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The first issue from Caduceus 2012 Editorial Board, hot off the press!
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CaduceusVolume 43 Issue 1 Spring 2012
專訪護理學四年級朱沛文同學
專訪
History
The Fall of Medic Night
簡介何善衡夫人醫學生宿舍-專訪宿生會主席李恩年同學
從濱海醫院發展到內地醫療制度初探
學生何時到濱海醫院實習?
濱海專題
Welcome, dear Reader, to the Spring 2012 issue of Caduceus. What you are reading right now is the
first of three issues to be published by 2012’s Editorial Board, into which we have put every effort to ensure
that this year’s run starts on a high note.
We view 2012 as a time to reflect on our past, not only as editors of this fine paper, but also as
students of the medical faculty, and as students of the University of Hong Kong. For us, 2012 is a year of
great historical significance, as it marks not one, not two, but three momentous landmarks in time: the
second year of the University of Hong Kong’s centennial celebration, the 125th year since the founding of
the medical faculty, and the 90th year since the founding of Caduceus.
Throughout the rest of the year, we will be exploring the histories of the institutions to which we
belong, bringing back events of the past to re-examine them under the modern eye. We will be sharing our
findings right here in these publications with you, and would love to hear your views on them, as well as
on any other issues that may be raised over the coming months.
For the current issue, we present to you a brief history of the notorious Medic Night – how it became a
tradition, decades ago, and how it eventually came to be abolished. Closer to the present time, we bring you
the long and the short on the new Biomedical Sciences curriculum, as well as an update on the development
of Binhai Hospital in Shenzhen, an issue on which Professor S.P. Lee has kindly provided a brief commentary.
Other topics discussed in the present volume include universal suffrage in Hong Kong in 2017, nurses’
uniforms, telomerase as a cure for aging, overseas employment opportunities for Pharmacy students, and
the morality of cannibalism. We also have the distinct honour of presenting interviews with Jackie Chu, a
former representative on the Faculty Board, Jubi Lee, former Chief Editor of Caduceus and current head of
Hall Association for the Madam S.H. Ho Residence, and So Tsz Him, a student representative on the Senate.
This, now, is the point where we wrap up the editorial and leave you to read on, so let us just end by
saying again that we hope you enjoy, and do feel free to let us know your thoughts and remarks!
Caduceus Editorial Board, Session 2012
From the Editors
www.hkucaduceus.net 3
CADUCEUS
CADUCEUS is published by Caduceus, the Society Newspaper Editorial Board, Medical Society, H.K.U.S.U., LLG01, Laboratory Block, 21 Sassoon Road, Pokfulam, Hong Kong. Cover illustration, photo courtesy of Bureau of Public Works of Shenzhen Municipality illustrating the design of the Shenzhen Binhai Hospital. Feel free to contact us at hkucaduceus@gmail.com. Electronic Version is also available online at http://www.hkucaduceus.net. The Design, “Retrospect at Midnight” is created by Gabriel Leung(M16) under the order of the Caduceus Editorial Board. Copyright © 2012 by CADUCEUS. All rights reserved.
專訪 People
Biomedical Sciences | 8
濱海專題 feature
Volume 43 Issue 1 Spring 2012
社會 Social Issues
從新政府總部醜聞看其管治危機│4
職途 Career
2017年普選特首,香港準備好了嗎? │6 簡介何善衡夫人
醫學生宿舍 | 32
另闢蹊徑,轉戰海外──藥劑師香港執業以外的出路│19
自私 | 44
濱海醫院事態發展│21
校園 Campus News
藝術 Arts
The Scrubs Debate | 10
科學 Science
Legendary Founder of Chinese Medicine – The Yellow Emperor | 12Cure for Aging? | 16
Psychology Spotlight: Schizophrenia | 18
聚賢 Societies
The 25th East Asian Medical Students’ Conference | 20
濱海醫院大解構│24
濱海醫院實習利弊初探│26
內地醫療制度簡介│29
專訪護理學四年級朱沛文同學 | 34
34
歷史 History
The Fall of Medic Night | 37
Chicken, Beef or Me? | 41
思辯 Discussion
品味 Lifestyle
六塊腹肌養成法 | 47
開懷 Fun
Images from the M16 | 50
CADUCEUS Spring 20124
從新政府總部醜聞看其管治危機鍾志豪 (M16)
新政府總部已啟用逾半年,由落成至今,醜聞不斷。表
面上是政府延續其做事馬虎、得過且過的一貫作風,實際上卻將近年政府的管治危機表露無遺。筆者認為建設新政府總部原意,是讓眾政府官員及立法會議員享有一個較舒適方便的工作環境,「門常開」的設計意念更是希望為公眾提供一個比以前開放、寬敞的公共空間。在討好市民的背後,更重要的是為政府的固有形象「洗底」,重新建立一個公正開明、不偏不倚、求同存異的正面形象,可惜事與願違,自新總部落成以來產生的種種風波,卻令政府威信反而每況愈下。
危機一: 政府高官好大喜功
新政府總部的醜聞風波始於退伍軍人症的來襲。也許讀者們已對退伍軍人症略有所聞,筆者在此則不詳述。教育局局長孫明揚入住瑪麗醫院,為退伍軍人症的爆發揭起了序幕。之後政府總部接連有九處地方被驗出含菌量超標,政府總部成了病菌的溫床。從過往本地及外國的例子可見,退伍軍人症的爆發,往往是由於供水水缸藏菌。為甚麼?根據專家的檢測和推斷,在正式啟用政府總部之前,工人未有徹底清洗及消毒供水系統。徹底清洗及消毒供水系統,是任何一幢新落成的建築物啟用前的必然工序,為何竟然未有做好一個如此重要的工序呢?輿論認為,行政長官曾蔭權好大喜功,為配合國家副總理李克強在
八月中到訪香港時主持開幕典禮,以及趕及在新政府總部宣讀任內最後一份施政報告,不惜命令工人鼓足幹勁興建新政府總部。這不單顯示政府做事欠嚴謹,更揭露了香港政府高官向中央政府阿諛奉承的嘴臉。
危機二: 政府企圖收緊採訪自由
另外,新政府總部保安處理記者採訪的手法亦大有商榷餘地。新政府總部啟用以來已發生多次保安阻撓記者採訪事件,其中以最近一次最為矚目,亦令筆者感到相當心寒。事發於本年一月九日,《蘋果日報》記者成啟聰採訪退伍軍人症病癒的教育局局長孫明揚首日上班,遭保安員粗暴拉扯、箍手、推撞,嚴重干擾採訪。保安員更自行跌在地上報稱受傷。香港記者協會批評政府阻止傳媒採訪,影響公眾透過傳媒向政府問責。另一方面,儘管政府聲稱「門常開」是新政府總部的設計理念,但事實上新政府總部的設計不方便傳媒採訪;
社會
新政府總部及立法會總部位於添馬艦,佔地124680平方米,於2008年動工,2011年落成。
www.hkucaduceus.net 5
左圖取自 http://webpic.chinareviewnews.com/upload/201201/10/101972649.jpg 右圖取自 http://caspart.files.wordpress.
傳媒即使出示記者證,亦只能前往少部分地方。政府多次以不同手段向傳媒的採訪施以阻力,使傳媒難以接觸政府官員,從而令他們無法有效執行第四權(監察權),最終削弱了市民應有的知情權。這樣的行徑還稱得上是「門常開」嗎?
危機三: 銷毀檔案, 讓城市失憶
新政府總部的醜聞連連,而最令人髮指的是在政府總部搬遷期間的疑似檔案遺失事件。一份政府文件指由二零一零至二零一一年六月,各個政府部門因搬遷而銷毀的文件數量高逾五百萬張。相對之下,保留的數量九牛一毛,只有約一萬。這反映了香港法律的缺陷:檔案的存棄缺乏《檔案法》的規管。據資料顯示,缺乏《檔案法》規管的香港,政府檔案的保留比率只有百分之零點二,遠遠低於英、美、澳等已有《檔案法》國家的百分之三至十。在美國,白宮文件的保留比率更高達百分之百。遺失檔案已不再是出於政府官員的粗枝大
「門常開」阻撓採訪事件簿2011年8月11日
新總部啟用前三名記者誤入新特首辦公室
範圍,被警察以企圖爆竊罪拘捕
2011年8月17日
正值李克強訪港,記者在外圍拍攝大樓外
貌被阻止及驅趕
2011年8月18日
新政府總部開幕時,記者被阻止到示威區
採訪
2011年10月
立法會綜合大樓啟用初期禁止示威區範圍
過大,保安員多次粗暴阻礙記者採訪
2012年1月9日
新政府總部保安以拉扯、推撞等手法粗暴
阻止《蘋果》攝影記者拍攝孫明揚上班
葉,而是出於他們對香港歷史的一份不尊重。曾經有人說過,一個不尊重歷史的城市是沒有靈魂的。如今特區政府不重視這個都市過去的發展,並試圖淡化香港長達一百五十多年的殖民地歷史,以期讓香港盡快去殖民化,投入國家的懷抱,這樣的「破舊立新」,會增加香港人對國家的歸屬感嗎?另一方面,有關回歸以後重大政策的文件,例如有關董建華時代「八萬五」房屋政策、基本法二十三條立法、SARS的檔案,可能都一一「遺失」了。正所謂「前事不忘, 後事之師」, 如今做錯的都像粉筆字被抹掉, 以後的決策又怎能汲取教訓呢? 從陰謀論的角度,特區政府恣意粉飾太平,把以往做得不好的都銷毀,意圖讓整個城市「失憶」。
總括而言,要得民心,政府必須解決當前危機,並減少不必要的政治化妝。筆者建議政府應認清傳媒的角色,不要視之為洪水猛獸,從而加強與傳媒聯繋, 以紓緩與傳媒的緊張關係。另外,政府應盡快立法以確保重要的檔案得以保留,維護本港歷史的完整。作為一個醫學生,筆者跟其他升斗市民的期望一樣,都希望特區政府多幹實事,少開空頭支票,不要只有「門常開」之名,欠缺「民永繫」之實。
從新政府總部醜聞看其管治危機
雖然新政府大樓取名「門常開」,但卻多次阻撓記者到訪,重門深鎖,因此有政治漫畫家特作此圖諷刺政府的「講一套做一套」。
com/2011/0
8/081211_0734_2581.jpg?w=600
CADUCEUS Spring 20126
社會
編按:筆者執筆之際,正值特首選舉提名期結束之時。因選情瞬息萬變,如本文內容有未周之處,還請讀者見諒。
數年前,泛民爭取2012雙普選不果,特首選舉的結果依然是在千
二名選委的掌控之內。儘管如此,本屆特首選舉仍在本地政壇中翻起千重浪。自二月起,兩名建制派候選人唐英年和梁振英的醜聞引起軒然大波。唐英年的「僭建門」及梁振英的「西九門」,令選委舉棋不定,更令市民質疑兩人的誠信。歐美的報章也罕有的評論這場「小圈子選舉」,香港廉潔的名聲受到衝擊。唐梁二人在參選之初還頻頻「落區」,現在卻要集中應付「黑材料」。泛民陣營也不甘示弱,揚言要跟建制派候選人作現場辯論。唐英年、梁振英和何俊仁相繼「入閘」,社會上比較、批判各候選人的聲音畢竟很多,筆者亦無意再就此多言;但我們在本屆選舉中觀察到的狀況,卻值得大家深思。究竟我們希望由怎樣的人當特首?我們的社會能否有效地培養政治人才?我們推崇什麼施政理念?我們要求什麼形式的「普選」?
誰來治港?
范徐麗泰以高齡為由宣佈不參選,而唐、梁二人競選則被評為「豬狼之爭」,可見不少港人並不屬意他們倆當特首。那麼屬「泛民」的何俊仁合適嗎?遠在九七回歸之時,港人在民調中亦傾向選擇中央接納的人選,即使當時
最受歡迎立法局議員李柱銘的支持度也不超過一成。一方面,港人一直視香港為中國境內人權自由的綠洲,每年的六四集會均座無虛席;另一方面,我們也不能否認香港的繁榮穩定跟內地的經濟增長有著唇亡齒寒的關係。在民主運動趨向激烈之際,我們能否找到一位既不放棄自由民主等核心價值,又可與中央溝通的理想特首呢?
目前本港法例不容許特首有政黨背景。筆者認為,政黨政治應為長遠的發展方向。曾蔭權在將近離任之際被揭發頻頻休假並多次接受富豪款待,一方面反映他欠缺政治敏感度,同時也突顯他的「看守政府」心態。如果香港由政黨執政,政黨要在普選中保持優勢,就會積極推動利民政策,而非抱「不做不錯」的態度,得過且過。
誰能參選?
本屆特首選舉有兩名建制派候選人
2017年普選特首,香港準備好了嗎?從2012行政長官選舉看本港的政治成熟程度
蘇奕嘉 (M16)
有人說唐梁之爭已造成建制派分化,建制派是否容不下競爭?
www.hkucaduceus.net 7
2017年普選特首,香港準備好了嗎?
競爭,親建制人士對此態度不一。政協常委陳永棋就曾表示建制派應「團結」,宜只派一人參選。其實,同一派別有多人有意參選在國外可謂司空見慣。篩選同一派別參選人以集中票源,原本無可厚非,前提是市民應有權參與不同派別的內部「初選」,而非由少數政客或北京政府指點江山。本屆泛民的初選亦未臻完善──三萬人的投票率能否有足夠的代表性?訪問一千人的民調又有多大的誤差率?
真正的普選平台應是百花齊放的。除了派別內的協調,提名門檻也值得關注。當唐梁二人接連傳出醜聞後,曾鈺成和葉劉淑儀有意加入選戰。最終曾鈺成以時間倉卒為由放棄,葉劉淑儀則不夠提名票「入閘」。如果實行普選後,候選人仍必須獲中央政府的「祝福」,或一定要得到大財團支持,那一人一票選特首還有甚麼意義呢?
施政哲學
綜觀所有候選人的政綱,無不牽涉增加福利。古語有云:「民為貴,社稷次之,君為輕」,政府大力投資改善教育、醫療及房屋政策固然沒錯,筆者亦不希望政府斂財。但世上並沒有免費午餐。十五年免費教育、大量加建公屋當然受歡迎,但庫房又能否支持?競選承諾會否淪為空頭支票或加稅的元兇?福
利主義的弊端在歐洲國家陸續浮現,希臘不合理的退休金制度和公務員福利令該國經濟陷入崩潰。香港一貫是自由經濟體,我們還想堅持「大巿場,小政府」的路向嗎?
