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Mao did not attend the Beijing meetings. He was still in Changsha. Wang Dongxing did not attend, either. He did not want to get embroiled in the factional disputes.
I wanted to return to Beijing. I had little to do in Changsha, but knew we were not prepared for a further deterioration in Mao's condition. The medical team in Beijing had yet to complete its plans. We needed to prepare for the medical emergency I knew we would soon confront.
Hu Xudong, Wu Jie, and I returned to Beijing in early January and organized a medical team consisting of Jiang Sichang, the director of the ear, nose, and throat department at the Liberation Army General Hospital; Zhou Guangyu, the director of surgery at Beijing Hospital, Gao Rixin, the director of anesthesiology at Beijing Hospital, and Yuan Zhaozhuan, from the dermatology department at Peking Union Medical College.
Hu Xudong accompanied the medical team to Changsha while I began briefing several top leaders, beginning with Ye Jianying, hoping to solicit their cooperation. With Mao so recalcitrant, we needed their help, and the entire politburo would soon have to be informed of Mao's problem. Marshal Ye had always been solicitous of the problems I faced with Mao. We chatted for a while, recalling the twenty-one years I had spent with Mao. Then I described Mao's condition over the last six months and explained how hampered the doctors were by Mao's refusal to see us. We talked about how to convince Mao to permit us to insert a nasal tube into his stomach for feeding. I was worried about his choking and the possibility of pneumonia if food were to get stuck in the trachea again.
Ye Jianying was encouraging. My relations with Wang Dongxing and Zhang Yaoci, with whom I was in daily contact, had become strained, however. No matter how I tried to explain the urgency of Mao's condition or how many models and diagrams I used, they still could not understand. Zhang Yaoci was particularly recalcitrant. As soon as he knew that Mao's disease was incurable, he wanted to distance himself as far as he could from involvement in his medical care. He was afraid that knowing Mao's condition would make him responsible if anything went wrong. Zhang's job was security.
Ye Jianying wanted to help. He did not think Mao would voluntarily agree to the nasal feeding, and he warned that Jiang Qing could still cause problems. He remembered the scene she had caused during Mao's illness in 1972 and believed she could turn against me again. He urged me not to be frightened and promised to come to my aid if I was attacked. He offered to help obtain medical equipment and sent similar assurances to the other members of the medical team, too.
On January 20, I met with Zhou Enlai, who was still living in a suite in the 305 Hospital. Zhou's health had taken another turn for the worse. Just before he had left for Changsha in December, the doctors had discovered blood in his stool. Knowing of the premier's scheduled visit to Mao and of the party plenum and the National People's Congress in January, they waited to tell him. The congress had concluded on January 17, and Zhou's report had called for a major redirection of the government, focused on the modernization of China. With the meetings over, Zhou was about to have a colonoscopy. The doctors suspected he had cancer of the colon.
Zhou was thin and pale, but he refused to be bedridden. He was sitting on a sofa, dressed in his usual elegant Mao suit. When I explained that I had been back for two weeks but had not wanted to bother him, he chided me for the delay. He wanted to know about the Chairman's health.
By then, Mao had left Changsha for Hangzhou, and I was scheduled to join him there the next day together with other members of his medical team. The first group had already left. In my absence, the Chairman had been persuaded to have a complete physical exam.
Zhou had also been talking to doctors about Mao. He knew the Chairman's cataracts would be easy to treat. His worry was the motor neuron disease and he wondered whether we had worked out a solution. It was still difficult for him to believe that there was no cure.
I reiterated that neither China nor the West had discovered a cure.
Zhou thought some doctors of traditional Chinese medicine should take a look. I explained that Mao did not believe in traditional Chinese medicine, and it would be almost impossible for him to take the type of medicine such doctors prescribed—herbs boiled in water, fed hot and in large quantities to the patient. Mao was choking on even small amounts of water. How could he drink large quantities of herbal medicine?
Zhou did not press the issue, asking me instead to give the Chairman his best wishes.
I left the next day with a team of twelve nurses and ten physicians—Wu Jie, two neurologists, three ophthalmologists, two radiologists, and two laboratory doctors. We would join the team of surgeons and ear, nose, and throat specialists who had gone ahead.
