Unexpected

The most satisfying kind of Christmas gift - and the one most likely to stay for years of festivity memory - is the unexpected kind.

For weeks before Christmas, my wife and I have included our three-year-old darling to prepare and celebrate the holidays. Christmas tree and gingerbread man were decorated in a funny manner. Some of the decorations are traditional, some unconventional, and many are exaggeration. The Santa Claus decoration, as she'd made in the school, had five whopping eyes.

On Christmas Eve, my wife invited Jasmine to wrap the gifts - and again in the most unusual style. Unbeknownst to me, they made use of chocolate gift paper to wrap a scarf for me ("So that daddy will think that's a box of chocolate!"). Jasmine was pretty much focused on the task. Alas, that's a secret to trick the daddy.

That is, until I came home just after they put a finishing touch on that "box of chocolate."

I had not the foggiest idea what my daughter and my wife were doing. "What a beautiful day and a lovely girl," I said. And she is.

"Nooooooo, daddy, don't get too close," my daughter was really excited, "and you won't know this box is a scarf!"

When I realized that she had been trying to keep the secret but actually leaked the story, I told myself, "It's sure to be a kid's secret to remember."

Stereotype

On my way to work, I heard the news that we have to follow incredibly stringent rules when submitting photographs for application of Chinese visa. Absurd as the requirement is, it states precisely the dimension of the face, the interval length between two pupils, the area for the two eyes to fall within the photograph, and emotion of the applicant. For this very reason, many applicants fail.

I had no idea what these rules are trying to achieve, but I tried to guess. Can they make the identification more accurate? Can they get rid of forged visas? The answer in both cases is no. Be not beguiled. Our brains don't need that detailed and sophisticated photograph to make a conclusion.

Which brings me, somewhat uncomfortably, to the question of how stereotype - and not detailed analysis - determines our decision. To try to prove this point, a psychologist carried out an experiment by flashing either a black face or a white face on a computer screen. The subjects caught a glimpse of the face, and were then shown either a picture of a gun or a picture of a wrench. Each lasted for 200 milliseconds. Imagine you were sitting in front of the computer, you would know that details like the dimension of the face and the pupil separation won't make a centimeter of difference in 200 milliseconds. Here comes the results of that study: when subjects were primed with a black face first, they would identify the gun as a gun a little more quickly than if they were shown a white face first. It's a grotesque "colour-bind" prejudice, to say the least.

What if the subjects were forced to make a snap decision within 500 milliseconds? Well, they were quicker to call a gun a gun when they saw a black face first. But you will be surprised at how many errors occur. In fact - and this is the interesting part - when they saw a black face first, the subjects were also quicker to call a wrench a gun.

Sure, it seems unfair. But so do lots of things. Judging application materials, for instance, seems very unfair. A recent randomized, double-blind study published in the Proceedings of the National Academy of Sciences confirmed a real bias against female students, even in science faculty from research-intensive universities. Researchers did an experiment by submitting identical curricula vitae to a broad, nationwide sample of biology, chemistry, and physics professors - there were 127 in all - to apply for a science laboratory manager position. The CVs were exactly the same except a random allocation to be submitted under a male or female name. In the end, women were significantly less competent and hireable than men even though student gender was the only variable that differed. Women were, I should make plain, also offered a lower starting salary. How can that be? Stereotype bias, but hey, it's something.

Rebuke

One day, a city was struck by a hurricane.

There's no joy for the citizens in such bad weather, and certainly none for the fire brigade. All the firemen were exhausted. And that's not all. Some frustrated firemen grabbed the streetsleepers' shawls and blankets to wrap themselves up in. Some defecated in the open. Some fled. Morale had been swept away as if by a tsunami.

So what can be done to a poor guy whose home happened to be on fire?

The answer: not much - at least not immediately according to that fire brigade's triage system.

There are few experiences as depressing as a fire brigade's manager who was helpless and watched his home ablaze. Horror. Sheer horror. That's what the manager felt when he decided to make a long distance call to his fireman friend in another city. His friend was a middle-aged fireman who had been in the fire service for years.

The middle-aged fireman rushed to the scene, did his job, and went home before the manager had time to thank him. The fireman, by now quite used to help people in need, didn't seem too flamboyant at the thought of his rescue. He almost forgot the event until, one week later, he received a complaint letter from the hard-pressed fire brigade. "Oh," said the middle-aged fireman, puzzled. He glanced at the complaint, with a frown. He said nothing for a while. He was more than a little bewildered by the intrusive language.

"All right," said the middle-aged fireman. "All right. I won't let this ridiculous letter sour my daughter's birthday tomorrow." He tried to control his temper and started to write a spur-of-the-moment reply:

My dear colleagues,

I confess that I went to your city and put the conflagration out last Wednesday morning. I had no right whatsoever to be critical of the way you feedback. Please forgive me.

The scene happened to be our fire brigade senior manager's home. The flames were out of control, and his home could have burned to the ground within minutes. I happened to know this manager for many years, and he requested me to make a quick assessment. I find it not true that I "didn't acknowledge any of your team member (as what was written in the feedback)." In fact, I was so grateful that your fire service superintendent handed me the hose and gave me a key to the equipments. I did return them after finishing my job.

Now I ask your forgiveness because I violated your policy. I'm very sorry that I had to let the poor gentleman "jump the queue (to quote your words)." I thought an early intervention was necessary to help my fire victim - before everything turns into ashes. I don't want to whitewash my stupid mistake, but the fact is that the house was saved.

When I read the sentence in your feedback letter that I "create more chaos and endanger all the other people waiting to be seen," I would beg to differ. I am in no position to make your department more chaotic than the current situation - and how can I?

You might call this type of wording an Attorney's Apology: "I confess to nothing, but if I'm guilty of anything, forgive me and please be lenient on me."

But my mother has always taught me that an apology requires our pride step aside, our egos lie low, and our prejudice die down. I will make this short and sincere...

"I'm sorry. Will you forgive me?"

Gorilla

Jasmine is going to be three years old tomorrow.

Three years isn't such a long time in the equation of life, but it was long enough for me to see every amazing new page in her life. What makes these three years special is the way my ever-more-independent daughter changes and grows. Gone is the packing of napkins every time we go out, so too is the bib. Before you know it, she walks. Before you know it, she talks. Before you know it, she is learning to use dental floss.

It's amazing that Jasmine loves storybooks, too. In fact, we bought so many books that she can reach with minimal effort. Some are silly like Gruffalo and Room on the Broom, others unfailingly interesting and humorous (yes, I mean Good Night, Gorilla).

Which brings me to a Sunday afternoon at the countryside. When we were looking for the helmet crabs, Jasmine tiptoed behind her mum's back, looking amused. I didn't know what's going on, except a glimpse of Jasmine who grabbed something from the pocket of her mum's trousers. I saw nothing and yet knew that Jasmine was somehow, by some miracle, really carrying something important. "Shhhhhhh.... this is funny," said her silly look.

"Honey," I said, "what'd you just take?"

"Keys," my daughter whispered. She held out her right hand as if opening a gate with an invisible key. "Out comes the elephant."

I got my intuition back when I made space for it, when I almost "heard" the clattering of keys in Jasmine's hand. Wow! She was pretending to be the Gorilla in the storybook. See, Gorilla tiptoed, followed by an elephant. Then a giraffe. And a hyena...

"And... armadillo!" We both laughed.

