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.

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.