CRISPR

As a voracious reader, I would check out a stack of books from the local library and finish them before renewal limits. Getting close to the end of the year, I get even more suggestion from the best books of the year. Not surprisingly, those selected books have an unparalled level of popularity. So much so that I won't be allowed to renew the books, which have already been reserved by dozens of readers.

That means I have to finish The Code Breaker within two weeks of borrowing this Walter Isaacson must-read. That is a gripping account of how Nobel Prize winner Jennifer Doudna discovered the gene-editing tool known as CRISPR. A tool even more thrilling than the Apple product of Steve Jobs.

When we open the box of an iPhone, we have the tactile experience to set the tone for how we perceive the product. When Doudna broke the code of CRISPR, she opened a Pandora's box. It's not just a matter of switching off the defective gene causing Huntington's disease. In addition to offer the prospect of curing an inherited neurodegenerative condition, it might be used to edit out a defective gene which would otherwise severely reduce body height. That seems ethical and reasonable, as most of us would think. But what about a genetic edit that could add eight inches to a kid's height? Should we allow CRISPR to be used on a boy who would otherwise be under five feet tall to turn him into someone of average height? Well, as if the slope is not slippery enough, let's take another step to ponder the use on a boy who would otherwise be average height to make him six-foot-five?

To make this thought experiment even more interesting, Walter Isaacson raised the key difference between an absolute improvement and a positional improvement. Increased height, when we think about it carefully, is a positional one. Walter Isaacson dubbed it the standing-on-tiptoes problem. Imagine yourself standing in the middle of a crowded room. To see what's going on in the front, you stand on your tiptoes. This trick works. But then everyone else around you do the same. They all get two inches higher. Then nobody in the room, including you, sees any better than the people in the front row.

Uh-oh.

Memory

If you believe our memory is like indelible ink, I'm with you. We thought we experience and remember anything - the way we celebrated our child's first birthday, the first "papa" she said, the first day of school. Who won't?

And then I brought with me a book by the neuroscientist Lisa Genova, Remember, during our family vacation this weekend. I come to appreciate how episodic memory about an autobiogrphical event can be warped. In the words of Lisa Genova, retrieval and reconsolidating an episodic memory is like hitting SAVE in Microsoft Word. Every time we recall an episodic memory, we overwrite the earlier version of the memory and update it. Any edits we've made are then saved to to the new version in our neural circuits. The old one is gone.

We happened to bring our daughter to the Kowloon Park this time. And then I noticed that she cannot recall having visited the large public park housing flamingos. Let me be honest: I have to look through my photo album to find out that it has been more than eight years since her last visit of Kowloon Park.

Now that I understand how fallible our episodic memory can be, I must mention a more stable and long-lasting memory: muscle memory. The memory for how to do things, as it turns out, is quite different from the memory for what happened. Muscle memory is unconscious, and remembered below our awareness. Once learned, the motor skills can be retrieved effortlessly. That's why my daughter doesn't have to think about how she's going to swing her body across the monkey bar at the Kowloon Park playground. Easy-peasy.

Unknown

As 2021 draws to a close, no one knows the answers to the how and when for ending coronavirus pandemic, least of all the WHO and CDC. Now you dont't see it, now you do. It's an "unknown unknown."

All these questions whetted my curiosity. After delving into Mark Honigsbaum’s lively account of the epidemiological mysteries, I have learned a great deal from his book The Pandemic Century.

To his credit, we know no one can say for sure when there will be new plagues or new pandemics. And we are more often wrong than right. His narration of the last century's struggling against disease outbreaks speaks how we make downright mistakes, one in 1976 and another in 2003, one at Bellevue-Stratford Hotel, Philadelphia, and one at the Metropole, a mid priced hotel in Hong Kong. In both instances, scientists thought the world was on the brink of a new influenza pandemic, only to realise that’s false alarm and that the real danger lurked elsewhere.

Next comes one baby after another born with unusually small heads, with virtually no foreheads, when Zika virus hit Brazil. Unbeknownst to the public, the exceptionally high rate of birth defects has been triggered by a frightening mosquito-borne virus outbreak. Unfortunately rumours abounded that it’s all due to insecticides or vaccines. It's an all too common story. Similar conspiracy theory keeps repeating itself in history.

"Everybody knows that pestilences have a way of recurring in the world," Albert Camus had already warned us, "yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky."

Birthday Party

Long ago, when my daughter was toddler, clueless, and looking for us to think of things to do, we decided the way of celebrating her birthday. Now that she turns twelve today, she has her say.

One thing I discover on seeing my daughter enjoy her way of orchestrating a sleepover party is how much she has grown up. She reveled in seemingly infinite topics of talking with three classmates she has invited. The four of them just kept laughing till midnight; their enery was astonishing.

By now, as I write this, after an hour of chasing swallowtail butterflies and kingfisher with my camera this morning, I have come to understand how much zoom telephotos matter for wildlife lovers. Come too close and the bird flies away. Too distant, no good. The same applies to my daughter. The relationship is complicated, that much is known, and we learn to keep a good-enough distance. A distance that would give both a balanced frame.

Verghese

Doctors' eyes wouldn't make any sense without being used to inspect for signs of disease. Odd as that might sound to you, every time, Dr. Abraham Verghese's eyes would be searching for signs. Not a day, maybe not even a waking hour, would pass empty of his peeping around, scrutinising people.

I've been reading his book The Tennis Partner, which has taught me the way Sherlock Holmes observes others. Verghese can't even stop himself observing naked tennis players in the locker room. On one man he saw a profusion of serborrheic keratosis. The next minute he came up with the idea of "Leser-Trélat sign" - a rare condition in which a slew of the usual seborrheic keratoses signifies an underlying malignancy.

