Vitamin

"Should I give my baby a few supplemental drops of vitamin D?" my sister asked me about the vitamins missing from breast milk. "The American Academy of Pediatrics said so."

"Though it may seem right for you to follow their recommendation," I murmured, not that enthusiastic, "it's optional in my personal opinion." There's really no scientific basis why I came to such conclusion. I have to admit it.

The simplest explanation would be that we're often bombarded with dozens of parenting dogmas - most of them conflicting - and each claiming to work. So it goes. What works for one may not necessarily work in another hemisphere. Foods that work in one culture, for example, will not be adequate in another. Well, so is vitamin B12, in a way. Vitamin B12 deficiency or megaloblastic anaemia, as every medical student learns in the first haematology class, is a risk for vegans who consume no meat because vitamin B12 is only found in foods of animal origin. Oddly enough, it was found that orthodox Hindus who had been quite healthy on a vegan diet in their native India began to suffer from a high incidence of megaloblastic anaemia after migrating to England for quite a while, consuming the same diet. This condition can be serious with nervous damage, and hey, even neuropsychiatric abnormalities. If it is obvious there is no real vitamin B12 in plant sources, the really interesting question is why so many Hindus are not affected in the first place. Not until the mid-1970s was the cause traced to vitamin B12 deficiency, which in India was prevented by insect contamination of grains. The same foodstuffs purchased in England were uncontaminated and therefore contained no animal source of vitamin B12.

In fact, neither plants nor animals are able to manufacture B12, so all animals obtain their (and our) supply of this essential vitamin either directly or indirectly from bacteria, which are the only organisms capable of making it.

All Fours

As my energetic little baby starts showing her kinetic energy, we know it's high time we do some childproofing around the house. Without the slightest idea of what to do, I ended up reading my favorite manual What to Expect the First Year.

I was taught that the best way is to take a baby's-eye view of our home. How so? Simply get down on my hands and knees, and crawl around the house. From there, alas, I will see the world in a different light and find a multitude of dangers I may not even have realized existed. I could have found hidden choking hazards such as the lost game piece under the couch and jettisoned food under the kitchen table. A carcass of cockroach, maybe.

Which brings me, somewhat uncomfortably, to the question of health care safety. It is not without irony now that the one who oversees patient safety in the hospital is often working at his consultant office without ever getting a look at the real world from down on all fours – but that is never, of course, the best way.

Smile

"Well, Jasmine didn't sleep well last night," my maid observed.

My wife touched the forehead and the nape of our daughter's neck, wondering. "Jasmine looks fine," I took a deep breath and asked my wife. "Do you think so?" Jasmine was sitting on the rug in our living room, her soft arms waving with enthusiasm, absolutely concentrating on her dad's making a tower of blocks.

At six months, she has been wearing an attractive smile on her dimpled cheek. So warm, her smiles and laughter, so catching and alive. While scientists have shown that simply reading happy words - verbs like "to smile" and "to laugh" - can bring a smile to someone's face, I don't need a scientist to prove that watching my daughter alone can serve the same purpose.

"I'm not sure," my maid said. "Jasmine doesn't eat very well."

Now we paused to listen to her. My maid nodded. "Like me," she said. "Can you believe it?" She was referring to her recent quarrel with boyfriend. Muddled and heartbreaking, the two of them talked as if their relationship was covered with ice. She didn't sleep or eat well.

My maid's voice was weary, but then a smile flickered across her face. "Oh, contagious - even my mood and appetite to a kid like Jasmine. Nothing's simpler."

Mindset

We all commiserate as our colleague told us how we doctors preach with daily exercise while we are culpable of the unhealthy lifestyle. But wait: do we exercise and walk the talk at all?

