Campers

Sure, many of you flew out of town to celebrate the Christmas. We didn't.

Last night, we slept in a waterproof tent at a country park campsite. That's our holiday idea. Oh, and I should mention that our idea of wild camping started with two families, and ended up with the third family joining us impromptu. With that, the fun more than triples.

Call me a fox who doesn't need sour grapes, or just plain jealous, but I do think that the magic of wild camping can bring new angles of holiday option.

If you haven't camped as a family before, let me tell you our tricks.

Before you go, it makes sense to buy or borrow essential camping equipment. Sleeping bag is a must, and I learned this lesson twenty years ago when I was camping without sleeping bags with my classmates (one of whom being my wife now). We did not faint as the temperature dropped after nightfall, because we didn't have time to. We were busy shivering.

Next, prepare for the bedtime rituals, as what your kids would have brought - although we'll never know for sure - when they sleep over at the best friend's place. Our examples included milk bottle, story books, stuffed panda and elephant.

What about food? Never think about haute cuisine. Your best bet in the outdoors (and, remember, in case of torrential rains) is easy-cook food. You won't have much problem with an outdoor gas stove, as a rule of thumb. On that note, here is one of our recipes last night. We cooked some rice, and brought with us seaweed. Kids could then create their own version of sushi.

The lesson? We don't have to bring an oven to roast a turkey, but we need ideas to burn off the kids' excessive energy.

Age

It should come as no surprise that the most common introductory sentences in doctors' commentary are about the age. These opening remarks appear every now and then in the morning round: "This is a 75-year-old man who came in with a fever."

That's the way medical students have been taught to describe a patient, I know.

The at-a-glance knowledge of a patient's age is so important (universal, I might add) that nobody dares to skip it. Well, yes and no. Yes, that number on the top right corner of patient's case note might give you an inkling how fit the patient is, but never emphasize too much on the chronological age. I'm more interested in my patient's biological age, and I've taught my students so.

Biological age, as it happens, is imprecise and less scientific. To many, this kind of guesswork seems like counting the grey hair. In the hands of experts, like yourself, it is a window into your real age. Instead of magical formula, it refers to "how old do you feel you are?"

Time for a quick quiz: How old do you feel you are?

A simple question, but a meaningful one. That's what I just learned from a research publication of the English Longitudinal Study of Ageing. Researchers studied some 6500 adults aged 52 years and older, asking the exact question I just mentioned. Some of them perceived their age close to their actual age; some felt more than one year older than their chronological age. More than half (me included if I were recruited), in fact, rated their age at least 3 years younger than their actual age.

Take one more close look at the mortality rate after 8 years of follow-up, and you'll see the pattern. Alas, after adjusting for the baseline health, physical disability, and health behavior such as smoking and alcohol use, those who felt younger live longer than those who felt their actual age or older. It's not hard to explain the finding if the terminal ill patients rated themselves older. But the same conclusion was shown after excluding death within 12 months of baseline question. In short, feeling young gives you a phenomenal edge over longevity. The upshot is that we now better understand the merit of feeling young - a sense of mastery.

Although trite, the old saying still is true. "It's not how old you are. It's how you are old."

Five

Jasmine turned five yesterday.

How do you know when your kid is five? That's the question I put up in the Facebook on my daughter's birthday.

What's so eerie about this question is that I don't quite know how to answer it.

Many parents have trouble with telling how five-year-olds should be different from those below five - some kids, too. I have no problem with the grey zone. What's wrong, I believe, is to prescribe the milestones and be obsessed with the yardstick.

What could be luckier for a five-year-old than to make the strides at one's own pace? I went to my daughter's school on her birthday, and found all those different traits. Some kids are mastering the monkey bar skills at a level that is supposed to be attained by gorillas. A few of them are even more skillful than great apes.

So what? We're not supposed to compare children to each other. And not even to our closest evolutionary cousin.

Clarity

"We don't always have to be clever, thank goodness. Often simply being clear is enough." So says the linguistics expert Christopher Johnson in his book Microstyle.

Apply this maxim to crafting the 140-character tweets. It works. Or, if you like, Facebook updates. And prayers too. As a doctor, I know that should also be the code for writing patient's discharge summary.

Neat summary leans heavily on the writer's efforts to distill the real important messages. Oh well, that won't happen if the computer allows us to copy and paste with ease. The first doctor jots down ten lines. The next copies them and adds some more. The third builds on that. The fourth joins. The discharge summary simply grows like the very hungry catepillar, eating one apple on Monday, two pears on Tuesday, three plums on Wednesday ...

Why bring up this overfed caterpillar and longer-and-longer discharge summary? Let's consider a case in more detail. One of our patients had a recent heart attack, and the cardiologist propped open the clogged coronary arteries with metal cage-like tubes, or stents. To keep these stents from blockade, our patient had to take two anti-clotting medications that stop platelets from sticking together. The price to pay for such "double anti-platelet" medications is a higher chance of bleeding.

Soon, the patient suffered from a stroke. A stroke is no joke; it means a clot is impeding the flow of the blood to your brain, wreaking havoc in your ability to talk or to walk. Doctors can't fix that, but can stop another blockade by adding a blood-thinner drug. In other words, that patient ended up taking an anti-clotting cocktail of three drugs. The bleeding risk of such "triple therapy", as you might imagine, is even higher.

Just don't expect the doctors to know (we don't) the best way to handle the tricky situation. The doctors discussed and decided to whittle down the time of taking triple therapy.

To cut the long story short, the resolution goes something like "drug A plus B plus C for 3 months, then A plus C for another 9 months, followed by B plus C forever." This is complicated, I know. The most complicated part of the story, alas, is how the discharge summary was written. That simply looked like a diary with one event after another, one medical decision after another - so much so that the summary ran for two whole pages. The last paragraph, under the heading of management plan, (where you expect to see the concluding remark) was "Home. Clinically stable and fit for discharge." Finding the crucial drug cocktail details within that two-page discharge summary is tough. Or at least, it's like finding a needle in a haystack.

I don't think I need to tell you the ending of the story: the patient ended up receiving the drugs in wrong way.

Teddy

Every so often we hear about a kid who can't separate from his or her teddy bear. The kid views the teddy bear the way an atom needs a proton - you simply become negative after losing one single proton.

A much overlooked teddy bear is another wet teddy bear that we all keep one at home. If you haven't heard of your wet teddy bear, you ought to read the picture book Cheer Up Your Teddy Bear, Emily Brown by Cressida Cowell and Neal Layton. I read this book with my daughter recently, and found out about the very wet teddy bear hidden in a toy-box. The toy-box belonged to a little girl named Emily Brown.

Emily Brown had been having great fun camping and then picked up this wet tearful teddy bear. What follows is classic contrast between Emily Brown and Tearful Teddybear. Emily first invited Tearful Teddybear to the Outback of Australia, and thought that lighting campfires and spotting kangaroos would cheer up Tearful Teddybear. They didn't. So Emily took Tearful Teddybear to the wild woods of Yellowstone Park, where they saw small bears and large bears and black bears and grizzly bears.

"But there is no teddy bears," wept the Tearful Teddybear.

Emily Brown tried many ways, but each time Tearful Teddybear repeated, "Po-o-o-o-o-o-or ME ... po-o-o-o-o-oor ME ... Poor little sad little wet little ME ... I'm a Lonely Only Bear and I'm feeling very blue, I've got no teddy friends and there's nothing here to do ..."