Years ago, when I was a medical student, I picked up the habit of religiously observing passengers on a train or a bus. That's how our eyes, from habit, study people and look for diseases. A swollen neck with protruding eyes. A feeble liver from too much alcohol. And indeed, from time to time during my intern year, I found myself gauging the size of veins on others as if I have to insert peripheral intravenous catheters for them.

Try as I might, though, my habit can never be as professional as Abraham Verghese. One of my favorite quotes remains that of Verghese: "If you get on a hospital elevator, don't get off without making at least one diagnosis on your fellow travelers."

Sunday

Our days of parenthood have been inextricably linked with each other in our family. My daughter is growing up with two of us. If anything, I am the one who is away.

And then there are rare occasions, like this Sunday, when I am with Jasmine on my own.

What might we do when my wife was hiking with friends of hers? My daughter didn't hesitate in the least to suggest games at home. Her footwork needs downtime after weeks of hiking, I believe. That means indoor downtime and mental space to amuse ourselves. Where should we start? Here's what we did: a game called Nitro Type for typing speed competition, a strategy type guessing game Battleship, Scrabble, and new version of Jenga invented by two of us.

What more could we do? I still long for outdoor activity. Instead of hiking, my daughter agreed with the suggestion to ride our bikes along the seaside, burning off at least 400 calories.

Nightingale

Can a book be too long? That certainly can be. Chances are, we can still handle a long one but not necessarily a heavy one. Sometimes, a book can be too heavy. So much so that I can hardly finish since I picked up the book four months ago.

Kristin Hannah is a lawyer-turned-writer who writes truly moving novels. She gives weight to the story that can't be forgotten. The Nightingale is one of her best historical novels. A captivating novel for a lifetime, narrating two women in war-torn France during World War II. The saddest story of a heroine saving over one hundred and seventeen men as she hiked across escape routes of the Pyrenees mountains. And that of her sister risking her life to save Jewish children from the invading Nazis.

I don't know how many of you can sleep well after reading chapters of women in concentration camp. I can't.

Kristin Hannah asked in an interview about her book, "When would I, as a wife and mother, risk my life - and most important, my child's life - to save a stranger?"

Most of us wouldn't. But it can be even worst: What good is safety if she - your child - has to grow up in a world where people disappear without a trace because they pray to a different God?

Deep Learning

When we talk about the world's famed adventure itineraries, I am sure that New Zealand, Costa Rica or Iceland will spring to mind. These destinations describe the very essence of what photographers or hikers dream about.

I'd say so, but then as anyone can tell that's more a dream than reality at present. With the travel restriction and quarantine policy in mind, I consider my daughter very fortunate to have chance to spend a special week outside the classroom, camping in glorious weather, kayaking, working out her perserverance in ropes courses and scenic ridge-line hiking at Pak Sin Leng. 

This week is furnished with all sorts of new and old friendship in the countryside, where she and her classmates laugh and joke like crazy buddies. That isn't as cozy as five-star hotels - when you count the way of washing dishes after meals - but the students love how they make their own hotdogs. That isn't as classical as holidaymakers snapping selfies - when smartphones aren't allowed - but they have their own journals to create their time capsules of memories.

It's heartening to imagine the fun she has had even without an air ticket or passport.

Hikers

I remember, with exquisite clarity, the time my daughter away from home, joining the overnight school camp. Next come the five-day camp in the week ahead. 

That means we're busy preparing her backpack this weekend, handing her sleeping bag, camping lantern, inflatable mattress and all gadgets she will need. The fun of kayaking, challenging Pak Sin Leng hike, stand up paddle, as I muse, justify the physical separation with our daughter for five days.

The way nature has been woven into the fabric of her school and family lives means we don't stay home the day before the exciting camp. We took a ferry trip to Lantau today and hiked on a sunny afternoon. If I am honest with myself - actually honest, in the sort of way all parents can understand - I need to stay close to my daughter for one good outing before she stays away from home.

We've been fortunate to have an outdoorsy family. You may think my daughter might whine about hiking (again) before her school camp, but she doesn't. We enjoy life in as much harmony as we can find. Flowers and trees, butterflies and dragonflies, the sights, the sounds, the smell all so rich in wonder.

The Four Winds

If you could step into a time machine to travel with Kristin Hannah to The Four Winds in the 1930s, you'd better make sure you have your return trip ticket. 

There's more dust than you would expect, when you finally know the meaning of the word "breathtaking."

That's when the protagonist of Kristin's fiction, Elsa Martinelli, was seized by the natural disaster of dust storm in Texas. Plagued by nightmares of dust raining down like a screaming monster, Elsa kept coughing despite pulling her bandanna up around her mouth and nose, squinting to protect her eyes. That reminds me of wearing the mask for our pandemic.

Dust was engulfing the land deep in the Great Depression. Even cow's milk turned into a dirt-brown stream, smelling fecund. Elsa's son ended up running fever, red eyes rolling back in seizure, wheezing, breathless. Her son ended up staying in a Red Cross makeshift hospital for more than two weeks. When the doctor told Elsa that it may take as long as a year to really heal from the dust pneumonia, I was thinking of the long Covid.

Elsa stopped sleeping well, or at all, really. Their family eventually moved to California with twenty-seven dollars. To make ends meet, Elsa started the low-paying job of cotton picking, her finger bleeding from the thorns, dawn to dusk. What hurt Elsa the most wasn't the thorns. It's the fight to stand up for the rights, for the minimum wages. She was paid a meagre ninety cents for a hundred pounds of picked cotton. Eighty cents if you counted the cut taken by the crooks.

What could Elsa do in the middle of seemingly never-ending wage cutting? One option is to reach and unionise as many of the migrant labourers as possible to organise a strike. To fight for fair pay. To stop the inequity between the haves and have-nots.

