Bird

Struggling for breath and beds during the dreadful pandemic five years ago, little did Dave Jones know how NHS would be able to handle the crisis. The intensive care unit consultant in Wales posted a tweet, "The NHS reminds me of a hippopotamus. It might sometimes appear slow, maybe a bit bloated and somewhat unresponsive. But my god, this last week or so has shown that like a hippo, it can move bloody fast and have some awesome power when it needs to."

As a doctor, I'm not sure how many hippopotamuses I have ever met. All I know is that all animals, humans included, are under the curse of the inverse care law which was coined by Julian Tudor Hart, another British family doctor in Wales. According to Tudor Hart's law, the availability of good medical care tends to vary inversely with the needs of the population it serves.

The stories in Dean-David Schillinger's Telltale Hearts resonate with the famous inverse care law. Before Schillinger became the professor of medicine at the University of California San Francisco, he saw a patient with back pain and fairly profound anaemia in a public hospital clinic. That immigrant from Guatemala, uninsured, turned out to have a cancer condition called multiple myeloma. Schillinger made a phone call to the oncology fellow but was told that the next available appointment was not for three months. Distraught at the long waiting time with which the patient had little, Schillinger made complaint but was simply told that the purse strings were held tight. Schillinger kept calling four other hospital systems in the city, including the university hospital and the Catholic-run hospital, but none of them offered his immigrant patient the "charity care" that they so often claim on their tax forms. 

After the stressful clinic, Schillinger received a hysterical call from the babysitter of his four-year-old twin boys. After a flurry of questions, he figured out his son's parakeet was sick. The languid bird just sat on the bottom of the cage, as motionless as a statue. In the same afternoon, Schillinger found a bird vet who ordered an x-ray to diagnose a germ cell tumour. The waiting time from presentation to laboratory workup to diagnosis to treatment options, as it turned out, was a matter of forty-five minutes.

Think about the difference between the Guatemalan immigrant with myeloma and a Central American parakeet. Every word from the inverse care law is true. 

Vulnerability

Stories of marginalised populations should be told and not silenced. The lesson from their experience is the importance of handling social vulnerabilities. 

Between the Mountain and the Sky is a true story of orphaned children in war-torn Nepal. It's sad to hear the story of Juntara, a miniature Nepali Celine Dion who, in a matter of five years, turned into a blind Ray Charles. Juntara sang the most beautiful songs in the echoey Himalayan amphitheatre, but could not see anything except flashes of light at around the age of five. There were no doctors.

What she knew is she might be cursed. Like many of the sick in Nepal, she had never seen a doctor before, and only knew that the ginger and herbs prescribed by the village shaman or Ayurvedic healers didn't make her see.

After Juntara got the rare chance to be diagnosed having a genetic condition of neurofibromatosis, it was instantly apparent her eye situation was critical. The architecture of her optic nerve, once a gossamer network for bringing light, was a mess destroyed by tumour. Juntara was suggested to have series of major surgeries. Nevertheless, the highly complicated surgery means that she could easily die during the operation. Dying on an operating table is downright catastrophic. 

Here's something you probably can't imagine: this doesn't seem to upset Juntara and her family. Death is different in Nepal where there are so few ways to prevent it. There are far more landslides and leopards than doctors. Unbeknown to her doctor and most of us, the surgery was already good enough to offer Juntara a glimmer of hope. Juntara wasn't afraid of death. And she did die of surgical complication at the end.

A heartbreaking story. That's a story to be heard. 

MacLehose

Not many of us are capable of running ultramarathon race. But everyone in Hong Kong should watch the documentary film, Four Trails, which captures our city's legendary endurance event where runner complete all four iconic trails, the MacLehose, Wilson, Hong Kong, and Lantau.

I have never run a marathon, let alone an ultramarathon. That's fine. If we spend all our time regretting that we aren't young anymore, or we haven't achieved finishing an ultramarathon race, we lose the opportunity to enjoy the moment we're in. 

