Wednesday, July 9, 2025

Coercion

In Alka Joshi's debut novel, The Henna Artist, she tells the story of forced marriage in India – from a powerless 15-year-old Lakshimi being told to to marry a man who spent most of his time in village sleeping and eating, to her bold move to escape three years after the abusive marriage, and her subsequent life a henna artist. 

To me as a non-Indian, Lakshimi's plight in 1950s seemed ridiculous, and yet also like something that we might be falling prey to nowadays. Think about blind recruitment, when a corporate top manager forced or coerced a hiring team to take up unmatched candidates simply to fill any vacant position. 

A total loss of autonomy. A threat to the alignment of the hiring team's standard with applicant's competence. 

So, if you think The Henna Artist is a historical fiction, be prepared for the sense of déjà vu when you find yourself sharing the same fate as Lakshimi.


Friday, July 4, 2025

Sparrows

To this day, the campaign of eradicating sparrows, one of the "Four Pests", by the Chinese leader Mao Zedong had remained the biggest disregard for the laws governing the natural world. 

Hundreds of millions of tree sparrows were killed after Mao had come to power in 1949. The cull is also known as the Great Sparrow Campaign, as a result of the Chinese rulers' perennial fondness for slogans. Somehow Mao's philosophy "People Will Conquer Nature" led to a superficially convincing theory. It all looked so very scientific to calculate that a single sparrow could consume 4.5 kilos of grain per year. It followed, intuitively, that for every million sparrows killed, enough would be spared to feed 60,000 people.

Oh, and let us not forget, there are more than the simple mathematics. What is abundantly clear, however, is that when we mess with nature we do so at our peril. On one hand, sparrows feed on seeds and grains in the autumn and winter. On the other hand, sparrows feed their hungry chicks on countless millions of insects during the breeding season. With all the sparrows gone, those insects – including vast swarms of locusts, the most destructive pests of all – were celebrating the biggest feast of crops. And then, along came the ill-fated famine. The rest is history.

When my daughter joined one of the tree sparrow census few years ago, I wasn't the first person to feel the relief that sparrows have now been thriving in Hong Kong. What is most remarkable about the survey finding is a 36 percent rebound in the tree sparrow population in 2022.

Or, as we might say, sparrow 1, humans 0.  

Sunday, June 29, 2025

Kauila

There are few things so simple, so heartwarming, and so very family-friendly as watching Disney movies. Especially when Lilo & Stitch is a live-action remake of the animated film, a retold story of a broken family, a six-year-old Hawaiian girl Lilo and her older orphaned sister. 

I went to the theatre with my daughter to watch the movie this afternoon. The relationship between Lilo and the creature Stitch reminded me of the Hawaiian goddess Kauila. I first learned about the huge sea turtle goddess, Kauila, from the marine biologist Christine Figgener's memoir, My Life With Sea Turtles. Lilo’s sister, by the way, also wished to become a marine biologist.

Kauila, like Stitch, transformed herself into a human girl to play with the keiki, the children, and protect them. In Hawaiian mythology, Kauila is associated with green sea turtle and empowered with the ability to turn from turtle to human guardian of the community, especially the children who play near the shore.

That's an admirable story which deserves to be told many times.

Saturday, June 28, 2025

Snowstorm

Take a walk in the forest with snowflakes glistening in the sunlight shining between the clouds. Feather-light snowflakes land on the bridge of nose and lips. The scene from the novel We Do Not Part, written by Han Kang who was awarded the Nobel Prize in Literature, is ethereal.

If you ever find yourself being served red bean juk to confront the fury of cold and hungry journey, the juk feels like a reward nothing short of heavenly.

As I kept reading, the story of bullets shattered the romantic masquerade of the woodlands landscape. The plot of social unrest followed by massacre, in a location Han Kang dared not name, made me shiver. Oh no, there were hundred thousand people slain; the dead bodies were washed out to sea, or abandoned in the cobalt mine. One of those who were imprisoned, but not shot, wrote, "I'm well, there's really no need for you to worry. I have six years still to serve, but considering how many folk from Jeju were sentenced to fifteen and even seventeen years, I'm one of the lucky ones."   

The more I read, the more I understood the meaning of the red bean juk. Because of the curfew, the gunshot victims could not go to the hospital. To make up for all the blood loss, the only chance to live would be to drink their own blood. If not, the red bean juk. My goodness.


Sunday, June 22, 2025

Newborn

Maybe you're one of those people who are optimistic enough to enjoy your barbecue party after your wallet has been stolen. Or maybe you're the person who's putting on a smile when your computer is beyond repair before you have backup of the files. Some of us can remain positive even when we're knee-deep in troubled waters.  

Except for childbirth, or the first one year of newborn. That's what Kerry Hudson wrote about in her beautiful memoir Newborn, a journey towards her parenthood. With countless trauma in her early years of poverty, Kerry Hudson never knew if her mother would be coming downstairs. And then her mother stopped eating, lying listlessly in bed. And that, the fate decided, would mean growing up between foster families and homeless hostels.

As tough as Kerry Hudson would be, she couldn't have imagined the challenge after seeing a second blush of pink next to the control line on a strip. The positive pregnancy test made her tense. Her anxiety soared. She and her partner watched YouTube videos for weeks practising how to install the car seat and did so expertly like a soldier reassembling a rifle in a blindfold. With little information about how the coronavirus might affect pregnant women, she dared not leave the house. Even she was convinced to go out once a day – mask on, hands deep in the pockets – she did not touch anything.  

The best description of her early weeks of caring for the child is the fourth trimester because, in reality, the baby should still be inside the mom's belly.

Saturday, June 21, 2025

Read-a-thon

Prize-winning writer Emily Henry is celebrated for her romance novels. That isn't among my favourite genre of books, though I borrowed her book Funny Story recently. The character of Daphne, a book lover and a children's librarian, reminds me of the good old days when I kept visiting library for my daughter's book choices.

There's no place so friendly as a chidren's library. Where the side-by-side beanbags seem to be heaven for readers, and where you'll find pictures books for the not-yet-readers. For where else can you step into a room amid a book club so tempting the kids (and parents) don't get distracted by their devices? 

I'm so proud of myself. I'm as proud as Daphne who has made big efforts to prepare a fund-raising Read-a-thon, an all-night reading thing for the kids. I know I mention this all the time, but it's still not enough: I am the luckiest to have a daughter who loves reading. I can't imagine anyone better. My Read-a-thon for my daughter is the marathon of choosing books for her. That's the highlight of parenthood.

Saturday, June 14, 2025

River

If, after a strenuous Mt Kinabalu climb, you'd like nothing more than an easy trip, you're in for a boat ride.

Our family were simply too frazzled to go for more walks after return from the summit. All because of aches and pains, we chose to take a break and wait for the recovery of our jelly-like thigh muscles. Luckily, there is something magical about river cruising in Borneo. On the last day of our trip, I picked a late-afternoon wildlife cruise down the mangrove, reminiscent of the novel Where the Crawdads Sing.  

