asked for a private room because I didn’t want us to be disturbed.”

Evan nodded.

Simon picked up the menu. “What would you like, Dr. Xu? Anything you don’t eat?”

“Anything’s fine. Just a couple of dishes. I’m not very hungry. I had something earlier.”

“All right.” Simon ordered a set meal, then let the server go.

The two of them were alone in the private room.

Simon frowned, unsure how to begin.

Evan leaned back in his chair and looked out the window. It faced the area just outside the restaurant entrance, where he could watch a steady stream of diners coming in.

“Go ahead, Dr. Liu,” he said quietly. “Say what you want to say.”

Simon nodded slightly. Looking at the cup of tea in front of him, he began to remember.

“Actually… I used to practice only Chinese medicine. That’s how I started out at the Chinese medicine hospital.

“I knew something about Western medicine, but I wasn’t proficient in it. I was young and inexperienced then, and my treatments often didn’t work very well.

“Later, the hospital offered an opportunity for postgraduate training. There were no places left in Chinese medicine, but there was still one in integrated Chinese and Western medicine. The hospital leadership asked if I wanted to go. So I went…

“Once I really began studying it, I discovered how effective Western medicine was. Its theories were scientific, supported by sound reasoning and detailed data. There was evidence-based medicine behind it all.[1]

“Chinese medicine, on the other hand, was all based on experience, with theories like the five phases and yin and yang that couldn’t be proved. I began to doubt it. That’s why I took the integrated approach.[2]

“When I came back, I found I’d become a much better doctor. I could prescribe both Chinese and Western medicines, and combining them worked far better than what I’d done before. That only made me more determined to follow that path. I completely abandoned the unscientific theories in Chinese medicine.

“But as I went on, as my clinical experience grew, so did my questions. With some patients, there was nothing wrong with what I prescribed, yet they didn’t improve. Some even got worse the more I treated them.

“Of course I don’t claim I can cure everything. But if I’m using the right medicines, why don’t they work? It wasn’t just one or two patients. Over the years, there have been quite a few.

“Some went to other doctors and got better with Western medicine alone. Why? Shouldn’t combining Chinese and Western medicine work better? Was something wrong with the Chinese medicines?

“But others went to Chinese medicine doctors, took Chinese medicines without any Western drugs, and got better too. Why? I’ve been baffled for years. I asked the Chinese medicine doctors at our hospital, and at other hospitals too, but none of them could give me an answer.

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“Then you came along. You really astonished me. That woman this morning who couldn’t pass urine or stool after giving birth—Western medicine had little to offer, but you cured her with a single batch of herbs.

“The point is, you followed Chinese medicine theory alone. There was nothing from Western medicine mixed in. At that moment, I knew I’d found a doctor who truly practiced Chinese medicine. That’s why I’ve come to you with these questions.”

Simon looked up into Evan’s eyes and asked earnestly, “Dr. Xu, can you tell me why?”

Evan turned from the window. “Because integrating Chinese and Western medicine was the wrong path from the start. Haven’t you noticed how little people have talked about it these past couple of years? Now it’s all about learning from each other, complementing each other, developing together, and making the most of each system’s strengths.”[3]

Simon looked taken aback.

“How are you supposed to integrate Chinese and Western medicine?” Evan asked. “They’re two completely different theoretical systems. Tie a fish to a bird, and you won’t get something that can both fly through the sky and dive underwater.

“How can you combine two completely different theories? One side has to give way! Which one? Chinese medicine. And in your practice, it’s given way even more completely.

“Why did those two patients get worse under your care today? Because you didn’t distinguish deficiency from excess, cold from heat. You’ve all but abandoned the four diagnostic methods of Chinese medicine.[4]

“You see the words ‘adenovirus pneumonia’ and a high white blood cell count. Pneumonia! Inflammation! The character for inflammation is two fires stacked together—how could that be anything but a heat pattern?[5] So of course you use pungent, cool medicines to release the exterior.[6]

“You see an acute urinary tract infection, a high white blood cell count, and burning pain on urination. Obviously a heat pattern! Drugs for the inflammation, plus bitter, cold herbs to drain fire.

“Is that Chinese medicine? You’re prescribing Chinese medicines entirely according to Western medical thinking. You’re forcing one onto the other, thinking rigidly. If you’re lucky and it happens to be a heat pattern, the treatment works quickly. If you aren’t, you can’t cure the patient.

