No One Embraces a Skeleton, Unless He Is Your Teacher

A middle-aged man wearing glasses stood before a human skeleton. After looking at it for a while, he stepped forward, suddenly reached out and embraced it, then lowered his head and wept like a child.

This might have been a somewhat unsettling scene, but it is hard to feel fear once you know whose skeleton it was.

Because the man he was holding was his teacher—Zhang Jinzhe.

Many Chinese people may not have heard this name. But if a child with appendicitis, intestinal obstruction, congenital malformation, or a tumor walks into a children's hospital and is eventually admitted to a department called "pediatric surgery," then Zhang Jinzhe is a name worth remembering.

Because when he was young, China barely had a true pediatric surgery specialty.

Children are not miniature adults

Today, when a child needs surgery, parents naturally think of children's hospitals and pediatric surgery. But decades ago, this was not a given.

At that time, China lacked an independent and mature pediatric surgery system, and children needing surgery often had to be admitted to adult surgery departments. But children are not miniature adults, especially newborns and infants. They have less blood volume, lose heat more easily, and are more sensitive to anesthesia, blood loss, and infection. Surgical trauma that an adult can withstand may be a matter of life and death for a baby weighing only a few kilograms.

Even if the surgery itself succeeded, the child could still die from anesthesia, infection, shock, or postoperative complications.

So when pediatric surgery was just starting in China, the first problem doctors had to solve was not even how to make surgery more refined, but a more basic one: how to get the child off the operating table alive.

It was against this backdrop that Zhang Jinzhe began his work.

He was born in Tianjin in 1920. In 1950, at the age of 30, Zhang Jinzhe began to establish pediatric surgery. After the Beijing Children's Hospital was founded in 1955, he came to work there and gradually built and developed the pediatric surgery system.

In those days, there was no mature pediatric anesthesia system, no surgical instruments suitable for children, no neonatal intensive care as we know it today, and even for many diseases, there was no direct experience to draw upon for pediatric surgical treatment.

With no ready-made methods, they had to find their own.

Zhang Jinzhe studied pediatric anesthesia, improved surgical methods, and devised surgical instruments himself. He even set up a small workshop at home to make and refine various tools.

Later, some instruments and techniques in Chinese pediatric surgery were named after him: "Zhang's forceps," "Zhang's membrane," and "Zhang's flap."

The significance behind a pair of forceps

One important application of "Zhang's forceps" was in surgery for conditions like congenital megacolon in newborns.

Congenital megacolon is a serious congenital disease. A portion of the child's intestine lacks normal ganglion cells, preventing intestinal contents from passing normally, which can lead to intestinal obstruction, infection, and even death in severe cases.

Under the medical conditions of that time, treatment for such diseases often required multiple stages. For a newborn, each additional surgery meant facing the risks of anesthesia, trauma, infection, and other complications again.

Zhang Jinzhe continuously improved surgical methods and instruments, designed specialized forceps, and pushed for simplifying treatments that previously required multiple stages. The significance was not just "one less surgery," but reducing the risks and suffering of repeated operations for the child.

Innovations like "Zhang's membrane" and "Zhang's flap" were used in biliary surgery.

One challenge in biliary surgery is that after reconstructing the bile drainage pathway, intestinal contents may reflux, causing new complications such as infection. Zhang Jinzhe designed and improved structures and techniques to address these issues, aiming to ensure normal bile drainage while reducing postoperative reflux.

These techniques and instruments were later applied not only domestically but also attracted attention from international pediatric surgery peers. Especially for regions with limited medical resources, methods that do not rely on expensive large equipment but can solve practical clinical problems have special value.

This is also a microcosm of the working style of doctors of Zhang Jinzhe's generation. They often faced not "what is the most advanced equipment in the world," but "under current conditions, how can I save this child?"

More important than being able to do surgery yourself

Zhang Jinzhe soon faced another problem: it was not enough for a country to have only a few doctors who could operate on children.

A doctor can perform a limited number of surgeries in a day, but China has a huge number of children. Therefore, the truly important thing for building a specialty was not just being able to do surgery yourself, but also training the next generation of doctors and forming a diagnostic and treatment system that could be passed on.

Zhang Jinzhe began to train a large number of pediatric surgeons. After becoming doctors, his students trained the next generation. At the same time, within pediatric surgery, more detailed subspecialties gradually emerged, including neonatal surgery, general surgery, urology, orthopedics, oncology, emergency, and pediatric anesthesia.

Thus, a medical specialty that had barely existed in China was gradually established.

From this perspective, what Zhang Jinzhe truly left behind was not a single famous operation, nor just a few instruments named after him, but a whole system that could continue to operate: doctors, techniques, experience, departments, teaching, and talent cultivation.

An excellent doctor can save many people, but establishing a specialty can allow countless patients he never met to receive treatment in the future.

"The practice of medicine is the art of love"

Zhang Jinzhe spent his life in surgery, yet he once summarized medicine with a gentle phrase: "The practice of medicine is the art of love."