Emily Brown talked over and over again about the magic power of overcoming the weather and gloomy thoughts: that in the hands (or heads) of cheerful boy and girl, the drippy, drizzly, wet weekend will never be too wet to enjoy life. If you're a believer that the story should finish with the sun coming out, think again. What impresses me most in this book is how Emily beats the weather, and be happy. The moral here is simple: No one can make sew our mouths upside down without our consent.

Language

When it comes to the how of English language, there is a genuine thrill of discovering and decoding kids' lingua franca.

Before my daughter entered kindergarten, she coined words like "mouses." With time, she made fewer grammatical mistakes and observed new rules from her teachers. One of the classic clues that she was making (some) progress comes from her question: "Daddy, who is the beautifulest princess?"

Remember, my daughter goes to international school, and has been exposed to a rich verbal environment full of native English-speaking teachers. Many a time her spoken English is better than me. Much better. In time, my little one learns English faster than I can imagine.

Just a few days ago the two of us watched a drama adapted from the book Stick Man by Julia Donaldson and Axel Scheffler. That's one of her favorite books. We love to replay the story as if on stage, "I am not a stick. I'm a Stickman, can't you see?"

"Oh, well," my daughter added, "you're Miss Stick Man, daddy."

"Excuse me. Why do you call me Miss Stick Man?"

"Hey, 'cause you're silly and make lots of mistakes. You're Mistake Man."

Buddies

For most parents, the choice of travel destination matters a lot.

It is not really that important. The real question is find the right playmates.

My daughter is one of the fortunate girls who has good friend's family whose company we enjoy. We traveled to Taiwan this week, and went with the family of Jasmine's best friend met in kindergarten. That's the best part of our trip.

Affectionately called the twins, the two girls look alike, smile alike, play alike, and talk alike. Almost the same as the Latina girl Dora and her companion Boots. When we announced that we're traveling together, my daughter's "wow" showed me that it's much more important to load the "luggage" with the close friend than packing anything else.

A huge difference.

And a guarantee to do away with the spell of "Are we there yet?"

Sandwich

To watch Salma and Lily, one from Jordan and another from the United States, play at school is to witness children's friendship in action.

These two girls appear in the fascinating story book The Sandwich Swap. (There's even a YouTube version with the same title of the book.) They're close to each other like a pair of gloves. Or at least sort of. They spent a lot of time together at school, played on the swings together, drew pictures together, jumped ropes together, ate their lunches together. In many ways, they are pretty alike, except the color of hair: Salma's is black and Lily's blonde.

Nobody could have predicted the day when Salma and Lily shouted at each other.

Why did they shout?

The weird sandwich.

This is their cultural conflict - what to think of the foreign (Middle East) hummus and pita, and what to keep for herself (peanut butter and jelly sandwich). Treading that line, keeping one's culture in mind, and accepting other's cookery, is what we call tolerance. And it isn't a trait we're born with. Lily didn't have the heart (or the stomach) to accept her friend's hummus sandwich.

"Your sandwich looks kind of yucky,"

It could have been Lily's slip of the tongue, but seemed to be bad enough to set up a tsunami of dirty words. Ewwww, yuck, gross, garlic breath, bad smell, weird, you name it - the surefire ways to start World War III. At the height of the War, the two girls made rude insults that had nothing to do with peanut butter or hummus. They just yelled. In effect, it insults, it intrudes, it intimidates. The insults can hurt, and are shockingly mean.

Although I was unaware of it when I borrowed this book from the public library, my daughter had just made the same mistake as Lily. I then told her the story of curse words that hurt the best friend.

She promised she would not do it again, and I tried not to think about the last time I promised this myself.

Blessed

Caring for a sick child, and what's the first thing you want to do?

Jasmine started to throw up for quite a few times last night. My wife had a quick examination of her tummy and didn't find anything serious. Or, to be strictly accurate, not that serious for a doctor. I dare say there won't be something called minor ailment for all parents. Ah well, still, there isn't much we can do except waiting for the virus to go away.

She looked less tired today but didn't want to eat. On our way to the music class later this afternoon, my daughter and I were rapt in conversation when I read her a story. She interrupted me, toward the end of our train ride. "Daddy," she said. "I have to vomit."

Without thinking, I handed my daughter a bag.

She paused, then looked at me. "Maybe I can hold for a while ... and try not throwing up."

I glanced at my daughter, and then at the bag I was holding. Oh, I'd given her a duffel bag with her name on it. That would have ruined the nice bag. Which is what my daughter didn't want to do.

I looked around and found another plastic bag for her. She was by now feeling better. I put the plastic bag away, sat closer to her, leaned over and hugged her.

There was a momentary silence. "Dad," my daughter looked at me and whispered, "I'm afraid I could give you my germs."

Then I realised my daughter has grown up a lot.

Cops

Over the course of seeing patients for many years, I've referred some of them to have their bodies cut open for further examination even after their cardiac monitor tracing went completely flat. It's a detailed process of cutting and digging into each and every organ of a dead body. Not all patients have to undergo such critical examination. The medical term for this process, autopsy, is the last thing we want to hear after losing a beloved family member.

It seems an odd thing - it strikes me now as it did then - that I read about a black teenager's autopsies in The New York Times two months ago. Autopsies, not autopsy. I mean it. The 18-year-old Michael Brown, as it turned out, had gone through no fewer than three autopsies. The story of three autopsies for a dead body is unsettling.

Wait. It's even more unsettling when you read on: Michael Brown was shot at least six times, and all bullets were fired into his front. He died in a storm of bullets from a police officer. Most people believed Michael was innocent. In any case Michael was unarmed when he was killed by a white policeman.

The public uproar and outcry are best summed up in the #handsupdontshoot hashtag on Twitter, not to mention the tension during the nine nights of protests. Sure enough, requests for three autopsies (one for the locals, one for the feds, and Dr. Baden on behalf of the family) spoke volumes of disapproval and untrust. Dr. Baden, in case you don't know, reviewed the autopsies of John F. Kennedy and Martin Luther King Jr.

Two months after reading this story in St Louis, I witnessed how armor-clad cops treated the law-abiding protesters with tear gas and pepper spray in our city. Quite similar really, except that we're yellow, and not black.

What wrong did Michael and the local demonstrators do? Why did Michael deserve six bullets and why did Hong Kong protesters deserve the volleys of noxious chemicals? You tell me!

Literacy

Around two years ago, I wrote about reading the classic picture book Good Night, Gorilla to my daughter. I knew I was just getting started: most kids younger than five can't figure out the written words.

"Don't push," I told myself. "Let her look at the pictures and come back to the words at a future time."

Now that my daughter is approaching five, her school has been celebrating the literacy week. What's that about? Bring a book to school, trade a book with classmates, spend money on books at the school book fair, dress up as the favorite book character. Read what you love and love what you read. This, I came to think, is the essence of literacy week.

Soon after the literacy week, my daughter came home and talked about the classic bear book by Eric Carle. This is the first time I heard about Brown Bear, Brown Bear, What Do You See? I didn't pay much attention until we found another book by Eric Carle at the public library. She then told me more about the bear book, and it seemed to me that my daughter really loves the book.

My wife decided to buy her the book this weekend. Little did we know that she can read most of the sentences in the book. On the way home, she kept reading it and couldn't take her eyes off the pages.

This intrigued us. Does she really recognise the words? Or, does she simply remember the rhymes? Or both? We didn't check. As long as she loves reading, it's a good start.

Birthday

What is your secret birthday wish by the time you turn 44?

Mine: Rewind the calendar and travel back by one year.

An irrational response, but a common one.

As irrational as this is, it makes sense, and I won't go into detail as to how my wife felt when Jasmine said she wants her mom to deliver her baby when she becomes a mother herself.