The scene of strikers would have scared many of us. When the strikers gathered to chant "Fair pay," they met rampant discrimination and resistance: the cops stepped out of the cruisers, guns drawn, shortly followed by a group of masked vigilantes and landing of metal tear-gas canisters. Now, the image still makes me flinch. You wouldn't wish to be there, and please make sure you have your return trip ticket. Trust me.

Birthday

Smack-dab in the middle of Hong Kong Island, Aberdeen Reservoirs offer me walking paths and a taste of nature near downtown, where I met the auditors this afternoon. 

An open green space is, of course, much more attractive than financial statement. After all, I deserve a more laid-back vacation on my birthday, I told myself. 

Just that - the fact that I could not afford to take a whole day off because of different engagements - was a good excuse for me to carve off time for my own. If I take a break - which I did, just for two hours - I could find a whole different world.

Tuesday

Long haul work has been part of my life so long it has become embedded in my DNA. Sometimes it is the full day clinic during which I experience the flow according to Mihaly Csikszentmihalyi and sometimes it is the every-now-and-then deadline I can hardly beat. But it is always there.

Lately, I realize that I should be more flexible.

Do I have to head back to hospital right after seeing our daughter off on the early morning bus at seven? On reflection: no. At least not on Tuesday. That's the only weekday I don't have clinic until nine.

Shortly after coming up with this idea, I have been spending that one "sabbatical" hour with my wife before starting work for several Tuesday mornings. That's how we can plunge into our favorite place of wilderness. A stroll at our alma mater university. A short walk at Sai Kung. Plus a perfect cup of coffee each time, before my work in full swing. Perfect indeed. A minibreak could fill a day to overflowing, apparently.

Diagnosis

As a medical doctor, what do you do to reassure your patients before telling them to leave hospital? You make sure that your patients understand their diagnosis. Easier said than done. I want to tell my patients what I suspect, and wish that I get it right.

In our clinical practice, we sometimes dare to say that we jump right into the correct answer like what Dr. Gregory House used to do, but not often. On bad days, like today, I knew that I made a mistake.

I'm going to tell you a true story about a young chap I met two weeks ago in hospital. That morning, I was shown his neck with swollen lymph nodes. In the past few days, he'd noticed sore throat, rising temperature and pain in the neck. What I knew was that my colleague had already excluded most infection.

"Now, if that doesn't sound like Kikuchi disease," I told my junior doctor. "I don't know what does." I went on to teach how the disease comes from an immune system going haywire and overactive. I didn't hesitate in the least to suggest my patient go home and wait for the weird disease to die down on its own.

Call it the naïveté of wishful thinking if you will, but it is what I believed and how the self-limiting Kikuchi disease usually behaves.

Two days later, my young patient returned with his parents, looking for me to recount his unremitting fever and neck swelling. I handed them one more prescription and reminded them the appointment to have a needle biopsy of his neck swelling. His mum appeared worried, and told me how another doctor suggested antibiotics for a possible diagnosis of infection.

I nodded. "Indeed. It can be difficult but your son will be better with time." I took a good look at the antibiotics she showed me, and politely said that I won't object to finishing the drug. I was not saying that my patient should get antibiotics. But I was not saying he shouldn't, either.

The overarching message: "I'm open. If you really worry, I can take you back to the hospital. If not, go home and find me whenever you get worse." As I said so, I wrote my mobile phone number on a piece of paper for him to take away. A piece of paper and a sense of you-can-reach-me freedom.

One week passed. The needle biopsy result of his neck lymph node wasn't telling me much. By the time he called me back, his lymph node swelling got more far-flung, spreading to the tummy and groins.

I sighed. "It isn't Kikuchi. I'd better get you back to hospital and will find a way out. Listen, this is more serious than what I'd thought." After few more tests and cutting out one of his lymph nodes, I crossed out the remaining possibilities one by one: from relatively benign Castleman disease to more difficult one like Hodgkin lymphoma. 

By the time I got the final rare diagnosis of anaplastic large cell lymphoma today, I shook my head. It didn't take a genius to notice that I got most thing wrong - except the piece of paper I gave my patient.

Vivek

Before I borrowed the international bestseller Surrounded by Idiots today, I've been reading a novel The Death of Vivek Oji.

The "idiots" book isn't really talking about idiots. Nothing can be further from the truth; the so-called idiots are simply four kinds of people based on their key behaviour types. With a simple colour code system, humans aren't that difficult to understand and interact with. Okay, my friend, the formula goes like this: Reds are dominant and commanding: Yellows are expressive and optimistic; Greens are laid-back and understanding; and Blues are systematic and logical.

Now, if that sounds easy and neat, go and read the story of Vivek Oji. Where should I start? Here's the plot: Vivek was born on the day his grandmother's death and he was raised in Nigeria. The nail-biting stack of photographs showing Vivek's life crisis would then be developed one by one as you went through the chapters. Vivek was alone. Nobody really understands the colour code of Vivek. In his own words, "I'm not what anyone thinks I am. I never was. I didn't have the mouth to put it into words, to say what was wrong, to change the things I felt I needed to change."

Vivek wished he would have been named Nnemdi, but it's a name for girl. This frustrated Vivek. Years rolled by. Life went on to pigeonhole Vivek into fighting with cousin in backyard, SAT prep classes, boarding school, all the way till his tragic death in an accident. The grave of Vivek read: Vivek Oji, beloved son. It would be quite a challenge for his parents to solve the colour code, before the grave inscription was finally changed to Vivek Nnemdi Oji, beloved child.

Memory

A slew of papers has shown that the best chance of rating an experience happy is to create peak moments. Rather than spending a fortune on a fortnight holiday, we should probably try splitting into smaller chunks.

The thing is when we recall an experience, we tend to ignore how long it lasted. We focus on few mental snapshots, so-called peak moments, and craft them into a movie memory.

