In 2002, Wei Ziqi had his first business cards printed up in Huairou. He settled on a humble name: A Small Post on the Great Wall. The back of the card invited tourists to “return to the simple nature of the past.” In recent years, even as rural migration accelerated, upper-class Beijing residents with cars have started taking pleasure trips to the countryside. By the summer of 2002, it seemed that almost every weekend somebody found his way to Sancha, usually by chance. When they saw Wei Ziqi’s hand-painted advertisement beside the road, they often stopped at his house for a meal cooked by Cao Chunmei. Wei Ziqi told me that, if he were able to advertise in the cities, he could triple his income.

He liked talking with Mimi and me, and often he asked us about life in America. He was amused by my inability to fix even the simplest electrical or mechanical problem, and he liked the fact that I was a writer. The other villagers were also interested; sometimes I turned around from my computer and saw a peasant standing in my living room, watching in rapt enjoyment. Nobody in Sancha knocks when they visit a neighbor.

I parked the car and walked directly inside. Wei Jia lay on the kang, the traditional northern-Chinese brick bed that can be heated by a wood fire. His face was pale, and Åecks of blood had dried dark around his nostrils. He didn’t say anything when I touched his forehead.

“It’s a lot of trouble for you,” Cao Chunmei said. She is a heavyset woman with short hair, and usually she has a lovely smile. But now her face was drawn; on the phone she had told me that her son might have a fever. “Will you eat some lunch?” she said politely.

“I already ate,” I said. “I think we should go now.”

Cao Chunmei had put a change of clothes and a roll of toilet paper in the Mickey Mouse backpack. They had decided that she would stay behind until Wei Jia was settled in the hospital. Wei Ziqi carried him down the hill and put him in the back seat of the car. The boy lay with his head in his father’s lap.

The road from the village is steeply switchbacked, and I drove slowly, so the car wouldn’t bounce. After ten minutes, Wei Jia said that he felt sick, and I pulled over. He made gagging noises but nothing came up. As soon as he sat up, twin trails of blood trickled down from his nostrils. Wei Ziqi dabbed at them with the toilet paper. We kept driving.

Fall is the best season in northern China, and it was a beautiful clear day. The peasants had come to the final crop of the year, the soybeans, and they were threshing the haylike stalks along the road. I knew that we had an hour of mountain driving before we reached the highway, and I tried to keep calm by concentrating on the details. We came to Nine-Crossings River—the orange-painted rails of the bridge, the white-streaked bark of the waterside poplars. At Black Mountain Stockade, we had to stop again; this time the boy vomited. There was a long descent from the last blue line of the mountains, and then we reached the plain, where the Ming-dynasty emperors are buried. We passed the faded yellow roof of the tomb of Xuande, the fifth Ming ruler. According to legend, he had killed three Mongols with his own bow. Next, we drove by the tomb of his grandfather, Yongle, the great ruler who had moved the capital north from Nanjing to Beijing, in 1421. Just beyond that tomb, Wei Ziqi asked me to stop again.

The boy spat something up and murmured that he had to go to the bathroom. I couldn’t tell how much of it was due to car sickness—it’s a common ailment among rural people, who are unaccustomed to automobile travel. Wei Ziqi took down the boy’s pants, and he produced a sickly stream of diarrhea. He was very pale now, and there was no expression in his eyes. The back of the car was strewn with bloodstained tissues.

“I think we should keep moving,”I said.

“Give him a minute,” Wei Ziqi said. We stood in a ditch next to a harvested apple orchard; tour buses streamed past on their way to the Ming tombs. I wondered if any tourists noticed the scene: the car with its lights flashing, the father cradling his son. The bare trees in the stark autumn light. The driver in the ditch, waiting.

Wei Jia ran a fever for most of that week. Mimi had arranged for him to be in the children’s ward of a Beijing hospital where the blood specialists are supposed to be good. On the fifth day, Wei Jia’s temperature reached a hundred and four degrees. His platelet count dipped beneath Äfteen thousand—if it went much lower, there was a serious risk of bleeding in the brain.
Mimi and I visited daily, and she generally handled any direct interaction with the doctors. It was safer that way—her spoken Chinese was better than mine, and she didn’t look like a foreigner. Nevertheless, there had been some difficulties in dealing with the staff. When we had first arrived at the hospital, after the drive from Sancha, one of the nurses brusquely informed us that Wei Ziqi couldn’t stay with his son, because only “female comrades” are allowed to spend the night
in the ward. Mimi begged for a one-night exception, because the Weis lived so far away, but the nurse refused. In the end, I had to make another four-hour drive, late that night, to pick up Cao Chunmei.