Christmas Party

With Christmas around the corner, I asked my mentor the other day why he has been volunteering to organise the department Christmas party for years. I was intrigued.

Actually, I shouldn't have been.

A story from BBC News today gave me the reason. That comes from an experiment conducted by a graduate student at Stanford University's School of Business. Volunteers were first requested to select an answer from a number of emotional responses to different hypothetical scenarios. Stories like "driving down the road, hitting a small animal" allowed an assessment of participants' "guilt proneness." The participants then completed group tasks in which they had an opportunity, but no real incentive, to take charge - somewhat like organising the Christmas party for the office. In this innovative experiment, the research team found that the higher one's level of guilt proneness, the more likely he or she was to step up as a leader in the activity. But the real surprise comes with their observation that the guilt-prone participants performed better than those who were extroverted (a trait often associated with leadership skill, mind you) but not prone to guilty feelings.

By further evaluating the performance feedback for people in real management positions, the team confirmed that those who were more prone to feelings of guilt were more often rated by their clients, colleagues, and former managers to be effective leaders.

Now I see. The willingness of my mentor to organise the Christmas party turns out to be the hallmark of effective leadership.

Cracker

If you find that you start a busy day that you lose your energy before the fag end of the day, that you don't ever bother remembering it, that you feel lost along the way, it may be that there is nothing at the end to cheer you up.

That end-of-the-day event probably feels like desserts, like ice-cream that we buy ourselves after hard work. You don't need a seven-course dessert. It may simply be a flickering moment of good bite at a candy. And then, you get your sense of humor back.

It was a busy Tuesday packed with activity and clinic sessions today. I was tired, but I kept awake long enough to finish the clinic and sign all the letters. Then I wrote to invite reviewers for a newly submitted journal manuscript. The rest - student assignments - I was forced to leave unchecked till tomorrow.

On my journey back home, I found that I had lost my voice. Still, one thing put me in the spirit to laugh. I went to the public library and borrowed Alison Jay's storybook The Nutcracker for my dear daughter. That is a great read for her after our recent watching of The Nutcracker ice skating performance. Jasmine was truly enchanted by the new book. Sitting on her mum's lap, Jamsine listened to the story, drew in her breath, as amazed as the story character Clara in the Sugar Plum Fairy. Before long, I forgot the day's hustle and bustle.

Priming

One day, a professor asked his student to his office. The student walked down a long corridor, came through the doorway, and met his professor.

"Look, this is a scrambled-sentence test. You can find a list of five-word sets in front of you. Your task is to resemble a grammatical four-word sentence as quickly as you can out of each set."

"Yes sir," the student's face lit up at the examination paper. "This is easy."

01  him was worried she always
02  from are Florida oranges temperature
03  ball the throw toss silently
04  shoes give replace old the
05  he observes occasionally people watches
06  be will sweat lonely they
07  sky the seamless gray is
08  should now withdraw forgetful we
09  us bingo sing play let
10  sunlight makes temperature wrinkle raisins

After a while the student finished the test like a piece of cake. He said goodbye to the professor, satisfied. It had never dawned on him that he walked out of the office and down the hall much more slowly than the way he walked in few minutes ago.

How so? That was hardly a difficult test, it seems, that could have made the student tired or frustrated to walk at such a slow pace. So it is perhaps surprising to find the same aftermath - slow pace - when the test was repeated in other students. Nobody could get the energy to walk fast. Ever. It was like falling down Alice's rabbit hole. One simply got weird and slow after the scrambled-sentence test.

Yes, it is possible, and the odds can be calculated quite precisely, according to the psychologist John Bargh, when you take a closer look at the words. See? Words like "worried," "old," "lonely," "gray," and "wrinkle" are scattered all around to prime our brains about being old. The exercise, as it turns out, is never meant to be a language test. The unconscious exposure to the priming words simply make one act old and become slow. Easy enough.

Healing

I went home last evening after giving a talk on open disclosure. That was a big term - open disclosure - close to naked; disclosure is in there, and appearing like a naked display. I wondered what my audience could have thought of my talk, what they could have said. But I was turning my attention to my daughter too soon to wonder long.

After dinner my wife told me a story at home.

Jasmine was crying at the top of her lungs all of a sudden in the afternoon. "What's the matter, Jasmine?" my maid asked, walking hurriedly out of the kitchen.

"I dooooon't want mom to come home," my daughter screamed, tears rolling down her cheeks. It was as unbelievable as the moon catching fire. My maid paused, looking at Jasmine's face and wondered. She then looked around the room, holding my daughter in her lap. Her eyes landed on one of our Charles Brown collection - with a broken neck. In a thoughtful voice my maid said: "I see. There we're. You must have worried to tell mom that you broke Charles Brown."

They talked over it for a while, and ended up putting Charles Brown under Jasmine's pillow. She herself would not have thought of this as casually metaphorical - almost like sweeping Charles Brown under the carpet. She didn't talk about Charles Brown when my wife went home. It just so happened that my wife saw Charles Brown, injured, at my daughter's bedroom. How did my wife talk to Jasmine? Hard to say, of course, but of all the things you might do at that moment, it's a pretty safe bet that we should help a little kid heal the wound.

This is the happiest story ending I've ever heard. It's about a mother and a daughter sitting together and putting glue to Charles Brown's broken neck. After the bedtime story, my wife asked Jasmine if she would tell mom when she breaks something again.

"Yes," said Jasmine affectionately, "and good night, mom."

Taboo

Rare is the family in which there aren't taboos hidden somewhere. I encountered two of them this week.

The Chung Yeung Festival falls on my daughter's kindergarten term break this year. We went to my father-in-law's grave - without bringing Jasmine with us. "How can I explain to her in very simple terms that her grandfather is somewhere else and won't come back?" I wondered. "And, what if Jasmine asks me when her grandpa is going to stop being dead so she can have picnic with him?"

Three days later, we brought Jasmine and her cousin to a playground. It was a sunny afternoon in autumn, the kind of weather that brings energy to people. "Should we ask our mother to join?" I asked my sister. I brought that up because we don't seen our mom that often. My sister didn't answer for a moment.

"Um." That word spoke volumes of disapproval.

It's never difficult to understand why we feel pressured to have our mom to join (and give unsolicited opinion). I know that it is no use to stop my mom complaining why her grandson hasn't been potty-trained like the girl across the street, why the bathroom habit of bringing a book in would make the process of toilet learning to go on forever, and countless worries for the umpteenth time. My mom thrives on worrying.

Oh no, why am I comparing the experience of death and meeting my mom here? Of course, that isn't and shouldn't be the case at all.

Fellowship

The president of the Royal College of Physicians of Edinburgh is visiting Hong Kong, and we are invited to attend the signing ceremony (after being accepted the fellowship status). I accepted the invitation with alacrity. With this feather in the cap, we feel we're reaching another milestone in our career. If you're a fan of titles - and who isn't? - you'll love the opportunity to have another string of alphabets at your name card.

At first I thought the ceremony would be awesome. Then, as the weeks pass, I begin to regret my reply to join the ceremony, envisioning missing another chance to read bedtime story to my daughter. What kid doesn't like bedtime story? Especially if the cartoon characters are amiable, the tone tranquil and the plot clever. There are good reasons for me to regret: I borrowed the classic picture book Good Night, Gorilla from the library two days ago. This bedtime book by Peggy Rathmann, I was told, is a great read you won't mind reading to your kids a million times. I still haven't had chance to show Jasmine how beautiful this book is.