近年,某些政黨盲目地爭取高福利、低稅率,以博取巿民支持。不少人擔心落實普選會令民粹主義抬頭,市民會被種種甜頭吸引,令為政者不再量入為出。筆者認為民粹主義不應成為阻礙民主發展的藉口。但我們也不能一邊盼望特首班子目光遠大,一邊貪婪地掠奪公共資源。我們不能不斷要求政府「派錢」,而應支持庫房用得其所,令「老有所終,壯有所用,幼有所長,矜寡孤獨廢疾者,皆有所養」,人人有向上流的機會。誠然,近年港人太習慣庫房「水浸」,對公共福利要求越來越高。如果我們不求不勞而獲,民主和經濟就不會對立起來。
展望2017
政制發展不能一蹴而就。筆者希望強調落實普選只是民主進程的起點,配套工作尤其關鍵。所謂有怎樣的市民就有怎樣的領袖,市民的素養將影響民選特首的品質。
唐英年及曾鈺成等人曾批評當下的選舉文化只重抹黑,缺乏針對政綱的理性討論。筆者一方面認為傳媒把候選人放在鎂光燈下審查無可厚非。大眾重視候選人廉潔、守法和言而有信等品質,說明香港人不再是政治冷感。另一方面,我們不應在選戰結束後忽視長遠民主發展。如果社會能洞察這次選舉暴露的問題,在往後的日子循序漸進的完善選舉制度、改進本地政治環境,普選才能發揮其最大優勢。香港人才能以行動告訴世界:「我們有能力選特首!」
「泛民」候選人何俊仁雖勝出機會渺茫,仍希望把民主訴求帶進特首選舉中。
左圖取自 中
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CADUCEUS Spring 20128
Campus News
Biomedical SciencesWong On Wai, Aaron (M16)
Th e L i K a S h i n g
Faculty of Medicine
will offer a new full-
t i m e p r o g r a m m e , B a c h e l o r
o f B i o m e d i c a l S c i e n c e s
(BBiomedSc), in the upcoming
academic year, which will be
the first such programme offered
by a local university. This new
p r o g r a m m e w i l l a c c e p t 2 0
students holding the Hong Kong
Diploma of Secondary Education
(HKDSE) and will be a 4-year
curriculum.
The faculty decided to
introduce the first Biomedical
Sciences programme in Hong
Kong given an increasing need
for such researchers. Many
overseas universities have already
launched similar programmes.
Moreover, healthcare workers
focus on patient care, whereas
professionally-trained scientists
lack knowledge in biomedicine.
Therefore, there is demand for
biomedical scientists who can
bring basic sciences into the
medical field, so as to benefit the
healthcare industry as a whole.
That is the aim of launching
Biomedical Sciences.
The curriculum gives a
taste of nearly everything related
to medicine of different depths.
There are three foci in this
programme:
1.The structure and function
of the human body and the
processes that are essential
to life;
2.The basic principles of
the processes, mechanisms,
patterns of disease and
concepts of therapeutic
strategies;
3.The essential analytical
methodologies and contemporary
information technology skills
in the field of biomedical
sciences.
(Adapted from Undergraduate
Prospectus 2012, issued by the Li Ka
Shing Faculty of Medicine)
Integrating sciences with
medicine, a wide range of
subjects will be covered,
including anatomy, physiology,
human biology, biochemistry,
pathology, etc. Interestingly,
this curriculum is not simply
all science-related. There are
also courses like healthcare
financing and policy as well
as epidemiology. In short, the
curriculum aims to not only give
pure scientists, but researchers
with broad vision who can
contribute more to the scientific
and medical worlds.
The curriculum is only
open to students who have
completed the DSE, and will be a
4-year programme. Its minimum
requirements will be the same
as that of Bachelor of Medicine
and Bachelor of Surgery (MBBS)
as well as that of Bachelor of
Pharmacy (BPharm), i.e. level
4 in English, level 3 in Chinese,
level 2 in Mathematics and
Liberal Studies. For the elective
part, students have to attain
at least level 3 in either Biology
or Chemistry (either as an
individual subject or as part of
“Combined Science”).
The structure of the
programme is divided into 3
parts, namely the foundation
level (Year 1), the introductory
level (Year 2) and the advanced
level (Years 3 and 4). The aim
of the first year is to build upon
foundations of high school
knowledge, allowing students
to be more familiar with basic
sciences, like human biology and
general chemistry. Then in higher
years, more specific courses
will be offered - subjects like
anatomy and physiology. A final
year project must be completed
in Year 4 and will bear 12 credits.
www.hkucaduceus.net 9
Biomedical Sceinces
The mode of learning is similar
to most science curricula,
including lectures and laboratory
practicals. Notably, problem-
based learning is also one of the
teaching methods. There are also
two minors available for students
taking this curriculum. They
are Genetics and Genomics, or
Pharmaceutical Sciences.
In terms of content, the
Bachelor of Biomedical Sciences
is broadly similar to the Bachelor
of Medicine and Bachelor of
Surgery. The difference would
be that the former does not
have a clinical
component. In addition, according
to Dr. Sham Mai Har, Head of the
Department of Biochemistry, the
Biomedical Sciences programme
provides a deeper understanding
of science subjects as well as
some laboratory techniques
that are absent in the MBBS
curriculum. Its career options
are expected to be wide. Dr.
Sham said that students who
have completed the programme
should be able to pursue their
interests in both governmental
and private sectors. They can
also further their studies.
Brian Chan, a student
of M16, got his first degree in
Biomedical Sciences
at Imperial
College. He
said the
Biomedical Sciences degree
offered by the University of
Hong Kong resembles, in many
ways, the programme he took
at Imperial College. The big
difference is the weighting
of some subjects. Imperial
College’s programme emphasizes
molecular pathology and
biochemistry to a greater extent,
whereas subjects like anatomy are
not of great importance. In HKU,
every subject bears the same
credit, probably implying equal
importance. Brian also pointed
out there is an actual need for
Biomedical Sciences, as there
does not exist a curriculum to
study the relationship between
human and disease in such detail.
Although the Chinese University
of Hong Kong offers Biomedical
Engineering, it focuses more on
the mechanical part than human
biology. Finally, he said that most
graduates of Biomedical Sciences
will further their studies, with
the most popular choice being
the Master of Public Health
(MPH).
Till now, the medical
faculty has only provided
curricula that train frontline
healthcare workers, like doctors,
nurses, etc. Hence, there is a
great chance that the faculty is
going to have a new programme
that allows students to pursue
their interest in the research of
medicine.
ON
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CADUCEUS Spring 201210
Arts
The Scrubs DebateNurses’ uniforms in the past and present
Luke Yiu (M16)
Th e m a i n t e n a n c e o f
uniform guidelines has
been, and may very well
always be, a crucial issue within
the nursing profession. A nurse’s
uniform must protect its wearer
from exposure to diseases, but
must also instil trust in the
nurse’s patient. Amidst rumours
that nurse uniforms of some
hospitals in Hong Kong are due
for a revision in the near future,
a consideration is presented here
on one of the greater healthcare
controversies of the present day:
that of the question of scrubs.
Historically, the nurse’s
uniform consisted of a dress,
pinafore apron and cap. This type
of uniform was believed to have
been derived from nuns’ habits,
since nuns were traditionally
responsible for caring for the
sick, up until 1860. Uniforms
of this style were maintained
in most parts of the world
throughout the majority of the
20th century. During the 1980’s,
however, significant alterations
were made to nurse uniforms.
These were driven largely by a
rapid increase in the number of
male nurses. Caps and aprons
swiftly fell out of fashion, to be
replaced by the white tunic tops
and dark trousers that remain
the standard nurse uniform in
the UK and Australia today. A
variant of this uniform is the
current norm in Hong Kong.
More recently, some
countries have begun to replace
tunics with medical scrubs as
standardised nurse uniforms.
Originally devised in the 1970’s
as protective wear for surgeons,
scrubs consist of a short-sleeved
V-neck shirt, drawstring trousers
and a surgical gown. Today,
they are regulation attire for
surgical staff in most parts of
the world, and donning the
garments before entering a
theatre is sometimes referred
to as ‘scrubbing in’. As of the
time of this writing, scrubs in
Hong Kong hospitals are a rare
sight outside of surgery.
Most hospitals in the
USA and Canada, at present,
either recommend or require
all nurses to wear scrubs while
working, usually in duller shades
of blue, green or grey, though
some hospitals allow nurses
considerable freedom in selecting
the colour and patterning of their
scrubs. One would assume, then,
that the current review of nursing
uniforms in Hong Kong involves
a proposed replacement of tunics
and dresses with scrubs. The
issue, however, generates much
argument, even in countries
where the use of scrubs as The traditional apron-and-cap nurse uniform, in use for over a century from the 1860’s up till the 1980’s.
The tunic-style nurse uniform, introduced in the 1980’s as a unisex outfit.
www.hkucaduceus.net 11
The Scrubs Debate
uniforms is widespread, and a
number of reasons have been put
forward both for and against the
case of scrubs.
Supporters of scrubs
point out that the simplicity
of their design means that
there are minimal places
for contaminants to hide,
such that they are easier
to launder and disinfect.
Scrubs also tend to be
made of synthetic material less
prone to penetration by dirt or
fluids, and are cheap to replace
if damaged or contaminated.
In brief, the primary argument
for scrubs as nurse uniforms is
that they are more conducive
to preventing infection and
maintaining safety for both
nurses and patients. This
consideration is not one that
is new to the design of nurse
uniforms – the original apron-
and-cap uniform of the 19th
century was created with the
intention of covering up nearly
the entirety of the nurse’s body,
so as to protect against infections.
Detractors of scrubs
point out that scrubs are so
nondescript in design that it
is impossible for patients to
recognise their nurses. Reports
from some nurses say that they
have been mistaken for cleaners
by their patients, who would
then proceed to ask for “real
nurses”. The problem is further
exacerbated by the wide variety
of colours and patterns scrubs
are now available in. A study
by Skorupski (2006) found
that patients tended to lose
confidence in nurses who did not
dress in white, as they were seen
to be less professional. Again,
this consideration is a historically-
established one – the use
of aprons and caps in
the 19th century was
chosen to project an
image of purity and
respectability.
It would
appear, then, that
what the scrubs
debate mainly
boils down to
is the balance of
infection prevention
against professional
appearance. These
considerations were
central to the design
of nurses’ uniforms
at the time of their
conception, and they
continue to affect
the design of nurses’
uniforms today.
Scrubs prioritise
infection prevention
above all else, but
should this really
be the case? Should Hong Kong
adopt scrubs as the standard
nurse uniform, or continue to use
the tunic-style uniform or even
design a new type of uniform
altogether?
You decide.
Scrubs. Originally designed as protective wear for surgeons, now commonly used as nurse uniforms in the US and parts of Europe.
ON
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ReferencesMy Nursing Uniforms - http://blog.mynursinguniforms.com
British Nurses - http://www.british-nurses.co.uk
HKU School of Nursing - http://www3.hku.hk/nursing
CADUCEUS Spring 201212
Legendary Founder of Chinese Medicine – The Yellow Emperor
Louis Fu MB, BS (HK, 1971), FRCS(Edin), formerly Consultant, Orthopaedic ‘A’ unit, Queen Elizabeth Hospital, Kowloon, Hong Kong
Edited by Jeremy Li (M16)
Science
Although his existence
has been disputed, the
C h i n e s e a c c e p t t h e
Yellow Emperor as the founder
of their nation. Attributed to
him is the authorship of the
Yellow Emperor’s Inner Classic .
Upon this all Chinese medical
classics are based, and even
today it is regarded with the
highest authority. It is beyond
r e a s o n a b l e d o u b t t h a t t h e
Yellow Emperor did not write
the work himself, but it was
compiled by different schools
of anonymous authors over a
period of several centuries. It
summarizes the philosophy
and experience of the ancient
times and is the earliest attempt
to systematize the medical
thoughts of those periods. It
reflects a break with the old
medical tradition of shamanism-
magic and demonology, and
the genesis of a new tradition
focusing on the environment,
laws of nature, acupuncture, and
dietetics in the prevention and
treatment of diseases, and in so
doing, marks the beginning of
medicine in China.
The Legend of the Yellow Emperor
Chinese history began with
the San Huang (三皇) followed
by the Wu Ti (五帝). The third
in this prehistoric lineage of
Chinese deities is Huang Ti (黃帝), believed to have lived from
2698 to 2598 BC. When his
predecessor, tribal leader Yen Ti
(炎帝) was unable to suppress
an uprising by a rebel tribal chief
named Chi-you, Huang Ti raised
an army, made weapons, and
restored peace. As a consequence,
the tribal leaders elected him to
be their overall ruler. Chinese
all over the world still call
themselves “descendants of Yen
Ti and Huang Ti”. (炎黃子孫)
He taught his people
how to make utensils, pottery
and metalware. One of his
concubines discovered the
production of silk by silkworms.
He regulated costumes for his
ministers, divided the land into
portions, and mapped out his
kingdom into provinces. He was
also believed to have written the
Huang Ti nei ching (黃帝内經): Su
wen (素問), Ling shu (靈樞), Tai
su (太素).
Genesis of the Yellow Emperor’s Inner Classic
From circumstantial
evidence based on geographical
names, literary style, historical
allusions and other points
of contrast, it may be safely
concluded that this work
appeared not earlier than the
Chou (周) Dynasty (1030 – 722
BC) and not later than the Han
(漢) Dynasty (202 BC – AD
9). The contents and concepts
were older, coming from an
oral tradition and recorded by
multiple authors. After that, the
Inner Classic had been shaped
and reshaped, layer by layer,
with extant versions being the
last in a progressive series of
compilations. In its present form,
the work has probably existed by
the 1st or 2nd Century AD.
Textural analysis of the
Inner Classic revealed that the
work has passed through several
phases in its formation:
www.hkucaduceus.net 13
Legendary Founder of Chinese MEdicine
The earliest version
transcribed the alleged dialogues
between Huang Ti and his
ministers. These were simple,
intelligent and rational queries
on medical and philosophical
issues. They were elucidation of
medical problems of their day.
This part was probably compiled
in the Chou Dynasty.
Between the Spring-
Autumn (春秋) period (722
– 480 BC) and the Warring
States (戰國) period (480 – 221
BC), the doctrines of yin-yang (
陰陽), wu-hsing (五行) and
numerology prevailed among
Chinese thoughts. Scholars took
the opportunity to recast the
work to fit those theories.
A court physician Yang
Shang-sang (楊上善) of the
Sui (隋) Dynasty (581 – 618)
prepared an edition of the Tai su.
