Dr. Xu: A Chinese Medicine Novel

A young doctor’s confidence surprises his colleagues, while Evan receives a call from the hospital.

Even Dr. Zhong looked surprised.

“Oh? What makes you say that?”

Alex smiled faintly. “The patient has cold pain in his stomach, especially after eating cold food. It looks like deficiency cold in the Spleen and Stomach. And it is. But that isn’t where the underlying problem begins.”

Everyone paused. The young Chinese medicine doctors stared at him in astonishment.

“Then tell us what the underlying mechanism is,” Dr. Zhong said.

Alex answered in a clear, ringing voice. “Kidney yang deficiency. Declining fire in the Life Gate. That’s the root of it.”[1]

They all stared.

“What?”

Kidney yang deficiency was causing this?

“How did you work that out?” Dr. Zhong asked, surprised himself.

Alex lifted his chin slightly and glanced at the others. “The pulse is fine and relaxed, with particular weakness at the right chi position. That points to declining Life Gate fire. That’s the underlying mechanism!”[2]

The young doctors were taken aback and began murmuring among themselves.

Alex surveyed these hopeless specimens, immensely pleased with himself. You didn’t know I had a tutoring session yesterday, did you? And you’d never guess that my tutor happened to cover the exact question that came up today. Yesterday’s two patients had pulses very much like this one’s, with the same weakness at the right chi position. He remembered that all too well.

Even Dr. Zhong was looking at him in astonishment. “Very good. Very good indeed, Alex. Your pulse diagnosis has improved a great deal.”

With their department head’s confirmation, the other young doctors knew Alex had got it right. They were more astonished than ever, wondering how he’d suddenly become so good.

“Yes,” Dr. Zhong explained. “This patient appears to have deficiency cold in the Spleen and Stomach, but the root is in the Kidney: declining Life Gate fire. Think of the Spleen and Stomach as a cooking pot, and the Life Gate as the fire beneath it. If the fire’s too low, how can the pot get hot?

“That’s why his Spleen and Stomach are so deficient and cold. If you concentrate on treating them and ignore the Kidney yang deficiency, you’re treating the branch without attending to the root. The treatment will take longer to work. We need to strengthen Kidney qi and kindle the true fire of the Life Gate—to supplement fire so it can generate earth. Then the deficiency cold in his Spleen and Stomach will resolve.”[3]

The others nodded and took notes.

Dr. Zhong looked at Alex again, with considerably more approval now. “Well done this time, Alex. You didn’t let the outward signs mislead you.”

Alex immediately assumed an air of utter righteousness.

“Of course! You can’t see cold stomach pain and simply treat it as deficiency cold in the Spleen and Stomach. Symptoms can deceive you. You mustn’t just treat each symptom as it comes. You have to break through all the confusion and get to the root mechanism. Find it, and you can deal with it!

“When the other examinations don’t give you a clear answer, the pulse can provide the evidence you need. You can never be too thorough when taking a pulse. Our job as doctors is to keep misdiagnosis to a minimum and earn our patients’ trust through real treatment results!”[4]

This time, everyone saw Alex differently.

Even Dr. Zhong saw him differently.

Even the patient was staring in amazement!

Alex felt prouder still. Didn’t see that coming, did you? I even copied my tutor’s exact words!

Evan went to check on Adam. The right side of his body had improved somewhat; he could move it a little now. He was getting better, but he needed to stay on the medicine.

After giving Clara his instructions, Evan went downstairs.

The online argument was fiercer than ever. DrXuChineseMedicine’s Weibo feed had been completely overrun. The topic they’d hoped to get trending—“Dr. Cinnamon spreads misinformation in the name of debunking it”—had never made the trending searches.

Dr. Cinnamon’s food incompatibility story had dropped off the list entirely. The other promotional accounts had deleted their articles and videos about it, pretending nothing had happened.

Dr. Cinnamon had a new topic on the list now: “Dr. Cinnamon debunks menstrual health advice.” As for DrXuChineseMedicine and Charlie, the two of them were being utterly demolished. They couldn’t fight back at all.

Clara hated leaving it like this, but there was nothing else she could do.

Evan rarely went online, so he had no idea his account had blown up. He had just come downstairs and hadn’t yet reached the clinic when his phone rang.

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It was Leo Cao.

“Hello, Dr. Cao,” Evan said.

“Ha! Dr. Xu, have you got a moment?”

“What’s up?”

“If you’re free, could you come over to the Chinese medicine hospital?”

Evan brightened a little. “Has Director Du sorted out all the paperwork?”

“Uh… not yet. But soon, soon. We have two rather difficult patients here. We’d like to invite you to consult on them with us. Would that be convenient?”

“Oh, I see… All right. I’ll come over now.”

Evan hung up and stopped at the clinic to let Ben know. He was getting busier and busier, often being called away for consultations. Whenever he left, there wasn’t even anyone at the clinic who could treat patients.

He could only hope Adam recovered soon. At least then there’d be someone else who could treat patients.

The deputy director’s office at the Chinese medicine hospital.

Leo put down the phone and spread his hands toward David Du.

“Director Du, I’ve made the call.”

“How’s the patient doing?”

“Same as before. Still no improvement.”

Du gave a slight nod and said nothing more.

After a moment’s thought, Leo asked, “Are we really not going to explain things to Dr. Xu?”