Think of what I did today. Being the invigilator of an international examination means a day chock-full with humdrum sitting. You ever been an invigilator? So, okay. That means you need a bum Velcroed to a chair for six to seven hours without whining.

To sprinkle in a few memorable experiences, I attempted the professional examination questions like a candidate. That works for me. An even better mix, I must say, is learning to enjoy a day off. Out of the six-hour stretch of examination, I didn't have much peak moments. The right mix, to my delight, was the free time before proctoring examination, when I could have a stroll with my wife at our alma mater, listening to chirping laughingthrush, photographing black-crowned night herons.

An hour of break but a peak moment indeed.

Pause

The school term is beginning. And, strange as it sounds to me, my daughter's summer holiday ends at the very height of summer. The day is still simmering like a freshly made hot dog, and it's intermingled with rainy spells, the way it can be in midsummer.

Before her school starts tomorrow, I have taken a day off to let our brains enjoy downtime. We had a short waterfalls hike to fuel up and to cool down. Downtime gives us the pause button, making us maximally effective. We toggle between full attention at work and free-form attention. If we fly out of the town (like what we usually did before the pandemic), we can get the sense of you-can't-reach-me freedom by putting our phone on airplane mode.

It's funny to consider short break - like a day off now and then - one of the least chaotic ways to switch on and switch off. So now, people have every reason to find me when I have short break - and no excuse for seeking complete solitude. All of this means that we aren't categorizing our time into binary opposites - much as we like to do so - and won't be completely on or completely off. It's also one reason why I like the short break. For one thing, I don't have to cram extra work at the last minute before vacation. And then, no more stressful return-to-office "mountain of work".

And there, with a simple swipe of working mode and downtime, I have my perfect way of family holiday.

Connection

I recently came across this quote from James Wallman's book - and I think it sums up perfectly my family holiday this Sunday: "There is no Wi-Fi in nature, but you'll get a better connection."

Ten miles adrift of Sai Kung, in the northeastern New Territories, is a tiny island called Port Island. We picked this location as summertime temperature leaves us few options to escape the city; we'd better opt for the nature at coastal margins. This Hong Kong UNESCO Global Geopark is a true gem, with its rare geological landforms beside the seaside.

What makes Port Island special is the bright red hue of the sedimentary rocks, thanks to the rich iron oxide. Think of the joy you feel when you are busy packing the snorkel gadgets and wearing your swimsuits at home. We were told there is no changing rooms, no facilities, no Wi-Fi signal. Nothing except the natural sights and sounds, and underwater marine life. 

In fact, I could think of dozens of reason why we don't need signal on this breathtaking island, unless you need Instagram to show your friends its beauty.  

Questions

Having signed up to a study involving Delphi method, I had to sit in front of computer answering bunches of questions this afternoon.

Now I should mention: that's a rather boring exercise when we're supposed to mull over a set of questions over multiple rounds. Delphi studies can - by their very nature - be repetitive. And downright time-consuming too. We do have opinions, of course, when we are being asked about judgment like "important uncertainty", "possibly important uncertainty", "probably no important uncertainty", "no important uncertainty", and so forth. But we will have to amend each round after gathering the anonymized views of others. The process of answering and modification of answers is long, that much is known, and we can't chicken out. And yadda yadda, we will come to a consensus step by step, round by round. Structured, systematic, and ah yes, stodgy.

After spending time on the Delphi study, I went home and decided to pick up something more witty and enjoyable. I was so happy finally to read some questions that differ from those "important" stuff. That's a pair of questions constructed by Dan Gilbert. Answer them and you'll see what I mean:

1. On a scale of 1 to 10, where 1 refers to no change at all and 10 refers to drastic and complete changes, by how much have your ideas, beliefs and preferences changed in the past ten years?
2. On the same scale of 1 to 10, by how much do you expect your ideas, beliefs and preferences to change in the next ten years?

Do you have higher score for the first question or the second question? Hey, if you have a higher score for the first question than the second, think again. Go and read up about the "end of history" illusion.

Mackesy

When my wife waited for the release of Harry Potter series previously, she didn't pause after each chapter once she got the new novel. The miracle happened more than twenty years later, when our daughter devoured the pages-turned-yellow handed-down novels avariciously. And I have to admit, she's tethered to the pages. So much so that I believe in a gene named Hogwarts-fans.

I wonder what it would be like to find a book that captures the shared attention of our whole family. Across all ages. A book that we rush to read and finish on the same day of borrowing from the library.

Ta-da! We've got one today.

The Boy, The Mole, The Fox and The Horse.

Instead of chronicling three BFF like Harry, Hermione and Ron, this book is a warm journey of four fictional characters reminiscent of those on the yellow brick road.

Nothing beats the wisdom gleaned from the conversation of the foursome.

"Is your glass half empty or half full?" asked the mole.

"I think I'm grateful to have a glass," said the boy.

Well. I'm grateful to have a family of three, all queuing to read an inspiring picture book this evening.

Nomad

I love books. I always have. The only thing about reading is I mostly borrow or reserve books from public library.

Determined to read the original nonfiction book after watching the American movie Nomadland, I made a library reservation three months ago. My enthusiasm for the book grew when I found out nineteen persons were queuing for the book in front of me. Oh, it's going to be a powerful and highly entertaining book, I rhapsodized.

And it is.

That's a provocative story of Linda May, and that of other wandering tribe cutting expense of stick-and-brick dwelling, hitting the road to live in "wheel estate"- vans, secondhand recreational vehicles, school buses, pickup campers, trailers, and plain old sedans. Many of these carefree Americans didn't like the label "homeless"; they refer themselves, quite simply, as "houseless".