Chances are, if you ask me, my daughter will be far more proud of a daddy who reads the funny story about gorilla, armadillo and zookeeper than a father who is a fellow from the Royal College.

Good Morning

This paragraph, written at McCafe after sending Jasmine to school this morning, gave me energy in the tens of thousands.

If it sounds comfy, I can attest that it is. I didn't go back to work after a week's holiday at Okinawa, and decided to take another half day off. Jasmine and I could then return the furry moose who had hitched a hike with us. When we were waiting for the morning class bell to ring, Jasmine took out the Okinawa seashells and gave them to her friends. And no sooner had the class begun than my daughter ran to tell her teacher the travel experience.

By the time she started her class, I went to take a sip of coffee, reading Vikram Seth's novel, deeply satisfied.

Okinawa

Jasmine was excited to learn the good news before our recent trip to Okinawa.

This is her fifth time out of town. And there seems to be no stopping us from bringing our kid around the world. The more mileage we go, the more I become confident of her growing up.

Not much hassle with packing diapers is one thing, negotiating with my daughter what to bring is a lot more easier. We planned to bring her own suitcase, and she could not wait to pack it with all her favorite books. But then we decided to scrap the idea at the last minute, worrying about the limited space in the rented car. She was let down, and strangely enough, let go after a while. With that, we gave her thumbs up.

Pleasant memory of this trip, of course, is not a matter of what we didn't bring; the highlight is what we brought with us this time. During a recent visit of my daughter's kindergarten, I read about a Norwegian moose doll that children can volunteer to babysit when travelling. Oh, this is great, I thought, beaming jovially when I showed Jasmine the moose. She giggled and promised to take good care of the moose. Indeed, the moose filled in lots of our photographs (to be shown to other classmates later). Jasmine taught the moose how to walk, showed the moose colourful tropical fish at the aquarium, and hugged it with love.

Without doubt, Jasmine was awed by the opportunity to travel with her school companion. No one would ever mistake this.

Parents

Most people choose to celebrate the birthday with fine dining. Well, that is fine but we decided to celebrate my birthday by having a day off to take my daughter to her school (and pick her up after class).

My chest swelled with pride, as would my daughter's, to know that we dedicate a birthday holiday to go with her to school. If we could calculate a birthday happiness index, it would be marching toward an all-time high yesterday. After another lovely afternoon with Jasmine at the beach, we then spent our evening at her kindergarten's parent teaching meeting.

It was late in the evening, and listening to her class teacher sounded more important than a birthday dinner. We stared at each class photograph and wondered how our kid gets used to the school. Normal, that's what. Parental anxiety is a fact of life, a behaviour that's virtually universal among the dads and mums - beginning for some as early as the first trimester of pregnancy. When it was our turn to talk to Jasmine's teacher, we asked if it's too difficult for our daughter to enjoy the English-speaking class.

"No, I see no reason why you should stop using your mother tongue at home," began her teacher. "After all, we will take care of her English and you can teach her Cantonese. Things might be a bit tough for her in the beginning. Don't worry, I know Jasmine has a lot to tell me, and she is talkative. Our assistant will translate her words in English (for her to learn how to say it) and let her realise that she's equally important to me even she doesn't speak in English."

We smiled. We were surprised to learn that her teacher can remember every bit of our daughter - her way of interacting with other kids, the colour Jasmine loves, her longest sentence in English in the class (about her story at the Disneyland).

"Look, if Jasmine loves our school (which she does), she is going to be fluent in English (which she is not - at least not yet) in a few months," her teacher added.

We then dutifully said thanks and goodbye to her teacher. We went home, pretty sure that the teacher is good to her and (we suppose) good for her.

Murphy

Over the years of medical practice after graduation, I recall an awful lot of good and bad memory, with stories interrrupted by medical errors aplenty, from wrong drugs to wrong patients. Many of these things, like leaving behind a gauze in patient's body, missing an important laboratory report, forgetting to consider the possibility of another serious illness, are the inevitable downside of having a (human) brain. And let's be clear: one definition of "human error" is "human nature."

One of the well-phrased laws is that "anything that can go wrong, will go wrong." It's a line that's been used ad nauseam by people who teach medical safety. Is it true, even a little bit, that doctors are never good at filling the gap between how things are and how we want them to be?

Murphy's Law is difficult to beat, whether we admit it or not. People might rightly scratch their heads and wonder why doctors can make careless mistakes. But trust me, I am no exception. Two weeks ago, I was sick and running a temperature. It was my view then, and still is, that I should not take sick leave without terribly good reasons. High temperature, I know, wears on the body, nipping away at the brain cells that keeps us awake and sane. Unsettling as it is, it's hard for me to resist the notion that I can pay extra attention to keep myself in the right mind, and not the other way round. I was sitting in front of the computer when I tried to copy my patient's name and identity number (to send out a special laboratory request for a blood test that is only available abroad). I looked dazed, my head spinning, and my eyes wide open but seeing nothing ahead of me. Wait. I told myself to be careful and not to copy the wrong patient's number. Who in his right mind would want to send out an expensive blood test and end up with a wrong patient's identity?

Good, fine, you think. Did I end up with the wrong number? Yes, I really did.

Cockroach

During a recent lunch meeting, my trainee met a startling cockroach in his lunchbox. He hadn't even noticed that his mouth was hanging open. He rushed out of the room as if he had stepped on the teeth of a rake or slammed his thumb with a hammer.

Uh-oh.

Which leads me to the theory of negativity dominance hypothesized by the pyschologist Paul Rozin, an expert on disgust. Just imagine a single cockroach in your most favorite dish such as a bowl of cherries. I can hear the screaming already, although I can't make out if the word is "Help" or "Hell". Now you see. A single cockroach really is enough to render a bowl of delicious cherries inedible. But what about the other way round? Consider a a dish of food that you dislike: a bowl of lima beans, cockroaches, or whatever. What could you touch to that food to make it desriable to eat - that is, any suggestion of anticockroach? Nope. As anyone in his right mind will tell you, a cherry will do nothing at all for a bowl of cockroaches.

That Russian adage said it best: "A spoonful of tar can spoil a barrrel of honey, but a spoonful of honey does nothing for a barrel of tar."

The point is not that it is never possible to make positive influence nor that there is no way to compensate. Rather, the point is simply that bad emotions, bad parents, and bad feedback have more impact than good ones.

Mobile

I was reading the Time magazine cover story Your Life Is Fully Mobile when my broadband service at home was upgraded to 30M yesterday.When it comes to the wireless mobile technology, Nancy Gibbs has commented that more people have access to mobile device than to a toilet or running water, and the average smart phone today has more computing power than Apollo II when it landed a man on the moon. She dares us to name one example of tool with which so many developed so close a relationship so quickly as we have with our phones. Two-thirds of us, myself included, take a mobile phone to bed with us.

Seriously, technology is a series of changes, some good, many bad.

Which makes me wonder: Just how much the intimate relationship with our gadgets improves the human relationships? Yes, I can now text my wife faster and better than two decades ago. The faster, the better. Everything, that is, except one: romance. When I started dating my wife at the dawn of the cell-phone era in the 1990s, we were calling one another on telephone landlines. For most of us, the memory of that long queue at the student hostel telephone kiosk has stayed for close to twenty years. Because waiting at the end of the queue can last forever in those days, every now and then I ended up running for one kilometre to meet my sweetheart instead.

