Zhu Hongsheng(1931~2024), Professor of Surgery, Former Director of Cardiothoracic Surgery at Renji Hospital

Introduction

Soft light filled the operating room, its sterile air humming with a quiet, focused intensity. The environment was strictly controlled, a world of absolute stillness.

The heart is the body’s metronome, its steady rhythm driving the circulation of blood that sustains life.

He was a pioneer in Shanghai’s medical community, performing the city’s first coronary artery bypass grafting using the internal mammary artery. He carried out the first emergency bypass graft to treat an acute coronary occlusion. And he was the first in China to apply laser angioplasty to treat stenosis of the circumflex coronary artery.

The Path of Medicine

In August 1931, a boy was born into a Shanghai family for which medicine was a legacy. Named Zhu Hongsheng, his life’s purpose seemed preordained; a commitment to healing ran through his family for generations. His maternal grandfather was a renowned practitioner of Traditional Chinese Medicine in the Jiangnan region, deeply respected by his community. Immersed from childhood in stories of his ancestors’ work, Zhu cultivated a dream of one day saving lives himself.

Zhu attended the affiliated high school of Datong University in Shanghai, a school known for its excellence in science and engineering. Upon graduation, he earned admission to Datong University. But as his peers celebrated, Zhu faced a dilemma: Datong had no medical school, a reality that threatened to force him to abandon his lifelong aspiration.

Zhu consulted his parents. His father, understanding his son’s passion, encouraged him to pursue his dream of becoming a surgeon of exceptional skill and unwavering ethics. “Since your heart has chosen medicine,” his father advised, “dedicate yourself to it completely. Eliminate all distractions and pour your energy into study and practice. Only then can you truly make a difference.”

Inspired by these words, Zhu made a bold choice: he relinquished his guaranteed spot at Datong. Through diligent effort, he earned admission to St. John’s University Medical College—a prestigious private institution founded by the American Episcopal Church. This was his first major milestone on the path to realizing his dream.

St. John’s Medical College maintained exceptionally high standards, attracting distinguished Western physicians whose expertise rivaled that of top medical schools around the world. Its rigorous admissions process required two years of preparatory study to build a strong foundation in the natural sciences and fluency in English before a student could even begin the medical program. The academic pressure was immense; failing even a single course meant immediate dismissal. This system ensured that its graduates were regarded as the medical elite.

“St. John’s was a seven-year program compressed into six because of the wartime conditions,” Zhu recalled. “I spent two years just on biology, honing my English so I could communicate with patients anywhere in the world. We didn’t even start the formal medical curriculum until our third year. We had to master both theory and practical skills through an accelerated course load, adding summer classes in biology, chemistry, and parasitology.”

He remembered studying anatomy to unlock the body’s secrets, biochemistry to understand the chemistry of life at a cellular level, and clinical practice to feel the pulse of life firsthand. This six-year journey was more than just an accumulation of knowledge; it was a period of profound personal growth and total dedication.

In 1952, during a major restructuring of China’s higher education system, St. John’s was merged into Shanghai Second Medical College, which is now known as the Shanghai Jiao Tong University School of Medicine. Yet, the rigorous academic spirit of St. John’s endured.

After graduating in 1955, Zhu joined Hongren Hospital, now the Shanghai Chest Hospital, a leading institution for cardiopulmonary medicine. There, he experienced its bustling intensity, where doctors moved tirelessly through the wards, caring for a constant stream of patients.

Hongren Hospital was home to three preeminent pioneers: Lan Xichun, Huang Mingxin, and Jiang Shaoji. As a student, Zhu had observed them during summer breaks. Later, all three moved to Renji Hospital, and Zhu followed his mentor, Professor Lan Xichun—a foundational figure in Chinese cardiovascular surgery with expertise in both biliary and cardiovascular procedures. Professor Lan demanded meticulousness and held everyone to the most exacting standards.

“During Professor Lan’s rounds, everyone was on high alert,” Zhu said. “He questioned us constantly. Even senior doctors faced direct criticism if they made a mistake. His demanding nature was immensely beneficial to my growth.”

Under Professor Lan’s guidance, Zhu mastered the nuances of case management, precise medication dosing, and the critical timing of treatments. His clinical skills advanced rapidly.

In 1962, Zhu became one of Professor Lan’s graduate students—a role he viewed not as an honor, but as a profound responsibility that demanded his skills be further refined. He absorbed his mentor’s rigorous approach to medicine.

“Professor Lan was incredibly thorough. During his rounds, we didn’t dare relax for a second. If he saw even a small piece of residual adhesive tape on a patient’s skin, he would criticize us for not being attentive enough.”

Despite his growing clinical success, Zhu admitted he was always nervous in Professor Lan’s presence—a lesson in the humility and humanistic care that are inherent to the practice of medicine.