Missing since the 11th Century,
yet rediscovered in a Japanese
temple during the 18th Century,
only eighty percent of texts
survived.
Wang Ping (王冰) of the
T’ang (唐) Dynasty (618 – 906)
encountered an authentic copy
of the original Nei ching. From
751 to 762, he restored the
work, rearranged the structure,
transposed test portions
and interpolated displaced
contents. He added over 5000
commentaries for missing
segments and deleted duplicated
passages.
During the Sung (宋)
Dynasty (960 – 1269), an
Imperial Editorial Committee
was formed in 1057 with scholars
Lin Yi (林億) and co-workers
from the National University to
re-edit Wang’s version, adding
rectifications of their own.
Anatomy in Inner Classic
Even though Western
views in the past often deemed
anatomy in traditional Chinese
medicine as a product of
imagination instead of dissection
and experiment, human dissection
must have occurred in ancient
times, albeit on rare occasions.
For example, the Inner Classic
recorded the length of alimentary
canal.
Pa Kao (伯高) said to the
Yellow Emperor, “Let me tell you
the lengths of the various parts
from mouth to anus: from the
lips to the teeth is 0.9 inch, the
width of the mouth is two and a
half inches … The small intestine
is attached to the spine behind,
goes round from left to right, and
overlaps with sixteen turns. Its
circumference is two and a half
inches; its length is thirty-two
feet … The total length of the
digestive tract is sixty feet and
four inches, and the number of
turnings in the small and large
intestines is thirty-two.”
- Ling shu Chapter 31: The
gastrointestinal tract (腸胃篇)
Measurements of the
skeletal system are also
mentioned.
“There are altogether
21 vertebrae in the spine –
12 thoracic, 5 lumbar, and 4
coccygeal vertebrae – and the
length is three feet. Each of
the seven cervical vertebrae
is 1.41 inches … These are the
bone measurements in a man of
average stature, and is the base
for one to measure the length of
the channels.”
~ Ling shu Ch. 14: Measurement of
bones (骨度篇)
The vascular system is
supposed to be comprised of
12 pairs of blood vessels named
ching-mo (經脈) and their
tributaries. Blood and air are
conveyed to different parts of
the body via ching (經), lo (絡)
and sun (孫), approximately
corresponding to artery, vein and
capillary respectively. Along the
course of these vessels are 365
ch’i-hsueh (氣穴), corresponding
to days in a year, used for
acupuncture. The twelve vessels
are deeply hidden in the muscles
and cannot be seen. Comparative
studies of the dimensions of
human organs given in ancient
Chinese texts with modern
standards have demonstrated
a reasonable correlation, where
allowances have been made for
CADUCEUS Spring 201214
post mortem changes, copying
errors and misprints.
Physiology in Inner Classic
According to the Inner
Classic, the heart is the prince
of the body, the seat of the vital
spirit. The lungs are the ministers
who regulate one’s actions. The
liver is the general who devises
strategy. The gall bladder is the
office in which courage resides.
The spleen and the stomach
are the granaries from which
the five tastes emanate. The
small intestine is the receptive
organ, the site of digestion.
The large intestine is the place
of communication where
matter undergoes change. The
pericardium is the ambassador
who brings joy. The kidneys are
the seats of vigor and strength
from which skill emanates. The
bladder is the reservoir storing
secretions, which are released
after interaction with vapour.
The triple burners are the sewage
system.
The brain is thought to
be a reservoir for marrow, an
abundance of which makes
one feel light and strong. Its
deficiency results in dizziness,
tinnitus, blurred vision,
tiredness and aches in the limbs.
Digestion is described as follows:
after food enters the stomach,
its essence goes to the liver and
from there its vital forces go to
the muscles, whereas its putrid
vapours ascend to the heart and
its essence reaches the pulse.
Finally its bulk descends by
way of the anus. Drinks enter
the stomach and then turn into
secretions, the essence of which
enters the spleen. The spleen
then sends its secretions to the
lungs, from which they descend
to the bladder.
It has been claimed that
the Chinese have discovered
the circulation of blood two
millennia before William Harvey
(1578-1657), based on several
passages commenting on the
concept of blood circulation.
“All the blood is under the
control of the heart.”
~ Su wen Chapter 10: On formation
of five viscera (五臟生成論)
“The blood current flows
continuously in a circle and
never stops.”
~ Su wen Chapter 39: On pain (舉痛論)
The above suggests that
the Chinese have grasped the
concept of the circulation of
blood. Unfortunately, beyond
this nothing further had
progressed. The blood is thought
to start its flow from the foot
to the kidneys, the heart, the
lungs, the liver and the spleen
respectively; and then from
the spleen back to the kidneys,
making a complete cycle. All
this suggests a concept of the
flow of ch’i (氣) in the form of
circulatory movement. The Inner
Classic contains no indications as
to the conceptualization of the
heart or lungs as fulfilling a kind
of pump-like function. Hence it is
incorrect to say that the Chinese
discovered the circulation
twenty centuries before Harvey.
For their knowledge of the
circulation of blood in the human
microcosm was intuitive, not
experimental, conjectured at
the suggestion of circulation of
the universal macrocosm. They Posterior (left) and anterior (right) views of the meridians (conduits) of the body.
Legendary Founder of Chinese MEdicine
www.hkucaduceus.net 15
divined the facts but they never
verified them. The “how” of
the circulation did not present
to their minds. In contrast to
Harveian theory, the concept
of circulation in the Inner Classic
is not based on biological or
medical science. It makes all the
difference between speculation
and scientifically-proven fact.
Significance of the Yellow Emperor’s Inner Classic
It is rare that an individual
can establish a culture and a
system within a short burst
of time. These are usually
products of collective efforts of
the community and innovations
of many persons over a long
period of evolutionary process.
It is quite impossible to attribute
an achievement to a single
person. The chief reason for
attributing authorship – factual
or metaphorical – of the Inner
Classic to the Yellow Emperor is
the ancient Chinese custom of
ignoring contemporary views in
preference for ancient authority.
In Chinese civilization, great
reliance is placed on tradition,
an exaggerated reverence for the
past, and what might be called
a disproportionate respect for
authority. In ancient China,
where values were greatly
determined by age and seniority,
such practices of “antedating
of priority” were of frequent
occurrence. As the Taoist Liu An,
Prince of Huai-nan (淮南王劉安)(2nd Century BC) opined,
“the ordinary people venerate the
old and despise the new. Hence
those who set up the Tao (道) are
forced to take the names of Yen Ti
and Huang Ti .”
This work is the most
important medical work by any
criterion, its mythical origin is
the most exalted because of its
claim of having originated from
the court of the Yellow Emperor.
Rarely has there existed between
the covers of one book such an
extreme variation in contents,
arguments, expositions, and
hypotheses, ranging from the
most irrational to the crystal-
clear logic. This lends support
to the hypothesis that the work
was the summation of the efforts
of various authors through many
centuries. Between its pages
are encyclopaedic collections
of all natural, supernatural, and
metaphysical hypotheses of
ancient China. On analysis, the
work yields a historical record
of the evolution, progression and
regression of Chinese medical
theory and practice. The work,
being written in an archaic,
condensed and concise manner
typical of the literary style of
ancient times, suggests that it
was originally composed in verse,
which would have made it easier
to memorize. This was inevitable
when information was passed
down orally from one generation
to the next. Starting in the post-
Confucian era by shaking free of
mysticism and supernaturalism,
it placed its trust in reasoning
for the solution of problems.
Unable to classify diseases for
lack of basic science, the ancient
Chinese contented themselves
with meticulous observations of
clinical symptoms and sometimes
accurately connecting them with
diseases.
Although nothing definite
is known of its authorship or
exact date of composition, it is
still regarded as the supreme
authority. The attribution of the
work to the Yellow Emperor,
or whether he even existed at
all, is of little significance now,
since it is a compendium of
all the philosophia perennis and
practical knowledge of Chinese
medicine. Just like the Hippocratic
corpus, it deals with all aspects
of the normal and abnormal
functions of the human body,
with diagnosis, therapy and
prognosis. Although a product
of later periods, its attribution to
civilization founders of legendary
antiquity demonstrates the
integral position of medicine in
the emerging culture of China.
As a compendium of precious
records of the medical legacy
of generations of Chinese since
antiquity, it remains essential
reading for all physicians.
Legendary Founder of Chinese MEdicine
CADUCEUS Spring 201216
Cure for Aging?Mephis Ko (M16)
Aging is, perhaps, the
u l t i m a t e d i s e a s e o f
humankind. Frankly,
we just cannot get rid of it,
and it is always going to get us
some day. Some researchers,
however, may beg to differ as
they gain understanding of the
enzyme telomerase. The ground-
breaking research that won
the Nobel Prize in Medicine
in 2009 is gaining increasing
media coverage as it brings up
promises to cure such diseases
as Alzheimer ’ s , congenita l
disorders, heart diseases and,
with time, perhaps even aging
itself.
In each of our cells
are delicate strands of
genetic information called
deoxyribonucleic acid (DNA).
To say these DNA strands dictate
our very existence is hardly an
overstatement, for they have the
blueprint to all the proteins made
in our body. The problem comes
when we are growing. When
our cells divide, the proteins
responsible for making more of
our DNA replicate the DNA by
scanning it from one end to the
other. These proteins, called
DNA polymerases, inherently
fail to work all the way through
to the end, making new DNA
strands that are just a little bit
shorter than the DNA it is made
from. At the end of DNA strands
are repeats of a code called
telomeres that act as protection
of the DNA end. Needless to say,
if this goes on, we will end up
losing more and more of our DNA
and when this protection is lost
the cells will stop replicating.
We are born with telomeres 15-
20,000 bp long, losing 50-200
bp of those every time the cells
divide (Xu et al, 2011). This is
like a ticking time bomb in our
body; our cells will run out of
juice in 40-60 replications if it is
unchecked.
Disturbingly, early studies
suggest that short telomere
length and a host of degenerative
diseases like cognitive aging seem
to occur hand in hand, although
whether short telomeres have a
hand in causing them is yet to be
confirmed.
Well, the good news
is, telomerase reverses this
by replenishing telomeres,
making telomeres longer and
counteracting the effects of
DNA replication. The bad news
is this enzyme, too, is limited.
Telomerase is activated during
foetal development when our
cells grow the quickest; it is
repressed as we age. The thinking,
then, is obviously to try to make
the telomerase in our body active
again. Indeed, experiments
on telomerase reactivation
have proven effective in cell
cultures and mice. By activating
telomerase from suppression,
tissue degeneration is reversed
in experimental mice.
While its research is far
from complete, “telomerase”
is hardly just another obscure
scientific term. Telomerase
Science
It worked on them… question is, will it work on you?
www.hkucaduceus.net 17
Activation Sciences Inc. (TA
Sciences) has been marketing
TA-65®since 2005, the first of
a brand new generation of anti-
aging drugs. TA-65® is a small
molecule extracted from the
plant Astragalus membranaceous,
acting as a telomerase activator.
The newest report by the
same company looked at the
telomere length of patients who
had had a 1-year course of
TA-65® (Harley et al,
2011). While there is
suggestion of some
immune cells of the
body returning active
from dormant, the
telomere length of cells
did not increase and the
overall bodily function
had no significant
change. The results
are by no means
definitive, but the
product sells for
up to a monthly cost of USD667
(~HKD5200), or USD4000
(~HKD31000) in a half-year
course.
Telomerase can let
cells multiply forever: what
immediately comes in to mind?
Cancer. It is known that 90%
of all malignant cancers include
activated telomerase which
grants the cancer immortality
and malignancy. It only comes
naturally, then, that the other
big field of application of
telomerase research lies in
targeted cancer therapy. One
reason pharmaceuticals want to
target telomerase is the almost
complete dependence of cancer
cells on telomerase activation
in achieving immortality.
The other is how normal
tissue will not be
affected by this drug,
because telomerase is
normally suppressed.
A putative drug is
Imetelstat (GRN163L),
a small length of DNA
that inhibits telomerase
by binding its active site,
blocking it from
action. Imetelstat
is in clinical trials
phases I/II in
multiple cancer types including
breast cancer and lung cancer
(Xu et al, 2011).
This concept of telomerase
in cancer is, of course, in blatant
contradiction to telomerase
activators as anti-aging
nutraceuticals. The argument
is whether supplements like
TA-65® will increase the chances
of getting cancer. Some hold the
fear that telomerase activators
can and will eventually lead to
cancer in patients, and rightly
so. Others argue that telomerase
activation will not make immortal
cancer cells more immortal, and
the concern is in making benign
cancer cells immortal. They
believe we can simply cease
taking the supplement to reverse
the effects should malignancy
arise from this.
With this brief review, I
hope I have given you a flavour
of where telomerase research is
at, what people are doing with it
and where the controversies lie.
While the field is still young, it is
rapidly growing and evidence is
mounting for telomerase’s role in
aging. On one hand, opportunists
seize the telomerase activators
as a golden chance to earn
money; on the other, researchers
are working through clinical
trials to establish telomerase
inhibitors as targeted therapy for
cancer. For now, we can safely
say humankind is slowly and
steadily overcoming the deadly
disease known as aging.
ReferencesHarley, C.B., Liu, W., Biasco, M., Vera, E., Andrews, W.H., Briggs, L.A., & Raffaele, J.M. (2011) A Natural Prod-
uct Telomerase Activator As Part of a Health Maintenance. Rejuvenation Research. 14 (1), 45-56.
Xu, Y., He, K., & Goldkorn, A. (2011) Telomerase Targeted Therapy in Cancer and Cancer Stem Cells. Clin. Adv.
in Hematology & Oncology. 9 (6), 442-455.
Cure for Aging
Telomerase activators grant us immortality… or a nice fresh tumour in the lung.
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CADUCEUS Spring 201218
Psychology Spotlight: Schizophrenia
Luke Yiu (M16)
Th e r e c e n t m u r d e r s
of a security guard in
Sheung Shui, and of a
woman and child in Tsuen Wan,
all perpetrated by schizophrenic
individuals, appear to have
sparked a new wave of fear of
schizophrenia amongst the
p o p u l a t i o n o f H o n g K o n g .
Unfortunate ly , i t does not
seem to be the case that this
fear is supported by a good
g e n e r a l u n d e r s t a n d i n g o f
schizophrenia. The present
article, thus, will provide a very
brief introduction to the so-
called “splitting mind disease”,
which has puzzled healthcare
w o r k e r s s i n c e t h e d a y s o f
Pharaonic Egypt.
Contrary to the popular
belief that mental disorders
are a relatively newfangled
occurrence, the symptoms of
schizophrenia have, in fact,
been known since ancient times.