"What," you might ask, "if you two are separate by far far apart, awfully longer than one kilometre? How can you possibly talk to each other without that mobile device?"

And really, there was no such mobile device (at least not available to me) when I went to Montreal for overseas training around ten years ago. Making a long distance call was one thing: we all know, each of us, that makes the world flat. Paying the phone call was another. So we wrote to each other. That's an added bonus. Believe me, there is a humanity to pen and paper that typing or taping with a stylus (or our thumbs) lack.

A letter with ink - to be exact: hundreds of letters over that one year - lasts much longer than the text messages on the smart phone screen.

Dogma

Most shutterbugs had heard, at one time or another, the unmistakable question concerning the number of pixels when people think about the choice of digital cameras. Every so often we consider high-pixel number to be sine qua non of high-quality camera. It isn't.

If you are to go looking for a place where people fall in love with magic figure - which is not magic at all, in fact - the field of medicine is a pretty good candidate. Overwhelmed by the work at hand and with neither the support, know-how, nor the time to step back for detailed history taking, doctors long for a magic figure from laboratory test to make decisions.

I would be remiss not to mention the coagulation test (the prothrombin time and activated partial thromboplastin time, in case you're in favor of big names) as the haemostatic oracle or passport for safe surgery. Not a day passes without some doctors postponing a procedure to wait for that laboratory result of coagulation test. Of course, we don't have a whiff of evidence to support that such battery of coagulation tests offer a good prediction of bleeding risk. Ahem. Perhaps what a normal coagulation test can serve is to make doctors "feel better," and nothing else.

Kindergarten

I have been looking forward to the first day of bringing my kid to the kindergarten.

Well, really - how could you not?

I decided to take a half day off. The sun was bright, the traffic heavy. My daughter, still every inch of her a toddler, was excited and brought with her the picture book "Let's Go to School." We heard the sparrows chirping as we ran up the hill to the bungalow campus. It was the natural and lively outdoor environment I like most about the school.

Surrounded by uneven paths on the slope, riddled with holes (and some mosquitoes, too), the school looks as if it has been designed to teach and prepare for Tarzan. A good news for Tarzan, after the recent typhoon storm, is the school and most trees were not blown down. A bad news is that the tyre swing at the campus was damaged beyond repair.

No surprise we miss the tyre swing badly.

Luck

Go ask a doctor how it goes after the on-call day, and odds are that the doctor will tell you how lucky or unlucky he has been.

Some of us take solace, after a stormy night, by calling ourselves unlucky. To us, a peaceful night means luck.

But be not beguiled.

Now that I've got senior enough to be on call once in a while, what I look forward to is the luck (sort of) to see more difficult cases and learn. I remember reading once that medicine is knowledge, judgment, experience, and luck. With that in mind, I called myself lucky (I still do) when my pager was bleeping all night during my recent call days.

Lest I be misunderstood: I do not want to suggest that a good doctor is one who prays for a busy on-call day. Nor do I think it always proper to work nonstop. Yet, when I think about my two recent on-call days, I see that I was really lucky to come across patients that I can learn from them: first, I learned to stick a long needle into the pericardial sac around a patient's heart, and next, I learned to place a balloon pump into the aorta of a failing heart.

And I owe it all to a bit of luck.

Peer review

Few words are more likely to make one think of impartial judgement and idealism than that big term peer review. A beacon of justice for scientific knowledge. Almost all manuscripts submitted to biomedical journals are now sent out to reviewers, selected by virtue of their knowledge about the manuscript's topic, before any decision on publication.

Reviewers are obliged to return the review within two weeks. The deadline is not difficult to meet, unless I forget the request. When I returned from Berlin, I thought I'd finished all the reviews and didn't pay attention until a reminder appeared in my e-mail box yesterday.

"Oh man, I thought I had submitted my evaluation. Did I?" I asked myself as I quickly searched my files. I didn't keep track of the evaluation scores and decision of each manuscript reviewed, but I saved the written paragraphs that summarize for the editors (the reasons for my recommendations for disposition of the manuscript) and for authors (as requested by most, if not all, journals). Imagine that you had submitted the review over one week ago and yet the reminder was sent to you because of computer system error. Would you be able to submit an evaluation identical to the first one?

I shrugged; probably I blushed. It's odd. When we write the paragraphs, we make use of slow, deliberative, and more logical mode of thinking (the System 2, as what the psychologist and Nobel-winning economist Daniel Kahneman calls it). By the time we enter the manuscript's rating with respect to the originality, scientific accuracy, interest to the readers of a specific journal, recommendation like rejection or acceptance with major revision, we're switching to System 1, a fast, automatic, intuitive, and emotional mode with little sense of voluntary control.

I tried my best to recollect how I entered the score. But my answer came out in stammers and meanders. The situation is that I typed the paragraph in the hotel and then brought my computer to a bus station (a free wifi hotspot) for final electronic submission. I could have missed the last step when the weather turned bad, with a sudden flurry of heavy rain. And if I'm candid, I do believe that I could have entered a lower score at that time, simply because of the rainy weather.

Recess

Remember the good old days – you know, at school? I didn't go back to school but went to Berlin this week. I was there attending a medical conference on transplantation. Going to medical conference has a lot in common with sitting in classroom. There is plenty to learn in a day when the conference starts every morning at seven sharp. I learnt everything from a minuscule virus to ethics.

Trouble is, I get sleepy sooner than any schooler. My eyes fixed on the projector screen, where all the letters morphed into the alphabet z. Shoulders sagged, eyelids fell, and all my internal circuit went into hibernating mode. If ever there is a sleepiness illness, it's synonymous with getting old.

Yes, it's true. If you're like me, fear not. I'm getting old – I know that – but without getting too stubborn. I learn new tricks. Here is how.

Skip class. While it might seem naughty to skip class, I did enjoy the freedom of go-as-you-like in medical conference. Throughout this week in Berlin, I took one-hour break every afternoon. Bring the camera and jump on a train. I wasn't disappointed. A 5-minute ride from the conference centre lies a picturesque French-style Baroque garden around a legendary palace. A brief walk brought my energy back. Soon, I found myself refreshed and young again at the conference centre.    

Berlin

Upon return from Japan, I caught another flight to attend a conference in Berlin. The fact that I could find my daughter's diaper in my baggage proves that I didn't prepare much for the trip. I didn’t even check the whereabouts of the conference centre until I arrived at the city.

It's late in the evening on a rainy Friday, and I went into a bookstore to find out more about this city. The first sentence from a travel guide book reads like this: If New York is the city that never sleeps, Berlin is the city that never stands still. It didn't take long for me to find out how this is so. Before I went on to the second sentence, the sun came out of the blue. Sure, the weather changes every minute in this city, I thought. Excited as a teenager on a first date, I grabbed my camera and was to leave the bookstore. The sad truth is that I found the very bottom of my shoe get loose at that very moment.

Ouch.

My shoe simply flip-flopped with each step, like a broken castanet. I got no choice but to buy all-purpose glue and tried to fix it. I told myself to forget about the shutterbug business and stood still for the glue to work.

And no prizes for guessing that the sun disappeared before my shoe could be fixed.

Just to make sure you understand what is meant by a city that never stands still, let me tell you my shoe could not be fixed. I bought a pair of new shoes, and the sun came out again.

Holiday

It can't be stressed enough: if you bring up a kid with the help from a domestic maid - usually the case when both parents are working - be prepared to take leave when your maid is on leave too. That's the case for me over these two weeks.

