We

I was asked to speak in a hospital forum about nonpunitive response to medical incidents. An apt illustration of the current climate comes from those stories in which honest doctors who make full confession find themselves viewed unfavourably. Should we then keep our mouths shut?

Hardly. There comes a time in the career of most doctors when things go badly awry. It comes earlier for those who work the hardest. No matter when it comes, however, the struggle is best overcome with support from the others. That's why I shared in the forum my way of handling my downright crestfallen colleague after a medical blunder. My usual response is a conscious effort to make use of the term we instead of the insulating pronoun you. "Did we forget to remove the tourniquet after blood taking?" is much preferred to "Did you leave the tourniquet on the patient’s arm?"

Wait. The human psychology of association behaviour is usually the other way round. Instead of linking ourselves to negative stigma, we tend to keep ourselves separate from the failure by the pronoun they. This is best shown by Robert Cialdini who did an experiment in which students at Arizona State University were phoned and asked to describe the outcome of a football game their school team had played a few weeks earlier. Some students were asked the result of a certain game their team had lost; the other students were asked the result of a different game that their school team had won.

How did the students describe the school team victory? "We beat Houston 17 to 14," or "We won."

How about the lost game? "They lost to Missouri, 30 to 20," or "I don't know the score, but Arizona State got beat." And, do you know what the most remarkable answer was like?

"They threw away our chance for a national championship!"

Farewell

"Will you still go to our departmental Xmas party?" It was the shaky voice of my colleague after attending the funeral service of my respectable patient last night.

I said yes. It wasn't that I did not shiver after temperature plunged from 20 degrees Celsius to five degrees. I did. No, the uneasy feeling of transit from a memorial service to a social event with party theme is difficult to shake off. And, I didn't miss the party that much. Going to say goodbye to my patient is even more meaningful. After looking after my patient for few months, I had never realized how awe-inspiring he was – not until I heard the obituary read by his daughter. It's really hard to say that I looked after him when I found out I knew so little about my patient before.

Actually, I'm going to say that I started to love my patient since last night.

Review

A recent British Medical Journal commentary argued about the fairest peer review system in biomedical publication.

Peer review system has been a time-honoured process of evaluating scientific manuscripts; qualified individuals within a relevant field are often invited to critique and comment upon a submitted manuscript (without monetary reward or academic recognition, in case you're interested to know) before the editors make a final decision to publish it or not.

Is it fair? Not even close. No, it's not fair; but it is a fact. Peer review is done by and large anonymously. It is never easy to be objective. The first sense to judge a manuscript is, if I'm being honest, the stomach. I'm serious. It occurs right in the pit of my stomach when I first judge a manuscript. I listen more to my stomach, far ahead of my heart of hearts, and definitely above my brain, if at all. Unsettling as it is, psychological evidence indicates that we experience our feelings toward something a split second before we can intellectualise about it.

I remember quite well my stomach feeling early this week, after accepting an invitation to review a manuscript submitted to the journal Peritoneal Dialysis International. I didn't know the authors, but my stomach tightened as soon as I read their cover letter. "On behalf of all the authors, I would like to ask you to consider our manuscript entitled XXX for publication in Clinical Journal of the American Society of Nephrology as a case report." All at once, things began to make sense. These were people (or lazy slug, dare I say) who submitted their manuscript to a far more prestigious journal, got rejected, and submitted the whole stuff unchanged (including the cover letter) to a second medical journal.

A decision was made before I read further.

Happy Birthday Jasmine

On the same afternoon in 2009, I was reading What to Expect the First Year, eager to set the stage for Jasmine's arrival. One year later, I brought Jasmine to her first preschool playing class today, carrying with me the special TimeFrames issue. That's an issue devoted to looking back at the stories of the past decade (and what it might presage about the future).

After taking a quick look at the Time magazine's content, I began to realize that quite a lot of changes have occurred since the start of the millennium. Understandable? Definitely, when I consider how many things have changed within just one year of Jasmine's birth. Never before have so many delightful moments of parenting been known to me. And never before have I witnessed so many new skills acquired by a human being within a matter of twelve months.

A year brimming with big surprises, I must say. Though it seems like just yesterday (okay, maybe the day before yesterday) when Jasmine mastered the skill of rolling over, my daughter has run around our living room umpteen times before I finished the first paragraph of this blog.

I can admit it freely now. I didn't think too much about having a baby. I couldn't have been more wrong.