They can be found unmistakably
described in the literature
of the Bronze and Iron Age
civilisations. However, it was
not until the 19th century that
the term ‘schizophrenia’ was
coined, and its clinical features
systematically categorised.
Symptoms of schizophrenia
are delusions, hallucinations,
disorganised behaviour, lack
of speech, lack of motivation and
lack of desire to form social
relationships. Schizophrenia,
on the whole, is more distinct
for the former three symptoms,
which manifests in such forms
as bizarre beliefs about being
observed by aliens, feelings of
having thoughts inserted into
one’s mind, or illusory voices
remarking on one’s actions.
The exact causes of
schizophrenia are currently not
well-understood, but it is
established that there is at least
some genetic component to the
disease, and first-degree relatives
of schizophrenics are frequently
at higher risk of developing
schizophrenia themselves. Living in
an urban environment, alcoholism
and childhood trauma are non-
hereditary factors known to be
correlated with a higher risk of
schizophrenia. Physiologically,
schizophrenia is believed to
be associated with impaired
functioning of dopaminergic
neurons in the frontal, temporal
and hippocampal regions of the
brain, which has the overall
effect of weakening the patient’s
ability to retain and integrate
information – thus resulting
in the characteristic
symptoms of schizophrenia.
Despite its unflattering
portrayal by the mass
media, schizophrenia is, in
reality, a largely harmless
disease. There is little
reliable evidence to suggest
a significant link between
schizophrenia and violence, and
schizophrenics are, really more
likely to be an inconvenience
than a danger to those around
them. What must be understood
is that schizophrenia is a
disease of mental imbalance,
not of aggression, and continued
stigmatisation of the condition
ultimately contributes nothing
to society’s collective ability to
control, cure and understand it.
Science
www.hkucaduceus.net 19
另闢蹊徑,轉戰海外──藥劑師香港執業以外的出路
陳子泰 (M16)
編按:筆者並非藥劑學學生,對藥劑學認識未必完全,只因編輯委員會內沒有藥劑學學生,不得不庶竭駑鈍。如有不足,還請指正。
香港醫院藥劑師學會副會長崔俊明在二零一一年表示醫管局正全力
發展臨床藥劑服務,將會聘請七十至八十名藥劑師;而有見及多宗藥物安全事故,衛生署成立了「藥物專責辦事處」,將會聘請逾30人,包括藥劑師。香港藥劑師前途似乎一片光明。
話雖如此,早在十多年前,香港醫學會已開始調查市民對醫藥分家的意見。政府、醫護界和市民一直對此議論紛紛,但目前尚未有定論。香港醫藥分家似是遙遙無期。可是,英、美、加等國早已推行醫藥分家,讓藥劑師有更多就業機會之餘,亦能發揮所長,完善醫療體系。在醫藥分家一制下,醫生不能直接出售藥物,只能處方藥物。藥劑師可在醫院或藥房,就藥物效力、藥物禁忌和藥物名稱覆核醫生處方,確保藥物適合病人服用。
筆者曾請教一位在加拿大英屬哥倫比亞大學任教藥劑學的師兄,他認為在溫哥華等大城市,藥劑師就業市場已頗飽和,但郊區人手短缺,因此在小市鎮工作能獲得不俗的待遇。人口老化,加上慢性疾病病人增加,更需要社區藥劑師長期支援。
當然,要在加拿大取得藥劑師執業資格,必先經過一連串的考核,例如科
學知識評核試和英語能力測驗;還要通過每年兩度的PEBC(The Pharmacy Examining
Board of Canada)專業試,其中包括筆試(多項選擇題)和口試(十六個模擬與醫護人員和病人溝通的情景)。筆試主要考核藥物和疾病的知識,所以準備充足就不難合格。而母語並非英語的外國人士,例如一般香港人,就可能因語言不通和不熟悉當地體制而未能通過口試。
讀者可能會對此望而生畏。雖然PEBC無公布每年合格率,但據筆者師兄的經驗,合格率約有八成;即使不幸未能通過考試,亦只需要重考不合格的部分。不過,考生只有三次重考的機會。若考生重考三次後仍未能合格,以後就不能再次申請有關執業資格。如需更多資訊,可瀏覽http://www.pebc.ca。
誠然,大多數人旅居外地都有懷鄉之情,而香港人尤甚──因為香港與外國大有不同。外地郊區人口不及香港稠密,生活小節中亦有諸多不便。即使有意到外國發展,也不一定要到加拿大,英、美、澳都不失為合理的選擇。拙文旨在指出藥劑師香港執業以外的出路,並無吹捧外國月亮之意。箇中利害,還請讀者衡量。
職途
CADUCEUS Spring 201220
The 25th East Asian Medical Students’ ConferenceWhere Convergence crosses with Divergence
Rachel Yiu, AMSA Hong Kong
As w e a p p r o a c h e d
Singapore after four
h o u r s o f f l y i n g , w e
greeted our destination in high
spirits and exclaimed, “Goodbye,
winter! Hello, summer!" During
the chilly pre-Chinese New
Year week, we, as a team of
29 medical students from the
University of Hong Kong (HKU)
and the Chinese University
of Hong Kong (CUHK), set
off to Singapore for the 25th
East Asian Medical Students’
Conference (EAMSC) 2012, held
from 15th to 19thJanuary.
A series of exciting
programs were unravelled
throughout the 5-day conference.
Bearing the brunt of all
academic programs, the paper
presentations took place in the
Guild Hall, National University
of Singapore, followed by the
scientific poster and health
campaign competitions on day
3, in an exhibition hall. It was
hard not to enjoy oneself in these
educational, yet entertaining,
sessions as one could not help but
sniff the immense enthusiasm
emanating in the air while the
presenters were delivering
messages and engaging the
audience.
One captivating feature of
the EAMSC was its diversity of
social and cultural programs. Non-
academic programs ranging from
community service, sightseeing
to cultural activities were there to
enrich the conference experience.
The variety of dialects and
cultures of the delegates from
different countries provided no
hindrance to our working or
playing together. Particularly
touching and memorable
moments included teaching
the kindergarten children hand
hygiene, dancing hip-hop,
Chinese dance, etc. We savoured
the sweet and rewarding
moments as we watched the
children’s mirthful smiles
and the joyous memories of
Cultural Night, which drew the
conference to a gratifying end.
On the last day of the
conference, we proudly brought
home the Most Persuasive Pre-
Conference Paper Award, the
1st prize in Scientific Poster
(Regional) and the 3rd prize in
Health Campaign. However,
most importantly, the tons of
unforgettable memories and
close bonds fostered with our
international friends will forever
be cherished. Now that we are all
back in our home countries, I am
sure that after this convergence
will come divergence: we are
ready to set off in different
directions that will eventually
bring about the same prosperous
fruits to our respective health
sectors.
Contact: rachel.yiu@amsahk.org
Societies
www.hkucaduceus.net 21
濱海醫院事態發展趙致遠 (M16)
濱海專題
數醫學院近年最大新聞,非於內地營運香港大學深圳醫院(下稱濱
海醫院)莫屬。由於此事對學生有切身影響,本刊特地從李心平院長處取得答覆,亦訪問了教務委員會學生代表蘇子謙同學,以求就事件緣起、發展、利弊、以至內地醫療系統作一概要。希望本文能拋磚引玉,不但令同學對此事有更詳盡瞭解,也從而對醫學院的發展動向關注更多。
緣起
香港大學在深圳營運醫院的計劃,於約三年前開展,當其時教務委員會(Senate)內部表決通過議案。作為少數知情者之一,蘇子謙同學(下稱蘇謙)當時不過初初步進Senate──這個無數港大教學方針誕生之處。
「三年前我剛上任後不久,Senate便通過了管理深圳濱海醫院(後改稱為香港大學深圳醫院)的計劃,至此我每年都會向新一屆醫學生簡單交代計劃的內容。」蘇謙娓娓道來。
深圳市政府斥資三十五億元興建的濱海醫院,屬深圳最高規格的醫院,更是當局鋭意打造的醫療改革橋頭堡。邀請港大醫學院管理及營運濱海醫院,不但是爲了給公眾打一支強心針,更希望藉此把港式(西式)管理帶進內地。
對於港大而言,因適逢三三四改制,學生人數將大幅上升,所以校方也傾向擴大校園規模。想深一層,內地醫療體制正急速改革,校方亦有意把握時
機在粵打造第一個試驗點,以開日後往內地輸出醫療服務的先河。這便撮合了有史以來中港醫療最密切的合作。
「[大學對]計劃的願景,是把醫學院打造成媲美北美的一流學府,因此必須擁有專屬醫院。我想,瑪麗醫院顯然不能滿足院方的要求。」蘇謙憶述年前與李心平院長的對談。一流學府……如此「雍容華貴」的銜頭背後,是否意味著需要動員未來醫學院的全體學生?
發展
深圳市政府於二零零四年成立濱海醫院籌建工作小組,二零零八年醫院正式施工;二零一一年年底工程基本完成,部分建築開始試運,較原定時間晚了一年多。如今,首屆董事會已經成立,深圳市副市長吳以環為董事長,前醫學院院長鄧惠瓊出任院長。
誠然,從網上的模擬圖可見,醫院選址風光怡人,建築風格時尚不凡,內部設計更是卓爾超群;尤其門診大廳之
訪問教務委員會學生代表蘇子謙
CADUCEUS Spring 201222
寬綽可媲美赤鱲角機場的客運大樓。濱海醫院的亮麗硬體比殘舊的瑪麗醫院至少略勝一籌。然而尺有所短,寸有所長,華麗的背後有賴同等優越的管理水準支持,這確實是內地建設一直為人詬病的一環。先進的器材、多樣的設施及讓人讚嘆的建築設計可謂濱海醫院的最大賣點,可是如果缺乏全面專業的軟件,多美麗的建築也只會是曇花一現。
醫院為管理文化訂立八個綱領,但這些綱領口號晦澀難明,讓人難以想通其管理理念,甚至懷疑醫院的運作守則是否具體可行。醫院的管理方針動輒左右醫療服務的質素,及外界對其專業規格的信心;尤其內地醫院在這領域上一向缺乏公信力,故有待院方盡快加以闡明。另一方面,院徽「以十字醫療標識爲原形,形成兩心相交,大鵬展翅,概意濱海醫院『精、誠、仁、和』的文化內涵」,倒是饒有深意。
此外,醫院人員招聘尚未開展。鄧院長曾交代醫院的高層管理人員主要由香港大學專家擔任,也有深圳的專家參與,並強調醫院不會拘泥於香港管理方式,而是會重視改革出創新模式,推廣普通門診及家庭醫學。如此一來,濱海的作用就不會局限於一間醫院當中,而是外展至每一位病人的家。香港大學校長徐立之早前提及醫院的人手調派,表示會有醫學院教授長駐當地,更直言所需人手之龐大,即使整個醫學院的職員合起來也未必足夠應付,故將逐步增
添人手。然而,所謂「君擇臣,臣亦擇君」,醫學院能否完全填補人才流失,仍屬未知之數。
對學生交代
當年計劃空降港大,學生僅能由報章及濱海醫院籌備辦公室的網站上,一窺其被遮掩的容貌;誰料時至今日,有關醫院籌備進展,乃至其教學用途及詳細安排的資料,仍然幾乎沒有別的可靠來源。
蘇謙十分坦白。「三年來的Senate
會議中,院方代表鮮有提及醫院的情況,我們更從未商討日後的教學安排。」對於資訊的貧乏,他直認不諱。可諷的是,一屆又一屆的新生卻都是從這張吐不出多少真相的口中得知消息;可想而知,這在當事人之中會造成如何紛擾的躁動,多麼糾結的迷霧。「候選白老鼠」們不知會否遭到波及,更不曉得「實驗」有多危險;人心惶惶,在所難免。其實,學生們在心裡對濱海醫院的一切揣測及醜化,僅因對其毫無認識。說到底,我們只是需要院方的一個解釋。
總而言之,濱海醫院計劃存在著無盡變數,唯一能肯定的只是醫院已矗立於深圳灣旁,北上從醫的巨輪正一步一步轉動起來。有見及這無奈的事實,徬徨的港大醫學生該如何自處?
院方聲明
有鑑於事件在一眾學生中多少造成
濱海醫院事態發展
濱海醫院籌備小組成立
醫院奠基
正式施工
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
時間線
www.hkucaduceus.net 23
濱海醫院事態發展
迴響,啓思曾先後聯絡濱海醫院鄧惠瓊院長及醫學院李心平院長,促請他們對將來的教學安排作出解答。李院長的回信明確表示,門診服務是醫院目前的重點發展項目。他更強調服務會逐步發展,以累積充足的經驗。李院長預計,門診將會在實施後三年達至成熟階段,屆時才會考慮擴充內外全科醫學的課程,安排學生遠赴當地上課。假如於今年年底開始門診服務,保守估計校方最早會在2015年拓展課程,也就是說現時一年級的醫學生或許會在五年級被安排到濱海醫院實習。
不過,在第一年,醫院的教學用途尚處摸索過程,屬最不成熟的階段;所以我們大膽猜測院方不會拿臨近畢業試的五年級學生作為白老鼠。故此,已入讀的學生大概不會受計劃影響。
以下附錄李心平院長回信全文:
I appreciate the questions posed by Caduceus.
They reflect a sense of care, interest and excitement
about the future evolution of the Faculty of
Medicine and the potential impact on education.
The background, objectives and plans for the
HKU-Shenzhen Hospital have been well covered
in public briefings. The vision would be to provide
high quality patient care, transparent management
and accountable governance to set a role model for
the healthcare development in our motherland.
This new teaching hospital is expected to bring
about mutual benefits for HKU, Shenzhen and
Hong Kong such as employment opportunities,
research capacity as well as learning opportunities
and China exposure for our students.
One first and foremost emphasis, and
exclusive focus, would be to launch a clinical
service system. This would be a stepwise process,
requiring effort, cumulative experience and time to
attain a level of maturity. Only then will we consider
introducing the HKU-Shenzhen Hospital site to
enrich our undergraduate teaching programme.
Details and specifics on learning opportunities and
transport will be formulated at the appropriate
time. Our current estimate would put a potential
time to consider activating a teaching programme
3 years after launching our clinical service. There
is an ever-present, perennial effort on the part of
the Faculty to strengthen and enrich the quality,
different opportunity and capacity of our network
to educate our students. This effort also includes
our existing and teaching hospitals in Hong Kong.
