On April 26 of this year, while Taiwanese society was reeling from the shock of the sudden SARS outbreak, Yeh Chin-chuan, a professor at Tzu Chi University, Hualien, received a letter asking for help from the staff of Taipei's Ho-ping Hospital. Stirred by a physician's urge to help others, the following day he rushed to the hospital, which had already been sealed off, to investigate the infection foci and to set up standard operating procedures to combat the epidemic.

At first it was thought that the epidemic had been restricted to the Taipei metropolitan area, but then it was spread by people infected in northern Taiwan who went to hospitals in the south of the island for treatment. In May, following outbreaks inside Chung-ho Memorial Hospital (attached to Kaohsiung Medical University) and at Kaohsiung Chang Gung Memorial Hospital, Yeh Chin-chuan once again entered hospitals shunned by people terrified of the epidemic.

Having worked all along on the frontline of the fight against SARS, Yeh Chin-chuan says that the epidemic was not as serious as outsiders thought, but that medical personnel and Taiwanese society in general suffered from low confidence and morale. Yeh recounts that when he saw the plans to separate SARS patients from non-SARS patients at the Chung-ho and Chang Gung hospitals, he realized that there wasn't much to worry about: "I only went there to endorse their work. People trusted me and thought that I wouldn't cover up any mishandling."

Yeh Chin-chuan is proud of being a "perennial public servant." For the past seven years, he has worked hard as executive director of the John Tung Foundation to promote anti-smoking campaigns.

Forever a public servant

Several months after the event, we asked Yeh Chin-chuan how he mustered the courage to enter hospitals outsiders considered to be deathtraps. He said, "At the time my only thought was: if I don't go in, they may not find anybody else who can do the job. I was also worried and afraid, because I had studied epidemiology some 20 years ago, but it was my duty to join the battle as a frontline commander, never to utter the word 'fear,' and to learn on the job." At the time, there were no experts and no one in the world knew much about SARS. Yeh had to consult the Internet and the US Centers for Disease Control for the latest information, and to come up with effective epidemic control measures very quickly.

In going to Hoping Municipal Hospital regardless of his personal safety, Yeh Chin-chuan manifested his caring and noble character. After serving as vice minister of the Department of Health, director of the Bureau of National Health Insurance, and director of the Taipei City Bureau of Health, last year Yeh decided to leave public service and take up a teaching position at Tzu Chi University.

There were also personal reasons why Yeh could not ignore the crisis at Hoping Municipal Hospital in Taipei: Chiu Shu-ti, director of the Taipei City Bureau of Health, who had been lured to that post from Ilan County, where she had been the director of the Bureau of Public Health, graduated together with Yeh from NTU; and Taipei City mayor Ma Ying-jeou was a fellow student of Yeh's in senior high school.

Yet, whatever the personal considerations, the desire to contribute to the public good was Yeh Chin-chuan's main motivation. For the past seven years, he has traveled every week between Hualien and Taipei to promote anti-smoking campaigns and the fight against clinical depression as honorary executive director of the John Tung Foundation; he has also been the director of the Buddhist Tzu Chi Stem Cells Center and consultant to the Tzu Chi Medical Foundation.

Bungee jumping

Compared to political luminaries like Chen Shui-bian and Ma Ying-jeou, Yeh Chuan-chin was not well known, but the battle against the SARS epidemic made him a household name. The media have styled him a "hero" and a "medical man of steel." Yeh compares himself to a volunteer firefighter: whenever a big fire breaks out, he must go to the rescue. He says it is "like bungee jumping; you just go for it."

Yeh Chin-chuan's career in public service has been as extensive as anyone's. But given that he was one of the best students in NTU's College of Medicine, one wonders why he did not become an eminent physician like most of the people he graduated with, including Hou Sheng-mao, head of the department of orthopedics at National Taiwan University Hospital (NTUH).

After Yeh graduated from NTU's College of Medicine in 1968, he joined its Graduate Institute of Public Health. On completing his military service, he applied to the Department of Internal Medicine at NTUH, and was recruited as the top-ranked candidate. Having read his resume, the day Yeh reported for duty Professor Hsu Cheng-jen told him, "Since you're a graduate of the Graduate Institute of Public Health and have passed the civil service examination, you ought to be working at the Department of Health." Yeh recalls that in those days, very few graduates of NTU's College of Medicine were willing to work in the public health sector, which was in dire need of fresh recruits. Young and full of idealism, Yeh felt that in the future he would have other opportunities to do clinical work, and never thought that he was taking a different path altogether.

