April 2, 2003
People’s Hospital Number 301, Beijing, China
2,397 Infected, 259 Dead
I HAVE NO BIOLOGICAL WAY OF EXPLAINING THIS, BUT I BELIEVE THE SARS virus also triggers memories, reminds those who have lived through epochs and been washed along the cruel tides of history that there are opportunities for redress. Stay alive long enough, keep looking, don’t stop thinking, and then suddenly that vast trove of memory will be unleashed, not as history or fact but as a moment of bravery and clarity.
He had watched this before, seventy-three-year-old Dr. Jiang Yanyong recalled, had seen the best and brightest brought down because of a lie, for the government’s prevarications, recalcitrance, and duplicity. He had been on duty the evening of June 3, 1989, when the People’s Liberation Army (PLA) massacred the students in Tiananmen Square. It was a pivotal moment in modern Chinese history, as significant and defining as Deng Xiaoping’s reforms or Mao Tse-tung’s declaration of the founding of the People’s Republic. But while those dates are noted and celebrated on the Chinese calendar—in Hong Kong, as in the rest of China, the founding of the People’s Republic is a public holiday—the massacre at Tiananmen is seldom discussed and never celebrated, and the protests themselves are always condemned by the government. If you were to write an alternative history of modern China, a sort of Plot Against America set in eighties and nineties East Asia, you would start with that gathering on Beijing’s main square, and instead of the Politburo Standing Committee and Deng Xiaoping ordering the army to clear the square and “put down the counterrevolutionary riot that has erupted in the capital,” there would be a brokered, negotiated deal between the students and Zhao Ziyang, the liberal premier who had been the actual architect of the Deng-era reforms. Instead, we are living that dark alternative history. The Politburo Standing Committee and Deng Xiaoping did declare martial law and order the square cleared; thousands of students were massacred; and Zhao Ziyang was kept under house arrest until his death in early 2005. Political reform in China has been relegated to an issue embraced by masochists and exiles as economic reforms have pushed aside concerns such as civil rights and democracy. Yet during the SARS season, the true human cost of that repressiveness once again became apparent as the government’s cover-up of the extent of the outbreak was allowing the epidemic to burn through first Guangdong, then Shanxi, and now Beijing.
Dr. Jiang Yanyong had been on duty the night of June 3, 1989, as the director of the 301 Hospital’s Department of Routine Surgery. He was resting in his dormitory room when he heard a succession of gunshots coming from the north. A few minutes later, his beeper paged, summoning him to the emergency room. “We are a big-city hospital,” he remembers. “We were not used to seeing young people coming in with this level of trauma.” Seven students had been dragged in by their compatriots, fellow protesters carrying red banners. Who would kill children? wondered Dr. Jiang. “The army!” the students shouted, their faces a curious mixture of fear and rage that distorted their features to cartoonish levels of expressiveness. “The fascists. It’s a bloody massacre.”
The protesters, upon hearing that the PLA was approaching Tiananmen with orders to clear the square, had sent a few dozen students out to Muxidi Bridge, near Dr. Jiang’s hospital, where they joined with local citizens and workers to build a series of barricades along the main avenue into Beijing. Drivers of electric-powered buses parked their vehicles across the roads, and students and workers began ripping up the roadway and stacking cobblestones in piles in preparation for a clash with the army. The hope among many of those who were on the avenue that night, or in the square, was that the army would not fire on its own people, on students. Yet Deng Xiaoping had made sure that the units rolling into Beijing were not drawn from the capital’s recruits but were instead from Shandong and had been kept in the dark regarding the events unfolding in the capital. They had been told that their mission was to suppress a counterrevolutionary rebellion; and being from Shandong, they would be less hesitant to shoot Beijingers, if it came to that.
