After the honor was conferred, while the doctor was making his usual rounds in the Hualien Tzu Chi Medical Center, the main topic of conversation with his patients revolved around his award. "Congratulations, Superintendent Zeng! I saw you on TV," one patient enthusiastically announced. Although Zeng's face glowed with its usual vitality, he looked a bit embarrassed, uncomfortable with all the talk focused on him. "Thank you. I've done too little to deserve the award," he replied with characteristic modesty.

In the consulting room where Zeng saw his patients, a 92-year-old woman complained to him about the constant aches in her feet. After listening attentively to the elderly woman's complaints, Zeng lifted his arm, kept it raised for a short while, and then put it down. With a smile, he told the patient that his arm felt sore even after such a simple movement. "When people get old, their circulatory systems naturally deteriorate. You're not the only one who suffers from this problem, but I'll prescribe some medicine to help alleviate your symptoms."

However, it isn't age alone that contributes to Zeng's own aches and pains. Three years ago, his shoulder blade was injured in a car accident. Despite two operations to repair his injuries, he has not yet fully recovered. On top of these injuries, Zeng suffered a minor stroke last September, triggered by his hereditary hypertension. Fortunately, with the help of physical therapy and regular exercise, he is getting along better now. His handwriting is again neat and orderly, and he continues to see patients twice a week at the Hualien Tzu Chi Medical Center. In light of his advanced age, the car accident, and his stroke, his compassion and dedication to his patients is even more extraordinary.

Even in his leisure time, Zeng does not sit idle. He prefers to immerse himself in books to acquire new knowledge. The thought of retirement never crosses his mind. "We can redo a thing, but we can never relive our life," he observes. "We must cherish every moment and never waste time." Mindful of his advanced age, he knows that he must try even harder to make the best of the time that remains. He hopes to make each day as fulfilling as possible by spending every day doing what he does best--practicing medicine.

Blackfoot disease

In spite of being the recipient of an award that commemorates his long-term contributions to medicine, Zeng states humbly that his only contribution to Taiwan's medical field was his participation in a research project on "black foot disease."

This strange ailment appeared on Taiwan's southwest coast in the 1950s. It was a severe form of vascular disease in which the blood vessels in the lower limbs were severely damaged, resulting in skin lesions and eventually in progressive gangrene. The disease caused unbearable suffering; its victims could often be heard wailing endlessly at night due to the excruciating pain. Because the gangrene spread up the affected limbs like a snake climbing a tree, local inhabitants called the illness the "black snake disease." The only cure for the malady was to have the diseased limbs amputated before the gangrene could spread too far.

In 1958, the Department of Health of the Taiwan Provincial Government instructed the College of Medicine at National Taiwan University in Taipei to form a research team to study the disease. Zeng, then 35, was an adjunct attending physician in the Department of Internal Medicine at National Taiwan University Hospital. Because of his interest and expertise in epidemiology, he was appointed as a member of the research team.

Zeng witnessed firsthand how the illness tormented its victims. He relates the story of a child he encountered early in the project. The boy's fingers began to ulcerate when he was three. At four, one of his feet festered. At five, the other foot showed signs of gangrene. In the end, both of the child's feet had to be amputated. Tragically, the child died anyway; the amputations and disease had left him too weak to survive a subsequent case of pneumonia. Zeng described the frightful disease as one that "dismembers a person alive." He resolved to do his best to root out the cause of the illness and bring an end to people's suffering.

During the first year of the investigation, Zeng spent one week every month in southern Taiwan diagnosing and treating the disease and tracking the conditions of his patients. The medical research was not easy, and inconvenient transportation only added to the difficulties of the project. He usually traveled to southern Taiwan from Taipei by train late at night, and then took a series of buses to arrive at the place where he and the other team members would meet. Most of the patients they visited lived in remote seaside areas. The pictures Zeng still keeps with him today record how he and the other researchers frequently had to take bamboo rafts and wade through mud to reach patients' homes.

