Newsletter No. 494

10 # 4 9 4 | 1 9 . 0 3 . 2 0 1 7 busy you are, you need to exercise three times a week for better metabolism to prevent blood vessel stenosis. A healthy lifestyle should be acquired as early as possible. Apart from clinical services, you also need to take part in administration, research and teaching. Which do you enjoy the most? The experience gained in each position helps me do better in the others, so I’m pleased to take up different positions. I first took up clinical work, and was assigned a teaching role later on. Some complicated diseases encountered have become case studies which help my students apply their medical knowledge. My administrative work in the hospital has enabled me to see what improvement in the system is needed and to improve it gradually. I now spend 70% of my time in research. I hope the findings would help improve diagnoses and enhance treatment effectiveness. For instance, we have just completed a 15-year follow-up study of stroke patients and discovered an increasing number of arrhythmia-induced stroke cases. One reason is fewer patients are willing to take anticoagulant. Then we have to figure out the root of the problem: Is the drug too expensive? Or, are doctors worried about the risk of anticoagulant-associated haemorrhage? You were in the ‘dirty team’ in 2003. How did it change your life? I’m glad I was part of it. The battle against SARS is a constant reminder of the insignificance of human beings, who could be very much at the mercy of the bacteria. I’ve learned to seize each day, do whatever matters to me, and cherish my family time. Working overtime is common among physicians. How do you strike a balance between work and family? It’s never easy to be a working woman nowadays. Absolute devotion is expected of her in family and at work. I do know what good a full-time mom would do to the family, but I also know that my experience of curing patients and taking on the challenges at work would help my kids understand life better. About two years ago, I was offered a part-time position at CUHK’s Faculty of Medicine. I could therefore remain in my beloved medical field to teach and to do research, and have the energy to take care of my family. Even though my income and career growth are halved as compared to other full-time physicians, I find it worthwhile. What caused you to engage in stroke treatment and research? I joined Prof. Lawrence Ka-sing Wong ’s team on stroke research 10 years ago. His vision and perseverance have been my motivation. Stroke is very common, which may not announce itself but once it has happened, the patient might be paralyzed or disabled. Blood vessel stenosis is the main cause of ischemic stroke. The location of stenosis varies across ethnicity: carotid stenosis is more common among westerners while intracranial stenosis is more common in the Chinese population. Hence, the treatment and medicine that work well on westerners might not work on the Chinese. My research is on better treatment for the Chinese patients. Howdoes the TeleStroke for 24-hour thrombolysis service benefit patients? In Hong