On one occasion, Zhu suggested revising the textbook “Water and Electrolyte Balance.” Professor Lan demanded proof that the existing method for measuring carbon dioxide combining power was imprecise. Zhu explained that modern blood gas analysis provided direct, objective data, whereas the older method required technicians to blow into apparatuses, leading to inconsistent results. Only after Zhu had repeatedly verified his claims did Professor Lan approve the revision.

“Professor Lan’s habit of ‘digging deeper’ was unforgettable,” Zhu reflected. “He would personally verify every formula in a textbook. This taught me that medicine is a field that demands uncompromising rigor.”

Medical Service in Somalia

Medical Service in Somalia

“That day, I was in the middle of performing heart valve surgery when Professor Feng rushed in. He told me to get a haircut and take a passport photo—I was being deployed to Somalia immediately. I reported to the hospital administration, then went to Wangkai Photo Studio, and finally rushed home to tell my family I would be in Africa for an extended period.”

At the time, Somalia was divided into three regions: the former Italian colony in the south, the former British territory in the center, and Djibouti in the north. Zhu Hongsheng was stationed in the southern zone.

“Our base was the ‘Grand Hospital’ in Mogadishu, which was a repurposed Italian military barracks. Inside, it felt like a medical United Nations: Soviet ophthalmologists, Italian surgeons, and specialists from other nations each managed their own departments.”

Reflecting on his mission with the Ministry of Health’s medical team, Zhu came to appreciate the value of being a versatile specialist. Despite long-standing Western aid efforts, local officials and international teams initially viewed the Chinese doctors with skepticism. This distrust only fueled Zhu’s determination to prove their expertise—not just to challenge biases, but to demonstrate the true capabilities of Chinese physicians.

One day, a Somali military officer rushed his daughter to the Chinese camp. The child had swallowed a coin that was lodged in her esophagus. After Soviet doctors had been unable to help, Zhu carefully studied the X-ray and used an esophagoscope brought from China to extract it. The officer’s tearful gratitude marked a turning point—Zhu could feel the community’s trust begin to shift.

As a cardiothoracic surgeon, Zhu’s adaptability proved critical. When a patient with an enlarged spleen caused by schistosomiasis needed surgery, Zhu performed Somalia’s first-ever splenectomy, with only an internist to assist. He credited this success to his mentor at Renji Hospital, Professor Lan Xichun, whose rigorous training had prepared him for such unpredictable challenges.

Many Somali children suffered from untreated cleft lips due to limited resources. “I had rotated through plastic surgery at Renji and knew the procedure,” Zhu recalled. “We began offering these surgeries, giving these kids a chance at normal lives.”

When the Prime Minister’s wife learned of this work, she visited the hospital to meet the children. Her public praise for Zhu’s efforts underscored the mission’s profound impact. Later, the president honored the Chinese team at the presidential palace—a moment Zhu cherished as a highlight of his career. In Africa, he embodied the spirit of medical humanitarianism, inspiring future generations of Chinese aid workers.

Venturing into Medical Frontiers

“Patients first, excellence always.” This principle guided Zhu Hongsheng throughout his six-decade career. He saved countless lives but saw himself simply as a doctor fulfilling his duty. “The purpose of medicine is healing,” he’d say. “We must exhaust every option to rescue our patients.”

Furthermore, Zhu believed that doctors must never make arbitrary judgments. They must draw upon all their knowledge, seeking the most suitable diagnosis and treatment plan with a comprehensive and forward-looking perspective.

In the 1970s, he was consulted on a construction worker who had been crushed by a crane boom. At Xinhua Hospital, experts were divided: some advocated for removing the patient’s entire right lung in a radical attempt to save him.

Zhu argued against this extreme approach. His examination showed the right lung had contusions that could heal, while the damage to the left lung was unknown. Removing the right lung could be a death sentence if the left lung failed. His perspective prevailed. Subsequent X-rays confirmed his insight: the left lung deteriorated while the right lung healed. His intervention had saved the patient from irreversible harm.

In the 1980s, cardiac surgery remained a high-risk field, but Zhu never abandoned a case.

Once, a patient required valve replacement surgery due to severe heart valve disease, but his heart rhythm remained poor after the operation. When the patient’s condition deteriorated critically, Zhu, who was attending a meeting at the medical college, rushed back immediately to perform emergency surgery. The procedure was a success. However, as they prepared to disconnect the cardiopulmonary bypass machine, a new crisis arose.

The patient could not regain a spontaneous heartbeat. This meant the bypass machine could not be turned off; otherwise, the patient would die on the operating table. The medical staff grew tense, all looking to Zhu for a solution. His first thought was a centrifugal pump, recalling from foreign literature that similar cases had been resolved using one. But the hospital didn’t have this device. Calls to other hospitals all came back with the same answer: “None available.”

