Newsletter No. 417

10 No. 417, 4.5.2013 陈家亮教授 医学院院长 你曾获多个教学奖,要当一位良师有何要诀? 要诀不在于怎样教,而是在于能否激发学生终身学习。好 的医科教师更须展现良医的典范—如何治理病人和对待 其家属、如何与同事相处。这是十分重要的,尤其在临床 实习期间,除了课堂学习,还有病房里学徒式的训练。 在中大这么多年,身分由学生到教师,可有什么好处? 我认识医学院,是甫自它成立开始,见证着它发展,从而 熟悉其文化、优势和弱点。我也很了解院内学生和教职员 的想法,这让我做起事来更得心应手。 在2003年,你曾为超过一万二千名市民统筹大规模的 沙士筛检。你预计会为H7N9进行类似筛检吗?H7N9 对香港和全球有何影响? 我们很难准确预计H7N9会如何发展,只知它由家禽传 人,迄今尚未有证据显示会转为人传人。大规模沙士筛检 是希望找出社区的隐性患者,除非我们怀疑H7N9在社 区有隐性患者(但现时尚未有案例)〔注:就访问当日而 言〕,否则不会推行此类检测。综观人类历史,不时出现 流感爆发导致疾病或死亡。流感病毒往往由候鸟传至禽 畜,但病毒变种至沙士般可人传人,则不常见。 出任院长的最大挑战是什么? 我预料会有很多难以估计的挑战,人是其一。身为院长, 当然希望带领学院更上层楼,但是,如何激励本已优秀 或自觉不俗的同袍继续追求卓越呢?团队努力诚然十分 重要。 为何选择医科,并专攻消化疾病? 我没有自小便立志助人的说法,那不是我习医的原因。 父母常告诉我医生是优秀的职业,社会地位高,所以我努 力读书,就是为了要当医生。然而,在这过程中,我发现了 这门专业独特之处。医学既是科学也是艺术,并非每一门 专业也可这样形容的。说它是科学固然显而易见,但为何 说是艺术呢?疾病可以用科学方法来界定和诊断,但说到 治疗,譬如说,十人患上同一种病,便需要用上不同的手 法去治疗,选择哪种方法就是一种艺术,不能以科学决定 和衡量。我常告诉学生:「你医的不是病,是病人。」 选择消化疾病科,得感谢 沈祖尧 教授的影响。我还是医 科三年级生时,他是刚毕业数载的内科医生,年轻有为, 更非常热心教导学生,这深深启发了我。即使毕业时外科 成绩获得金奖,但我选择了内科。沈教授其后离港深造, 回来后获邀领导消化系统部门。这小部门连我在内只有四 位医生,很难与其他有很多支援人员的专科部门相比,但 我选择加入,因为相信没有组织架构的包袱,发展空间更 大。我亦深信年轻的沈医生可带领部门迈进新里程。现在 回看,我想是选对了。 当今的生活模式如何影响消化疾病和肝脏的研究? 饮食模式渐趋西化,对两者均大有影响。1990年代初,大 肠癌并不常见,但近二十年,却成为第二号的致命癌症,预 计很快便会超越肺癌,成为头号杀手。脂肪肝通常由高脂 肪饮食引致,继而导致肝硬化,增加患心脏病和糖尿病的 风险。在美国肝硬化和肝癌主要由脂肪肝引起,在香港则 是乙型肝炎,可是,我预计脂肪肝很快会取而代之。 身为医生,可有什么座右铭? 我的就职演说题目为「吾生有杏」,我有幸成为医生、教师 和研究员。我告诉学生:「研究员撰写了革新创见的论文, 可成为谈论焦点一年,甚或最多十年;医生若治愈一位 病人,病人和其家属会一辈子铭记于心;而当教师培育学 生,学生又再培育其他学生,受惠人数将是天文数字。不 管你们日后会是哪种医生,也要教导其他人,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

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