Fibs

How much distortion can we make in retelling a narrative? By a long way.

On most days, we tell stories from memories and in our own style. In other words, we create stories. To remember something verbatim is a difficult task, made more so when exaggeration and minimization aren't considered lies.

My recent conversation with representative from drug company provides a nifty example. A pharmaceutical sales representative came to solicit my opinion about the recent treatment guideline for prescribing an expensive anaemia drug. To help you set the scene in your mind's eye, I should tell you that he approached me after my whole day of clinic sessions. My face and eyes looked tired, perhaps the result of seeing too many patients. Though I had tried to listen to his question to make sense of it, I could not.

"But wait," the sales representative told me, "I will keep the question brief. What do you think about the latest U.S. Food and Drug Administration recommendation to start treatment of anaemia in patients with kidney disease when haemoglobin level drops below 10?"

"I hear you," I replied after blinking a few times and swallowing what felt like a large goldfish, "but did you omit the second part of the new FDA recommendation? The gist of their new advice is not to make it a must to achieve a haemoglobin level of 10; they didn't define how far below 10 is appropriate to initiate drug treatment."

"Yes, good points," he answered, permitting himself the slightest trace of a smile.

Face Value

I went home by minibus after giving a talk to the interns last evening. I opened my book shortly after taking the seat, but I confess I was paying more attention to the people around than my book. And conversation of the passengers, in many ways, is about their stories in the hospital.

A couple sitting behind me started their conversation about a young doctor. That young doctor found profoundly offensive the idea that she was being addressed as a nurse - as most people did, I must say. "You know, it's difficult to tell without a closer look," the man said and began to tell his wife how the young doctor quickly corrected his mistake.

"After she returned a stern stare," the man continued, "I froze, sucked in my breath, and quickly called her a doctor. My fault, certainly, but hers too. She looked like a college freshman. Even now. I remember her baby face."

"Absolutely, this teaching hospital is full of green trainees," the wife rhapsodized.

Their story is almost funny - except that it's not. It is symptomatic of all human impressions. There always seems to be something to the snap impressions we form about people's faces. One study at Princeton University, for instance, showed that human inferences of competence based solely on facial appearance predicted the outcomes of congressional elections better than chance. Indeed, the inferences about the competence of politicians occurred within one second of being exposed to their black-and-white photographs. It won't make a centimeter's worth of difference even when people were given more time to think about it; their first impression stuck.

Mood

Hospital can be an intimidating and stressful place, one in which doctors can sometimes feel blue - and not just for the patients.

After returning from my Singapore trip, I started my first working day with an overnight call. The long work hours, as usual, were interrupted by the beeper calls from everywhere. Anyone who works in the hospital quickly learns that it's a race to see whether your beeper battery goes dead before you do so.

Did the work drive me nuts? Not really. I keep telling myself to be in good mood rather than working like Eeyore. A number of behavioural studies, in fact, have already shown that emotions can influence our mental activities. A good example of this proved that the mood affects the way we see things by modulating the activity of the visual cortex. When the study subjects in that Canadian study were shown photographs of faces expressing positive emotion (and with a higher self-reported mood after that), they have better better peripheral vision (confirmed by functional magnetic resonance imaging that monitored the visual cortical activity).

In case you're wondering whether doctors are immune to the unconscious influence from the mood, here's the answer: No, they're worse. In another experiment, a group of doctors were given a small bag of wrapped candy containing Hershey's chocolate and another group received nothing. They were then told to look at a patient's history and make a diagnosis. The doctors who got the candy were quicker to detect the liver problem than those who didn't.

Zoo

When it comes to visiting Singapore, it turns out that the zoo is the most unforgettable destination.

It was the middle of summer, and the overcast day made it an ideal one to walk around. To my little girl, that was her first time to come face to face with giraffes and zebras. It's hard to describe the feeling of ecstasy that swept across her that moment. The children's song came closest: "Oh, we're riding on a train called the Allee-Allee O - All through the zoo today!"

A few steps away, four nearsighted rhinoceros strolled in a leisurely fashion, with birds perched atop their thick skin. Just as I was reading the Time magazine featured story of (skyrocketed) rhino poaching recently, I found myself, by chance, in the midst of this endangered species. I surveyed the innocent look of these pachyderm mammals. They must be disappointed to learn that their friends got killed because of their horns, which consists of nothing but keratin. No kidding. That's the same stuff that makes up hair and fingernails.

And then, in the labyrinthine Night Safari, we were joining the nocturnal animals - hyenas, otters, elephants and leopards - in darkness. A strong wind blew through the trees. It took me a minute to recognize that it was a flying squirrel, as big as a pizza, gliding between trees. We were stunned.

Yet the climax memory of the Singapore Zoo trip came for me at the very end: When I returned to the hotel I realized my wallet was gone. That would be a nightmare. Money is just part of the equation. Lost identity cards and credit cards made my heart beat faster. I phoned up the maxi cab driver (who took us to and from the zoo) sheepishly, and waited for his search.

"No problem, I found it in the backseat. I'll hand you the wallet tomorrow. Good night."

I could not believe my ears. My wallet is definitely much more worthy than the rhino horns, and I was able to keep it.

How lucky, I thought.

Universal Studios

I was riding a roller coaster. I wasn't flying like a piece of paper in a tornado, but the speed was fast enough for me to lose my mind.

True, it's a must-do experience for most Universal Studios theme park visitors to get flung around on cutting-edge roller coasters. Nobody wants to miss the game. Not even the faint-hearted. Nor do the harried people, although there are exceptions. Those ups and downs, stunning as they are, didn’t get me addicted. As the roller coaster sped on, I kept wondering which turn it was going to make, and which direction I should keep my head. A minute's inattention, and one loses track blankly of one's whereabouts.

"Is it that easy for others to get carried away by roller coaster?" I asked myself after the ride. Maybe, just maybe, I'm too old or too slow for roller coaster.