别换，人命至重有贵千金

Eleventh of July, two in the afternoon, Turpan City People's Hospital. Neurology is on the third floor. A long corridor, wards down both sides, a few plastic chairs in the middle. Alim was on the third chair from the end, still in yesterday's clothes with dirt on the trouser legs. He stood up and didn't say anything.

Which room? A gesture at the far end. 307. What's the situation? Cerebral haemorrhage. The right side won't move. He can't speak. Can he hear? He can — and his voice changed on the word. The doctor says he can hear and he understands. He just can't get it out.

I paid the deposit first. Eight thousand. Standing at the window afterwards I opened the banking app and looked. Thirty-five thousand four hundred became twenty-seven thousand four hundred. I knew while doing it that I shouldn't. I did it anyway. Alim, at the door: we'll pay that. Not now. My second brother lands the day after tomorrow — he's in Guangzhou, flight tomorrow. My sister's coming from Ürümqi tonight. I didn't raise the money again. At that moment anything you say about money is wrong.

307 at half past three. Four beds; his is by the window. He was lying with his head turned to the glass. The right hand on the coverlet, fingers slightly curled, not moving. Alim said something in Uyghur. His eyes moved and came round. He saw me. His mouth opened. No sound. It opened three times, and after the third he stopped, still looking at me. Alim: he knows you.

Sun Simiao came at nine, after visiting hours, down the dark end of the corridor — very old, white hair and beard combed neatly, not an official's robe but a Daoist one, blue-grey, a cloth bag on his back with the ends of some herbs showing at the mouth. He sat down on the next chair and said nothing for a while. Then: at the payment window just now, you looked at your phone. Sir. Sun Simiao.

On the title: I wrote two books, both called Qianjin — a thousand gold. Essential Prescriptions Worth a Thousand Gold. And the Supplement. Why that name? It is in the preface. A human life is of the utmost weight; it is more precious than a thousand pieces of gold. And a single prescription that saves it has a virtue beyond even that. And: so I took those two characters for the title.

I asked how much a thousand gold is. He looked at me. You're asking for the figure? Yes. And: I paid eight thousand this afternoon and then looked at what was left. I know I shouldn't have looked. — You should have looked. Immediately. I stopped. And then: in my Great Physician's Sincerity I wrote: he must not look before and behind, calculating his own fortune or misfortune, cherishing and protecting his own life. And: a great many people read that as: you may not calculate. And, and I sat up: what I said was that you may not use the calculation as a reason not to go. And: not that you may not calculate.

And the elaboration, which is the part nobody quotes: I practised for sixty years. Every call I went out on, I knew how far the road was and how cold it would be. And: a few times I walked three days. And: during those three days I worked out how much medicine I could have gathered in the hills instead. You calculated that too? I did. And I went anyway. Drawing the mouth of the bag tighter: a man who does not calculate arrives after three days with nothing inside him. He thinks himself admirable. And: a man who thinks himself admirable does not examine carefully. And, three times into the book: the man who has done the sum and goes anyway arrives steady.

Then the six characters, and the three readings: (i) leave last year's string up; (ii) hang none this year in house three; (iii) use house two's string for house three this year. Which of the three takes the least doing? The first — the first requires nothing at all. Then set the first one aside. Why? A man whose half body will not move and whose mouth will not work gathered one breath and produced six characters. And: if those six characters meant "do nothing," he would not have said them.

And the eight characters from the same essay: observe the signs in detail and lose nothing so fine as a hair. What are the signs? The things you can see. Colour of the face, the tongue, the pulse, whether he sweats, when the pain comes. And: the illness is inside and cannot be seen. All you can see is the signs. Shouldering the bag: your patient at present is those six characters. The six characters are the inside. And, and I was back at the row by first light: go and look at the signs. — M.

Memo to file. Turpan, 11–14 July 2031. Abdul Rahman, 69: cerebral haemorrhage, right hemiplegia, expressive aphasia. He hears and understands.

1. Money, recorded because I did the arithmetic and would rather admit it than pretend. Deposit ¥8,000. Bank 35,400 → 27,400. Alim's family will repay; I am not discussing it this week. Second brother in from Guangzhou, sister in from Ürümqi. Sun Simiao's correction to the famous line — he must not look before and behind, calculating his own fortune — is that it forbids using the calculation as a reason not to go, not the calculation itself. And his own practice: sixty years, and on a three-day journey he had costed the medicine he could have gathered instead, every time, and went. A man who does not calculate arrives with nothing inside him and thinks himself admirable; a man who thinks himself admirable does not examine carefully. The man who has done the sum and goes anyway arrives steady.

