The call by the doctor illustrates the custom of physicians in China — a tradition that carried on from the earliest dynasties; that is, a doctor is paid a set fee to keep a patient well. Loss of that patient is punishable by law; this liability holds until the patient is fully recovered. In this case, the doctor sees that there is no hope for O-lan, so rather than admitting that he does not have the ability to save her, and rather than speak of her death in front of O-lan and Wang Lung, the doctor sets a prohibitive fee. This fee, in effect, says, "the woman will die."
In the following chapter, we see the custom of coffin buying. Wang Lung buys the coffin for O-lan and tells her of it to show her that she will be provided for after her death. It is also interesting to note that Wang Lung does some "bargain shopping" at the coffin-maker's shop. Knowing that his father is soon to die, and informed that by buying two coffins he can get a discount off the price of two, Wang Lung buys two coffins.
The sickness of O-lan is greatly felt in the house: the house becomes messy, the old man misses O-lan in his senility, and Wang Lung now has to care for the "poor fool." And the whole time, he thinks of O-lan and what her loss means. He tells her that he would sell all of his land to save her life, but she is ready for death and points out that the land is more permanent than life, for she must die eventually, but the land will always be there after her.
Having seen her coffin, O-lan is more content to die because, in the Chinese custom, a person who can be buried in an expensive coffin is a more honorable person than one who is simply thrown into the ground without the benefit of a coffin. Thus, O-lan knows that she is dying as one who began as a slave, but has ended her life as the wife of a prominent man, and who has borne that man sons. As O-lan says to Cuckoo on her death bed: "Well, and you may have lived in the courts of the Old Lord, and you were accounted beautiful, but I have been a man's wife and I have borne him sons, and you are still a slave."