From the very moment I set eyes on my daughter's black-and-white photo taken inside the womb until she goes to primary school this year, the clock starts ticking. It's the clock that times my hours with Jasmine, my experience of seeing her grow up, her need for my attention, protection, wisdom, and love. Our time is limited, I know.

I was told that all dads only have eighteen short years before our daughters are on their own. And that means I should make the best use of my time with her before I'm too old.

Copy

Like many authors, I wasn't paying much attention when the editor sent us an email about the online edition of the textbook that we had contributed.

I downloaded other chapters and mine because I simply wanted to keep a copy. So I followed the link, and within minutes, the full version is neatly archived. I didn't read the book. And the point - or certainly one of the main points - is to know that the information is somewhere out there for my easy access.

Next day, I received quite a few "reply all" mails debating whether authors should have free access to the book.

Their discussion intrigued me, and this cannot be an oversight. They must have tried the link, followed by the prompt to payment before access. On the contrary, I'm pretty sure I can download more than the table of content page. I had no idea why the other authors were denied access, though I knew they would welcome my sharing the copy.

I didn't distribute my soft copy, after receiving a gentle reminder hinting on legal restriction and copyright issues. My free access to the book chapters, I was told, comes from my institution library.

Looking back, the enthusiasm of the publisher to protect their copyright seems quizzical in a digital age. A few clicks could have inadvertently bypassed the ownership of publication, music, pictures and data.

Which brings me to the demise of photocopying stores. You'll be forgiven if you've never heard of photocopying stores. Return with me to the days of yesteryear - the 1980s, the decade of my studying high school. Every so often we wanted to buy a textbook and could not afford it. Then you could borrow the book and bring it to the photocopying stores. Place a order (say, how many copies to make), choose the colour of the cover and make the prepayment. Come back in one week and the double-sided copy is yours.

Copyright, oh, forget it.

That said, it's still much more cumbersome than a few clicks on the computer.

But

Dale Carnegie once described the effective way to correct others' mistake this way: "call attention to people's mistakes indirectly."

One of the examples Dale Carnegie quoted in his book How to Win Friends and Influence People goes like this, "We're really proud of you, Johnnie, for raising your grades this term. But if you had worked harder on you algebra, the results would have been better."

Yes, the opening with praise is superb. It's hard to think of a better way to catch Johnnie's attention. But wait: it didn't take long to hear the word "but' and Johnnie might then question the sincerity of the original praise.

What on earth does this mean? Here's a tool of thumb that Dale Carnegie suggests: change the word "but" to "and."

Still don't get it? See what Dale Carnegie suggested: "We're really proud of you, Johnnie, for raising your grades this term, and by continuing he same conscientious efforts next term, your algebra grade can be up with all the others."

His teaching is worth remembering, but it was not until we'd made the same mistake as Johnnie's parents that I understood what it meant. Two days ago, my wife talked to Jasmine after reading her school newsletter. "Jasmine, you did well in the class and I am impressed that you're paying attention."

Jasmine looked up at us, both eyes wide. "Is there a but, mum?"

Elsa

What did Cinderella eat?

Whether we know it or not - and apparently we do not - the Disney Princess swallowed up our daughters.

Is it true, even a little bit, that parents should do our best to rescue our daughters from the inexplicable obsession with Cinderella, Sleeping Beauty, Ariel, Belle, Snow White (and many more)? Are girls destined to go gaga over the Disney princess? I've been reading Peggy Orenstein's Cinderella Ate My Daughter to find out more. Orenstein saw no reason for the royalty of girls (and hers) to the submissive, low-achieving and pink femininity, earnestly waiting for the prince to rescue, protect and take care of them.

She had a point. Many of us have a hard time when a preschooler answers "Princess" when being asked what she wants to be when she grows up.

What about the latest Disney princess movie Frozen? I know most of you will ask by now.

Unless you haven't met any little girl over the last six months, you must have heard about this popular movie with two Oscar nominations. Girls are simply drawn into the gravitational pull of the story about Queen-to-be Elsa and her sister Anna, and never quite get back out. My four-year-old, enamored of the fictional snow kingdom and icy power, told me her favorite color is blue now (and not pink any more). I swear, my daughter has sung the hit song "Let It Go" for three hundred times.

To those of us who are somehow uneasy with the traditional plot of charming prince saving a princess, Frozen departs from the kissy-kissy formula and broadens the message to include another type of true love - the bona fide sisterly love. In many ways, the blueprint of this Disney movie is a breakthrough. The prince remains charming, and yet he turns out to be the bad guy. Exactly the opposite of the case in Beauty and the Beast.

Written on purpose or not, as this Disney movie has shown, the big step away from the romantic fantasy is the way to go. Let us go.

Kakadu

Visiting Australia's national parks is pretty different from going to the theme park Legoland in Malaysia. I did both.

As an adult city-dweller, I prefer the wilderness and natural environment. I'm not suggesting that you should delete Legoland from your itinerary. If you have kids, they will tell you to go there and stay for many many many many days and nights.

When I started off planning this summer trip, I wasn't sure if I want to fill the whole page with playgrounds. Over the course of time, as I get the knack of travel with my daughter, what seems to adult's dream can also be kids' wonderland. Now that we've come back from Litchfield National Park and Kakadu National Park, I knew I'd made the right move. Jasmine enjoyed the scenic experience among open forests, spring-fed waterfalls, rock-art galleries and wetland areas.

It's such a pleasure to hear that Jasmine rates both Legoland and Aussie national parks equally funny. Yes, she said so.

There wasn't water park, as what they have in Legoland, but the impressive Wangi Falls plunging into rock pools made an ideal swimming area safe from crocodiles.

Instead of using Lego blocks to create castle, the Aboriginal guide taught us to use paperbark tree's bark sheets to make new tools. These can be creative, like canoe-shaped containers for holding water, cradle for carrying newborns, quasi-raincoat, impromptu bowls and plates.

Compared to the hotel in Legoland, which is attractive (I must say), the campsite and picnic table at the national parks offered much more variety and surprises. We could never guess what would come up when we heard the sound of scurrying up tree trunks, scratching, squish, or food foraging. "Squirrel?" "Whoops, it's wallaby."

Seasick

Try this quick word association: fishing tour.

And you respond … barramundi? Snapper? Mackerel?

Actually, I didn't come up with these targets when we took a boat ride in Darwin. I was completely at sea. And seasick. Or both. As the boat departed from the ferry terminal, I was overcome with a wave of nausea. My heart went wonky in my chest, my brow knitted with anxiety and my stomach spinning. My tummy flopped and bloated like a puffer fish on the hook.

Still lost in thought after I threw up in the toilet, I took few photos that weren't in focus. Yet what could I do? I didn't have energy to hold the fishing rod. I could not eat. I simply could not keep on an even keel.

The irony is that I didn't have to worry about my daughter who was as excited as kids in Ferris wheel.

On the way back, my friend told my daughter the good old stories in the Outward Bound course. It was the year I graduated from medical school. The summer course took place on a yacht Ji-Fung, and in the rough sea. We didn't have to hold fishing rods at that time, but were told to put on harness and make sure we vomited on the right direction on the deck – the lee side and never windward. Obediently I followed. When it was our turn to clean the cabin toilet, it was going to be much, much harder than what you'd thought. Harder than that of Sisyphus. Obviously, enclosed area inside the cabin is the last place in the world to go when you have seasickness. Up, down and around my stomach plunged, like a bad roller coaster ride. Wait. What else could I complain? Isn't being nearest to the toilet better than running to the leeward deck? Well, if and only if you're not supposed to clean up the toilet.        

How could I have believed myself joining the course on Ji-Fung 19 years ago? Yet I had.