The research work was unpaid and required the investigators to spend a lot of time away from home. Zeng's wife, Cui-wei, once took their children to southern Taiwan to see him at work. She saw firsthand the challenges that confronted her husband and his compassionate dedication to his patients. Her memories of what she witnessed during this time are still clear. For example, she remembers that although the local public health office had notified patients to come to the office to undergo examinations, some patients refused to comply. They were afraid and did not want their illnesses to become public. As a result, the doctors had to visit the patients in their homes. Cui-wei recalls seeing her husband going into dim huts at the seaside, carrying patients out on his back, and then checking their condition in broad daylight. Sometimes he even washed the patients' feet to have a clearer look at the affected areas.

These challenges to the project, and many more besides, were so much that it would have been impossible to surmount them without a deep sense of compassion, a hearty enthusiasm, and a strong interest in research work. Fortunately, Zeng possessed all three, and he was able to stick with the project in spite of the obstacles.

Hard work comes to fruition

In 1961, the research team published its first paper on black foot disease. Two years later, the team discovered that the ailment was related to the consumption of artesian well water containing high levels of arsenic. The findings prompted the Taiwanese government to allot NT$800 million (then US$20 million) for the installation of piped water systems to the regions affected by the epidemic. As he had vowed, Zeng had helped to unravel the mystery of the disease, and his efforts were already helping to improve the lives of these rural villagers.

In 1968 and 1977, Zeng published two more important papers elucidating the link between black foot disease, skin cancer, and the consumption of arsenic-rich well water. Later, based on his data, the U.S. Environmental Protection Agency and the World Health Organization established 0.05 milligrams per liter as an allowable concentration of arsenic in drinking water. (The current drinking water standard for arsenic was upgraded in 2002 to 0.01 mg/L of water. As before, this standard was adopted by the U.S. Environmental Protection Agency and the World Health Organization to protect the water quality of public water systems.)

After 1980, an increasing number of areas affected by chronic arsenic poisoning were discovered in more than 10 countries, including China, the Philippines, and Poland. Zeng's research findings not only contributed to the identification of arsenic-related diseases in these areas, but to their treatment and prevention as well. Furthermore, his dedication and scholarly research served to greatly elevate Taiwan's academic status in the world.

Given the high level of technology currently available to medical researchers, it is difficult to imagine that Zeng's advanced scientific findings were obtained using only "primitive" medical and research methods. At the time of the study, there were no computers or advanced medical equipment to aid the researchers. Zeng didn't even have the benefit of an electronic calculator to aid him in performing all the complex computations. He had to draw charts and diagrams by hand and conduct the statistical analysis that accompanies medical research projects by himself. Because of the lack of automated equipment, lab technicians had to repeatedly heat specimens of well water and add in reagents time and time again to obtain results. Needless to say, the difficult research conditions posed a great challenge to the researchers. "It took ten times the effort to produce a research paper back then than it does now," Zeng states.

Research can often be a lonely and time-consuming enterprise. Since the beginning, Zeng has spent a total of four decades in the investigation of black foot disease. This represents a lifetime of work. He did it not to gain fame or wealth, but purely because he had a passionate interest in the work. "Because he cares about his patients, he never feels doing research is hard work," Cui-wei observes. "Besides, he's always enjoyed carrying out research projects. He was never interested in making money." Having been married to Zeng for nearly 60 years, Cui-wei knows her husband and his motivations better than anyone else.

Zeng's work, however, did bring him benefits more real than fame or money. "He cherished the relationships he built with his patients, and his patients were generous in returning his love," said Cui-wei. "They often said he was their benefactor." She mentioned that one year Zeng was diagnosed with liver disease. When his patients found out about his condition, they brought him many Chinese herbs known to have curative effects on liver disorders. "Dr. Zeng is our benefactor, and we cannot let anything bad happen to him," said the patients. In the same way that the doctor had once dispensed care and compassion to his patients, now they did the same for him. They counseled him on the effectiveness of the medicinal herbs and urged him not to forget to take them. During this time, Cui-wei took comfort from the fact that her husband was loved by so many people.