Like Kya, we came close to fireflies along the river, but didn't go into that much detail about the female fireflies drawing in males of another species by dishonest flash light signals. As twilight set in, a romantic firefly light show is wild and poetic enough to wow nature lovers. The long, soft-bodied nocturnal fireflies, known as kelip-kelip, produce a greenish-yellow light along the mangrove waterways. The way hundreds of kelip-kelip display their light show is remarkably reminiscent of Christmas-tree lights.

Besides watching kingfishers and fireflies, another highlight of the waterways is the chance to meet the proboscis monkeys. These big-bellied (and even bigger nose) monkeys live only on Borneo. They now rival orangutans as the most popular primates to see in Borneo. Sadly, both are threatened by modern-day poaching, logging and habitat destruction.


Kinabalu

Mention the word Mounjaro and you're likely to conjure images of blockbuster drug glucagon-like peptide-1 receptor agonist with global prescription growing at 38 percent annually. To me, the brand name resembles Kilimanjaro, or, for that matter, Kinabalu. 

One good reason is my chance to climb Mt Kinabalu this week. I tried to make the ascent almost 30 years ago, but failed without the legally required mountain guide and climbing permit. My wife and I have longed to return. 

After my planning of the climb with my wife and daughter, I read about a German who is interested in tropical ecology and brought his family to Borneo. His son and niece were young and as animated as dogs on a road trip, metaphorical heads struck out the figurative car window, tongues flapping in the wind. As time goes on, it is getting more difficult to stay composed when we are no longer kids. Not anymore. My daughter is more prudent. We made a list of all the ingredients for survival we would need for the ascent of Borneo's highest mountain – from water filter bottle and energy bar to walking poles. With a hefty dose of luck, we told ourselves, the odds of ever surviving the climb are higher than the sea turtle hatchlings returning to the sea. 

Step after step after step. The knee-jarring ascent from start to finish, according to the estimates of the Lonely Planet author, is like scaling seven Eiffel Towers or six Empire State Buildings.

I still remember the engineering maxim, "Good, fast, cheap. Choose two – you can't have all three", mentioned by the German visitor who was buying car after moving to Borneo. Even we're not having project management, the "good, fast, cheap" triangle seems to apply to our Mt Kinabalu climb. 

The fee is not too costly (unless you're comparing dorm bed to dorm bed). The box “cheap” is checked.

The magical sunrise at the summit is hard to beat. We were literally on cloud nine with its majestic crown of wild granite spires. The box “good” is checked.

But let's be honest, the trek to the summit at Low's Peak is never meant to be fast. We can never forget the unforgiving steps uphill and the gruelling descent. And that kind of exercise, I guarantee, would be much more effective than Mounjaro.

Tuesday, June 10, 2025

Green Turtle

Borneo is the world's third largest island, after Greenland and New Guinea. Slice Borneo in half and chances are you'll see the equator bisecting this island twice the size of Germany. There is no better or worse time to visit Borneo; equatorial climates mean year-round rain which rarely lasts long. Our family arrived in Borneo this week, after our daughter's examination.  

We first stopped at Selingan Island in Sandakan Archipelago, where sea turtle conservation has been underway for many years. Watching gravid turtle coming ashore to lay eggs is nothing short of awe-inspiring. Sea turtle nests are called clutches, and a female may dig several of them in the sand in one nesting season. A clutch may contain between 50 and 200 eggs. The eggs are buried deep in the sand for about sixty days. When the young turtle hatchlings break out of its eggs, they must make a race to the water. They don't have GPS; many a time they follow the moon's reflection on the water for guide. If they don't make it, they die.

For every one thousand hatchlings, about one will survive to adulthood. Hear me out: one in one thousand. That's even more difficult than securing the Research Grant Council funding after research grant application. 

As part of the efforts to save the endangered sea turtles from predators, the rangers at Selingan Island patrol the beach every night and transfer the eggs to the hatchery. They also release the new hatchlings on the beach.

Our family were lucky enough to have facetime with three green turtle hatchlings burrowing up through the sand and scuttling down the beach before sunset. These three brave young turtles aren't those collected by rangers; they are from naturally hatchling eggs. We saw three up close, small and fragile. The fourth one didn't make it to the sea; it was swallowed by a hungry water monitor lizard. In the field of harsh and competitive academia, these three young hatchlings are early-career researchers with neither senior support nor RGC track record. I don't know if I should quote the Beat poet Allen Ginsberg who advised "Follow your inner moonlight. Don't hide the madness." I simply know we had wished all hatchlings good luck.   

Wednesday, June 4, 2025

Intermezzo

Curated with modern elements like text messages and emails, Sally Rooney's novel Intermezzo is a masterpiece.

In this moving story of two heartbroken brothers after their father's death, we are told how one of them regretted about not giving the eulogy at the funeral, and how another one struggled with the divorce of parents.

As we follow the journey of Ivan and Peter, we recognise the sentimental way Sally Rooney depicts the two brothers' navigating the grief. 

Ivan is withdrawn. So much so that he "locks the screen of his phone, but still doesn't look up." 

Peter, more than ten years older than Ivan, is more provocative. He wrote text messages now and then. "Thumbed his way through the text once more and hit send. Instantly a single checkmark appeared beside the message to indicate that it had been sent."

In short, Sally Rooney has shown us not just how people actually speaks, but how we articulate with our phone screen. 

Not just speech, but text messages. 

Not just mood, but emoji.   

Wednesday, May 28, 2025

Fatherhood

There are no shortcuts in grief. After a loss, every day hurt. Then each month. And then every special days of the year. 

The opposite is true of bringing up a child. Every day comes with surprise. Then every week ends with a Sunday when the parents find something new. And it is really, really, really funny. When I read the book of parenthood by Fredrik Backman, I can't stop laughing.

If you've read his novel Beartown, you might have remembered the dark theme of a hockey team in a small town. The book, Things My Son Needs to Know about the World, is very different. Whereas Beartown is heartbroken and agonizing, the dad-and-son memoir is stinky yet harmless. His own story of fatherhood is an absolutely hilarious one.

Backman's uncensored love letter to his son tells the honest jokes of being a dad. One letter about his secret wish for his boy to play football sums up the parenting experience pretty well. "I'm not saying you have to play football. Of course, you don't. I'm not going to be one of those dads who puts pressure on you and stands on the sidelines screaming and shouting."

Is that all? Pretty cool, huh? I know. 

"Fine. You might end up hating football. I'm afraid of what people will say if you don't play football. Afraid of the shame. The nicknames. The being left out. Afraid that they'll ... you know."

Tuesday, May 27, 2025

Butter

Not many writers are chefs. 

Charles Dickens had gone into such details of Christmas dinner. Amy Tan previously told a story of cooking crabs in The Joy Luck Club. Nigella Lawson's book How to Eat does not have a single photograph of food, and yet presents us with the best recipe of mayonnaise.

Asako Yuzuki's novel, Butter, turns out to be the best reading experience of mine recently. The secrets of butter and gourmet cooking could have been a reason for getting the 2025 British Book Awards. It's more than that. In the end, we don't just learn why butter is much better than margarine. Part psychological thriller, part fiction, part story of a real case of serial killer, this book relays a tasty lesson of fatphobia in Japanese culture. 