Medley

With so many destinations, choosing which to visit during my daughter's summer holiday can be tough. When you hear about wild explorer's opening an atlas randomly for the choice, this might not sound rational. But it should. There are many theories. The simplest explanation is probably this: it feels good. Plus, it doesn't cause any major harm.

Few months ago, I happened to see the Lonely Planet's Central Australia in the public library new collection. I checked out the travel guidebook and started to plan our trip. As I sat down and invited my friend to go, I was told that his family had already planned to visit Singapore. Translation: my plan didn't work out.

Like most – maybe all – travel plans, mine worked out by itself. "Wouldn't it be so much easier if we visit Singapore together? Then we can fly directly into Darwin Airport; there isn't direct flight from our town to Darwin." We ended up fixing a medley of itineraries, including my friend's family, and that of his brothers, dad and mum, all the way to Singapore Zoo, Legoland in Malaysia, and our two families' last stop in Darwin, Litchfield National Park, followed by World Heritage-listed Kakadu National Park.   

I didn't say it is logical, I said it happens. And it works.

 

Vocabulary

For as long as I can remember, I had a notebook next to my dictionary during my primary school days. (I was 12.) I kept a list of new words in that notebook. The list grew as I looked up more words in the dictionary.

My four-year-old daughter isn't equipped to find words in the dictionary. Well, she doesn't need a dictionary; a child's vocabulary simply grows by asking and listening. It reminds me of a recent conversation with my daughter, when she asked me for the meaning of new words.

"Touching. What does that word mean?" Jasmine looked at me.

"You must have heard it somewhere. This is similar to moving. It's a feeling, of being moved and touched by something that brings special meaning. Bittersweet, umm, what shall I say? I'm not exactly sure what can that be. Let me tell you when we have something really touching."

The day after the conversation, we went to the wedding ceremony of Jasmine's kindergarten teacher. She decided on her dress pretty quickly. She picked a white one, almost the same as her best friend, and quite close to that of the bride. By the time the bridegroom and bride said their speech, my daughter whispered, "Dad, why is Ms Anna crying?"

"This is touching," I smiled back. "Do you remember the word touching? Anna cries. That doesn't mean she is sad. The wedding brings back memories from when she was a girl, as small as you, when her dad and mom brought her up with love. There are so many touching memories with her family. In fact, she cries because she finds the memories touching."

I didn't know if Jasmine got the meaning right until Jasmine connected the word touching to a shadow and puppetry show two days ago. That's the story of a boy suffering from a rare disease that threatens his eyesight. He will lose his vision by Christmas, the doctor told his father. The boy's father decided to give his son lasting memories of the world's amazing sights before it's too late. He sold his small business and started a heartwarming globetrotting journey with his child.

A touching story, I agree.

Tiger

Playing violin is hard. Making a four-year-old practice the bow stroke is quite impossible. Bringing up a daughter to be violinist, with the house turning topsy-turvy while the wife crumpled invalid after getting multiple sclerosis, almost never works.

You'll know just how hard this is for the Ukrainian-born music teacher Mr. K to do so after reading the book Strings Attached.

As a dad who asks my daughter to practice piano for not more than (and often less) ten minutes each day, I can't imagine the number of hours Mr. K's daughter spent on practicing and symphony rehearsals. I dare not think about the instrument's strain on the chin and neck, the throbbing pain between the shoulder blades, the row upon row of sweep back and forth, bow up and down.

That's why I've never had the courage to read Amy Chua's Battle Hymn of the Tiger Mother. Some of you might be proud of the stamina that can be found in the blood of a tough mother and her daughter. I am not sure if I am.

Passion

Many people have a preferred way to motivate themselves, to arouse enthusiasm and uncover what they want in their life and work. Some of us buy ourselves good coffee before work, and others go for Häagen-Dazs ice-cream after a big project.

Yesterday morning, as the sun was breaking open the clouds, I took my camera and crafted a picture before going to work.

Not a groundbreaking picture, but good enough to build my energy for the long hours of hospital work.

I worked till the sun set behind the hills next day. I didn't sleep too much in the hospital last night. Even so, I'd kept my sense of humour, stayed clear about my mind, and then took another nice picture of the dusk after work tonight.

Okay. Why am I still awake after these long hours of work? To me, the most important thing is to avoid the pitfall of poached frog. When we drop a frog into boiling water, it will instinctively jump out. And if you place a frog in a pot of cool water and increase the temperature slowly, the frog can't - and, in fact, is not supposed to - notice. All this boiling goes on little by little, most of the time without the frog even being aware that it's sitting in hotter and hotter water, until it got burned and burnout.

The moral of the boiling frog seems all too clear: Look out for the slowly boiling water that indicates we've lost touch with our real self and lost the fun at work.

Chain

If you find that your friends start a number of upbeat feeds on the social network Facebook, and that your mood and performance soar along their suggestion, it is probably more than coincidence. I didn't know where to start, but I did know that emotional contagion has been recently demonstrated by a study published in the Proceedings of the National Academy of Sciences.

In The New Leaders, Daniel Goleman quotes the example of circulatory system being a closed-loop system which is self-regulating because "what's happening in the circulatory system of others around us does not impact our own system." On the other hand, an open-loop system depends largely on external sources to manage itself. Our limbic system is one good example.

I found out more about emotional contagion after a child died in our hospital last month. Well. I do not know if the eight-year-old boy really died of a contagious disease. Everyone talks about the unfortunate child, but nobody knows the exact story. I spoke to the daddy of the child today. Three more doctors joined in, and we began to talk about our educated guess, like a trial lawyer making a case to the jury, explaining various aspects of this difficult case, some of which, in my desire to protect the privacy, I did not put down here. Of course, there is always more we can do, and I reminded myself that we should spend time listening to the story of the daddy.

And then the father told us more: how badly he missed his son who fell sick after the Father's Day, the flickering moment he thought about going to heaven to look after his son, and why he worried his wife could collapse by the time new school term starts in September (when there won't be chance to wake up their kid for school).

At first I looked calm and listened.

Then I started to feel a knot in my stomach.

And teardrops.

Say Goodbye

After giving a lecture at the Hong Kong Convention and Exhibition Centre this weekend, I went to the public library and returned an unfinished book.

I wasn't able to finish the Pulitzer Prize-winning novel The Goldfinch before the book is due. I could not renew the library loan because it has been reserved by someone else.

Saying goodbye (for a moment) to this book isn't hard. Riding the emotional roller coaster with the story's narrator Theo Decker is.

It's a very tough thing to see how Theo lost his mum during a terrorist bomb attack, got carried away when he met a red-haired girl who was also injured and then (literally) carried away. I decided to take a break. At the beginning it was because they wouldn't allow me to keep the book, and at the end because I didn't want to. I should borrow the book later, not now.

So that was the plan.

As it turned out, I borrowed another book: Too Soon to Say Goodbye by the Pulitzer Prize winner (again) Art Buchwald. Buchwald wrote the book when he was in a hospice after declining dialysis. He shared his dream that he have an air ticket reservation to go to heaven. He went to the terminal and looked at the list of flights. Heaven is at the last gate.

Buchwald went up to the departure desk and asked, "Am I entitled to frequent flyer miles?"

The agent said, "You won't need any, because you're not coming back."

The next thing he heard was the loudspeaker announcement, "Because of inclement weather, today's flight to heaven has been cancelled. You can come back tomorrow and we'll put you on standby."

