Disclaimer: This post was originally written in Chinese and translated into English by GPT-5.2.
At 23:35 on November 17, 2015, a female teacher at Hunan University, Chen Juan, posted in her QQ Zone a blog entry titled “A thousand calls and ten thousand summons—still I can no longer wake up my dear child—Lin Zhiyuan”. This grief-stricken article recalled her son’s experience of seeking treatment three times in early November at the Third Xiangya Hospital of Central South University, only to ultimately die despite treatment. The author believed that the main culprits behind her son’s death were the hospital’s irresponsible attitude in handling matters, the relevant doctors’ “misdiagnosis and mistreatment,” and the lack of “conscience” and “professional ethics” on both sides. To this end, the author wanted to seek justice for her son.
The next day, the Third Xiangya Hospital of Central South University issued a statement in response. The hospital first “expressed” “deep sorrow,” “understanding,” and “regret,” respectively, regarding “student Lin Zhiyuan,” who “died of illness,” the feelings of Chen Juan and her husband “on losing their beloved son,” and the “occurrence” of this “incident.” Next, it provided, in a targeted manner, the “diagnosis” or course of Lin Zhiyuan’s three visits. Finally, it “sincerely hoped that everyone could put forward more and better opinions and suggestions for the hospital’s work,” and would “resolve,” “through reasonable and lawful channels,” “questions about the treatment process.”
According to what both sides say in common, on the 17th “both the medical and patient sides” held a “coordination meeting.” The patient’s side felt that “even up to the coordination meeting, they still could not give the cause of my child’s death,” which was a manifestation of the hospital having betrayed the “patient’s trust.” The hospital, calmly, announced a “preliminary autopsy diagnosis” of “Type I aortic dissection rupture; death due to pericardial tamponade,” and patiently awaited the “third-party autopsy report” to be “issued after one month.” This means that this “medical dispute” has not completely ended. “One matter, each tells their own version.” Since the fundamental positions of the two sides are opposed to each other, then before the dispute ends, the relevant controversies are unavoidable. Through a plain-text sorting-out of both sides’ statements, I have found that the two parties’ narratives differ regarding the facts of Lin Zhiyuan’s three visits. In order to strive for a good restoration and re-presentation of this “medical dispute,” it is necessary to detail them as follows:
I. On November 5, Lin Zhiyuan made his first visit at the Third Xiangya Hospital of Central South University. As for the diagnostic result, both sides stated it as “① upper respiratory tract infection ② myocarditis?” (Author’s note: as in the original). The divergence lies in that Chen Juan said that after the diagnosis, relevant hospital personnel “did not provide any treatment or medical advice,” whereas the hospital offered the opposite account: “The doctor planned to further complete relevant examinations, but the patient’s family refused … to accept further diagnosis and treatment, and then left the Third Xiangya Hospital outpatient department. (See outpatient medical record)”
II. In the early hours of November 16, Lin Zhiyuan made his second visit at the Third Xiangya Hospital of Central South University. Because Lin Zhiyuan’s condition was relatively serious the second time, it seems that he was shuttled between internal medicine and surgery at the hospital. I say “seems” because the two sides’ accounts are inconsistent regarding the details and the ending of this visit. According to Chen Juan, Lin Zhiyuan “went to the Third Xiangya emergency department at 1:30; the triage desk saw him vomiting and told him to see surgery first; the surgeon ruled out an acute abdomen and suggested seeing internal medicine,” and after the internal-medicine doctor looked him over extremely perfunctorily and irresponsibly and assured them that “a young person’s heart wouldn’t have problems,” “he then told him to go home.” According to the logic of the article, the author and her party therefore returned home. The hospital, however, pointed out that Lin Zhiyuan first finished seeing internal medicine, and after all indicators were normal, he “was referred to emergency surgery due to left abdominal pain for half an hour,” and before the surgical “physical examination” was finished, “the patient … left the hospital.”
III. At a little after 4 a.m. on November 16 (Author’s note: Chen Juan’s account is 4 o’clock; the hospital’s account is 4:30), Lin Zhiyuan made his third and final visit at the Third Xiangya Hospital of Central South University. Chen Juan’s side said that the emergency-department surgeon “had no clear diagnosis,” that the “hospital” “did not instruct him (Author’s note: Lin Zhiyuan) to stay for observation or to return for follow-up,” and that “the nurse told me to come back the next day,” while the hospital’s side said that “with the cause of the patient’s abdominal pain and chest tightness unknown … the doctor, in accordance with diagnostic and treatment norms, required the patient to stay in the hospital for observation (in the emergency department observation room, bed 12), but the patient stayed for observation for less than 2 hours and, after completing preliminary treatment, left the hospital on his own,” and had evidence from both “emergency examination materials” and “observation-room surveillance video.” As for Chen Juan’s mention that the hospital injected Lin Zhiyuan with “IV drip 6542 milligrams,” the hospital did not address it.
