From a heavily guarded hospital room in Beijing, human rights activist Chen Guangcheng sent a desperate message to U.S. Secretary of State Hillary Clinton after she arrived in the city for talks with the Chinese government. "We are in danger," Chen told CNN on Thursday. "If you can talk to Hillary, I hope she can help my whole family leave China."

Chen's plea was the latest twist in a dramatic plot that began unfolding last week when the blind human rights lawyer-and one of China's most well-known activists-escaped his arbitrary house arrest in Shandong Province. Chen had spent four years in prison and two years confined to his home after exposing the brutality of China's forced abortions and sterilizations of thousands of women.

Now Chen and his family are exposed: After escaping house arrest and taking shelter in the U.S. Embassy in Beijing for six days, Chen left American protection to seek medical treatment at a Beijing hospital. The attorney said he fears that he and his family face grave danger if they stay in China, and has asked to travel to the United States-perhaps even on Clinton's plane when she leaves the country.

Whether Chen can leave China is a diplomatic quagmire with gritty implications. Fighting for Chen could compromise U.S. relations with China during a tense moment. But failing to defend the activist guarantees another kind of danger: compromising the human rights platform that American officials insist they uphold and the future of a human rights hero and his vulnerable family. For Chen, his plea to the United States is simple: "I want them to protect human rights with concrete actions."

In Chen's case, concrete actions would include allowing the activist and his family to seek asylum in the United States. But that possibility grew complicated when Chen left the U.S. Embassy to seek medical treatment at a hospital. With Chen outside of U.S. protection, leaving the country would require Chinese permission-a request the government isn't likely to approve without significant pressure.

That leads to an obvious question: Why did Chen leave the embassy? Though the question is obvious, the answer is unclear. U.S. officials said that Chen willingly left the embassy to be reunited with his family at the hospital. They said that the lawyer originally declared that he wanted to stay in China, an assertion other human rights groups have confirmed.

But once Chen reached the hospital, the dynamic changed. In a phone interview, the activist told CNN that the embassy promised that U.S. officials would stay with him at the hospital. "But this afternoon … I noticed they were all gone," he said. By Thursday afternoon (early Friday morning in China), Chen told the BBC that Chinese officials had prevented American envoys from visiting him.

Chen also made another disturbing discovery: His wife told him that after his escape Chinese guards tied her to a chair for two days and threatened to beat her to death. She said Chinese officials told her that if Chen didn't leave the embassy, they would send her home "and people there would beat her." It was a convincing threat: The couple said their guards severely beat them last year after they smuggled out a video describing their deplorable living conditions.

The absence of U.S. officials and the threats of serious violence shook Chen. So did another discovery: Chinese authorities had detained several activists suspected of aiding his escape, including members of his extended family. That finding undercut promises that the Chinese government reportedly made to allow Chen and his family to relocate to another part of China without harassment or retribution.

"After seeing the reality, we both want to leave this place with our kids as soon as possible," said Yuan Weijing, Chen's wife. "It's very dangerous for us."

U.S. officials said they exerted no pressure on Chen to leave the embassy, but acknowledged that he now wants to leave the country. They said they would continue conversations with the activist to discuss his options. When Clinton arrived in Beijing, she didn't publicly mention Chen's case by name but spoke of the importance of upholding human rights.

U.S. Rep. Frank Wolf, R-Va., recalled Clinton's comments early in her tenure that U.S. concerns over human rights in China "can't interfere" with discussions about the economy, global warming, and security threats. In an online editorial, Wolf insisted that Chen's case should interfere with those discussions this week: "There is a place for pragmatism in diplomacy. … But pragmatism must not result in Chen's abandonment in the name of good relations."