A year later, Yeh Chin-chuan went to the United States to pursue a doctorate in public health at Harvard University. In 1982, before he had obtained his PhD, Hsu Tzu-chiu, his former professor and then minister of the Department of Health, lured him back to Taiwan to take on the post of vice director of the Bureau of Medical Affairs. In 1993, Yeh began to work on the plans for a national health insurance system, and when the Bureau of National Health Insurance (BNHI) was founded two years later, he became its first director.

Pride in a job well done

Although his role in combating SARS is one of the great accomplishments of Yeh Chin-chuan's life, he is proudest of having set up the national health insurance system.

Looking back, Yeh Chin-chuan recalls that he was under enormous daily pressure during the months leading up to and following the establishment of the BNHI. He had to manage more than 4000 staff recruited from various departments and institutions, all of whom had to be trained in short order to perform their new duties. Although the work was tremendously difficult, Yeh thinks that if the establishment of the national health insurance had been postponed until these days of dire fiscal straits, it might have suffered the same fate as the national pension system, which is getting nowhere in the Legislative Yuan.

Because many large private hospitals refused to take in SARS patients during the height of the epidemic in May, the emergency services of NTUH were overstretched and had to be closed down. The BNHI came in for heavy criticism for its failure to order private hospitals to accept patients during the crisis.

Yeh Chin-chuan says that compared to the education reform that has recently come under heavy criticism from various social groups, although the national health insurance system does have its drawbacks, few people would argue that it ought to be abolished. It is self-evident that the system's merits outweigh its demerits: at the very least it ensures that the weakest members of society receive medical care and are not too disadvantaged compared to the wealthy. The three strong points of national health insurance are that it offers fairness, reasonably good quality healthcare, and low medical costs.

"There is room for improvement in national health insurance, but it's nothing that cannot be done working within the system," says Yeh Chin-chuan. Infection control in hospitals, the tradition of patients' relatives keeping them company in hospitals, and overly short consultation times are all related to the need for better-quality healthcare. Improving the quality of healthcare costs money, and achieving the right balance between healthcare equity, quality, and cost will test the wisdom of the people in charge.

When some dermatologists and gastroenterologists in Hoping Municipal Hospital saw no need to return to the hospital and join the ranks of those battling the epidemic on the grounds that they were not part of the internal medicine department, many people said that there ought to be a critical reexamination of the medical education system. These days, when Yeh Chin-chuan teaches medicine at Tzu Chi University, he tells future doctors that if they end up practicing medicine just to make money, monotonously going around in circles between a hospital, patients, and family, they will have wasted their lives. His advice to future young medical students is, "Don't follow someone else's path; be the master of your own fate."

Soaring like an eagle

Yeh Chin-chuan compares his 20 years in public service to "an eagle that has come of age in a forest." He says, "I was able to understand and endure everything the forest offered me, but I did not love it. Perhaps my decision to leave public service was an escape of sorts, but it has in no way diminished my concern for the national health insurance system, for society, and for Taiwan."

"Before I was 50, I dedicated myself to public service, but today I am living for myself," says Yeh Chin-chuan. No longer burdened with public office, Yeh is manifestly free and unrestrained. He has fulfilled a number of dreams he has had for many years, including climbing a mountain in Kyrgyzstan, competing in the Ironman Triathlon, swimming across Sun Moon Lake, and taking part in the Taroko marathon. In July he climbed the difficult Nan-e section of the Central Mountain Range, and set himself the challenge of climbing all of Taiwan's tallest peaks before the age of 55.

In his poem "The Road not Taken," the American poet Robert Frost wrote: "Two roads diverged in a yellow wood, / And sorry I could not travel both / And be one traveler, / Long I stood / And looked down one as far as I could / To where it bent in the undergrowth. / Then took the other, as just as fair, / And having perhaps the better claim, / Because it was grassy and wanted wear; / Though as for that the passing there / Had worn them really about the same... / I shall be telling this with a sigh / Somewhere ages and ages hence: / Two roads diverged in a wood, and I- / I took the one less traveled by, / And that has made all the difference."

Many years ago, Ye Chin-chuan's professor Hsu Tzu-chiu told him, "whatever you do, do it in earnest." Yeh took the road less traveled and has consequently lived an extraordinary life.