Yanwen’s blog

I read a disturbing news story today about a 13-year-old girl who nearly lost her life after heart surgery. According to a lawsuit filed by her parents, the crisis began when a prosthetic heart valve was implanted upside down during surgery.

The girl underwent open-heart surgery at Oregon Health & Science University (OHSU) in Portland in August 2025 to receive a new heart valve. Her parents have since filed a $17 million lawsuit against OHSU and cardiac surgeon Dr. Ashok Muralidaran.

After the operation, her heart was unable to function, and she was placed on ECMO for 18 days, a form of life support that temporarily takes over the work of the heart and lungs. OHSU doctors told the family that the surgery had gone well and attributed her worsening condition to postoperative complications rather than a surgical error.

Over the following weeks, the girl underwent additional procedures and exploratory surgeries as doctors tried to determine why she was not improving.

At one point, doctors warned her family that she was near death and discussed end-of-life decisions, including organ donation. The family was also told that she might require an artificial heart or even a heart transplant.

The turning point came when she was transferred to Seattle Children's Hospital. OHSU physicians had warned that the transfer itself could be fatal. However, shortly after her arrival, surgeons at Seattle Children's discovered that the prosthetic valve had been implanted upside down, obstructing blood flow through her heart. They corrected the problem, and her condition improved rapidly, allowing her to be removed from ECMO support.

What makes this case especially striking is the allegation that the source of the problem went unrecognized for weeks despite the girl's severe deterioration. It was only after her transfer that another hospital identified and corrected the valve-positioning error, a step that ultimately saved her young life.

While medical accidents do occur and complications can arise even when surgery is performed correctly, there are still important lessons that ordinary people can learn from this case.

First, when recovery is not progressing as expected, keep asking WHY.

When a patient's condition remains unexplained or continues to deteriorate, patients and their families should continue asking questions. What exactly is causing the problem? What possible causes have already been ruled out? What tests, scans, or other evidence support the current diagnosis? Are there alternative explanations?

Patients and families do not need medical training to ask for a clear explanation of what doctors believe is happening and why.

Second, a second opinion can be lifesaving.

One of the most striking aspects of this case is that the alleged error was identified only after the patient was transferred to another hospital.

For some people, seeking a second opinion may feel like a sign of distrust or even seem offensive to the treating physician. In reality, it is often an important safeguard, particularly when the diagnosis is uncertain, treatment is not working as expected, doctors disagree, or the patient's condition continues to worsen without a clear explanation.

Third, do not be blinded by reputation, authority, or expertise.

Highly respected hospitals and highly trained physicians generally provide excellent care. However, medicine is practiced by human beings, and human beings make mistakes.

A hospital's reputation does not eliminate the possibility of error. Patients should respect expertise without assuming that expertise is infallible.

Fourth, family members play a critical role in patient care.

Critically ill patients are often unable to advocate for themselves. In such situations, family members may need to ask questions, request medical records, seek clarification, and push for additional evaluations when necessary.

The most effective advocates are not confrontational. They are persistent, attentive, and well informed.

Fifth, keep detailed records.

During a prolonged hospitalization, families should maintain a timeline of events, test results, procedures performed, medications given, and questions asked along with the answers received.

Such records can help families understand what is happening, improve communication with healthcare providers, facilitate outside consultations, and provide important documentation if problems later arise.

Sixth, learn to distinguish between complications and medical errors.

Not every unexpected outcome should automatically be dismissed as "just a complication." Patients and families should remain open to both possibilities and continue seeking answers when the explanation does not seem to fit the facts.

Finally, maintain a healthy degree of skepticism.

We should not assume that doctors are always right. Trust should be accompanied by questions, verification, and active involvement in one's own care.

The broader lesson is not simply that doctors can make mistakes. The more practical one is that do your own homework when your life is involved, and especially when a serious medical problem remains unexplained, you should feel empowered to seek additional opinions and perspectives rather than assuming that the current explanation is necessarily complete, correct, and final.

Today, I met a college classmate at a coffee shop near Pier 2 in Brooklyn. As we chatted, we discovered that we both knew the same person—a connection neither of us had been aware of before. The conversation brought back a blog I had written in 2023, about her daughter, Tiantian jiejie.

3/5/2023, yesterday, we went to the American Museum of Natural History with the children. On the way, I told them that I would like to interview Tiantian jiejie about her career path. She has had a very interesting journey, and I’m curious about the thinking behind her decisions. But she is very busy right now.

I shared her story with them. She was born in China, came to Ohio at age seven and half in the fall of 1988, studied philosophy at Harvard University, earned a master’s degree in theology from the University of Chicago, and then returned to Harvard Law School. After that, she worked at WilmerHale as a senior associate. Nearly three years later, she left her job, went to China, and spent about five years starting a company. Then back in the United States in her late 30s, she tried her hand at baking. Today she is a mother of three young children, running a successful bakery business.

Normally, people know what they want to do when they choose a college major, and then follow a path from school into a related career. But she seems to have spent years exploring different interests and trying new things. I am interested in identifying a central thread that runs through her experiences. I also want to think of a message I can share with the parents in our online group. What is it? I asked my children.

