Lung specialist extends care to mountain areas

Tucked in the pocket of doctor Du Ronghui's white lab coat is a magnifying glass, her trusted tool for making accurate diagnoses.

With the glass, she often pores over chest CT scans, hunting for subtle clues to pinpoint anomalies. As a result of her meticulous attention to faint lesions, she spotted a long-misdiagnosed lung disease case in her hometown of Tongcheng county in Xianning, Hubei province, back in 2009. The experience fueled her commitment to deliver free medical services to patients in the mountainous areas of Tongcheng every month.

Over the past 17 years, Du has carried out this mission without fail, driving about 500 kilometers every last weekend of the month to the area. To date, she has clocked more than 100,000 km in total and served over 7,000 local residents.

Du, vice-president of Wuhan Pulmonary Hospital, was named Hubei's sole recipient of China's 2026"Most Beautiful Doctors" on Aug 19 by the Publicity Department of the Communist Party of China and the National Health Commission.

"Many people mistakenly believe that mountainous areas boast good air quality and a lower incidence of lung disease. That is not the case. A large number of complex and atypical cases cannot be diagnosed locally, leaving illnesses untreated for long periods," she said. "Symptoms such as chest tightness cannot easily be distinguished between pulmonary lesions and cardiac problems. Scheduling scans and waiting for test reports at hospitals in bigger cities involve cumbersome procedures. After countless tiring trips, many patients opt to abandon diagnosis and treatment."

This is further exacerbated by the tendency of elderly patients in villages to delay telling their adult children about the seriousness of their conditions until they deteriorate.

In the Mufu Mountain area, constrained by local employment opportunities, many residents have to take up jobs with heavy exposure to dust in coal mines, quarries and brickwork. Long-term dust exposure, compounded by smoking habits, inflicts multiple injuries, leading to rapid deterioration of lung function. Workers are susceptible to chronic obstructive pulmonary disease and pneumoconiosis, which may trigger subsequent complications including bullae and emphysema, Du said.

Du said that while grassroots doctors are capable of diagnosing common lung diseases, when it comes to rare and difficult lung diseases, the task becomes more challenging.

During the 2009 Spring Festival, Du returned to Tongcheng for the holiday and a local woman came to her with persistent hemoptysis. She had been treated for pulmonary tuberculosis for several years, but the condition never improved.

Poring over stacks of medical records and CT scans, Du spotted critical clues in imaging results. She suspected the problem was not TB but pneumoconiosis. Further inquiries revealed the woman had worked in a tile factory for eight years. Her occupational history matched the imaging findings: calcified lymph nodes, long misread as TB lesions, had lacerated bronchial blood vessels and caused repeated bouts of coughing up blood. Du contacted the Wuhan Pulmonary Hospital to open a green admission channel and admitted the woman. The calcified lymph nodes were surgically removed, putting an end to the coughing up of blood.

Previously, the woman had to be hospitalized three or four times annually, with each stay costing thousands of yuan, and her family lived in an unsuitable house. After recovery, she found an accounting job in the county town. With a steady income, her family built a three-story house within a few years.

Patient-focused approach

Word of her recovery spread fast across the county, driving a growing number of patients with incurable lung diseases to seek out Du for medical help.

Back then, communication in the rural areas was poor; not every household had landlines or mobile phones. To make medical consultation easier for local villagers, Du set a fixed schedule: free clinical services at a designated venue on the last Saturday of every month. She kept this routine unchanged for 17 years. At each clinic session, she saw between 50 and 100 patients. "I make the trip alone so many others don't have to. It is well worth it," Du said. She has pledged to carry on for as long as local residents are in need.

One 40-year-old male patient she treated a couple of years ago left a deep impression on her. When he turned 18 on the eve of the college entrance examination, he developed a cough and was diagnosed with TB locally. After he failed the exam, he attended a technical secondary school while undergoing repeated TB treatment but was never fully cured.

