On Being Resilient

Recently, I came across a book by Hong Kong Shifts and decided to give it a read. It was a collection of 50 human stories – street portraits and interviews of ordinary people across Hong Kong, published in a bilingual (English and Chinese) format. While this idea was not new – Humans of New York became viral in the 2010s – Hong Kong Shifts presented a captivating account of how grassroots workers lived their lives and sustained our city's prosperity.

If I were to summarise these stories in one word, it would be ‘resilience’, a virtue best understood by those who have endured humble beginnings. Being resilient means having the ability to recover from life disruptions readily and gracefully. A resilient person is likely to see obstacles and failures beyond their immediate significance, valuing these “negative experiences” as resources for personal growth. One may even transform hardships and frustrations into incentives and inspirations that fuel perseverance and creativity.

Fong, a street cleaner from Shau Kei Wan, was a great example: “There are, of course, others who are rude and look down on us, maybe because they think that this line of work is ‘dirty’ or not respectable. I just ignore them; it's better to focus on the positives! If you take ownership of your work and do your job with dignity, the results will speak for themselves.” (Hong Kong Shifts, p.41)

I see a hint of resemblance between Fong's story and my grandparents' stories. My late grandma, like many other women of her generation, did not have the privilege of receiving formal education. Life was difficult until her children and grandchildren finally saw some success in society. She worked menial jobs, including being a garbage collector. Yet, she was always a cheerful and sociable person. My grandpa, who is now suffering from dementia, still manages to vividly recount his past. He lost his father at a very young age and barely survived the Japanese occupation of Hong Kong as a kid. He was a tram driver but lost his job amid political struggles between labour unions and the colonial powers. He resorted to manual labour to support the family until his retirement. He always tells me to become a righteous and diligent person. They were all resilient people.

Interestingly, the first documented usage of the word resilient in the English language, according to the Oxford English Dictionary, was in 1644 by John Bulwer in his work Chirologia. Bulwer was a physician with research interests in hand gestures and deaf education. Chirologia, also known as The Natural Language of the Hand, was a work dedicated to the observation and analysis of gestures that people use when they communicate. Bulwer was literally referring to the recoiling of the hand, and the figurative use of the term only became common after the beginning of the 19th century.

It has been shown that resilience may protect physicians from burnout, and it is likely that resilience can be developed over time (rather than being an unlearnable trait), although we do not yet know the best way to achieve this. In my opinion, resilience is something we can teach and learn by example. Listening to our patients' stories often enlightens us on how human beings can endure pain and suffering in amazing ways. The humbler we are, the better we can perceive the beauty of our world and learn from the wisdom of the people we encounter.

Honouring others’ life stories is also how we can combat the epistemic injustice present in clinical medicine and biomedical sciences. While a significant degree of asymmetry within the doctor-patient relationship is likely to persist as a societal norm in the foreseeable future (and I doubt it is sensible to radically undermine a physician’s authority), I believe that cultivating greater sensitivity and openness towards our patients’ narratives will make us better practitioners of medicine and surgery.