It's hard to think of a better excuse to take vacation. Uh-oh! Don't forget to tell the kid that the nanny will be away. We did this over and over, each time giving our two-year-old a chance to accept and prepare for the separation. It can make a kid feel frustrated and left out.

After a few rounds of struggles, my daughter has learned to live without her maid. Of course, there are many ways to let her relax. Put our sandals on and bring her to the beach, and pretty soon, she was soaking herself in the water like a mermaid. To make this splashing experience even more a real standout, we brought her to Japan and plunge in an onsen. The first incredible thing my daughter knows about onsen is the ultimate freedom of going naked.

Relax. That's what onsen are all about. Ditto for being the parents.

Poo

It's hard to say how long it takes me to stop saying no when my wife makes a suggestion. Like going to the dentist, much depends on how long problems have been ignored.

I know that I'm hard-wired to maintain the status quo and I'm very stubborn; really, if you ask my wife, impossible to change. But saying no to the wife is forbidden; this I know, this I have learned in my lifetime. I've been learning to replace the word "no" by sounds like "humph," "uh-huh," and "hmmmm." Not that easy. I dare you to name one example of Martian who had ever heard of these sounds before arriving on Venus.

That admitted, I must further confess the shame I feel when caught saying no to my wife's idea - and then proved wrong. Many a time the idea is not a serious one. Sure, it makes saying no to a not-that-serious idea even more stupid. The question is not whether I'm wrong. The big question is, What's the big deal about who's right and who's wrong? A couple of months ago, my wife was looking for picture books to buy for our daughter. A second after she showed me the book about human digestive system, I heard myself say skeptically, "Uh-oh!" I felt the word no coming out of my mouth, and just in the nick of time I caught myself, before I made another mistake.

Okay.... okay... my daughter really loves that gorgeously gross picture book showing how the food journey comes to an end.

Burger

It's every doctor's worst nightmare - your patient suffers from a surgery complication, clinging for life by the slimmest margins, irate family members stomping the feet and the lava flow of hot emotion rushing in. During our lunch meeting today, my mentor told the story in such detail that our adrenaline was swooshing through the bloodstream with him.

"There is a great deal of emotion to deal with under such situation," he taught us. "First priority here is not to state your stand. Acknowledge the family's emotion before you say anything. The secret - if there is one - is to acknowledge and narrate their feelings, and then, once they calm a bit, it's your turn to say what you want to say."

And this is exactly what I've learnt to communicate with an "uncivilized" toddler who happens to be in a fit of outburst.

Harvey Karp, author of The Happiest Toddler on the Block, calls this the Fast-Food Rule when he tells a story about a guy who was pulling up to the fast-food restaurant order window. "May I help you?" "Yup," the man replied, "A burger and fries, please."

And what should the waitress say back to that guy? One might think that the guy is too lazy to cook (and he is), and should have ordered two burgers because he looks hungry (that too). Anything wrong with that? Nothing, except we should not say it. The very first thing, really, is to repeat the order, "Okay, that's a burger and fries. Anything to drink?" The key point is to let the guy know we understand exactly what he wants.

The magic of the Fast-Food Rule is that it works wonder for my daughter. The quickest way to show Jasmine that I care, whenever she's upset, is to describe what I observe: "You look sad." Then before I know it - pronto - my lovely kid begins to soften.

Good advice, that.

Vacancy Chain

What are common to hermit crabs and humans? A bit unsettling to hear that question? Sure. Much as I find the question difficult to answer, you might be more eager to tell me the difference between a layman and a sociologist. Well, that's another reasonably interesting question.

I find the answer to both questions after my recent reading of Scientific American article about hermit crabs, by Ivan Chase.

Most of us know three facts about hermit crabs: they're crustaceans, we often meet them near shorelines, and they've got their own mobile seashell homes. In that article, the professor of sociology gives us details of the animal so precise - and so easy to relate to what we're sharing the same behaviour - that I realize what is meant by professor's gift. It was a summer morning, children's footsteps everywhere at low tide along the beach. We can picture an avid sea kayaker wading into a shallow tide pool on Long Island. He was fascinated by a small hermit crab running toward an empty snail shell he dropped into the water a few minutes ago. The curious sociologist wrote, "almost quicker than I could follow, the crab pulled itself out of its old refuge (smaller in size) and thrust its vulnerable abdomen into the (more spacious) snail shell I had dropped." Before he left the scene, another hermit crab discovered the first one's discarded "home" and, after a most intricate three-dimensional inspection, worked out that the new lodging measured bigger than its own. Without second thought, the second crab exchanged his lodging. What next? Read on: "About 10 minutes later a third crab found the second's old home and claimed its prize, abandoning a small shell with a large hole." 

The curious sociologist doesn't stop at discovering the animal behaviour. He is eager to learn the beauty of a well-orchestrated "vacancy chain" - an organized method of exchanging a more desirable possession abandoned by another individual. By individual, he's referring to animals with relatively simple brains and nervous systems, say, hermit crabs, limpets, lobsters, fishes, octopuses and woodpeckers. 

How about humans? Good. Is there room for a broader application of the same vacancy chain strategy among ourselves? Yes indeed. Automobile industry, I was told, depends a lot on this vacancy chain. That explains why car dealers have been so eager to take the old vehicles of any new car buyers in trade (and sell those old cars to yet other buyers).

Prefrontal Cortex

"It's mine, it's mine!" was the first thing Jasmine blurted out on seeing another kid's grabbing her toy. What made her say so when the toys belong to neither of them?

The obvious answer: Jasmine has her own belief about the centre of the universe - and by now you should be able to guess who. It is Jasmine, hands down. The earth revolves around a kid rather than the sun.

That seemingly reference point, however, can change without my knowing it. She went to her favourite bookstore yesterday. Most kids would love that place. It was small enough to be comfortable, large enough that they can take a seat and play with building blocks, puzzles and read at leisure. At leisure, that is, except one: when another preschooler joins in. A boy came and took away my daughter's building blocks. But Jasmine didn't display even the ghost of a whine, quite the opposite really, because she went on and suggested, "Let's play together."

As the boy continued to grab every piece of building block, Jasmine relaxed, leaning back against her chair. I was expecting a tirade from that boy's father, but Jasmine said first, "Playing together is happier than playing on your own."

The boy didn't listen. In that sense, tension was building, and fast. Yes, at first blush, it seemed to foretell spine-tingling screams and shrieks, wild thrashing, and a fight ahead. No, nothing goes as smoothly as one would hope.

Jasmine made a sigh, and told her mother, "Okay, mom, let's move to read."

Wrinkles

"Elephants have wrinkles, wrinkles, wrinkles. Elephants have wrinkles, wrinkles everywhere." My two-year-old came back from her dancing class, uplifted and energetic.

"On their toes. On their toes." I joined in the dance and raised my foot to touch my toes. If I am candid, I do believe that the original exercise should be keeping my knees locked and banding over to touch the toes - of which I no longer believe I, 41, can manage.

Of all the movement songs of children, "Elephants Have Wrinkles" has surely given us the pleasure of dance with words.

"What is meant by wrinkles?" my daughter asked.

Good question - to which I'm afraid not being prepared to be asked. Much to my chagrin, I found it difficult to explain the word to my two-year-old. I wasn't sure what to say. Picture me at home sitting with my daughter, wrinkling my brow in concentration to find a good answer.

