Commuting to work by public transport can disappoint at first glance. The added time and distance might not be worth the hassle, I know. If that's not enough, the trip can be ruined by greedy seat searchers – to say nothing of someone who blocks the middle seat with a school bag.
Yet I'm unflinching: the best-kept secret of enjoying my train ride is the reading time. This week I traveled to Guangzhou for a conference. Getting there by train takes close to two hours, and that doesn't seem to bother me. The only question for me is what books or magazines to pack.
I was glad to have picked Daniel Gottlieb's Letters to Sam this time. I'd read this book few years back, but I still enjoyed reading it again. As I read the story of this man who has been paralyzed from the neck down (after an automobile accident), I learned great lesson from his struggle with bedsore on his buttocks. The quadriplegic psychologist went to see the doctor, who then examined the skin and said, "It's broken."
"I know," Daniel answered. The doctor had no idea that Daniel was referring to his heart, but not his skin.
"Too much pressure," the doctor explained, meaning his buttocks on a wheelchair all day. "I know," Daniel said, meaning his life.
When the doctor found out the moist wound, he commented on the unhealthy sign, in medical parlance, "It's weeping."
"I know," Daniel gave the same answer. But he wasn't still talking about his wound.
Saturday, March 19, 2011
Wednesday, March 16, 2011
Peppermint
"Guess what," Peppermint Patty told her classmate Marcie one day, "I'm going for the "Most Improved Student" award."
"School just started today, sir."
But Peppermint didn't lose her hope, quite the opposite really, because she went on, "And I'm already better this afternoon than I was in the morning."
The story of Peppermint is the story for all of us to learn. It's not that we should learn to console ourselves when we just receive a D minus - as what Peppermint gets most of the time - but we're to remember the lesson not to envy our neighbours more than we need to. The question is not whether we should compare with others, because we all do. We compare the job title, the size of our house, the examination scores of our children, and the inches around the waist (or the breast, if you like).
The big question is, When should we compare with ourselves rather than our neighbours? Just think about the hypothetical question posed by the economist Robert H. Frank. In World A, you earn $110,000 per year; others earn $200,000. Compare that with World B, in which you earn $100,000 per year; others earn $85,000. So which would you pick?
The truth is, even though the absolute income figures represent the real purchasing power, the majority of people choose World B.
"School just started today, sir."
But Peppermint didn't lose her hope, quite the opposite really, because she went on, "And I'm already better this afternoon than I was in the morning."
The story of Peppermint is the story for all of us to learn. It's not that we should learn to console ourselves when we just receive a D minus - as what Peppermint gets most of the time - but we're to remember the lesson not to envy our neighbours more than we need to. The question is not whether we should compare with others, because we all do. We compare the job title, the size of our house, the examination scores of our children, and the inches around the waist (or the breast, if you like).
The big question is, When should we compare with ourselves rather than our neighbours? Just think about the hypothetical question posed by the economist Robert H. Frank. In World A, you earn $110,000 per year; others earn $200,000. Compare that with World B, in which you earn $100,000 per year; others earn $85,000. So which would you pick?
The truth is, even though the absolute income figures represent the real purchasing power, the majority of people choose World B.
Thursday, March 10, 2011
Fountain Pen
Off all effects created by fountain pen, none is more eye-catching than that created by ink spillage on a white shirt.
Since I started using fountain pen over ten years ago, I came across time and again the creepy experience of wearing a white coat stained with black ink. Never shall I forget the embarrassing story which reminds me of - oh, say - say the Persian Gulf War oil spillage. I was trying to examine my patient yesterday morning, with medical students around. Before I put my hand on the patient's tummy, I noticed my dirty looking fingers stained with Waterman black ink. Just when I thought things couldn't get worse, a cursory glance at my white coat pocket showed another messy ink stain. I shrugged; probably I blushed. Uh-oh.