My son said that it is perfectly okay to spend years exploring and figuring out what you want to do with your life. Some people take a few years; others need more time. I think the most important part of her story is that she takes time to ask herself, “Is this what I want?” instead of rushing from one goal to the next without reflection. Some people spend their entire lives doing things they don’t enjoy. Others never discover their passions because they never try anything new. It reminds me of an unexamined life. I think she is remarkable. I would really like to hear how she herself makes sense of her journey.

My daughter said she is very courageous—not afraid to start over, even at this stage of her life, even after attending Harvard Law School. The message, she said, might be: don’t limit yourself to one path just because that is what you studied in college.

Well said. Thank you to both of them.

This is the seventh and final essay in my series on Delivering Food: The World of a Female Rider by Wang Wan.

Over the past few essays, Wang Wan has taken us into a world most people rarely see closely—the world of female food delivery riders. Through her writing we see the pressure of the algorithm, the fear of late penalties, the physical wear and tear on the body, and the particular vulnerabilities faced by women riders.

At first glance, this work appears to represent the harshness of the modern platform economy. The system measures every minute, calculates every route, and pushes riders to move faster and faster through the city.

But Wang Wan’s story is not only about hardship. It is also about how people continue to search for security, stability and dignity inside systems that often seem indifferent to human limits.

Like many migrant workers in China and globally, Wang Wan left her rural hometown at a young age and moved to the city in search of a livelihood. Over the years she tried 17 different jobs before becoming a food delivery rider. The work is physically demanding and often exhausting. Yet it also gives her something she values deeply: a sense of control over her own time.

She once wrote:   

“Although my time is broken into fragments and my body slowly wears down, I feel a certain peace of mind. There is always this work that I can return to, and through it I still have a life I can control.”

This sentence captures a simple truth about the lives of many workers. What people seek is very basic. They are simply looking for a way to support themselves independently.

The story of Wang Wan’s mother expresses the same idea. When her mother proudly handed her the 200 yuan she had earned from doing small jobs, the money itself is insignificant. But the meaning behind it is: the ability to earn something through one’s own labor, without depending on others.

In recent years, there has been much discussion about platform labor. Journalists examine working conditions. Economists analyze labor markets. Sociologists debate about inequality. Each perspective reveals an important part of the story.

Yet Wang Wan’s book gives us something those analyses often miss: the voice of someone living inside the system.

She does not romanticize or glorify the work, nor does she see herself as a victim at the hand of the system. She understands the costs of the choices she has made, and accepts them with a calm and gratitude for being able to preserve a sense of dignity in the process.

Cities will continue to change. Technologies will evolve. New systems of work will replace old ones. Yet Wang Wan’s story stays with us, inviting us to think about the millions of people around the world whose lives resemble hers. For them, work rarely means glory or wealth or passion. More often, it means something very basic but just as important—the assurance that they can live by the work of their own hands.

This is the sixth essay in my series on Delivering Food: The World of a Female Rider by Wang Wan.

Wang Wan describes in detail the hardships of working under algorithmic pressure: the constant fear of penalties for being late, the wear and tear on her body, and the particular challenges faced by a female rider.

Yet her writing is not filled with despair or hopelessness. Instead, it reveals a certain tranquility. In Wang Wan’s own words, she says that she “feels calm and steady inside.”

Wang Wan left her home village at the age of nineteen and went to Beijing to make a living. Over the years she worked at 17 different jobs—from a printing factory to transporting medical specimens, from cleaning work to waitressing—before eventually becoming a food delivery rider. The job pays better and, more importantly, gives her some degree of control over her time.

As she writes: “Even though this job wears down my body every day, it is the first job that has made me feel steady and secure.”

Wang Wan tells a story about her mother. Once, when she returned to her hometown during the wheat harvest, her mother took 200 yuan from under her bedding and said, “Daughter, I earned this doing odd jobs for people. It’s all for you.”

Wang sensed the pride in her mother’s voice when she said this.

For most of Wang Wan’s childhood, her mother rarely worked outside the home. First she took care of her children, and later her grandchildren. In the past two years, after her grandchild grew older and required less care, she finally had time to take on small jobs for others—pulling weeds, planting scallions and garlic, picking chili peppers.

Each time Wang Wan urged her not to go. Her mother would simply smile and say nothing. After listening for a long while, she would gently reply, “I can make 80 yuan a day. That’s better than sitting idle at home.” As of today, 80 yuan is equal to $11.65.

Wang Wan refused the money again and again, but her mother slipped it into her pocket anyway. The next morning, Wang Wan secretly put the money back into her mother’s pocket.

That 200 yuan was more than money. It was proof that her mother could still earn something through her own labor—that she did not need to reach out and ask others for help. Even better, she can help her daughter.

As Wang Wan writes: "Work is how they maintain dignity and decency. It is also how I maintain mine.”

She describes her delivery job this way: “Although my time is broken into fragments and my body slowly wears down, I feel a certain peace of mind. There is always this work that I can return to, and through it I still have a life I can control.”

Another side of Wang Wan’s life is this: she is an avid reader and enjoys writing. Even with long hours of riding, she still finds time for what brings her joy: reading and writing.