Even after Zeng began his work at Hualien Tzu Chi Hospital in eastern Taiwan, there were patients who made special trips from the southern part of the island to visit him. The visitors reported that their parents had told them they must journey to Hualien to see Zeng, because he was the one who cured them of their black foot disease.

Interest in research work

Ever since Zeng was young, he has been interested in medical research, especially in the field of clinical epidemiology. As a resident doctor at National Taiwan University Hospital, he was especially interested in studying coronary heart disease, hypertension, and apoplexy. In 1966, he pursued further studies at Harvard University in the United States. He was profoundly influenced by his studies under Paul Dudley White, the "Father of Modern Cardiology." Although Zeng continued his research on black foot disease after returning to Taiwan, he also started an investigation on the incidence and distribution of cardiovascular diseases in Taipei, Sanzhi Village, and Wufeng Village. The report he issued two years later summarizing his findings was the first data published on the prevalence of cardiovascular diseases in Taiwan.

Commenting on his research, Zeng notes that, "Doing epidemiological research is like doing field research or archaeological studies--one has to step out of the lab in order to collect correct, objective data. It entails strenuous, laborious effort." A cardiovascular epidemiological study he conducted in 1973 serves as an example. The study involved residents of seven areas in Sanzhi. Each day, lots were drawn to select random individuals to participate in the study. Zeng's research assistants would then visit the home of each candidate to notify them of their selection. At 5:00 p.m., a bus hired by Zeng would travel through the villages to pick up the people (usually more than 10 of them) and take them to the hospital. Beds were prepared for each of the subjects so they could spend the night comfortably. Early the next morning, a series of blood tests and electrocardiograms were given to each patient. Finally, the patients enjoyed a specially prepared breakfast and were then returned to their homes. Such intense sampling continued daily for at least half a year, with a total of 1,009 subjects sampled.

Because of his intense commitment in carrying out research projects, Zeng was able to publish at least three research papers per year. Every time he presented a research proposal to government organizations such as the Department of Health, the National Science Council, or the Council of Agriculture, he made a point of carrying through with the project and publishing the results. "If we want them to help us and trust in our projects, we must be able to present the results to them," Zeng said.

Zeng's research projects and his findings have proved to be invaluable over the years, but his contributions to society have not been limited to his research projects--he has also actively worked to promote public health. In 1978, he established the Medical Counseling Service Association, which provided free medical counseling to the general public. In addition to publishing books on medical care, hygiene, and health, the association operated a telephone hotline. The public was encouraged to call and ask questions about medical treatment, health care, and other related issues.

Zeng also formed a medical team consisting of 30 doctors, dentists, nurses, pharmacists, and other medical professionals. Every month, they traveled to remote, hard-to-reach areas in the mountains of Taiwan to carry out free clinics for people who might otherwise have no access to health care. Zeng participated in this work for six years.

In 1984, he assumed leadership of the Hypertension Prevention Association, where he launched a series of activities to promote the prevention and control of hypertension. These activities included providing free blood pressure checks at public places, producing short films on preventing hypertension, and helping to issue postage stamps that helped raise people's awareness of the disease. These activities attracted a lot of attention throughout Taiwan.

Zeng has traversed the country to measure people's blood pressure and give lectures promoting the idea that "prevention is better than cure." Ironically, Zeng himself has suffered from hereditary hypertension for the past 35 years. However, he has used this condition to his advantage in his role of educating the public: by keeping regular hours and taking his medicine on time, he has been able to keep his blood pressure in check. In this way, he sets a very good example for his patients.

Joining Tzu Chi

After Zeng received the Medical Dedication Award in April 2005, he paid a visit to Master Cheng Yen. His attitude was as modest as ever. "I really don't deserve this," he said. "It's by chance that I won the award." The Master, however, praised him for his accomplishments and reassured him that he was truly worthy of the honor. "You have always shown the courage of your convictions. It has not always been easy," she reassured him.

The Master first met Zeng in 1980. At the time, she had decided to establish a hospital in Hualien, in eastern Taiwan, and was looking for first-rate doctors to staff the new medical facility. When a Tzu Chi commissioner recommended Zeng as an excellent candidate, she went to visit him at his home.

