Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in Pulmonary Rehabilitation?
成為一名醫(yī)生是我從小的夢(mèng)想。我的大學(xué)生活在柏林開(kāi)始，隨后我還去了美國(guó)、荷蘭求學(xué)。剛開(kāi)始我學(xué)習(xí)的是內(nèi)科，我對(duì)肺病學(xué)也很有興趣。而且我從小就對(duì)科學(xué)感興趣，大學(xué)也是如此。大學(xué)期間，初次接觸肺病學(xué)的時(shí)候，我得到很多機(jī)會(huì)從事我喜愛(ài)的科研工作，所以后來(lái)我就留在了肺病科。 至于為什么我后來(lái)專(zhuān)攻肺康復(fù)，是因?yàn)槲覐氖铝嗽S多重癥監(jiān)護(hù)的工作。這里的康復(fù)中心有別于傳統(tǒng)，它會(huì)接診很多危重癥病人，所以在這里我學(xué)到了很多關(guān)于重癥監(jiān)護(hù)的知識(shí)。我們接診了眾多移植前后的病人。當(dāng)然現(xiàn)在更多的是接診新冠肺炎患者。 Doing or being a medical doctor was my dream since childhood times. I started university time in Berlin, and I went to the US and also to the Netherlands. First, I started with a kind of internal medicine, and pulmonology was just that I was very interested in. I saw a lot of patients suffering from pulmonary problems. I was always, since childhood and since starting university career, I was interested in science. In the university where I did my first pulmonology education, I had the opportunity to do a lot of scientific work, so I stayed with the pulmonology. You ask me why I then went to the rehab part. I did a lot of intensive care medicine. The rehab here is something which is not the classical rehab. That means rehab here has more severe patients, and the intensive care education just had me taken up. Here we see a lot of transplant patients, we see a lot of patients before transplant. At the moment, we see a lot of Covid patients.
02
您的早年經(jīng)歷如何塑造你的成就？
How did your early youth experience shape your success?
我想分享一個(gè)童年的故事。小時(shí)候我的眼睛受過(guò)傷，是醫(yī)生讓我重見(jiàn)光明恢復(fù)視覺(jué)，那時(shí)我就被醫(yī)生這個(gè)職業(yè)深深吸引了。從那次受傷中恢復(fù)過(guò)來(lái)后我就對(duì)醫(yī)學(xué)很著迷，這也是鼓勵(lì)我進(jìn)入醫(yī)學(xué)領(lǐng)域的原因之一。 There is a nice story. When I was a little boy, I injured my eye. I was fascinated by the doctors who had me just to keep the opportunity to see and to have that sense of seeing. So I recovered from that injury and I was fascinated by medicine. I think that's one of the parts which inspired me to come to the field of medicine.
Who have been you greatest influences? What have they taught you and how have they inspired you?
醫(yī)學(xué)院的老師們對(duì)我影響很大。在我醫(yī)學(xué)生涯中，對(duì)我影響最大的人是Claus Vogelmeier教授，他是一名慢性阻塞性肺部疾病專(zhuān)家，在我醫(yī)學(xué)生涯中擔(dān)任著父親般的角色。一些杰出的醫(yī)學(xué)教育家對(duì)我也影響深遠(yuǎn)，比如來(lái)自休斯敦的心臟外科醫(yī)生Denton A. Cooley教授，還有我在荷蘭求學(xué)期間遇到的Klaus Rabe教授、Pieter Hiemstra教授以及Peter Sterk教授。 There were some teachers that influenced me of course at medical school. But the person who influenced me most during my medical career was Claus Vogelmeier. He is a specialist in chronic obstructive pulmonary diseases. He was kind of my father figure in medicine. But there were also some really prominent educators, like Denton A. Cooley from the heart surgery in Houston, Klaus Rabe, Pieter Hiemstra and Peter Sterk where they were the influences during my time at the Netherlands.
There are not many W3 professors in Pulmonary Rehabilitation. How did you feel when you obtain the professorship at the University of Marburg?
作為德國(guó)唯一的肺康復(fù)系教授是一份極大的榮譽(yù)。當(dāng)然這份榮譽(yù)也意味著重大的建設(shè)責(zé)任。我們迫切需要推動(dòng)這一領(lǐng)域的前進(jìn)，我也甘愿投身于這個(gè)領(lǐng)域的建設(shè)與發(fā)展?；仡欉^(guò)去四年，看到我們?nèi)〉萌绱硕嗟某删?，我感到非常開(kāi)心。 It is a big honor to be the only professor for Pulmonary Medicine in Germany. And of course it is also a position that has a lot of responsibility for future structures. There's also the demand of developing something which helps to bring the field forwards. So I like to structure that, I like to develop that. It is just a nice feeling to see that we’ve achieved quite a lot in the last 4 years.