Superior-quality butter should be eaten when it's still cold and hard, as I learn from the storyteller, to truly luxuriate in its texture and aroma. I can't tell if this is really the case. I simply know that I need to finish the 452-page book within 2 weeks, because this bestseller has already been reserved by many public library users.   

Friday, May 23, 2025

Owl

I learned about Pablo Picasso's weird friendship with an owl in one of the first major exhibition of his in Hong Kong. In 1946, Picasso adopted a little injured animal, bandaged up its broken claw, and kept the owl until it healed, then decided to take the owl with him back to Paris. 

The famous self portrait of Picasso as an owl, his ceramics, etchings and drawings of owls, seem to depict the artist's personal relationship with owls. When it comes to the world's foremost experts on owls, Picasso pales in comparison to Jennifer Ackerman. 

Jennifer Ackerman is the author of What an Owl Knows. She tells us the birdcalls of owls, the huge number of hair cells inside owls' cochlea, the roosting sites of owls. And, believe me, she knows about owls more than any one of us. It's not just Jennifer Ackerman's knowledge on the animal that is impressive. It's her writing that is vibrant, authentic and absorbing. In the way Jennifer Ackerman describes owls' sound, a hoot is not just a hoot. Owls don't just hoot. Or so I was told. They shriek, yap, chitter, squeal, squawk, warble, and wail. Some chirrup like a cricket. Some chuckle with maniacal laughter. Some utters a strange sliding whistle, like a dropping bomb.  

Oh-oh. Owl. Owl.

Monday, May 19, 2025

Laughter

"The secret to happiness is either to have had a happy childhood or a poor memory." So says the psychiatrist Benji Waterhouse, whose mother was surprised to hear his speaking about childhood to his therapist. Can a mother remember her son's childhood? That's where things often get murky.

Here's why laughter matters: If you're wondering the way to fend off sickness or stress, go and read Benji Waterhouse's book. He wrote the comic medical memoir as a NHS doctor, You Don't Have to Be Mad to Work Here.

Hardly a day goes by without frustration under the overstretched NHS, as we can imagine. One fine day, Benji came across Gladys, a new patient admitted for Cotard's syndrome, a rare delusional disorder in which patients believe they're dead, have lost their internal organs, or are roting. 

"So you taught biology, the study of living things?" 

Gladys nodded.

"But if you're dead, how do you explain talking to me now?" Benji confronted Gladys.

Gladys pondered for a moment. "You must be dead too."

"What a way to find out," Benji was amused. "Also, it certainly won't reflect well on me, if in the afterlife I am still working in the NHS."

I nearly laughed my head off.

Friday, May 16, 2025

Maame

Every death is a tragedy, whether in Ghana, Punjab, or Gaza. You get hurt over the loss. I do, too. Everybody does. We all have suffered the tragedy with the death of a loved family member or close friend. But Jessica George's novel is one of the most heartbreaking stories, in which a London-born Ghanaian daughter lost her father with Parkinson's disease. 

Maddie Wright, with a nickname Maame meaing "woman" in Twi dialect, has been the main caregiver of her dad. She can't rely on her brother to pay the council tax and bills. She can't even ask her mum to help the funeral expense after her dad's death. 

The overwhelmed daughter faces the challenge by herself. When things go wrong, she would try Google searches. The questions she typed in the browser, and the list of Google-provided responses, tell a good story.

Is Parkinson's disease genetic?

How to be happy? How to get flatmates to like you?

How do you write a eulogy for your dad?

Symptoms of depression?

When do you start feeling better after losing a loved one?

Stages of grief?

Did I skip bargaining and is it too late to start?

Monday, May 5, 2025

FOPO

Social psychologists like to describe our brain comparison machines as a "sociometer". That's a gauge hidden inside our brain, running from 0 to 100 to denote where we stand in the local prestige rankings, moment by moment. 

Think about the electricity bill you receive once every month, after which you will know your electricity consumption. If you're meticulous, you can view your meter in real time. Most of us won't bother to do that. Now we do. We check the sociometer, swiping through bottomless feeds. Post a picture with beauty filter on Instagram or Snapchat, and see if this dials up your sociometer score, as reflected by the number of followers, likes, shares, or comments. That is the way to move the needle in most adolescents' sociometer. 

I read about the mechanics of this maladaptive sociometer in the book The First Rule of Mastery. That's about the three phases of a FOPO loop. FOPO means our "fear of people's opinions". The circular cycle begins with an anticipation phase: think about browsing through our closet before a social gathering. Or else, photoshopping or airbrushing the photos to boost our Instagram beauty. Next, during the checking phase, we relentlessly scan for external cues of acceptance or rejection. The third phase is responding phase. That's how we react after we take in the perceived cues. "Am I good?" "Do my sociometer plunge?" The FOPO cycle goes on and on. 

We can't get out of the cycle until we recognise that we are worthy exactly as our intrinsic virtue.We are not our grade. We are not our job, our age, our marathon time, our place on the organisation chart. Our value stems from our being, not our doing.

Sunday, May 4, 2025

Technology

Randomised controlled trials are the gold standard of scientific proof. 

Much of what we now believe is the result of experiments in which people are randomly assigned, like lottery, to receive a treatment and other people are randomly allocated to be in the control group. Researchers then look at the outcomes of intervention. Unlike the observational studies, this tool can get rid of selection bias, when groups being studied are already significantly different after they are "selected" to receive treatment.

Observational studies often fall prey to "reverse causality", in which the outcome drives the "exposure", rather than the other way around. When we observe that people with obesity survive better, it doesn't mean obesity causes longevity. One explanation for the observation or correlation is that people with deteriorating health, such as advanced cancer, often lose weight. When we aren't careful, as it turns out, we could have assumed obesity is the cause of living longer.

All of which is to say that we should put more emphasis on randomised controlled trials. 

This much we know. Yet when it comes to social science, randomisation is not often practical. The idea that social media have detrimental effect on adolescents have been around long enough to become cause of concerns. Jonathan Haidt, the American social psychologist who wrote The Anxious Generation, found 20 randomised controlled trials on social media, most of them randomly assigning students to limit the use of social media platforms (or not reduce the use in the control group). More than two-thirds of these experiments found evidence of harm.

Quasi-experiment study design to measure the effect at community level, on the other hand, is more practical (or realistic) than randomly assigning all students in 20 middle schools to put their phones in a phone locker for a year. One good example of such studies takes advantage of the rollout of high-speed internet. In a "natural experiment" in Spain, researchers made note of the fibre-optic cables and high-speed internet, which came to different regions at different times. Drawing on data that are proxy of internet penetration in Spanish households, the study examined the group-level effects rather than the individual-level effects. As it turns out, there was a significant effect of access to high-speed internet on hospital discharge diagnoses of behavioural and mental health cases among adolescents.

This natural experiment study spoke volumes to the potential epidemic of teen mental illness after the arrival of world-changing smartphone technology. 

Thursday, May 1, 2025

Upgrade

Getting our DNA upgraded would be really exciting. We get excited just writing the phrase "upgraded." 