As time ticked by, anxiety grew. Cardiopulmonary bypass during heart surgery has strict time limits; exceeding four hours can easily lead to hemolysis, causing catastrophic damage to the patient’s other organs.

Zhu made a decision: he would stay in the operating room and continue the rescue. He adjusted the bypass method, switching to a left heart bypass. He remained by the patient’s side for forty hours and ultimately succeeded in saving the patient’s life. This incident led those around him to believe Zhu was a medical genius, but he knew it was simply a reflection of the effort he was willing to expend for his patients. Later, he often told his students never to give up easily—every patient deserves a doctor’s utmost effort.

Zhu frequently shared these two experiences with his students. He hoped they would, like him, truly understand the essence of medicine: to give one’s all to save patients, to never yield, and to have the courage to break through medical frontiers. In his view, these were the essential qualities and virtues of a good doctor.

See the World to Improve Skills

“We decided to initiate coronary artery bypass grafting (CABG) and surgeries for coronary heart disease.”

Subsequently, Zhu pioneered numerous innovative procedures, including internal mammary artery coronary artery bypass grafting and China’s first emergency coronary artery bypass surgery. He performed the nation’s first emergency bypass for acute coronary occlusion and successfully applied laser angioplasty to treat circumflex coronary artery stenosis. He also developed unique insights into the one-stage radical repair of Tetralogy of Fallot, establishing detailed and feasible surgical indications and postoperative protocols that reduced the mortality rate to below 2%, reaching international advanced standards.

Zhu integrated his domestic clinical practice with the knowledge he gained abroad. In the 1980s, he launched a series of innovative surgeries and technologies, making exceptional contributions to the development of China’s cardiothoracic surgery.

During that era, a significant gap existed between Chinese and international medical technology. Recognizing this, Zhu actively engaged in exchanges with his global peers, sharing his clinical expertise with doctors from other countries. He also emphasized close collaboration between internal medicine and surgery, substantially reducing the surgical mortality rate for infective endocarditis and achieving zero deaths across 60 consecutive surgical cases.

Beyond surgery, Zhu championed the translation of medical engineering into practice. In 1975, lacking intensive care units (ICUs) in China, he established one to improve surgical outcomes. To overcome resource limitations, he even obtained a loudspeaker box from the hospital’s labor union to create a rudimentary ECG device, enabling clear monitoring of patients’ heartbeats.

“Medical equipment supply was a persistent challenge at that time. But we helped local factories build China-made equipment which helped us save lives.”

In the early stages of China’s medical development, difficulties were inevitable. Zhu, however, faced them fearlessly, proactively seeking solutions. He firmly believed that learning from global advancements would accelerate innovation, introduce high-quality medical technologies, elevate healthcare standards, and deliver better outcomes for Chinese patients.

Using Technology to Benefit China and Medical Ethics to Inspire Youth

To extend Renji Hospital’s achievements nationwide, Zhu tirelessly promoted the development of cardiothoracic surgery across China. He led the establishment of the East China Cardiothoracic Surgery Collaboration Network, assisting nearly 20 hospitals in provinces including Shandong, Jiangsu, Zhejiang, Jiangxi, Anhui, Yunnan, and Guizhou in launching their own cardiac surgery programs. He also served as the lead instructor for the Ministry of Health’s national cardiothoracic surgery training programs for over a decade, playing a vital role in cultivating a new generation of surgeons.

“I participated in the first coronary artery bypass surgeries at cardiovascular institutes in Guizhou and Anhui. We trained local doctors comprehensively—including anesthesia, nursing, and surgical techniques—over approximately one year. Initially, we collaborated with several hospitals to organize thoracic surgery training programs and compile teaching materials. Gradually, Renji Hospital began hosting these programs independently, earning strong national recognition.”

Zhu placed special emphasis on the growth of young physicians. He believed that doctors at prestigious institutions like Renji Hospital should not limit themselves to clinical work but must prioritize research. He felt that future medical progress would increasingly depend on research capabilities; only through continuous exploration and innovation could physicians establish themselves and achieve breakthroughs.

In their journey to becoming doctors, young professionals must focus on honing their technical skills. Zhu stressed that hands-on training was crucial for surgical development. Surgeons should actively participate in diverse procedures annually, accumulating substantial case experience. This enables them to better address complex diseases, deliver precise treatments, and improve patient outcomes.

On December 5, 2024, at the age of 93, Dr. Zhu Hongsheng passed away due to illness.

Editor: Chen Qing @ ShanghaiDoctor.cn

Note: Chinese Sources from “The Path of Benevolent Medicine” which was published in 2024. It records 90 important medical figures in the history of Renji Hospital. Yewen Renyi (ShanghaiDoctor.cn) team was one of the major writers of the book and is authorized by Renji hospital to create English version on the website of ShanghaiDoctor.cn