濱海醫院小檔案
目標
國家最高規格醫院
内地醫療改革的
示範單位
啓用時間 預計2012年底
地點 深圳福田區濱海大道
設施
2000張病床
20個診療中心
12個醫技中心
特需診療中心
管理層
董事會主席:吳以環
院長:鄧惠瓊
副院長:葉炯賢
學生北上實習時間 落成後預計三年
教務委員會通過方案
醫院基本落成,開始試運行董事會成立
預計正式落成啓用
學生最早開始實習
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
CADUCEUS Spring 201224
A B C 住院樓
雙人病房
護士站
門診醫技樓
院長檔案
鄧惠瓊教授,1971年
於港大醫學院畢業。
成爲婦產科醫生後,
鄧教授於79年加入醫
學院婦產科,擔任講
師、高級講師、教授
等職務。由1998至
2001年間,鄧教授更
擔任院長一職。除了
教學外,鄧教授也曾擔任香港醫學專科學
院院長,也是現任醫務委員會教育及評審
委員會主席。
體檢大廳
濱海醫院大解構
濱海專題
www.hkucaduceus.net 25
濱海醫院大解構
特需診療中心
門診醫技樓
門診大廳
成人輸液大廳
急診大廳
副院長檔案
葉炯賢博士,1988
年於中山醫科大學
畢業,後來成爲泌
尿外科醫生,也曾
擔任北京大學深圳
醫 院 副 院 長 。 在
2006年,葉博士被
委任為濱海醫院籌
備辦公室主任,同
時也是醫院的共產黨支部書記。在濱海醫
院董事會成立後,葉博士擔任香港大學深
圳醫院常務副院長。
濱海醫院大解構
CADUCEUS Spring 201226
當筆者剛剛得知可能要北上實習時,心情和大部分學生一樣,都
是又驚又喜。驚訝的,是以前從未聽過這個計劃,而且在內地人生路不熟,又要長途跋涉上學;高興的,是到內地實習可以擴闊視野,認識更多新事物。可是,經過一番訪查,筆者卻發現北上實習帶來的利弊,遠比上述更多。因此,雖然不打算振聾發聵,筆者卻期望能透過以下分析來刺激大家思考,甚至自發尋找更多資料,以便對濱海醫院這計劃有更多認識。
利
於濱海醫院實習,好處有三。
首先,到濱海實習,有助同學接觸到更多參考病例。想豐富對疾病的認識,除了可以從書本獲得有關資訊外,臨床經驗亦十分重要。可惜也可幸的是,相對深圳而言,香港由於人口較少,衛生較好,很多疾病每年僅有寥寥數宗。在這情況下,同學對某些疾病的認識,便流於紙上談兵;到臨床與該疾病交戰時,很容易手忙腳亂,甚至一籌莫展。所以於濱海實習,有助同學接觸到更多在香港少見的疾病和病患,增加日後治療的信心,甚至診斷的準繩度。
不但如此,由於現時濱海打算以向港大醫學院購買服務的方式營運,故院方將有更多資源購買教學設備,從而提升教育質素。而且,醫學院的學額日益增加,安排學生到濱海實習有助紓緩壓力,減少資源競爭。
最後,北上實習,也為同學提供一個感受當地文化的機會。中港交流融合已是未來大趨勢,醫學界亦不能例免。近年來,越來越多內地人來港就醫,雙非嬰兒也成爲社會大熱議題。可是,內地的醫療制度和文化習慣卻與香港大爲不同。故此,早與內地醫療制度接觸,便能早有心理準備,免得在執業遇見內地病人時措手不及。
弊
在濱海實習,主要帶來三個問題。
第一個問題,是院方與學生溝通不足。自落實有關方案以來,校方從未向學生正式介紹計劃的詳情和安排。幾年來,學生得知此事的媒介,就僅僅來自教務委員會的學生代表,以及大衆傳媒的零星報道。雖然院方曾承認因細節尚未確定,故無法通知學生;可是學生作爲這件事的主要持份者,理應在細節還未落實時被知會,甚至邀請參與討論。
缺乏有效管道向學生發佈資訊,不但有損雙方關係,打擊學生士氣,也令校方損失一個吸取學生意見,從而優化
濱海醫院實習利弊初探李沛朗 (M16)
面對中港醫療衝突,我們該如何應對?
濱海專題
www.hkucaduceus.net 27
方案的機會。故此筆者建議,院方可定期與學生舉辦論壇,讓同學能就是次計劃表達意見。筆者相信,既然此事對學生有切身影響,大家定必熱烈發表意見;同時,學生也可主動與院方聯絡,或透過有關媒介,例如班代表、醫學生評議會、以至本刊等表達意見。
由於院方與學生欠缺有效溝通,有兩個隱憂仍未有解決方案。
第一個隱憂,是學生北上後師資安排失當。校長徐立之曾表示,在濱海醫院成立後,很大可能有教授常駐內地,以至整個醫學院北上也未必足夠,故須逐步增加人手。在這種情況下,如果教師供應不變,而需求大增的話,即使大學有足夠資源增聘人手,也未必有那麽多優秀的老師來填補空檔。不但如此,校方從未説明在當地的老師,會否全由港大職員擔任,還是在當地聘請。如果後者屬實,則師生間可能會產生語言隔膜,當地老師也可能因爲不熟識港大教育制度而令教育水準下降。
第二個隱憂,是屆時生活細節安排未臻完善。濱海不比瑪麗醫院,交通極爲不便;若當地不設寄宿服務,學生需每日乘搭穿梭巴士來回深港的話,不但長途跋涉,更是損耗人力──試想像,假設有一位學生住在九龍區,回校需一小時;如果穿梭巴士於醫學院開出的話,到濱海也至少需要一小時半。如是者每日來回,該學生每天便需花五小時於交通上;如果有一天八時半上課,那學生便需六時出發!這樣一來,不單學生怨聲載道,叫苦連天;教學效果更可
能因學生溫習時間減少而下降。不但如此,縱使濱海醫院設有留宿設施,問題仍然可能存在,因我們仍未清楚當地治安和衛生情況。院方在設計方案時,務必在學生生活安排上考慮妥當;要知道,魔鬼往往隱藏於細節裏。
第二個問題,是內地醫療體制和文化習慣與本港大不相同。例如,在內地流行「打點滴」(吊鹽水),病人即使患感冒也會在醫院吊半天鹽水。這種做法,在香港醫院資源緊絀的環境下根本難以實行。另外,由於內地醫療人員工資偏低,某些人會透過收取藥廠回佣,甚至病人紅包來增加收入。不但如此,由於內地幅員遼闊,而且醫院不受政府津貼,所以病人一般會被要求先付按金,然後才開始診治,以免日後拖欠款項。雖然深圳政府設立濱海醫院的目的,是為內地醫療改革作模範;可是我們難保當地一些陋習不會透過在濱海受訓的學生帶回香港。這種反滲透現象,相信任何人也不願目睹。
第三個問題,是醫院興建進度遠遠落後,營運架構存在暗湧。根據原定計劃,濱海醫院應該早於去年落成。可是
濱海醫院實習利弊初探
濱海醫院(紅圈)位於米埔對面,與瑪麗醫院(綠圈)可謂天南地北。
左圖取自 新
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CADUCEUS Spring 201228
據我們瞭解,現時醫院只有非醫療性質的科教管理樓和後勤服務樓在試運行,其餘醫療設施一概未啓用,人手招聘亦未開始。換而言之,濱海醫院現時仍未有能力提供醫療服務,遑論正式落成運作。雖然進度遲緩本身並未直接影響學生,但我們卻可從中窺見內地政策的運
濱海醫院實習利弊初探
作。據消息人士透露,其實在內地工程可以興建得很快,所以啓用日期延誤並非計劃本身出現問題;只是管理階層權責不清,往往一紙來歷不明的批文宣佈「暫緩」已可令工程完全癱瘓,所以才令醫院距落成遙遙無期。
不但如此,醫院現在的行政架構也存在暗湧。根據深圳新聞報道,濱海醫院採用「董事會領導下的院長負責制」;董事會主席由深圳副市長吳以環擔任,院長為前醫學院院長鄧惠瓊教授,副院長為原籌建辦主任葉炯賢,內地人。有趣的是直至現在,綜觀醫院新聞發佈,一般會議仍是由葉炯賢主持。這情況不禁令人擔心,鄧教授「空降」領導醫院能否成功,能否突破內地權責不清的現象,行使院長權力,令濱海透過香港模式運作。再者,萬一醫院出錯,院長會否成爲代罪羔羊?萬一中港雙方管理層發生摩擦,在當地實習的學生會否成爲磨心?這些潛伏的問題我們必須留意。
結語
正如世上大部分計劃,興一利必生一弊,濱海醫院並不例外。可是,既然這計劃已是箭在弦上,不得不發;我們的責任,已不再是純粹對此事表示歡迎或反對。相反,我們應充分取長補短,甚至主動向院方發表意見,才能真正對計劃有幫助。所以,不要吝嗇你發言的權利;因爲你的意見即使未必影響自身,也和我們下一輩的福祉息息相關!
內地人習慣打點滴(輸液),09年全國共輸液104億瓶。
從醫院網站可見,人才招聘階段尚未開始。
www.hkucaduceus.net 29
醫院
內地醫院的架構與本港醫管局體系有頗大分別。內地的醫院基本上
是在政府監督下獨立營運的機構,除了某些偏遠地區外,政府一般不會直接補貼醫院,以致由一針一線到輸液打針都須逐項收費。雖然很多醫院為非牟利機構,但為了達到收支平衡,整體收費也不會太低。有些醫院為了增加收入,更不顧病房實況,無上限地收症,造成病房滿溢,病床隨便放到走廊上的情況。
雖然政府對醫院的各類收費皆有上限,但因某些地區監管不善,醫院胡亂收費的情況仍然時有出現。另外,由於掛號費、程式費等上限普遍比較低,追
不上通脹;醫院收入較多來自藥品,變相以賣藥的利潤補貼醫院運作 (以藥補醫) ,所以有機會令醫院偏向使用較貴的藥品。
內地的醫院質素確實參差不齊,城鄉差距尤其嚴重。大城市的現代化醫院醫療設備完善,但地方上的小醫院卻問題叢生──新聞上時有所聞的假藥假氧氣等嚴重問題,便多出現在後者。
醫院分級
內地的醫院根據設施規模等準則,2012年開始由中央政府衛生部分類為三級十等,其中以三級特等為最佳。各個等級的醫院在角色、收費上都有所
內地醫療制度簡介李仁泰 (M15)
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CADUCEUS Spring 201230
不同。表一為各級的一些標準:
在級以下,有關審批部門會根據實際情況將醫院分等。表二為一些著名醫院的等級。
醫療保障
由於醫院基本上缺乏政府直接補貼,各種醫療保障隨之出現,以保障每個市民有病都能就醫。在香港常見的私營醫療保險在內地不大流行;相反,一些公營或半公營的醫療保障就比較普遍,大部分居民的醫保都受政府直接或間接的補貼。
大多數城市居民的醫保整體上如香港的強積金般,分為僱主(單位)供款以及僱員(個人)供款。供款會進入兩個帳戶─統籌賬戶(與其他供款人集中攤分)
和個人賬戶。病人住院的費用會從統籌帳戶中提取,門診則從個人賬戶中支出。醫保有指定的覆蓋範圍,在藥品、診療服務和醫療服務設施都有起付標準、最高支付限額等,如果超出限額就得從個人賬戶中扣除。醫保的報銷比例
內地醫療制度簡介
等級 病床 床均職員 審批 例子 角色
一級 20-99 0.7+ 地(市)級 基層醫院
衛生院
直接向一定人口社區提供預
防、醫療、保健、康復服務的
基層醫院、衛生院。
二級 100-499 0.88+ 省級 地區性
醫院
向多個社區提供綜合醫療衛生
服務和承擔一定教學、科研任
務的地區性醫院。
三級 500+ 1.03+ 部級 區域性
醫院
向幾個地區提供高水準專科醫
療衛生服務和執行高等教育、
科研任務的區域性醫院。
表一
醫院 等級 所在地 病床數目 創立年份
北京大學第一醫院 三甲 北京 1500 1915
解放軍總醫院 (301醫院) 三甲 北京 4400 1953
復旦大學附屬中山醫院 三甲 上海 1700 1936
中山大學附屬第一醫院 三甲 廣州 2548 1910
北京大學深圳醫院 三甲 深圳 925 1999
香港大學深圳醫院 / 深圳 2000 2012
瑪麗醫院 / 香港 1400 1937
註:在2012以前,醫院最高等級為三級甲等
表二
首都某頂尖三甲醫院。
www.hkucaduceus.net 31
內地醫療制度簡介
還會隨病人就醫的地方、所在的單位而有所不同。
如果是大型國企的僱員或其家屬,單位更會提供醫療保障;他們基本上以公費治病,全面覆蓋各種的需要。如果是現任或前任中國共產黨高級幹部,除了在住院期間由國家負擔所有開支外,更會入住幹部病房以享更優質服務,充分體現國家對領導人的重視。
除了普通醫保外,內地也有為農民而設,由政府補貼的「新農合作醫保」,保費極低但賠付的醫療費用也相應地低。其實農村醫療整體情況,與剛才所述的大有不同,但因篇幅所限,恕未能在此探討。
可是,除特定重症病人能轉往大醫院診治外,居民在離開其所在地或戶口屬地後,自己的醫保很大機會不能在別處報銷。換言之,如果居民到別處看病,就會面對成本偏高的問題。如果病人沒有任何醫保的話,就只得自己支付全部收費。入院一般都需要先付押金,否則連入院也成問題(畢竟中國地大人多,欠款逃走的話肯定很難追回)。當然,如果是急診的病人,在像樣的醫院裏一般情況下都可以先收症診治,後談付款事宜。
醫療人員
內地的醫療人員水準、操守普遍參差不齊,城鄉差距也是非常大。某些鄉鎮的人員在知識上以至手法上都很不到位,醫療失誤和事故也頗為普遍。此外,由於醫療人員的基本工資偏低,某些人員會透過收取藥廠提供的回扣,或病人自願提供的紅包等作為額外收入。另外,由於現時內地醫科學位未被香港承認,內地醫師沒有應考香港執業試的機會,所以內地醫師到香港執業的情況並不存在。
此外,在醫院裡,醫師的權利還是挺大的。即使在同一病房裏的病人,也會根據不同醫師的個人關係及喜好而使用不同品牌的藥品、注射液和營養液等。因此,病房護士根據醫囑撿藥時,即使是同一種藥品也要拿對某個醫師喜好的品牌。這種情況在比較優秀的醫院裏也會出現;姑勿論它對病人安全會否有影響,就是成本效益也會因沒有集體採購而下降。
當然,內地也有很多盡忠職守、廉潔奉公的醫護人員。在大大小小的醫院裡,穿白大褂的在病房間穿梭不斷,不求回報(也不收紅包)的為病人利益奮鬥;白衣天使們每夜手腳俐落的為病人配藥、打點滴,不為打賞,只為好好照顧病人。在救急扶危之外,無數的內地醫師也會花時間到農村服務貧困戶,為人民健康出一分力。顯而易見,醫院裡很多人都對病人十分著緊,中國醫療系統的未來仍然是有希望的。
鳴謝:楊洋醫師 (北京大學第一醫院)
圖片由 李
仁泰 (
M15
)提供
國家特別照顧公僕: 幹部病房。
CADUCEUS Spring 201232
專訪
簡介何善衡夫人醫學生宿舍專訪宿生會主席李恩年同學
陳子泰 (M16)
有人認為「何善衡」(何善衡夫人醫學生宿舍)是醫學生的監獄,
一個個單獨囚室不見天日;有人會說「何善衡」沒有舍堂生活,住「何善衡」算不上是大學五件事中的「住hall」;還有人認為「何善衡」不應該是醫學生獨佔的福利,畢竟醫學生也是凡人。