Her story reminds us that food delivery riders are not simply the “temporary workers” we often imagine them to be. For many people, this job becomes their final refuge. What they seek is a life in which they can decide when to work and how long to ride, even if that control sometimes comes at the cost of physical wear and tear.

Wang Wan’s story also helps us understand what labor means for people with limited choices. It is not that hardship itself deserves praise. But there is something truly respectable in the determination to support oneself through honest work.

For people like Wang Wan and her mother, work is a way to stand upright in the world—to earn one’s meals through one’s own effort, to live without depending on others, and to maintain a sense of dignity.

In a modern society filled with many safety nets, welfare and conveniences, keep in mind that this simple desire—to support oneself through one’s own work—still remains one of the most fundamental sources of human dignity.

3/11/2026

This is the fifth essay in my series on Delivering Food: The World of a Female Rider by Wang Wan.

Last Sunday, March 8, was International Women’s Day. It reminded me of a section of Wang Wan’s book describing the particular challenges faced by female delivery riders.

Platform-based delivery work has spread across cities around the world. In New York, London, and Delhi, riders thread through traffic under the same pressures of time, ratings, and algorithms. The technology processing orders may differ from platform to platform, but the structure of the work is remarkably similar: speed determines income, delays mean penalties, and every minute becomes measurable.

For women, however, this system carries an additional layer of challenge. Like Wang Wan, many female riders find themselves navigating work environments designed largely for men. Safety concerns, harassment from customers or colleagues, and the lack of basic facilities—something as simple as access to a restroom—turn ordinary working hours into a series of risks and discomforts that most male riders rarely have to consider.

For instance, Wang Wan recounts how male customers sometimes opened the door wearing nothing but their underwear. When they saw that the delivery rider was a woman, “they looked embarrassed and flustered, stumbled over their words, hurriedly grabbed the food from my hands, and then quickly shut the door.” On unlucky nights, she might encounter several such customers.

Sexual harassment, unfortunately common across cultures, also became part of her experience. One male rider repeatedly tried to approach her. Once, while she was swapping her battery, he reached out and touched her shoulder. It was not a brief tap—his hand lingered for several seconds. She immediately stepped back.

Later, that same rider even grabbed her phone from the mount on her bike, opened her WeChat interface, scanned his own QR code, and accepted his friend request on her behalf.

On another occasion, after she had picked up an order and was about to leave from the second basement level of a building, the man suddenly appeared again. Without warning, he placed his hand on her shoulder and slid it down along her back until it reached her buttocks before finally removing it.

This time Wang Wan exploded in anger. “Stay away from me. I don’t even know you. Get off.”

To survive in this male-dominated field, Wang Wan gradually adopted strategies to conceal her gender. She tied up her hair, wore a helmet and mask, and spoke as little as possible when handing over orders.

After a while, she writes: “I gradually forgot my identity as a woman. I stopped caring about what I wore. Except for my irregular menstruation and when I had to use the restroom, I rarely had any sense that I was female. The rest of the time, I was simply a person without gender.”

In fact, many female riders adopt this kind of “de-gendering” strategy in order to survive in the industry. To avoid unwanted attention, they try to make themselves appear as gender-neutral as possible.

Yet even then, some difficulties remain uniquely female. One of the most basic is something most people never think about: using the restroom.

Wang Wan writes: “To avoid needing the bathroom, my first strategy was simply to drink less water. It worked for a day or two, but over time it became a problem. When I stopped drinking water, my mouth and nose felt constantly dry and burning. I often had nosebleeds, and I also became constipated.”

Outside Beijing’s Fifth Ring Road, public toilets are scarce. Male riders can easily find a secluded place to relieve themselves, but women cannot. Wang Wan usually had three options: wooded areas, municipal public toilets, or restrooms in shopping malls. None were convenient. In the woods she worried about being seen; public toilets were too few; and in malls the lines were often too long for someone racing against delivery deadlines.

One night, while urinating in a secluded corner of a wooded area in a villa compound, she was discovered by a security guard. The guard suspected she was stealing something and demanded to know why she was squatting there.

She claimed she had lost her keys, but the guard did not believe her and insisted on searching her bag. “I told him he had no right to search my bag and tried to leave,” she recalls. “But he grabbed me and refused to let go.”

At that moment another guard arrived. After hearing what happened, he pulled the first guard aside and said quietly, “She’s just a woman delivering food. Life isn’t easy for her. Let it go.” He gave her a look signaling that she should leave quickly. She ran off immediately.

What Wang Wan describes goes beyond the experience of a single rider in a Chinese city. It reveals a broader tension in modern urban labor. Technology can organize work with remarkable efficiency, but very often the lives of the people performing that work mean something else—subject to fear, fatigue, vulnerability, insecurity, and even lack of dignity.

On International Women’s Day, stories like hers remind us that behind the seamless convenience of food arriving at our doors lies an invisible workforce. Among them are women navigating not only traffic and deadlines, but also the challenges of working in spaces that were never designed for them, and understand that the female workers must improvise constantly just to stay safe, respected, and human.

3/10/2026