Inevitably, the priority of daily exercise tends to get eclipsed by the stressful job, examination, family and many other obligations. Be that as it may, our well-being depends on how we process our lives on the inside – on our thinking or mindset. I remember reading once an interesting psychology experiment by the researchers at Harvard University. They randomly assigned each of seven hotels to one of the two conditions: informed or control. Female hotel attendants in the informed condition were told about the benefits of exercise. Specifically, they were informed that how their daily housekeeping work satisfied the Centers for Disease Control and Prevention (CDC) recommendations for an active lifestyle. For example, a 140-pound woman burns 40 calories after changing linens for 15 minutes, and another 50 calories after vacuuming for 15 minutes. Hotel attendants in the control group were also told about the benefits of exercise but they did not receive information about how their work is, in fact, good exercise.

Can you guess what happened when these hotel attendants were tracked down one month later? By virtue of learning that work might serve as exercise, the hotel attendants in the informed condition lost an average of 2 pounds, lowered their blood pressure by an average of 10 mmHg, and trimmed their body fit even though they didn't change their diet or add any exercise to their routine. I don't have to tell you the only change was a shift in the mindset. Yeah, yeah. I know it sounds unlikely, but consider the evidence.

In no way am I suggesting that you indulge in the Pollyanna comfort blankets. And I doubt that I have much in common with a hotel attendant – except that my work of scurrying around the hospital helps to burns loads of calories too. With that in mind, I go to bed at ease.

Pass

The memory of failing examination didn't come to me out of the blue. Have I mentioned I failed the driving test two months ago? And I will never forget the frustration of failing the clinical examination for the Membership of the Royal College of Physicians (MRCP).

Students, of course, are unhappy about failing to pass an examination, though it is nothing new. Over the years, we have been going through the ordeal of worrying "Did I pass?" or "Will I pass?" Obviously there are few occasions in which I didn't pass. At such moments I asked myself one very helpful question: "What are the examination results or those tick boxes on the score sheet really about?" (Not just "What are the examination results about?") Love the word "Pass" though I do, I've learned to live with the word "Fail" at times. Who says that a good doctor has to get the membership qualification in the first attempt? One consolation for those of you who have failed in the MRCP is that quite a number of distinguished physicians had shared the same experience with you.

Fast-forward to my second attempt of driving test this morning (drumroll please). I passed. Yet I dare not call myself a competent driver.

So don't be deluded that our self-esteem depends solely on the two words "Pass" or "Fail." In one way or another.

Examination

The first thing I ever failed was high school music written paper twenty-odd years ago.

Until then I'd scored well in my school examination. Summoning my knowledge (which I barely had) about musical notation and scales, I managed to score two marks – out of 50 full marks.

Hell, yeah! Two marks out of 50. A world record; everyone in my class said so. Absolutely. It's amazing for those of you who know the subject – and many do – how I can totally get lost within the five-line staff.

I then code-switched the difficult-to-comprehend musical notation into numerical figures. The way I designed my own eccentric navigation of the five-line maze reminds me the remark by Alfred Korzybski – that the map is not the territory. Yes, that was loathsome rote-learning without seeking to understand the subject. But strangely – and here was the bombshell – I passed the written paper next school term with full marks. It just isn't a good way to learn music, I know.

I received my report card with no illusions about any future with music.

Wording

I was recently drafting a letter to our medical interns. This is a letter about the common professional, medical, and ethical challenges they will face in daily practice – and more so at the end of their internship. It took a long time to write.

"If you don't mind," my friends told me, "you sound like Sir Humphrey Appleby, always beating around the bush. They will understand not an iota of what you mean. These days you should put away the toolkit of etiquette." Everyone says so.

It's rather sad, don't you think, to be downright explicit in our communication? It wasn't always so. I kept remembering that masterpiece toilet sign. It was something that Ruth Wajnryb wrote about in one of her books on language, of having linguistic politeness. In a ladies room, she read a sign above the cistern. It said: "There's a toilet brush next to the bowl in case it is needed." Not a single word of "you". Absolute anonymity. This is the most unblemished and unblaming communication I've ever known. Some of you might probably scoff at this example and say, "That's so goddamn beating around the bush." In that case, you will no doubt teach me to rewrite the sign like this: "If you dirty the bowl, you should/could/must use the brush."

If I could have one wish, just one crummy little wish, it would be that I don't have to rewrite. There was part of me that admired sitting on the fence, and part that loved the characteristic role of middle-born as a peacemaker.