Have you heard the famous saying ‘Sticks and stones may break my bones but words will never hurt me’? Words hold great potential to emotionally injure, but what happens when your bones are broken? You go see an orthopaedic surgeon.
Professor Patrick Yung is a professor of Orthopaedics and Traumatology at the Chinese University of Hong Kong. Having worked for 26 years in the field of orthopaedics, he is one of the pioneers of Sports Medicine in Hong Kong, internationally recognized for his work, including the first ever Master Course in Sports Medicine & Health Science in Hong Kong.
Why Orthopaedics?
To the casual bystander, orthopaedics may not seem the most interesting field to go into. But to Dr Yung, an avid footballer since his high-school days, orthopaedics seemed the natural choice. Playing for the CUHK football team during his years of study, he tore his ACL in his second year, and after returning to play, suffered repeated injuries. Hospitalised four times and operated on twice, he developed a first-hand knowledge of the subject, as well as familiarizing himself to the staff. After graduation, he was quick to choose it as his specialty, having developed an interest due to his frequent visits to its specialists.
What does he do?
As a professor at CUHK, Dr Yung splits his time between teaching, clinical work, and research. For most doctors, they spend 99% of their time doing clinical work, or stereotypical ‘doctoring’. For Dr Yung, he spends about 60% of his time seeing patients, and the rest of his time is split 20-20 between teaching and research. As a consultant at the university, as well as working for the Hospital Association, he teaches both students and junior doctors, in and out of the classroom. Even though on paper, his research and teaching time is split from the remainder of his work time in a ratio of 20%-20%, he usually ends up spending all his non-clinical time on his work, due to the demanding nature of his work.
Dr Yung believes that for clinical researchers, especially translational researchers like him, a balance between academia and clinical practice is important. If someone fully leaves clinical work to focus only on research, they will become too detached from their work, losing the ‘sense’ to care for patients and take good care of them. With the loss of this sense and connection, their research will suffer, especially translational research, which depends on the link between science and application.
As for his own research, as mentioned above, Dr Yung prefers doing translational research. Basic scientists mostly research non-clinical, scientific topics, and doctors can take on both clinical research and research relating to underlying cellular and molecular mechanisms. Clinical research focuses on improving surgery, improving medications, with the final goal of improving patient care and focusing on patient benefit. Dr Yung likes translational research as it can speed up the application of new science and discoveries. It’s not very upstream or Nobel Prize level work, but it has wide reaching benefits, as it can quickly be used in treatments and be beneficial to patients. Of course, not everyone can go into translational research, as some have to produce the basic science research to translate.
Sports Medicine: The Details
Hong Kong currently remains part of the cream of the crop in Asia for sports medicine. Sports medicine is an area of orthopaedics that focuses on improving quality of life, not just healing injuries. In less developed countries, orthopaedics focuses more heavily on lifesaving and treating serious injuries, like injuries of the spine. Usually in those areas, there is only one orthopaedic doctor in a hospital, who oversees all injuries and has to treat all of them. As a result, they usually lack specialties and sports medicine knowledge. As HK has a relatively higher quality of life, as well as being an international centre with an inflow and outflow of talented and skilled doctors, we were able to develop our sports medicine knowledge.
Hong Kong, in the south of China, combines traditional Chinese medicine with sports medicine treatment at times. For instance, acupuncture is better at first-response managing injuries than western medicine, as it can alleviate swelling and pain far beyond the level of ice and painkillers. Furthermore, traditional Chinese bone-setting (跌打) is also useful in treating sports injuries. Although Chinese and Western medicine is rarely used together, doctors frequently refer patients to each other to give them the most appropriate and best quality of care possible.
Frequently, people find themselves confusing sports medicine and physiotherapy. However, Dr Yung clarifies for us that they aren’t the same thing. Physiotherapy focuses on sport rehabilitation, and physiotherapists can choose to take a masters course in Sports Physiotherapy and Non-Operative Sports Medicine at The Hong Kong Polytechnic University (PolyU), but sports medicine is not taught in their undergraduate course. Furthermore, sports traumatology is only a small part of sports medicine, which also includes surgery, nutrition, rehabilitation, biomechanics, etc. Some physiotherapists do prefer working with sports injuries, but on a whole, although two fields share common ground, they’re quite different.
Progression of Technology:
With new advances in technology and artificial intelligence, Dr Yung has high hopes for improvements in the field. There are three main areas of development: Technology, Regenerative Medicine, and Healthy Aging. Technology includes 3D printing organs, AI, and robotic surgery, and these all have high potential in orthopaedics.
