30 Dec 2010


Earlier this month, I met KK on the way to the clinic. The retired cardiologist seemed very happy. He heartily came over and gave me a big hug. I was slightly surprised by the warm act, and thought I should be the one hugging my teacher.

In 2003, our Boss took his sabbatical and visited the Johns Hopkins University School of Medicine. Among all things, he was most impressed by the way clinicians there greeted their patients. Those patients might have AIDS or other rare infections, but the clinicians hugged them all the same. With our cultural background, it is unlikely that we could practice the same act here. Nevertheless, after listening to our Boss’s story, I found myself touching my patients’ hands more often.

That night, I was filled with joy and warmth. The moment I went back home, I opened my arms wide to hug my daughter.

"Yikes!" the girl ducked and ran back to the living room.

23 Dec 2010


Ever since we started wearing masks, my mentor complained he could not recognize any student.

We adopted the policy of wearing masks in all clinical area after the SARS outbreak. While many colleagues were infected, DH was miraculously unaffected despite having seen the index patient. “We have to see a lot of patients with respiratory infections including tuberculosis everyday,” recalled the Professor of Respiratory Medicine. “It is our custom to wear masks during consultations.”

Now that we are so used to masks, it is easy to forget we do not even know what our colleagues look like.

Last week, a young lady called me at the hospital corridor. I looked at her and tried to hide my hesitation. Was she my patient? After a while, I finally realized she was the nurse who worked in my consultation room in the last two years. “Humph, I could not recognize you with the mask off,” I remarked rather awkwardly.

One day, a patient asked at the end of a consultation, “Doctor Wong, I have known you for years but have never seen your face. May you take off your mask?” I duly complied. Secretly, I was quite happy and recalled a scene from The Return of the Condor Heroes.

After a brief encounter, Yang Guo (楊過) granted Guo Xiang (郭襄) three wishes. Guo Xiang immediately made the first wish and requested Yang Guo to take off his mask. Yang Guo was not pleased. He thought Guo Xiang did not understand the value of his gift. As one of the greatest heroes at that time, he could perform the most difficult tasks and solve whatever problems she might have in the future. Guo Xiang disagreed, “How can I say I know you if I haven’t even seen your face? This is not trivial.”

May the piece of paper mask my face but not my heart.

16 Dec 2010


In my trainee days, many colleagues feared a senior consultant across the harbor. Rumor has it that she would take a week off before the membership examination for private study. During examination, she enjoyed asking difficult questions and failed a lot of candidates.

Partly because of her influence, I never read any books before serving as an examiner. The main reason, obviously, is because I am lazy. However, I feel the behavior does not make sense.

If I ask a candidate something that I only know after referring to a book recently, there are two possibilities. First, this may be something a practicing doctor does not need to know. That makes me an unfair examiner. Second, this may be something a practicing doctor should know. In that case, I should have been keeping up with the knowledge and not just look it up before examination. Otherwise, by failing a candidate I fail myself too. I should thus not continue to be a practicing doctor.

I should become an administrator.

9 Dec 2010


Last week, we held the licentiate examination for the Medical Council. This was an examination for medical graduates from other countries who wished to practise in Hong Kong. In the practical session, candidates were required to obtain history from and perform physical examination on patients. New examiners were often surprised to find how different the candidates could be. British-trained graduates performed examination in a systematic way. Others might jump from one step to another, picking up clues on the way and deciding what to do next as the case unfolded.

Many of us would allow a less systematic approach so far if important signs were not missed. Some examiners were less flexible and would already frown when a candidate pulled out the stethoscope before carefully inspecting a patient. The chief examiner repeatedly complained that Americans relied too much on investigations and did not examine patients properly.

A few examiners asked how we should mark the candidates. Since this was not a specialist examination, we could not expect candidates to get every diagnosis right. But how far should we tolerate?

“Shall we adopt the same standard as our own graduate examination?” suggested one examiner.

“Nope,” another examiner disagreed, “we pass 99% of our students every year. There isn’t a clear-cut standard.”

As usual, Szeto came up with the most useful advice. “Think if you are happy to be treated by the candidate in the future.”

But the room went silent.

What a terrible thought!

2 Dec 2010


Last weekend, our team visited Guangxi Medical University and gave a few talks. To our surprise, the whole lecture hall was jammed with students. All seats were filled. Latecomers sat on the floor and stood at the back for the whole three hours. On the second day, even more people came. Although many could not enter the hall, they were willing just to stand outside and listen. The questions and answers session would never end if the chairman had not called the event to a close.

How does our own faculty in Hong Kong run a similar event? The organizers usually inform the students that their attendance would be recorded. Some students would sign their names and leave immediately.

On this, JW shared his recent experience.

His college invited a CEO of a big company to give a talk at a dinner symposium. While the students from mainland China listened attentively, the local ones chatted and played with their iPhones. After the talk, only the mainland students asked questions. The last question was how the CEO chose employees.

The CEO described a few qualities and concluded, “For example, I would choose those who asked questions just now.”