Mao's physical examination took four days to conduct. Regulations specified that a doctor treating a top leader could deal only with the aspect of the patient's illness relevant to his own specialty. Doctors were not allowed to consult with each other either on their diagnoses or recommended treatment. My job was always to analyze the different reports and put together a plan of treatment. The rule was designed for reasons of security rather than health and was especially counterproductive for Mao. Mao had several interrelated diseases, and consultation among the doctors was crucial to determining both the nature and severity of his illness and deciding the best course of treatment. Upon prodding, Wang Dongxing finally agreed that while the specialists would each examine Mao separately, we could meet together afterward to decide how to treat him. The ear, nose, and throat specialists and the surgeons conducted their examinations first, followed by the internists, neurologists, and ophthalmologists. Then an electrocardiogram was done, and chest and heart X rays were taken. The purpose of the heart X ray was to determine whether his heart was enlarged. An enlarged heart indicates danger of heart failure.
The results confirmed that Mao had cataracts, amyotrophic lateral sclerosis, coronary heart disease, pulmonary heart disease, an infection in the lower half of both lungs, three bullae in his left lung, bedsores on his left hip, and a shortage of oxygen in his blood (anoxia). He also had a slight fever and a severe cough. The medical team believed that a nasal tube was necessary both for feeding and for administering medications. They also recommended cataract surgery.
I was responsible for drafting the report to Mao explaining both the diagnoses and the proposed treatment. On January 27, 1975, I presented the report to Zhang Yaoci, going over the contents with him in detail and urging him to explain the document to Zhang Yufeng. Mao was blind, and Zhang was responsible for reading and explaining his reports.
At five-thirty the next morning, Zhang Yaoci woke me. The entire medical team was to meet with him and Wang Dongxing immediately. Zhang Yufeng had just delivered Mao's response to our report.
We gathered in the building where Wang Dongxing was staying. Zhang Yaoci reported. Zhang Yufeng had objected to the doctors' report. In her opinion, none of the treatment procedures we had suggested was any good. Zhang Yufeng had her own suggestion about how to treat the Chairman, and Mao had agreed. Zhang Yufeng wanted to treat Mao through infusions of glucose. Glucose injections had become a popular tonic among several top leaders during the Cultural Revolution, as had blood transfusions. After Jiang Qing heard that blood transfusions from healthy young men were a way to promote longevity, she had arranged to have young PLA soldiers donate blood for her transfusions. Reports of these treatments had reached Zhang Yufeng, who believed that glucose would both supply the necessary nutrients and treat the Chairman's illnesses as well. She wanted the infusions to begin immediately.
The medical team was stunned, silent. Wang Dongxing wanted to know what we thought. He refused to allow us to discuss the question among ourselves. Instead, he went around the room asking each member whether he agreed or disagreed with Zhang Yufeng's recommendation. If we all agreed, the infusions would begin immediately.
Incredibly, most members of the team agreed—not for medical reasons but for political ones. They had to obey the party leaders.
I was the last to be asked. I pointed out that while glucose infusions are often used in emergencies, they would be of little help to Mao and could cause complications. I was worried about the effect of such large amounts of fluid on Mao's already weakened heart. Moreover, since impurities in the glucose occasionally cause anaphylaxis, steroids would have to be added to counteract the possibility of a massive allergic reaction. We did not want to do anything to add to Mao's medical problems. Zhang Yufeng would not be responsible if anything went wrong. She was not a doctor. As head of the medical team, I would be responsible, regardless of the fact that I had disagreed with the treatment. I was adamant.
Zhang Yaoci was exasperated. Mao was still rebelling against the doctors, but at least he had agreed to Zhang Yufeng's suggestion. Now he wondered what to do.
I blamed both Zhang Yaoci and Zhang Yufeng. We all knew that Mao would not like our prescribed treatment, and since Mao would see neither me nor any of the other doctors, responsibility for reading and interpreting the report to Mao rested with Zhang Yufeng. But Zhang Yufeng refused to talk to us, so I had urged Zhang Yaoci to explain the report to her and try to persuade her to convince Mao to follow our recommendations. She was our only intermediary, and her cooperation in his treatment was essential.
Wang Dongxing was angry with me. I was the only doctor to oppose the infusions. He insisted that I had to obey the party and warned that I would face trouble if I continued to insist on my own views.
