Songbirds

When a novelist finds the power of written words, according to short story writer Joseph Conrad, that's going to make you hear, to make you feel, and, above all, to make you see.

That is all, and it is everything.

My recent reading of Songbirds by Christy Lefteri is a good example. The story appeals to all the senses. I hear the cacophony of birdsongs. I feel the arduous way birds making migration to cross borders, to search for better life, to find themselves trapped. I see hundreds of grey herons, blue rock thrushes, crossbills, coal tits and tree creepers. One by one, they fall prey to the lime stick on poachers' mist net. They crash into the massive net, flapping and screeching, struggling and crying. 

Up and down and up and down and up and down they go, moment by moment, one by one, from migration routes to the grave. 

Songbirds, at first glance, is a story about migratory birds crossing the Mediterranean Sea. But then I realised that the story is more about the migrant workers leaving hometowns to find new life abroad, and the tragic way they find themselves more trapped than they had been before. That's a disheartening and true story of worker leaving home. 

Like the birds caught by poachers, the domestic worker never returned.

Fever

For some reason that I don’t understand, it has continued to bother me to think of my passing a virus to my family. I kept thinking: Stay away from your beloved ones when you’re sick.

During my recent Krabi trip in Thailand, I kicked up a fever on the day of arrival. These days a high temperature is a little horrifying, isn’t it?

My minds started racing. I had no idea how I was going to protect my family if we were staying together in a hotel room. My wife was more empathetic and keen to look after me.

“We could have been infected by now if you’re having the coronavirus. Don’t worry. All that matters is that you’re getting better.”

I slept and leaned out of my bed to keep a safe distance.

I waited for the symptoms to come up for me to check. Sore throat: nil. Loss of taste or smell: crossed out. Cough: not much. I put on my mask.

I managed to go kayaking - slowly - and then recovered without knowing what the heck that germ is.

For that, I thank my wife.

By the Sea

Elizabeth Strout's novel Lucy by the Sea is a beautiful chronicle of our pandemic before the era of vaccination. Truly it is.

Lest you think you're alone when you feel like you've been hung upside down over a cliff with mask on, Lucy from this novel will be your companion. Feel free to listen to Lucy's thought every time she watches the news. "This will end, I kept thinking. This will have to end. And every night it did not end, or indicate in any way that it would ever end."

Reading about anxiety on catching the virus can sometimes trigger our anxiety. OK, that's not entirely true; I'm bringing this novel on my Thailand trip this week. Naming the emotion - whatever the hell that is - is actually a way to tackle it. Our family loves travel. As much as we don't want to catch the coronavirus, being on a plane and having a restful, restorative week can be a sensible, healthy thing to do.

Marvellous, eh? Trust me, it is.

Textrovert

Too low vocabulary to say what you mean? No such thing. We can make up words.

The idea to create word from scratch may not sound like our traditional way of learning English - but the power of new words should not be discounted.

I was in for a big surprise when my daughter told me yesterday how the teacher gave them a lesson to craft DIY words. Her class has come up with new words. They are interesting. So interesting, in fact, that I decide to jot down here.

It isn't too difficult to imagine how one can be nervousxcited before joining a summer camp. And I'm sure you know what is meant by impendoom when you sit for an examination unprepared.

One of the most inspiring examples of neologisms from her class, if I am to vote, is the term textrovert. What could be better word than this one to describe those who keep texting instead of face-to-face conversation?

Game

Imagine paying to enter a café with uncomfortable chairs and without Wi-Fi. Why would people line up in the Toronto cold for a table in such unusual café named Snakes & Lattes?

There's nothing special about their food and drinks. The Snakes & Lattes café attracts guests by their board games.

Board games are almost laughably simple, yet endlessly fascinating: half mentally entertaining, half socially interactive experience. Go there and you'll be able to select any game out of the café's roughly 1000 items.

The Canadian journalist David Sax once quipped, "Table gaming creates a unique space apart from the digital world," You can never compare the fun of Scrabble with digital one like World of Warcraft. Think about the more realistic sting of defeat when you sit across from your smiling conqueror. Or the other way round.

Humans want few things more than to connect. And nothing connects people like the genuine feelings of thrill and reward when we play face to face. That brings me to a recent family holiday with good friends of mine, when we had a naughty card game Cheating Moth. The rule of the game allows us to cheat. In brief, we hold our cards above the table and are allowed to cheat one card at a time. 

To be successful, we have to be proper and yet creative. Say, drop a card on the floor or throw it over our shoulder. Or else, put a card up our sleeve. Whatever tricks as long as we aren't caught by the player who holds the Guard Bug card. On another note, we can't be too enthusiastic about cheating away the cards and need to be attentive. Whenever a player plays a Mosquito card, all other players must slap the hand down upon the card. Whoever slaps the card last will end up drawing one card from all the others. And there's more than juggling balls with cheating and Mosquito card. The rules about Cockroach card and Ant card are going to blow your mind.

Funnily enough, cheating, slapping, racing and shouting are the perfect ingredients for a delightful game.