As the troops arrived in armored cars and trucks, they launched tear gas canisters over the barricades of buses. The protesters responded by throwing rocks and bricks. About fifty riot police wielding batons stormed Muxidi Bridge, where they were repulsed by a steady stream of projectiles. As regular troops were ordered into the battle, they began chanting, “If no one attacks me, I attack no one; but if people attack me, then I must attack them.” They turned their weapons on the crowd. “People began crumpling to the ground,” wrote Zhang Liang, compiler of The Tiananmen Papers. “Each time shots rang out, the citizens hunkered down; but with each lull in the fire they stood up again.” At least one hundred unarmed citizens were shot as the army fought its way across the bridge. Most of those were rushed to 301 Hospital.
“Lying before me were my own people,” Dr. Jiang would later write, “killed by children of the Chinese people, with weapons given to them by the people.” That night, however, Dr. Jiang did not have time to reflect. There was another salvo of gunshots, followed, a few minutes later, by another delivery of the wounded. He was a surgeon who usually performed intricate cancer and tumor procedures, as well as particularly complicated intestinal operations; he had not seen patients as severely injured as these since he had worked with a PLA engineering unit during the construction of the Chengdu-Kunming Railway, during the 1960s. There he had seen soldiers who had been run through by railroad spikes or crushed beneath truckloads of timber. Yet even those injuries were different in degree of magnitude and violence from what he was seeing here. In 1989, the hospital had eighteen operating theaters. On the date of the massacre, doctors, working in shifts, spent the entire night performing emergency trauma procedures, attempting to save, according to Dr. Jiang, “those who could be saved.”
Eighty-nine students would be rushed to 301 Hospital that night. Seven would die.
An on-duty doctor experiences cataclysmic historical events differently from you or me. Dr. Jiang was so busy trying to stop bleeding, reinflate lungs, and transfuse blood that he could not pause to ponder about why he had been called upon to perform these tasks. It was the bloodiest night of his long and storied medical career, and one that would leave him wondering why and how this had happened. Tiananmen Square was no abstraction for Dr. Jiang, nor was it a political struggle or counterrevolution or culmination of an era of reform. It was blood. Up to his elbows, staining his gown, coating his galoshes. Every surface of each article of clothing would be tinged with students’ blood. While it was figuratively on Deng Xiaoping’s hands, it was literally on Dr. Jiang’s.
HE IS SEATED IN HIS DAUGHTER’S APARTMENT IN WESTERN BEIJING. It is already becoming dark, and outside, in the dusty spring warmth, in those paved gaps between the busy traffic and the buildings, badminton rallies are under way, as they are every temperate evening without rain in Beijing. There are courtyards with sooty bushes and a jungle gym between the buildings of a danwei, “work unit,” built during the 1970s, when two cramped rooms for a family of three or four seemed a reasonable amount of space. These buildings were allocated according to work unit, and if you worked at a hospital in Beijing, as Jiang’s son-in-law does, then you were lucky enough to be granted a place to live in a six-story walk-up with halls that are never cleaned and walls perpetually coated with slick soot. I’ve encountered this same earthy, oily grime in aged housing developments all over China, and it has begun, for me, to represent China’s pre-reform past. That history, in my uneducated mind, is one of mire and muck; and no one can be bothered to take a long enough look at the mess to clean it all up. Gradually, even these decades-old complexes are being torn down to make way for more modern, expensive buildings that will unlikely house those currently living here. The folks in these old danweis will be paid off and then offered the option to buy some lower-priced housing in a distant suburb, beyond some external ring road that has yet even to be numbered.
Dr. Jiang sits on the bed, sipping from a clear mug of green tea. Next to him is a Konka television, and beside that, for some reason, is a toy U-boat mounted on a plastic display. Jiang is tall, thin-boned, and gap-toothed, and has a delicate chin that flattens to a perfectly horizontal line at its base. As he talks, he is animated, energetic, his Mandarin a torrent, and he corrects the interpreter as she relates in English what he has said. For a moment, when you first see him, you think he must be in his fifties—his hair has remained an unnatural crow’s black—but there is an aged droop to his eyes, as if the ocular muscles themselves have worn out from squinting in disappointment at how often his naïve assessments have been proven wrong.
