如果有收看英国新闻，关注英国球赛，或是参与跟英国有关的活动时，大家可能会注意到许多公众人物，都会不约而同地在胸前佩带一朵小红花。这小红花的名字叫“虞美人”，又名丽春花、赛牡丹、满园春、仙女蒿、虞美人草。每逢十一月，大概是1日到11日，英国人都会戴上红色的“虞美人”，目的是纪念世界大战中为国捐躯的战士们。英国退伍军人协会(Royal British Legion)，都会在纪念日前夕，发动募捐，出售人造“虞美人”，也就是所谓的Poppy Appeal。
在第一世界大战当儿，当任外科医生兼军人的Lieutenant Colonel John Alexander McCrae, 在他的出名的战争诗"In Flanders Fields"里头，描写了比利时战场上盛开的“虞美人”，影射当时战事之死伤惨烈。原文如下：
In Flanders Fields In Flanders fields, the poppies blow Between the crosses, row on row, That mark our place and in the sky The larks, still bravely singing, fly Scarce heard amid the guns below. We are the dead, short days ago, We lived, felt dawn, saw sunset glow, Loved, and were loved, and now we lie
In Flanders fields! Take up our quarrel with the foe: To you from failing hands, we throw The torch; be yours to hold it high. If ye break faith with us who die We shall not sleep, though poppies grow In Flanders fields!
虞美人，学名为Papaver rhoeas，经常被称为corn poppy, corn rose, field poppy, Flanders poppy, red poppy, red weed, coquelicot等名。此植物属于罂粟科罂粟属草本植物，花色有红、白、紫、蓝等颜色，浓艳华美。这原产于欧洲，北美洲的温带地区的花，秋播春开，在3－4月会放纵绽放，展示美艳。薄如蝉翼的花瓣，在纤细的花茎上，释放着血一般压目的色彩。在徐风中翩翩摇摆，像夜色中翩舞的女郎，婀娜生姿，挑逗心弦。有人曾讹传“虞美人”是会跳舞、说话、唱歌的花草。这美丽的花朵下，全草有毒，而以果实毒性较大。若是误食果实液汁，会导致昏睡，心跳加速等症状。
Somehow in the past 2 weeks, cough and cold is on the rise. Some blame it on the very unpredictable fluctuation of temperature on daily basis, while others blame it on the haze that hit us several weeks ago.
A young English lady came in for fever and sore throat last week, while I was having my clinic downtown. She had typical symptoms of strep throat, fulfilling centor criteria of tonsillar exudates, cervical lymphadenopathy, and absence of cough.
She would make a lovely candidate to be started on amoxicillin, if she hadn't been allergic to penicillin. Being the typical private practitioner, I did a throat swab on her and gave her Azithromycin instead.
This morning, I came into my office from my trip from Singapore, and found the lab report sitting on my desk. The result showed that the throat culture was Strep alright, but unfortunately, the sensitivity test showed that the strep was resistant to nothing but Azithromycin!!
I quickly contacted the lady, explained the lab result and requested her to come back to get a different antibiotic treatment.. She was happy that I called, but told me that the antibiotics worked like magic for her. Her sore throat went away despite taking the supposingly-no-good-antibiotics that I gave her.
These kind of disparities between the lab results and clinical outcome of the patient is not new to me. Should I have not done the throat swab, I'd probably think that the Zithromax worked. However, the lab result also set me thinking of: Whether the throat swab was necessary? Could the lab results different from what really happen in the host? Should I have not given her any antibiotics, could she have gotten well on her own anyways?
Sometimes patients come in requesting for antibiotics even if they don't need it. Most of the time, even family members and friends around me, would think that their symptoms improved and went away immediately after a dose of antibiotics, even though the symptoms suggested viral etiology. Getting better could be due to the placebo effect, or maybe somehow along the line, antibiotics did something else that made a difference in the disease progression.
Nevertheless, patient education in antibiotic use is very important in promary care settings. We all know if antibiotics were given out without proper selection, we are digging our graves by creating superbugs that will not response to any antiobitics in years to come. Hopefully in the years to come, people will start questioning why the need antibiotics in the first place.