“A doctor like Evan has nothing in his head except patients and their illnesses. There’s no room for anything else. Telling him won’t help. Say too much and he’ll only end up resenting us.”

Leo remembered what Evan had said when he’d gone to treat Mr. Xie’s wife. He nodded.

“True. That’s exactly what he’s like. But… no doctor can guarantee a cure. What if Dr. Xu can’t cure the patient this time, or something goes wrong? Wouldn’t that make things worse? Deputy Director Guo would have even more to say. He’s against it already.”

Du thought for a moment.

“Fair point. Here’s what we’ll do, Dr. Cao. When Dr. Xu gets here, tell him the medical affairs office requires him to wear a white coat and a mask. Once you’re inside, just say you’ve brought in a specialist. Nothing else.”

Leo’s eyes lit up.

“If Dr. Xu cures Director Guo’s wife, we’ll tell everyone about it,” Du continued. “He’s so stubborn. Doesn’t he doubt Evan’s results and the authenticity of his case records? Cure his wife, and what can he say then?

“Then we’ll have a word with his wife and get her to talk to him. This old problem has been tormenting her for years. Surely she’ll want to thank the man who finally helps her.

“And if—just if—Dr. Xu fails to cure her, we’ll act as though none of this happened. He was never here. For the consultation record, sign a paper agreement first. Don’t enter it into the system yet. Let’s see how it works out. Any prescription he writes, you issue to the pharmacy under your own name.”

Leo couldn’t help giving him a thumbs-up. “Brilliant, Director Du!”

Du waved it away. “Oh, it’s all for the patient’s sake. And isn’t that important suspect from the criminal investigation unit being held in our hospital? Didn’t they say it was urgent? Tell your younger brother later. Have Dr. Xu see the suspect too.

“That’s two difficult patients. I don’t believe Evan will fail with both of them. Whichever tree bears fruit, we’ll have something to work with.”

Leo nodded at once. “Understood. I’ll arrange it now.”

Evan rode his electric scooter to the county Chinese medicine hospital and arrived in no time.

Just as he entered, a group of young Chinese medicine doctors happened to be coming toward him, with Alex at the front.

Grinning broadly, Alex strutted along, lifting his feet high. He was putting on the voice of a seasoned veteran.

“Now, treating patients requires great care. Don’t worry about how long it takes. Only by being thorough can we ensure good results!”

The young doctors beside him watched in silence as he showed off. He’d been at it ever since his moment of glory that morning. A whole hour, and he still wasn’t tired!

The others couldn’t be bothered to respond.

Alex paid no attention to their disgust. Somehow, he still had more to say.

“Pulse diagnosis is particularly important. You don’t spend enough time on it. You can’t just get a rough sense of the overall pulse and leave it there.

“You have to examine all three positions—cun, guan, and chi—carefully. Of course you can finish in two minutes if you only give both wrists a quick check. But examine each position properly, six in all across the two wrists, and it’ll take five or six minutes.

“That’s why you couldn’t work it out. Your pulse diagnosis isn’t good enough. Mostly, you aren’t thorough enough. The underlying mechanism is a tricky thing. You can’t let it fool you. Pay closer attention from now on, all right? Remember that!”

Reader Notes

Reader Notes

↩︎ Kidney yang and the Life Gate. These names belong to Chinese medicine’s account of bodily functions. Kidney yang concerns warming and activating functions; the Life Gate, or mingmen, is associated with their source. Its “fire” describes those functions, rather than literal burning or the acupuncture point that shares the name. Alex locates the patient’s digestive cold at this deeper functional level. That is his traditional pattern assessment, not a finding of anatomical kidney disease. Source: WHO — International standard terminologies on traditional Chinese medicine, entries 156, 179–180 and 1276.↩︎ Pulse qualities and the right chi. Fine describes a threadlike feel. Relaxed renders huan, retaining its distinction from the slow pulse discussed earlier. Cun, guan, and chi are three adjacent positions on each wrist, with chi nearest the elbow. This chi (“尺”) names a position, distinct from the word for a slow pulse (“迟”). Traditional correspondences associate the right chi with the Kidney and Life Gate. Alex’s inference from this patient’s pulse remains his assessment. Sources: WHO — International standard terminologies, entries 856–857, 891, 896 and 907; Jingyue Quanshu, volume 5 — Right chi (in Chinese).↩︎ Root, branch, and fire generating earth. The “branch” is the manifestation being treated; the “root” is the underlying disturbance in the doctor’s explanation. Fire generating earth belongs to the Five Phases’ cycle of support. Here earth refers to the digestive Spleen system, and supplementing fire means supporting the warming function Dr. Zhong identifies as deficient. His pot-and-fire image explains this particular treatment principle; it is not a claim that the organs contain literal soil or flames. The predicted improvement is part of his teaching, not an outcome already observed. Sources: WHO — International standard terminologies, entry 2598, Supplement fire to cultivate earth; Beijing University of Chinese Medicine — The Five Phases in diagnostic thinking, “Generation and restraint” (in Chinese).↩︎ The other examinations. Chinese medicine groups assessment into observation, listening and smelling, questioning, and palpation. Feeling the wrist pulse belongs to palpation. Alex is referring to the other sources of information when he says they can be unclear. The wider framework combines those sources; his speech gives pulse examination particular emphasis. The passage records his confidence in a careful examination. It does not add findings from the other methods or show a treatment outcome. Source: Hong Kong Polytechnic University — Four diagnostic methods.