Surgery may be one of the specialties that emphasizes technical precision the most. Where the incision is, how to handle blood vessels, how to suture tissue—every step must be accurate. But Zhang Jinzhe's patients had a special characteristic: they were children.

Adults know why the doctor is giving them an injection or performing surgery, but a three-year-old does not. He only knows that the stranger in the white coat might hurt him.

So when Zhang Jinzhe examined children, he paid attention to small things that seemed unrelated to advanced medicine. On cold days, he would warm his hands before touching the child; if a child was afraid of doctors, he would find ways to amuse them, sometimes even performing magic tricks.

These details do not make a surgery more technically advanced, but they make a frightened child more willing to accept the doctor.

For a pediatric surgeon, this is also part of medicine.

From Chinese pediatric surgery to the international stage

As Chinese pediatric surgery gradually developed, Zhang Jinzhe also became an influential figure in the international pediatric surgery community.

In 1997, at the age of 77, Zhang Jinzhe was elected as an academician of the Chinese Academy of Engineering.

In 2000, at the age of 80, he received the Denis Browne Gold Medal. This is one of the most prestigious honors in the field of international pediatric surgery, named after Denis Browne, an important pioneer of modern pediatric surgery.

Counting from 1950 when he began to establish pediatric surgery, Zhang Jinzhe had already worked in this field for a full half-century.

But he did not leave the clinical front line because of age or honors.

Even at the age of 94, Zhang Jinzhe still insisted on seeing patients in the outpatient clinic.

This is a very interesting thing.

A doctor born in 1920, in his later years, sat in the consultation room of a modern children's hospital. Outside the door, young parents held their children in line, registering for pediatric surgery, waiting for a dedicated children's surgeon to examine them. They would take all this for granted.

But when this old man in the consultation room was young, this very system had not yet been established.

What he spent decades helping to build eventually became something that later generations took for granted.

This may be the most important achievement of a medical pioneer.

After 102, he became a teacher again

On December 24, 2022, Zhang Jinzhe passed away at the age of 102.

Before the end of his life, he had already decided where his body would ultimately go.

He chose to donate his body to the cause of medicine.

A man who taught students all his life became a "silent teacher" in medical education after his death. Later, his remains were made into a skeletal specimen and placed in the anatomy specimen exhibition hall of Capital Medical University.

When his student, Han Wei, a doctor at Beijing Children's Hospital, learned the news, he went back to visit his teacher.

Thus, the scene at the beginning of this article occurred.

When Han Wei saw Zhang Jinzhe again, his teacher was still "standing" before him.

Only this time, the teacher who had stood on the podium giving lectures, guided them beside the operating table, and sternly criticized them when they made mistakes, could no longer speak.

The teacher and student met again, but they could no longer converse.

For a man who had been a doctor for decades and had seen countless life and death, this scene still brought a huge shock.

Han Wei stepped forward, embraced the skeleton left by his teacher, and could not help but weep.

No one embraces a skeleton, unless he is your teacher.

When Zhang Jinzhe was alive, he taught his medical knowledge to his students; after his death, he left his body to the medical school so that future medical students could continue to study the human body structure.

For his students, this may be the last lesson their teacher gave them.

From 6.1% to 0.62%

If we shift our gaze from Zhang Jinzhe alone, we can see an even greater change.

In 1991, China's under-five mortality rate was about 6.1%.

By 2023, this figure had dropped to about 0.62%.

During the same period, China's infant mortality rate fell from about 5.02% to 0.45%.

In just over thirty years, China's under-five mortality rate dropped by nearly 90%.

Of course, this change is by no means the sole achievement of Zhang Jinzhe, nor can it be simply attributed to the development of pediatric surgery.

Behind it is the combined progress of the entire society and the medical system: economic development, improved nutrition, clean drinking water, vaccines, antibiotics, maternal and child health care, obstetrics, neonatal medicine, pediatrics, pediatric surgery, critical care medicine, and the joint efforts of countless doctors, nurses, scientists, and public health workers over decades.

But Zhang Jinzhe's life allows us to see a part of this enormous change through a specific person.

He was born in 1920. In 1950, he began to establish pediatric surgery. After that, he performed surgeries, improved techniques, designed instruments, established departments, and trained students. After becoming doctors, his students trained the next generation.

By the time he passed away, pediatric surgery in China was no longer a specialty that needed to explain to the public "why it exists."

Today, parents carrying sick children into a hospital naturally look for pediatricians; when surgery is needed, they naturally look for pediatric surgeons.

Few people think that these things, which seem so natural today, were not natural decades ago.

Zhang Jinzhe did not single-handedly create all the achievements of today's Chinese children's medical care.

He was just one of several generations of Chinese medical workers.

But he spent more than seventy years advancing the part he was responsible for.

Finally, he left his body to medicine as well.

Years later, a student he had once sternly taught returned to his alma mater and saw his teacher again.

Only this time, the teacher did not tell him what to do.

The student walked over and embraced him.

The teacher could never speak again, but he still gave his student the last lesson.