Dr. Xu: A Chinese Medicine Novel

Outside the resuscitation room, the doctors learn why the patient’s survival matters so much to the police.

Director Guo hurried out of the ward. “What’s happened? What’s going on?”

“Director, I was bringing Dr. Xu to see this patient,” Leo Cao replied. “I didn’t expect her to have been taken for emergency treatment.”

“Has she suddenly gotten worse?” Guo asked, puzzled.

Leo nodded. “Yes. The thing is, she’s no ordinary patient. She’s a human trafficker. After her arrest, she was kept under guard here for treatment. She has idiopathic pulmonary fibrosis with cor pulmonale. She’s extremely important to the police.”[1]

Guo’s heart sank.

So did everyone else’s.

This was an incurable disease. At first it could look much like acute or chronic bronchitis, with repeated attacks of violent, spasmodic coughing and wheezing. It might seem unremarkable in its early stages, but by the time it was diagnosed, it was generally already advanced.

And there was no cure. No one had ever been cured of it. It was one of the most difficult respiratory diseases to deal with: hard to detect, harder still to treat.

Even someone lucky enough to have a mild case could live only ten years or so at most. Most patients were already severely ill by the time of diagnosis, with roughly two to four years left.

Lung transplants were available now, but they were extremely expensive. Even a transplant could add only another three to five years at most. It still couldn’t cure the disease.

In the end, everyone with the disease would develop cor pulmonale and die of systemic collapse, heart failure and respiratory failure. Medicine was powerless, whether Chinese or Western.[2]

Evan Xu looked at Leo in surprise too. He hadn’t expected this to be the patient Leo wanted him to treat!

Leo’s brow was tightly furrowed. “Shall we go over to the resuscitation room and see?”

“All right.” Guo nodded.

The group headed that way.

Several plainclothes detectives stood outside the resuscitation room.

Leading them was Leo’s younger brother, Captain Marcus Cao.

“Goddammit.” Marcus kicked the wall, then paced in angry circles with his hands on his hips.

The other detectives looked just as frustrated, their brows furrowed.

Marcus turned to a nurse. “Tell me, can they save her or not?”

“Well… it’s hard to say,” she replied helplessly. “We’ll have to wait until the doctors come out before we know.”

“Isn’t there something you can inject to keep her conscious for three to five days? Something that guarantees she’ll be all right for those few days, so we can question her?”

The nurse was at a loss. “I don’t know about that. You’d have to ask a doctor.”

Marcus scratched at his short hair, anxious and irritated. “Shit. Don’t you die on me now!”

Leo and the others were hurrying over.

“Marcus!” Leo called from a distance.

Marcus looked toward the voice.

A group of masked doctors was striding toward him.

For a moment, Marcus stared. All those white coats and masks, advancing together—at first glance, it was almost as though the emperor’s elite guard had arrived.

Then he looked more closely and saw his older brother leading them. His spirits dropped. Right. Just his imagination.

The young nurse stared too. They certainly looked impressive.

Leo jogged up. “Marcus, how is she?”

“How do you think? They’ve taken her in to save her. Said she was critical, with ‘threefold failure’—heart failure, respiratory failure, this failure, that failure. Who knows if they can bring her back?”

Before anyone could answer, Marcus went on angrily. “It makes me so damn angry. She was half dead when we caught her. After all this work, I haven’t even questioned her yet. If she dies, it’ll all have been for nothing!”

He stamped his foot, pressed a hand to his stomach, then shook his head in discomfort.

“Captain Cao, calm down. Your stomachache and headache are both from anger. Liver constraint has turned into fire and risen to the crown of the head, causing dizziness and headache. It also moves across to attack the Stomach, which is why your stomach hurts. Try to calm down.”[3]

NovelPhoenix publishes this author’s chapter, but this copy was taken without permission; the author’s version there supports their work.

The voice came from among the doctors.

Marcus looked over, startled.

Evan took off his mask. After hurrying all this way and looking around, he’d seen hardly any doctors or nurses wearing one. What was Leo playing at?

He turned and stared at Leo.

Leo guiltily avoided his gaze.

The other young Chinese medicine doctors took off their masks too.

“Dr. Xu?” Delight and surprise crossed Marcus’s face. “Can you do anything for this patient?”

He quickly added, “I don’t mean cure her. Just keep her alive and conscious for a few days so we can question her.”

“Marcus, watch what you’re saying,” Leo cut in. “Calm down. You’re a captain!”

“So what if I’m a captain? Captains aren’t allowed to get angry? To lose their temper?”

Leo had no answer.

“Besides, I really am… You have no idea. This trafficker’s been wanted for over ten years. All that time, we couldn’t catch her. Who knows how many women and children she’s sold?

“Damn it, it was sheer luck we finally caught her this time. She was already half dead when we arrested her, so we rushed her here because it was the nearest hospital. We thought we’d question her as soon as she was a little more stable. And now look at her. Someone like that dying would only be getting what she deserves.

