Newsletter No. 417

10 No. 417, 4.5.2013 陳家亮教授 醫學院院長 你曾獲多個教學獎，要當一位良師有何要訣？ 要訣不在於怎樣教，而是在於能否激發學生終身學習。好 的醫科教師更須展現良醫的典範—如何治理病人和對待 其家屬、如何與同事相處。這是十分重要的，尤其在臨床 實習期間，除了課堂學習，還有病房裏學徒式的訓練。 在中大這麼多年，身分由學生到教師，可有甚麼好處？ 我認識醫學院，是甫自它成立開始，見證着它發展，從而 熟悉其文化、優勢和弱點。我也很了解院內學生和教職員 的想法，這讓我做起事來更得心應手。 在2003年，你曾為超過一萬二千名市民統籌大規模的 沙士篩檢。你預計會為H7N9進行類似篩檢嗎？H7N9 對香港和全球有何影響？ 我們很難準確預計H7N9會如何發展，只知它由家禽傳 人，迄今尚未有證據顯示會轉為人傳人。大規模沙士篩檢 是希望找出社區的隱性患者，除非我們懷疑H7N9在社 區有隱性患者（但現時尚未有案例）〔註：就訪問當日而 言〕，否則不會推行此類檢測。綜觀人類歷史，不時出現 流感爆發導致疾病或死亡。流感病毒往往由候鳥傳至禽 畜，但病毒變種至沙士般可人傳人，則不常見。 出任院長的最大挑戰是甚麼？ 我預料會有很多難以估計的挑戰，人是其一。身為院長， 當然希望帶領學院更上層樓，但是，如何激勵本已優秀 或自覺不俗的同袍繼續追求卓越呢？團隊努力誠然十分 重要。 為何選擇醫科，並專攻消化疾病？ 我沒有自小便立志助人的說法，那不是我習醫的原因。 父母常告訴我醫生是優秀的職業，社會地位高，所以我努 力讀書，就是為了要當醫生。然而，在這過程中，我發現了 這門專業獨特之處。醫學既是科學也是藝術，並非每一門 專業也可這樣形容的。說它是科學固然顯而易見，但為何 說是藝術呢？疾病可以用科學方法來界定和診斷，但說到 治療，譬如說，十人患上同一種病，便需要用上不同的手 法去治療，選擇哪種方法就是一種藝術，不能以科學決定 和衡量。我常告訴學生：「你醫的不是病，是病人。」 選擇消化疾病科，得感謝 沈祖堯 教授的影響。我還是醫 科三年級生時，他是剛畢業數載的內科醫生，年輕有為， 更非常熱心教導學生，這深深啟發了我。即使畢業時外科 成績獲得金獎，但我選擇了內科。沈教授其後離港深造， 回來後獲邀領導消化系統部門。這小部門連我在內只有四 位醫生，很難與其他有很多支援人員的專科部門相比，但 我選擇加入，因為相信沒有組織架構的包袱，發展空間更 大。我亦深信年輕的沈醫生可帶領部門邁進新里程。現在 回看，我想是選對了。 當今的生活模式如何影響消化疾病和肝臟的研究？ 飲食模式漸趨西化，對兩者均大有影響。1990年代初，大 腸癌並不常見，但近二十年，卻成為第二號的致命癌症，預 計很快便會超越肺癌，成為頭號殺手。脂肪肝通常由高脂 肪飲食引致，繼而導致肝硬化，增加患心臟病和糖尿病的 風險。在美國肝硬化和肝癌主要由脂肪肝引起，在香港則 是乙型肝炎，可是，我預計脂肪肝很快會取而代之。 身為醫生，可有甚麼座右銘？ 我的就職演說題目為「吾生有杏」，我有幸成為醫生、教師 和研究員。我告訴學生：「研究員撰寫了革新創見的論文， 可成為談論焦點一年，甚或最多十年；醫生若治癒一位 病人，病人和其家屬會一輩子銘記於心；而當教師培育學 生，學生又再培育其他學生，受惠人數將是天文數字。不 管你們日後會是哪種醫生，也要教導其他人，即使只是病 人也好。」 Prof. Francis Chan Dean of Medicine You have received a number of teaching awards. What’s the key to being a good teacher? The key lies not in how you teach but whether you inspire students to engage in lifelong learning. A good teacher of medicine shows by example how to be a good doctor—how we treat our patients and their families, how we get along with our colleagues. This is crucial, especially in the clinical years when there is bedside teaching and apprenticeship. What are the benefits of having been with CUHK for so many years as a student and teacher? I have known the Faculty of Medicine since its establishment. I have witnessed its development so I understand its culture, strengths and weaknesses. I also understand the mindset of medical students and medical staff here. This makes my job easier. You organized a large-scale SARS screening test for over 12,000 during 2003. Do you foresee similar arrangements for H7N9? How do you think H7N9 will affect Hong Kong and the world? We cannot be certain how H7N9 will develop. We only know that it’s transmitted from fowl to humans. So far, there’s been no evidence of human-to-human transmission. The large-scale SARS screening test was conducted to look for silent carriers in the community. Unless we suspect there are silent carriers of H7N9 (and we don’t as yet) [note: as at the time of interview], there will be no such screening. Throughout human history, there have been influenza outbreaks from time to time, leading to illness and death. The influenza virus is frequently transmitted by migratory birds to domestic animals, but it is not often that the virus can mutate to a form capable of crossing the human barrier, like in the case of SARS. What has been the biggest challenge in your deanship? I foresee many unpredictable challenges. One is the people. As dean, I want to bring this Faculty to