It will still take time for the dust to settle; the young bones are sealed in the coffin without a conclusion. Emotionally, I naturally know how difficult it is for a life to survive. But rationally, I do not dare to casually “draw a period” for this matter by human fiat. Which of the materials provided by the two sides is right and which is wrong, I do not know; the relevant medical knowledge, I do not know; the “third-party autopsy report” “issued after one month,” I do not know; whether this “medical dispute” can be resolved after a month, I do not know. Besides that, I neither know Chen Juan’s family at all, nor do I have any real connection with the Third Xiangya Hospital of Central South University; what I know is nothing more than the “common knowledge” that anyone can see online. Since without investigation there is no right to speak, how could I dare to make arbitrary judgments of right and wrong when right and wrong are not yet clear? I know full well that a serious social commentary should be based on solid facts, not on imaginary invention behind closed doors—after all, social commentary is not a good business that can be started without capital. Up to now, I have only heard the sound of one shoe of this “medical dispute” hitting the ground, while the sound of the other shoe—“ending the dispute”—has been long unheard. Before this pair of shoes has landed, I can only talk about some personal thoughts on this matter itself.
As everyone knows, the phenomenon of medical disputes is widespread in Chinese society today; this matter is merely one example in terms of number, a recent example in terms of time. Chen Juan and the hospital each sticking to their own story afterward is also merely a common concrete manifestation of the medical-dispute phenomenon. Logically speaking, it is impossible for both of their mutually exclusive statements to be entirely correct; in other words, at least one of them is lying. I often think: with the frequency of medical disputes getting faster and faster and the update cycle getting shorter and shorter, for the people who have long been tested as outsiders, such matters may be nothing more than the story in Xianglin Sao’s mouth, betel nut chewed thoroughly—giving people the feeling that there is no longer any deep feeling. The absence of deep feeling implies the formation of an ideology. This ideology, plainly speaking, is the increasingly intense mutual distrust between doctors and patients. Since this mutual distrust has already become prevalent in society as an ideology, it inevitably becomes an a priori, beforehand psychological preset, rather than an after-the-fact sigh of dejection. In life, of course I am unwilling to view those medical workers who treat illnesses and even save lives through colored glasses, like Qian Zhongshu who, at the mention of doctors, thinks of butchers. But when I feel that medical workers instead wear colored glasses, and treat patients carelessly or even with a perfunctory attitude, I also cannot achieve Liang Qichao’s magnanimity after having a kidney mistakenly removed, and refrain from having my distrust further reinforced. After multiple rounds of vicious games, it is no wonder that mutual distrust between doctors and patients has evolved into an ideology that is clamorous and pervasive. Chen Juan and the hospital each sticking to their own story afterward—seen this way—becomes clear evidence that the two sides distrusted each other in advance.
Mutual distrust is indeed an “open secret” of contemporary Chinese society. It is said to be open because everyone knows it in their hearts, and even the authorities have acknowledged it—namely, that the so-called social credit system is not sufficiently developed. It is said to be secret because no one points it out; everyone only keeps it in their hearts and bellies, and is not afraid that it will rot and ferment. Medical disputes are precisely a typical example of this mutual distrust.
Life truly is full of many regrets, paradoxes, and ironies. Some people have the guilt and self-reproach of wanting to support their parents when they have children, but their parents are no longer there to wait; some people have the coldness and decisiveness of not supporting their parents when they have children, while their parents wait; still others, like Chen Juan and her husband, have the helplessness and grief of white-haired people sending off black-haired people. Not only life—perhaps history is also like this; life is merely a miniature in concrete form. Every generation lives in the best era with ever more abundant material things, yet all lament that this is the worst era with ever more collapsed morality. On the one hand, the heart inclined toward good does not adapt to, or does not like, such a great spiritual gap; on the other hand, human nature inclined toward evil has no choice but to flow downward like water amid the vast surging world and the rolling sea of people. This conflict and contradiction between the human heart and human nature may be the root of life’s oppression and unhappiness.
This conflict and contradiction between the human heart and human nature may also be the root of people’s mutual distrust and mutual slander.