To finally get a genetic upgrade that ramps up our performance would be a huge milestone for humanity. After reading Thomas Cech's book about RNA and CRISPR, I picked up a sci-fi novel Upgrade

I am not sure if genetic upgrade is a real thing or fiction fantasy. The story of Logan Ramsay in Upgrade lets us get a better picture. Logan literally got a mind-blowing transformation in his genome. All of a sudden, Logan read faster and finished all twelve books that had been languishing on his nightstand, including that of Kazuo Ishiguro. He could even read a book with his eyes while simultaneously listening to an audiobook. He easily made a fortune at casino by recalling the seven poker strategy books he'd speed-read at the library. His energy was bottomless. He slept four hours and woke as fresh as a daisy. 

If you aren't excited about the quantum leap in the genetic makeup, there's indeed a grain of truth in that argument. Imagine Logan Ramsay getting trouble with people interaction. After all, if Logan has  supernatural neurons, then he should be able to predict what someone is going to say long before another human being manages to say it. And if Logan has upgraded intelligence, then he will find speaking with a bright adult somewhat like holding a conversation with a ten-year-old. When Logan revisited a pristine stream in a primeval forest, he could no longer feel the tranquility of the sublime spot. 

Everyone who has read the fairy tale of The Little Mermaid knows how an upgrade could be suffering in disguise. I felt a twinge of loss for Logan, like what we do for the poor mermaid.

Sunday, April 27, 2025

Cancer

What is it about cancer that so petrifies us? 

Cancer has been like death sentence for many people. Azra Raza, an oncologist with special interest in myelodysplastic syndrome, wrote a book to tell the stories of men and women facing death. I learned about Omar Azfar, a thirty-eight-year-old graduate of Oxford and Columbia, who fought his battle with a highly malignant osteogenic sarcoma of the left shoulder.

After many aggressive chemotherapy slash-burn-poison cycles, radiation therapy, and multiple lung surgeries, he decided to go to Greece for his honeymoon. He didn't want to tell the doctors, and never complained throughout the trip despite the cancer pain. He never lost the life of the mind. Instead of coming up with a list of the hundred books one must read before dying, he had shared with Azra Raza his list of a hundred books that one must read in order to live.

Azra Raza was devastated by Omar's death. The main theme of her book, The First Cell, is to avoid what is known as "group think", when the majority of oncologists have been striving to chase after the last cancer cell. Surgery to remove half of Omar's shoulder, arm and chest. Cisplatin, ifosfamide, and unpronounceable experimental monoclonal antibody like robatumumab. None of them were able to kill the last cancer cells of Omar.

Azra Raza thinks of the first cancer cell instead of the last cancer cell. That's a quantum leap. She reminds us that the best way to fight cancer is not to target the last cell, but to detect the first cancer cell. She pulls back the curtain on the holy grail of tackling cancer. The goal should have been to detect the first cancer cell's footprint, to find every cancer at the earliest precancerous stage. 

The last cancer cell rarely happens (or matters). The first cancer cell does. I think for the thousandth time how much we owe Azra Raza for her first and last duty to the cancer patients.

Saturday, April 26, 2025

Knife

The idea of assassinating a novelist after his writing about Muhammad is brutal. 

The way Salman Rushdie was stabbed fifteen times onstage scares me. His liver was damaged. His small intestine had to be removed. He had stab wounds over the neck, the right eye, the left hand, the chest, and over all the face. One year after the miraculous recovery from the knife attack, the Booker Prize winner wrote a memoir to reflect on his journey close to death.

His message about the freedom of expression is clear. It is therefore no surprise that one day after the knife attack, Biden reminded all Americans and people around the world of our commitment to truth, courage, resilience, and the ability to share ideas without fear.

Who won't support freedom of speech? We all should value the right to speak freely. 

But what about the right not to? Sometimes silence is golden. Salman Rushdie mentioned his right eye injury. After the serious damage to the optic nerve, he lost his right eye. His doctor proposed to lower the eyelid and then stitch it shut. I didn't have to listen to his loud noises of anguish to know that procedure really hurt.

Salman Rushdie gave us two pieces of advice. First, if you can avoid having your eyelid sewn shut, avoid it. Second, if you are the surgeon, don't say to your patient "it was successful" after the awful operation. If you choose such expression, mind you, your patient could have sewn your mouth shut.

Thursday, April 24, 2025

Lasker

On December 23, 1971, the United States President Richard Nixon signed the National Cancer Act into law. A number of things happened before Nixon's war on cancer. First, Mary Lasker, who remembered her family's laundress who died terribly of breast cancer with seven children around her bed, decided to lobby for expansion of cancer research when "less is spent on cancer research in America than on chewing gum." Next, Mary Lasker recruited her friend Ann Landers to write a column on Reader's Digest appealing to the public.

Nixon's effort wasn't going too well. We knew Nixon wanted to turn the kind of concentrated effort that took man to the moon toward conquering the dread disease of cancer. That's why the President infused more than 100 billion doctors into cancer research. After that, the jaw-dropping statistics showed little decline in death rates for cancer.

The breakthrough seemed to have surfaced after Dr. Luther Leonidas Terry, the ninth Surgeon General of the United States, released the report concluding that smoking causes lung cancer and chronic bronchitis. He quit smoking and encouraged millions of Americans to do the same. The efforts to cut smoking made bigger impact than that of Nixon. 

Whose responsibility is it to save the lives of the country, you might ask? The President Donald Trump, the anti-vaccine health secretary Robert Francis Kennedy, or the National Institutes of Health paralysed after the funding freeze? 

Saturday, April 19, 2025

RNA

It strikes me that discovery of RNA can be more groundbreaking than that of the famous double-helix DNA. RNA turns out to be more than a humble servant of DNA. And an important molecule it is. A game changer.

As far as scientific recognition is concerned, RNA-related breakthroughs have led to 11 Nobel Prizes since 2000. Do I have to remind you the 2023 Nobel Laureates have been working on the mRNA vaccines that save millions of lives?

But the structure and functions of RNA have proved to be a lot trickier than DNA's. To learn more about RNA, I borrowed The Catalyst written by the Nobel Prize-winning scientist Thomas Cech. 

To be frank, it is a book I wish I had read before my biology class. It is extraordinary to see how Thomas Cech explains the complicated subject in an easy-to-understand way. One trick of his is to use figurative language or analogy. To explain the concept of splicing noncoding DNA or introns, Thomas Cech reminds us the repair of a badly frayed rope segment by a sailor. That's how a sailor would cut the rope above and below the frayed segment, throw away the damaged piece, and attach (or splice) the ends of the two good pieces back together.

To give us a better idea of splicing, Thomas Cech invites us to think of an intron as a few meaningless words, a string of "blahs," interrupting an otherwise intelligible sentence: You really smell nice blah-blah-blah-blah-blah-blah-blah today. Splicing is explained like a word-processing system which can highlight the offending interruption. Press "Delete", and the blahs are spliced out. You really smell nice today.  

What if there is something called alternative splicing? That happens when there are two introns instead of one: You really smell blah-blah nice blah-blah-blah-blah-blah-blah-blah today. As usual, both introns are spliced out, and then the final version reads: You really smell nice today. But wait, hang on a minute. An unexpected mistake, or so-called alternative splicing, could have come with a hefty price tag. The alternative step could have skipped over nice, resulting in smell being joined to today. That way of splicing would then change the sentence.