Burnout

When summer students joined me to learn medicine, we'd have lunch together and work like a team. And as much as I wanted to, I knew I couldn't skip the conversation topic of burnout, that to sweep this burnout issue under the carpet was to behave like an ostrich. It's a hot topic among our colleagues. And there is also the nettlesome question of whether our medical interns are getting less enthusiastic near the end of the term (translation: June) - that's an imperfect but perfectly human behavior, too.

Truth be told, I don't want to show these to an aspiring medical student. That's too frightening. If all doctors and doctors-in-training talk about losing their sense of empathy with time, burnout becomes synonymous with getting old. Everyone gets old and everyone has burnout. It's only a matter of time before you will.

Perhaps, but not necessarily.

Because grumbling begets more grumbling, the importance of teaching the spirits exceeds the importance of the textbook knowledge. So I tell my students everything that has helped me along the way. I wish I had a secret recipe I could pass on, some formula that has enabled me to go to work on a daily basis and still as happy as a kid going to the carnival. Is there a magic key? Maybe there is one, maybe not. But I hope there's one way for my student to find out.

Turtle

My friend tied the knot in Singapore, and I stayed in the diamond-shaped island over this weekend.

Travelling to Singapore is nothing but a three-hour nonstop flight. Before departure, I'd been reading a book on decision making but I decided not to bring the unfinished book with me this time. The idea is for something less serious; it's joyful time to go with the newlyweds and witness a couple saying "I do." Of course, "I do" is a big decision too. I just preferred to read something more romantic, and picked an easy-to-read book Making Marriage Simple.

It took barely a few pages, on the bus ride to airport, to get me absorbed in the book. The chapter on Turtle and Hailstorm simply cut to the heart of my problem. Truth be told, I used to be the Turtle who stays hunkered down in the shell at times (okay, a lot of the time) when my wife (dare I say) becomes storm-like. Turtles are said to have long life. And this has to do with turtle's stubbornness not to stick its neck out. The strategy of retreating into the shell holds true for many husbands like me. It appears much safer to hide when the dark clouds are gathering. Turtles aren't keen to "show up" when the tensions get high. Who would be?

As I read through the chapter, I figured out pretty easily that a turtle firmly stuck in the shell could have saved life, but that is incompatible with marriage. Let's face it, running away won't soothe the storm cloud away.

Don't try to run away from a golf-ball-sized hail, I learned, unless you want to receive an even bigger hailstorm.

Guaranteed.

Hyperbole

Not so long ago, really - four days ago when I was leaving for Japan - I read the book The Art of Thinking Clearly at the airport bookstore and learned about planning fantasy. In brief, it's the illusion of grandiosity when we make plans. How often do we allow this idea of grandiosity to go rampage at the buffet dinner? If there's an Olympics for that kind of fantasy, I should have been awarded a thousand world-class gold medals.

Now imagine your teacher gives you an assignment and lets you decide the length of that paper and fix up the deadline to hand in the final script. The temptation is oh so great. You might have known that you'd failed to hand in term papers in due course, but you guess you're better this time. Your - I should say our - tendency always is to come up with an exaggerated goal. Plus, we make wrong estimation how quick we can achieve the goal. We promise way more than we can deliver. We set the alarm clock at such unrealistic hour that we sleep through it. We have a natural penchant for the rose-tinted spectacles.

If I'm candid, I do not believe the lesson of planning fantasy made me worry one jot about how easy I fall prey to the fantasy. You can bet I still have that fantasy. That's the reason I have been kicking myself to finish as many items on my to-do list as possible during the last four days. The good news is I did manage to complete a peer review for a medical journal, write few magazine and newsletter articles, reply a number of unreturned e-mails at my hotel room.

"Not bad," I congratulated myself and packed my luggage (before checking out tomorrow). Then I remembered that I'd brought two books and few magazines for this trip. Oh drats, I didn't even finish one book.

Guess the second book will just have to wait till next trip.

Never mind, I tried to find a crumb of comfort by reminding myself that the title of that unfinished book is The Slow Fix.

Thursday

In many ways, going to academic conference is a good way to learn: the program usually runs the gamut from basic science (like zebrafish) to patient care (that we do now and then). The downside is that some lectures aren't attractive and there's a day's worth of activity outside the conference venue.

This week, I'm attending a conference in Tokyo. Thinking of all the Tokyo's top sights mentioned in Lonely Planet, I knew pretty well the reason of some empty chairs in the conference hall. Many of the sights are impossible to miss, I know. But when it comes to the courage that students are traditionally supposed to be born with to skip class, I'm a little lacking.

I hadn't meant to leave the conference hall until the cows come home. That I stayed late led me to feel both irrationally proud and profoundly tired. Unfortunately, most museums in Japan close at five (and with the last entry around half hour before closing). After that, I picked up the program book and handy guide, figuring out the next move. That is when I found out Tokyo Metropolitan Museum of Photography opens till eight on Thursday. And it's Thursday today.

I'd be mad not to call this luck.

Chameleon Effect

Call myself professional on one hand, and I teach my students to learn from waitresses on the other.

It does make sense.

After my recent lesson from the waitress, I went on to read more on the waitresses' strategic mimicry, and how mimicry increases the odds to build rapport and move others. To me, the answer that the waitress also doesn't want her customer to wait is trying to attune, to enhance liking, to get inside the head of the customer, to draw the map showing we're in the same boat. Unbeknownst to her customer, the two parties had been led to go in synch with each other at the drop of a hat, sharing common ground.

If you aren't convinced, you might not have heard the experiment of verbal mimicry. And if you'll let me, I'd like to tell you a little bit about how that experiment works. Just think: When was the last time you went to a restaurant and made order for your dinner? How did the waitress answer? In an experiment of customer behavioural patterns, sixty groups of customers like you, without their awareness, were randomly served by two types of waitresses. In the mimicry condition, waitresses repeated all orders from the drinks to the cheque. Word for word. In the non-mimicry condition, the orders were not repeated, but the waitress made clear that she understood the order by words like "okay" or "coming up!"

At the end of the day, the mimicking waitresses earned a whopping 70 percent more tips. I repeat: 70 percent more.

What is the lesson for doctors? Well, I'll let you decide.

We Too

Sometimes the line between the professional and unskilled job is blurry.

Tonight I went to order takeaway dinner. Quite a number of people were waiting outside the cafeteria. Most of us, it turns out, were there because domestic maids don't usually work on Sunday. Getting a table is tricky and may not be easy on Sunday evening. And yet it's practical. It's visceral. I wasn't surprised when the customers grumbled about the long wait.

"Heck, it's quite a bit of waiting for my turn," one of them shouted, hungry and cantankerous, "but we're just looking for a table for two. Why so?"

The scene is pretty familiar to me. It's the same as waiting at any emergency room in public hospitals - okay, not exactly the same, because it happens seven days a week in hospital instead of on Sunday. I'd expect the waitress to talk back and piss them off. That's very much what we heard in the emergency rooms. But, to my surprise, there's a flip side to the story at the cafeteria tonight. "I wish, too," answered the waitress, "that you don't have to wait. If only those people finished their meal earlier and left."

A real professional way to talk to the customers in a queue, I thought on my way home with the takeaway dinner.

Secret

What happened when a hundred-year-old man climbed out of the window (in his slippers) and disappeared? Go read Jonas Jonasson's novel and you will find out the man set off in his pee-slippers (so called because men of his age rarely pee further than their shoes) and unravelled one story after another.

But what if a four-year-old climbed out of the bed and disappeared?

Ah, a mystery.

That four-year-old turned out to be Jasmine's cousin. We were celebrating the Easter holiday in a hotel at Discovery Bay. And then the two kids entertained themselves by falling under the spell of jumping around the hotel bed. They simply forgot to go out and let every parent feel good about the decision to book a hotel and - you have to admit - any hotel with beds to jump on will do.