「何善衡」有一百五十個專為高年級醫學生而設的宿位。一張床、一張書桌、一個洗手盆、近六十呎的空間──這就是每個房間的寫照。再加上一疊疊讓人目不暇給的參考書與筆記,以及散落各處的裇衫和皮鞋,已沒有生活空間可言──只剩下太空艙式的生存空間。宿舍的設備簡陋,公共廚房和健身室都只有一百多呎,但大多數醫學生都樂意在此蝸居。為甚麼?筆者於是訪問了宿生會主席五年級的李恩年同學。
李同學表示,住在「何善衡」的同學之中,約有一百位五年級醫學生,其餘則為三、四年級和從外國來交流的同學。五年級醫學生需在一年中不同時段學習六個專科──內、外、婦、兒、骨、精──除了在瑪麗醫院婦科實習的同學有宿舍居住外,其餘時間大部分同學都會住在「何善衡」。四年級生會被分派到港九不同醫院長期實習,故較少
同學選擇入住「何善衡」。至於三年級及以下同學,由於宿位有限,很難獲分配宿位。由於高年級醫學生上課時間長,往往朝九晚五,甚至早上七點多便要回到醫院,為了節省交通時間,不少同學選擇入住。
可是近年醫學生數量增加,由一百二十人漸增至一百六十多人,三三四後甚至會達到二百一十人,加上其他宿舍較少招收醫學生,可能將來醫學五年級生也未必能夠入住。反觀友校中文大學的醫學生宿舍有逾三百個宿位,足夠容納所有希望住宿的醫學生。有鑑於此,近年來宿生會與醫學會等學生組織不斷爭取更多宿位。李同學指出,臨床醫學訓練需要長時間在醫院,了解病人進展,故實習醫生的英文名houseman,有「住客」的意思。觀乎世界各地的醫學院,無一不為醫學生提供宿位,若果港
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簡介何善衡夫人醫學生宿舍
大不設法跟隨,勢必影響醫學教育的素質。經過多番游說,港大終於答應將沙宣道的白文信學生宿舍變為醫學生宿舍,並在未來的一至兩年生效,提供五十至一百個宿位,但長遠而言,仍需要另一方案,當中的提議包括在「何善衡」頂層加建、在附近一處斜坡另起爐灶,或收納「沙宣三寶」中的Student Flats等等。由於李同學將於下年畢業,他寄望師弟師妹們繼續爭取宿位。
誠然,醫科課程頗為吃力,但生活過於苦悶,工作之餘也要調劑身心,於是宿生會便在三年前應運而生。李同學表示,「何善衡」宿生會與其他宿生會的最大分別,就是不會強制同學參與活動,而且不會舉辦如集體叫囂等活動。宿生會不但負責籌備大型活動,如一年一度的高桌晚宴和五年級「勁過飯」,還會著手舉辦小活動,如非撞式欖球比賽、集體跑步和遠足,甚至吃「樓飯」和「winning eleven」聯賽等。李同學表示,每年大型活動均有近百人參與。如此出席率,是他與莊友繼續辦下去的動力。
當筆者問及一二年級的科學知識對未來高年級的學習有沒有幫助時,李同學認為只有一部分會在臨床醫學上有實際用途,但這些概念非常重要,甚至在專科醫生的初級試(例如MRCP/MRCS)也會出現,所以同學必須溫習課程的重點。李同學又認為,基本科學如生物化學、遺傳學等越來越重要,甚至有一些測試如PCR/FISH等已經應用於臨床上,要由醫生安排,所以必須了解其原理。
被問及如何應付低年級的考試,李同學表示,低年級同學在考試中不及
格,往往與讀書方法有關。有些同學不習慣沒有老師家長督促,只顧參加活動或享受自由,沒有定時溫習,到臨急才抱佛腳。又有同學迷失於「浩瀚無邊」的課程裡,過於深究某幾個題材而忽略整個框架,又或者只背誦一些瑣碎的細節而忘記大綱,最後事倍功半。還有一些同學不懂得自學,看講義又不明白,選擇背誦整本課本,浪費時間,各位同學要避免這些通病。李同學又認為,香港的大部分考試,都可以靠過往的試題過關,醫科的筆試也不例外,如果沒有時間,最實際的就是在考試前多做試題。
最後,李同學認為,醫科同學在頭兩年應該多參與課外活動,善用「大學生(college student)」和「科學生(science
student)」等身份,因為從三年級開始,作為真正的「醫學生 (medical student)」,便需要將全副心力放在臨床醫學上,不會有餘暇參加這些活動。據筆者了解,李同學曾參與不少課外活動,如擔任啟思總編輯、代表港大英文辯論隊到英國參賽、參與港大毅行者和寫作生化研究論文並獲得國際獎項等。同學不妨參考他的經驗,全人發展。
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專訪
專訪護理學四年級朱沛文同學李亭慰 (N15)
朱沛文同學(Jackie)是護理學四年級的學生。由於Jackie曾擔任護理
學會幹事、護理學會評議會主席及院務委員會學生代表等職務,同學們都對Jackie有不同程度的認識。我們衷心感謝Jackie在百忙中抽空接受訪問,與各位同學分享一下四年醫學院生涯中的一點一滴。
Jackie=護士?
在 Jackie眼中,護士這個職業要求高,壓力大,無論是上級、病人還是病人家屬都會給護士壓力,是比較辛苦的工作。在醫院實習的三年間,Jackie自言較少趣事;令她印象深刻的,卻是生命消逝的速度。「昨天看見病人的情況還不錯,怎料隔天回到病房就發現那位病人已經離世。這件事令我明白到生命是何等脆弱,而健康又是何等珍貴。」
談到註冊護士的工作時,將近畢業的Jackie坦言她仍在找尋她未來的路向。「縱使我用了四年時間修讀護理學,但我仍在考慮畢業後是否會投身醫護界。無論你是否想作護士,都應『既來之,則安之』,享受每一次『出ward』。『享受』不是指隨心所欲去做事,而是好好把握每次得來不易的學習機會。」
「出ward」小貼士
對於到醫院「出ward」,Jackie有不少提示給低年級的同學,讓同學們能為出ward做好準備,順利度過出ward的日子。「出ward的同學必須要有責任心,
要三思後才作出正確的選擇,並謹慎小心地執行每個動作;因為病人的性命就在你手上,即使是細微的程序也可能會對病人造成巨大的影響。除了學習護理技巧外,同學們還要明白自己做每一個步驟背後的原因,並有批判性思考,才能與醫生合作,互補不足,為病人提供最好的服務。」
對不同年級的同學來說,「出ward」有不同的意思,學習的重點亦有所不同。「一、二年級出ward時的導師(Tutor)是受僱於學校,以教導學生為主要工作。但三、四年級出ward時的助教(Mentor)則是醫院職員,主要負責照顧病人,在百忙中指導學護是間接加重了他們的工作負擔。因此,低年級出ward與高年級出ward是截然不同的。高年級的同學應特別留意他們在出ward時所擔任的角色──出ward已不是單純的學習,亦不是被動地等待別人施教,而是主動地與醫護人員一同協助病房的運作。」
實習期間,熟練的護理技巧是必備的,但良好的態度亦是不可或缺的。「教與學是相對的。學護要表現得謙虛,肯虛心學習,別人才會給你機會。若學護的態度良好,導師就會願意教授更多知識,亦願意包容學護的不足。這樣一來,工作環境會較融洽,學護實習時也更有信心;相反,若學護表現出不肯受教的態度,導師就算想教授再多的知識也是枉然。到醫院實習前,校方一再強調態度的重要性,希望同學們能順利完成實習並從中有所得著。據我所知,大
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專訪護理學四年級朱沛文同學
部分同學被評為不合格的原因往往都是因為出ward時態度欠佳,可見良好的態度是必須的。此外,同學應在出ward的頭幾天多與導師接觸,了解導師是一個怎樣的人。若導師喜歡抽書的話,同學就應該投放多一點時間來溫習筆記。我不是鼓勵大家去故意討好導師們,不過在出ward的過程中,同學們應盡力表現出自己是有備而來的。」
「相比起中大、理大和公大,港大護理學生出ward的日數雖然合乎香港護士管理局規定最低時數的要求,但暫時是四所大學中最少的。成為正式的註冊護士後,將不會再有導師在身邊指導、協助自己。所以同學們應在還是學護的時候多問、多學、多做,好好把握每一次學習機會,為未來打好基礎。」
幫助人的方法不限於醫治病人
除了應付護理學生日常的學業和出ward外,Jackie亦曾擔任不同職位,為同學表達意見,爭取權益。例如在她擔任院務委員會(Faculty Board)學生代表時,她就以為護理學生爭取宿位作為她的政綱。「因為瑪麗醫院是最多護理
學生出ward的地點,而很多同學都不是住在附近。當同學遇上『追更』的時候,來回醫院和家所需的時間幾乎是休息時間的一半。雖然瑪麗醫院設有護士宿舍,有關方面卻表示不會有宿位留給實習的學生。因此,我認為有必要為護理學生爭取宿位,讓他們有充足的時間休息。當時護理學會訪問了大部分三年級和四年級的護理學生,他們對此都表示支持及關心。當護理學院的高層得悉調查結果時,他
們感到非常驚訝,因為之前從未有人提及過有這樣的問題。護理學院表示會考慮我們提出的要求,但到現時為止還未有確實的決定或方案。」
對於有關方面仍未著手解決問題,Jackie並不對此感到憤怒或不滿,但她強調護理學生的宿位問題必須獲得重視。「我認為有一些可行的方案可以改善這個問題。首先,由於附近沒有適合的地方而且耗資龐大,建一幢新宿舍是不可能的,因此護理學會只能嘗試向沙宣三寶(偉倫堂,利希慎堂和利銘澤堂)、白文信學生宿舍和何善衡夫人醫學生宿舍索取宿位。由於何善衡夫人醫學生宿舍是內外全科醫學生的宿舍,為護理學生索取宿位會直接損害醫科生的利益,因此這是一個難度頗高的方案。而原本住在白文信學生宿舍的非本地學生將搬到其他地方,因此護理學會可爭取該宿舍成為護理學生宿舍。第二,有關方面可考慮提供接駁巴士服務,把學生從不同地區接載到學生出ward的主要醫院。雖然暫時未有完美的解決辦法,但我認為護理學會有必要跟進此事,為同學謀福祉。」
CADUCEUS Spring 201236
專訪護理學四年級朱沛文同學
回顧——人生有幾多四年?
回顧 Jackie將近四年在醫學院的生活,她曾擔任二零零九年護理學會Navitas的幹事、護理學會評議會主席及院務委員會學生代表等職務。有豐富上莊經驗的她表示,上莊那段時間是她在醫學院最快樂的時光。「上莊是一件開心的事,每次開會也像聚會一樣,與莊友和上下莊暢談,如同一家人,十分窩心。上莊不只是為會員服務,亦是個人成長的一種磨練。因為每位莊員的背景、經驗和處事手法都不盡相同,處理莊務的時候難免會有磨擦。上莊正是給我們一個機會去學習如何與不同人磨合,合力完成一件事。另外,時間管理亦是其中一個重點──若果時間管理失當,不僅追不上學習進度,還不能好好處理莊務,結果只會進退失據,甚麼事都做不好。」
作為一個過來人,Jackie對正值莊期的同學有一些由衷的勸勉。「我認為學業比上莊更重要,絕對不值得因為上莊而延遲畢業。要平衡上莊和讀書,首先要處理好莊內的分工,清楚自己需要做的事。其次是要團結莊員,互相幫忙,互相分擔。第三,上課時要專心聽講,而且一有空就要溫習筆記,尤其是生命科學科(Life Science)。第四,要做的事要盡早完成,切忌拖到限期前才開始做。第五,無論是上課還是實習,都要一早做好準備,準備充足已是成功的開始。」
見 證 了 數 屆 護 理 學 會 內 閣 更替,Jackie認為護理學會一直在轉型。「早期的護理學會主要著眼於活動,希望會員能參與他們籌備的活動。然而,護理學生既要應付緊湊的上課時間表,又要定期實習,又怎會有時間參加活動呢?所以我認為護理學會應減少投放在
籌備活動方面的資源。而近年的護理學會則比較接近會員,著重於為會員提供福利,較了解會員的真正需要,因此亦較受會員歡迎──如在九至十月時舉行的Welfare+就取得成功,醫學會幹事會也參考我們舉行了一個類似的福利活動。我希望現屆和以後的護理學會能夠以會員的基本需要為依歸,例如向有關方面表達改善基本設施的需要,如更換實驗室裡使用已久的設備,還有解決護理學生的住宿問題等等。」
寄語
在訪問的最後,Jackie特意寄語低年級的護理學生。「我聽過不少人說理科生修讀護理學有優勢;但身為一個理科生,我並不覺得我比別人佔優。有時候文科生的記憶力比理科生要好,反而成了他們的長處。只要肯付出時間努力溫習,不要給自己太大壓力,無論是文科生或理科生都能夠做好。面對困難的時候,要認清自己的目標及初衷,對於自己認為值得的事就要堅持到底,要清楚自己正在做的是甚麼。修讀護理學雖然辛苦,但亦是一個難得的機會,意義重大。所以要珍惜每次實習機會,盡力做好本分,切忌自怨自艾,才會成功。」
後記
筆者身邊有不少認識Jackie的朋友,但他們大部分對Jackie的印象都是「很嚴肅、脾氣欠佳、難以接近」等等。回想起筆者邀請Jackie接受訪問的那天,Jackie
沒有任何遲疑,爽快地答應了筆者的要求。訪問結束後,她更親切地摟著我的肩膀,與我笑談日常事。深入認識Jackie
後才明白,她時刻都有著一顆照顧後輩的心。希望讀者們能夠從Jackie的訪問中有所得著,亦祝畢業在即的Jackie前程似錦。
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The Fall of Medic Night
Chan Kwok Hei, Kenny (M16)
History
Medic Festival 2011
w i t h t h e c o r e
theme of “Panacea”
encompassed a myriad of events,
for example, the Halloween
Carnival, Uniform Day, Talent
Quest and Ms and Mr. M16
Pageant. To freshmen it was
d e f i n i t e l y s o m e t h i n g n e w ,
fun and refreshing as the first
w e l c o m i n g e v e n t f r o m t h e
Medical Society. Perhaps to
many old graduates, it is not
new but reminiscent of a long-
lost tradition, the Medic Night.