The award-winning journalist Jessica Bruder did a wonderful job of chronicling the new human tribe. For one thing, Bruder might soon find an emerging tribe of nomads hitting the road: Hong Kong citizens leaving and emigrating. Homeless, but not houseless.

Signs of Life

Hospital is a messy place, where trivial symptoms can turn nasty within minutes. And even messier in July.

It's hard to get too excited about July. Hard, that is, unless you've never met new doctors. They were medical students who have completed rigorous training for six years.

But do we actually grasp the know-how of being a doctor after graduation? Hardly.

I have been reading the story of an intensive care doctor, Aoife Abbey, who reminded me the first time we experienced fear as a doctor at work. My first job as an intern was on paediatric care ward, and for obvious reasons, it took me quite a while until the issue of a dead patient presented itself during my internal medicine rotation. Both Aoife and I were confused and frightened by the steps we had to go through to verify death for the very first time.

What did Aoife do? She stared. The more she stared at her patient, the more she became convinced that her patient was going to open her eyes. Aoife pictured them snapping open, her hand lurching towards where she had her hands on her neck, and her grip closing itself around her wrist. She stood frozen, waiting for the requisite two minutes to make sure there was neither respiratory effort nor heart beat. After the ordeal of two minutes, she raced out of the room, heart pounding.

I wasn't any better than Aoife. After my first announcing death of a patient, I had to convince myself that I did everything properly until I was taking a short nap in the hospital call room. My patient woke up and went straight from mortuary to find me in my dream. My heart was thumping like a cat in a clothes dryer, when my patient stared at me, face crimson with rage, "Doc, why did you certify me when I wasn't dead?" After the nightmare, I never went back to sleep that night.

Alaska

Bears killing you faster than pistol, daylight shorter than the runtime of the movie The Lord of the Rings, and winters darker than shit.

That's Alaska.

I haven't been there but experienced the harrowing story of a teenage girl Leni moving to Alaska during my recent reading of Kristin Hannah's novel The Great Alone.

Alas, the life of Leni is even spine-tingling than the hardship of Alaska. Leni didn't have much difficulty in mastering the skill of shooting to keep herself safe and stay at the top of the food chain. Her biggest challenge is to live with a troubled dad back from the Vietnam War. A six-feet-tall broad-shoulder man volatile with smell of alcohol and impulsive from POW and PTSD.

My heart ached with the Leni's family tragedy. The way Leni's mum getting her face purple and her eye blackened, her lip torn and nose broken, showed me how human brutality can be a lot colder than the temperature of Alaska.

Injury

Good writers bring us up and down a repertoire of life events. At the very bottom are bloody stories of injury, such as the Good Friday when Melanie Reid fell from her horse.

The moment Melanie, the journalist with The Times, was pinned to the ground with a broken neck and fractured lower back, she knew it was catastrophic, fully aware that her life as she knew it had ended. She chronicled her nine years of daily life following her chestnut mare accident in The World I Fell Out Of.

Her legs froze. Her body numbed. Her arms felt stiff, and her feet were swollen. 

My, what could have been worse? Tiny drops of sweat during her challenge to use a pair of tweezers to lift coloured beads to place on pegs (after loss of motor function). Rivulets of tears after struggles to go through crash of blood pressure and heartbeat (after loss of autonomic nervous system). Pools of pee from leaking bags.

Melanie's description of her spinal injury and tetraplegic life moves every reader. So terrifying and haunting is her irrevocably damaged life that I felt nothing out of my injury. My previous knee injury from ski, my midfoot fracture last year, and that of my recent problem with posterior tibial tendon supporting the arch of my foot. Those are trivial. No story is sadder than the one told by Melanie Reid.

Grebe

If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.

Or is it?

The vibrant spectrum of plumage in the bird world often fascinates us with surprises. That's how I had the duck test during a recent trip to birdwatching site near Sheung Shui. Beneath the shade of giant lotus heave pad, a small water bird with deep chestnut cheek was swimming like a duck.

Before the what-I-thought-to-be-duckling disappeared with a dive, I just managed to take a picture. That turns out to be a little grebe but not a duck. Despite the similarity to loons and other water birds, recent DNA research shows that the grebes' closest relatives are flamingos.

That's a big surprise.

Actually, I shouldn't have been.

As biologist E. O. Wilson once said, when you have seen one bird, you have not seen them all.

Debate

Adam Grant once described the mantra of karate this way: "never start a flight unless you are prepared to be the only one standing at the end."

When I met the secondary school students coming to medical school admission interview yesterday, quite a number of the interviewees highlighted their hobbies, most often debating, less so for karate.

When details of debate championship appeal to the interviewees, I would let them go on to expound on the impressive number of debate tournaments they won. To make sure they understand the downsides, of course, I would then debrief the students. I acknowledged their skill but went on to walk them through the collaborating doctor-patient relationship, as opposed to the way a doctor who marshals his or her best arguments to win a debate.

It's one thing to convince patients to do what a doctor thinks should be done. It's another to approach in an adversarial die-hard debate argument. 

A good doctor, in other words, shouldn't be too strong-willed to perpetuate a defend-attack debate spiral. He or she should be the one prepared to listen and rethink.

Instinct

Seldom do I get home from work before eight in the evening. I did so today.

After spending an afternoon examining doctors, I left the examination venue without heading back to hospital. On my way home, I visited the public library to pick up a reserved book. That's a must-read: Think Again by Adam Grant.

Cognitive skills from the book reminded me of our examination in which candidates are being asked to give their medical diagnosis, and then second-guess when the first answer doesn't fit the scenario. In other words, rethinking is central to the game of finding out the answer. Unfortunately, the first instinct of many doctors is to stick to the first answer, and prefer not to change.

Which brings me to the Eraser Study at the University of Illinois at Urbana-Champaign, where psychologists counted eraser marks on the multiple-choice midterm examination taken by more than 1500 students. If you think revising multiple-choice test answers will hurt the score, think again. Many a time, revising the answers makes sense. Only a quarter of the changes were from right to wrong, while half were from wrong to right.