Outward Bound

Outward Bound School is not a school, strictly speaking, but an adventure program, a chance to learn perseverance, or a life lesson. 

When I and my wife mention the Outward Bound sea diploma course we’d taken 27 years ago, it is impossible not to speak with fond memories. My heart still speeds up – and contracts with fluttering – when I think of the expedition from Sai Kung to the South China Sea and back to Lantau. That was when we just graduated from medical school, before embracing the year of internship. An ideal reason to get ourselves prepared physically and mentally.

We had not recently thought much about the Outward Bound course until my daughter is going to join their course next week. Our family are all excited, in ways no less than we were 27 years ago. To this day some of the Outward Bound challenging activities are unsurpassed – and are likely to remain so. We were antsy. Of course no Outward Bound students expect an extravagant trip. More of a jolt is the pre-course information that there will be no shower for the hiking and sea kayaking trip until the last day of the whole week.

"Okay," I said, wide-eyed, realizing the once-in-a-lifetime experience for my daughter next week.

Accomodation

The great thing about budget travel is minimalist travel style, including bare-bones, smelly backpacker lodging. 

I still remember my Youth Hostel Association membership card which worked like magical phrase "open sesame" during my university days. That worked well from Vancouver to Lake Louise, and Interlaken to Luzern. When I was a student, I could not afford hotel and, obviously, didn't have Airbnb. What I needed was pretty basic at that time: dorm beds, linen and kitchen. Most are lacking in ambience, but who cared? I would only be there for 12 hours, and eight of them I would be asleep.

I don't mean to create a false sense of nostalgia for the too-far-gone pre-Wi-Fi times, but we didn't really need signal thirty years ago. Indeed, if we were lucky, we might come across a small computer in the hostel, offering us free-of-charge five-minute slow dial-up modem connection. When I say slow, I mean ten times slower than whatever Wi-Fi signal you can snag from any nearby Starbucks nowadays.

Now that I can afford a better choice of accomodation, I haven't stayed in youth hostel for years. Not until this weekend, when our family chose to stay overnight next to the Lantau Trail. We didn't have other choices, honestly, if we wanted a location within a five minutes' stroll from the start of the Lantau Peak climb. Consider two contrasting takes on the accomodation within this same week for our family: one with just enough space for only two double bunk beds (without counting public washrooms), and another with almost 800 square feet size and one king bed. I am impressed by the way our brains can accomodate that quickly, from one way to another, as a true wayfarer from luxury holiday to minimalist's travel.

Wong Chuk Hang

To those of us who often attend fellowship conferment ceremonies at the Hong Kong Academy of Medicine, mention the place Wong Chuk Hang and we will associate that with formal dress code. When I say often, I mean seven times in one month. Yes, it’s that many.

To break the seemingly fixed rule, I booked a hotel located at Wong Chuk Hang during my daughter’s recent term break. That’s how I had chance to have casual wear and run along the Aberdeen Harbour. Venturing to the south of Hong Kong Island on a quiet Wednesday, we got chance to enjoy the long beach at Repulse Bay. 

It was truly unique experience, both magical and revival at the same time.

Irrational

As we navigate the pandemic, everything is new. We don't know what's under each rock. We don't know the path ahead. This, I believe, is why we are panic-stricken.

But as we get along, and the patterns become more obvious, we find the storyline predictable.

I guess that's the reason I borrowed Geraldine Brooks’s novel Year of Wonders. A story of the plague year, 1666, when we heard about how breathing would cease. More times than not, the patient's throat would give a wet gurgle, straining for air, and chest would rise and fall in a series of swift, shallow pants. After a moment or two, these would slow and diminish, until breathing stopped.

I read about the villagers' decision to quarantine themselves within Eyam, a village in the rugged mountain spine of England. And how the rector exhausted to dig graves. Day and night. How nobody was troubling with coffins, and how families simply carried their loved ones to their graves, or if they were not strong enough, dragged them with a blanket slung beneath the armpits of the corpse. And their great difficulty in poring through the book to find the repertoire of herbs: nettle for the blood, starwort and violet leaves for the lungs, silverweed to cool a fever, cress for the stomach. I felt every bit as similar as what was happening now and then, more than 300 years ago. Think of the way panic leads to a wealth of irrational remedies, from frantic attempts to resist contagion of plague, all the way to absurd judgment of who is right and who is wrong. Imagine the way to tell whether someone is a witch: throw her into water, and if she floats, she's a witch. If she sinks, she isn't.

All manners of falsehood. That was utterly nonsense. Okay, thank God, that was 1666. But I'm not sure we are anything better today.

FUO

The word uncertainty is loaded with negative connotations. Or much in the way that American psychologist Virginia Satir would say, "People prefer the certainty of misery to the misery of uncertainty."

One reason the word uncertainty lands on my head is a mysterious patient of mine. A colleague of mine, and a nice guy who had attended the same high school as mine. He had been having a condition called FUO. To say your patient had a FUO is like saying you bumped into a UFO. Mysterious, yes, alarming, maybe, but never easy to settle. The name FUO may not ring any bells, but if you study medicine you know the acronym stands for "fever of unknown origin." 