"Dr. Zeng shared with me his experiences in studying black foot disease," the Master recalls. "In order to locate the cause of the illness, he spent a lot of time with his patients. He told me he would carry his patients out of their dark thatched huts and wash their feet to check their condition. I was touched when I heard him say that. I thought to myself that he was such a good doctor, exactly the man I was looking for."

Zeng identified with the compassionate ideals espoused by the Master in establishing a hospital in Hualien, a relatively backward, undeveloped area where medical resources were insufficient. In September of 1981, he became a member of the Hualien Tzu Chi Hospital Preparatory Committee. Every month he would spend one Sunday in Hualien. In the mornings, he saw patients at the free clinic conducted by Tzu Chi, and in the afternoons he would go with the Master to survey suitable construction sites for the hospital. When the Master came to Taipei, he also joined her and other Tzu Chi volunteers to discuss blueprints and designs for the hospital. Such meetings often lasted late into the night.

"At that time almost no one believed in me, but Dr. Zeng did," said the Master. "Although I had no money and only a little help, he never doubted that I'd be able to accomplish such a big project as establishing a hospital. Since the very beginning, he has been at my side supporting me."

Building a hospital from the ground up is a monumental undertaking. Zeng clearly remembers the tenuous financial situation at the time. "In the beginning, only NT$30 million dollars (US$750,000) had been raised for the construction of the hospital. Even after the ground had been excavated to a depth of three meters [10 feet], only NT$140 million (US$3.5 million) had been collected by Tzu Chi volunteers. We were still a long way from our goal of NT$800 million (US$20 million)." But with the same persevering and determined spirit which Zeng had manifested in conducting academic research, he silently did whatever he could do to help bring the hospital into being.

Zeng helped open Hualien Tzu Chi Hospital in 1986 as the vice-superintendent. He was appointed superintendent in 1989, after the passing of Du Shi-mian, the first superintendent of the hospital. Although Zeng's goal was for the hospital to become a complete medical center, he knew such things could not be rushed. The goal would only be attained through a sustained, committed, step-by-step process--the same methodical approach that Zeng had adopted in his research work. "When the hospital was first established, few doctors were willing to work here [because of its situation in remote, backward Hualien]. But later, through all our efforts, things began to improve. With everyone's combined efforts, we were finally able to achieve our goal."

In 1999, thirteen years after Zeng assumed leadership, the hospital was upgraded to a medical center [in Taiwan, only hospitals that possess a stringent list of qualifications are honored with this designation]. Thinking that this was a natural time to pass down the baton of leadership to younger people, Zeng resigned from the position of superintendent. Even so, he still sees patients regularly at the cardiology department. He says he will continue to abide by the "just-do-it" spirit of Tzu Chi volunteers and contribute his medical experience and expertise to serve more people.

Love of books

Zeng loves to read, and he reads extensively to acquire new medical knowledge. In regards to his passion for reading, he admits, "Although I don't teach in school, I know I must constantly learn new things to keep abreast of the latest developments in medicine. That's the kind of attitude a researcher should have." He has long been in the habit of shopping for books, clipping articles from newspapers, and keeping notes. Wherever he is, there is always a pleasant aroma of books. Books take up almost every corner of his living space. Visitors to his home in Hualien soon discover that not only is his study full of books, but so is every other room in the house. All available tables and desks are piled with books. His collection extends even to his garage. There isn't even a single bottle of moisturizer in the master bedroom because there is no room on the dressing table, also buried in books. "He has so many books that I'm afraid their weight will cause our house to sink into the earth," teases Cui-wei with a smile on her face.

Zeng's interest in reading material extends beyond medicine, however; his tastes cover literature, biographies, history, economics, fine arts, and management. He keeps his books and periodicals in excellent condition by putting them in slipcases, and he never dog-ears a page or writes commentaries in the margins. Zeng is not the only one to benefit from his habit of collecting books. When he left National Taiwan University Hospital to work at Hualien Tzu Chi Hospital, he had to hire trucks to transport his books from Taipei to Hualien. He used that occasion to donate many precious foreign books and periodicals to the library of Hualien Tzu Chi Hospital.