05
您如何平衡行政、臨床、科研、教學(xué)工作及個(gè)人生活？
How do you balance the personal life, administration, clinical practice, research activities and lecturing?
在日常工作中，我會(huì)接診很多病人也經(jīng)常到病房巡視病人。出診是我工作的一個(gè)重要部分。有時(shí)很難平衡教學(xué)和臨床工作。平時(shí)我們會(huì)在醫(yī)院舉辦講座周，讓學(xué)生們參與一周的教學(xué)講座。我也會(huì)出差到馬爾堡和薩爾茨堡開(kāi)展講座。 科學(xué)研究也是我日常工作的一部分，我們會(huì)核查病人能否入組參與科研項(xiàng)目。我們科室有多個(gè)并行的臨床研究。我們還有特殊設(shè)定，讓病人留院至少三周，以便收集更多的科研數(shù)據(jù)。這些是我們能在醫(yī)院同時(shí)開(kāi)展多個(gè)研究的原因。在基礎(chǔ)科學(xué)方面，我們與馬爾堡大學(xué)有合作，那邊的同事會(huì)幫助我們收集科研數(shù)據(jù)。 I see a lot of patients, and I am doing rounds quite often. I also have a major parts in the diagnostics. The balance between the lectures and the clinical setting, it's sometimes difficult. So we have some lecture weeks here. That means we have the students here for a week. I also travel for the lectures in Marburg and in Salzburg. The research is part of the daily business. We will check every patient if he/she can be part in a specific study. We have a lot of parallel running clinical studies in our department. We have a special setting that the patients stay here for at least three weeks that gives you a lot of opportunities for scientific questions. That's the reason why we run so many studies here. For the basic science, we have the collaboration with the Marburg where I have some employees that help to answer that scientific questions.
Could you please share one case that you think as the most challenging and impressive one?
在呼吸科，我們接待過(guò)許多危重癥病人，遇到過(guò)很多富有挑戰(zhàn)性的病例。在過(guò)去的幾周里，我遇到最具挑戰(zhàn)性的病人是一位新冠肺炎康復(fù)患者。這名患者剛轉(zhuǎn)入我們科室時(shí)，自身情況非常糟糕。但是最后他能夠自己走上飛機(jī)樓梯并回到他自己的國(guó)家。 We have a lot of challenging cases, since we see a lot of severe patients in pulmonary medicine. But one of the most challenging in the last couple of weeks was a patient suffering from post-Covid. He came in a really bad shape, but later was able to enter the stairway of the plane himself and went back to his home country.
You have been an active member of a number of leading organizations or societies in the field of pulmonology; how has this helped to shape your career?
我認(rèn)為通過(guò)加入學(xué)會(huì)，可極大幫助你在臨床和科學(xué)研究方面發(fā)展人際關(guān)系網(wǎng)絡(luò)。通過(guò)這些人際關(guān)系網(wǎng)絡(luò)可助你成功，提高你的工作質(zhì)量。建立人際關(guān)系網(wǎng)絡(luò)是必要的，例如加入一些科學(xué)學(xué)會(huì)。 I think the networking based on society context or in the society is a major part of developing network systems for clinical and for scientific questions. It is increasing your success, increasing the quality of your work by using these systems. So I think it's mandatory to have that kind of networking, for example, joining some societies.
The COVID-19 pandemic is one of the biggest challenges facing modern healthcare. What impact do you see this having on the field of Pulmonary Rehabilitation?
你說(shuō)得對(duì)，新冠肺炎疫情是一個(gè)大挑戰(zhàn)。但通過(guò)應(yīng)對(duì)新冠疫情，加強(qiáng)了呼吸科各亞專(zhuān)科之間的聯(lián)系，各科室之間的知識(shí)共享與交流也增多了。在新冠疫情期間，呼吸科領(lǐng)域的地位也發(fā)生了變化。各種會(huì)議和政治決策中必須要有呼吸科醫(yī)生的參與，呼吸科醫(yī)生為政治家們提供了很多醫(yī)學(xué)建議。新冠疫情期間，呼吸科和整個(gè)醫(yī)學(xué)領(lǐng)域的地位都有所提高了。 You're completely right. The pandemic was challenging. But by just coping the pandemic again, the networking between the pulmonary departments increased. I have the impression that there was a lot of exchange of knowledge. It was possible also from the standing of the field of pulmonology that changed during the pandemic. It was mandatory to have respiratory physicians included in the conferences and the political decision making. There was a lot of advising also for the politicians by respiratory physicians. So I think that our position and the great field of medicine increased during the pandemic.