If you're like me, you should celebrate the beautiful trails we are able to enjoy. This weekend, I spent a morning hiking the MacLehose Trail Section 7 and 8. The Needle Hill is one of the most challenging climbs on the whole trail. I was lucky enough to finish despite the thigh cramps. I could have looked back on the days – maybe 20 years ago – when I ran faster without cramps. But why should I? That's what Emil Zátopek, the great Czech Olympic long-distance champion, meant when he said, "Don't look back. You're not going that way." 

We should not compete with our past. That's a race we could ever win. I would rather remind myself to go home and have more core strength training.  

Runner

One of the greatest gifts you can give yourself as a runner is the low entry cost. There isn’t membership fee, like what you do for a gym. There isn’t expensive equipment, like what you do for golf or ski. All you need is a pair of running shoes, and some would even argue that those are optional. 

To join the tribe of runners, on the other hand, you will quickly realise there is something called runners’ lingo. I’m going to be really honest – I didn’t know much vocabulary within this group. Thankfully, there are informative books such as Think Like a Runner. 

That is how we learn the meaning of hitting the wall, Fartlek, footstrike, or bandit. What did I learn today? Well, terms like negative splits (I have those) and relative energy deficiency in sports REDs (that too). 

Breath

Sometimes we write in the heat of the moment. Better still, we reflect, breathe, and tell the story in retrospect. 

The memoir of Rachel Clarke on the first wave of the coronavirus pandemic, Breathtaking, weaves interviews with patients, families, and colleagues. That’s an account of what happened during the crisis. Clarke writes after recovery, and not in the midst of the tsunami. At that time, we could barely breathe, let alone write. 

The strict social distancing in awkward estrangement is so hard to explain, but Clarke finds ways to remind us the tough life. I like the way she pictures ourselves shuffle and jostle like identically poled magnets, each repelling the other. 

Challenging ourselves to break the magnetic field is a nightmare we can’t forget.

Dark

There are many reasons for us to feel dark after reading the novel of Charlotte McConaghy, Wild Dark Shore. 

The book takes us to a fictional Shearwater Island near Antarctica, where royal penguins, humpback whales, seabirds, and seals are at the mercy of climate change, floods and bushfires. This remote island is also home to the world's largest collection of seeds, the United Nations' Shearwater Global Seed Vault. The idea is to save humankind, to outlast humanity, to live on into the future in the event that people should one day need to regrow from scratch the food supply that sustains us.

Then there are supernatural storms, breaking radio system and satellite internet. The miserable residents of Shearwater Island don't even have power to keep themselves warm, not to mention keeping the seeds safe.

If there is a raw lesson to learn from this captivating story, it's the chapter about wombats' fighting the natural disasters of bushfires. How do wombats deal with the challenges of climate change and bushfire? They make extensive burrow systems for shelter, food and even drinking water. During bushfires, they take their families underground, into the burrows. And then the mum and dad wombats stick their bums up into the burrow entrances to block the fire and ash from coming down. And their bums get burned, and sometimes they die. 

The dark bum story of wombat is one that shines in the dark.

Journey

It has been a short while since I finished reading the book of Edith Eger, an eminent psychologist and Holocaust survivor. One of the themes in her guide book, The Gift: 14 Lessons to Save Your Life, is to free ourselves from unresolved grief. 

Let the dead be dead, that is.  

The reason? Denying your grief won't help you heal – nor will it help to spend more time with the dead than you do with the living. The same goes for forgiveness. To forgive isn't to give someone permission to keep hurting you. The harm is already done. No one but you can heal the wound.

Edith Eger's lessons are great but a bit dark. To be honest, it might be a better idea to explore similar ideas in a more heartwarming way. That's how I jumped from Edith Eger's book to that written by Toshikazu Kawaguchi. The mysterious cafe in his novels is one tucked within a small back alley in Tokyo. Go there and find a certain chair, and you will be allowed the unique opportunity to travel back in time. 

The time you can spend in the past begins the moment the waitress has poured your coffee, and it ends just before the coffee gets cold. The more important rule – and lesson – is that nothing you do while in the journey back to the past will change the present. Isn't that exactly what Edith Eger means?