Labeled as having infectious TB all those years, he lived under immense psychological strain and never started a family. After traveling from place to place, he came to Du. Systematic examinations confirmed he did not have TB. Instead, he had allergic bronchopulmonary aspergillosis triggered by asthma. With a clear diagnosis and targeted medication, his condition was cured, Du said.

"The patient was overwhelmed with emotion. He told me his life would have turned out completely differently had he received an accurate diagnosis 20 years earlier. I told him that 40 was not too late and he could still start a new life. Still, this patient's story touched me deeply," she said.

Another patient, Wu Hong, had undergone four years of follow-up visits for a pulmonary nodule without a definitive diagnosis. Du judged the nodule to be early-stage lung cancer and recommended timely intervention. Wu traveled to Shanghai for surgery and returned specially for a review with Du to express her gratitude.

In mountainous areas, most patients with chronic lung diseases such as COPD and pneumoconiosis belong to low-income groups. To ease patients' financial burden and accurately identify pulmonary lesions with low-cost examinations, Du and her team developed a set of cost-effective medical technologies.

For instance, chronic lung diseases tend to cause multiple pulmonary bullae, or air-filled spaces within the lung, in their advanced and end stages. Patients suffer from poor respiratory function and face recurring life-threatening spontaneous pneumothorax.

To mitigate this, Du's team developed a minimally invasive, low-cost pulmonary bulla ablation system with stable long-term effects and wide applicability. It drastically cuts treatment risks, improves recovery outcomes and reduces medical expenses by nearly 90 percent compared with conventional therapies.

Mao Weibing, a 60-year-old patient from Yueyang, Hunan province, told Hubei local media outlet Changjiang Daily that he had endured six years of suffering from pulmonary bullae, until his stubborn ailment was cured by precise treatment from Du's team. "A small amount of money solved my huge problem," Mao said.

Grassroots development

Du knows her personal time and energy are limited and she cannot stay stationed in the mountains permanently. Rather than one-off treatments, a more sustainable solution is to "teach people how to fish".

Du turned free clinic sites into mobile classrooms, training grassroots doctors on site. Working alongside grassroots physicians on real-life cases, she explains CT imaging features and pulmonary function report interpretations for various lung diseases, helping them distinguish typical from atypical symptoms. After hands-on training, grassroots doctors are capable of handling most commonplace cases independently.

Over 17 years, Du trained more than 3,700 medical personnel for respiratory disease prevention and treatment, leaving behind a cohort of local doctors capable of diagnosing and managing illnesses. When grassroots doctors encounter cases they cannot confirm, they send QR codes of cloud-based CT scans to Du. After a careful review of the images, she provides diagnostic opinions. Patients no longer need to travel long distances to provincial capitals to obtain specialist diagnoses.

She said that lung disease in mountainous areas has improved nowadays. "In the past, most patients who came were already in end-stage lung disease with severe symptoms. As living standards and health awareness rise, more people take the initiative to get physical check-ups more regularly. Many pulmonary nodules are detected in early screening, enabling early intervention and treatment."

Furthermore, most grassroots health centers are now equipped with CT scanners. The biggest shortfall in diagnosis and treatment lies in the lack of specialist doctors capable of accurately reading scans, judging whether nodules are benign or malignant, and formulating follow-up treatment plans. She said cultivating high-caliber medical teams at the grassroots level remains an ongoing process. While advancing clinical treatment, Du's team also moves medical services forward, carrying out disease screening, health education and chronic disease management, striving to reduce the incidence of severe illnesses at the source.

Du also advocates lung protection tips: quitting smoking, proper dust-proofing at work and regular CT screening for high-risk groups.

In 2019, supported by the Party Committee of Wuhan Pulmonary Hospital, the Du Ronghui Health Assistance Volunteer Service Team was established, drawing more than 300 medical workers. Team members travel to grassroots sites for free clinic duties on weekends in batches. Today, the free clinic program covers 17 prefectures and cities in Hubei and has extended to the Xinjiang Uygur autonomous region.