09
您認(rèn)為新冠疫情何時(shí)會(huì)結(jié)束？
When do you think the Covid-19 pandemic will end?
對(duì)于這個(gè)問(wèn)題，我準(zhǔn)備了一個(gè)東西。你知道它是什么嗎？這是一個(gè)水晶球，女巫會(huì)從水晶球中看到她想要的答案。但說(shuō)真的，其實(shí)我不知道疫情何時(shí)會(huì)結(jié)束。 我認(rèn)為在接下來(lái)幾個(gè)月，特別是在冬季，疫情仍在肆虐。眾所周知，氣溶膠在濕度高的環(huán)境以及低溫的冬季會(huì)帶來(lái)更大的危險(xiǎn)。我預(yù)測(cè)疫情可能在明年春天有所緩解。目前，德國(guó)受感染的病人數(shù)量仍在增加，感染數(shù)量幾乎和去年同期持平，而且大部分新冠病毒感染的病人未接種疫苗。德國(guó)開(kāi)始為特定的病人進(jìn)行第三針疫苗接種。但在過(guò)去的幾周里，感染人數(shù)仍在上升。我預(yù)測(cè)新冠疫情后的問(wèn)題也將持續(xù)至少幾個(gè)月。因?yàn)橐恍┌Y狀需要很長(zhǎng)一段時(shí)間才能痊愈，這意味著未來(lái)幾周乃至幾個(gè)月后都要面對(duì)新冠疫情后的問(wèn)題。預(yù)計(jì)明年我們也會(huì)接診很多新冠康復(fù)后的患者。可能到明年春天，急性感染病人數(shù)量會(huì)有所下降，但我推測(cè)新冠疫情后的問(wèn)題將至少持續(xù)到明年年底。 For that question, I've prepared something. Do you know what it is? It's a crystal ball, and you know all the witches try to get something out of the crystal balls to read something inside. But no kidding, I do not know. I think for sure some months, the pandemic, especially during winter time, will let us suffer, because we know that the aerosols during a higher humidity state and during the winter times, are bigger dangers. So I would guess that it probably decreases in spring. At the moment, in Germany, the numbers of infected patients increase. We are nearly as high as last year during that time. We see a lot of infected patients which were not vaccinated. We started the third vaccination for specific patients, but at the moment, the numbers have increased during the last couple of weeks. I would guess that the post-Covid problems will just be present for at least a couple of months, since we know that symptoms can be cured over a long time period. That means over weeks, over months in the post-Covid field, I would guess that the next year also will bring us a lot of patients suffering from post-Covid. So I would guess that the acute infection goes down, let's say, at spring; and the post-Covid problems will maintain to at least on the end of the next year.
In order to fully regain their health and to avoid reinfection, what advice would you give to those Covid-19 patients during their recovery phase?
首先，我認(rèn)為需要制定個(gè)性化的康復(fù)方案。醫(yī)生需要了解病人的所有癥狀。病人可能有很多需求。當(dāng)然我們會(huì)觀察他們的癥狀。我的首要建議是制定個(gè)性化的康復(fù)方案。這就意味著除了診斷，如果在康復(fù)治療階段醫(yī)生對(duì)藥物治療無(wú)法提供很多建議，那么就需要尋求更多針對(duì)新冠康復(fù)后患者用藥的醫(yī)學(xué)循證，更深入了解該疾病的病理。 對(duì)于非藥物治療部分，確實(shí)物理康復(fù)治療起到一定的成效，但也需個(gè)性化的康復(fù)方案。醫(yī)生要先了解病人能做什么，能做到什么程度以及病人能恢復(fù)到什么程度。相比之前，我們對(duì)功能障礙患者的康復(fù)治療的進(jìn)展會(huì)更慢，這是一個(gè)很大的區(qū)別。同時(shí)要記住，疲勞、慢性疲勞綜合征也是一個(gè)問(wèn)題。要把一切因素都考慮周全。所以我的建議是基于對(duì)病人整體的診斷，或者說(shuō)基于病人癥狀的復(fù)雜性為病人制定個(gè)性化的康復(fù)治療方案。 I think, first of all, we need a personalized approach. That means we just have to get all the symptoms of the patients. We have learned that they can require a lot. Of course, we see patterns. But my first advice is a personalized approach. That means besides the diagnostics, and if you turn into therapy, and we do not have a lot of advice and evidence for the pharmaceutical therapies. Just to get more evidence based medicine in the pharmaceutical part of the post-Covid treatment. We need to understand better the physiology and part of the physiology of the disease. For the non-pharmaceutical part, we know that rehab bring some success, but also there we need a personalized approach. That means we have to check what can the patient, what does the patient able to do, where we can get him? And where we can bring him? For that, we start more slowly than before we started for those patients who are deconditioned. So I think that's a major difference. You have to keep in mind that also the fatigue or the chronic fatigue syndrome can be a problem. Just taking it all together. My advice is to make a very individualized plan for the patient, a therapy plan based on the broad diagnostic which probably is based on the symptom complex of patients.
