I am a specialist in premature babies, technically called a neonatologist. In fact I was even more specialized than that, since I focused on nutrition in premature infants. Furthermore, if you can believe it, I became even more specialized, and focused on calcium within the field of nutrition of babies. I think you have an idea of how super specialized I became. You might even call me a “Neonatal Nutrition Calcium” doctor. In fact all my life I have been urging people around me, young people especially, to “focus, focus, focus”, for different life stages, for research goals, or for ultimate life goals.

我是早产婴儿的医疗专家，严格来说就是新生儿科医生。其实我比这个还专，因为我专门研究早产婴儿的营养。此外，如果你能相信的话，我后来在婴儿营养领域里再钻研钙，成为更加专业。我想，你可能对我超级专业的程度有些概念了。我甚至可以被称呼“新生儿钙营养”医生。实际上，我在一生中一直劝说身边的人，特别是年轻人，要对人生的不同阶段、研究目标及人生的最终目标“聚焦，聚焦，聚焦”。

I was heavily involved in academic research, and knew that if my trainees followed this advice, they would focus on smaller and smaller, more and more refined, and more and more specialized things. This would result theoretically in thorough understanding of the research subject, greater creativity, and more and more research papers! Which is sort of what happened to my own academic life!

我之前投入于学术研究，便深知我的学生们只要跟着这个指导做，他们的焦点会越来越小，越来越精，而且越来越专。在理论上这样做的结果是透彻了解研究对象，得出更多创新，还有更多的研究报告！我自己的学术生涯差不多是这样的。

So it was with a great deal of trepidation that we started our medical mission in Southwestern China in the 1990s. My super specialization was of near zero practical help, since our mission dealt with relatively rural general medicine, in small villages and communities. There was no need, nor realistic opportunity then for modern premature baby care, the main focus of all my clinical life. In the regions we worked in, I barely saw a modern infant incubator. Let alone a mechanical ventilator! There were no intensive care units, and no support staff with all kinds of sophisticated baby related expertise. I felt literally abandoned and naked.

所以，我们 ₁₉₉₀ 年代在中国的西南部开始了医疗援助工作时，让我忐忑不安。因为我们项目涉及的需要是乡村小村庄和社区的普通内科，之所以我超级的专业几乎起不到什么实际的作用。当时对我行医生涯的主要焦点——现代的早产儿治疗，没有任何需求或者实践机会。在我们工作的地区基本上见不到一个现代的婴儿保温箱，更别说一个机械呼吸器！没有加护病房，也没有在婴儿护理方面经验丰富的支助工作人员。我真的感到束手无策了。

Essentially I had now gone in the totally opposite direction. I was completely out of my realm, out of my box, and facing medicine that I had nearly forgotten. I remember that even going to the clinic to see “ordinary” pediatric patients was a challenge. I had become so specialized in premature infants, it was decades since I took regular care of patients older than a few months of age. Children in a clinic instead of an incubator! It was a surprising turn of events in my life, a great challenge clearly worth facing!

实质上，我当时的方向跟我一直主张的是相反的。我完全出了我熟悉的领域，面对已经不在自己记忆里的医学概念。我记得连在诊所看“普通”的儿科病人都是一个挑战。我一直专研早产婴儿，好几十年都没有去照顾超过几个月大的病人了。现在是在诊所里看孩子，而不是在保温箱里！那是我生命中的一个令人惊讶的转变，一个值得去面对的大挑战！

Actually even before I served in rural China, I already had academic “focusitis” (I made up the word, the disease of “over” focusing). Even when I was practicing medicine among nursery babies, I could even lose perspective. I was supposedly an expert in nutrition, and wrote many books on infant nutrition, but in practice I paid little attention to practical issues of giving nutrition to each baby!

其实，我去中国的乡下服侍之前已经得了学术“聚焦炎”（我造出来的一个词，意思是“过度”聚焦的疾病）。即使我在育婴室的婴儿当中行医时，也可能会失去洞察力。虽然我在名义上是营养专家，也写过不少婴儿营养有关的书籍，但在实践当中我不怎么留意每个婴儿如何得到营养！

When young doctors and nurses were reporting daily to me about exactly how many cc’s of fluids were given to the babies, or how fluids were given, through tubes via the nose to the stomach or through veins, I confess I was often not totally engaged. Sometimes I distinctly felt my eyes glaze over whenever they mentioned such details. Which sounds terrible of course! My focus and attention was likely on some theoretic nutrition concept or practice, preferably involving calcium! The egg-headed absent minded professor syndrome in academic clinical medicine, basically “focusitis”.

