Dr. Ai Zhilong (Meet up with China top Head and neck surgeon)

Dr. Zhi-Long Ai

He graduated with a bachelor’s degree in clinical medicine from the former Shanghai Medical University and is currently the Chief of the Thyroid and Breast Surgery Department and the Chief of the Day Surgery Ward at Zhongshan Hospital, Fudan University. He also serves as the Deputy Director of the Chinese Medical Doctor Association’s Thyroid Surgery Group, the Secretary-General of the Chinese Day Surgery Alliance, and a National Member of the Chinese Medical Association’s Thyroid and Metabolic Surgery Group, the Chinese Anti-Cancer Association’s Thyroid Cancer Professional Committee, and the Chinese Research Hospital Association’s Bone Metabolism and Parathyroid Disease Professional Committee. Additionally, he is the Deputy Director of the Shanghai Medical Association’s Thyroid Surgery Group.

Professor Ai specializes in the diagnosis and treatment of diseases such as thyroid, parathyroid, and neck masses, as well as lymph node dissection surgery for lymph node metastasis in thyroid cancer. He is particularly skilled in surgical resection of large thyroids in the neck. He has accumulated extensive experience in open surgery and places great importance on postoperative rehabilitation and the prevention of complications.

YeWen Renyi interviews with Dr. Ai Zhilong

YeWen Renyi:What are some of the recent high-difficulty surgeries you’ve performed?
Professor Zhi-Long Ai:

Like the 51-year-old woman with advanced thyroid cancer I mentioned earlier. She is a sanitation worker, living a tough life. I saw her in the outpatient clinic last Thursday and admitted her to the ward on Saturday. Every step of the surgery was very difficult, as the major blood vessels were all adhered. Part of the tumor couldn’t be removed because it was impossible to determine if there would be any nerve damage, and there was a risk of her losing her ability to work. So, I left a part of it unremoved. The surgery took three to four hours, and I still don’t know how her voice will be post-surgery. When faced with two evils, we have to choose the lesser one. Many things cannot be perfect.

YeWen Renyi:How do you understand minimally invasive surgery?
Professor Zhi-Long Ai:
Many people think that minimally invasive means small incisions or even no incisions. I believe that the best minimally invasive outcome is when the disease is treated thoroughly and cleanly. Of course, aesthetics are also important.

YeWen Renyi:Do you have weekends off?
Professor Zhi-Long Ai:
In principle, I have to be at the hospital on Saturday and Sunday mornings. One aspect is the surgery itself, and another is postoperative management, communication with patients, and resolving specific issues, which don’t stop on weekends. Although no one forces us to work on weekends, it has become a habit. Most patients are reasonable and understanding, but patients also need to be educated. They shouldn’t think that medical services should be cheap—when we say we treat patients like gods, some patients really start to think they are gods.

YeWen Renyi:How do you manage your patients during your expert clinic?
Professor Zhi-Long Ai:
When I see patients in my expert clinic, if there are many, I ask them to queue and maintain order. If they don’t follow the rules, I’m sorry, but you won’t get my service today. For patients who come from far away or from other cities, our hospital is very efficient. Blood tests taken in the morning can be ready in four hours, so I start my afternoon clinic an hour early to see these patients, but they still have to queue and don’t have priority. My clinic has a fixed number of appointments, but even if the patient is referred by a scalper and is in a critical condition, I will add them to my list when they come to me. Since 2015, the Good Doctor website has set up a WeChat platform for me to interact and answer questions from patients.

YeWen Renyi:Do you sometimes have negative emotions?
Professor Zhi-Long Ai:
We are all ordinary people with feelings. It’s impossible to have no emotions, but it’s about how you manage them. When you encounter unreasonable patients, sometimes you might feel that being a doctor is not worth it, and that the lack of understanding and respect from patients is the biggest regret. However, if I had to do it all over again, I would still choose to be a doctor.

YeWen Renyi:Do you think doctors’ incomes are reasonable now?
Professor Zhi-Long Ai:
From a social division of labor perspective, I believe the income gap between top workers and top doctors shouldn’t be too large. In China, the current pricing system values medical equipment more than doctors’ skills, which is the opposite in the United States. Health insurance standardizes our medication use and fees, which is absolutely correct. However, medical fees are becoming cheaper, and I remember that a CT scan used to cost 800-900 yuan, but now it’s 500-600 yuan. An ECG used to cost 30 yuan, but now it’s 20 yuan. For doctors to maintain their previous income, they have to work at least two to three times as much. I understand why the government keeps medical fees low—there are many other urgent needs for funds and deeper reasons. But we should acknowledge that society has not treated doctors fairly.

YeWen Renyi:Would you want your child to continue being a doctor?
Professor Zhi-Long Ai:
My son is in junior high school now. I originally wanted him to be a doctor, although many say it’s a tough and less respected profession in China. I think it’s still okay. He’s young and hasn’t made a decision yet. Now I want him to study in the UK, where schools focus more on developing students’ abilities, helping them maintain good health and character.

YeWen Renyi:What makes a good doctor?
Professor Zhi-Long Ai:
Simply put, a good doctor is one who is recognized by patients and provides good humanistic care. However, being a good doctor often means being less available to family and friends. This profession requires you to wake up early; I usually get up at six, and my family can’t get a good sleep. For example, I sprained my ankle in February, and it was swollen for more than a month, but I still continued to perform surgeries. I feel very happy when I help patients get better. What I detest most is when patients try to stuff red envelopes in your hand during surgery and then don’t even say thank you after the operation. When they try to give me red envelopes, I refuse them, citing the potential impact on my surgical mindset, and suggest other ways to express gratitude, such as writing thank-you letters.

YeWen Renyi:If you had a year off, what would you like to do?
Professor Zhi-Long Ai:
I would spend more time with my mother. Although we live close to each other, I simply don’t have the time to be with her. She has lived a hard life since she was young and now lives alone, praying and doing needlework every day. The Qingming Festival is coming up, and since my parents are from Hubei, I plan to bury my father’s ashes this year.