The courage and innocence were always there, wrapped around his history like wreaths around a snake. Born to privilege in a wealthy Shanghai banking clan, he was the youngest son in a family of sisters, doted upon in their large house in the French Concession. He was bright, quick, and handsome, and had the revolution never happened, his life would surely have followed a different trajectory, out of China to a university in the West, then a return to live in the gilded splendor of modern Shanghai. An avid golf, basketball, and tennis player as a boy, he devoted little attention to his studies and was forced to repeat the fifth grade. Yet when his beloved aunt passed away from tuberculosis in 1948, he became determined to pursue a career in medicine.
He then surprised even those Communist classmates who labeled him a “reactionary alien” by sitting for the college entrance examinations a year before he had even graduated from secondary school, “just to get some experience of exam hell,” and then by gaining admission to Beijing University’s Peking Union Medical College, the most prestigious medical school in China. The faculty included Western doctors who taught in English, such as the famed Canadian surgeon Norman Bethune, who encouraged Jiang to specialize in surgery. An adroit surgeon, Jiang won a residency in the surgical department of the General Hospital affiliated with Beijing University. He was notoriously disciplined as a surgeon, and impressed his superiors with his ability to take quick, decisive action that saved many lives. He married and had two children, a son, Jiang Qing, in 1959 and a daughter, Jiang Hui, in 1960. The family moved into an apartment provided by the hospital. Soon, some of his superiors, when they themselves needed an operation, began asking if Jiang would perform the procedure. For the young surgeon with the quiet confidence and steady, delicate hands, the future should have been bright.
But the Cultural Revolution was a malevolent force of (human) nature that did not recognize talent or utility. It is remarkable to visit the Middle Kingdom and speak to Chinese of a certain age: it seems everyone who survived that era has a horror story to tell. Mao’s vision of a deurbanized peasant nation heaped the worst opprobrium on anyone with Jiang’s background. He was branded a member of the reactionary classes, and, like so many descendants of those who had thrived under the nationalists, he was repeatedly denounced as an “alien class element” and criticized for having a cousin, Jiang Yanshi, who was a famous agronomist in nationalist Taiwan. As a result, Jiang Yanyong was rusticated to Yunnan province as part of a PLA railway engineering corps—that was where he saw his first trauma cases. Then, in November 1967, when he returned to Beijing, he was arrested and locked up in the top floor of his hospital. Because he was so highly valued as a surgeon, the hospital party secretary was persuaded to allow him to continue practicing during the day. At night, he was escorted back to his ward, where he was occasionally bound until time for his breakfast of cold congee and tea. After a few months, the party chief of the hospital relented and allowed Jiang to sleep in a bed in an unlocked room on the top floor. To make sure he wouldn’t flee, Jiang had to surrender his shoes and belt every evening. Through the whole ordeal, remarkably, Jiang believed that if he could somehow report to a high-ranking official outside the hospital what was going on—that innocent doctors were being treated like common criminals—then surely he would be released and the party secretary of the hospital would be arrested.
On a Thursday night in 1967, Jiang made his break, holding up his heavy cotton trousers with one hand and charging barefoot down the stairs and out a side door. It was a cold evening. He picked his way down the rough macadam until he found a bus stop, where he hopped an electric bus to Hepingli, where his mother lived. There, he told her that he had to get in touch with the party leadership in Zhongnanhai. “I have to tell them the truth,” he insisted. “If they knew what is going on at the hospital, they would put a stop to it.” Jiang asked his sister to tell her husband, a party member, to pass along his story.