Physicians like me are indulged in solving the puzzle of FUO, but it's sometimes hard to crack the code. A caveat is warranted here: you simply have to unlock one bad thing after another, one by one, bit by bit. The FUO patient could have typhoid fever, malaria, cat scratch disease, cancer, AIDS, and all sorts of difficult-to-pronounce autoinflammatory diseases. The list of scans and of blood tests can be unbearably long. So much so that your patient might wonder if the weight loss can simply be a result of too much tests. When Jedidiah Jenkins suffered from FUO, he went to the hospital ten times and "had enough blood drawn to deflate a whale."

His doctor, like me, couldn't figure out what was wrong with him. I remember Jedidiah Jenkins quoting his doctor who said, "Believe it or not, this happens all the time. People get better, and we never find out what happened." For me, that captures what I believe I have to tell my patient. That's exactly where I am after tonnes of blood test, after removing a small piece of his kidney for examinaiton under a microscope, after ordering antibiotics and steroids.

It pains you to tell a patient you didn't find out what happened, but this happens. A lot.

Peers

Today is a wonderful day. It's the day my daughter's buddy saying goodbye to tween years and is turning thirteen. Without getting into the linguistic details of the word "tween," just take my word for it and believe that a girl turning thirteen is no longer a little child.

To celebrate the transition, five close friends of them had a fun-filled and action-packed sleepover. Their favorite day of the week. Watching them grow up reminds me Jedidiah Jenkins saying, "Do you remember the last time one of your parents picked you up and held you? There was a last time, and no one noticed."

This can sound silly. But my wife and I keep thinking of the good old days when our daughter was still holding our hands. The last time our two-year-old kept walking despite heavy eyelids, doing her best not to burden mummy's carrying her. It was a truly unique memory, both magical and comical at the same time. And we never tire of talking about the endearing memory of such a considerate toddler.

Now that my daughter is close to thirteen, I know very well our influence on her is in inverse proportion to the number of candles on the birthday cake. There are still ways, however, to boost our luck with her upbringing. One good example is to pray and facilitate her getting around positive and nice peers. For that, my daughter is lucky.

Kayak

A few weeks ago we had a seaside hotel stay with another family who are good friends of mine. We had known each other since school days, the sort of friendship that you can find in Hogwarts School. Our plan to go kayaking had come to naught last time because of tropical cyclone.

We scheduled our kayak trip today.

Choosing to paddle in the open water is not my usual modus operandi. But the aquamarine waters of Sai Kung is attractive in its own way. Braving the hot weather, we brought along our sunscreen, water bottles and snorkel masks. The sea resplendent with multi-coloured kayaks, I'm glad to have captured it photographically. Absurb as it may sound, I did bring along my Nikon camera. And yes, you read that correctly: a full-frame mirrorless camera. The view is truly memorable, but it pays to be careful. What I lack in water sports skill I more than make up for with determination not to capsize.

The journey of chat and splash of paddles, as it turns out, is more fun than I'd imagined. Ask Ratty in Kenneth Grahame's novel The Wind in the Willows, and he will tell you, "There is nothing - absolutely nothing - half so much worth doing as simply messing about in boats." If you were to ask me, I would say, "No. Please, no splash of water to get me wet; my camera doesn't need washing."   

Owls

I came to learn about two types of flower this week. Tulip and jasmine.

One of them is my wife's favorite and another one my daughter. One closes its petals shut at night, another blooms at night.

Day-blooming tulips need daytime pollinators because their pollen is best transferred when dry. In essense, tulips shut the door at the first sign of rain or darkness to maximise the best chance of seeding.

Night-blooming jasmine, on the other hand, has learned to open their petals at night because they are pollinated by nocturnal moths. To attract and be easily seen by moths at night, jasmine flowers tend to be white in colour.

It's hard not to be fascinated by their setting routine to bring out their strengths. The same is true of humans, who have different natural body clocks. What works great for morning larks won't do good to night owls. And vice versa. My daughter, Jasmine, is a night-blooming one who can come up with at least ten probable reasons not to go to bed. Reading Raina Telgemeier's graphic novel, enjoying story of Percy Jackson, cheese feast, writing diary are prime examples. 

Cloud Nine

This week I am supposed to be giving three lectures in a conference held in Singapore. But it's been a pretty difficult time to travel. I realized the question wasn't so much how inconvenient our city's hotel quarantine period can be, but how on earth we can guarantine coming back on time.

I decided offering recorded lectures. Instead of travel outside Hong Kong, I had a family vacation in a theme park with my daughter's classmate. Oh yes, I'm fairly certain I am not a theme park fan, but not in a stubbornly anti-theme-park manner. Life is a rich tapestry of what we do and don't know. More likely than not, I can find delight in our family event.

