A student named Ernest decides that instead of apprenticing with whoever is local, he will go find the best doctor in the land. The search keeps embarrassing him.
He finds Dr. Chen first — the celebrity physician who brought the emperor’s son back when the boy was believed dead, whose practice never stops, who lives in a palace with every luxury you could name. Dr. Chen hears him out, agrees he would make a fine apprentice, and then tells him to go talk to his older brother, who is better.
Dr. Yang lives in a mansion. Respected in his province, comfortable, but no palace. He treats illnesses while they are still chronic or minor and keeps them from becoming catastrophes — and when Ernest cannot stop himself from asking why the better doctor has fewer patients and less money, the answer is that nobody is impressed by a catastrophe that did not happen. He sends Ernest on to the eldest.
Dr. Hu’s house does not stand out in a neighbourhood that was not impressive to begin with. He heals sickness before it develops, before the patient has any idea they are sick. “My methods and skills are only seen and truly appreciated by the wise.”
So fame runs exactly inverse to skill, and for a structural reason rather than an unlucky one: the better the intervention, the less there is to see. The best possible outcome is indistinguishable from nothing having been wrong.
The oldest form of this is in the Heguanzi (鶡冠子·卷下·世賢第十六), where King Wen of Wei asks Bian Que which of the three brothers is most skilled, and Bian Que — the famous one, the one history actually remembers — says he is the worst of the three:
長兄於病視神，未有形而除之，故名不出於家。
My eldest brother observes the spirit of an illness; before it has taken form, he removes it, and therefore his reputation does not extend beyond our family.
若扁鵲者，鑱血脈，投毒藥，副肌膚，閒而名出聞於諸侯。
As for Bian Que, I pierce the blood vessels, administer medicines, and cut into the flesh; therefore my reputation spreads and becomes known among the feudal lords.
The Huangdi Neijing compresses the same three tiers into one line: 上醫治未病，中醫治欲病，下醫治已病 — the superior physician treats what is not yet illness, the middling one what is about to be, the inferior one what already is.
Where I depart from the Chinese sources, and the part I would like argued with: the parable terminates in prevention, and prevention is still the management of a body that is going to fail anyway. So in my telling Dr. Hu sends Ernest on one more time — to his own teacher, a disciple of the Buddha:
To cure illness is noble, to prevent illness is better. But to discover and realize the root of illness, the root of existence, is beyond compare.
That fourth step is mine, not Heguanzi’s, and I want to be explicit about that rather than smuggle it in. What makes it available at all is that the medical frame is not something I am importing from outside — bhisakka, healer, sits in the list of epithets at AN 8.85, and the simile of the good doctor who cures the gravely ill person on the spot is Piṅgiyānī’s in AN 5.194.
The question I cannot settle on my own: the three-tier hierarchy is doing real work in the Chinese material, and I have helped myself to it as a ladder with nirvana on top. Is there canonical warrant for treating prevention as a rung above cure, or is the ladder entirely my construction and the epithets just an epithet?
Full post, with the Chinese original and the English side by side: