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In September 1974, we left Wuhan for Changsha, the capital of Mao's home province of Hunan.

Mao wanted to swim. He was trying to treat his illness himself and thought he could build up his strength through exercise.

The doctors from Beijing, Wu Jie and Hu Xudong, were appalled. With the paralysis of his larynx and pharynx, any accidental ingestion of water could easily choke him. His limbs were atrophied and weak. There was no way Mao could swim. But the staff in Group One who had worked with Mao for years knew no one could stop him, that if anyone tried, he would become even more defiant and accuse them of trying to control him. Wang Dongxing refused to allow the doctors to raise their concerns with Mao. They had to be on hand, prepared to intervene in an emergency.

Mao went into the pool as the doctors stood ready, but the swim was soon aborted. Every time he put his face in the water, he choked and his face turned red. The guards quickly extricated him. He tried two more times in Changsha, with the same result. After that Mao never swam again. Deng Xiaoping was visiting Mao in Changsha at the time and reported to the politburo upon his return that Mao's health was fine. The Chairman had even gone for a swim.

Mao became more immobile after his aborted swim. He spent most of his time in bed, lying on his left side, because he had difficulty breathing in any other position. He developed a bedsore on his left hip as a result, and from then until his death, bedsores were a recurring problem. As soon as one healed, another would form. He developed an allergy to his sleeping pills and broke out in an itchy rash all over his body. We changed the medicine and applied an ointment to the rash, and that problem subsided.

I saw little of Mao during the two months I spent in Changsha, and he refused to see other members of the medical team at all. Wu Xujun kept me informed of his condition, and I got occasional word after he met with his visitors from Beijing. But shortly after that, Wu Xujun left Group One for good.

Mao's hostility toward doctors was heightened by news of Zhou Enlai's decline. His bladder cancer had recurred, and a second operation had been performed in August. Mao's conviction that surgery did not work was thus confirmed. “I said he should not have an operation,” Mao complained, “but he insisted. So now he has to have a second one, right? I think he will have a third one, a fourth one, until he dies. When ordinary people are sick, they often let it go. After a while, the illness is gone. If it's not, that just means it can't be cured.”

The political situation in Beijing was still tense. The Second Plenum of the Tenth Central Committee and the Fourth National People's Congress were both scheduled for January 1975, and both meetings would appoint new personnel. Deng's positions as vice-premier, vice-chairman of the Military Affairs Commission, chief of the PLA general staff, and politburo standing committee member had to be approved, and Jiang Qing and her group opposed them. They wanted Wang Hongwen appointed vice-chairman of the National People's Congress. As the time approached, the power struggle heated up, and both factions began sending emissaries to meet with Mao, trying to win him over.

Wang Hongwen visited Changsha on behalf of Jiang Qing and her faction. With Xu Yefu dying from lung cancer, Zhang Yufeng had taken over all his secretarial responsibilities—reading documents to Mao and screening his visits—and was maneuvering to be formally appointed Mao's confidential secretary. Wang Dongxing was reluctant to approve the appointment, but Wang Hongwen supported it and met with Zhang Yufeng frequently. He arranged for several servants to assist her, to do her laundry and cook her meals, while she served Mao. Before the arrangements were complete, Mao issued a personal edict—“Whoever is meddling in my domestic affairs, get out”—Wang Hongwen beat a hasty retreat to Beijing.

Wang Hairong and Nancy Tang arrived in Changsha on October 20, 1974, representing Zhou Enlai. Jiang Qing's most recent barrage against the premier accused him of selling out to foreigners. Zhou had been trying since before the Cultural Revolution to increase China's shipping capacity, both by promoting a domestic shipbuilding industry and by buying ships from abroad. When China launched its own Shanghai-made Fengqing ship in 1974, Jiang Qing accused the premier of betrayal for buying foreign ships. Deng Xiaoping, back on the politburo, sided with Zhou. The meeting ended in a deadlock until Mao sided with Zhou and Deng.

Formally, Zhou Enlai and Wang Hongwen were jointly responsible for the slate of appointments for the upcoming party and government meetings. The two came together to visit Mao in Changsha on December 23 to review their proposals with him. I knew little of the political machinations behind the appointments. Zhang Yufeng knew even less, but her appointment as Mao's confidential secretary had finally been approved, adding to her arrogance. When Zhou came to discuss the appointments with Mao, she accosted the premier to complain about her odious responsibilities to Mao—helping him eat, drink, bathe, and use the bathroom and putting him to sleep. “Can't you do something about it?” she demanded. Zhou was too embarrassed to reply.

When the Second Plenum of the Tenth Central Committee met in January, Deng's appointments as vice-chairman of the party and member of the politburo standing committee were made official. Later, at the Fourth National People's Congress, Zhou was reelected premier of the State Council and Deng Xiaoping was made first vice-premier. Mao needed Deng to help Zhou Enlai run the country's day-to-day affairs and insisted on his appointments. Zhou's illness made Deng Xiaoping's leadership all the more urgent. Deng took charge of day-to-day work of the Central Committee. Once more, Jiang Qing and her faction had been held in check.