With that in mind, I packed my swimming suit, a novel and iPad (for the live Q&A after the lectures) for the theme park lodge stay. Before going, we watched the weather forecast (not too reliable, if I'm honest) and looked at the clouds (pretty helpful for the plan next day, I believe). There were cumuloninbus clouds. My goodness, that means rain, thunder and lighting ahead. If I need a reason to feel hopeful about the cumulonimbus, I can think of the classification of clouds by number. Cumulonimbus is number nine on the list of the US Weather Bureau. Remarkably little is known about this. So little, in fact, that it took me a while to reckon that we're on cloud nine.

Very well, there was indeed heavy rainfall. We grabbed umbrellas but couldn't stay dry. There is a silver lining behind all those clouds, if of the somewhat unexpected one. It's practically the shortest queue for the otherwise-busiest-and-crowded roller coaster ride.

Paddleboard

As I was going to take two days off for a family trip, the city logged more than seventy imported cases of malaria. Not an auspicious beginning.

Then, at one point, we had to cancel one of the kayak trips because of thunderstorm. One gratifying part about our holiday, however, is the chance to have a sunny day despite a looming tropical cyclone. We stayed in a lovely ocean-side resort which works out great for us, even when we are not beach people.

Okay, here’s a difference between me and my daughter. I couldn’t for the life of me to comprehend how to swim properly. My wife and I joined a beginner course of stand-up paddleboarding: our first sojourn on the board. Soon, two of us were in a state of physical exhaustion with sweat. Our daughter was chilling out near us, rowing, and had no inkling how we kept stumbling in a bizarre circle instead of heading in a straight line. In short, being clumsy.

Nevertheless, we enjoyed.

Summer

Travel is extremely gratifying on every level. Heading into our third summer of travel restriction, one way or another, we were discovering our means to have school break. Or stepping off the hamster wheel, if I could, to nibble some cheese and watch the world go by (but emails still come in, I know).

No sooner had we completed this thought, than right in our mind, we came up the idea of taking walk at Victoria Peak and Lantau Trail. Those are two of our favourite tracks. We first took the option of traversing a circular nature walk at the Peak: a cleanly maintained, easy-to-navigate path peppered with many banyan trees.

Ngong Ping Cable Car is another tour option to offer jaw-dropping views, best sandwiched with hiking between the two-way ride. We trudged up the trail to the craggy hill section where we could see the Zhuhai Macau Bridge and full view over Ngong Ping. Despite the hot temperature of midsummer, my daughter’s humour has augmented our joy by writing poem during hiking. “How amazing it is to hike with a poet,” I thought. To which I reply, yes, exactly right.

Narrative

Doctors - or medical students, for that matter - wouldn't come close to Barack Obama in terms of reading materials. 

Except novels. 

"It was important to pick up the occasional novel during the presidency," Obama told the interviewer a few days before leaving office in 2017. Reading memos and proposals every day, according to the first African-American president of the United States, makes a lopsided analytical brain that has lost track of the depth of fiction. Fiction should therefore be a way of seeing and hearing the voices, a useful reminder of the truths under the surface of what we argue about every day.

Substitute Obama's memos and proposals with doctors' x-ray reports and lab values, and you will see how medical professionals can be led astray in the analytical brain. 

This is the good reason for doctors to follow Obama's example, and pick up reading materials other than those from medical journals.  

Remarkably little on fiction reading is mentioned in medical curriculum. So little, in fact, that Dr. Suzanne Koven at Massachusetts General Hospital has come up with a program on narrative medicine. I learned about her session of Literature and Medicine after recent reading of her memoir Letter to a Young Female Physician. Each month, Dr. Koven brought humanities into workplace when the doctors and nurses met to discuss novels, short stories, plays, essays, and poems. 

Understanding the story obscured beneath a series of facts, as Dr. Suzanne Koven taught us, not only make us see a patient, but also ourselves, in a more compassionate and incisive way. 

Anthony

Switching back and forth, as any neuroscientist will tell us, is not efficient. I'm biased and like to multitask, but that doesn't make it less true.

Absurd as it may sound, I'm typically reading four or five books at once. For novel, I tend to read one at a time. Right now I'm reading Love Anthony. That's a two-fold story about two characters whose lives intersect. Two mothers, one of whom raised a boy with autism. A boy named Anthony, who doesn't speak. A boy who loves the number three. Always three. No more or less. Three French toast stick. Three Pig story. Three blind mice.

For people like me who has spent years doing not three things but four or five things at once, the book is not too difficult. I simply adjust my brain to read the stories of two mothers. Now, having said that, when it comes to connecting two characters, I must agree that I'm lucky not to suffer from or struggle with autism. Otherwise, it'll be hardly possible for me to get connected.

Party

The way Hong Kong's iconic Jumbo Floating Restaurant sinking like Titanic is sad. But nothing earth-shattering, if you ask me, when compared to the story of my friend who can't make it to go on board the boat today.

That's a boat party she missed. Not an impromptu party, but a boat party she planned after her diagnosis of stomach cancer. Flecks of cancer had already broken free of her bleeding stomach, floating off into her body. Her liver first. And then bone. And her lungs. She knew she was counting her days. Last month she came up with the idea of throwing a boat party for her family, her son's buddies at school and ice hockey team.

