Content Warning: This section of the guide discusses violence, including executions and suicides.

Yu Hua begins by recounting his first job out of medical school in 1978, working as a dentist in a small town in southern China. In addition to his regular duties, he was tasked with administering vaccinations to factory workers and children each summer. At the time, China was a poor country, but it provided free immunizations through a strong public health network.

Due to the lack of disposable needles and primitive sterilization methods, the reusable needles would develop barbs over time. While the factory workers endured the pain stoically, Yu Hua was deeply affected when he witnessed the intense distress and bleeding the barbed needles caused in young children. This experience led him to take the time to grind the needles to keep them sharp, despite the toll it took on his fingers.

Yu Hua expresses remorse for not having realized sooner the pain he was causing others, believing that if he had pricked his own arm with a barbed needle he would have understood their suffering. This realization left a lasting impact on him, both as a person and as a writer, teaching him that knowing what it means to live and write comes from making the suffering of others a part of one’s own experience.