greater heights of course. But how do I motivate people to be excellent when they already are or feel they are very good? Teamwork is certainly important. Why did you choose to study medicine? And why digestive diseases? I don’t have tales of wanting to help people since childhood. That was not my reason. My parents always told me that being a doctor was an excellent job that would give me a high social status. So I studied hard to become a doctor, but in the process, I discovered the uniqueness of the profession. Medicine is both a science and an art—you certainly can’t say that of every profession. The science part is obvious, but what makes it an art? A disease can be defined and diagnosed using scientific methods, but to treat, say, 10 people suffering from that disease, you’ll need different approaches. And what approach to use is an art that cannot be determined or assessed by science. I always tell my students, ‘You don’t treat the disease. You treat the patient.‘ I got into digestive diseases, thanks to the influence of Prof. Joseph J.Y. Sung . When I was a Year 3 medical student, he was a doctor who had only graduated a couple of years ago. I was deeply inspired by this teacher (of internal medicine) who was not only young and capable, but also extremely keen on teaching students. So though I graduated with a gold medal in surgery, I went into internal medicine. Professor Sung left Hong Kong to further his training and upon return, was asked to head the digestive division. There was hardly anyone there compared to some other specialties which had a lot of supporting staff—just two doctors, a senior medical officer, and myself (medical officer). But I chose to join this tiny division because I felt that, without the shackles of an established infrastructure, it had more potential for development. And I had no doubt that the young Dr. Sung would take us to a whole new level. In retrospect, I think I made the right choice. How is the contemporary lifestyle affecting trends in digestive disease and hepatology research? The effect of our increasingly Westernized diet on both has been great. In the early 1990s, colon cancer was not common, but in the last 20 years, it’s become Hong Kong’s second most common cause of cancer death. I foresee that it will surpass lung cancer to become the number one killer in the near future. Fatty liver, caused often by a high-fat diet, leads to cirrhosis of the liver, and ups the risk of heart disease and diabetes. In the US, it’s the main cause of cirrhosis and hepatic cancer. In Hong Kong, hepatitis B is the main cause, but I predict that it’ll soon be replaced by fatty liver. Are there any mottos that you live by as a doctor? My inaugural lecture was titled ‘ 吾生有杏 ’ which I translated as ‘My Life in Medical Education’. I feel myself lucky to be a doctor, teacher and researcher. I tell my students, ‘If a researcher writes a revolutionary paper, she’ll be talked about for a year, or 10 years at most. If a doctor cures a patient, she may be remembered by the patient and his family forever. But when a teacher nurtures students who go on to nurture other students, the figures are astronomical. Whatever type of doctor you become, teach someone, if only your patients.’ Photos of Prof. Francis Chan in this issue by Keith Hiro