She wished she were here today. We wished too. 

She died two weeks ago.

Bittersweet

In my quest to help my patients, I do my utmost to keep them alive and safe. Not a must for some patients.

So. What happened?

One of my good friends - and my patient - died tonight. Kübler-Ross was hovering over the room when I brought my daughter and her classmate to say farewell. For an instant we were wired together and humming, like two engines on the same circuit. I began to feel a lump in my throat. Okay, I whimpered. We cried.

There are doctors who are particularly skilled at not letting the suffering get to them. They seem impervious. I can't.

Susan Cain tells us that compassionate instinct - the way we humans are wired to respond to each other's troubles with little distinction between our own pain and the pain of others - is as much a part of us as the desire to breathe. A fundamental human nature. If someone pinches us or burns our skin, this activates the anterior cingulate region of the cortex - an unique part of our brain responsible for high-level tasks like paying tax. And our anterior cingulate region of the cortex activates in the same way when we see someone else get pinched or burned. This is what I have recently learned from Susan Caine's new book Bittersweet.

What does it mean? This implies that our impulse to connect and experience sadness of other beings sits in the same location known as anterior cingulate region of the cortex. Our need to breathe? Anterior cingulate region of the cortex. To digest food? That, too. To reproduce and protect our babies? Anterior cingulate region of the cortex again. Read: right at the heart of human existence.

Match

Dr. Vanessa Grubbs has been in love with a man called Robert Phillips. That's a beautiful story I have read from her book Hundreds of Interlaced Fingers. On the day Robert made proposal with a diamond engagement ring, Vanessa smiled at him, surprised at how nervous he was. How sweet, she thought, because there could not have been a surer thing - she had just given Robert her kidney. Of course she would give her hand.

Yes, you heard it right. Vanessa has already donated her kidney to Robert, even before their engagement. She believed at her core that giving Robert a kidney is the right thing to do, and far better than seeing Robert's ordeal of three-times-a-week dialysis.

You won't read about this type of living kidney donation very often. Most of us would respond similar to what Vanessa's colleague did, "It's not an extra pair of shoes."

The answer lies deep in Vanessa's mind, as she puts it nonchalantly, "He needs one and I have two."

Try as we might, many of us could not follow the noble example of Vanessa. But that doesn't matter. Everyone is in debt, and many of us are takers. As long as we remember to be givers now and then, it's going to make a better world. Recently, I tried my best to help a good friend of mine after her diagnosis of metastatic stomach cancer. An incurable disease for a twelve-year-old boy's mum. It's as unbelievable as the moon catching fire. The bad news is that she has bleeding from the stomach and, at the same time, dangerous blood clots lurking inside her leg and lungs. Each clot damages her lung a bit more, each insult sending the signal for me to start blood thinner until, soon, the bleeding intervenes.

She needed transfusion and we gave her blood. One unit. Another one. And on and on. And so I went to donate blood this afternoon. Blood group B. Same as my friend. I wished that helps. Amen.

Human Kind

On my way to a public education event this afternoon, I was reading Mitch Albom's story of ten people on a lifeboat. Imagine them making an inventory of their rations after a yacht explosion: half can of water, three protein bars from the ditch bag, four bags of cookies, two boxes of cornflakes, three apples, and few peanut butter crackers. Wait a minute, one more: one seasickness pill, and that’s all.

On my way home, I delved into another book, Humankind, written by a historian and provocative thinker Rutger Bregman. He asked us to imagine two different planets.

On Planet A, the passengers turn to their neighbours to ask if they're okay. People are willing to give their lives, even for perfect strangers.

On Planet B, everyone's left to fend for themselves. Panic breaks out. It'd be like the cut-throat reality competition Survivor in which you either trample others underfoot or you get eliminated.

Now the question: Which planet do we live on? Choosing the planet is like opening our mind's eyes so that we can see humanity from the most positive possibility: upgrading from the operating system of surviving to thriving.

Live Concert

We've all been programmed - at all levels including school, work and socal - to think, act, and live in a virtual world under various restrictions. We have Google Classroom; we attend virtual scientific conferences; we watch Netflix movies.

With time, the good news is that we are now gravitating toward out-of-home activities after relaxed social distancing. Who in their right mind would choose not to go out?

Going to live concert by the Hong Kong Philharmonic Orchestra last night has been one of our best family activities after the fifth wave of Omicron. In my opinion, none is greater than their idea of blending music with the Blue Planet II nature documentary.

As I sat staring at charming puffins rattling their beaks together after fish hunting expedition, mouth hanging wide open (mine wider than puffin holding a mouthful of sand eels), I was in awe and blown away by the matching music on stage. Live music by an 80-piece symphonic orchestra in a concert hall. Giant screen of the BBC marine life series, side by side. Ebb and flow. Mind-blowing. I was elated.

Grip

To be honest, I'm not good at remembering characters. But that's what most novels ask us to do. 

