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 甚麼原因促使你投身中風治療及研究？ 十年前我加入 黃家星 教授的團隊從事中風研究，他的視野與毅力是 我的動力。中風十分普遍，發病前未必有先兆，但一旦中風，有機會導 致癱瘓或殘障，失去自理能力。血管狹窄是缺血性中風的重要原因， 但白人和華人血管狹窄的位置各有不同，白人主要是頸部血管，而華 人多是腦血管。由於位置殊異，治療白人的方法和藥物未必適用於華 人，所以我投身華人中風研究，冀尋找更有效的治療方案。 廿四小時遠程中風溶栓治療服務如何令病人得益？ 香港每年有超過二萬名中風病人需要住院治療，但公立醫院的腦神 經科醫生約只有六十位，礙於整體醫生人手不足，診治專科病人以 外，其實大部分時間都用於診治普通科病人，更不可能有廿四小時駐 院的腦神經科醫生。2012年起，威爾斯親王醫院率先利用流動影像 傳訊系統，讓專科醫生在非辦公時間隨時隨地遙距評估及診斷送院 病人，並指示中風專科護士為確診者提供急性中風溶栓治療。直到今 年，威院接受溶栓治療的人數比以往增加達四倍，而提供這服務的公 立醫院也增加至七家。現時，威院是新界東聯網唯一提供廿四小時遠 程中風治療的醫院，我們打算拓展此服務，讓威院、雅麗氏何妙齡那 打素醫院和北區醫院的腦神經科醫生組成團隊，為這三家醫院的病 人提供遠程中風治療。由於需要更多人手配合新計劃，我們正與醫管 局磋商額外撥款。 近年各地中風患者有年輕化趨勢，如何從生活習慣入手預防？ 改變飲食習慣和適度運動有助控制血壓、血糖和血脂，減低中風風 險。要盡量少吃紅肉和加工肉類，多吃新鮮蔬果，果汁是取代不了蔬 果的；無論生活有多忙碌，也要堅持每星期做三次運動，以改善新陳 代謝，避免血管狹窄。良好的生活習慣，愈早建立愈好。 治療病人以外，你也要負責行政、研究和教學等，你最享受哪類  工作？ 在每個崗位累積的經驗，都能讓我在另一個崗位發揮得更好，所以我 樂意承擔不同的工作。我初出道時主力臨床工作，後來多了教學的機 會，曾遇見的奇難雜症，往往成為我教學的臨床個案，幫助學生活用 醫學知識。在醫院累積的行政經驗，亦幫助我逐步改善制度上的不 足。現時我投放七成時間於研究，希望研究成果有助於改善診斷，提 升治療成效。例如我們剛完成長達十五年的病人追蹤分析，發現多了 病人因心律不整引發中風，而原因之一是少病人吃薄血藥，那麼便要 找出原因：到底是藥太貴，還是醫生擔心病人吃藥會有出血風險？ 2003年沙士肆虐期間加入dirty team那一段經歷對你的人生有何  影響？ 我慶幸是其中一分子，因為沙士一役令我體會到人很渺小—隨時會 被細菌擊敗。這教我要珍惜每一天，善用時間做重要的事，同時珍惜 與家人相處的時光。 醫生超時工作甚為普遍，你如何兼顧事業與家庭？ 現代的職業女性一點也不易，因為無論在家庭或工作崗位，家人和同 事都期望你全情投入。我深知全時間照料家庭的好處，但醫治病人的 經歷、應對工作挑戰的毅力，都可以令孩子對生命有更深體會，所以 我不會毅然放下工作。直至約兩年前，我有機會獲中大醫學院半職聘 用從事教學與研究，既可繼續我喜愛的醫療工作，又有精力照顧家人， 雖然收入減半，比起全職醫生少了發展的機會，但我覺得十分值得。 蘇藹欣醫生 Dr. Yannie Soo 醫學院內科及藥物治療學系腦神經科 臨床專業顧問及名譽助理教授 Clinical Professional Consultant and Honorary Assistant Professor Division of Neurology, Department of Medicine and Therapeutics Faculty of Medicine 口 談 實 錄 / V iva V oce Photo by ISO Staff