The stubborn ink stain is not pleasant - how could it be? - but it never deters me from being a fan of fountain pens. And, oh, yes, you thought it was nuts at first, and even more so for nurses who found a drop of water falling upon my handwriting in ink. But it has made a heck of difference in how I found my footprints in the patient record. It takes more than a standard template on the computer screen (in this age of electronic medical record) to keep track of the patient story. Patient story on a computer screen is emotionally dead, that's the crux of it. If you put the story in ink, you will be surprised at how much you will remember when you look back at the handwritten record. By surprised, I mean amazed; and by amazed, I mean stunned and impressed.
Since I started using fountain pen over ten years ago, I came across time and again the creepy experience of wearing a white coat stained with black ink. Never shall I forget the embarrassing story which reminds me of - oh, say - say the Persian Gulf War oil spillage. I was trying to examine my patient yesterday morning, with medical students around. Before I put my hand on the patient's tummy, I noticed my dirty looking fingers stained with Waterman black ink. Just when I thought things couldn't get worse, a cursory glance at my white coat pocket showed another messy ink stain. I shrugged; probably I blushed. Uh-oh.
The stubborn ink stain is not pleasant - how could it be? - but it never deters me from being a fan of fountain pens. And, oh, yes, you thought it was nuts at first, and even more so for nurses who found a drop of water falling upon my handwriting in ink. But it has made a heck of difference in how I found my footprints in the patient record. It takes more than a standard template on the computer screen (in this age of electronic medical record) to keep track of the patient story. Patient story on a computer screen is emotionally dead, that's the crux of it. If you put the story in ink, you will be surprised at how much you will remember when you look back at the handwritten record. By surprised, I mean amazed; and by amazed, I mean stunned and impressed.
Thursday, March 3, 2011
Closet
"I've never known anybody who didn't have a skeleton or two in their closet," writes Robert Fulghum, noting that there are always those things we don't want to talk to anybody about.
It is true that all of us have a few demons being locked somewhere in a closet or drawer. Fulghum, the American author who wrote All I Really Need to Know I Learned in Kindergarten, explains that shame, guilt, and embarrassment are the locks on the closet door. I have long been wishing for a secret recipe to erase the demons, and I have always felt it to be just as well for me to clean up the lockers other than mine - I'm responsible for at least dozens of demons hiding in others' closets.
It's not hard to understand my excitement when I read about a memory molecule that appears in a recent edition of the scientific journal Nature. Researchers have discovered ways to manipulate a protein in the rats' hippocampus to enhance or diminish memory. This means that the scientists are able to deliver electric shocks to rats on entering a particular entrance to a box, but then erase their bitter memories of the shock.
Another way of making sense of the science is to develop a novel target for cognitive enhancement therapy. If you want people to keep remembering a story, you can. The question remains: Do we?
It is true that all of us have a few demons being locked somewhere in a closet or drawer. Fulghum, the American author who wrote All I Really Need to Know I Learned in Kindergarten, explains that shame, guilt, and embarrassment are the locks on the closet door. I have long been wishing for a secret recipe to erase the demons, and I have always felt it to be just as well for me to clean up the lockers other than mine - I'm responsible for at least dozens of demons hiding in others' closets.
It's not hard to understand my excitement when I read about a memory molecule that appears in a recent edition of the scientific journal Nature. Researchers have discovered ways to manipulate a protein in the rats' hippocampus to enhance or diminish memory. This means that the scientists are able to deliver electric shocks to rats on entering a particular entrance to a box, but then erase their bitter memories of the shock.
Another way of making sense of the science is to develop a novel target for cognitive enhancement therapy. If you want people to keep remembering a story, you can. The question remains: Do we?
Friday, February 25, 2011
Good Morning
I used to work in the hospital till late hours. But not now. To a new father, eager to see his daughter, being at home is the only way to make the day count.
If you thought I'm getting lazy, I would have answered, "Quite the opposite." And I would have added, "If that surprises you, it surprises me, as well."
Lest I be misunderstood, let me make it clear that the longer we stay at workplace doesn't necessarily mean the more we would have accomplished. This is often the case when we keep taking breaks to play Farmville.