Chinese hospitals have a reputation for mistreating peasants. Whenever we visited, Mimi and I tried to monitor the boy’s care, and we had advised the parents to avoid a transfusion, if possible. The blood supply in China isn’t safe; donors are in short supply, and the system relies primarily on people who are paid for giving blood. Testing practices vary widely from region to region, blood bank to blood bank. In China, an estimated one million people have been infected with H.I.V.; the epidemic has been particularly severe in Henan Province, just south of Beijing, because of unsanitary donor conditions. Even in cities like Beijing, hospitals usually rely on antibody tests, which are cheaper and less reliable than the molecular diagnostics used by blood banks in developed countries.

In the evenings, after visiting the hospital, I often e-mailed my doctor friends in the United States with questions. On the morning of the seventh day, the Beijing doctors performed a bone-marrow test for leukemia. Immediately after the procedure, Wei Ziqi telephoned me and asked to borrow eight thousand yuan—nearly a thousand dollars. The doctors had decided that the boy needed a transfusion, which had to be paid for in advance. In China, most peasants have no medical insurance, but the Weis had taken the unusual step of purchasing a private policy when their son entered kindergarten. It would cover about half of his bills, but the money could be claimed only after the fact.

That day, Mimi was preparing to leave on a trip, so I went to the hospital alone. When I arrived, Wei Jia was sleeping fitfully. His mother told me that he had been bleeding from the mouth. Accompanied by Wei Ziqi, I introduced myself to one of the doctors on duty. I asked her if the transfusion was critical.

“Who is this?” she said sharply to Wei Ziqi. “Why is he asking questions?”

“He’s a writer,” Wei Ziqi said proudly.

“I’m a friend, as I just explained,” I said quickly. “I have some simple questions about what we should do.”
“This isn’t his affair!” the doctor said to Wei Ziqi. “You’re the parents, and you have responsibility for the child. He has nothing to do with it.”

“I just want to make sure we make the right decision,” I said.

“The decision has already been made!” I had assumed that the hospital staff would be patient with me just because I was showing concern for a Chinese child. But now they glared at me: three nurses and two doctors, all women.

“Who can I talk to about this?” I said, but the women ignored me. I repeated the question—silence. Finally, one of the nurses whispered something, and the others laughed. I felt my face turn red.

“It’s very simple,” I said. “I’m paying for this. I have to know why he needs a transfusion before I pay the money.”
One of the doctors, a middle-aged woman named Zhao, turned to me. “He needs immune globulin,” she said tersely. “If he doesn’t get it, there’s a risk that he’ll have brain damage from internal bleeding. Already he is bleeding inside his mouth. We know what to do, and you don’t understand anything about it.”

“I’m trying to understand as much as I can,” I said. “If you speak slowly, it helps. I’m only asking these questions because I care about the boy.”

“If you care, then let us give him the transfusion.”

I asked if it might be better to wait for the test results to come back, but Dr. Zhao said that the lab was too slow. Finally, I asked if there was a risk that the immune globulin might be infected with a disease.

“Of course there’s a risk!” she said. “It could be infected with H.I.V. or hepatitis or something else!”

“Don’t they test the blood?” I asked.

“You can’t test blood completely,” she said.

“I think you can, actually.”

“Believe me, you can’t!”

“Where does the blood come from?”

“How am I supposed to know?” She was practically shouting now. I backed out of the room with Wei Ziqi. I told him that the blood supply was my main concern, and he nodded calmly.

I used my cell phone to call an American I knew who worked in medicinein Beijing. She was familiar with one local organization that followed international testing standards for blood. After checking with the organization, she called back to tell me they could sell a clean unit for three hundred and seventy-eight American dollars. They could have the blood delivered, but I’d have to get the hospital to accept it.

I took a deep breath and walked back into the staff room. “I’m sorry to bother you again,” I said to Dr. Zhao. “But if we find guaranteed clean blood can we use that?”

“There’s no guaranteed clean blood in Beijing,” she said.

I told her that the other organization performs thorough H.I.V. tests.

“There’s no test like that,” she said.

It sounded like a lie, but I realized that it might simply mean mei banfa—nothing can be done. I said, “If I buy clean blood from them and have them deliver it, can we use it?”