You really smell today.

Monday, April 7, 2025

Burial

It's no accident that crime gets lots of attention. This speaks for the journalism cliché: If it bleeds, it leads.

When I read the story of the Lockdown Ladies' Burial Club recently, I was technically sympathising with five women who had killed their husbands. The novel The Best Way to Bury Your Husband looks like a black comedy – and it is.

After the five women had been caught on the dilemma of disposing the dead bodies, they put their heads together to make plans and brainstorm for disposal-site ideas. By pure, horrific change, two of them came up with the ingenious idea of pouring cat litter to dry the body out and stop it stinking.

Slushy nonsense? Not a bit of it. All the women had good reason and deserved the option to get rid of the abusive relationship. Their choice seems to be the only one to stop men being violent. Instead of hiding blue-green bruises by ivory makeup, shutting up to avoid burns because of wrong words, wrong tone, or even wrong place to set the cup down, the women killed in self-defense.

The way this novel was set in the lockdown period speaks for the spiking of domestic abuse since 2020. The abuser says, "You can't go out; you're not going anywhere." As the pandemic dragged on, one of the women in the novel paused at the newspaper front page showing volunteer gravediggers hard at work, with the headline "funeral and burial services unable to keep up with demand." Surely, nobody would notice if one more dead husband was filled in.  

The sad truth is that far more women were killed by the partners than vice versa. Can anyone notice?

Friday, April 4, 2025

Blossom

Every spring, Hong Kong Instagrammers love to post the deciduous golden trumpet trees in full blossom. Also known as yellow poui trees, these bright yellow trumpet-shaped flowers are the prime photographer draw. 

I arrived at the alma mater early two weeks ago so I could pick a serene spot, and an unmistakably beautiful one, to have a stroll before attending an organ donation ceremony. As soon as I arrived, I saw the vibrant golden flowers, resembling wind chimes or bells. Their blossoming period lasts for less than a month. By the time I returned today, the flowers have gone. 

After the golden blooms, long furry brown seed pods hang from the branches. It's one thing to capture the yellow flowers by camera, quite another to capture the seeds. Nowhere else do you see such a dramatic change in appearance. That’s almost a fairy tale of The Ugly Duckling in reverse order.

Wednesday, March 26, 2025

Genie

Would the field of education be better without Gemini, GPT-4 or DeepSeek? It is an uncomfortable question.

As quickly as OpenAI released the groundbreaking ChatGPT in 2023, the Los Angeles Unified School District became the first major school system to ban it. Soon, Seattle Public Schools were prohibiting generative artificial intelligence on all campus devices. Within months, schools from France to India to Australia outlawed the AI chatbot. Tools like Grammarly or Copilot are often thought to be evil monsters that violate the natural order, so one might qualify for sainthood without using any one of them.

What would the brave new world of education be like when more artificial intelligence tools become available online? Not all people view the transformation as positive as Salman Khan, the founder of Khan Academy. Khan laughed at the irrational panic triggered by the students' using AI technology. Perhaps never more so than during the pandemic, which we had witnessed spread of rumors from toilet paper crisis to the current plague of ChatGPT infecting students' minds. Educators have been talking about the threat of student cheating, so much so that the entire system of learning appears to be collapsing. 

To many, the threat is overwhelming. As one op-ed for Inside Higher Ed put it, "To their shock and dismay, teachers will find that their classrooms has tested positive for GPT." For the most part, the higher education or university examiners are worrying about AI-powered cheating in writing term papers or assignments. Some think about using AI detection tools, and misconduct panel if students' work has been flagged. Others suggest having students work on their writing and papers in class. 

Of different reaction to the technology of artificial intelligence, Khan's seems the most brave and exciting. Not blind bravery, but educated bravery. "Everyone was talking about AI enabling cheating by writing papers for students," the American educator says. "But what if it didn't write for them at all? What if, instead, it wrote with them?" 

Oh, there is. The genie is out of the bottle. It is time for us to follow the advice of Salman Khan, and throw the bottle away and our outsized fear of generative AI along with it. 


  

Saturday, March 15, 2025

Deaf

I know many people who are aching to be public speakers with oratory skills and have no idea how to begin. There seems to be a great gap like an open wound. What about people who are cut off from the others because of deafness? Will they be desperate to have hearing?

For decades, cochlear implants have been promoted to make the hearing world easier. The small electronic device has an external portion sitting behind the ear, and a second portion surgically placed within the skull. Signals from the external transmitter will be converted into electric impulses, to be sent to the auditory nerve via an array of electrodes. For a long while cochlear implant was thought to be a cure for deafness and remedy for deaf children to learn oral language. Or is it? That is more controversial than what I have believed. 

Enter the visionary exponents of Deaf culture. Deaf culture believes in having membership in a beautiful culture. The Deaf culture doesn't feel they lack something. Strange as it may seem for us, the deaf community is proud of their membership. A previous school newspaper poll, as I have read from the book Far From the Tree, asked whether students would take a pill that would give them hearing instantly, and the majority answered that they would not. When I watched a movie on Deaf culture with my family today, I was reminded of the bioethicist Teresa Blankmeyer Burke who said, "It is rare that one grieves for something that one has not lost."

Hearing parents are, therefore, thrown back on their own dichotomy: do they have a deaf child, or do they lack a hearing one?

Friday, March 14, 2025

Consultant

Warren Buffet has reminded us that a barber is the last person you should ask whether you need a haircut.

There is no mystery to getting outside advisers. Those who are eager to get help should go and read Surviving the Daily Grind written by Philip Coggan, the columnist for the Economist. For those who are keen for hiring management consultants, however, there is good reason to remember the old joke that management consultants borrow your watch so they can tell you the time, and then they walk off with the watch.

Therefore, in his book, Philip Coggan laughs at large companies attracting outside advisers in the same way that jam jars attract wasps. I do not think of myself as cynic, and certainly most of us don't. But I must confess that I keep laughing at his jibe about teachers: "Those who can, do. Those who can't, teach."

Wednesday, March 12, 2025

Shirt

When it comes to packing luggage, I tend to pack too little. As opposed to overpacking, my careless way of packing is more laughable. It's embarrassing, for example, to find that I had only one shirt for my trip to Macau this week. One shirt, and nothing else, for three days.

Wearing the same shirt for all occasions is fine, as long as I didn't go running. The way of my wearing shirt goes along with the story book I brought with me to Macau: Welcome to the Hyunam-dong Bookshop. The barista of the bookshop, Minjun, talked about the way of wearing shirts. 

"In high school, my mum used to say that if the first button is done up properly, the rest of the buttons will line up neatly."

At first glance, it makes good sense. The first button, as it turns out, refers to the expectation to get into a good university; the second and third, fourth buttons are smooth sailing after fastening the first one.

As it happens, this isn't the way for everyone. Some might be better off wearing a buttonless shirt. Some might get stuck because the shirt lined with expensive and beautiful buttons on one side, but there are no holes. 

At the end of the story, remedy for the dangling buttons comes into light. "Easy. I changed my shirt," Minjun said. "This time I cut the holes first before I made the buttons that fit. Now, the shirt is buttoned up nicely."