His mother served him some dinner and fetched him a pair of his father’s old shoes. Later, relishing his sudden freedom and eager to see some of Beijing, Jiang decided he would walk to his sister’s house. There was a park between his mother’s and his sister’s, and he cut through it, breathing in the night air and feeling just a bit gleeful that now he would see his hospital party secretary get upbraided—and probably arrested—for his criminal acts.
Leaning back on a bench in the park was a stocky figure in a black padded-cotton coat and a fedora.
“Little Jiang,” the man said. “Have a seat.”
It was the deputy head of 301 Hospital; he told Jiang that Jiang’s own sister had turned him in.
Those officials who Jiang was sure would be outraged by the treatment of surgeons at one of Beijing’s elite hospitals? Throughout China, such injustices had become official policy. China had gone mad. Dr. Jiang, it seemed, was the last person to figure that out.
Upon his return to 301 Hospital, he was subject to an even harsher course of discipline, ordered to wash his fellow surgeons’ feet, shovel pig shit from a sty behind the hospital. Then, one midnight, he was awakened in his fourth-floor room and taken in his long underwear to another room on the same floor. Two uniformed soldiers holding rubber truncheons were waiting for him. They ordered him to sit in a wooden chair, then began shouting shrilly that he was a counterrevolutionary, that he was from the wrong class. This was the first of his “struggle sessions.” By this point in the Cultural Revolution, these struggle sessions had evolved into sadistic spectacles, sometimes attended by just a few officials and soldiers and at other times witnessed by thousands. The denounced, their faces smeared with ink, would be forced to bow for hours while standing on chairs or to wear grotesquely elongated dunce caps and placards with their names crossed out or deliberately distorted. Afterward, in some instances, they would be paraded through town on the backs of flatbed trucks. Some would be imprisoned, like Jiang, only to be exposed to criticism after criticism, denounced hundreds and, in some cases, even thousands of times.
The soldiers shouted at Jiang to admit his class-criminal past. He had heard all that before, though now he realized that his detention and the perverse language of the struggle session were actually national policy. In his first struggle session, the soldiers beat him so hard on the head that he passed out from the loss of blood. Two weeks later, he was pulled from his room again and beaten about the thighs, back, and stomach until he was bleeding profusely from four places. He was dragged back to his room in his long underwear and left on the floor. He couldn’t take his clothes off for two weeks because the dried blood had adhered the fabric to his skin.
Today there are tears in his eyes as he talks about those evening sessions. “But I don’t hate those soldiers,” Jiang says, shaking his head. “They were just following orders.”
When he was well enough to travel, he was sent to a horse farm in Gui Nan, in western China, for reeducation. The place was so isolated that authorities did not even need to put a fence around it to keep the political detainees from escaping. There was only one road from the farm, which led through the desert and to a village three days away by foot. The journey was correctly viewed as being impossible to survive. At the farm, Jiang subsisted on a diet of roots, grass soup, and rice. He did not see his family for five years. Remember, all he had done was be born into the wrong class. What is remarkable about his history is not its extreme hardship but rather how typical it was for Chinese of his generation.
TODAY, JIANG, WHO RETURNED TO 301 HOSPITAL IN 1973, HOLDS A military rank equivalent to general because of his title as chief of surgery at the hospital. He lives in a housing compound in western Beijing reserved for high party officials. In the afternoons, he takes walks through the courtyard and occasionally joins other retirees on the pathways or on benches in the afternoon sun.
Throughout March of 2003, Jiang had been spending more time indoors, like many people around the world, watching television for news of the war in Iraq. The U.S. struggle with the Arab world was of interest to many Chinese, who felt that China would benefit by not being a participant in what was bound to a protracted and bloody clash of cultures. By staying out of it, China could continue to modernize and prosper while American resources were bled away by battles with terrorists and rogue states. China, meanwhile, had no sympathy for fundamentalist Muslim aspirations and was happy to use the pretext of the war on terror to crack down on ethnic separatists in far western Xinjiang Uygur. SARS was only a bottom-of-the-screen crawl on CCTV, a glowing proclamation that it was “under control and there has never been a better time to visit Guangdong Province.” The SARS outbreak had so far been reported as primarily a Hong Kong problem; the disease, if it was in China at all, had probably been brought in by foreigners, the official Chinese media were reporting.