“We won’t accept it!” she shouted. “It’s against hospital policy. Who do you think you are?”

I stepped outside again. At the time, I didn’t realize that Dr. Zhao was actually in the right—such a sale of blood was strictly illegal. My American contact also hadn’t known. In China, pragmatism often blurs such regulations, and a foreigner can find himself operating in shady territory without even knowing it. I called the American again to see if she had any ideas.

“I know some Chinese doctors who used to work at your hospital,” she said. “I’ll ask them to check on the blood supply, and then I’ll call you back.”

I waited in the hospital room with Wei Jia and his parents. During everything that had happened in the past week, they had remained completely calm: no tears, no raised voices. Life in Sancha had taught them that there were limits to what you could control and understand. During my argument with Dr. Zhao, Wei Ziqi had stood in the background, as if it were not his affair. He had a deep respect for my doctor friends in America.

The only decoration in the hospital room was a clock featuring Mickey Mouse and Donald Duck. There were two other patients: a teen-ager with a heart problem, and an eight-year-old with an ailing kidney. The kidney treatment involved large amounts of hormones, and since June the eight-year-old’s weight had increased by fifty per cent. Everything about his body, especially his face, appeared stretched and swollen. My phone rang.

“It’s pretty good news,” the woman said. She told me that the hospital that was treating Wei Jia used the same blood bank as the medical organization that followed international testing standards. “They haven’t ever come up with a positive for H.I.V. That blood bank has been safe so far.”

On impulse, I tried to call a doctor friend in San Francisco, but his answering machine clicked on. I stared at my cell phone. “I think it’s O.K.,” I said finally to Wei Ziqi.

We went downstairs to the hospital’s payment division. Clerks sat behind windows, and money was everywhere: strewn across tables, spinning in counting machines, bound into red bricks. From my bag, I took out a thick wad of cash. Without a word, the clerk tossed it into a counting machine.

After the immune globulin was given, Wei Jia’s fever broke, and within two days his platelet count was back to normal. It held steady for the rest of the week. The bone-marrow examination showed no leukemia; the doctors decided that the condition was in fact ITP. Five days after the treatment, a group of Wei Jia’s relatives came to visit.

There were four men: a grandfather, a great-uncle, an uncle, and a distant cousin named Li Ziwen, a peasant who had joined the military and then moved to the city a few years ago. The rest of the men had come in from the countryside. The great-uncle told me that he hadn’t been to Beijing in almost thirty years.

The men gathered around Wei Jia’s hospital bed. Cao Jifu, the grandfather, put his hand on the boy’s back and spoke softly to him. But the sudden attention had made Wei Jia shy, and he sat in silence at the head of the bed. The sheets had red-brown stains on them from blood tests.

After ten minutes, somebody mentioned lunch. Li Ziwen reached into his pocket and pulled out a wad of bills. He dropped the money onto the bed.

“Use this for the child,” he said.

Wei Ziqi tried to give the money back, but Li refused. For a minute, they argued gently, and then Wei nodded his head in thanks.

The uncle was next, and then the grandfather. The great-uncle went last. He was poorer than the others, and his stack included some tens and twenties. The money lay in four bright piles on the sheets. The boy looked very small, and now he leaned back, away from the bills. There was an awkward silence, and finally somebody mentioned lunch again. Cao Chunmei pushed the money out of sight, under the boy’s pillow. The men filed out of the room.

We went to a restaurant across the street. Wei Ziqi studied the menu intently. When the waitress brought a bottle of grain alcohol, he examined the seal. “Can you guarantee that this bottle isn’t counterfeit?”

The waitress seemed surprised by the question. “I’m pretty sure,” she said. “But I guess I can’t say for certain.”
Wei Ziqi sent back that bottle, and the next one as well. Finally, the third one satisfied him. When the food arrived, he commented that the iron-plate beef wasn’t so good. Carefully, he monitored the dishes, and for a moment I had trouble believing that this was the same man who had stood in the background during the arguments about his son’s treatment. But, as a farmer, Wei Ziqi knew food; he was the expert at the restaurant.

The men drank steadily. The grandfather’s face was the first to turn red with the grain alcohol. He stood up and gave me a formal toast: “We appreciate all of your help with Wei Jia.”

Everybody downed a shot. Wei Ziqi told the story of our drive into Beijing, and the men began discussing the boy’s health. Wei Ziqi turned to me.

“You know,” he said quietly, “I was frightened during that drive.”

I told him that I had been scared, too.

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