Repose

Much as thought-leaders had described, travelling opens our mind. We slow down when we travel. We open up when we slow down.

That’s what I did after I’d taken a week off. Of course, a family vacation during Chinese New Year means opportunity to relax with far fewer unread work-related emails.

The first thing I notice is the number of blog posts written. Next, I watch myself shaking things off like Taylor Swift’s hit song “Shake it Off.”

I leaned back, gazed out the window, and watched the snowflakes. That’s the time when everything - except my hair - has turned white.

Swing

With lesser and lesser pandemic restrictions, borders have reopened in many places around the world. Our family have longed to travel since three years ago. 

The silver lining of all the hiatus in luggage packing is that I have found my daughter grow up a great deal when we are on the road again. So, when we were taking Shinkansen bullet train from Narita Airport to our town, she did most of the luggage carrying and moving. I saw her preparing own luggage, bringing her diary and picking the snow gears. 

Without realising it at the time, I’d come to travel with an independent daughter, in large measure. It would take some time for a daddy to accept this. Before we headed back home this morning, I took my daughter to a playground near where we had been staying. Without anyone telling us to do so, we made a beeline to the swing. She quickly wiped clear the snow and enjoyed her swing. There’s something magical about swing in playground - jumping on the seat and riding high, for anyone with any age and of any race. As she stood up and asked me to push her, I felt like being on cloud nine. I’ve discovered that I still treasure the way a daddy can be serving the way one does for a toddler.

Snowboard

Who doesn't hesitate to try something new?

No one is born a skier. We are all, at one time or another, going to stumble before getting used to the ski. Now that my daughter is pretty comfortable on ski slopes, her next activity would be snowboarding. It isn't easy. Landing on the butts again and again can be achingly frustrating. That requires patience. And perhaps a mindset to stay low.

In our quest to encourage her to learn snowboarding, we have bolstered learning by watching YouTube video last night. Learning snowboarding by YouTube might not be as easy as learning a language by Duolingo, or learning algebra from Khan Academy for that matter. But that's the most popular experience of learning nowadays. As an intro tutorial before the on-the-ground practice, at least, for my daughter.

We rented the snowboard gear and let her try. She fell. She tried. Along the way, she had toppled over - a lot. One after another, step by step, she found her way on chair lift, and maneuvered her way down the slope. And another. And another. Many times.

Ski Pole

I don't think I am a good skier, and even more so after our family encountered heavy snowfall in Japan this week. 

Skiing in a cold snap has cost me heavy lactic acid load today after repeated falls and pushing up from snow.

For a novice like me, learning to ski is tough. The older you grow, the tougher it is. I struggle to remember ski technique 101: learning which leg I have to put my weight to make parallel turn, to lean forward but not back to avoid falling, and how to position my skis and poles to get back up after falls. Getting off-kilter on ski track, believe me, is as scary as accidentally pressing the WhatsApp group call and fumbling to find the cancel button.

Thankfully, my family ski trip started after my recent reading Tom Vanderbilt's Beginners, an inspiring book for a lifelong quest of learning, at any age, and on any subject. As I took the chairlift with my daughter, I was brimming with pride. Not a proud and professional skier. More as a proud dad who can share the precious moment of learning together with my child. I knew that I would struggle. That I would fall. But the joy on the ski track with my daughter has made my life feel richer.  

Taylorism

I love the New England Journal of Medicine story told by Jerome Groopman seven years ago. The title of that article, Medical Taylorism, rhymes with "medical terrorism."

Misleading as it may seem, Taylorism in the context of medical care can be threatening. And make no mistake, we know that Frederick Winslow Taylor wrote the most influential book on management: Principles of Scientific Management. Since his book came out more than a century ago, business owners around the world, Toyota included, have embraced Taylor's approach. He believed in devising a system as machinelike as possible, a factory assembly line as standardized as possible, a conveyor belt as precisely timed as possible.

Does this sound familiar to the clinical pathway, also known as integrated care pathway, in the healthcare system? Believe me when I say they are.

Keep that image of Toyota manufacture factory in your mind. Each of the factory employees work repetitively, precisely and strategically. To do this in the clinic, we can have a standardized electronic health record like Toyota. Press a button when a diabetic patient enters the consultation room, and presto, the computer will have a template consultation page prepared automatically. The doctor won't even have to type extra keystroke to have all the laboratory results filled in the boxes.