我不得不承认，当年轻的医生和护士向我做每天的报告时：他们解释给婴儿输了多少毫升的液体，是通过鼻孔到胃部的管子还是通过血脉输的等等，我经常不是完全注意的。有时候他们讲到此类的细节我明显会走神。这当然听起来很糟糕！我的注意力很可能留在了某一个营养理论的概念或者实践上，最好是与钙有关！这就是学术临床医学领域中所谓的心不在焉的理论家综合症(用英语说‘absent-minded professor’)，基本上可称“聚焦炎”。

On the mission field, I discovered I was not the only person with this problem. A good friend was an experienced highly expert heart transplant surgeon who was also trying to help in China medical missions. However he was so hyper-specialized that he was of little practical help, since heart transplants were mostly fantasy at the time and place.

在援助工作当中我发现自己并不是唯一有这个问题的人。我的好朋友是一名经验丰富的心脏移植外科专家，也想参与在中国的援助工作。然而，他是极其专业的，以至于帮不上忙，因为在大部分时间和地方要做心脏移植仅仅是一个幻想。

Another friend was a high level neurology expert who would be welcomed enthusiastically in any western specialist hospital. But it was difficult to find the right fit for such a sophisticated discipline. All of us, hyper specialized because of training in Western academic medicine, found ourselves like fish out of water!

另一位朋友是资深的神经科专家，在任何西方的专科医院都很受欢迎。但当时我们很难给如此复杂的学科找到合适的用处。我们每个人经过西方的学术医学培训成了超级专业的，却发现自己如鱼离水！

On the home front, my wife had developed ovarian cancer looked after by an excellent gynecologic oncologist. I knew him well from my medical school and hospital. As gynecologist, he specialized in problems of women, and as oncologist he specialized in cancer, so he was highly qualified and specialized. Impressively, he explained her treatment in thorough academic detail to us.

论到家，当时我的妻子得了卵巢癌，由一位杰出的妇科肿瘤专家来治疗。我们之前是医学院和医院里的同事，所以我对他很熟悉。作为一个妇科医生他的专业是妇女的问题，而作为肿瘤专家他的专业是癌症，于是他的资格和专业水平都很高。他以细致透彻的学术方式解释了治疗计划，给人印象深刻。

The operation indeed went superbly well, including meticulous removal of a large number of lymph nodes, and the chemotherapy was excellent. The commonly fatal cancer was eradicated, to our immense relief. He was certainly the super specialized academic colleague I readily identified with.

手术果然做得非常成功，包括细心去除不少淋巴结，化疗也进行得很好。这普遍致死的癌症被消除了，让我们感到万分欣慰。他确实是我所认同的那位超级专业的学术同事。

But this specialization did not cover the simple process of putting in a “port” to infuse the chemotherapy.  A port is a device inserted under the skin, in this case in the chest area near the neck veins, so that the nurse could regularly puncture the port, to infuse intravenous chemotherapy fluids into the body. However, it had surprising problems. For example, its removal was a painful mini-operation and the wound became an uncomfortable puckered scar.

可是，他的专业没有涵盖用来注入化疗液体的“输液港”的简单安装程序。输液港是一个放在皮肤里的器件，而我妻子的话要放在靠近脖子血脉的胸部位置，好让护士可以定期通过刺穿接口来把化疗液体注入到身体里。然而，它出了一些意外的问题。比如说，去掉它是一个痛苦的小手术，而伤口结了一块不舒服的起皱的疤痕。

In retrospect, we found out this “mini” surgery side effect was common. And the port wasn’t really essential, since a simple option was to puncture a vein once a month, for 6 times. But super specialists are not normally involved with offering choices on these “simple” things, just practical details, I suppose! Another version of my kind of academic “focusitis”. But see the happy ending at https://reggietales.org/scars-english-version/

我们后来发现这种“微小”的手术副作用是很普遍的。而且输液港原来不是必要的，因为可以选择简单一个月一次直接刺穿静脉，一共六次。可是，超级专家一般不会考虑在这些“简单”的事情上提供选择。我想，他们认为那只不过是一些实践的细节而已，正是我所得的学术“聚焦炎”的另一个版本。不过结尾是圆满的，你可以打开（https://

reggietales.org/scars-english-version/ ）来读。

I’ve often heard of the unfair joke that super specialized ophthalmologists could be called “ left eye ophthalmologist,” or even left eye retinologist (for the left eye retina). Ophthalmologists really are split into so many sub, sub, sub, specialties, with each branch being so very refined and sophisticated.