Two final words occurred to me. Crow's feet.

How adroitly the words crow's feet sum up the concept. But hey! There are many more in English. Think about goose eggs, hives, bear hug, goose bumps and ponytail.

Lost in Translation

Some time ago I read an article on communication. It was, in the dry prose of a medical journal article, a reminder for doctors to spend time on talking. The lecture about communication can drone on and fill the pages of the academic journals. It isn't easy to follow.

Listen to our real stories, though, and you'll tell what we don't know the patients don't know.

A friend of mine recently shared a story on the Facebook. She is working in the medical outpatient clinic, where elderly patients aren't quite sure where they should go, what the doctors say, or what they should ask the doctors. Near the end of a busy clinic day, the doctor glanced at his wristwatch, the steady sweep of the second hand ticking off precious time. For one thing, the doctor was hungry. For another, he thought he had covered everything except the instruction for his patient to return for blood test.

The doctor wrote on the blood test sheet: "One week before the clinic appointment fasting blood test."

The patient picked up the paper, and was startled. This was obviously an instruction she'd not been expecting. She stared at the doctor. "But, doc, how can that be the case? I would have died of starvation if I follow your instruction - to fast for one week before my scheduled blood test."

Mea culpa

This is one story I've never told before. Not to anyone. Not to my peers. Not to my juniors. Not even to my wife.

Even now, I'll admit, the story makes me squirm.

It was a hot summer afternoon over ten years ago, shortly after I had got my membership title in medicine. There were membership examination study aids stacked waist-high in my office, all shrink-wrapped against the gathering dust and pale in comparison with my overflowing ego. I was running around the hospital to see my patients. By noon, several dozen new patients had been admitted to our department. As the medical beds within our department were being used up, patients had to be shuffled. That means patients from one overcrowded department would be moved to another department. That's never a good idea. And there's more to patient safety than inconvenience. I didn't even know that one of my patients had been relocated until late evening.

I was intrigued, and furious. "Who in the right mind would want to know how a doctor can handle patients staying in one building, and at the same time, those far far way?" I wished to change the situation and decided to make some written complaint out of my hectic schedules. I wrote a complaint letter on behalf of my patient and coaxed her to sign it (to be submitted to the hospital). After I finished the letter, I thought I'd done a wonderful job, even more satisfying than publishing a paper in a prestigious medical journal.

At the end of the day, I was caught red-handed and received a serious reprimand. I can still remember the stern face of my boss, and the lesson sticks like Velcro to my memory. Now, decade later, I've learned to tap into my social brain, preparing myself better for the ups and downs. Much as we teach our kids to reframe an upsetting moment (like the old saying "No use crying over spilt milk"), I make use of similar wisdom to deescalate emotional storms.

In the Dark

It's the human nature everywhere, including the medical profession, to learn the know-how by habits.

We practice medicine by copying what our predecessors do, though we're unwilling to admit this. After a while, it's second nature and we keep our routine doggedly. And if a bold student comes to ask why, there comes the dismissive reply, "Simply because we've been told to do so."

This morning, I went to see a patient whose large blood vessel developed a tear and began to rip. There is a good chance that my patient can die if the blood pressure are left unchecked. High blood pressure can weaken the wall of that broken vessel, further tearing the outer wall. His team doctor had started him a drug labetalol intravenously. I thought I'd do the same, too. But I was stupefied to see a "naked" tubing infusing the medication. By naked, I mean the tubing was not covered like how we wrap a candy.

"How come? We should have wrapped it to protect the drug from light," my resident shared with my view and shook his head. "We've been taught to do so since graduation from school."

We started to worry that naked tubing could have exposed the drug to excessive light, making it ineffective. It would appear that I should pull evidence to show the nurses why they should cover the tubing. What stunned me even more was that I could not find any evidence to prove them wrong. Not a bit of it. And then the pharmacist confirmed that it's perfectly fine not to keep the drug in the dark.

I gave a vague smile but could think of nothing to say. If I am candid, I'm among the ones kept in the dark.

Heart

I was asked to examine the first-year medical students yesterday.

The way simulation driving test gives novices an idea what driving is like, medical school examination teaches students how to behave like a real doctor. I handed out a detailed description that would begin something like this: "A 45-year-old man with the chief complaint of chest pain over several works came for clinic assessment. He worried about a heart attack. Please examine his heart and demonstrate to the examiner where you place the stethoscope to listen to his heart sounds." Heart sounds, by the way, are produced when blood is being pumped through different heart valves.

Unfazed and without losing a beat, the students meticulously showed me where they located the landmark to listen to the heart sounds. That said, I concede that, it isn't really what a real doctor like me usually do in flesh-and-blood patients. Rather, we make a cursory examination and back up with tests like x-rays and echocardiography. Unsettling as it is, it may be hard to resist the temptation to read the x-ray and ECG before listening to our patient's heart, and not the other way round. My daughter has been fascinated by the stethoscope and she often takes mine to listen to the heart sounds. Believe me, she spent more time with the stethoscope on the chest than I did on my patient.

Which brings me, somewhat uncomfortably, to my recent encounter with an elderly woman in the hospital. Her blood test showed that the body didn't do well to seal off any bleeding in case a blood vessel is injured. I dutifully followed the logic I learned in the medical school, and came up with the conclusion that the patient's liver was not doing well. I turned to the page of liver function test to find out the abnormal figure, which indeed it was. "Her liver is enlarged," I told my resident after pressing on that patient's tummy. We went on to see the next patient after making sure an ultrasound scan of the liver has been requested.

After the weekend, my resident told me the ultrasound scan result. The patient's liver appeared large because it was engorged with blood. Another doctor listened to the elderly woman's heart and then a cardiologist asked for an echocardiography. It turned out that the patient's heart was failing because the blood could not be pumped out through the left ventricle into the aorta, thus filling up the liver. Neat answer - to which I'm afraid I didn't think of. I kicked myself, but it's too late. My shoulder sagged, face fell, and heart sank. It would have made a heck of a difference if I had listened to the patient's heart - and it only takes a few minutes. 

First

Picture a twenty-month-old baby sitting on a potty for the first time. There's a good chance that you can't hear the sound of poo-poo going into the toilet bowl. You don't need me to tell you that the laughter and victory cheering ("Hurray!") from the parents are the loudest at that very moment.

Seeing a baby grow has been a fountain of joy for our family. The baby's first smile. The first word of "mama." Her first step. The first sentence "It's wet because it rains." Most parents would rate these key milestones even higher than that of Neil Armstrong's moon landing. We will never forget them. Ever.

For every first moment, I'd been reminded, there is another moment when it ends. We tend to remember the beginning and then forget the end. You will remember when the first tooth appeared, but won't be able to tell when the baby stops biting her toys. You remember the first "Why" and never realise when the kid stops the "why's" (and, of course, the answer should be the beginning of "Why not?").

Tinkers

Shortly after the family trip to Taiwan, I packed my suitcase and headed for an investigator meeting in Seoul. No one will mistake a business trip with a family journey. I didn't, at least not knowingly.

Before boarding the flight to Taiwan one week ago, I came across Paul Harding's novel, Tinkers, at the airport bookshop. I thought of buying it but decided not to. I made a reservation from our public library system, now that it can be done electronically by pressing few buttons.