“But we still haven’t caught her accomplices. We still don’t have information on the women and children they sold. If she dies, every lead is gone. All that work for nothing! We won’t even know where to look for the women and children they’ve trafficked. There are still so many parents out there desperately searching for their children!”

For a moment, Leo had nothing to say either. He knew how important this suspect was to the police. That was why he’d asked Evan to help. He hadn’t expected Evan to cure an incurable disease. But critical cases involving heart failure and respiratory failure were precisely the specialty of Chinese medicine doctors like them, who were skilled in using wutou and fuzi.

In a critical case of threefold failure, with the body surrounded by layers of yin cold, large doses of those aconite medicines were exactly what was needed to break through the cold and restore yang. Curing her wasn’t the point. If Evan’s medicine worked, improved her condition and brought it under control, that alone would be a tremendous help to the police.[4]

And this case would be enough to demonstrate Evan’s ability, as well as why he needed to go beyond the usual limits when prescribing large doses of wutou and fuzi. They could even ask the police to put in a good word for him. After all, he’d already helped them twice.

Surely Guo would have no reason left to object then?

That was Director Du and Leo’s plan. One plan, several payoffs!

What Leo hadn’t expected was for the patient to need emergency treatment already. How had she deteriorated so fast? Was she about to die?

Marcus was still looking at Evan with desperate hope. To him, Evan was practically a god of medicine.

He knew how close to death his mentor had been. Only two or three days had passed, and the man was almost completely recovered.

If Marcus hadn’t seen it himself, he would never have believed it.

“Dr. Xu, how confident are you?” Marcus asked again.

Guo frowned at Evan too.

Evan’s expression was grave. “I can’t say before I’ve seen the patient.”

Marcus turned to Leo. “Leo, can you let Dr. Xu go in and help save her?”

Guo looked at Leo as well.

So did Evan, immediately.

“Well…” Leo looked uncomfortable. “Hospital regulations. I’m afraid… we can’t.”

Marcus’s brow tightened at once.

“Marcus, trust the doctors,” Leo said reassuringly. “Let’s wait until they’re finished in there, then see how things stand.”

Still frustrated and helpless, Marcus could only nod.

“Dr. Cao, what’s happening?” Director David Du had arrived too.

Reader Notes

↩︎ Pulmonary fibrosis and cor pulmonale. Idiopathic pulmonary fibrosis, or IPF, is a disease in which lung tissue becomes scarred and stiff without a known cause. Cough and breathlessness are common, and its course can vary considerably. Cor pulmonale, discussed earlier in the serial, concerns failure of the right side of the heart associated with disease of the lungs or their circulation. The two names here describe the patient’s reported diagnosis and complication. They do not mean that her heart has stopped; the chapter supplies no finding of cardiac arrest. Sources: NHLBI — What Is Idiopathic Pulmonary Fibrosis?; MedlinePlus — Cor pulmonale.↩︎ The prognosis described in the story. The narration’s absolute claims and survival figures are retained from the Chinese novel. They should not be read as fixed limits on individual survival or a current clinical summary. NHLBI describes a variable course and treatments that may slow progression and extend life; lack of a cure does not mean that nothing can be done. NHS Blood and Transplant reports that some recipients have lived with a transplanted lung for more than twenty years. Cor pulmonale can complicate lung disease, but the sources do not support its inevitability in every patient with IPF. Sources: NHLBI — IPF overview; NHS Blood and Transplant — Lung transplant FAQs; MedlinePlus — Cor pulmonale.↩︎ Anger, Liver fire and the Stomach. These capitalized names refer to traditional functional systems. Within this framework, constrained Liver qi can transform into “fire,” which can rise toward the head or interfere with the Stomach. Moving “across” describes the latter relationship, rather than something physically traveling from the anatomical liver to the stomach. Evan uses that model to explain Marcus’s headache, dizziness and abdominal discomfort. This recalls earlier Liver–Stomach explanations while adding the upward movement toward the head. It remains his interpretation of the symptoms, not a finding of liver inflammation. Source: WHO — Traditional Chinese medicine terminology, entries 426, 1246 and 1317.↩︎ Aconite and “restoring yang.” Wutou and fuzi are related aconite medicines, rather than two names for an interchangeable product. Fuzi uses the processed lateral root; chuanwu uses the mother root. The contrast between enveloping yin cold and restored yang belongs to the warming approach informing Leo’s plan. It does not establish that aconite reverses pulmonary fibrosis. “Threefold failure” retains the earlier translation of the original’s shorthand: heart and respiratory failure are named here, but a third system is not identified. The chapter gives neither a new prescription nor a dose or preparation regimen. Source: Hong Kong Department of Health — Aconite roots, processing and toxicity (in Chinese), pp. 11–14.