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Juliana Chan: It is more important to treat the people than their symptoms

Prof. Chan Chung-ngor Juliana
Director, Hong Kong Institute of Diabetes and Obesity
(Photo by ISO staff)
(Photo by ISO staff)

You completed your medical studies in the UK in 1984. It was a time when the future of Hong Kong was hanging in the balance. Why did you choose to come back?

I had been living in the UK for more than 10 years. But Hong Kong is always my home. Back then the Prince of Wales Hospital (PWH) had just opened. I saw it as an opportunity, so I decided to return and start from scratch and seek greater professional fulfilment.

How was your experience when you first worked in the psychiatric wards? How did you get into the specialty of diabetes?

At that time, internist posts in public hospitals were heavily sought after. I had been out-posted to work at the Hong Kong Psychiatric Centre on Bonham Road for 15 months. During the period, I got to see how childhood, upbringing, and education impact a person's mind, body, family, and career. Every patient has a story to tell. Listening plays a vital role in psychiatry, and I happen to like listening. I was doing fine, and my supervisor said I would get promoted in no time. Later I was transferred to the PWH where I met my mentor Prof. Clive Cockram, a gentleman and a fine clinician. He treats his patients with genuine care, which has influenced me deeply. He invited me to join the endocrinology division, which I accepted without hesitation. The deeper I look into diabetes, the more I learn about its psychological, cognitive and behavioural aspects. They are closely interlinked.

Curing is usually thought of as prescribing the right medicine. Do we need to redefine the concept?

Treating the disease through medication is just part of the curing process. When it comes to chronic illness like diabetes, it is more important to treat the people than their symptoms, because cognition, emotion, and behaviour are also critical parts that need to be addressed. Health care professionals stand behind patients to empower them in all sorts of ways so they can take care of themselves and change for the better.

In this case, is there a need to redefine a doctor's role, too?

Doctors assume additional roles in research, administration, and education. They act as bridges between technology and patients. The chronically ill in particular have different needs at different times and places. Doctors have first-hand knowledge of what kind of technology is best for their patients. We have to rely on long-term research to figure out the causes and consequences of the disease, and pass the findings onto collaborators to work towards new solutions. Doctors should be able to educate patients in simple language how to manage themselves and take control of their health, and to teach the new generation of health care providers to keep improving.

Tell us about your style in teaching, doctoring, and researching.

I have no qualms saying that medical students and professors owe their existence to patients, that studying is more than the means to obtain a medical degree, but to become a doctor. That is the cornerstone of any teaching, training, and examining. I am a very demanding teacher, because I want my students to graduate with values, skills, and medical ethics. They must realize the weighty social responsibility that lies on their shoulders.

During the 20-plus years of my medical career, I've seen a vast variety of patients, some young, some middle-aged, some early-stage, some with multiple complications. They tell me about their families and their emotions. I always encourage them to confront diabetes, to look after themselves, and to understand the importance of self-determination. I believe they are convinced of my sincerity and feel that I listen to them.

The cure and prevention of diabetes is an interdisciplinary subject, covering epidemiology, genetics, chemical research, management, and even cost-effectiveness analysis. I have decisions to make. I need to train my colleagues and to foster mutual understanding and idea sharing. Perhaps some would call it a lack of focus, but that's not true. I'm very focused on patients' multiple needs to use an all-encompassing approach to achieve my goal.

How about the other roles you play in life?

Another role that I cherish, of course, is being a mother. Both of my sons are in their twenties. All these years I have been busy working, but whenever I have time, I spend it with my boys. That's what I treasure most. I try to share with them my knowledge and my life experience. The support from my husband and my family is a giant safety net. It enables me to throw myself into work.

How do you spend your leisure time?

Every day I allow myself 10 minutes of solitude in my room to re-examine what I have done and should not have done, what to continue doing and what to start doing. I enjoy reading sociology, psychology and management books. I am very curious about the way societies work and people interact. Hopefully the knowledge is beneficial to my teaching and medical practice. I also like travelling to historic places. Human beings are particles of dust in the universe, present for an instant in eternity. The more we learn about the past, the clearer we see how we come to the here and now, and probably what the future will look like. So, in a few fleeting decades, what can we do to make the world a slightly better place?


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