Kong, over 20,000 stroke patients per year are admitted to hospital for treatment. Neurologists in public hospitals, however, are merely around 60, and these neurologists have to spend time on general clinical services on top of neurological patient care. To have a resident neurologist around the clock is out of the question. The Prince of Wales Hospital (PWH) launched the mobile visual communication system TeleStroke in 2012 to facilitate neurologists' off-site assessment of thrombolysis during non-working hours and to instruct specialist nurses to administer thrombolytic therapy in urgent cases. PWH has recorded a fourfold increase in the number of stroke patients who receive thrombolysis. The public hospitals offering this service have now reached seven. PWH is currently the only hospital in the New Territories East Cluster providing 24-hour telemedicine service. We are lining up the neurologists in our cluster (including PWH, Alice Ho Miu Ling Nethersole Hospital and North District Hospital) to offer telemedicine services to patients in these three hospitals. As more manpower is required for the project, we are negotiating with the Hospital Authority for additional resources. Young stroke patients have been increasing worldwide. What kind of lifestyle helps prevent this? A healthy diet and optimal exercise help stabilize blood pressure, blood glucose and blood lipids, which minimize the risk of stroke. Don’t eat too much red meat and processed meat, but eat fresh fruits and vegetables. Note that the latter can’t be replaced by juices. However 什么原因促使你投身中风治疗及研究? 十年前我加入 黄家星 教授的团队从事中风研究,他的视野与毅力是 我的动力。中风十分普遍,发病前未必有先兆,但一旦中风,有机会导 致瘫痪或残障,失去自理能力。血管狭窄是缺血性中风的重要原因, 但白人和华人血管狭窄的位置各有不同,白人主要是颈部血管,而华 人多是脑血管。由于位置殊异,治疗白人的方法和药物未必适用于华 人,所以我投身华人中风研究,冀寻找更有效的治疗方案。 廿四小时远程中风溶栓治疗服务如何令病人得益? 香港每年有超过二万名中风病人需要住院治疗,但公立医院的脑神 经科医生约只有六十位,碍于整体医生人手不足,诊治专科病人以 外,其实大部分时间都用于诊治普通科病人,更不可能有廿四小时驻 院的脑神经科医生。2012年起,威尔斯亲王医院率先利用流动影像 传讯系统,让专科医生在非办公时间随时随地遥距评估及诊断送院 病人,并指示中风专科护士为确诊者提供急性中风溶栓治疗。直到今 年,威院接受溶栓治疗的人数比以往增加达四倍,而提供这服务的公 立医院也增加至七家。现时,威院是新界东联网唯一提供廿四小时远 程中风治疗的医院,我们打算拓展此服务,让威院、雅丽氏何妙龄那 打素医院和北区医院的脑神经科医生组成团队,为这三家医院的病 人提供远程中风治疗。由于需要更多人手配合新计划,我们正与医管 局磋商额外拨款。 近年各地中风患者有年轻化趋势,如何从生活习惯入手预防? 改变饮食习惯和适度运动有助控制血压、血糖和血脂,减低中风风 险。要尽量少吃红肉和加工肉类,多吃新鲜蔬果,果汁是取代不了蔬 果的;无论生活有多忙碌,也要坚持每星期做三次运动,以改善新陈 代谢,避免血管狭窄。良好的生活习惯,愈早建立愈好。 治疗病人以外,你也要负责行政、研究和教学等,你最享受哪类  工作? 在每个岗位累积的经验,都能让我在另一个岗位发挥得更好,所以我 乐意承担不同的工作。我初出道时主力临床工作,后来多了教学的机 会,曾遇见的奇难杂症,往往成为我教学的临床个案,帮助学生活用 医学知识。在医院累积的行政经验,亦帮助我逐步改善制度上的不 足。现时我投放七成时间于研究,希望研究成果有助于改善诊断,提 升治疗成效。例如我们刚完成长达十五年的病人追踪分析,发现多了 病人因心律不整引发中风,而原因之一是少病人吃薄血药,那么便要 找出原因:到底是药太贵,还是医生担心病人吃药会有出血风险? 2003年沙士肆虐期间加入dirty team那一段经历对你的人生有何  影响? 我庆幸是其中一分子,因为沙士一役令我体会到人很渺小—随时会 被细菌击败。这教我要珍惜每一天,善用时间做重要的事,同时珍惜 与家人相处的时光。 医生超时工作甚为普遍,你如何兼顾事业与家庭? 现代的职业女性一点也不易,因为无论在家庭或工作岗位,家人和同 事都期望你全情投入。我深知全时间照料家庭的好处,但医治病人的 经历、应对工作挑战的毅力,都可以令孩子对生命有更深体会,所以 我不会毅然放下工作。直至约两年前,我有机会获中大医学院半职聘 用从事教学与研究,既可继续我喜爱的医疗工作,又有精力照顾家人, 虽然收入减半,比起全职医生少了发展的机会,但我觉得十分值得。 苏蔼欣医生 Dr. Yannie Soo 医学院内科及药物治疗学系脑神经科 临床专业顾问及名誉助理教授 Clinical Professional Consultant and Honorary Assistant Professor Division of Neurology, Department of Medicine and Therapeutics Faculty of Medicine 口 谈 实 录 / V iva V oce Photo by ISO Staff