Tuesday, March 11, 2025

Macau

I attended the Macau Nephrology Association Annual Scientific Meeting more than a year ago, when I stayed close to Taipa but was unable to locate the Ecological Pond nearby at that time. When I had another chance to visit Macau as examiner today, I decided to use Google Maps to visit the wetland after the examination. This area of ecosystem is smaller than Hong Kong Wetland Park, but it’s excellent for my sunset stroll. 

In the past, there were lots of bitter vine near the mangrove swamp area in Avenida da Praia, Taipa. Said to be one of the ten most harmful imported invasive plant species in the world, Mikania micrantha or bitter vine has once invaded the reed beds there. The Macau government worked hard to protect the vanishing ecosystem and restore its ecological value, clearing the invasive plant and increasing its biodiversity. 

This might not be the case for everyone, but I must say that I like Ecological Pond in Avenida da Praia more than Venetian Macao Casino. And definitely the Everglades more than Las Vegas.

Saturday, March 8, 2025

Aging

My treating older people have been dotted with experiences of ageism which, years later, will recount to me something I regret. So common is ageism, and so natural is it to those of us who have received little training in geriatrics, that functional decline becomes the sine qua non of old age.  

Recently, I read about the origin of the term "ageism," coined in 1968 by an American gerontologist Dr. Robert Butler. Known for his decades-long passion to challenge the deep-seated age-based discrimination in healthcare, Butler called for sweeping policy reforms when older patients were often neglected and simply shrugged off. 

We've all been there. I've lost track of the number of times I said something like "You know that she's very old. She can't tolerate more treatment. You are asking too much. She will soon be no more."

I have learned more about special needs of old people by looking after my dad than any lecture in geriatrics medicine. It's challenging, but I must agree with Butler that many of the ailments of the old are possibly preventable, probably rewardable, and most certainly treatable.

Thursday, March 6, 2025

Pineapple

We tend to look inside of ourselves to explain the norms and outside of ourselves to call something deviant.

The debut novel of Jenny Jackson, Pineapple Street, is a good example of such conflict. Think about the chaos when a middle-class New England girl married into a family of much higher social class. Characters in the novel are our witnesses to opposite values. Millennials, who only bought things from Instagram ads, stand in contrast to Generation X who still sift through catalogs from mailbox. Daughters who prefer texting to talking on the phone are decidedly different from their mum who pronounced wi-fi as "whiffy."

The difference between apple and orange, when we come to think about it, can be up to our interpretation. All we need to remember is never compare one with another. Apple is apple. Orange is orange. Pineapple isn't apple, either. 

Sunday, February 16, 2025

Back on Feet

Wealth or health (or lack thereof) is the catalyst for tension in almost everyone – though we can often decide which of them is the priority.

My dad has suffered from a stroke and repeated falls recently. Is that an high stakes situation? Absolutely. After everything that had happened last week, and pondering everything that could happen later, our family found comfort in tackling the mess one by one. 

It's like the tangles in our hair. We can't settle unless we start from the bottom and gently work our way up. We must take our time and can't tug or pull.

Be a patient, and be patient.

Saturday, February 15, 2025

Medication

In September 2015, a drug company's CEO Martin Shkreli ordered a price hike of pyrimethamine from 13.5 to 750 dollars per pill, after his purchasing exclusive rights to distribution.

Pyrimethamine is a medicine to treat life-threatening parasitic infection in disadvantaged AIDS patients. The reason for lofty profits from jacking up the price is nothing other than greed. There were no development costs because this drug has existed for over 60 years. To prohibit manufacturers from "price gouging" on essential off-patent or generic drugs, the court had ordered Shkreli to repay the profits, and  barred him from the industry for life.

I didn't know this shameful story until my friend recommended me Elisabeth Rosenthal's book An American Sickness. I couldn't agree more with Elisabeth Rosenthal that doctors in training are generally taught little to nothing about the cost of medicine. We have been taught how to prescribe medicine, but knew little about the market. 

Neither doctors nor patients could have heard the story how a drug company intentionally moved its acne medicine from one form to another three times in order to keep its costly brand-name drug status. We knew nothing about the tactic of developing a "new" version (that could be chewed, or broken up and sprinkled on applesauce) to eke out time with patent protection. We didn't know that drugmakers can gain extra months of protection by filing a lawsuit to stymie or delay the launch of a generic.

Now I know.

Thursday, February 13, 2025

Lie

You know the feeling: you have a hard time recalling the name of someone you know – in many case, an old acquaintance.

You appear to have recalled someone's face or voice, but not the name. You have to admit having a lousy retrieval system for name. The older you grow, the worse the system will be.

One way to train myself is reading novels with more characters. I don't know your manageable number of characters without the need of a cast spreadsheet. I recently read a novel, First Lie Wins, in which the central character operates under multiple aliases. That gives me the challenging experience of not mixing up Lucca Marino, Evie Porter, Izzy Williams, Regina Hale, Wendy Wallace, and Mia Bianchi. Those are simply different names of one protagonist. 

If I wish to tell you a lie, I would pretend that I didn't get confused with these names.

Sunday, February 9, 2025

Muscle

If you have been told about your age-related muscle mass loss, join the club. 

About half of adults older than 80, like my parents, are having sarcopenia or low relative muscle mass, often defined as skeletal muscle mass being two standard deviations below the mean of a young reference group.

I must admit that I don't visit my parents frequently enough. I hardly ever, if ever, look into the fridge of them. We checked today upon visiting them. I saw an empty freezer and plenty of space after opening the lower door. My wife leaned over and shook her head. Chances are high that my parents aren't taking enough proteins. We don't even need to check with a dietitian. 

Before teaching them squat exercise or body resistance training, we knew the quickest way to reverse the downhill sarcopenia course is to fill up their fridge and stomach. Our home visit then turned into a grocery errand. A fulfilling one.

Tuesday, February 4, 2025

Technology

In November 2022, the release of ChatGPT became a viral hit within two months. By then, the milestone of reaching 100 million daily active users (within two months, let me repeat here) was a testament not only to the explosion of artificial intelligence, but also to a new era of technology. This year, a powerful model DeepSeek emerged in China and shunned the world.  

Fifty years ago few of us were familiar with VCR, let alone computers. Now that we get problem comprehending TYVM and ICYMI texts from our children, we will get further behind if we don't prepare ourselves with mainstream real-world AI skills.

To get myself less outdated, I borrowed the book Teaching with AI written by two educators, José Antonio Bowen and C. Edward Watson. They cautioned that AI will eliminate some jobs, but it is going to change every job: those who can work with AI will replace those who can't. Rather than banning AI, they clarified the need for teachers to help students move above and beyond what AI produced for them. A few good examples of writing assignments would be asking students to grade a paper produced by AI, and to write a better paper or improve the AI-generated essay (and include tracked changes and comments).

Another way of understanding the new changes is to look at the history of calculators. Think about the days when we were busy with learning multiplication tables, doing long division, or adding long columns of numbers. Then came the technology of calculators. The calculator did not really eliminate the need for human math, but changed which math skills we needed. By the same token, AI won't eliminate the need to write well and with ease, clarity and voice. Trust me, never ask AI to write your wedding vow, or your Valentine's Day love letter.