我常听说一个不太公平的笑话，说超级专业的眼科医生可以叫做“左眼眼科医生”，甚至“左眼视网膜科医生”（治疗左边的眼睛视网膜）。眼科医生确实会分许多“亚亚亚专业”，每一分支都精细而复杂。我们有两只眼睛，于是确实有可能有一个亚专家在治疗一只眼睛的同时另一个亚专家在治疗另一只眼睛的问题！

After we moved to Seattle, I was delighted to visit a super specialized ophthalmologist who only specialized in glaucoma. I had great confidence in her expert care of my glaucoma, and her sophisticated explanation of my condition and treatment. I felt greatly reassured I was in excellent hands, which was true.

我们搬到西雅图之后，我去看了一个只从事治疗青光眼的超级专业的眼科医生。我完全信任她治疗我青光眼的能力和她对我病情及其治疗的细致解释。我感到自己在能人手里，很让人放心。

However, I complained several times over two years that my eyes were getting blurry, and I could not see the power point projections in church too well. My complaints were essentially glossed over, I suspect because it wasn’t directly related to the glaucoma. One day, fully two years after I had first expressed my concerns, the super specialist said to me, rather

nonchalantly, as if it had just occurred to her, “Oh, why don’t you just get new glasses?”

可是，在那两年里我几次抱怨我的眼睛开始花了，参加教会的时候看不清楚大屏幕上的字。我的抱怨却基本上被含糊过去，我猜是因为它不是直接与青光眼有关的。有一天，从我第一次表示自己的担忧整整两年之后，那位超级专家好像刚刚想到了似的有些漠不关心地对我说：“哦，要不你配新的眼镜？”。

What a revelation! I went to get my new glasses right away, and lo and behold, my vision was restored. To my relief, I could see the screen projections at church, and the running words on television, all quite clearly. What a simple solution to a vexing problem to me, the “poor patient”. I’m guessing the vexing was overlooked because it was likely “too simple”. All I needed was glasses. Pretty much out of the hyper focused super specialized realm! The ordinary person might be forgiven to think that simple good vision was a critical end point of eye care.

真是一个惊人的发现！我马上去配了一副新的眼镜，我的视力竟然恢复了。令我很欣慰的是，我可以清清楚楚地看到教会大屏幕上的字和电视上的字幕了。困扰“可怜病人”的问题有了如此简单的解决方式！我的烦恼被忽视，我猜很可能是因为“太简单”。我所需要的只不过是眼镜。完全出乎极其集中的超级专业领域！普通人都会想单单良好的视力作为治疗眼睛的关键终点再正常不过了。

We often hear a common expression that we sometimes “cannot see the forest for the trees,” or get stuck in details and not remember the big picture. A situation that could entangle a subspecialized neonatal clinician-scientist, a subspecialized gynecologic oncology surgeon, or a subspecialized glaucoma ophthalmologist. It’s a particular warning to specialized people like me, since I tend to always urge people to be more focused in life!

我们常常听到一句俗话，说有时候我们“见树不见林”——换句话就是困在细节上而忘记大局。这种情况能纠缠一个亚专业的新生儿科医生科学家、亚专业的妇科肿瘤外科医生或者亚专业的青光眼眼科医生。这是给一个像我这样的专业人士的特殊警告，因为我总是喜欢劝告别人要做事集中！

To prevent my focusitis making me stuck in minutiae, I often step back periodically to think about the full perspective. As a practical step, I make systematic 5 or 10 year plans, allowing regular pauses and course corrections in my life journey as necessary. Details (even sub, sub specialization ones) are important; just don’t let them take us off track from the key end point (the main point, the vision if you wish).

To belabor the point, I really prefer a crystal clear vision for my final key destination, the ultimate goal of life. I trust you also have a clear vision?

为了避免我的聚焦炎令我困到小细节上，我经常会定期跳出来做全面的思考。我的一个实际步骤是做系统性的五年或者十年计划，这样以来，如果需要的话，可以在我人生的一路中有规律的停顿和方向调整。细节（甚至“亚亚专业”的细节）是重要的——只要不允许它们使自己偏离最重要的终点（主要的目的，也可以说意向）。再强调这一点，我要对自己最终的目的地，人生的最终目标，有一个非常清楚的意向。我相信你也有一个清楚的意向吧？