A silly but incredible idea. The kids jumped from one bed to the next. The last drops of a hundred-year-old man's urine might not quite make it to the toilet bowl, but it isn't difficult for a four-year-old kid to jump and land exactly on the bed next to one another. Halfway through the jumping, they - only the kids, not you - could hear the roar of crocodiles underneath. Hungry crocs they were too.

"Be careful, Aaron and Jasmine."

"Of course, we will, unless anyone of you want to be the dim sum of the crocs."

Over the first hour, if not more, of arriving at the hotel, dads and mums usually have plenty of time to read and relax. We were having tea and coffee when things turned out a bit different. I heard a sound louder than a crocodile's roar, and the next thing I knew, Jasmine's cousin was lying next to the coffee table and crying. We could never imagine how this could have happened.

"Interesting," my sister said, and meant the opposite.

In the end, we gave up our attempts to solve the mystery, and settled for soothing the pain of Jasmine's cousin.

Three days later, during her bedtime story session, Jasmine disclosed that her cousin was trying to rescue few cats from the crocodiles' breakfast plate when he lost his balance (and his face). That's a secret.

This could be brilliant, I thought, for her to keep the secret. Disclosing openly the story of a Humpty Dumpty firefighter would be a faux pas and definitely embarrass her cousin.

Whodunnit

Let's pretend that you're the mummy. You have two little girls. One of them breaks fifteen cups as she is coming into the dining room, the other breaks one cup as she is trying to get some jam while you are not there. Which of them would you punish more severely?

I didn't make up this story myself. That's the way the Swiss psychologist Jean Piaget explored the child's understanding of morality. This story comes from my recent reading Teaching Right from Wrong: 40 Things You Can Do to Raise a Moral Child.

See what happens when Piaget conducted an interview with seven-year-old Constance:

Constance: The one who broke the fifteen cups...
Piaget: Have you ever broken anything?
Constance: A cup.
Piaget: How?
Constance: I wanted to wipe it, and I let it drop.
Piaget: What else have you broken?
Constance: Another time, a plate.
Piaget: How?
Constance: I took it to play with.
Piaget: Which was the naughtier thing to do?
Constance: The plate, because I oughtn't have taken it.
Piaget: And how about the cup?
Constance: That was less naughty because I wanted to wipe it.
Piaget: Which were you punished most for, the cup or the plates?
Constance: For the plate.
Piaget: Listen, I am going to tell you two more stories. A little girl is wiping the cups. She is putting them away, wiping them with a cloth, and she broke five cups. Another little girl is playing with some plates. She breaks a plate. Which of them is naughtier?
Constance: The girl who broke the five cups.

Suddenly I began to see parallels everywhere.

Let me explain.

Not too long ago, I signed an apology letter to the family of a patient who died in our hospital, saying sorry for our intern doctor who didn't turn up to certify death until an hour after the patient had his last breath. Hmmmm... Let's think about another scenario - and that is a real one, too - in which an intern doctor went to vertify that his patient was dead ten minutes before patient's electrocardiogram went completely flat. The nurse was a bit concerned with the occasional waveform displayed on the electrocardiogram paper, pointing out the waves that might imply few heartbeats. The doctor was less eager to wait for the electrocardiogram's going dead than the death of the patient. "Don't worry, can't we see that the electrocardiogram is abnormal enough? It will go flat pretty soon."

So that was that. Let's count. Sixty minutes' delay and a gap of ten minutes. Which of them would you punish more?

Genius

Close your eyes. Picture a scene inside a cooking school. Odds are you will see students learning how to chop vegetables, make bagels, wash dish, or prepare a kitchen. Perhaps even more bottom job.
 

Isn't it the right way to learn cooking? It's hard to think of better ways to learn.
 

Impractical ways of learning, such as staying in library chock-full of French culinary books, are funny when you think about it. Silly, in fact.

However, I repeat, we are in a funny society where silly things are more often than not. So when I heard about a real funny cooking school, I am not surprised at all. That school - in case you're interested to know - pays great efforts to improve the safety. Before the students learn the ropes of being a cook, they are taught safety first. They have to attend fire drills, infection control class, and data privacy ordinance lecture. The school head keeps wondering how one could do without those certificates.

After the monumental achievement (of getting those certificates), I suppose, the students will move on to learn cooking. But wait. The school head gets pretty upset about the kitchen accidents. Two students cut their fingers when they were preparing carrots last year. No more bare knives in the kitchen cupboard. Not any more. After lengthy discussion, the cooking school decides to introduce a knife with special safety design like Swiss Army knife. Here's how it works: using a digital lock, the knife won't unfold until you've keyed in the user-defined password. Truly otherworldly and brilliant.

Did the students find the new knife a success story? Alas, I never get the answer from the students because it has been decided that students are not granted access to the password at the cooking school. Not any more. Not until they graduate and become a chef. But what if they could go back to the traditional knife and learn the knife skills? No. Those knives are unsafe and banned in the school. Period.

This scenario probably sounds bizarre to you. Of course it does — you've never been studying or teaching in that school. Pity those, like me, who have to.

Wonderland

Among the unusual things that we may think we know, some of them can't be taught. Dreaming is one of those.

There is no picture, not a single detail, about what a dream is like. We never know if babies have dreams. I didn't have the feeblest idea how to teach my angel daughter what a dream is like, until she woke up one afternoon asking for her aunt.

"Auntie Simmy, what?" I stared at my daughter, nonplussed

"Oh yes, we're having udon. Where is she?"

Until then, I had not been able to tell my daughter she'd had a dream, and how a dream looks like.

Bit by bit, she learned and told us her dreams in the morning. At one time, she described playing pirate game with teacher in the kindergarten. It was as if we knew her dream because her mum was next to her in the dream, as if we had lived together in her dream and she was surprised to hear that her mum asked about the details of her pirate game.

"What do you mean? Mum, you should know. You were there."

Not that Jasmine thought her dream is real, far from it. In fact, she knows that the dream is imagined. If there is one thing we can make up - and there is only one thing - it's her dream. Any dream, any wish.

My daughter just told her mum yesterday, "Goodnight, let's meet again tonight and play Lego in my dream. Remember."

Sorry

The very idea of apology is that it means respect between two parties. The phrase "I am sorry" opens the window to restore broken relationships. Everything before and everything after might as well not have mattered at all.

It seems to me that apologies have become increasingly rare. Over one month after an unfortunate story of a young doctor, we haven't heard the word sorry. I won't describe the story in detail here, because even in print it's too distressing.

I really don't want the story ruin my day, and quickly forgot it after I went home today. It's a lot happier to see my daughter playing with her best friend after work. The two of them had already played outdoors for an hour, with all kinds of games they come up with by themselves, and was running around indoors when I met them. I say I met them because I didn't really joined them. As parents, I was told, we should hover less because kids gain more when we do less.

I talked with the mum of my daughter's friend, when our children were within eyesight. It's not unusual to see and hear some arguments in the playroom: an unsupervised boy wielding a gun and blocking the way, another stroppy boy in green sweatshirt calling kids by nickname, other children joining in the bullying. As we chatted, we kept an eye on our children but tried not to go near. Kids would learn much more about the world when they make up, negotiate, and derive their own rules.

I stepped in at the end, when a boy said dirty words about girls' underwear.

I didn't think it solved the problem. Anyway, my daughter was fed up with those naughty boys and asked to leave. When she and her friend were putting on shoes, to my surprise, a boy came up and spoke to my daughter with a bow. "I'm sorry. I was mean to you."

I didn't expect to hear an apology today. Now I have.