Well, in the old days, medical
students didn’t have the Medic
Festival but the ancestor of it –
the Medic Night.
The Medic Night was an
annual event organised in Loke
Yew Hall by the Fraternity
Committee of the medical
faculty. With the aim of bridging
the gap between junior and
senior students, the Medic Night
was an opportunity to gather
students and unite them through
collaboration in performances
in the Medic Night. However,
the Medic Night was hugely
influenced by one factor –
“seniority”, which denatured the
original aim of the event.
Culture of Seniority and Medic Night
Before the curriculum
reform conducted in 1997, all
medical students were required to
sit for the First M.B. examination
at the end of Semester 3 in Year
2. The First M.B. examination
granted students with “half”
of the professional degree –
Bachelor of Medicine. Once
the students passed the
First M.B. examination, they
would conventionally proclaim
themselves as “Big Seniors (大仙)”. There was an interesting
tradition that students passing
the First M.B. examination
were entitled to purchase the
“Senior Tie” produced by the
Medical Society. This was a
watershed in the five years of
study in the medical faculty,
as it signified the promotion of
students’ status, from “Junior” to
“Senior’. Throughout the years,
the culture of seniority was well
established, as seen in many old
Caduceus articles.
「但醫學院教育課程的架構,間接培養成高班同學的自豪感(Sense of
Superiority)。同樣地,教授方式亦鼓勵這種風氣的滋長。高班的,無論學識和經驗都肯定比低班的為高。」
《校園MEDIC知多少之大仙》1983 卷 15 期 4
Students in a performance, the Doctors Hit Parade.ON
TH
E R
IGH
T: P
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CADUCEUS Spring 201238
As one of the establishing
faculties of HKU, Chinese
culture from the early days was
inevitably permeating in many
aspects of the medical faculty.
There has been an unspoken
golden rule which sustains until
nowadays – the higher your
year of study, the more respect
you earned. This culture of
“pecking order” that has long
existed in Chinese community,
compounding with students’
sense of superiority, gave rise to
the culture of seniority. It played
a dominant role in the culture of
MBBS curriculum, especially in
the annual Medic Night.
The following excerpts
from old Caduceus articles give
you a glance of how seniority
influenced every facet of the
medical curriculum through
various dreadful anecdotes on
the campus.
“During my first year,
even though I came across many
friendly elders, I still felt very
uneasy when I had to see one
whom I didn’t know. It was
probably because some of my
classmates were occasionally
shouted at, or were even shot at
from above when walking under
the Residential Building. Some
were driven out of the library
study room, simply because
some elders ‘need’ it. There was
also a ‘table for the finals’ in our
canteen.”
The Seniors, by Tse Kong, 1981
Volume 13 Issue 5
「在飯堂內只有大仙可以高聲嘻笑,甚至講粗口及賭錢。」
《校園MEDIC知多少之大仙》1983 卷 15 期 4
「因為以前在Medic
內有一個傳統習慣, 1st
M.B. 過後,才可以名正言順地戴上Medsoc呔,於是當放榜後,最高興做的第一件事,就是一窩蜂買Medsoc呔。」
《校園MEDIC知多少之大仙》1983 卷 15 期 4
Ferocity of the Senior
Apart from unequal
privileges between the senior
and the junior students in
many occasions, the culture
of “seniority” was illustrated
atrociously in the Medic Night.
「首先,座位是按照年級高低而安排的。五年級的同學坐在最前面,四年級緊隨其後,如此類推。然後,演出的次序為新生先行,『大仙』壓軸。每年如是,秩序井然。而坐在台前的部份『大仙』會對低年級的表演者盡騷擾、侮辱之能事。」
《從前的醫學會之夜》黃樂孺 2008 卷 39 期 1
「當時場面頗為尷尬。八七的師兄在無可奈何的情況下勉強玩完那所謂的遊戲:可是接着台下八八班的同學便一窩蜂的擁上台,使到場面非常混亂,而這個抽獎節目亦因此而不了了之。」
《這一個晚上》呼啦咕吱囉 1985 卷 17 期 5
‘Suddenly paper planes
came flying. Some people
immediately accused with great
certainty that it was Medic
students (referring to a group of
Year 4 students) who drove the
planes. But I was surprised that
The Fall of Medic Night
A performance of proposal from Petruchio to Kate.
www.hkucaduceus.net 39
no one was caught red-handed.’
The Seniors, by Tse Kong, 1981
Volume 13 Issue 5
「會場的紛亂──一方面,這本是無可厚非,因為這是台上和台下打成一片的必然結果,但這卻限制了Medic Nite成為一個有教養,有文化的function。事實上,如果你想表現些什麼,會場的氣氛,卻不容許你這麼做。故此,這實在是Medic Nite的致命傷。」
《評Medic Nite的戲劇表演》SILLEL 1969 卷 1 期 11
Curtain of ReformThe long-oppressed junior
students demanded a change.
Opinions requesting a decent
and well-mannered Medic Night
were voiced louder and louder.
The curtain of reforming the
Medic Night was raised in 1976,
however, consequently it leads to
the abolishment of this tradition.
The following excerpts look into
the crux of the reform and the
subsequent development.
“Students nowadays are
enthusiastic over reforms. They
want to annihilate any old
tradition which is standing in
the way of their ideals. However,
it is a pity that no such attitude
existed towards our Medic
Night. The editors are not trying
to be iconoclastic. Neither are
intending to be censoriously
‘hounding’ after the Society
function. It is merely that time
has come for revolutionary
sublime changes in our Medic
Night.”
Editorial — Medic Night, by
Cornithians, 1969 Volume 1 Issue
11
「近年改革風尚大盛,同學皆視破除傳統陋習為己任。『醫學夜』更成眾矢之的,部份同學嘗作中流砥柱之舉,排演『反傳統樣板』戲劇,圖作先導,力挽頹風。更有若干激進份子,誓滅此風,倡議廢除此項活動。」
《社論──「醫學生之夜」》編委會1974 卷 6 期 11
“‘Fighting against the
Seniors’ has repeated year after
year. There seemed to be a cycle
that the last youngers would be
fought against by the present
ones years after their anti-senior
act. I don’t know the reasons
behind.”
The Seniors, by Tse Kong,
1981 Volume 13 Issue 5
「這些年來,醫科學生人數增加了,入住舍堂由『必然』而轉為一種選擇……舍堂的中心
位置消失了,大仙風氣亦難以逆着時代的轉變而存在,所以便漸漸地消失。很難說有什麼事件促使它的末落。」
《校園MEDIC知多少之大
仙》1983 卷 15 期 4
Swiftness of Actions
With the influence of
societal factors and the desire
for the long-awaited change,
the junior students took prompt
actions to demonstrate their
determination and avidity for
betterment of the Medic Night.
「在一九七六年度醫學會之夜舉行之前,醫學會跟為數約五十人的各班代表討論改革醫學會之夜的可行辦法。部份M80的學生認為如果要令醫學會之夜真正成為各級同學友好交流的橋樑,就一定要廢除歧視低年級同學的習俗。他們認為改革應由學生自由選擇座位的權利開始。最後,與會的各班代表得出以下共識。第一,表演的項目應該更多元化,以削弱備受批評的話劇項目的主導地位。第二,加入非班際表演項目,以淡化表演隊伍的高、低班色彩。第三,以抽籤決定各班的表演次序和座位安
The Fall of Medic NightO
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CADUCEUS Spring 201240
排,以突顯各班同學的平等地位。」
《從前的醫學會之夜》黃樂孺 2008 卷 39 期 1
However, the milk
turned sour. The actions out
of good intentions were never
appreciated especially when they
would undermine the supreme
privilege of the senior students,
leading to direct conflicts
between the senior and the junior
in the Medic Night and, worse
still, on local newspapers. The
severity of the cleavage between
junior and senior students was
so immense that immediate
intervention was necessary to
mitigate the situation.
「當晚一班為數約三十多人的低年級同學根據抽籤的結果,不理會前排只准『大仙』使用的傳統,一起坐在首行, 引來不少『大仙』不滿。不消一會兒,『大仙』便已經將他們重重圍住,並高聲叫罵,當中不乏粗言穢語,要求他們離座……場面再陷混亂。籌委見情況失控,於是即場發起全民投票以決定醫學會之夜應否繼續根據先前的共識繼續舉行。
當天早上,無論課室、病房、圖書館內外都可看到傳閱文匯報的學生。原來,有『七位醫科同學』致函該報,指醫學
院有歪風,低年級的學生被欺負,及醫學會之夜有意淫劇目演出,希望社會關注,以免將來『一些所謂醫學生遺禍人群』。」
《從前的醫學會之夜》黃樂孺 2008 卷 39 期 1
Good bye, Medic Night
It was the time to say
farewell to the Medic Night.
The Medical Society decided to
relieve the dispute over the Medic
Night between junior and senior
students through polling. A
general polling sanctioned by the
Medical Students’ Council was
organised to allow all students
to express their will over the
abolishment of the Medic Night.
Students were enthusiastic to
embrace the reform of the Medic
Night, with reference to the
exceptionally high polling rate
compared to other years.
「適逢新幹事會選舉,正好以此問題向有志服務之同學作一考驗,切盼眾人能正視此項陋習。」
《社論 —「醫學生之夜」》1974 卷 6 期 11 編委會
「參選醫學會幹事會選舉的學生正是發起改革的骨幹成員,並順利當選。那次選舉投票率達八成 (零八年度約為兩成)
,反映學生對改革的熱切期待。幹事會在選後隨即在醫學生評議會通過發起全民投票,以決定醫學生之夜應否有繼續存在的價值。結果,在改革的洪流下醫學生之夜暫時退出歷史舞台,一別三十年。」
《從前的醫學會之夜》黃樂孺 2008 卷 39 期 1
ConclusionIt is such a shame to have
abolished the old tradition
of HKU MBBS. Although the
Medic Night revived in 2008,
the reception of it was never as
good as that of the old days. The
abolishment of the Medic Night
marked the decline of the culture
of seniority. It might somehow
alleviate the detrimental
influence of the culture on the
junior students. However, on
the other hand, the cohesion and
bonds between junior and senior
students were further weakened,
with a view to the scarcity of
events catering to both groups
of students. Perhaps we should
ponder, whether or not a radical
abolishment of the Medic
Night was necessary to put the
wrong things right. I believe
the culture of seniority could
do junior students a world of
good, if without the undesirable
elements.
The Fall of Medic Night
www.hkucaduceus.net 41
Discussion
Chicken, Beef or Me?A Journey to the Edge of Humanity
Gabriel Leung (M16)
Imagine seeing an online
advertisement recruiting
for “well-built men, 18-30,
who would like to be eaten by
me.” By first impression, such
a statement would probably
s o u n d l i k e a p r a n k . B u t i n
reality, this was the exact post
made in 2004 by Armin Meiwes,
a German computer technician.
Was the advert effective? It was.
Cannibalism, anthropophagy
in clinical terms, an act of
consuming another person or
part of another person, is taboo
in most of the Eastern and
Western communities. There
is no legislation against it in
most countries, but people don’t
accept it. Despite the taboo,
people still practise cannibalism.
Survival Cannibalism
“Ka Ming” has probably
become one of the most popular
names in Hong Kong since
the airing of the TVB series,
When Heaven Burns (天與地).
The series depicted three men
getting on with their lives
after cooperatively killing and
consuming their friend, “Ka
Ming”, in Xinjiang. Such drama
is the perfect example of survival
cannibalism, where cannibalism
is practised for the sake of
survival of the remaining few.
The Narrative of Arthur
Gordon Pym of Nantucket, a book
published in 1838 by Edgar Allen
Poe, narrates the tragic fate of
a sailor named Richard Parker,
who was chosen by drawing lots
to be sacrificed for the survival of
others on board. Strangely, that
scene was realized 45 years later
in 1883 when a man bearing the
same name had the same tragic
fate. Four men were on board on a
lifeboat, namely Captain Dudley,
Stephens, Brooks and Parker,
after escaping from the yacht
Migonette in the aftermath of a
storm. Parker, already severely
dehydrated from the sea water,
was chosen as the sacrificial
victim. After the remaining
three were saved, the Captain
and Stephens were sentenced
to death penalty, however then
commuted to six months of
imprisonment.
Other instances of survival
cannibalism have been reported
in history, for example the
Andean plane crash in 1972
Records of cannibalism can be found in various kinds of arts.
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CADUCEUS Spring 201242
Chicken, Beef or Me ?
and the Donner Party in 1846.
However, there is insufficient
archaeological evidence available
for these incidents, therefore the
occurrence of these incidents
still needs further investigation.
EndocannibalismIn studying anthropophagy,
endocannibalism is classified as
the consumption of the body or
part of the body of a member in
the same group or tribe. Reasons
for such a practice are very
diverse, ranging from ritualistic
reasons to emotional reasons.
In the Amazonian forest,
the Wari’ people practise
endocannibalism to overcome
grief over the loss of family
members. The closest kin to
the dead member would first
hug the dead body, and then
the corpse would be left for
three days and prepared. Family
members, except the closest kin,
would consume small parts of
the corpse to help cope with the
passing of the family member.
On the other side of the
globe, in Papua New Guinea
(a country in the northeastern
part of Oceania), the Korowai
tribe adopts endocannibalism
to kill the khakhua, a witch
that disguises as a human, that
lurks within their community.
According to local folklore, the
khakhua will devour the insides
of a person and deliver the killing
blow by a magical arrow into the
person’s heart. At the moment
of death, the person will tell
their family members the name
of the khakhua, and then the
family members would kill and
consume the khakhua afterwards
for vengeance.
