When I heard in November that Wei Jingsheng, China’s most prominent dissident, was released from prison and on his way to Detroit’s Henry Ford Hospital—which is part of the institution where I work—I had two thoughts. First, like millions of others throughout the world, I was happy that Wei would finally have a chance to realise his most-cherished dream: the ability to speak freely. “I have waited decades for this chance to exercise my right to free speech”, said Wei, after having arrived in the United States. Considered the father of China’s modern pro-democracy movement, Wei had been imprisoned for all but six months since 1979.

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From his bed at Henry Ford Hospital, Wei Jingsheng meets with his sister, Wei Shanshan, and her six-month-old son, Sebastian, whom Mr Wei saw for the first time. Ms Wei came to visit her brother from her home in Hamburg, Germany. Photo by Ray Manning, Associated Press.

My second thought—okay, maybe it was my first—was a curiosity about his smoking status, and how he would deal with our no-smoking policies. I assumed that Wei, like 60% of men in China, was a smoker. Given the suffering he had to endure, and the harsh prison environment to which he had been exposed, I figured the odds of him smoking were even greater than 60%. If I was correct, how, I wondered, would he endure the 12-hour, non-stop, no-smoking flight on Northwest Airlines from Beijing to Detroit? And how would he handle his nicotine cravings as a patient in our hospital, which, like all accredited hospitals in the United States, prohibits smoking indoors?

As Wei was treated for mild high blood pressure, chronic bronchitis, arthritis, and a mild liver condition by my colleagues at Henry Ford Hospital, snippets about his smoking came out in the massive media coverage surrounding his release. An article in the Detroit Free Press (22 November 1997) noted that “Doctors also told him to quit smoking. One human rights activist chided him for insisting on smoking in his hospital room.” Time magazine (1 December) reported that “Wei was showing just a touch of the spirit of defiance that got him into such trouble back in China. He was caught smoking against doctors’ orders and later demanded a speedy release from the hospital.”

I was pleased to hear from Judith Mackay, who runs the Asian Consultancy on Tobacco Control in Hong Kong, that an important health message was getting back to China and other countries of Asia. “The most wonderful thing”, she told me, “is that it has been widely reported around Asia that his (Wei’s) main health problem is due to his smoking and that your Henry Ford Hospital has told him to quit!”

I had hoped that our doctors and our policies might convince Wei to give up smoking. But that hope seemed illusory when I read in theWashington Post (14 December) that he had lit up at a dinner party in our nation’s capital, a few weeks after having left the hospital. His dinner hosts were chagrined that this had happened in their home, which up to that point had had a strictly enforced no-smoking policy.

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Wei Jingsheng, in a photograph similar to the one that appeared in “Newsweek”, wearing a Henry Ford Health System (HFHS) “no-smoking” lapel pin (inset). The cloisonné pin features the staff of Æsculapius (the mythical god of healing) as part of the international “no-smoking” symbol. Photo of Wei Jingsheng by Ira Wyman of Sygma Photo News (New York), reproduced with permission.

How would Wei’s hosts explain this behaviour, and their own “bending” of the rules, to their children, who had never seen anyone take a single puff inside their home? “Even great people are just people”, they told their children, “and they may do unwise things in their personal lives . . .. Tolerance of weakness in others is often the door to appreciating a person’s special qualities or strengths.”

I took this sage advice to heart, focusing my attention on Wei’s strengths and setting aside my preoccupation with his smoking status. And as the nation’s press corps turned its attention to more titillating news, Wei Jingsheng faded from my radar screen.

Two weeks later, though, the story hit me again, when I saw a column by Wei in the 29 December/5 January issue of Newsweek. A large picture of this hero, smartly dressed and looking fit, jumped out from the page. But my eyes zeroed down to one small item in the photo—the round pin on his black leather vest. I was stunned, and befuddled, to see this. It had to be the “no-smoking” lapel pin I had distributed to all the physicians in the Henry Ford Health System. Although it was difficult to be certain, the colours of the pin in the photograph seemed to match the distinctive colours of the pin we had created (figure).

I promptly contacted Dr John Popovich, chief of our Pulmonary Division, who was in charge of Wei’s medical care at Henry Ford Hospital. Dr Popovich confirmed that he had indeed given Wei our lapel pin.

So my first question was answered. Yes, the pin in the photograph was indeed our very own. But a greater mystery remained unsolved. By all accounts Wei was continuing to smoke—even where it violated local rules and mores. Why then, would he wear a “no-smoking” pin in a posed photograph, taken to accompany an article he was having published in a prominent international magazine?  Perhaps Wei considered the pin to be an attractive piece of jewellery. Or maybe it was his way of thumbing his nose at the loss of his “freedom” to smoke—a “liberty” which, ironically, he could still enjoy back in China. “I know all about your stupid rules”, he might have been thinking, “but now that I’m free, I’m going to do as I please.”  But my optimistic take on this is that he wants to quit smoking. By wearing the pin, Wei is telling the world that he longs for the day when he can achieve another freedom—freedom from a deadly addiction.