Monday, February 3, 2025

Diversity

For most people, the words diversity and inclusion are used interchangeably. But hear me out: this is more difficult than what we think to have love or acceptance that transcend every prejudice.

That's the reason many of us will find the book Far from the Tree unsettling. Andrew Solomon, who is gay, wrote seven hundred pages on families coping with deafness, dwarfism, Down syndrome, autism, schizophrenia and transgender children. Despite his proposition that diversity is what unites us all, dwarfs still carry with them the historical and cultural baggage of being "ugly Rumpelstiltskins." Parents still struggle with undue blame on themselves when their sons suffer from autism. "It's because I went skiing while I was pregnant," said one highly educated activist. Many trans kids are referred to as "idiots" and "freaks."

Sadly, we still hear reports of human children with disabilities being discarded in Dumpsters. It's terrifying to think that Andrew Solomon's book could have the same fate soon. Let's pray that its time has not yet come.  

Saturday, February 1, 2025

Cat

Japan's connection with cats is always tangible. The legacy of cats goes all the way back to the famous robotic earless blue cat. The Japanese have also created Totoro, Hello Kitty, Guest Cat and the grey kitten from Chi's Sweet Home

I couldn't help but feel obsessed to fit in one more book, The Cat Who Saved Books, when my wife shoehorned our travel luggage for Hokkaido trip. That's the story of a mysterious talking tabby cat called Tiger. 

If you love books, you will love Tiger. If you want to discover the way to connect with kind-hearted but introverted people –  otherwise known as hikikomori in Japan – you will be eager to find the feline friend Tiger.

I feel so lucky to have picked the book about Tiger to travel. It's like the best cheese and wine pairing – uplifting and deeply satisfying.

Tuesday, January 28, 2025

Pottery

No trip to Otaru is complete without a stroll through the glassware studios and stores, This is probably the third, and maybe the fourth, times our family have visited Otaru. We booked a wheel pottery workshop, instead of glass blowing craft class. 

The joy of ceramics, as mentioned by Florence St. George in her postnatal depression story The Potter's Way, is getting more down to earth with clay. The whoosh of feel-good connection with the motion of rolling is calming and soothing. We learn to get the hang of pottery technique: centring the clay on the wheel, catching up with the wheel, letting go at the right moment. The motion of rolling, as we were taught, should be hard enough for the clay to listen to us, but soft enough so that it doesn't fly off the wheel like a frisbee.

Making the pot at breakneck speed and air bubble can get trapped in the clay. When it goes into the kiln, it could crack, break or explode. 

Nine times out of ten my pot didn't work out. That's fine, as the experience is to restore balance with a lump of clay, and find solace in the therapeutic touch of clay.

Saturday, January 25, 2025

Break

Every morning, I carve out a niche for myself to work at my office desk, when I am at a state of productivity Zen. 

This Wednesday, I switched on the computer as usual and planned to invite authors to draft guidelines on dialysis. Except it wasn't as straightforward as that – nothing ever is – because my laptop was not working. Little did I know then that I would come to a standstill like my computer screen.

My eyes darted up and down the dark screen and said "open sesame" over and over in my head. 

Nothing happened. 

These days we can't finish most jobs without a computer. By then, I knew I needed to ask for tech support. 

The computer reset takes time. Still, I'm more than grateful to know my laptop can be fixed. That's just a matter of time. To allow myself to pause, I took a half day off next morning. Discovering the computer break, and a break from my computer, turned out to be a blessing in disguise. That morning, I went for a hike and brief trail run, followed by a bike ride to make my blood donation. 

Tuesday, January 21, 2025

Plant

The science of plants is something new to me. Before reading The Light Eaters recommended from my friend’s post, I never realized that ferns can have up to 720 pairs of chromosomes, versus humans’ mere 23. 

As I read more about the green world, I get more impressed by the amazing plants. The endurance athletic prowess of fern’s sperm is something we can never compete with. The male gametophyte fern releases swimming sperms when water is present. Shaped like tiny corkscrews, fern sperms can swim up to sixty minutes. But swimming to fertilize eggs is only one feat. To survive, reproduce, and thrive – all while facing the pressures of predators, scarcity, and blight – is another thing entirely. The super-smart ferns have learnt a crafty trick when competition for reproduction gets fierce. To get an upper hand, ferns can emit a hormone that causes the sperm of neighbouring fern species to slow down. Slower sperm means less of that species survive. Which is why the sabotaging fern can enjoy more of whatever is scarce, be it water, sunlight or soil. 

How can plants without brain do that? Nobody knows but there are indeed indicators of memory in plants. The latest research reveals that a wide variety of plants are wired to distinguish themselves from others. And, yes, they can tell whether or not others are genetic kin. When such plants find themselves beside their siblings, they arrange their leaves within two days to avoid shading them. When searockets are surrounded by unrelated plants in the lakeshore dunes of Indiana, they would grow roots aggressively into the sandy soil to monopolize nearby nutrients. But when they grow beside their kin, they would politely confine their roots. 

There are more snippets of hard evidence for plants' kin recognition. We simply don't know how they do this. Do plants have ears? The beach evening primose – a lemon-yellow teacup-shaped flower – has been found to increase the sweetness of its nectar within three minutes of being exposed to an audio recording of honeybee flight. Doesn’t it make sense for the plant to entice pollination? 

Whatever anthropology behaviour you might wish to name for that of the plants, one thing’s for sure: the plants are deeper than what we have perceived.

Monday, January 20, 2025

Magic Number

After the internet, and more specifically the World Wide Web, has changed our knowledge, artificial intelligence is going to transform everything. It's not a stretch to say that artificial intelligence is a game-changer. And it seems inevitable that doctors are being affected, if not under threat. 

A randomised clinical trial, published in JAMA Network Open, found that the use of a large language model did not significantly enhance doctors' diagnostic reasoning beyond that of conventional point-of-care decision support resources such as UpToDate. Surprisingly, though, the large language model alone performed better than the physicians.

Wait, does it mean a chatbot can be the solution? Even if that were a good idea, we should be mindful of the pitfalls. We shouldn't just copy and paste what patients say to a chatbot. That brings me to the story of Nicky in Blue Sisters, a beautiful novel written by Coco Mellors. Nicky suffered from endometriosis, a painful condition in which the cells in her uterus are growing in the wrong places. Sadly, Nicky died of fentanyl overdose. Can you imagine how many times Nicky had been asked to rate her pelvic pain on a scale of one to ten? 

It was a riddle: Choose too low and she might not get the painkillers she needed, choose too high and she'd be dismissed as hysterical. A chatbot can never imagine that Nicky had to do tricks with the number. She tried six, seven, eight, nine ... She never dared consider herself a ten. 

That riddle can never be solved by a chatbot, not even by a doctor without empathy. 

Saturday, January 18, 2025

Gravel

Forget, for a moment, we don't have enough hours in the day.

I was recently taught this trap we all get snared in. At first glance, it feels undeniably true because we have more things on our task list than time to do them. But it's no longer the case if we can offload any nagging tasks that have the lowest-yielding bids for our time.

David Allen calls it "brain dump", a tool to banish those energy-sucking tasks from our brain with a mental spring cleaning. 