The truth is that I'm making better use of the morning hours. Often I need my alarm clock to wake me up. Hey! But then the miracle happens when I get up and start my morning rituals, and one thing leads to another, and eventually, before eight forty-five, I find myself calm and satisfied. By then, I should have had my morning coffee, thumbed through a few pages of medical journals, read my mentor's blog, entered quite a few ticks in my diary's to-do-list.
Now, see, I got time to write a blog this morning.
If you thought I'm getting lazy, I would have answered, "Quite the opposite." And I would have added, "If that surprises you, it surprises me, as well."
Lest I be misunderstood, let me make it clear that the longer we stay at workplace doesn't necessarily mean the more we would have accomplished. This is often the case when we keep taking breaks to play Farmville.
The truth is that I'm making better use of the morning hours. Often I need my alarm clock to wake me up. Hey! But then the miracle happens when I get up and start my morning rituals, and one thing leads to another, and eventually, before eight forty-five, I find myself calm and satisfied. By then, I should have had my morning coffee, thumbed through a few pages of medical journals, read my mentor's blog, entered quite a few ticks in my diary's to-do-list.
Now, see, I got time to write a blog this morning.
Friday, February 18, 2011
Silver lining
Teaching our children has always been more by trial and error than science, but that has been pursued for some time, at least in experiment.
Think about a beautiful example done at Temple University in Philadelphia some years ago. The parents of a 4-year-old girl invited a research team to their home. The two professors explained to the little girl that she will get a prize at the end of their visit. This is just what they did, handing out 10 potential "prizes" and asking the girl to rank them from the best prize to the worst prize. Right before the girl, she found a truck, a doll, a broken pair of sunglasses, a pair of socks, and so forth. She was deliriously joyful at this game because she was told further that she will get the prize she liked the best.
The girl zeroed in on Barbie, and happily waited for the moment to receive the best prize. Yeah (drum roll please), and wait - oops. Something wrong. The researchers explained that they had made a mistake and they had to give the girl that she ranked as dead last - a pair of brown socks.
"Sorry for this big mistake."
Now, how does the parent help the child cope with this disappointing news? And this is the real research question.
What will you do? Before I tell you the answer, take a few minutes to think about the possible ways out.
Do you shift your girl's attention away from the socks toward the nice wrapping the prize came in? Do you comfort your girl by holding her or verbally soothing her? Do you "reframe" the situation, putting the socks on your hands and making them into a puppet or suggesting you give the socks to another kid who might really like them? Do you encourage your girl to change the situation, say, by talking to the researchers and telling them that she got the wrong prize?
Of all the options above, none are more positive than shifting the girl's attention and cognitive reframing. The effect of looking more closely at every cloud, to see the silver lining, is riveting. This is, in fact, associated with the lowest level of sadness and anger. If you think you are helping the child who was encouraged to change the situation by talking to the researchers, nothing could be further from the truth. That would lead to more anger and sadness than those in other conditions. The child would simply lose the ability to regulate her emotion in a positive way, directing herself to vent and lash out, instead.
Taking another perspective to look at adversity can always be a new opportunity. Whining never is.
Think about a beautiful example done at Temple University in Philadelphia some years ago. The parents of a 4-year-old girl invited a research team to their home. The two professors explained to the little girl that she will get a prize at the end of their visit. This is just what they did, handing out 10 potential "prizes" and asking the girl to rank them from the best prize to the worst prize. Right before the girl, she found a truck, a doll, a broken pair of sunglasses, a pair of socks, and so forth. She was deliriously joyful at this game because she was told further that she will get the prize she liked the best.
The girl zeroed in on Barbie, and happily waited for the moment to receive the best prize. Yeah (drum roll please), and wait - oops. Something wrong. The researchers explained that they had made a mistake and they had to give the girl that she ranked as dead last - a pair of brown socks.
"Sorry for this big mistake."
Now, how does the parent help the child cope with this disappointing news? And this is the real research question.
What will you do? Before I tell you the answer, take a few minutes to think about the possible ways out.
