Li Zhisui: Personal Physician to China's Greatest Tyrant

Aug 4

by Dr. Konrad Katterle

There is much to be said about the special bond that inevitably forms between a physician and their patient. Doctors see their patients in their most vulnerable state and obtain an intimate portrait of their lives to treat them. This gives the physician great power over their patients, which is why great emphasis is placed on medical ethics. This brings up an interesting question: What if the power dynamic was reversed? What if the patient is a powerful tyrant with power over the physician? It is one thing to discuss the difficult ethics of treating celebrities, as our medical school curriculum does. It is another thing to consider the privileges and dangers that come with treating individuals who could easily dispose of their physicians if they so choose. This was the scenario faced by Li Zhisui, the long-time personal physician of Mao Zedong, the communist dictator who ruled China for nearly thirty years.

Li Zhisui was born to a wealthy family in Beijing in 1920. He studied medicine at Western China Union University and left China to work as a surgeon in Australia. Motivated by patriotism and sympathetic to the promises of communism, Li decided to return to China in 1948 after the Chinese Communist Party had assumed control of China. Using the connections of his brother, a communist party member, Li received a job as a primary care physician to the families of senior communist party officials. As his clinical reputation grew, Li was offered an opportunity to become Mao’s primary care physician.

At that time, Mao had a legendary reputation as a guerilla fighter and political theorist. Millions of Chinese people adored him with a passionate fervor that came to resemble religious awe during the Cultural Revolution. Li considered it a great honor to treat him and accepted the offer. Mao at first appeared to be a very gracious and charming man, but it soon became apparent that there would be certain difficulties with taking him on as a patient. Mao had specifically chosen Li because he knew that he could manipulate him. Under Maoist ideology, farmers and the industrial proletariat were the elite class of China. Well-educated professionals and intellectuals were frowned upon as ‘bourgeois’ elements. Li quickly realized that if he displeased Mao for any reason, Mao could use his family background and his status as a medical professional to blackmail him. Being declared a counterrevolutionary or reactionary in Maoist China could result in imprisonment or death. Furthermore, it became apparent that Mao would only accept medical treatments if he found it ‘appropriate’.

Li’s disenchantment would only continue to grow as he was exposed more and more to Mao’s personal life. The unprecedented access to Mao revealed he had some repulsive personal habits. Mao never brushed his teeth, instead rinsing his teeth with tea every day. As he grew older, Mao’s teeth turned black and started rotting off. Mao also refused to bathe, preferring to get wiped down with wet towels by servants every night. Finally, though he was married, Mao was a notorious womanizer. He would sleep with dozens of young peasant girls that his bodyguards would procure for him. Mao infected some of his paramours with Trichomonas vaginalis but refused any treatment for it because he was asymptomatic.

Li was also disenchanted with Mao’s inability to empathize with anyone except for himself. Mao believed that only he could transform China into a modern superpower, and he did not care if he had to sacrifice millions of lives to achieve this goal. He launched ‘The Great Leap Forward’ in 1958, an attempt to boost agricultural and industrial production by forcing unrealistic production quotas on peasants and threatening death to anyone who could not meet them, among many other foolish policies. The resulting man-made famine killed anywhere from 30 to 45 million people. Mao ended the program when other communist officials criticized it, but he obtained revenge on them later by launching ‘The Cultural Revolution’ in 1966. Mao encouraged students and later soldiers to terrorize and remove ‘rightist elements’ from the communist party. An estimated 2 million people died in the chaos that followed, and many more were brutalized and tortured. Despite the massive body count attributable to Mao’s actions, he never displayed any remorse for his actions. In fact, Li wrote that “Mao was devoid of human feeling, incapable of love, friendship, or warmth.”

Li was fortunate enough to outlive Mao, who died from a heart attack in 1976. Li had been Mao’s personal physician for 21 years. Li left China for the United States in 1988 and was able to get his memoir published in 1994. At this point, Li was a harsh critic of Mao, denouncing him as a cruel megalomaniacal tyrant who sacrificed millions of Chinese people for the sake of his ambition. Li died a year later, in 1995. Serving as Mao’s physician took a great toll on Li. His job required long hours and a great deal of stress, given the consequences that would arise if something were to happen to Mao. But perhaps the greatest tragedy in Li’s life was seeing the horrifying consequences of his patient’s actions and feeling powerless to stop him.