And then I received a notification the book was ready for pick-up today, just before leaving for Seoul. It turns out that this Pulitzer Prize winner made a good read. In Tinkers, an old man lies dying from cancer and kidney failure over the course of eight days. This dying man, a repairer of clock, is drifting back in time to his recollections, the opposite of winding a clock. Like free radicals, his story unwinds in a chaotic manner, but with a passionate theme.

And as if that's not enough to convince me that the gears and cogs of experiences are intertwined, I watched the movie Hugo on the aeroplane. That's another story of tinker who takes care of the clocks.

Travel

You might have been led to believe that holiday trip comes to an end after the arrival of baby. I don't. It's always a comfort to have the same view shared by others. That is the reason I purchased the book Travel With Children from the Lonely Planet shortly after my first trip with Jasmine.

As parents, we're no longer footloose travellers off the beaten track with itchy feet. This isn't to say we have less lovely memories for the family trips. We spent another brilliant week in Taiwan, where I wrote this blog together with my wife painting next to the lake - before my daughter woke up.

Like magic, travelling with kids is highly unpredictable and yet fun. Each morning we ventured out after packing the baby wipes, snacks and loads of plan (okay, and most of them not fulfilled at the end of the day).

Our idea to travel with kid is not to have structure; our sweetheart will suggest her own mileage as she goes along. Instead of checking out every detail of aboriginals at the cultural village yesterday, for instance, we ended up soaking in sunlight and chasing each other in a long stretch of pasture. My daughter's laughter looked like it's fun - and it is. If you come to think that those "must see" items on the travel guide sound irrelevant to a kid, that's because it is.

Ginkgo

The very first time I paid attention to the yellow triangular leaves of ginkgo tree was when I visited Hiroshima more than four years ago. After taking a stroll around the city, I saw quite a number of ginkgo trees. It is called Ginkgo biloba, "biloba" meaning "two lobes", which indeed its leaf is.

I learned more about Ginkgo after my recent reading of Survivors, written by the paleontologist Richard Fortey. This tree appears to have survived for a long time, even longer than the dinosaurs. The more I read about it and the more I thought of the ginkgo tree, the more impressed I got with it.

Living fossil of Ginkgo biloba has been found to survive the blast of the atomic bomb dropped on Hiroshima at the end of the Second World War, even though it was only 1.1 kilometres from the epicentre of the explosion. Ginkgo trees simply regenerated from scarred trunks one year after the total destruction. No question, it is a survivor.

For those of you who have seen the fan-shaped ginkgo leaves, you'll find veins radiating into them from their petioles. That means they are easily recognised in the fossil state, and fossils tell us that the ginkgo must have survived for 280 million years. And then you will reckon that Ginkgo biloba must have survived several mass extinctions. Atomic bombs, as Fortey says, is probably small potatoes in comparison.

Wild

A coda to this weekend's true delight is an outing with my daughter at the countryside, spending time under the tree and savouring its glamour and allure.

The lively walk was sprinkled with surprises. We met butterflies. We bumped into bird nest. We touched the ferns. It's hard to imagine a more funny way to learn the beauty of nature than playing with achenes attached to pappus of fine hair, watching them fly in the wind.

Which brings me to the scene with the glee of Jasmine pretending to eat the leaves of Ginkgo biloba before. She was one. It was another sunny afternoon, I remember, colder in temperature but warm with my kid's laughter. Jasmine resisted the temptation to laugh, when her mother's eyes bug out like a cartoon character's ("Wait wait, can we eat this leaf?"). You may call this acting silly. We think this is my baby's brand of humour.

In fact, there shouldn't be a time too early for children to have humour, and neither is there any age too late to play.

Natural

Heard about René Redzepi? Not many do - even though, as the top chef running a restaurant voted the best in the world.

Redzepi hates artificial products. The Danish chef has never indulged in technological wizardry of molecular gastronomy; his restaurant served only foods produced within his region. To go with his philosophy of serving clients to taste the soil, Redzepi digs deeper into his immediate surroundings and comes up with dishes like a flowerpot stuffed with carrots and radishes.

To which a natural response might be "Ingenious" or "Genius." After reading the Time magazine profile article about this genius chef, the highlight of my weekend happened to be a literal experience of tasting the soil. It's an outdoor funfair without machines but replete with games made out of natural resources. My daughter was invited to play with hay, paint on leaves, and have fun with toys like pine cones or twigs. The more time we spent with the games, the more I started to wonder if the Toy"R"Us should be closed down. If Redzepi's restaurant is the Michelin-starred place to taste the soil, this funfair becomes the best one to feel the buzz of the nature.

Penguin

I have long been an admirer of the behavioural ecologist. Animal behaviour, as most people know, is important but not easy to study.

I couldn't quote a better example than the recent white-flippered penguin story from the Science magazine. Those noisy penguins often squabble over their colonial territory, fighting with each other mano a mano. When it comes to fighting, the scientists were not particularly interested in whether it's a fist fight (of course, penguins can't) or flipper bash. Rather, the researchers paid attention to the triumph displays after the penguin's beating an opponent. The victory calls were recorded using a microphone and played back to bystander penguins. Each of the bystander penguins - there were 43 in all - were monitored when they listened to winner's victory call.

Monitoring bystander penguins' response is reputed to be difficult and unreliable - and the researchers had found it so - but it was solved by a trick: they temporarily swapped out the penguin eggs with an infrared egg. The fake eggs were used to count the brooding penguins' heart rate, as a barometer of stress levels.

As things turned out, male penguins were more stressed in the apparent presence of of a winner's vocal signature, and they were more likely to challenge an approaching loser by calling. The penguins' triumph display to make their victory known and build a "reputation" within the colony, of course, is not new, and certainly not unique to them. My guess is that birds do it, reptiles do it, mammals of all kinds do it. In fact, I myself made similar "victory dance" not long ago, when my colleague was proven wrong after arguing with me the diagnosis of a sick patient.

Goldilocks

I've moved house for the umpteenth time. But this is the first time to move with a two-year-old baby.

Like other parents, we're inundated with myriad advice from everyone we know (and many people we don't know) on do's and don'ts, such as "don't pack the baby in a box." Ugh.

Like the three bears who venture in the story of "Goldilocks", we could never make prediction about what lies down the road. Will Jasmine get upset when we pack her purple dinosaur and fill the living room with boxes? What if she asks to go back home after moving into our new home? Will she love the new cot?

I knew she'd be excited, but I was afraid she'd be a little overwhelmed by the new changes, too. We unloaded the boxes in the new place, played with her, and waited. No, instead of whining, Jasmine simply loves her new castle. And honestly, I'm grateful for this. Seeing her makes me realize, I needn't have worried one jot about this particularly lovely girl.

Did I lose any box or my mind during the move? Not really, except my belt. The busiest moment for me was when I kept holding my sagging pants running after my daughter.

Move

Count me a skeptic when it comes to moving house - and my skepticism is not ill-informed. I've moved more times than I have fingers.

Moving around, from the medical intern's hostel to any unoccupied room inside the hospital, is one of those skills you can never get better than me. Well, that was my nomadic way of living, if not necessarily my preferred one, and it turned out to be the cheapest way to stay near the hospital in my early years of work. I simply toted a bag with red, white and blue stripes. It's the size of a suitcase, zipped up without lock, shiny with repeated force of friction, blooming with self-sufficiency.

I settled down, finally, when I bought my home fourteen years ago. As the days went on, one bag with red, white and blue stripes could never be enough for me. I know I can buy more books when I got a book shelf at home. Um, buying books is like potato chips. You can't stop at just one. Obviously I can't move house at the snap of a finger after all these years. I metamorphose into a centipede who, when asked which foot it moved first, froze.

