AIDS

Long before the coronavirus struck us, a mysterious case of pneumonia appeared in Los Angeles.

On a summer day in 1981, an unusual pneumonia, called Pneumocystis carinii, affected four persons, each of them had been in excellent health. Shortly after, the new kind of illness characterized by new acquired cellular immunodeficiency made its début in the New England Journal of Medicine. It’s a kind of “a distinct and unusual clinical syndrome. All were exclusively homosexual and had been in excellent health before late 1980.”

That story, as it turned out, signaled the beginning of the age of acquired immune deficiency syndrome known as AIDS. During my recent reading of three interns’ diary, I learned more about how the disease were soon recognized in five children with identical symptoms. The story of full-fledged explosion of paediatric AIDS was told by the interns when they worked in a major New York medical centre in 1985. They didn’t encounter that many deaths in paediatric wards (because children tended to recover from illnesses) until the AIDS brought in more and more sick children.

Before AIDS, those interns drew blood, inserted intravenous cannula, and did mouth-to-mouth resuscitation without giving it a second thought. Not any more with the concern over the rampant spread of AIDS. All house officers wear gloves. The increased use of latex gloves has caused a worldwide shortage of rubber around 1986.

Looking back, we saw many similarities between our fight against AIDS and Covid-19. The more I think about them, the more similar they look. At the beginning, we were all taken aback by a new kind of illness. Before scientific breakthrough, the only way to prevent HIV infection has focused on behavioural interventions. This was somewhat working but not a panacea. With time, we saw treatment options other than primary prevention. Availability of more than 30 antiretroviral drugs has given better quality of life for more than 38 million people who are now living with HIV, not to mention markedly lower mortality.

The rest is history.

Reframe

For most peole, a shitty situation is a shitty situation, but when your mindset is what affects how you feel about it, what you do about it and, in some cases, the outcome.

To feel more in control of our destiny, we can change the way we look at things, and then the things we look at change.

According to Deborah James, this is the best way to handle the shit. She was diagnosed to have bowel cancer at the age of 35. Not usual cancer. A nasty one with notorious BRAF mutation, driving very rapid cancer cell growth and giving rise to a resistance to standard chemotherapy. Relentless. Cannibalistic. Rampaging.

Even if her destiny seems bleak, she reframes it and sees the positives. In her book How to Live When You Could be Dead, she never uses the word "terminal" in relation to her cancer - she consciously refers to hers being an "incurable cancer."

The way she finds her hope and reframes her thinking would help all of us to become a happier optimist who sees the rose and not its thorns. 

Setbacks are part of any journey, as I come to realise from Deborah's, but not the destination.

Technoference

Many of us have heard someone, perhaps ourselves, say something like "Oh that's smart", when that turns out to be dumb.

It's even more interesting when we parents refer to our cell phone as a "smartphone", but then tell our child "Get off of your dumb phone!"

I have a rather dumb habit when it comes to parent-child or household relationships intermingled with my phone. I've lost count of the number of times I've been caught checking my phone during family dinner time. Parental distraction by smartphone is a sin, I admit. A sin I am famous for. In fact, I have been told off repeatedly for stealing look at the phone's message at the dinner table. Not once. Not twice. But distraction ad infinitum.

There's such a strong case to be made for sentencing my behaviour. So much so that it deserves a name: technoference. That's a name I recently learned from reading a book about our digital landscape and technology.

Parenthesis

Everyone wants attention, and I am no different. Is this unusual? No. Does this mean we desire and crave for validation? Yup. Does it mean a teacher can get the attention all the time? You betcha.

I can't imagine the awkward way I was entering the lecture theatre this morning, with a big crowd facing me but walking in opposite direction.

A bitter welcome it would be.

I pretended to be oblivious to my students skipping my class. I kept walking - it didn't take long - and I overheard a few medical students teasing the title of my lecture: Communication skills. But hold on, I want to be clear, from the start, that I agree it's never a good idea to use didactic leacture to teach communication. I don't know how to make the lecture useful, much less how to make it interesting.

To eke out the most fundamental virtue of empathy, we can't simply teach the students "how" without the "why". So what, you might ask, can bring out the empathy? Simple: be a patient. If not, read more stories about illness. There are so many good novels or memoirs about illness. To give but one example: I finished a graphic memoir of a French artist who learned to accept her repeated seizures from a brain tumor. For a long time, she had been pretty messed-up with memory and lucidity, suffering from what people described as "spells of shaking". This story of an inoperable tumor would have been far better than my lecture to remind students to be empathetic.

Weekend

You think when people talk about vacation that they must be referring to the paid annual leave, but they don't neccesarily have to be so. Listen to Cassie Mogilner Holmes, a professor at UCLA's Anderson School of Management, and you will see how.

I came across her thinking on how to get more people take their vacations - and I think her answer sums up perfectly: "But then we realized, we actually have breaks in our lives already." Presenting: the weekend.

Holmes' team ran a series of experiments and found surprisingly impressive effect of having the mindset to treat the weekend like a vacation. Nothing special. Simply being randomly assigned to instruction "to treat the weekend like a vacation." That was it. This may seem impossibility, but it is true that a vacation mindset is enough to get the participants happier, less stressed and worried, and more satisfied on Monday than those control subjects who were instructed to treat the weekend like a regular weekend.

The good news, if you could call it that, is that we can still reap the benefit from an hour of protected time (say, on Saturday afternoon) even we can't have two consecutive days of Saturday and Sunday off work.

What better way to celebrate my weekend?

Balance

Who among us haven't relieved ourselves in the traditional Japanese style squat toilet and thought "Oh, it is slightly less embarrassing than behind the bushes."

Don't laugh. It's not as easy as you would have believed. During our family trip in Hokkaido, we happened to find a poster teaching the know-how of proper squatting above that ceramic squat toilet. A step-by-step manual to keep us on an even keel. A detailed one. So much so that we are taught to face the correct direction, to take down pants to ankle, to focus and aim correctly. We laughed until we couldn't breathe.

Laughing aside, I didn't realize the wisdom behind that poster until our family talked about the dreams we had on the road. Well, my daughter's dreams were funny, and so were my wife's. "I don't know," I said. "I didn't have much interesting stories in my dream last night. Not much, really. I dreamed about rehearsing with my colleague who is going to appear in the coroner's court."

My wife could hardly believe in what I dreamed during the family vacation. She tried to hide her disappointment, and appeared to pity me for being such a workaholic.

My daughter nodded, hearing me. "Balance, you know, daddy. Remember the teaching we'd had yesterday: if you lose balance, you are gonna fall down on shit."

Fishing

My travel buddies used to bring us to go fishing during summer trip. A simple yet difficult-to-master pastime that gives us a more jolly experience.

Imagine drawing a line using the softest pencil you could find - I guess that would be a 6B or 10B. Now imagine the nearly invisible line to be cast into the sea or river. Lighter than you're thinking - all fishing lines are invisible but palpable. Stay still and feel for the thrill. You can't see it but you can feel it: the thrill of a fish bite.

I don't get hooked on the hobby of fishing but often enjoy the way I can connect with nature on a boat or canoe.

Calm water. Calm mind. Calm space watching wildlife. That much is the reason good enough for me to go fishing.