Wu Gensheng's Medicine Box

The clinic of Houhe Village stood at the eastern end of the settlement, three brick rooms with a chipped wooden sign reading Village Clinic above the door. Wu Gensheng was fifty-nine that year, and he had sat in those three rooms for forty-two years.

He had learned to give injections from a doctor at the township hospital when he was seventeen, and later became a barefoot doctor, carrying an aluminum medicine chest across every ditch and ridge of Houhe. He had delivered half the village into the world and seen the other half off it. When a woman labored hard, when a child convulsed with fever in the night, when an old man could not catch his breath, he was the first thought of every household. In those days his chest was a treasure box, needles, pills, violet tincture, everything at hand.

The trouble began five years before. An order came down: the village clinic might stock only essential medicines, some three hundred items on a list, all sold at zero markup, and a single cent of profit meant a penalty. The blood-pressure pill Wu had always given Old Tian was not on the list. When he asked someone to bring it from the county town, Director Zhou of the township hospital named him at a meeting: a village doctor buying medicine on his own was a violation, and every case found would be dealt with. After that Wu dared not.

The essential medicines were cheap, but they ran out. The delivery truck came once every two weeks and unloaded little but cold-remedy syrup. Old Tian's pills were missing from the shelf for days on end, and Wu could only substitute another drug from the list that did not work. The old woman muttered, Uncle Gensheng, why has your medicine lost its power? He could not explain, and only slid the empty box into a drawer.

His income went with it. In earlier years he lived on the markup and the fees for house calls; now the markup was gone and charging for a visit was forbidden. All he could count on was the public-health subsidy, a few dozen yuan per person per year, on condition that he built a health file for every soul in the village, followed up on the hypertensive and diabetic month by month, and gave every elder an annual exam. Each task had to leave a trace: a located photograph, a signature, an entry into the computer. Wu could not work a smartphone; his middle-school grandson taught him for half a month before he could barely open the locating app.

The assessments grew finer. File completeness, follow-up authenticity, exam rates, miss one and the money was docked; fake a record and he was reported. He often filled forms by lamplight past midnight, his reading glasses sliding to the tip of his nose, his hand shaking so that he could hardly write his own name. His back had been ruined by house calls in the old days and would not straighten; his eyes were ruined by the forms and had gone dim.

Then came the trouble of last winter. Old Tian's pills ran out again, and the substitute could not hold her down. In the night her blood pressure rose; first one side of her would not obey, then she could not speak. Her son Dayong came pounding on the door in his clothes. Wu felt the pulse and knew it was a stroke; she had to reach the county hospital for clot-busting at once. But the snow fell thick, the road to the county was iced over, and the ambulance took two hours to arrive. She was saved, yet half her body stayed paralyzed.

Dayong stood red-eyed at the door of the ward and roared at him: Doctor, you cannot even keep your medicines in stock, my mother was lost to your neglect! Wu opened his mouth to say the medicine was forbidden from above, that the hospital delivered only every two weeks, and in the end said nothing. He remembered forty years before, when Old Tian had labored hard, and he had kept watch by the oil lamp through a whole night to deliver Dayong. Dayong remembered none of it now.

The township hospital wanted integration, bringing village doctors under its command. In name a good thing; in truth it made him a gatekeeper: the hospital would pay his wage, a little over a thousand a month, but he must still pay the rent and the electricity himself. Director Zhou spoke with him, hinting at elimination by last-place ranking: At sixty, if you cannot keep up, step down, so you do not occupy a blank spot.

A blank spot. Wu heard the term first in a county bulletin, wherever a village had no doctor, it counted as a blank spot, and someone would be held to account. Yet it was the rules from above that pressed the village doctor into precisely that blank spot. He recalled how the township had once sent two young doctors; neither stayed, one found it too far, the other found it too poor, and both left. Houhe could turn without anyone; without Wu Gensheng, it could not.

He was fifty-nine, had never paid into a worker's pension, and drew a little over forty yuan a month from the rural scheme. Retire, and he would have no food; not retire, and the post grew emptier by the day. The young had all left; half a day passed at the clinic without a single visitor. He took out the old aluminum chest and found a few medicines he had bought in earlier years, now all violations. He looked at them a long while, then locked the chest in the cabinet and slipped the key into his pocket.

One day after winter set in, he went as usual to the township hospital to collect the essential medicines, and by the way to settle his retirement. Director Zhou handed him a form and asked him to sign: he was voluntarily leaving the ranks of village doctors, the subsidy paid in a lump, and thereafter the clinic would be sealed and its patients handed to the township.

He signed. The pen was heavy, as if it pressed down forty-two years of snow.

Back home he took down the wooden Village Clinic sign, wiped the dust with a cloth, and leaned it against the door. The lamp inside was lit no more. For the first few days people still came groping in the dark to knock for medicine; he told them through the door that the clinic was gone, and they stood a moment, cursed the world, and turned into the deeper dark.

Old Tian lay paralyzed on the brick bed. Dayong tied rebar at a county construction site and came home once every two weeks. Sometimes Wu passed by and through the window saw the old woman staring at the ceiling, mumbling. He thought to go in and sit a while; he lifted his foot, and in the end did not cross the threshold.

At year's end the new township hospital lit up, its tiles glaring white, with an elevator and specialist numbers inside. The clinic of Houhe stayed dark, like a well half-filled with earth. When the bulletin came again, in the column of blank spots, the name of Houhe Village was at last filled in, neat and proper.

Wu took the key from his pocket and worked it to a sweat in his palm. He thought of the babes he had delivered in his life, now all grown and gone, like the young of Houhe, never looking back. The medicine chest was locked in the cabinet, the key in his hand, yet the kindness, the remedies, the forty-two years of night roads it once held had long been drained to emptiness by a sheet of assessments and a few out-of-stock essentials.

Wind slipped through the door crack and stirred the wooden sign behind the door. It no longer creaked; it only waited, quiet, to be remembered, and then forgotten.