Demir Bentley and Carey Bentley, the productivity power couple, ask us to imagine pushing a wheelbarrow full of gravel. The more gravel we add in, the heavier the wheelbarrow becomes, and the more energy required to push it. Notice the way we fill up the wheelbarrow. It all seems so easy. Fill the wheelbarrow first with the trivial tasks, the size of gravel. Then the last bit with heavy rock, which turns out to be the highest-ranking or priority task. By that time, the wheelbarrow can hardly fit the rock. 

A good habit, in other words, is to triage our task list and fit in the most important one first. Get the rock in our wheelbarrow first. Once we have settled the rock, the gravel will find the way to go in (or out wherever appropriate). 

Sunday, January 12, 2025

Trail Run

I didn't begin running seriously until my late forties, and have hit the roads and pavement since then.

I'd never heard of trail running before. With not an iota of idea about the hardship of trail run, I joined one few years ago. That afternoon, I brought nothing – not even a water bottle. It had never crossed my mind to wear special shoes. Ask any experienced trail runner, and they'll tell you I'm an idiot.

I suppose, looking back on it now, I was simply lucky to have finished the trail run without getting injury circumnavigating the terrain.

Not anymore. Fast-forward to this weekend. I managed to join my second trail run, this time with a new pair of shoes. When race day arrived, I was nervous but felt ready to enjoy the experience as much as possible. This is the first time I brought along water in a running vest. I didn't know how to use the bite valve, and ended up opening the lid to drink. I didn't prepare too much but tried to soak up the experience after taking off from the start line. Pretty soon, I came to realise that I didn't descend fast enough when the stair spacing is too narrow for me to place the whole foot on the step. My cadence, on the other hand, can be high to go downhill with rugged landscape. I fetched bananas twice for replenishment, my face aglow in the sunlight and my heart rate quickening above 170 beats per minute.

If you're new to trail running and wondering whether you can do it, let me reassure you even an idiot like me can do that. Call me an idiot if you want, but it's okay to make rookie errors. What brings me the most joy is being able to explore the nature and my body. There's nothing better than a trail run to just forget about life for a few hours and enjoy the fresh air and scenery.

Saturday, January 11, 2025

Universe

The more I thought about time, space and universe, the more fascinated I became by what I have learned from Jorge Cham and Daniel Whiteson. They wrote a witty and entertaining book Frequently Asked Questions about the Universe

Will time ever stop? Why can’t we teleport? Do we live in a computer simulation? 

Yes, I know, that might seem like an outrageous question. Then again, maybe it doesn’t. 

As we can see, simulation is no joke. People start to imagine a future in which everyone is running a simulation of a universe in their home computers. The idea that the world isn’t real and that there could be simulated people inside of them running more simulations might be technically feasible. That’s a simulation inside a simulation. Why not? The more simulations being run, statistically speaking, the more likely that the so-called universe is a big video game. 

We don’t currently know whether the world we live in is real, and we might never know.

Sunday, January 5, 2025

Inheritance

If you're looking for a contemporary vision of medication abuse, go to read the novel My Year of Rest and Relaxation by Ottessa Moshfegh. 

Central to the idea of "relaxation" is a young New York woman's numbing herself to near-coma with a remarkably huge repository of dangerous drugs. Risperidal, Ambien, Valium, Ativan, chewable melatonin, trazodone, Nembutal, Benadryl, NyQuil, Xanax, Lunesta, and her list goes on and on.

The tragedy of this miserable woman goes all the way back to her baby days when her mother, a bedroom drunk, crushed Valium into her milk bottle to "console" her for colic and crying. 

You might wonder how a zombie poisoned by that many psychotropic medications could have survived. Well, she could barely arouse the enthusiasm to stand up straight. She took a shower once a week at most. She didn't do much in her waking hours besides watching movies. That woman didn't have to work as she had all her bills on automatic payment plans. She didn't have to worry about property taxes on her apartment, because rent money from the tenants in her dead parents' old house upstate showed up in her checking account by direct deposit every month. 

In short, she survived by inheriting the fortune from her parents. Or, should we say, she inherited the misfortune from her mother who mixed alcohol with sedatives?

Thursday, January 2, 2025

Fix

Nearly 30 years ago, I had no idea about patient safety as a junior medical intern, much less keep my patients safe. 

The vivid real-life stories from Amy Edmondson's Right Kind of Wrong reminded me of the internship experience. She mentioned the near-fatal mistake of complex failure in a ten-year-old boy, whose face turned blue after surgery. The boy was given a morphine overdose – several times more than was appropriate. 

Alas, that story was exactly what I had encountered in a surgical unit where a domestic maid was found unarousable after an appendicitis operation. Within minutes of being paged by the nurse, I rushed to check on the patient and found a near-empty bag of morphine. I ordered a dose of antidote, which worked like true love's kiss for Aurora. That fixed the problem and my patient woke up. End of the story. 

Except that it's not.

Looking back, I was so naive to take a quick fix without reporting the incident. I dared not speak up. And that's it. 

As a matter of fact, we tend to take short cut in the working environment, even for simple process failure like running out of clean linens. The so-called "first-order problem-solving", as you can imagine, is simply walking to another unit and taking linens from their supply. Problem solved. Minimal time and effort.

It is time for me to quit the first-order problem-solving habit. We better think about what Amy Edmondson dubbed "second-order problem-solving." That could simply mean reporting the shortage of linens and taking the initiative to work around the linen ordering system.

Wednesday, January 1, 2025

Legend

In his 2018 book Through My Father's Eyes, the son of Billy Graham recounts his personal relationship with his father, an iconic American evangelist.

In 2007, the Billy Graham Library (ahead of his death at the age of 99) was dedicated in the presence of former American president Jimmy Carter (who recently died at the age of 100).

Carter also followed Jesus and taught Sunday school classes before, during, and after his time in the White House. 

Both are legendary.

Humor

For those of you who like the witty hashtag on Twitter (or X, or whatever you call that), you should have heard of Jimmy Fallon who likes to tweet movie or song title, add one word to change the meaning and tag it to ask for more suggestions. Those humor habits with social media users could have started with Jaz-Z who hashtagged #mylaugh years ago.

If you're anything like me (bad news: you are), you might be less obsessed with hashtag and more old-fashioned. A nerd like me would have prefered  The New Yorker magazine caption contest, which comes up with a blank cartoon for anyone to create funny captions. That would be good exercise to rewire our brain to stress less and laugh more. I learned this kind of writing during my high school days, when a newspaper posted a blank cartoon every week and invited submission of short fiction on that cartoon. To me, back then, the comic story crafting meant a conscious desire to be funny, to make people laugh, and to reward myself with pocket money. 

Another prime example of humor habit, as I recently learned from Paul Osincup, is game called Guess the Punchline. The goal isn't to build six-pack abs (which will be used only when you laugh too much), but to exercise your humor muscle. All you need to do is pause a video after a comedian like Jimmy Fallon made a setup, and guess the possible punchlines. Here's an example of the setup: According to most studies, people's No.1 fear is public speaking. Number two is death.

What's the punchline?

"This means, to the average person, if you go to a funeral, you're better off in the casket than doing the eulogy."