This is a lesson that runs so contrary to human nature, or at least to many examination candidates, that we need to be mindful of: the ability to rethink and unlearn.

Runner

One thing I discover recently is that come summer, every run gives me buckets of sweat. That's fine. Runners are addicted to perspiration, desperate for the runners' high.

My favorite Sunday evening activity is running to Science Park for dinner. Off I ran tonight. A silver lining in running 8 kilometres as mercury rises above 36 degrees is the extra highs. My head burnt with unwavering joy and endorphins.

After dinner, I saw a waiter running even faster than me, and probably close to Usain Bolt. I fixed my eyes on this extraordinary runner, puzzled with his pace. Eventually he stopped running. He turned out to be chasing a customer who had left a bottle behind.

That is a splendid run. Random act of kindness, according to American psychologist Martin Seligman, gives us the single most reliable momentary increase in well-being of any exercise that has been tested. To return my kindness, I went to tell him he is splendid. 

The waiter must have had even more endorphins than me. If you ask me, mine is a close runner-up.

 

Tech

I stopped at public library en route to running home this Saturday, and borrowed a novel by the Pulitzer Prize-winning author Anne Tyler: Redhead by the Side of the Road.

To my surprise, I'd finished reading the story within three days. That's about Micah Mortimer, a self-employed computer fix-it guy calling himself the Tech Hermit. To be precise, the Tech Hermit mostly serves old ladies in his neighbourhood.

I don't want to compare myself (but close enough) to the computer illiterate customers of the Tech Hermit, but Micah conjured up the technical support hotline I often encounter at work. Micah's favorite answer says it best, "Did you try turning it off and then on again?"

No single advice better expresses the essence of what we need to deal with a computer glitch.

School

For centuries, people have been interested in dream interpretation. So much so that we have oneirology, the scientific study of dreams.

Finding yourself back in your old school in the dream has special meaning, for instance. That means you have to learn important “life” lessons.

Oh, and it’s not a dream. My daughter and her classmates recently came up with a plan to visit their former teacher at their primary school. For me, that’s the best reason to take a half day off. For the kids, they decided to skip formal lunch to save time for such a jovial event.

Way back in the all-too-familiar campus today, we were fortunate to meet their favorite teacher. As we stood talking, we quite enjoyed reminiscing about good friends we once knew. A few minutes later, we were in such high spirits that two basketball teams were lined up: grown-ups against students. What could be better than an afternoon holiday spent with kids shouting and laughing?

By the time we were to say adios, my sweat (okay, puffing) were more than I like to admit.

Chickadee

Medical school year-end examination is no place for sissies. Inasmuch as the event is the final hurdle to overcome before a student can add the title "Dr." in front of their name, this has haunted many doctors-to-be, year after year.

If, however, I am the examiner instead of being the candidate, I would say this is probably good way to learn medicine. Student examination is for students. Yes and no. It's also to benefit teachers, because we are all vulnerable. A cardiologist might forget most of the lessons taught by a neurologist. A kidney disease specialist might need to brush up the knowledge in digestive system. Who won't?

One of my favorite stories about brain's use-it-or-lose-it hard disc space is scientific study of birds' memory. You've probably heard that our feathered friends somehow remember exactly where thousands of different clumps of seeds are buried without a single yellow sticky note. Incredible memory, huh? In one fascinating study of chickadees, however, wild-caught birds lost a staggering 23 percent of their hippocampal volume just five weeks after being brought into captivity. Caged birds had less need to remember and track down cached seeds than their wild counterparts, and then ended up with shriveled brains. 

Specialist doctors, by the same token, can be "caged" in our own turf, and literally lose our head. We'd better challenge the idle hippocampus before it shrinks too much.

Hair-Raising

Can you believe I finished reading Christopher McDougall's book (okay, second half of the book) at Ocean Park?

I did so today.

I spent two hours standing because the queue for roller coaster ride was incorrigibly long in the theme park. But, as my daughter puts it, our time spent queuing is worth it. Two of us had front-row seat, thrill-charged experience of Hong Kong's fastest roller coaster Hair Raiser.

Being truly honest, I am not a big fan of thrill rides.

This time, though, was different. I knew this is the first time my daughter is tall enough (more than 140 cm) to scream her heart out at the floorless roller coaster. I knew that she had looked forward to the experience. You never know. Nobody can tell when his daughter is going to choose her twist-and-dive trip with another alpha male. So, hold on tight, I told myself, and enjoy as much as I can.

Improvise

A year after travel restriction in place around the globe, the unprecedented threat to the emotional toll of boredom remains difficult to beat. But it's worth saying that improvisational travel adventures may still be the ticket to globe-trotter's pleasures.

Small as it might be, Hong Kong can offer us quite a number of captivating countryside paths to explore.

The farther we explore into the countryside, the more we love the hidden green places. With flight trips off the agenda for now, countryside walk has become our family’s pastime.

No two hikers agree on the best local hiking route, but a good starting point would be those falling off the radar of the public. Be aware that popular hiking trails could be too crowded to give us a leisurely weekend break.

Often, even without highly revered attraction (think sweet gum trees in autumn, bell-shaped Chinese New Year flower in spring, or cherry blossom in Japan, for that matter), a dash of imagination is good enough to help our family capture the best of nature. There’s nothing quite like being far from the madding crowd, our creative minds running wild. In this I owe much to the ingenuity of my wife and daughter, who always make their own games, a state of mind as quick-witted as Julia Donaldson. Today, we spent an afternoon putting leaves on the zigzagging downstream water along a pretty stream near Luk Keng, the way Englishmen enjoy punting in Cambridge. Such an unbelievable way of having fun.