So, the gods and goddesses, mythical beings, as what my daughter's reading of Rick Riordan's book series entails, would be almost impossible for me to comprehend. I don't even know how to figure out "who's who" when I read the not-so-divine novel Beautiful World, Where Are You by Sally Rooney.

But there is a catch: It's not every novel that has a large cast of characters for us to keep track of. If you're easy to get lost in the cast, you may decide to pick up the novel by Jeanine Cummins, American Dirt, as what I recently did after my brother's recommendation. There aren't too many characters: a Mexican mother and her son, and sixteen other family members. If you worry about the number of characters, I will be the first to reassure you. The sixteen of them, for that matter, were dead bodies in the backyard by the end of the first chapter. All killed by the end of the first few pages.

Seriously, though, story of the mother and son after the massacre is riveting enough to grip our attention.

Terminology

Language is a rich tapestry of what we feel, what we see and what we record. Think of language as our lens to perceive the world. Chances are, as what exactly Sapir-Whorf hypothesis states, you will be led to believe that the language we speak influences how we think.

Odd as the counterargument would sound to you, the relationship between language and culture can be the opposite way round. That means our language we speak doesn't shape the way we percieve the world. Quite the opposite - one might argue that it's language that reflects our view.

I'll bet the debate can go on forever. The only thing we can agree is that we should mind our words. A recent British Medical Journal article about medical language will show you why.

A real-life scenario that exemplifies how doctors' language belittles patients: "Patient denies fever, chills or night sweats." To deny, according to the authors, is to refuse to admit the truth. Isn't that connotation of untrustworthiness?

Another not-too-uncommon language usage that emphasises the patient as passive of childlike: doctors "take" a history, or "send" patients home.

Now, there's no question that we can use language to blame patients after treatment failure: "the patient failed chemotherapy" rather than "chemotherapy failed the patient."

Noise

I genuinely believe that credibility of recruiting interviews is overblown. To put it more starkly, as explained by the authors of Noise, they are often useless.

Job interveiw sounds robust and effective, but turns out to be as predictive - or unpredictive, for that matter - as any information source from marketing.

What's missing is the awareness of cognitive bias: an illusion of interviewers who think they can make sense of information collected from an interview. The same is true in our imaging a shape in the contours of a cloud. That's literally having our heads in the clouds: spend enough time looking at the sky and we will start seeing pattern out of the clouds. We use the term pareidolia to describe our natural tendency to perceive a specific image in a random or ambiguous visual pattern. You read that right: the interviewers are often imagining a pattern out of answers given by the candidates.

To figure out how likely interviewer is to have excessive tendency to seek and find coherence, researchers had designed experiments by asking some of the interviewees to answer questions randomly. Can you imagine giving a random answer "yes" or taking the "this" option as determined by the first letter of the questions? But you know what? Not a single interviewer realised that the candidates were giving random answers. This might sound counterintuitive, but the interviewers in this "random" condition were as likely as those who had met truthful candidates to agree that they were "able to infer a lot about this person given the amount of time we spent together."

Such is our accuracy of recruiting interview. As good as throwing a dice.

Storm

Read up about heart attack in medical textbooks and, chances are, you will learn about the plaque that clogs the arteries, the lipid-rich core of vulnerable plaque covered by a thin fibrous cap - as thin as half of our hair diameter. Think of it as a trash bin secured barely with a foil instead of a sturdy lid: when things has gone haywire (as they always did), that fibrous cap or foil breaks suddenly and erupts like the deadliest volcano, with all the junk suddenly bursting like lava to cause blockade of the artery.

Heart attack or acute coronary syndrome is serious, that much is clear. Remarkably little is known about the lung attack by the new coronavirus. If the devastating attack of this virus sounds completely mind-blowing, I'm with you. The blitz or ambush by this ever-changing-from-delta-to-omicron virus can be worse than a volcano eruption - ask anyone who has looked after an infected patient. It's practically called a storm. The virus simply kicks off a lid and spews out powerful drivers of inflammation, setting up a cascade of bushfire spreading everywhere, faster than you can imagine.

Every time I came across such a patient, I had that same precarious feeling I'd met him or her too late, like there would have been a better and earlier time window to find a trash can lid lock. Every time I thought I should have control, the bushfire bounced back like a boomerang. So it lingered. On and on. And on.

I seemed to tame the fire in one of the worst patients more than one month ago. Initially, she struggled to breathe when the hyperarousal state of immune system shut down her lungs. With time, she was getting rid of the coronavirus but still needed high flow moistened oxygen delivered through tubes into the nose. I told her I would go back to see her every day. I did. Day after day.

I told myself, as with anything, if you don't try then you will never know. I was carried on a wave of enthusiasm through that nasty wild bushfire fighting, here and there, week after week.

She didn't make it at the end.

Looking back, what do I remember?

If it doesn't set your soul on fire, it's not worth the burn.