"Because I received my schooling under the Japanese [Taiwan was a Japanese colony from 1895 to 1945] and have only a limited understanding of Chinese, the Master gave me this Japanese copy of the Wonderful Lotus Sutra," Zeng said, pointing to the Buddhist scripture on a bookshelf. He said that it was not until he joined Tzu Chi that he began to be exposed to the ideas of Buddhism. Because he spends most of his time acquiring new knowledge to keep abreast of the times, all he knows about Buddhism is that it teaches one to cultivate one's mind.

Although his strength is failing as he grows older, he still studies as hard as ever. During the day he sees patients and reads. In the evenings he watches the TV news, reads newspapers and books, and takes notes late into the night. Sometimes Cui-wei tries to keep her husband from overworking by turning off the lights to force him to go to bed. But Zeng just turns the lights back on and keeps reading. "My daughter told me I must go to bed before 10 o'clock, but I've never obeyed her orders," he remarks with a sonorous laugh.

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Forty years after he graduated from the College of Medicine of National Taiwan University, Zeng wrote an article for a school publication. The following is an excerpt:

Forty years have passed since I was an intern earning a meager monthly salary of NT$49 (US$1.20). Over the years, I've witnessed a great deal of change in our society as Taiwan has undergone an economic metamorphosis and become a wealthy society. I am happy to see that many of my former classmates have stuck to their youthful ideals and have never pursued fortune and fame, as many people in our society have done. They live a simple and spiritually enriching life that is truly worthy of our admiration.

What Zeng eloquently wrote of his classmates can be equally applied to himself. For half a century, throughout his career as a medical doctor and researcher, he has always held firm to his ideals and never pursued material wealth or worldly fame. His focus has always been on the patient, not his own well-being.

Once an entrepreneur traveled to Hualien to see Master Cheng Yen, and Zeng happened to be present at the meeting. When he heard the name of the corporation owned by the entrepreneur, he immediately recalled that the entrepreneur's mother had been his patient more than 40 years before. Despite the passage of four decades, he still remembered her name and the details of her illness. When the Master heard Zeng recall these details from long ago, she said, "The close relationships Dr. Zeng maintains with his patients is really touching. Such exemplary doctor-patient relationships are hard to come by nowadays. Today, when we ask a patient who his doctor is, he's likely to answer that he doesn't know. When we ask a doctor about a patient's condition, he might have to go check his medical history. As doctors focus their attention on curing diseases instead of really caring for patients, there will naturally be more distance in the doctor-patient relationship." Clearly, Zeng's warm and compassionate style of dealing with patients and treating disease stands in stark contrast to the clinical approach adopted by many "modern" doctors.

Chien Sou-hsin, vice-superintendent of Dalin Tzu Chi Hospital, served on the panel of judges for this year's Medical Dedication Award. Speaking of Zeng's unique contributions to medicine, Chien remarked, "Dr. Zeng has made solid contributions to Taiwan's medical field through his studies of black foot disease. What's more important is that behind all his contributions are the distinct marks of care, love, and dedication. Zeng builds and maintains good relationships with his patients. Back in the years when the cure for black foot disease had not been discovered, he was able to cheer his patients up by showing genuine care for them and thus enabling them to see rays of hope in their times of darkness."

Zeng's accomplishments as a doctor are especially noteworthy and valuable at a time when reports of medical disputes and malpractice lawsuits are frequently spotlighted in the newspapers and on television. Chien reflects poetically that Zeng's style of practicing medicine is "like hearing a beautiful song amidst a medley of discordant notes." Indeed, Zeng's work has served as a "beautiful song" in the hearts of his patients for half a century, helping to heal both their bodies and their spirits.

By reviewing Zeng's life, his work, his challenges, his success, and his ultimate contributions, comparing his life to a "beautiful song" seems an appropriate image. Given the good doctor's love of books, perhaps a more literary metaphor would also be appropriate, for Dr. Zeng Wen-bin will most certainly be remembered for writing several important chapters in Taiwan's medical history.