In life and work, you will encounter many hurdles, pitfalls, and steep cliffs. Sometimes, it can be incredibly difficult. It may even feel like reaching a dead end…

I experienced one of the darkest moments of my life a few years ago, while working as a pathologist in Canada. I encountered a breast cancer lumpectomy containing a few atypical acini around the previous core needle biopsy cavity, for which the margins were negative – over 2 mm clear. Following the principle of "step back, not over call" due to significant inflammatory reaction, I called it atypical ductal hyperplasia.

However, a second opinion gave the diagnosis of ductal carcinoma in situ. In terms of treatment, there was actually no difference. However, during the review at my institution, this was deemed a misdiagnosis.

I appealed my right to submit the case for a third-party review, suggesting two of the most renowned breast pathology experts from Harvard or Cornell. But my employers refused. Instead, they sent it to a commercial genitourinary pathology lab on Long Island and, shockingly, the consultation results were not disclosed to me.

My lawyer consulted one of Canada's most esteemed pathologists who reviewed my reports, concluding that the so-called "major discrepancy" rate in my three-thousand-plus case reports was less than 0.2 percent. That is far below the 2 percent severe misdiagnosis rate that is the criterion for retraining, set by the College of American Pathologists.

Moreover, none of these "misdiagnoses" posed a threat to patient lives, requiring no further surgery, meaning they had no bearing on treatment or patient survival. Ultimately, in the provincial medical association's review, this so-called "breast cancer misdiagnosis" case that ruined my reputation was not even included in their analysis. They instead considered another cancer case of mine as benign, while the renowned pathologist hired by my lawyer fully agreed with a cancer diagnosis I made.

The renowned Canadian pathologist, Dr O’Connor, hired by my lawyer, wrote a five-page report stating: "The literature on major error rates of 1 percent or greater is not uncommon. Dr He is well below that. In my opinion, the error rate for Dr He doesn’t suggest that he is incompetent in practicing pathology. I suspect that if any pathologist’s practice was subjected to the same level of scrutiny as that of Dr He, errors would be found at a similar rate. Dr He is practicing within the expected standards."

But the damage was done. The misdiagnosis ruling was reported to the press, and aired nationally on CBC television, making me a "world-renowned doctor."

To me, the situation was reminiscent of the famous "sewing of the anus" case in China. An OB/GYN doctor was sued for sewing a patient’s anus after a vaginal delivery baby as a result of a nonsense claim by an unprofessional reporter. Even though the doctor's innocence was subsequently proven, the claim totally destroyed that doctor’s life and career.

To this day, both in China and among the Chinese medical community in the US, particularly within the Chinese American Pathology Association (CAPA) and other Chinese medical associations, there are still some unethical colleagues who relentlessly attempt to "expose the facade" of American pathologist Gang He online, publicly, or secretly.

The darkness and pain I have experienced over the years are likely beyond what my peers can comprehend. At one point, no one dared to employ me. Eventually, I found employment in a pathology lab run by a Chinese doctor in New York. I worked from 9am to 11pm, six days a week, performing the duties of both pathologist and technician, overseeing procurement, and even doing the cleaning. Yet my salary was less than that of a restaurant server or gas station employee. Few would believe that my first paycheck as a pathologist was only $1,000 a month.

I endured isolation, disdain, slander, and exploitation from my peers. And I persevered…

I am grateful for the careful care and companionship of my wife, who stood by me through thick and thin. The support, comfort, understanding, and love from several college classmates was invaluable. I also thank the online friends I met for their support.

I especially want to thank my junior, Wang Jiping, who works in the surgical oncology department at Harvard BWH/Dana-Farber Cancer Institute. When I expressed my intention in a doctor’s social media WeChat group to self-fund a group of eight back to China for exchanges, Jiping was the first to publicly declare, "Dr. He, I will stand with you!" Seeing his immediate response brought tears to my eyes! As an old Chinese saying goes: "In life, having one confidant is enough!"

Shengguang Xiao, the director of liver transplantation and hepatobiliary pancreatic surgical oncology at Drexel University, was another ally. Along with several other doctors in oncology and family medicine, he enthusiastically supported and participated in my group exchange activities. We were invited to the 26th Great Wall International Conference on Cardiovascular Disease in Beijing, where we engaged in academic exchanges with major Chinese cancer centers. For this exchange, I personally took out a loan of over $100,000 to purchase business-class tickets and accommodation for all participating doctors, while I traveled in the cheapest economy class. My income was less than a postdoctoral fellow's salary in New York at that time, and I only managed to pay off that loan slowly over the years.

In these fourteen years, the question "To be? Not to be?" has also been a ghost spirit hung around my mind, a critical juncture in my life. I am grateful for the companionship, understanding, and support of my dear wife and a few friends during my darkest hours. Slowly, I have recovered and regained confidence in life.

Although there are no longer opportunities to work in academic institutions, I continue to practice as a surgical pathologist and mentor Chinese medical students in the US looking to enter residency programs. I have mentored eighty-eight senior Chinese medical students, who graduated 15 to 26 years ago and had low scores or failed matches multiple times. Over 75 percent of these previously desperate students have successfully entered US residency programs, with many training at prestigious Ivy League schools or renowned cancer centers. Many are now practicing physicians in the US and Canada, or serving as sub-specialty directors in renowned university pathology departments.

I can also attribute my recovery to my healthy obsession with tennis. At the age of 56 I found myself a key player in a team that won the USTA League's Eastern Conference Runner-up, the state championship for the WTT League's 50+ 3.5 division, and ultimately the national championship! When I turned 60, my teammates and I again claimed the WTT league national championship and two runner-up titles in the Super Senior division.

Having passed my sixtieth year, I have come to view life, fame, and wealth as light as air, and the warmth and coldness of the world with indifference, distancing myself from the political tumult of the academic circle. I now lead a simple yet colorful life, enjoying activities like picking chrysanthemums by the eastern fence, working in the fields, gardening, raising chickens, playing tennis, traveling, and extensively reading English and American classics, while starting to write. I have published nineteen essays in The Pathologist, reflecting on my experiences as a medical professional in the US.

Life's journey is like a competitive field, often requiring stepping back, falling down, being knocked down, or facing failure. However, one must pick oneself up, brush off the dust, clean the blood and tears, and slowly recover with the care of family and close friends, continuing to move forward. Despite sometimes being difficult, painful, and incredibly lonely, life has no hurdle that cannot be crossed.

Hemingway famously said in The Old Man and the Sea: "A man can be destroyed but not defeated."

I once penned a little poem to encourage myself:

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