Schadenfreude

Let me be the first to confess that I've been having unbridled antipathy towards patients coming to hospital, sick with the virus but without vaccination. I'd describe myself as having difficulty with being neutral to antivaccination folks, even I know pretty well a doctor shouldn't be.

The terrifyng rage moment of seeing the unvaccinated status, every time I admitted such patients, would set off a curse inside my head. God forbid, I know how a doctor should have behaved otherwise. But still.

Enter Brené Brown, American professor, long-time researcher on shame and vulnerability, who recently published her book Altas of the Heart. In this book, Brené Brown has devoted thirteen chapters to a kaleidoscopic medley of emotions. Here, too, she raised the topic of schadenfreude. How true: the undeniable-yet-so-guilty emotion during our struggle with schadenfreude toward unvaccinated people who get infected. That's a topic we don't talk about openly. At least not for a doctor like me.

Descale

Of all my rituals after waking up, making coffee appears to be the most highly consistent. I crave coffee every morning. We all do. It is little wonder, then, that it's disconcerting for me when my coffee machine didn't work two days ago.

People used to think that it can be dangerous for heavy drinkers to suddenly stop alcohol. Alcohol withdrawal actually kills. Not infrequently, I think this applies to coffee, too. I was, of course, trying hard to troubleshoot by googling. I started calling the service hotline after several unsuccessful attempts.

It was then I realised that my coffee machine was getting stuck because of the need for descaling. I have never bothered to do so since my purchase of coffee machine nearly four years ago. As I checked from the machine website, I learned that, with time, minerals in water will accumulate on the machine's heating element. Hard deposits like calcium have to be removed or else the limescale build-up will disrupt the coffee-making. Worse still, the machine heating elements can't be seen. Months of mineral build-up could have existed without our knowing it. The terrifying calcium burden inside the coffee machine is no different from the silent killer of calcium-rich cholesterol plaques growing inside our artery wall. First, nothing, I mean nothing, can be felt. Not until the build-up of plaque is heavy enough to rupture and completely clog our heart artery to trigger a heart attack.

As I stood next to the machine watching the rinsing cycles, one after another, I felt a gush of relief. It turned out that I descaled my coffee machine shortly after a weary overnight shift at the hospital. Think about it; those of us working for years without descaling should do so too.

Apples

After a month, I have almost finished Liane Moriarty's novel Apples Never Fall.

The first chapter of the novel starts in a far corner of a café where four siblings leaned over a round table, their foreheads almost touched. At the last few chapters, the tables and chairs were piled up on top of each other gathering dust in the corner; they were only doing takeaway coffees. No more table service.

Well, that's exactly what we'd found our life turns out to be recently. This is a month we have gone through something so chaotic, so unexpected and volatile, so entirely out of our control and out of our imagination, it is like a splash of icy water on a snowy day. Ukrainian residents are facing nightly air strikes. Disease outbreaks are spreading like wildfire in our local nursing homes. Round-the-clock crisis happens in hospitals with shortage of beds and shortage of mortuary spaces. I think we might have come close to the World War III.

For the first time ever, it occurred to us that the healthcare system probably would collapse and fall like a tower of Jenga. I don't know if apples would ever fall, but I shall pray that ours won't fall.

Toll

The pandemic kills in many ways.

We know the virus kills when it messes up our lungs. We know the virus kills when our body's immune cells can't stop setting fire on the fighting cascade. One of the yet-to-be-told stories about the untold toll is the pandemic's effects on the uninfected persons.

More often, it's a difficult trade-off between tackling pandemic and keeping others healthy. A back-and-forth between the two. Back and forth, back and forth: the sweet spot isn't easy to define. What are those stories of untold toll about? Running out of sleep after unbearable working hours. Running out of drugs like hydroxychloroquine after the misguided use to treat coronavirus disease. Running out of teaching opportunities for medical students, or even kindergarten students.

Or simply running out of friends or hugging.

Think about loneliness and social isolation. Social distancing is often the magic word for anti-pandemic measures. On the flip side, we can be truly alone (subjectively) and isolated (objectively). All that is bad news, and more so for a centenarian who can go downhill quickly, because loneliness messes with our stress response. Cortisol, the stress hormone, jumps higher after our connection with others are being cut off. Worse still, the risk of death goes up. And yes, you read that correctly: increased risk of death. It isn't a question of objective or subjective social isolation. It doesn't matter, according to a meta-analysis. Objective social isolation may raise the risk of death by 29 percent, and reported loneliness ups it by 26 percent.

That means we need friends. Don't let the coronavirus steal yours.

Present

If we choose to live our lives like a monk, it means we tell our monkey mind to be present to the moment. A seemingly simple mantra but easier said than done.

Jay Shetty - the oracle of mindfulness, the award-winning storyteller, the author of inspiring Think Like A Monk- once wrote that we're almost always somewhere else. Instead of thinking about what mattered in the past or what the future might hold, we are taught to "be here now." After all, the past is unchangeable, and the future is unknowable.