Pain

Do animals have rights? Does that mean we should treat animals equal as human beings?

That's a philosophical question I happened to come across during my recent reading.

Every so often in life we get to admit we cause animals pain, for one reason or another. Not many people (me included), on the other hand, would be prepared to stop eating animals because slaughtering animals induces animals pain.

Pain may be pain, Julian Baggini reasons, but it can become more (or less) serious depending on how and when it is felt, by what kind of creature. That is not to say that animal pain is trivial. There is clearly a moral concern when we kill animals, say, for the sake of testing cosmetics. Few things turn the stomach more when reading a passage how people torture dogs and cats for fun. How about chasing or killing a cockroach at your kitchen? Well, yes, being slapped by a slipper is unpleasant and painful, but as soon as it has passed, life of the cockroach goes on - or off, depending how precise we hit the cockroach. The same is not true for humans, as made clear by Baggini, because some more mentally sophisticated animals (like Homo sapiens) can turn their pain into longer-lasting suffering and become haunted by the memory of nasty pain.

That is why we should prioritise reducing human pain over animal pain. That made sense.

Yesterday morning, I taught my students how we inserted a catheter into the tummy of a patient whose kidneys suddenly stopped working. If we didn't make an effort to dialyse him, I told them, he would die shortly. Nonetheless, we had to use a pretty sharp needle to pop open his tummy. That's painful. Indeed, it seems hard to imagine how we can do that without causing suffering. The point of getting my patient sedated was discussed. Some of my students worried about getting the patient into sleep; they would rather suggest a bigger dose of painkiller. But that may not be the whole story of pain management. In other words, pain becomes a less serious problem if it won't be remembered or anticipated over time. That is why sedative, I would argue, serves to make the pain go away.

Chirps and Beeps

Today there's no hospital area - day or night - that isn't noisy. Add to this spectrum of decibels all the increasing number of machines, like infusion pump alerts, monitors that sound when patients try to leave their beds, blood pressure and heart rate alarms. Add all the pagers and hospital telephones. Ultimately the (health care worker) attention deficit-(alarm and noise) hyperactivity disorder prevails.

As a new article in the Journal of the American Medical Association states, a tenet of medical alarm is that "the alarm activates only when a serious problem develops." As the level and complexity of patient care increase, unfortunately, more and more alerts have been invented. And no wonder: many of us believe hospital alarms should improve patient safety. This is true for critical alarms. On the other hand, many of the current alerts - visual or audible - probably don't bother a doctor or nurse that much, and are often disabled (such as a pop-up message about a patient's history of hepatitis) or muted (as is the case with a patient who triggers an alarm after minor movement in bed).

Simply put, we are caught up in a chaotic maze of cues, signals and noise. Whether we realize it or not, most of the modern hospital alerts are hyperactive enough to cause attention deficit or alarm fatigue. And the last thing we want to see is a man found dead in his hospital bed with a cardiac monitor that has been set to mute.

Happiness

Simplicity is the secret recipe of happiness.

I remember a blog by my mentor who wrote about the way to make himself happy. He suggested to build happiness on something simple, regular and durable. That's why writing blog has become part of his everyday life.

For me, writing blog is fun but I don't do it daily. It turns out that preparing lunch box is much more regular and generates tremendous happiness for me, my wife and my daughter.

Preparing lunch for my daughter (who is now attending full day school)? Me? It's a pretty safe bet that my daughter would wince at it. First, a disclaimer. I am all thumbs when it comes to cooking. Whenever I told people that my daughter loves the lunch box that I prepare for her, I would typically get two reactions. The first was the natural and straightforward response. "Oh?" my friend would say. "I didn't know you can cook."

It was the second response that I found easier to answer.

"Oh, what did you put in her lunch box?"

It's no secret that my maid prepares the lunch food. One of the best-kept secrets about making the lunch box lively is that we add a handmade lunch box card each time. On the night before, my wife and I will take out colour pencils or watercolour brushes, scissors, paper and thermal laminator. Few things are easier than conjuring up the happy events with our daughter during the day, and few things are harder than picking only one of them to draw on the lunch box card. Crazy game that she invents, silly story that she loves, monkey bar that she is proud of, animals like cheetah or ladybird, and the list goes on and on.

The card reminds us how lovely our life can be, and lets my daughter remember our love forever.

Missing Mummy

There aren't too many books you wish your children don't have to read.

Last week I found one that I pray my daughter doesn't have to read, and didn't borrow it then. This week I changed my mind and feel blessed that we have read the book together.

This is how the first page of the picture book started. On a cold and rainy morning, a boy went to the funeral of his mummy. He wasn't sure where his mummy has gone, and had tried looking for her everywhere, peeking behind the sofa and underneath the bed, in vain. He found lots of her belongings except her. The story itself, or at least the theme, is tearful.

We've been shying away from death the way people avoid talking about sexual education. I also felt a certain nagging worry, somewhere in my heart and my stomach (or my guts), wondering if my daughter would come out of the story shattered and frightened. "Does my daughter understand death and find ways to grapple with the emotional turmoil? And if she can, will she?" And on and on.

I read the story together with my daughter and wife last night. We were impressed by the way Rebecca Cobb painted the painful picture of child bereavement. Like dark chocolate, the bitter story isn't easy to swallow but still feels sweet in the throat. And of course, the lesson that Jasmine is about to learn could hardly be more permanent than the boy's memory of his mummy.

Karri

In many ways the Dave Evans Bicentennial Tree, which is the tallest lookout tree (at 68 metres) in Warren National Park of southwestern Australia, is more like a circus totem than a fire lookout station.

We had a lot of funny ideas in mind during our recent Perth trip, and this tree is one of those. For one thing, I kept asking myself if I should let my daughter climb the karri tree (and without worrying as I follow her steps up and up).

Spiral pegs around the karri tree trunk make the climb less daunting - but still somewhat scary. There's even a tree-house cage station midway, swaying up to 1.5 metres in case of extremely windy day. And did I mention there is no safety net below?

Which is to say you'd better mind your step and put your foot down with each step. Make any split-second decision carelessly and you will never have chance to make any decision. Best not to speak at all in moment like this. 

My daughter didn't say much during her ascent. "Focus," she simply said few words to herself, "and don't give up." Rarely has a game captured so much attention so firmly - young and old, daughter and her dad. The first time she climbed the tree, she started to try few steps, gaining an internal sense of control, and came down. This isn't surprising. One has to sense the footing before going further up. I stayed behind and held my breath, whereas my wife had decided to take the lead. She climbed and asked my daughter to follow. I peered anxiously at the bottom of the karri tree (you know, broken arm, shattered skull and the like), wondering whether I should tell my kid (and my wife) to come down. Or, should I let her push her personal boundaries just a bit? Or, could I?

On my return flight, I happened to read a news story about playground behavior of Auckland children, who had motion sensors strapped to them (for monitoring physical activity, as a research project). The researchers talked the schools into relaxing outdoor play rules, including lifting bans on running, riding bikes or climbing trees.

Their success rate in persuading schools to throw the rule books out the window is marvelous on its own, but all the more astonishing in light of how allowing children to take "risky" play resulted in a drop in bullying and serious injuries. And, I'm serious, an improvement in students' concentration and behaviour in class. 
 

I wish I'd read the story before visiting this karri tree.

Perth

People get crazy whenever travel is mentioned and I can understand why. We just had an adventure in Perth, and the week is packed with fun.

I and my wife had some trepidation at the thought of holidaying with our four-year-old kid in a country after eight-hour flight. Ah, eight hours. A sudden attack of the "are-we-there-yets" is always fingernails on parents' chalkboard, and can sometimes be more serious than Murray Valley encephalitis virus.