Do you shift your girl's attention away from the socks toward the nice wrapping the prize came in? Do you comfort your girl by holding her or verbally soothing her? Do you "reframe" the situation, putting the socks on your hands and making them into a puppet or suggesting you give the socks to another kid who might really like them? Do you encourage your girl to change the situation, say, by talking to the researchers and telling them that she got the wrong prize?
Of all the options above, none are more positive than shifting the girl's attention and cognitive reframing. The effect of looking more closely at every cloud, to see the silver lining, is riveting. This is, in fact, associated with the lowest level of sadness and anger. If you think you are helping the child who was encouraged to change the situation by talking to the researchers, nothing could be further from the truth. That would lead to more anger and sadness than those in other conditions. The child would simply lose the ability to regulate her emotion in a positive way, directing herself to vent and lash out, instead.
Taking another perspective to look at adversity can always be a new opportunity. Whining never is.
Saturday, February 12, 2011
Emotional Intelligence
By any reasonable standard, no doctor would like to be called back to the hospital in the middle of the night. But some of them can't be judged by any reasonable standard.
Last night I went to see a 92-year-old woman who has been bleeding from the ulcer in her digestive tract. My guess was that I might have to ask someone to perform an upper endoscopy procedure to help that anaemic patient. Probably it's the most helpful means to control bleeding through a flexible tube going all the way from the mouth to the first part of the small intestine. But that's quite impossible – her doctors have tried this way for three times within one week but to no avail. Strictly, however, she wasn't fit enough for us to take her to the operating room.
I hesitated for a moment, and then phoned up the radiologist team. They had already attempted more than once to put a tube into her blood vessel in the leg and thread it up to block the bleeding artery near the stomach. My classmate radiologist barely flinched when I told him the story. "Prepare her for the third angiography," my classmate told me, "and I'll be back within an hour."
To give you a sense of what it's like for a radiologist to perform the angiography, imagine yourself wearing a sturdy apron made of lead (instead of cloth) and standing for an hour in front of a monitor. But wait: the monitor isn't as colourful as the Wii video games; it is a maze of black-and-white pictures where the radiologist navigates with the wires. So how can the radiologist go without getting lost in the maze? Hardly. They get lost as often as a puppeteer gets his strings entangled. Skill isn't enough. A radiologist can lose his way during the angiography but cannot lose his temper. That's the easiest to lose and the hardest to survive without. When my classmate found his way to the target artery, I was amazed to find that he couldn't go further because of the machine breakdown. More amazing still: he was perfectly composed to finish the task with his bare hands instead of the machine.
I was amazed. Even now.
Last night I went to see a 92-year-old woman who has been bleeding from the ulcer in her digestive tract. My guess was that I might have to ask someone to perform an upper endoscopy procedure to help that anaemic patient. Probably it's the most helpful means to control bleeding through a flexible tube going all the way from the mouth to the first part of the small intestine. But that's quite impossible – her doctors have tried this way for three times within one week but to no avail. Strictly, however, she wasn't fit enough for us to take her to the operating room.
I hesitated for a moment, and then phoned up the radiologist team. They had already attempted more than once to put a tube into her blood vessel in the leg and thread it up to block the bleeding artery near the stomach. My classmate radiologist barely flinched when I told him the story. "Prepare her for the third angiography," my classmate told me, "and I'll be back within an hour."
To give you a sense of what it's like for a radiologist to perform the angiography, imagine yourself wearing a sturdy apron made of lead (instead of cloth) and standing for an hour in front of a monitor. But wait: the monitor isn't as colourful as the Wii video games; it is a maze of black-and-white pictures where the radiologist navigates with the wires. So how can the radiologist go without getting lost in the maze? Hardly. They get lost as often as a puppeteer gets his strings entangled. Skill isn't enough. A radiologist can lose his way during the angiography but cannot lose his temper. That's the easiest to lose and the hardest to survive without. When my classmate found his way to the target artery, I was amazed to find that he couldn't go further because of the machine breakdown. More amazing still: he was perfectly composed to finish the task with his bare hands instead of the machine.
I was amazed. Even now.
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