I can't tell you how many times I have deliberately deleted all those templates and came up with my own paragraphs in the clinic notes. Ask Jerome Groopman, and he will tell you Taylorism doesn't work in human patients. "If patients were cars, we would all be used cars of different years and models, with different and often multiple problems, many of which had previously been repaired by various mechanics."

In other words, none of our patients want to be treated like a Toyota car. None. Zip. Never.

Goat Cheese

We are the proud record holders for the most teen sleepover parties during this pandemic. Mentally healthy as it may seem, gathering activities like sleepover are often skipped when Omicron strikes us. Our family, and that of my daughter's classmates, are heartily convinced by what Priya Parker has written in the book The Art of Gathering: How We Meet and Why it Matters.

We didn't want to deprive our children of chance to meet friends. And then, wonder of wonders, we had invited one, two and even three buddies of my daughter to come for sleepover. You can imagine the way we experimented with breakfast choices. Once we prepared Cantonese sponge cake and dim sum. It turned out that my daughter's friends from Greece and France didn't find our choice match their taste buds. And that's fine. Teenagers are mature enough to be grateful and yet honest enough to tell their preference. Telling the truth seems reasonable enough but then it is far from the truth for grown-ups.

I'm reading a psychology book about collective illusions. I learned about the author's joining a summer wine and cheese taste party in his postgraduate days. That was a story when he met the Ivy League stereotype, a guy called Ambrose whose last name was followed by the Roman numeral III. Ambrose wore a navy-blue tailored suit with a crisp white pocker handkerchief, topped off with his usual bow tie. A wealthy and cultured guy, that is. Smart, yes, outstanding, maybe, but never aesthetically wrong. As Ambrose entered the party, he quickly pinged his wine glass with a cocktail fork to call for attention. "Hi, everyone!" he announed with an air of superiority. "Just wait until you taste this! It's a rare vintage from a family friend's vineyard in Sonoma. I recommend getting a fresh glass." Everyone in the party dutifully followed and received a few ounces of the ruby-red wine. They took a sip and looked at the others, all of whom nodding their approval. The wine actually tasted like weird rancid vinegar. Ambrose was satisfied, that’s for certain. He remained so until a statistics professor, a true wine afficionado, arrived and took a taste. The professor immediately spewed it out onto the glass. "This is corked wine," the professor stated matter-of-factly.

"Corked" wine is tainted with a molecule known as 2,3,6-trichloroanisole, which makes it smell like anything from a wet dog to a dirty restroom.

That brings me to another story when it's my daughter's turn to have pajama party at her friend's house two weeks ago. They made their own salad breakfast. The host family served goat cheese with salad, and many of them talked about how delicious goat cheese can be. In fact, everyone liked goat cheese that morning. Everyone, that is, except my daughter and her close friend. My daughter averted their eyes, took the smallest possible nibble of goat cheese with a sheepish smile. After a few swift kicks under the table, two of them confessed how somebody can think less of goat cheese, and then laughed out loud.

Journey

Few things in the animal world fascinate us quite like bird migration. 

The feathered globetrotters' journeys are packed with energy and stamina. My recent reading about bird migration includes classic annual outward and return "flyways", "loop migration" with a different return journey, or even "migratory divide" meaning more than one route for some species.

One of the evolutionary eurekas that go with migratory journey is the advantage of moving. At a glance it might seem that the exhausting migration is hazardous. It's hard work, mentally and physically, with long, chaotic hours. The truth is, however, that survival rates among sedentary species - those that stay put over winter - are often lower than among related species that migrate. It's not just birds which have to migrate to survive. We too have our own need. As I keep working for the last two weeks - fourteen days in a row without break - I know very well that pattern doesn't confer any survival advantage.

Similar to birds that migrate to find resources to keep them alive, I have tried to depart even I'm obliged to return to hospital daily. Instead of undertaking the long haul African-Eurasian or Asian-Australasian flyway routes, I strike a balance between moving and staying put, and made short hike to a mountain nearby. Not once but twice, in different direction.

Believe it or not, moving around is the best way to fill our tank with fuel to strike for survival.