Greetings from Guangzhou — the last stop of a thirteen-day journey across China, and the place where this trip quietly found its closing metaphor.
This afternoon I had the honor of speaking at the SUNYIXIAN (逸仙) Forum, the Sun Yat-sen symposium convened with our gracious hosts at China Resources Double-Crane and with Prof. Li Yan and his team at Sun Yat-sen Memorial Hospital — one of the great diabetic foot and metabolic research groups in China. My talk: “A New Paradigm in Wound Healing: Global Evidence of Macrophage Modulation in DFU Management.”
Here is the argument, in brief. For decades we have treated the chronic diabetic foot wound as a surface problem — something to cover, debride, and dress. But the wound that will not heal is not failing for lack of a dressing. It is failing because its underlying program is stuck: the macrophage, the master switch of the healing response, refuses to flip from its inflammatory posture to its reparative one. Increasingly, the most interesting therapies in our field are the ones that speak to that switch directly — that reset the operating system rather than just patching the screen. The global evidence is starting to converge, across very different molecules and mechanisms, on the same idea: heal the biology, not just the hole.
And then there is where I was standing when I said it.
Most people know Sun Yat-sen (孙中山 / 逸仙, Yixian) as the founding father of modern China. Far fewer remember that before he was a revolutionary, he was a doctor. He trained in medicine here in Guangzhou — at the Canton Hospital Medical School, the oldest Western medical school on the Chinese mainland, whose roots run back to a small mission hospital opened in 1835. He carried a scalpel before he carried a manifesto. He understood, in other words, that the most radical thing you can do is fix what is broken in front of you — and then refuse to accept that it had to be broken in the first place.
That is not a bad creed for a limb preservation surgeon. We are, all of us, in the business of small revolutions: an amputation that doesn’t happen, a wound that closes, a patient who walks back into their own life. To give a talk about rebooting the wound’s biology in the very city where Chinese medicine and Chinese revolution were born from the same person, in the same place, felt less like a coincidence and more like a closing argument.
It is also the perfect bookend to the two weeks behind us. We began in Shijiazhuang at the SIDC meeting, building a common language of risk around WIfI and the Toe-and-Flow team. We moved to Shanghai, where CODHy China hosted its first-ever dedicated limb preservation session — and I had the rare privilege of co-chairing it standing between one of my great mentors, Prof. Sir Andrew Boulton, and one of my world-class mentees, Prof. Wuquan Deng of Chongqing. Three generations, one table. And now Guangzhou, where the through-line of the whole trip came clear: the science is portable, the team approach travels, and the mission — remission, not just closure — is the same in every language.
Deepest thanks to Prof. Li Yan and the Sun Yat-sen Memorial Hospital team for their warmth and their hard questions; to Prof. Zhangrong Xu, who set this entire tour in motion; and to Yurui Lai, Yuhao Bai, and the whole CR Double-Crane family, whose hospitality across five cities was, as always, gracious beyond description. To the colleagues who stayed afterward to ask exactly the right things — about offloading, about timing the biology, about how to build a limb preservation team inside their own hospital — those are the questions that change practice. Keep asking them.
Tania and I fly home tomorrow with full hearts and a longer list of friends than we arrived with. Onward — and 谢谢, China.
This is what putting weird ideas together with wonderful people looks like.
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