“There’s nothing wrong with Chinese medicine. There’s nothing wrong with Western medicine. It’s integrating the two that’s the problem. They can work alongside each other, but they can’t be combined.

“Study Chinese medicine on its own terms. Identify the pattern, then use the appropriate medicines to treat the patient. You’ll get a swift response—as prompt as a drum answering a strike. It can hold its own against Western medicine. There’s no reason to think less of it.”

Simon looked thoroughly confused. “But… but there’s no evidence that Chinese medicine theories are scientific. We can’t prove the existence of yin and yang or the five phases either.”

Evan smiled. “If modern science can’t prove it, that’s a problem with modern science. I’ll tell you this: results are the best proof. Using Chinese medicine alone, I cured two patients whose cases even Western medicine found difficult. That’s proof!”

Simon’s frown deepened, his confusion only growing. “But the results are exactly what’s confusing me. Most Chinese herbal medicines don’t have evidence-based medicine behind them.”[1]

Reader Notes

Reader Notes

↩︎ Evidence and clinical experience. Evidence-based medicine combines clinical expertise with the best available research evidence when making decisions for individual patients. It does not mean disregarding a doctor’s experience: clinical judgment is part of the approach, including attention to a patient’s circumstances and preferences. Nor is the term a guarantee that every treatment within a medical system has equally strong research support. These distinctions help explain the vocabulary of Simon’s account. His broad comparison of the two medical systems remains his own assessment. Source: Sackett et al. — Evidence based medicine: what it is and what it isn’t, p. 71. ↩︎↩︎ Yin, yang, and the five phases. These terms refer to traditional explanatory frameworks already used in earlier chapters. Yin and yang describe paired, interdependent aspects and processes. The five phases—Wood, Fire, Earth, Metal, and Water—organize relationships and changes; they are not five chemical elements or a set of substances expected to appear as such in a laboratory test. Simon is questioning these frameworks as a basis for medicine. A terminology standard defines their traditional meanings without resolving that argument. Source: WHO — Traditional Chinese Medicine Terminologies, entries 3 and 28.↩︎ Integration and working alongside one another. “Integrated Chinese and Western medicine” also names an established field of medical education and practice in China, which explains Simon’s postgraduate training. Evan draws his own sharp distinction between combining theoretical systems and allowing different approaches to cooperate. That distinction is central to his criticism here. Official descriptions have used the language of complementary strengths and coordinated development while also recognizing integrated medicine institutions. They do not establish the chapter’s claim that integration had recently stopped being emphasized. Source: State Council Information Office — Traditional Chinese Medicine in China, sections II–III.↩︎ Patterns and the four diagnostic methods. The methods are inspection, listening and smelling, inquiry, and palpation, including pulse examination. Findings are considered together to identify a traditional pattern and guide treatment. Deficiency and excess concern insufficiency and excess within that framework; cold and heat are pattern categories, rather than simply readings on a thermometer. These distinctions belong to the eight-principle framework introduced earlier in the serial. The sources explain this diagnostic vocabulary. Evan’s assessment of the two earlier cases remains the character’s clinical judgment. Sources: Hong Kong Department of Health — Diagnostic Methods and Features of Chinese Medicine Practitioners; WHO — Traditional Chinese Medicine Terminologies, entries 931 and 992–995.↩︎ The “two fires” in inflammation. In Chinese, the character 炎 (yan), used in words for inflammation and pneumonia, is visually formed from two 火 characters, meaning “fire,” one above the other. Evan is mimicking the shortcut he attributes to Simon: the word contains fire, so the patient must have a heat pattern. The point depends on the written Chinese character, so it is made explicit in the dialogue. The word’s form and meanings do not themselves establish a medical classification. Source: Taiwan Ministry of Education — Revised Mandarin Chinese Dictionary, 炎 (in Chinese).↩︎ Cool, cold, and releasing the exterior. In Chinese medicine, “pungent” and “bitter” are taste categories associated with traditional actions, while “cool” and “cold” describe attributed medicinal properties. “Releasing the exterior” is a treatment principle for certain exterior patterns; “draining fire” refers to reducing a traditional excess-heat condition. These expressions describe the treatment logic under dispute, rather than the temperature of a drink. “Drugs for the inflammation” preserves the original’s broad wording without naming a new drug or specifying its mechanism. Sources: Hong Kong Department of Health — Diagnostic Methods and Features, final section; WHO — Traditional Chinese Medicine Terminologies, entries 2284, 2330, 2638–2644 and 2686.