Birder

It is no secret that birds have a way of getting people hooked. So fascinating is bird-watching experience that it is more than grateful for me to find out the BioNTech vaccine station is within a stone's throw of a wetland in the north-west New Territories.

The sheer wonder of getting an excuse to take a relaxing afternoon off to have a jab, away from everyday chores, and then follow birds through the camera viewfinder!

The rewards from opening up to the world of birds are simply endless. The soothing green of the vegetable fields where birds flock. The whoosh of wagtails flying overhead. The blur of motion froze by each click of the shutter.

And now, I must say, I look forward to my second BioNTech shot three weeks later.

Burning

If I am stuck with finding fiction books to read, the first and most sensible way is crowdsourcing. A pretty good source is looking up the book recommendation from The New York Times. That's how I come to hear about Megha Majumdar.

No single word better expresses the essence of what makes her debut novel a powerful one than "Burning." No less important is the way Majumdar entitles the book A Burning.

One of the main characters, Jivan, was accused of sedition in the aftermath of a terrorist attack at a railway station. A few nights after she posted a careless comment on Facebook, she was dragged up in her nightie by the police. The next morning, at the courthouse, Jivan was told by the judge the list of charges against her.

"Crime against the nation," he said. "Sedition." (Call me a coward if you will; I dare not cite Jivan’s anti-government Facebook post here.)

No more than a few hours after Jivan was arrested, she was transported from temporary lockup to the prison. I could imagine the scene she cried, my own eyes dry and throat burning. Of course, you'd read more burning stories behind bars. Take Americandi, her cellmate. She pushed a man who was trying to snatch her necklace but then fell, struck his head on the pavement and became comatose. That's how Americandi ended up in jail.

As I read on, I heard and saw more burning of scapegoats, or maybe I imagined it. Maybe.

Soul

On the day public libraries reopened, I went there to borrow dozens of books a fortnight ago. Before the calculation of overdue book fines is to be resumed tomorrow, I finished Brit Bennett's novel The Vanishing Half today.

At the same time, I realized the chance to watch Pixar's production Soul is long overdue, after closure of cinemas in the fourth wave of pandemic in the city. Ultimately, our family have the chance this afternoon.

The stories of Vignes twin sisters separating, and that of jazz pianist Joe Gardner bumping into a delinquent soul named 22, are both prime examples of how intertwining the fates can be. In different cities, across different skin colours and different generations, and even different zones from unborn to afterlife.

It cannot be said too often: all life is one.

Plumage

Hands up if you know the reason for the plumage of the adult male birds to be more vibrant and ornamented than that of female?

Natural selection, I hear you say. The more beautiful male birds have been thought to be for the sake of courtship, offering an advantage whereby the feathers attract females.

Is this simply for natural selection favoring handsome males to attract their mates?

My recent reading on the subject is more positive. And less sexist than the old-fashioned male chauvinism theory. At times, it is better to look at the upper hand of drab female birds. I rather like the idea of female birds preferring a drab plumage for their own advantage. Ah, think about the usual role of female birds to raise the young, and conspicuous plumage at a nest can make both the female and the nestlings more vulnerable to predators.

In other words, females need a camouflage or dull attire to stay safe.

Tulips

Almost four hundred years ago, a mania for tulips swept the Netherlands, when a single bulb of the legendary Semper augustus fetched the equivalent of more than 10 years' wages for their average workers.

No arguing with that. No understanding it either.

I still remember vividly visiting Keukenhof with my tulip lover wife during the 2003 outbreak of severe acute respiratory syndrome. The Dutch people were friendly, until they realized we were from Hong Kong. Mention the term "Hongkongers" and everyone became apprehensive back in 2003.

Now that we aren't able to make a pilgrimage to the country with the famous beloved bulb, we find the local garden with tulips. We were so fascinated when we visited a tulip field during our hike to Sai Kung this afternoon.

Oh, thank goodness - "tulipmania" didn't vanish with the virus; it blooms perfectly.

Bird's-Eye View

Essays of Helen Macdonald, an award-winning naturalist, are exemplary pieces of heart-tugging writing about hawfinches, cuckoos, orioles, magpies, swifts, barn owls and many wildlife.

My recent reading of her Vesper Flights had prepared me to immerse myself in the thrilling details of spotting birds. An inchoate attempt with instant gratification. The happiness and the spectacle I've discovered with my camera has held me spellbound.

I watched in awe today afternoon in Tai Po Kau Nature Reserve, populated by songbirds. And so I listened agog when their aerial appearance swelled my heart out of all proportion to the size of my viewfinder. It was thrilling. If there is a better way to conclude a birdwatching walk than seeing a bright grass-green leafbird with a plumage tinge of cobalt-blue, then I don't know it.

Biodiversity

In the days after the pandemic has ground air travel to a halt, I became obsessed with the flight of other species, which include the resident birds as well as passage migrants. 

The Mai Po Nature Reserve, a Ramsar site of International Importance as a stop-off point for migrating water birds on the transit flight between New Zealand and Siberia, held me spellbound every time I visited the wetland. Instantly. Joy, breathtaking, gratitude; an avalanche of emotions from the riveting encounters between urban humans and wild animals. 

Today, I went there with my family and friends after buying a telephoto zoom lens. The pastime of birdwatching increasingly fascinates me, and more so with a new gadget. That was when I recognised the telescopic sights of birds can have a magic pull. On my way home, I had a stopover at my university campus and spotted few more species. So perfectly did this detour give me chance to see a strikingly colourful kingfisher, it had the force of absolute addiction. 

Start a wildlife photography journey and you could lose yourself for days.

School

The coronavirus has always been a rich source of new words for English. Or for me, at least.

Unknowingly, the word "webinar" has become way more popular than Ribena. Inarguably the lingua franca of our times. The idea of listening to webcast lecture is our new normal.