2. The six characters: 三号房那一串，今年别换. Three readings: (i) leave last year's up; (ii) hang none this year; (iii) use house two's for house three. Sun Simiao's elimination is not textual. Which takes the least doing? (i). Then set (i) aside — a man in that state gathered one breath for six characters. If they meant "do nothing," he would not have spent the breath.

3. What I found at the row, 12 July — the "signs," and none of them is conclusive. I took all three strings down and laid them on the ground side by side, houses one, two, three, for the first time in two years. — House three's fruit is smaller than the other two. — House three's is darker. — House three's are spaced closer on the string. Heights re-measured: 1.54 m, 1.53 m, 1.29 m — the same as May 2030. I cannot say what any of the three observations means. I wrote them down anyway, one line each.

4. And then Rehmanjan at house twelve, who took the ground out from under two years of my notes. — Do you hang a string? Yes. Since when? Since I saw the book last June. And before that? We didn't. Then how did you compare? We didn't compare. You bite it and you know. There's no need to compare. — Then why does Abdul Rahman hang one? He looked at me, and the nephew hesitated before rendering it: "Because you told him to."

5. Which I cannot dispute. I saw the string in Chang's doorway in March 2030. At the closing in November 2030 I asked Abdul Rahman to keep one back. He said one word: 好. There have been three strings on those doorframes for two seasons. In two seasons I have never once asked whether he uses them. I assumed: he bites, then checks against the string. The other possibility is that he bites, and the string hangs there to be looked at. Looked at by whom? By the person who comes. In the book: those three strings may never have been used once. They hang because I look. Chang's string is thirty-one years old and regenerates itself out of the accepted batch; it is an instrument. Mine is two years old and was installed on my instruction; it may be a display. The two are indistinguishable from the doorway, and I have been treating the second as evidence of the first.

6. 14 July, 307. Both siblings had arrived. He was awake and had been watching the door. I crouched to his eye level and reported: I went and looked. I took all three down. House three's are smaller, darker, closer together. I don't know what those three things mean. And then waited. The coverlet moved. The left hand came out, slowly, rested on the cover — and the index finger drew. Slowly, three times, the same shape each time. A circle. And then the hand stopped there and did not go back. Alim asked him something in Uyghur; no response; he was still looking at me. I put my hand on the cover beside his without touching it and said: I understand. My voice was not steady.

7. Because the circle is mine. On the morning of 4 June, in that courtyard, I explained it to him in two sentences: this line I asked, you couldn't answer, so it doesn't count — and it does not mean you did anything wrong. I thought I was handing over an explanation. What I handed over was the one mark this man now has any use for. He cannot speak, he cannot write, he has never read a character in his life — and he has exactly one piece of shared notation with me, and he used it to tell me he does not know either.

8. Which leaves the position, stated plainly. The bite exists in four men in two prefectures, three of them over sixty. The one I know best can no longer say anything except "I can't answer." The six characters remain undecoded. The July take-down for those three houses is in about a week and somebody has to decide.

"What I said was that you may not use the calculation as a reason not to go. Not that you may not calculate."
The two books are named for a line in the preface of the first. A human life is of the utmost weight; it is more precious than a thousand pieces of gold — and a single prescription that saves it has a virtue beyond even that.
The essay that goes with them is the one every physician in the tradition has had to answer to since. It requires that a doctor treat the noble and the base, the rich and the poor, the beautiful and the ugly, enemies and kin, strangers and friends, foreigners and Chinese, the foolish and the wise all alike, as though each were his nearest relation — and then adds the harder clause: nor may he look before and behind, calculating his own fortune or misfortune, cherishing and protecting his own life.
Told by a man that he had paid a hospital deposit that afternoon and then immediately checked his own balance, and had known while doing it that he should not have, the author of that clause said, without pausing: you should have looked.
And then he explained what the clause forbids, which is narrower and more usable than the way it is usually read. Sixty years of practice; every journey costed before he set out; three-day walks on which he had worked out exactly how much medicine he could have gathered in the hills instead — and went.
A man who does not calculate arrives after three days with nothing inside him. He thinks himself admirable. And a man who thinks himself admirable does not examine carefully.
The man who has done the sum and goes anyway arrives steady.
The same essay contains the instruction that governs everything after the arrival: observe the signs in detail and lose nothing so fine as a hair. Asked what the signs are, he was concrete — the colour of a face, the tongue, the pulse, whether the man sweats, when the pain comes — and then stated the reason the list matters.
The illness is inside and cannot be seen. All you can see is the signs.