The World Health Organization (WHO) lists four lung diseases among the top ten causes of death. What’s your opinion on this and how can international collaboration contribute to this issue?
到目前為止，我認(rèn)為呼吸科醫(yī)生在醫(yī)學(xué)領(lǐng)域的地位沒(méi)有得到充分表現(xiàn)。我們知道，比如肺部感染和慢性阻塞性肺疾病(COPD)在未來(lái)幾年里都在增加，正如你提到的，成為全球十大死因之一?，F(xiàn)在我們需要的是發(fā)展科學(xué)合作和增強(qiáng)預(yù)防工作。例如我們必須通過(guò)控制香煙、大麻和電子煙來(lái)預(yù)防COPD，同時(shí)也要解決環(huán)境污染問(wèn)題。這樣就有希望在未來(lái)的幾代人里減少肺部疾病。我認(rèn)為預(yù)防、合作和科學(xué)方案以及藥物輸送管理可改善這一現(xiàn)狀。 I think that the respiratory physicians, and the rank of the respiratory physicians in the field of medicine is underrepresented so far. Just based on what you just cited, that means, we know, for example, pulmonary infections and the COPD that increase over the next couple of years, and will become one of these, as you mentioned, leading causes of death. For that time, we need the scientific networking and we need the prevention. That's very important. For example, in the field of COPD we have to prevent by limiting cigarette, smoking and also vaping, but also the environmental problems that we have to decrease. Then we can hope that for the future generations, perhaps these diseases can be decreased. I think, preventing, networking and scientific approaches to become better and the field of drug delivery should be a major point.
12
對(duì)于想要從事肺康復(fù)的人，您有什么建議？
What advice would you give to someone hoping to start a career in Pulmonary Rehabilitation?
I think just to cover the whole range of pulmonary rehab. For me, pulmonary rehab starts at the ICU and also on the other side, starts in the prevention. You should be broad educated. The ICU experience and the specification and intensive care medicine was ahead for me just to cover that part of the very severe disease patients. For me, it is also very important to combine always the 3 columns. The university education, including the lecturing, the clinical approach and the scientific approach. These three parts should be taken together, and that gives you a very interesting, a very demanding, but also a very fascinating field of medicine. I like that quite a lot and so I can recommend to be part of that rehab society.
13
假如您不從醫(yī)的話，您會(huì)從事什么行業(yè)？
What would you have been if you had not been a medical doctor?
我母親曾經(jīng)希望我成為一名演員。我以前會(huì)花一些時(shí)間在劇院練習(xí)表演，并在學(xué)校的劇院里扮演一些小角色。 My mother wanted me to become an actor. So I spent some time in active practicing in theater and acting little roles in the school theatre.
14
除了醫(yī)學(xué)外，您還有什么興趣愛(ài)好？
What are your hobbies outside of practicing medicine?
我喜歡文化藝術(shù)方面的東西。比如戲劇、電影。我對(duì)音樂(lè)也很感興趣，喜歡聽(tīng)音樂(lè)。我還喜歡踢足球、打網(wǎng)球、雙板滑雪、單板滑雪，以及各項(xiàng)山上運(yùn)動(dòng)。 I'm interested in cultural stuff. That means theater, cinema. I'm very interested in music, I like listening to music quite a lot. I also like soccer playing, tennis playing, and skiing, snowboarding, so all the things you can do in the mountains.