Another interesting tradition
of endocannibalism happens in
West Africa, in the Junkun Tribe.
In this tribe, normal tribesmen
do not take part in cannibalism.
However, in
the passing of
power down
the line of Tribe
Chiefs, the Tribe
Chief consumes
the heart of the
precedent chiefs
to maintain an
extraordinary
position in the
tribe.
ExocannibalismThroughout history,
exocannibalism, the consumption
of humans or part of humans
outside one’s own tribe, has been
reported in almost every part
of the world. In ancient times,
exocannibalism was mainly
conducted due to ritualistic
reasons, vengeance and ecological
reasons.
An example would be
the mysterious Aztec people
in Mesoamerica (an area from
Central Mexico to some countries
in the lower part of North
America). Captives or sacrificial
victims were first sacrificed on a
narrow stone slab on the altar by
cutting open the chest, and there
the heart would be torn out and
be offered to the sun. After the
sacrificial ritual, the body would
be thrown down the steps of
the altar, and then carried off
to be butchered. Apparently,
the Aztec people may be blood-
thirsty and cruel, but in 1977,
Michael Harner theorized that
they might be compensating
for the lack of proteins in their
normal diet as a result of the
ecological environment.
In the modern world,
exocannibalism exists in China
where human foetuses are
consumed for their medical
value. Such practice is especially
popular in the Guangzhou
area, and there is yet to be any A Korowai tribesman and his child.
www.hkucaduceus.net 43
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literature confirming the medical
value of human foetuses.
Apart from these strange
traditional formulas, exocannibalism
has evolved into a form of
pathological mind state based
on hatred, satisfaction and
other factors. Armin Meiwes,
the German cannibal mentioned
at the start of the article is
a good exemplification of
exocannibalism. Through the
advertisement, Meiwes found
his voluntary victim, Brandes,
a 43-year-old man. They had
conversations online, in which
Meiwes repeatedly revealed his
altered mental state by saying
that he had been ‘readying
himself with his dreams’ and
that he once drew blood from
himself to get the taste of real
blood. From a translation of
their conversation by Jina
Moore, Meiwes explained his
plans calmly and scientifically,
where Brandes expressed his
excitement and hopes for their
meeting. Then when they met
on March 9 in 2001, Meiwes
removed flesh from Brandes,
who had taken painkillers, and
consumed the flesh together. In
the end of the case, Meiwes was
charged for the killing only, since
there was no law in Germany
prohibiting cannibalism.
To eat or not to eat?
Cannibalism has been a
very controversial topic since the
start of history. Most Western
communities have been quite
lenient towards the previous
cases of survival cannibalism,
since they are convinced that
necessity is sufficient to justify
the act. Also, as in the case of R
v Dudley and Stephens, there is a
Custom of the Sea that allows
the sacrifice of one person for the
sustaining of others on board.
In Christianity, even if
there is no explicit prohibition
of cannibalism, there is no sign of
approval of the act. According to
the Bible, intake of any blood is
explicitly prohibited in Leviticus
17:10-14, due to the belief that the
life of an animal is in the blood.
Also, cannibalism has been
depicted as a punishment from
God for the sins of the people. It
is also recorded in the Bible that
cannibalism is a disgusting act as
in 2 Kings 6:2-29, by the disgust of
the King of Israel over the pact
of two women to consume their
sons in a famine.
In Buddhism, the Buddha
had mentioned that man should
not take in any human flesh
explicitly.
However, in the legal system
of many countries, there is no
legislation against cannibalism,
and cannibals including Meiwes
and other serial killers are often
charged only with the killing act.
Without any common
consensus on the morality of
cannibalism, the decision of
whether cannibalism is correct
lies in the conscience of us
humans. Therefore it is up to the
morality of the community and
our own ethical consideration
that we can determine if
cannibalism should be approved
of.
It is your choice to make.
Armin Meiwes, a German cannibal who was charged with murder in 2004.
ReferencesThe Enigma of Aztec Sacrifice - http://www.latinamericanstudies.org/aztecs/sacrifice.htm
My dinner with antrophagus - http://harpers.org/archive/2008/01/0081861
Top 10 Cases of Human Cannibalism - http://listverse.com/2008/12/19/top-10-cases-of-human-cannibalism/
How Cannibalism Works - http://www.howstuffworks.com/cannibalism.htm
Chicken, Beef or Me ?
CADUCEUS Spring 201244
思辯
自私小紅帽
香港人應該不是狗,但肯定是自私的。
我說港人自私並無貶義,畢竟如經濟學所說,人應謀求經濟利益最大化。在處理香港與內地關係時,雙方的自私都反映得鉅細靡遺。如要解決現時困局,應從自私的角度去看,以認清問題癥結──利益的衝突。
香港回歸後幾經風雨,到零三年SARS後,本來已頗依賴內地轉口的經濟全面進入「全盤中化」的時期。不知不覺間,我們跟祖國很快已達到「更緊密經貿關係」,緊密的程度到了「沒老爸不行」的地步。我們貴絕全亞洲的貨櫃碼頭在祖國出口強勁的庇蔭下仍未倒閉,我們的機場為祖國進口金銀珠寶龍蝦石斑,成為全球貨運量最大的機場。我們的旅遊業酒店業、零售業餐飲業,迎來無數的遊客,為香港疲弱的經濟打下一支強心針,遊客數字從一千七百多萬倍增至近四千萬。金融業更是不用多說,聯交所從全球第十攀升至全球第五。現在上市公司中祖國企業佔了過半市值、三分二成交,IPO連續三年全球第一,中環的銀行投行賺得盤滿砵滿。香港自此跟紐約倫敦合稱NyLonKong。
就是我們最引以為傲的高等教育,內地生也佔了重要的地位。香港的大學在世界上的排名近十年出現大躍進,不少大學晉身全球二百以內。姑勿論香港的大學生水平有否大幅提升,大學排名始終非常依賴研究。可惜的是,本地學生一般都不太喜歡做科研,認為有關的工作既枯燥乏味又不能賺大錢。幸好近年內地研究生湧入香港,為大學注入新血(港大研究生三成半為內地人),扛起復興本地學術研究的重任。正因如此,在科學生化等實驗室裡,聽到的全是普通話。港大在國際排名上升至二十多位,壓倒北大清華等成為亞洲第一,內地研究人員實在功不可沒。
www.hkucaduceus.net 45
簡單的說,香港過去十多年的成功,很大程度上要歸功於香港與祖國的融合,以及「阿爺」為「咱們」提供的各種措施。當然,香港引以為傲的法制、自由、國際視野等也有很大的功勞,但香港確實不能脫離中華人民共和國的庇蔭。
既然如此,為何會有排斥雙非、諷刺內地遊客的情況出現呢?我們對於中國大陸,一方面給予「強國」的稱號,一方面將內地同胞揶揄為某些昆蟲,網上更出現中港的罵戰。我們有能耐去向米飯班主說不嗎?為甚麼有部分港人會有歧視內地人、憎恨內地人的傾向性呢?
人其實挺喜歡歧視──世界各地的種族歧視,北京人歧視「鄉巴佬」等等。有些香港人會歧視大多為永久居民的「阿差」,或陪伴80後90後長大的「賓賓」。有趣的是,這些歧視很少會達到深仇大恨甚至「昆蟲化」的地步,很
少會引致報章上出現有關的全版廣告──我們對北方的米飯班主們究竟怎麼了?
歸根究底,還是利益衝突的問題。香港的南亞裔為數不多,未有跟港人「爭飯碗」;本港的家庭傭工雖然每個星期天都佔領中環,但畢竟星期天大家都不會到中環上班,對大部分人的生活無甚影響。就算某些人對這些人士看不過眼,既然沒令自己「蝕底」就採取愛理不理的態度。
零三年本港開放「自由行」,內地遊客簽注手續不斷簡化,令到港的內地人激增。報章上雖然偶有內地遊客在港涉嫌行為不檢,以及因他們太喜歡本港某些商品導致缺貨,面對零售業的暢旺港人實在沒話說──畢竟錢是實質的。甚麼「在街上拉屎」的行為頂多是看不過眼、有礙市容;賣斷也是短期現象,供應商多拿貨就行──還沒有影響到一般人。
其後內地人開始來港讀書工作,新移民持續增加,政府也推出「優才計劃」吸納專才、「投資移民」吸引富戶。這時,開始有勞工界的呼聲指內地人奪去港人的工作,但隨著失業率長期低企,他們在這方面都沉默了,集中爭取最低工資標準工時。此外,內地人對本港房地產的熱衷令樓價節節上升,但在年輕人抗議未能「上車」的同時,本港一百多萬的小業主卻因手上物業價值連城而沾沾自喜──打個平手罷。既然內地人好像沒太大負面影
自私
CADUCEUS Spring 201246
響,以港人的性格當然不會投訴。
可是在內地孕婦的事情上,問題來了。本港長期人口老化,港人最初還為新生嬰兒的增加而雀躍。當醫院出現人滿之患,令港人不能享受本來已經緊絀的醫療服務時,有些人耐不住了。生孩子是女性最痛苦最危險的時期,在這時因為一些「外來人」而出現變數……香港人受不了。因為某些緊急分娩令急症室人員疲於奔命,以致服務受阻,令港人性命受到威脅……香港人受不了。因為某些嬰兒出生時有健康問題,令本來已經床位緊張人手缺乏的NICU爆滿,令出生嬰兒受到不必要的風險……香港人也受不了。
香港人其實是挺能忍耐的──只要別太影響到自己。廣東道全是內地豪客?香港賺錢就好;某些人把街道或廁所弄髒?加緊清潔及多加警告便可;股市全是國企?股民有回報就行。基本上,港人很少會作聲──利益的直接衝
突乃現在問題的癥結所在。
解決方法?別讓港人的利益受威脅,別讓港人的性命安全受威脅(如自駕遊等會令港人在家門口擔驚受怕的就萬萬不可)。港人不會介意內地人來港消費,但必須保障零售業多元化,以確保珠寶店以外的商店有生存空間。港人不太介意內地人為房地產市場「注水」,只要增加房屋供應,令港人能負擔自己的安樂窩就行。港人本來不太介意內地人來港接受醫療服務,如果實施配額令本地人醫療服務和性命安危不受影響,有關內地孕婦的反對聲音肯定大為減少。
香港經濟一直「食住條水」,與祖國同步繁榮向好,只要別令港人受驚嚇,港人就能「把氣吞回去」,為整體利益而忍!香港與內地的融合不能逆轉,倘若港府在制定政策時多留意人自私的本質,並好好平衡各種利益衝突,港人對內地的怨氣一定會大為收斂。
自私
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六塊腹肌養成法周鴻傑 (M16)
數年前,韓國男星Rain、權相宇剛出道不久就以黑馬姿態迅速竄紅,除了多才多藝,健碩的身型亦是讓粉絲為之瘋狂的主要原因之一。韓國演藝圈因此
盛傳「韓國男性腹肌數量與走紅程度成正比」的說法。
不只在韓國,好萊塢賣座電影暮光之城的年輕演員泰勒·洛納亦憑著擁有迷人體格的狼人角色迅速冒起;影壇長青樹湯告魯斯、畢彼特等風靡中外數十載,除了其帥氣容貌以外,渾厚結實的六塊腹肌亦大增其男士魅力!
此時此刻,作為一位學業繁重,每天被講義與形形色色的實踐課壓得透不過氣的你,也許只能甘於屈服,對著君子,JMEN等時裝雜誌上的型男海報咬牙切齒。其實只要向前邁一步,鼓起勇氣嘗試,一張軟墊就能讓你安坐家中練成六塊腹肌!
1.仰臥起坐
雙腿微曲,與小腿成九十度,腳板平放在地雙肘離地,手指觸碰臉頰用腹部肌肉舉起上半身,胸部往膝蓋處移動保持彎曲姿勢1至2秒後放鬆腹部肌肉,將上半身放回原處整個過程中腳板須一直緊貼地板次數,視乎個人體能,久未運動者可借助他人幫助固定腳板
CADUCEUS Spring 201248
2. 逆向仰臥起坐平躺在軟墊上,大腿與地面垂直,膝蓋彎曲九十度雙手平放在軟墊上以保持平衡大腿向胸部方向彎曲,期間大腿與小腿須一直保持九十度最後慢慢放回原來的位置
3. 單邊仰臥起坐
右邊身體平躺在地,形成一個垂直的平面,雙腿微曲右手平放在胸前,左手微曲,手指接觸臉頰用一側腹肌拉起上身,如圖示在頂端位置維持1到2秒,然後慢慢回歸原處以左邊身體重複以上動作
4. 交叉仰臥起坐右腳踝放在左膝蓋上,雙手彎曲接觸臉頰如圖示用腹部肌肉把上身往右腳的方向拉起扭曲軀幹,使左手肘與右膝蓋觸碰將上身慢慢放回原處以左邊身體重複以上動作
六塊腹肌養成法
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六塊腹肌養成法
5. 離地平躺身體呈一直線,雙手與雙腿均須合攏,雙肘緊貼地面,雙眼向下望盡最大可能延長此姿勢的保持時間
6. 單邊平躺身體呈一直線,並以右手手肘作支點,右腳外側與地面接觸盡最大可能延長此姿勢的保持時間以左邊身體重複以上動作
7. 捲腹雙手如自由泳般合攏,雙腿亦合攏用腹部肌肉將上身和腿同時拉起,在腹部上方呈兩條垂直線期間雙腿盡可能保持垂直狀態放鬆肌肉,慢慢將上下半身放回原處
另外一個鍛煉人士經常忽略的問題就是覆蓋在腹肌上面的脂肪。如果缺乏相應的餐單控制能量攝取和適量的帶氧運動,即使你每日做上百下仰臥起坐,練完就吃六塊巧克力,也只會被脂肪淹沒,不見天日!
羅馬非一日建成,練成六塊腹肌的目標更不可能在數小時內迅速達到。但只要擁有堅毅的意志,配合恰當的鍛煉以及飲食習慣,請相信,肚腩可以變腹肌!
圖片取自
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.co.
uk
CADUCEUS Spring 201250
Fun
Images from the M16Just because you spend all your days learning about pain, death, and horrifying flesh-eating diseases
the darkest corners of Stephen King’s macabre mind would be envious of doesn’t mean you can’t have a
sense of humour. Here are a few just-for-fun images in the style of 9gag memes, created and submitted to us
by the class of M16.
Lacking Something?
Not Having Enough?
Calling for all forms of submissions!Submission: email to hkucaduceus@gmail.com or in person to ANY of our Editors. For further details, please feel free to contact us or go to hkucaduceus.net.
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