Pavlov

After reading the social scientist Dan Ariely's book, I've learned that I'm no better than Pavlov's dog. Ditto for Dan Ariely.

Dan experienced a devastating chemical burns accident and got a liver virus from an infected blood transfusion after three weeks in the hospital. For that, he had gone through an eighteen-month ordeal of interferon injection to kick the virus. While interferon treatment has clear health benefits and survival advantages, the medication came to effect at a big price - each shot is followed by shivering, nausea and headache, plus the fact that the drug can cause depression. Dan carried out a ritual every injection day: He would stop at the video store on the way to school and picked up a few films that he wanted to see. He then think about how much he would enjoyed watching them later. Once he got home, he would give himself the interferon injection and immediately jump into his hammock and start his mini film festival.

That way, Dan learned to associate the act of the injection with the rewarding experience of his favorite pastime. The trick allowed him to spend less time mulling over negative feelings of injection. Somewhat like the philosopher's stone that turns lead into gold. Sounds silly, but it isn't. In case you're wondering whether it works, here's the answer: He never skipped an injection.

Pavlov's dog started to salivate in response to bell after repeatedly hearing the bell together with the presentation of meat powder. Much the same could be said about mundane tasks that we would rather procrastinate. I did similar tricks by buying myself can coffee on the way to morning ward round and a can of Coke before the afternoon clinic. I also buy myself teddy bear gum sweets every month, before the otherwise miserable task of duty roster preparation. I could go on and on.

Lottery

Have you heard of the HK$100 million Mark Six dream? Of course you have. Everyone has.

I'll confess it; I'm kind of tired of lottery winner frenzy. Maybe it has something to do with the earliest adaptation level theory study on overall life happiness among lottery winners.

This might not be news to you, but in case it is you should hear the experiment in which psychologists compared a sample of major lottery winners with normal controls, and also with paraplegic accident victims. At issue in this case wasn't the level of happiness immediately following the event (of the miserable accident or the lottery win). At issue was simply their effect one year after the event. In the end, the differences in happiness levels among the three groups were not as pronounced as we might expect. Both paraplegics and lottery winners were surprisingly close to normal levels of life satisfaction. What strikes me most about the study was that lottery winners took significantly less pleasure from a series of mundane events.

These ideas dovetail with my recent reading. In his book The Upside of Irrationality: The Unexpected Benefits of Defying Logic at Work and at Home, Dan Ariely talked about how we get used to (with time) the euphoric feeling or painful experience. The point is that, in his words, even if you feel strongly about something in the short term, in the long term things will probably not leave you as ecstatic or as miserable as you expect.

Spider

My wife's sling bag always reminds me of the vulnerability of adults, and how easily we can be lured into the shortsightedness.

The bag looked fine until I made a careless splash of ink on it (when I hand-painted a T-shirt). So, what can be done to the blemished bag? The answer: not much - at least not immediately. A small voice inside me said, “Let's forget about the ink.” But the wounded part was less comfortable. It said, “Excuuuuuse me? What's the matter about the two black dots?”

My wife didn't throw away the bag but I still feel bad and guilty, and, if the truth be told, rather uneasy about the stain. I was worried, but not for long. It has made a heck of difference when my daughter Jasmine looked at her mum's tote bag. She smiled and pointed to the two dots of black ink. And, oh yes, she uttered a few words "dah dah." I didn't know what she meant until my wife nodded her head and sang the children song "Itsy Bitsy Spider."

Bingo. The two dots look really like two little spiders. Amazing spiders. I almost laughed my head off as Jasmine pointed to the two "dah dah."

Barber

Not long ago, I read the blog post of my mentor who had to say goodbye to his barber. I found a great example of loyal customer who visited the same barber for over thirty years. Then came the moment for me to have haircut for my Jasmine. This turned out to be a haphazard zigzag style.

Which brings me to the memory of my barber.

The experience of being a child to visit the barber for the first time has a common affliction with visiting the dentist: fear of the knife and the chair. Both are frightening. Dentist and barber are alike when it's the first time you visit them. I started seeing the difference between a dentist and barber after the second visit, of course. My barber's razor never hurts, his smile always shines.

The place was essentially a tenement building where I climbed the terrazzo staircase to find my barber, who was much older than the decrepit building. And it was the comic magazine I liked most about visiting that barber. To me, those magazines were dog-eared but amiable. And by the time my mother allowed me to visit the barber on my own, I had finished all his comic magazines. At the age of 10, I'd still looked forward to visiting my barber. Next I heard about my barber's plan to retire. After that he welcomed me to visit him for haircut for another one year or two – before he really retired.

Sayonara to the barber is hard to say, and it is.

Diffusion

I always recommend mentorship to young medical student or doctor who wants to learn medicine.

That is what I'd been doing over the last few weeks when the summer students joined me. Did they learn from me - as a nephrologist - how dialysis works? Not really. For that bit, the students can figure out themselves from the textbooks. It's a good start, of course, to teach them that haemodialysis works under the principle of diffusion.

And that is exactly how mentorship works its magic: by diffusion.