His teaching is life-changing, that much is clear. I was working late at hospital tonight and could not finish admitting patients until midnight. I decided to run back home. Little did I know, when I was planning my run after work, it was a blustery and rainy night. Fat raindrops dotted my short-sleeved tee, mingled with the moisture on my face, soon after I started my run. Regardless of the weather, I told my monkey mind to go ahead and be present, as I felt the cold air against my skin, my breath traveling through my body. I willed myself not to take short cut by train, even though the monkey mind wanted to.

And that's a good exercise to practice tuning in to my mind.

Camping

After a full week of rebound in local coronavirus infections, I haven’t had time for running. All hours seemed to be taken up by the one objective of clearing the cases.

It’s not just a matter of keeping my head above water; I have to keep my head behind surgical respirator and, yes, face shield.

If I had a dollar for every time I don personal protective equipment, I could be dining at Four Seasons Hotel.

At long last, I have taken two days off for a family camping vacation. The air is colder here, but being in the outdoors lifts my spirits. It’s a pretty landscape, but not in an extravagant way. There is no Michelin star, but we were happy to be the chef ourselves. It's not about the five-star dining, it's not about the wine. It's not about the world-class gastronomic experience. It's about the raw experience of making and cracking open our own beggar's chicken in the wild.

Change

All of the ways we've been talking about the coronavirus involve changes: changing strain with new variants, changing reproduction number R-naught, changing rules of the game.

We'd all been shellshocked. We worry. We panic.

But then, I try to remind myself to get prepared for changes. Today, one has fun at school or on school bus. The next day, there is in-person school suspension. Pretty soon many parents - including me - hear about the news of a teacher being quarantined and their children thus declared as close contact.

How should we make sure nothing bad happens? Try this. Open our eyes to the new opportunities. That's what my daughter showed me when school closure was announced without warning. She had come up with many pen-and-paper games when she spent time with classmates on school bus. She then switched to teach me her self-made game. First, write a list of categories: name of celebrity, villain character of any book, city, song, body parts, elements in periodic table. Next, think of an alphabet. We then have to race to complete the list by giving one example for each category, using that alphabet as the first letter of the example.

As it happened, we ended up having a non-stop-laughing night when we kept competing, and changing the categories for fun.

Monk

Omicron is anything but blameworthy. I suppose that's what most of us think.

Little did I expect silver lining on such cloudy days, when things turn dark earlier than usual. Actually, everything, cafeteria and restaurants included.

Besides the curfew on dine-in services, many venues are closed. No bars. No karaoke roooms. No gyms. No swimming pools. No cinemas. No libraries. 

In my case, there was something quite magical about my clairvoyance to time my public library visit. I was able to check out more than ten library books one week before our government ordered all those premises to shut. I then took a deep breath, sipped my coffee and nodded, feeling accomplished like Chip 'n' Dale after stocking enough for the winter. It's simply more than awesome. Quite a number of the books have been reserved by others, and I could have had only two weeks to finish them if not because the library is closed.

Good, simple, hassle-free. I'd figure I should have more than enough time to go through all those highly popular books before the library re-opens: Jay Shetty's Think Like a Monk, Michael Lewis' The Premonition, Oprah Winfrey's What Happened to You?, Liane Moriarty's Apples Never Fall.

Hero

BioNTech is a wonderful vaccine developed from a brand-new technique. So much so that some of us remain skeptical of the new technology of messenger RNA platform. Consider how we compare with any earlier vaccine - the fastest one was mumps vaccine which took four years to develop - and we are amazed by the way Pfizer-BioNTech was developed within 12 months.

The fact is, we all forget how much longer the scientists have been solving the puzzle of mRNA vaccine. The answer, as it turns out, is more than 15 years. That's what l learned after reading the story of a Hungarian biochemist Katalin Karikó, who is named one of 2021 "Heroes of the Year" by Time Magazine.

During these years, Karikó has been fascinated by RNA. If DNA makes up the letters of life, RNA creates the words, and ultimately the sentences, as explained by Time. In her pursuit of turning our body into its own drug-making factory, Karikó has been figuring out ways to use messenger RNA to instruct the body to make proteins, enzymes and different molecules. Think about her working late nights and early morning, writing at least one new grant application every morning, being turned down and rejected again and again - at least 24 times. But the key is that she kept pushing, even after being fired by her supervisors at the University of Pennsylvania.

The breakthrough came after her collaboration with an immunologist years later, when they found out the trick of encasing the mRNA inside a fat bubble, thus protecting the precious genetic code without triggering a cascade of inflammatory storm. The next thing they knew, in a lightbulb moment, is the flexibility of creating any vaccine once they get the readout of a virus's genetic sequence. Get the code, build the correspoding mRNA with chemical compoundes, pop it into the fat bubble and that's the birth of a new vaccine. Simple and smart. When this smart solution was first published in the journal Immunity in 2005, the beauty of their findings was clearly not appreciated by the scholars around the world. The night before the paper was published, Karikó was expecting a flood of phones calling to congratulate next morning. No one called. Nothing.

Not until 15 years after the original work of Karikó, when we are now blessed with the protection by BioNTech.