I set my alarm clock to wake up after midnight to learn about the controversial topic of school closure today. That's one day after my daughter returned to campus as soon as Government guidelines permit. At long last. Of course, it isn't full-scale yet but opening at not more than one sixth of the school's capacity.

And this is what my daughter did. She went to school for morning face-to-face session once weekly. Yup, a precious moment, reconnecting with friends. Perhaps the best part of her school lesson is the whereabouts of the classroom: the teachers move the classroom to the countryside on her school's doorstep. I was told that they were having indigenous animal tracking exercise, tree climbing and meditation.

We'd never been more content with school life before and it is probably my daughter's best lesson during the pandemic.

Memoir

For many years, I've kept the habit of browsing through the best book list from Goodreads recommendation site, and will never run out of books to borrow.

One of the real surprises this year is The Beauty in Breaking, a memoir written by an emergency room physician Michele Harper. Looking past the years (and tears) of healing gunshot wound victims, resuscitating neonates, juggling between intoxicated patients and bed debt, Harper has shared many heartfelt lessons she has learned.

Among much else, her navigation through night shifts has touched a raw chord within most doctors. Harper states the cold, hard truth: "Night shifts are always inconvenient and much like hangovers: The older you get, the hard they are to recover from. For some, they are a badge of honor; those types sprint them like marathons, race after race, year after year, with the stamina of a long-distance runner."

One can't help but think of bleary-eyed Michele Harper, kept awake by the sound and aroma of the percolating coffeemaker. I can always find my similarity with her liking for extra-dark coffee, as what she calls "the elixir of life."

Of course, coffee is our life. How could it not?

Team

One of the famous opening sentences in Brené Brown's talk goes like this, "Connection is why we're here; it is what gives purpose and meaning to our lives."

This, it seems to me, is at the heart of a recent campaign The Billion Steps Challenge. In essence, we were encouraged to sign up into teams of between two and five people, who then log in our daily step count by syncing our mobile device.

It is a beautiful example of what behavioral scientists mean by nudging healthy behavior with group-based incentive, a far more effective tool than individual incentive. Some years ago, scientists have experimented with the two types of incentive to help people shed pounds. Slimmers were randomly organized into groups of five people or separate individuals. Offering groups a collective reward for meeting target weight loss is more successful than incentives offered to each individual.

Whether you call it social pressure or peer motivation, the trick simply works wonder.

School

In the days after the tightening social restrictions, going to school became an exception rather than the rule, which doesn't make sense to me. 

Talk to the parents and you'll hear curse words about suspending face-to-face teaching. Listen to the students and you'll know how they long to go back to classrooms. A low incidence of severe coronavirus infection among schoolchildren without closing schools in Sweden, unfortunately, didn't seem to have allayed fears of the Education Bureau.

To stay calm and remain sane, we came up with an idea of hiking at the countryside near my daughter's school campus today. Thankfully, I've picked a sunny afternoon to take a half day off from work. My daughter was in seventh heaven when she found a tree to climb, reading a novel by J.K. Rowling on cloud nine.

Today, I have learned to trust my intuitions more.

Pleasure

What makes us happy?

Ask people this question and you'll get a truckload of answers. Brace yourself for some bad news and be prepared to find out that we often misremember what made us happy in the past, and foretell wrongly what will make us happy in the future. In short, we have imprecise prediction.

If you're skeptical, and you should be, you might assume buying new running shoes after 400 km is going to double the joy - as what my Runkeeper tracking app keeps reminding me. Wait, and think twice. As far as research data are concerned, runners in high-end shoes are more likely to get hurt. In case you skipped over the last sentence, I'll repeat it, and put it in italics. For double the price, you get double the pain. That much is clear.

Next, I am surprised to find out that beat-up running shoes are safer than newer ones. Little did I know that as shoes wore down and their cushioning thinned, runners gained more foot control.

And heigh-ho. There is no point trying to make lives happier by spending a fortune. In the real world, it's next to impossible to overcome the pitfall of hedonic treadmill. We simply can't make ourselves happier by making our wallet emptier. Now, if you know how expensive a Montblanc fountain pen can be, I have to say that one of my happiest moments this week is buying a Hero fountain pen which costs 40 dollars.

MacLehose Trail

Which trail should we go during weekend? 

It's the question on everyone's lips now that gyms and cinemas are closed, and it's the question no one knows the answer.

Escaping the city and getting away from the claustrophobic confines of crowded places need both brainwork and legwork. That's how we picked the destination of Tai Mo Shan this Sunday. That means a long stretch of hike to Hong Kong's tallest mountain standing at 957m.

Heading west from Tai Po, our family had walked for six hours, across the ridgetop path after Lead Mine Pass all the way to the summit. We joked about the cow dung sprinkled around the jumbled boulders, and at the same time realized the heaps of boulders on the slope suggested violent eruption once Tai Mo Shan was a volcano in the Jurassic period. All of them, prehistoric or more recent "footprint" from feral cattle, gave us a good day away from modern city.

Repose

Of all New Year celebration customs and traditions, none is more extraordinary than those of Bali people. Nyepi Day, as how their New Year is called, means total silence. And total silence means "no fire", "no travel", "no activity" and "no entertainment".

On that special Neypi Day, no one drives or goes to work. Everyone is off duty, and even ATMs are no different - but of course, no one needs money because there's nothing to buy. Or, as the Dutch call it, niksen, meaning "doing nothing" or "being idle".

The creepy experience of shutting down everything including airport is clearly going to give us uneasy fear, and it pains me to say this, but fear mounts if such "niksen mode" isn't an one-off event on the New Year. Having a Neypi Day once a year is fine, but we don't need that many months of silence.

May we wish for an audacious new year ahead.