 

Mention boredom on the plane and movie is sure to come up. Jasmine had never watched a movie before, so watching her first one about an injured dolphin was a bit intriguing. The friendly animal lost her tail after being strangled by fish net. Jasmine worried a lot. Uneasiness became so palpable that I could see it on her face. She asked me for words of comfort, and didn't laugh even when a naughty pelican made a scene of chasing people.

 

Dolphin Tale takes many turns in its unfolding how the dolphin got her tail back, which I will leave you to explore.

 

The movie, as it turned out, quite matched our trip to the Penguin Island two days later. We saw hundreds of Australian pelicans (like the naughty one in the movie) on the way to the Penguin Island. Home to long-term injured or orphaned penguins (like that dolphin with tail maimed), the ecoconscious island is perfect for teaching my daughter how to appreciate our nature and love the wilderness. No food is sold there and yet we had picnic by bringing our own. No flushing system is available at the toilets and, still, they aren't smelly with composting design.

 

Unforgettable.

Hueys

Guess what? When it comes to the world of the Hueys, wherever they go, whatever they do, whatever they think and wear, it will be the same.

Like it or not, in the story written by Oliver Jeffers, the Hueys eat the same and look exactly the same.

By same, I mean the little cute Hueys look like a crowd of Dolly coming right out of cookie cutter. A robot way of living and seeing. My daughter exclaimed, "Oh my, I would be in great trouble calling my students if I were their teacher."

As I read picture book, I was drawn to the sheer joy of seeing how my daughter figured out the essence of the story herself. Amazing. She came up with the question and told me her answer.

"See daddy, I don't think we have to be the same. Chile and I aren't the same, but we're friends. Selina and I are different, too. Right?"

After writing hundreds of story pages for kids, Zilpha Keatley Snyder summed it up this way: "The answers aren't important really... What's important is - knowing all the questions."

Right brain

I attended a conference at Shinjuku last weekend. Since there wasn't much time for sightseeing, I decided to visit a bookstore that is open till night.

It's hard to limit yourself to the English session at a bookstore in Japan; it is either too small or nonexistent. Many readers may be having problem understanding Japanese book, as I did. But I'm fine with the children's books. Picture books make use of a universal language that connects us beyond country. "Just as the mode of the rational mind is words, the mode of emotions is nonverbal," writes Daniel Goleman. No surprise, then, that my daughter loves the story book that I bought even that is written in English but translated into Japanese. She likes the boy wearing a balaclava and rescuing a beached whale. A lot.

My daughter can read the expression and intuit the boy's emotion. We created a name for the boy, came up with our own ideas what the Japanese text should have meant, and laughed together.

And this is exactly what Paul Ekman has shown before, when he traveled to Japan, Argentina, Brazil and Chile, bringing along photos of faces in different expressions. Asians and South Americans interpreted the expressions the same way Americans did. Still, the psychologist wasn't sure if television could have influenced the common interpretations. Ekman went to the highlands of New Guinea and showed the same set of facial expression photos to tribesmen. The same.

Touching

Often, when I see patients and their families, I like to let them tell their stories that, for one reason or another, might help us see the big picture. And actually, many of those stories that doctors might have considered irrelevant may turn out, the more we listen, to be important.

But listening to their stories - important though it is - is not the only purpose. The benefits of story telling go well beyond that. The idea of narration is to let both parties go through the same journey. Trying to explain the anatomy jargon and medical facts, on the other hand, would sound like the voice of a brain in formaldehyde, talking to an angry family from a jar.

Listening to stories (instead of medical lecture) can be remarkable for many reasons, one of which is shown by my patient's mother yesterday. My patient didn't tell the story. She'd been struggling to find some way to let us know how she felt, but could not say a single word with tube sticking from her throat. She was dying. The story came from her mother. What did she say? The sort of voice that will sooner or later make you want to pull your hair out. It was like being a volcano, plugged and stoppered and unable to get rid of the boiling stuff inside. Nearly everything she said contradicts whatever professional knowledge we have.

I let her continue and didn't argue. Then with a little luck I heard her outrageous hatred towards one doctor, and then how she thought her daughter might have survived if she was seen instead by another good doctor. At once I realised she was referring the good doctor to my mentor. On this subject, I imagine, both of us will agree. No doubt, my mentor is a caring doctor with good knowledge. It's always gratifying to hear something positive out of a sad conversation. It would seem absurd to dismiss her praise for my mentor and move to another topic. We identified. We agreed. We talked about someone who had been taking care of her daughter for 20 years. I promised to convey her gratitude to my mentor, and asked her for more story of my mentor.

"Well, look," she said. "Many doctors don't bother to answer my daughter when she's sick with lupus. Many doctors don't even come close to see my daughter last month when she developed nasty skin problem. But he was not afraid of that. He examined my daughter's skin every morning, not even wearing gloves."

She's right. That is the way of doctoring. A touching way to heal.

Lever

Often when you step on the bathroom scale, what you have in mind is a figure about your size or a wish - oh, say - say ten pounds minus your usual size. Close your eyes, picture a magic figure and nine times out of ten it will be wrong when you look at the display.

Now think about the weighing scale with a lever that goes up and down like a seesaw. Though little known among young people on diet now, this scale was popular some thirty years ago. In case you have difficulty recognising such scale, go to the market and see how the old guys put the fruit or vegetable on one pan and add standard masses on the other pan until the beam is as close to a horizontal line as possible. The same applies to measuring our own body weight on the lever. Step on the base, and set the weight by moving a sliding weight to and from the fulcrum. Hmm... how about 120 pounds? And then the lever arm goes up. You must have taken too many muffins and cakes. So let's slide the weight to the right by one notch, waiting for that lever arm to fall again. Tap, tap. The lever arm moves, but just a little. Fine, let's move it by five notches, tap, tap, tap. The lever arm falls but then overshoots. Try again by going left.

Yeah, that's pretty similar to what we call diagnostic accuracy and calibration in guessing the true answer when doctors see patients. We come up first with an answer with somewhat fair confidence, and struggle around as we move back and forth. You don't have to move the sliding weight too much if you aren't confident in guessing your body weight. Go slow. In other words, zero in on the true answer bit by bit. Consider its similarity with doctors' search for an answer. The less confident a doctor is, the more diagnostic tests he will request. The catch is, doctors move the "sliding weight" but can't see the "lever" in real-world cases. That means shooting one after another, but without being told how far or how close one is from the bull's-eye. Which is why doctors' level of confidence won't be that sensitive to diagnostic accuracy and case difficulty - and definitely worse than the accuracy of guessing your body weight.

Candy

As mentioned few days ago, I found Ian McEwan's Sweet Tooth a breezy and good read.  If Candy Crush is enticing, Sweet Tooth is more entertaining. Oh, surely I exaggerate. But not much.

All right, I'm exaggerating because I never play Candy Crush.

It does seem an odd thing - it strikes me that this mobile game has been downloaded some 500 million times in the past year - that I have never spent one single minute on this popular gumdrop game. To be sure, the game has its own sweet tricks to get people hooked. Much as people with weakness should never try LSD or cannabis, I find it stupid to let a greedy toddler open a box of candy. Yes, I suppose I can't resist the temptation to keep renewing my lives in the Candy Crush game. To get around the sweet trick, I decided not to touch the candy at all.

And without strong mind to resist from getting addicted to Facebook or mobile games, I have never installed Facebook at my iPhone. So far, so good. Even with my recent addiction to Words with Friends, for example, I won't be able to play unless in front of my laptop computer. So far, this strategy works. So far.