Every doctor learns, usually the hard way, that patients forget most of what we tell them in the clinic but never forget how we made them feel. A correct diagnosis delivered with a sneer can do more harm than a wrong one delivered with kindness. We call it bedside manner, and in medicine it is not a nicety. It is part of the treatment.
I thought about this a great deal this past week, after reading what Chinese Ambassador Jing Quan told reporters in Manila on Oct. 15. Asked about Defense Secretary Gilberto Teodoro calling China a regional “troublemaker,” the ambassador said that if China wanted to use force, it “may easily win”—but that it would not, because China loves peace. He added, for good measure, that Filipinos should feel fortunate to have a neighbor like China, and invited us to look at Ukraine, Gaza and Venezuela to appreciate the calm we enjoy.
I read the statement several times, hoping each time that a gentler reading would surface. Nothing has.
Imagine a surgeon walking into the pre-op room and telling a nervous patient: “If I want to, I can easily end you on that table. But I won’t, because I am a healer. You should feel lucky to have me.”
The words may be technically true. The intent may even be reassuring, in some convoluted way. But no patient comes away from that encounter feeling safe. The patient comes away looking for a second opinion—and perhaps a lawyer.
That, in essence, is why the Department of Foreign Affairs summoned the ambassador on Oct. 19 to tell him his remarks were provocative and unacceptable, and why President Marcos said they sounded very much like a threat. It is not oversensitivity. It is the normal immune response of a sovereign body to something that does not belong.
Beijing has since backed its envoy and called Manila’s reaction an overreaction, while the embassy insists the remarks were taken out of context.
I am willing to grant that context matters; in medicine, we never interpret a single lab value in isolation. But some values are alarming no matter what else is on the chart. A serum potassium of 7.5 (which can make the heart suddenly stop) does not become reassuring because the sodium is normal. “We may easily win” is one of those values.
Diplomats, like doctors, have a first duty. Ours is “primum non nocere”—first, do no harm. Theirs, I would think, is something close to it—first, do not inflame.
An ambassador is, in a sense, the physician one nation assigns to tend its relationship with another. He is expected to listen more than he talks, and to choose his words as carefully as a clinician chooses a dose. The dose, after all, makes the poison. A milligram of candor can clarify. A gram of condescension turns toxic.
Let me be clear about what this piece is not. It is not an argument against China, or against the Chinese people, with whom Filipinos share centuries of trade, intermarriage, food, faith and family. Filipino-Chinese families are woven into every community, every hospital and every parish I know, and they are as Filipino as anyone else. Nor is it a call to cut ties. Neighbors, like relatives, are not chosen, and any good doctor knows that a chronic condition is managed, not wished away.
What this piece is, is a plea for a better bedside manner.
Consider the clinical setting in which these words were spoken. Barely a week earlier, on Oct. 8, a Chinese Coast Guard ship fired its water cannon beside a Philippine Coast Guard vessel during a medical evacuation mission.
In every civilized tradition I know, the medevac is sacred ground. Even in war, the ambulance is not a target. When a patient is being moved from danger to care, everyone else steps aside. To spray water at that moment, and then days later tell the patient’s family they should feel fortunate—the cognitive dissonance is enough to give anyone a headache no paracetamol can touch.
Then there is the matter of comparison. Telling Filipinos to look at Ukraine and Gaza and count our blessings is a little like telling a patient with crushing chest pain that at least he doesn’t have cancer. It may be true. But it is also beside the point. Pain is not invalidated by the existence of worse pain elsewhere, and peace is not a favor bestowed by the stronger party. It is a shared responsibility, like the health of a household.
Years of clinical practice have taught me something else: The most dangerous physician is not the one who knows too little, but the one who is too sure of himself. Overconfidence is a well-documented cause of diagnostic error.
The doctor who believes he cannot be wrong stops listening, and the moment he stops listening, he starts missing things.
National power, I suspect, works the same way. A great nation that reminds a smaller one how easily it could be overpowered has revealed, perhaps without meaning to, that it has stopped listening.
And Filipinos have a long memory for tone. We are a people who say “po” and “opo”, who call strangers “kuya” and “ate,” who apologize when someone steps on our foot. We are not easily offended—but we notice.
Some of our senators are now talking about censure, even expulsion. I am not sure expulsion is the right prescription; drastic therapies carry side effects, and channels of communication, once closed, are hard to reopen. But I understand the symptom that produced the outrage.
So what is the treatment? In the clinic, when a doctor has said something wounding, the remedy is simple, if not easy. You sit down. You make eye contact. You acknowledge that your words landed badly, whatever you intended. You do not argue about whether the patient ought to have been hurt. You restore trust first, and resume treatment after.
A brief, gracious word from the ambassador—not a retraction of China’s positions, which no one expects, but an acknowledgment that his phrasing caused genuine hurt—would do more for bilateral ties than a hundred embassy statements accusing others of misinterpretation. In medicine, we have a name for that kind of humility. We call it good clinical practice.
Your Excellency, you represent a great and ancient civilization, one that gave the world acupuncture, a vast herbal pharmacopeia, and a philosophy that prizes harmony above all.
Confucius himself taught that the superior man is modest in his speech but exceeds in his actions. We would welcome more of that ancient wisdom in Manila, and a little less bluster.
As a man of faith, I would add only that history has a way of humbling the boastful, and that the meek, not the mighty, were promised the earth.
The relationship between our two countries is not terminal. But it is, at the moment, in need of careful nursing. Kind words cost nothing. Their absence, as any doctor will tell you, can prove very costly indeed. CS
Dr. Rafael R. Castillo is a cardiologist, educator, and public health advocate. He was president of the Philippine Heart Association (PHA) and the Asian Pacific Society of Hypertension, and was a longtime health columnist of the Inquirer. He has over 45 awards to his name, including the PHA Lifetime Achievement Award, and continues to champion preventive cardiology and public health reforms here and abroad.