AI and robotic surgery are newly developed, and don’t work well with soft tissues due to the difficulty in differentiating them. However, bones are rigid and easy to navigate, and thus hold high potential for robotic surgery. AI can also quickly spot patterns and problems in a scan and get a digital report to a patient many times faster than it would take a doctor to examine and analyse one. Of course, one cannot completely rely on AI because humans are both physical and mental creatures, and robots lack the emotional depth to comprehend and analyse everything, as well as deal with issues with a softer human touch. It might fix things that should not be fixed, and thus it should be used in conjunction with an expert doctor with a good clinical sense.
As for regenerative medicine, it holds high potential in the future. Currently, medicine removes or replaces affected areas with artificial replacements, which can lead to infections, rejections, or degenerations of the replacements. However, regenerative medicine, which will heavily involve stem cells, proposes a re-growing of body parts. With growth factors like BMP2 and biomaterials, inventions, and developments in science, it could be the future of medicine. It’s up to doctors and scientists to work together to pioneer the face of medical development.
Healthy aging will combine the above technologies. Currently, old people live to great ages, but their quality of life decreases as their age increases. The aim is to have people age well and healthily, instead of just looking to extend their lives. By utilizing regenerative medicine, or developing technologies that can help them in their day to day life, we can greatly improve the quality of life of older people.
A little closer to home:
As everyone knows, it’s important to exercise often for health. However, how many of us actually do that? Dr Yung says that although education is important, it’s also important to provide an incentive in education. For instance, for students, he urges us to take an hour or so each day to exercise. Although it might seem like an inordinate amount of time, wasting our precious working time, it could actually increase our productivity and focus after the little break, increasing our efficiency. For adults, he reminds them that by investing a little time in health each day, it can save a lot of time and money later when they don’t need to be treated for various healthy problems. The main point, he emphasizes, is to sell it right to the right audience, because establishing a proper incentive will lead to a desire to do the thing.
In 2004, Dr Yung started a multidisciplinary Masters course in sports medicine. In 2008, he opened a campaign for sports medicine in the community, opening classes to accept teachers, coaches, athletes, etc. In his course, he covered the basics of nutrition, injury avoidance, and basic first aid, among others. This greatly helped in the coaches and athletes’ own training and teaching, and improved sports safety greatly.
As for his thoughts on more down-to-earth developments in sports medicine, he’s proud of how far HK has come. Although one would think that sports medicine is mostly for professional athletes and people of higher social classes, in recent years, it’s begun to depend less on family and economic status. As sports medicine develops alongside quality of life, more people are able to have a chance to do sports, and most people have a pretty solid knowledge of basic sports medicine knowledge. Many young people have a good grasp of nutrition, warm ups, basic first aid knowledge, etc. This proves the importance of education, especially supported by the DSE PE program, which contains a little bit of sports medicine, which Dr Yung himself wrote!
Memorable things:
It’s common knowledge that doctors receive many messages of thanks from people they’ve saved. It’s also common knowledge that most doctors have that One message that’s their favourite, that inspires them in turn. When asked about his most memorable experience, Dr Yung surprisingly doesn’t cite any famous athletes, most of whom he’s treated, many of whom he’s treated since they were very young. His most memorable experience is with a high school student, a non-professional player. The student was not an extremely talented or outstanding athlete, but he dreamed of being a professional footballer. After being hurt in a match and seeing Dr Yung, he made a speedy recovery. Now, he plays for HK. He wrote Dr Yung a letter, in which he thanked him, saying that “You are a dream maker.”
Sports is the dream of youth, and the dream is to be able to keep on enjoying playing sports. Before then, sports medicine was just another thing Dr Yung did, another part of his job. This letter really showed him the impact his work had on the life courses of people, and touched him greatly. It helped him realise that even on non-professional athletes, it was meaningful and important.
Advice to everyone:
Apart from the general advice of “Exercise frequently!” Dr Yung broadcasts to all, he also has more specific advice for aspiring medical students.
In higher ranking schools, everyone is very academically successful, and naturally will want to go into the medical field and the top schools of the medical field. However, Dr Yung gently reminds us that the concept of “good grades = med school” is a bad concept, especially in this day and age. He doesn’t mean to discourage students, but he reminds us that the difference between doing something and doing it well in a way that contributes to society is your interest in the topic. As a professor and a doctor, he’s seen many top students go into med and come out still uninterested in their field.
It’s not easy to know where our interests truly lie, especially given our young age, but a real interest in med has two main indicators:
1. A huge satisfaction from helping others
2. Earning money, or the lack thereof, is not an issue.
The journey of a doctor is long and arduous, but ultimately spiritually rewarding. If you’re only in it for the money, you’re not going to have an easy life or an easy career.
Not everyone has to be an excellent doctor, but a good, even great, doctor, always finds interest and joy in their work. In the future, doctors may not even command the highest respect in society, so who knows? Before you step on the path of a doctor, be sure that you have interest in it, and you can succeed in your field and contribute the most you can to society.