Among international public health officials, of course, there was increasing consensus that the outbreak in China was far worse than the Chinese government was admitting. On March 31, the State Council Information Office reported that there had been only twelve SARS cases and three fatalities in Beijing. It seemed impossible: there were thousands of cases in Guangdong and Hong Kong, and hundreds in provinces throughout China. How could Beijing have just twelve cases?
Dr. Jiang found that discrepancy curious but had no way of contradicting the government’s numbers. But near the end of that month, a good friend of his fell ill with lung cancer, and naturally Jiang was brought in to consult on the case. The patient, a medical professor, was hospitalized at 301 Hospital. Surprisingly, he developed a high fever and a spot was found on his lung. After another specialist was brought in, Jiang’s friend was diagnosed with SARS and transferred to the ICU, before being removed and sent to 309 Hospital, dubbed the official SARS Control and Prevention Center for the People’s Liberation Army. Checking on the treatment his friend might receive, Dr. Jiang phoned respiratory specialists at 309 who were former students of his from Beijing University Medical College.
“They sounded very upset,” Dr. Jiang recalls of those conversations. “I didn’t understand why. There were just a few cases, and that was such a big hospital.”
There were sixty cases, Jiang was told, dozens of them medical staff themselves. Seven patients had already died of the disease. Now 309 Hospital was reenacting the crash-and-burn of Prince of Wales Hospital in Hong Kong, of Hanoi French Hospital in Hanoi, of Tan Tok Seng in Singapore, and of Scarborough Grace in Toronto. Dr. Jiang had never heard of anything similar happening at the top-tier hospitals. He called other colleagues and found that there were similar outbreaks occurring at 302 Hospital, which had forty cases, and even at his own hospital, Number 301, which had forty-six SARS cases. “This is a terrible disease,” one of his colleagues told him. “It acts so quickly. I’ve never seen any disease progress this fast. You go from breathing normally to intubation in three days. You die in a week.”
Why had the health minister, Zhang Wenkang, said there were only twelve cases in all of Beijing when there were sixty in just one hospital? He had even appeared on television and chastised a foreign reporter for wearing a gauze surgical mask, telling him, “You are safe here whether you wear the mask or not. Beijing is perfectly safe to visit for business or pleasure.” Watching the press conference on TV, Jiang could not believe what he was hearing. Either the health minister was lying or he didn’t have the correct data. Both scenarios were unacceptable, considering the nature of a highly contagious, infectious disease. Later, while taking a late-afternoon walk in the courtyard behind his apartment complex, he came upon two fellow retired People’s Liberation Army senior officers. They discussed the fact that there were far more cases than Health Minister Zhang was admitting.
“There must be something wrong with the health information system,” one of the officers said.
“You need to talk to the health minister,” said the other officer. “He’s a doctor. He should know better.”
Jiang agreed. If this disease was as deadly as reports from Hong Kong and Guangdong indicated, then the health minister should be making every preparation to ensure the safety of Beijing, rather than appearing on television assuring the citizenry that there was no risk. Then, Jiang says, he thought about the night of June 4, 1989, and reverted back to that young surgeon locked up on the top floor of 301, before his escape, who thought if only the government knew what was happening there, they would put a stop to it. Naïve to this day, he now speculated that if he just told the health minister about these hundreds of cases in Beijing, about this outbreak, then appropriate prophylactic action would be taken. He would come forward and tell the truth; the Communist Party would see the light.
His wife told him, “Don’t do it. You will get yourself in trouble. Why are you sticking your neck out?”
And then he cried, tears welling in his eyes, “This is bigger than me, or you, or China. I have to tell the world. This could be a disaster for all of mankind.”