Newsletter No. 460

8 460 • 19.6.2015 本刊由香港中文大學資訊處出版，每月出版兩期。截稿日期及稿例載於 www.iso.cuhk.edu.hk/chinese/newsletter/ 。 The CUHK Newsletter is published by the Information Services Office, CUHK, on a fortnightly basis. Submission guidelines and deadlines can be found at www.iso.cuhk.edu.hk/english/newsletter/ . 請掃描QR碼閱讀全文版： Scan the QR code for the full version 觀看錄像，請掃描QR碼或瀏覽以下網址： To watch the video, please scan the QR code or visit: www.iso.cuhk.edu.hk/video/?nsl460-juliana- chan 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 1984年你在英國醫科畢業，那正是香港前途未卜之時，為何還 決定回港執業？ 那時我在英國居住十年多了，然而，香港始終是我的家，剛好威 爾斯親王醫院成立不久，我覺得是個機會，所以毅然決定回港從 頭做起，希望能夠在事業發展上得到更大的滿足感。 最初在精神科病房工作的經驗如何？何時決定專研糖尿病  治療？ 當時政府醫院的內科職位非常熱門，我被要求先在般含道的精 神科工作十五個月，這段時間，我了解自童年開始，成長過程、教 育等怎樣影響一個人的心理、健康、家庭和事業。每人背後都有 一個故事，精神科重視聆聽，碰巧我也喜歡聆聽。我在精神科做 得不錯的，主管也說我會很快升職。後來我轉職威爾斯醫院，遇 到啓蒙老師 郭克倫 教授，他很儒雅，醫術精良，對病人很細心， 我深受影響。他邀請我加入內分泌科，我很快便答應了。深入認 識糖尿病後，我了解到這病的心理、認知和行為，就像瓜與籐般 夾纏不清。 治病便是「對症下藥」。這個觀念有修正的需要嗎？ 「對症下藥」是治病的一個環節，像糖尿病這種長期病患，醫人 比醫病重要。病人的認知、情緒和行為，也是很重要的環節。心 病還需心藥醫，醫療團隊需要在背後支援，用各種不同的方法給 病人賦能，讓他可照顧自己，健康起來。 這樣，醫者的角色是否也需重新界定？ 醫生還身兼科研、管理、教育的多角色。他是科技與病人之間的 橋樑，尤其長期病患者在不同的地點、時刻，有不一樣的需要，唯 有經過醫生的直接了解，才可適時選擇最好的科技來防治。我們 得通過長期研究，了解病的成因和後果，把問題呈示給合作夥伴， 研發新的治療方案。醫生應深入淺出教導病人或高危人士怎樣自 我管理，掌握自己的健康，並教育下一代的醫護人員繼續改進。 談談你教學、行醫和研究的風格吧。 我非常直言，常常強調醫科生和教授都是因為有病人而存在的， 學習不是單為了醫科畢業，而是為了將來要做醫生。所有的教學、 培訓和考試，都是在這個基石上發展的。我的要求很高，希望學 生畢業時有價值觀、技術和醫德，知道自己有重要的社會責任。 行醫二十多年了，見過不同的病人，年輕的，中年的，早期的，也有 已經出現很多併發症的。他們會讓我知道家裏的情況，了解他們 的情緒。我會鼓勵他們正面面對糖尿病，照顧自己，認識自主的重 要性。相信他們也感覺到我的真誠，覺得我真的聽到他們說話。 糖尿病防治的涵蓋很濶，包括流行病學、基因學、藥物科研、管 理學，甚至效益計算等，是跨學界跨業界的理念。我要決定策 略，訓練同事，激勵大家互相了解，分享理念……。也許有人會覺 得我不夠專注，其實不然，我是非常專注於病人的多樣需要，才 採用跨界的模式去達到這目的。 閒下來的時候，會做些甚麽？ 每一日我盡量給自己十來分鐘，獨自在房間裏靜下來，反思一下 當天做了些甚麽，哪些不應再做，哪些應繼續做，哪些該開始 做。我很喜歡看社會學、心理學和管理學的書，很想了解為甚麽 社會是這樣的，人與人之間的互動是這樣的，希望這些知識有助 教研和行醫。我也喜歡到有歷史感的地方旅遊，人在宇宙只是瞬 刻的一點一滴，多知道過去，便會明白為何此刻身在此處，或者 還會知道將來會是怎樣。那麽，在這短短的數十年裏可以做到多 少把這個世界改變得好一點兒呢？ 陳重娥教授 香港糖尿病及肥胖症研究所所長 Prof. Chan Chung-ngor Juliana Director, Hong Kong Institute of Diabetes and Obesity 口談實錄 Viva Voce ’ Photo by ISO staff 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 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?