But this was not a matter of party discipline. Doctors, not Zhang Yufeng, Wang Dongxing, Zhang Yaoci, or the party, were the experts in this case. Even Mao himself had said that when a person is sick he has to listen to the doctor.
We had reached a stalemate. Wang Dongxing instructed me to write a report to Mao explaining why I alone opposed the glucose treatment. He would leave the final decision to Mao.
I wrote the report immediately. Zhang Yaoci gave it to Zhang Yufeng, and the word from Mao came back that evening. Mao had decided against the infusions.
But my position was untenable. No one was happy with me. Without direct access to Mao, I needed all the cooperation I could get—from Zhang Yufeng in particular and from Zhang Yaoci and Wang Dongxing as well. But they were impeding Mao's medical care. Mao's condition could only worsen. And if we caved in now to their intimidation, they could continue to interfere with Mao's treatment and we doctors would be held responsible when anything went wrong.
The medical team was worried. They agreed with me medically but did not want to alienate Zhang Yufeng, Zhang Yaoci, and Wang Dongxing further. We needed their help. My survival was at stake. Since 1968, Jiang Qing had been trying to brand me a counterrevolutionary, and in 1972, when Mao was so sick, she implied that I was part of a spy ring around him. If I insisted on giving Mao proper medical treatment, refusing to give in to the arbitrary advice of Zhang Yufeng and others, I might be declared a counterrevolutionary and accused of deliberately trying to harm the Chairman. But I still stood a chance of protecting myself. If anything happened to Mao after the glucose infusions, Jiang Qing would have all the rope she needed to hang us.
I discussed the implications of our situation with Wu Jie. He thought that we should resign. We could turn our responsibilities over to another medical team. He thought that I was in trouble no matter what.
He was right. Mao's disease was incurable, and even with the best medical care, his end was certain. Mao's death was inevitable. But I could not quit. I was director of the team. Even if I wanted to quit, Wang Dongxing would not let me go. I was still convinced that our only course was to continue insisting on the best medical treatment we knew. I could not let politics interfere with my medical opinions.
Wang Dongxing was conciliatory when I talked to him alone, and he apologized for getting involved in the decision about the glucose. “I acted too rashly,” he said, agreeing that it was a matter for the doctors to decide. Still, he accused me of being inflexible. He had decided that after Chinese New Year he would accompany me, the nurses, and several of the doctors back to Beijing. We would decide on the treatment procedures there. Hu Xudong, the two ear, nose, and throat specialists, the anesthesiologists, and the surgeons would stay in Hangzhou. If Mao's cataract problem could be solved, we should try to resolve that first. He suggested that we find cataract patients comparable to the Chairman in age and health and first perform operations on them. The reports of the operations could then be submitted to the Chairman, who would then decide whether he wanted the surgery performed. Wang also thought that more consideration had to be given to how to treat Mao's motor neuron disease. He was still not willing to accept the possibility that there really was no cure.
The full politburo had to be officially informed of Mao's illness. Among the top leaders, only Zhou Enlai and Ye Jianying had been briefed, and the Chinese press still described the Chairman as glowing with health, his cheeks a rosy red. Neither the Chinese people nor the high-level cadres knew anything of Mao's illness. Telling the politburo was a way of protecting both the doctors and Wang Dongxing. Jiang Qing was on the warpath against Wang Dongxing, too. She never asked Wang about her husband's health but was waiting for her opportunity to pounce if Mao died. The doctors, of course, would be blamed, and so long as Zhou Enlai, Ye Jianying, and Wang Dongxing were the only politburo members fully informed of Mao's illness and course of treatment, they too would be held responsible. Once the politburo was briefed, its members would also assume responsibility. If there really was no cure, the politburo would have to know. We needed its approval for our suggested course of treatment.
During the flight back, on February 8, Wang called me into his cabin. He knew I was angry. I explained that I was particularly perturbed about Zhang Yufeng's suggestions about glucose infusions.
Wang was defensive. Everyone around Mao relied on Zhang Yufeng to communicate with the Chairman. By now his speech was all but incomprehensible. Only Zhang Yufeng understood him. She had learned to read his lips. “If we dismiss her,” Wang said, “how will we be able to understand Chairman?” Zhang Yufeng was there to stay. Her ability to understand his speech gave her remarkable power.