The Help

In case you're wondering whether Kathyrn Stockett's novel The Help is as good as To Kill a Mockingbird, here is the answer: No. It's better.

Both stories talk about black African-American maid or housekeeper. Aibileen and Calpurnia were black, and I mention this for a reason. My domestic maid is coloured, as well. I love The Help more as the black maid in this novel, Aibileen, was helping to raise a little girl and that hits a strong chord with me. When I read the chapter in which Aibileen taught the preschooler to potty, I can't stop thinking about my daughter.

It's either unsettling or ironic - or a bit of both - that Aibileen was only allowed to visit her coloured bathroom made for the blacks. She ended up bringing the baby girl out to that weired makeshift "bathroom" with no proper walls but plyboards hammered together. This, of course, is how the girl learned to go in the potty. But anyone with even a cursory knowledge of American history - to be exact, in 1962 for Aibileen - will realize that the white baby's mother is going to throw a fit once she finds out her daughter go to the coloured bathroom. "This is dirty out here, Mae Mobley. You'll catch diseases! No no no!"

Yes, at first blush, it seems like a ridiculous act of racism, but when we think about it some more, it's happening somewhat similarly nowadays. I knew people who set up house rules banning the domestic maid from kissing the toddlers, even if the maid is supposed to love the children.

On Call

It's a Friday in hospital full of activity for me. The first thing I did in the morning was to make sure my fountain pen brims with ink, and my cup with coffee.

On your mark, get set, go.

Within minutes, my beeper was on full blast, and my footprints were all over the hospital.

This is a hospital, and there's no reason why we don't talk about death. Soon after my morning clinic, I joined a pre-inquest meeting for a coroner's case. Before long I had to rush to another hospital building where a patient had a cardiac arrest. By the time I finished the meeting, there were plenty of patient consultations for me to take care of. I didn't take lunch and tried to finish seeing them, lest they grew in number. When the debt grows, believe me, it grows like compound interest.

Soon I found out one of the neurosurgery patients had been seen by my colleague few days ago. I quickly turned to that page, and told the intern knowingly: "This, you should find my colleague to continue seeing your patient."

Not that passing the buck is an honourable thing to do. But everyone of us will probably do this once in a while. When I settled most of my jobs, an inner voice nudged me to get back to the neurosurgery patient. He wasn't seen by my colleague yet. That didn't come as a surprise. What surprised me is that the nurse in the neurosurgery unit came and handed me a fountain pen that I left behind in the morning. I was surprised, embarrassed, and brightened all at once.

I Know

Similar to comrades in the army, doctors within a team call each other for dinner even though we're busy.

It's fairly obvious that there isn't convenient time common to the doctors. "Alright, you go first, and I'll finish admitting my cases and join you guys in a minute."

As we all know, virtually nobody will turn up one minute after that remark. Even so, the phrase "in a minute" can mean anything like fifteen minutes or forever. The difference in sense of time is unbelievably easy to grasp. Doctors know each other well and recognize what that particular colleague usually means by one minute. We just know.

Any of us who has worked in an office with someone else for few months can usually tell when that person will be back if he says, "I'll be gone for a while." The interesting thing is that we don't have to be that explicit soon after we get along with each other.

Once we start getting used to the I-know-you-know-what-I-know manner, there is embarrassing story waiting to happen. This I know, too. There is another story I like to tell. Many years ago I was asking a nurse to help me getting a needle into the knee joint of my patient. I had to wear sterile gloves and cleanse my patient's skin with povidone iodine solution before puncturing the joint; these are the rules for doctors to prevent infection. "Could you please fetch me the soya sauce?" Lest I begin to confuse those of you who aren't working in the hospital, let me say that soya sauce is a byword to describe the brown povidone iodine solution. The nurse disappeared. I waited. I mused. "What, for heaven's sake, keeps my nurse from getting back to me?"

And no prizes for guessing that I found my nurse busy scratching her head to find a bottle of soya sauce in the pantry.

Grieve

I happened to open an old e-mail when I tried to find the address of an acquaintance of mine. I read on.

It's a story of my laptop computer being stolen during my overseas training in Montreal. This is a hard story to swallow, and I skipped meals for two days, as what people do after having a heart attack. Two days isn't a long time, but it was long enough to see me rewrite a manuscript (over four thousand words without a backup copy), to lose my wit, to leave a vacuum where I tried to fill with buying a book When Men Grieve.

It came as no surprise, after nine years, to see that I forgot most of the details. Memory is not, as many of us think, an accurate transcription of past events. Rather it is a story we tell ourselves about the past, inundated with lessons that we learn, or lessons we wish we should have learnt. To that matter, what am I supposed to remember? I found a quote in my e-mail, "Clenching the sands of life too tightly only causes more of it to slip through our fingers."

Thoughtful remark, I would say.

Kodak

How many people would be surprised to hear that Eastman Kodak filed for bankruptcy after struggling to adapt to an increasing digital world? I'd bet it isn't a lot. Since the digital photography technology has improved in leaps and bounds, I never dream about buying the traditional films (who does?).

It's obvious now that we are getting used to digital camera. And for good reason. We are accustomed to the beauty of digital photography. Take film speeds; once fixed for each roll of camera film, sensitivity of the digital imaging system can now be changed with just a click on the button. Or the secret trick to load the 36-exposure film cleverly to give 37 exposures in the not-so-distant past; now, we can press the shutter as often as we like.

We started seeing the new experience of taking digital photos, but I wonder how on earth one could ever imagine the change before digital camera was invented. At a time when digital photography may seem straightforward, I've come to the conclusion that it's always clearer to look back at the rear-view mirror than look ahead of the windshield.

Transmogrified

Everyone wore business attire (suit with neck tie for male colleagues, tailored trousers or skirt for females) when the team took photo with our hospital chief executive this Friday - it's just that a handful of us were wearing shirt and white coat. I meekly hid in the back when I found that my white coat didn't blend in with all those dark business suits.

It's not the first time that I feel that the dressing code means an entry ticket to a certain position. I still remember vividly my student days, when I started the pilgrimage to the medical ward wearing the white coat, with stethoscope hanging round the neck, to justify my presence. I tried to look as though I could behave as a doctor, talk in a professional parlance - or at least to blend in a bit more.

Now, in a matter of years, I am wearing white coat not to justify myself being a doctor, but to keep myself from becoming an administrator. I wear the white coat to keep me from the exit.

Atishoo

There are few experiences as common as that minor ailment known as common cold, where you sit on a train with people staring at you like an extraterrestrial creature, abashed with water running down your nose. And at the same time, you're running out of tissue paper.

Common cold is going to happen to everyone of us. You may feel a little as if having a cold is the sine qua non of having a winter. But, you might ask, why the heck do we sneeze when we catch a cold? What purpose does a sneeze serve, apart from embarrassing us on the train? The best perspective to take, as pointed out by Richard Dawkins, would be from the virus's point of view. From the standpoint of the virus (or more precisely, the standpoint of the genes that create the virus), I was told, it has evolved to manipulate the human respiratory system to expel it into the air, which in turn makes it more likely to infect more people. This makes sense.

Think of an even better-adapted cold virus that infects its host's nervous system and compels the host to kiss other people on the mouth.

If you find that idea weird, well, think about the rabies virus.