Fish

It's one week before the birth of my baby and I have many ultrasound photos capturing her adventure from the earliest embryo inside the womb. It is hard not to feel awestruck watching her growth from a humble-looking yolk sac to a lovely one with brain, heart, nose and legs.

Having a wife as an obstetrician means abundant opportunity for me to watch and adore my yet-to-be-born baby's face. Sure, the photos of her face invite lots of oohs and aahs from our enthusiastic friends and families. "Amazing! The nose looks like mum's and her mouth resembles dad's…"

In no ways is her face to be confused with others. No one will be surprised that we're obsessed with the question how different and unique our baby is to be. I really believe it's so.

After my recent bedtime reading of Neil Shubin's Your Inner Fish, however, I start to look at our body in another way.

It turns out that we all look incredibly alike, instead of being unique in oneself. In his entertaining book, the distinguished paleontologist showed me all the exciting similarity between our anatomy and that of mammals, reptiles, and even fish. The chapter on the twelve pair of cranial nerves is the funniest. Most medical students, writes Shubin, should have had lost their ways amidst the maze of these twelve nerves, branching to take bizarre twists and turns inside the skull. Complicated as they are – believe it or not – cranial nerves inside our head shared a remarkable and elegant blueprint with every skull on earth. This applies, alas, to that of a shark, a bony fish, a salamander, or a human. Quite contrary to my imagination, virtually all of our cranial nerves are present in sharks, for instance. The parallels go deeper than having the equivalent trigeminial nerves, facial nerves, glossopharyngeal nerves, vagus nerves: these equivalent nerves in humans and our aquatic cousins supply similar structures, and they even exit the brain in the same order.

The message from Neil Shubin is clear: we're profoundly similar to each other. We are.

Team

When Stephen M.R. Covey told the story of a business student sitting her final examination, the punch line was the last question of that business degree exam: "What is the name of the person who cleans your dorm?"

What a question! This sort of question made the student want to pull her hair out. Crestfallen, she asked the professor if the question really counted on their final grade. "Indeed it does!" he replied. "A good leader takes nothing for granted and recognizes the contributions made by everyone on the team."

Obviously I am not a leader. Yet, I'm lucky to have someone clean my house. With my baby on the way to landing, we hire a domestic maid. The hardest rite of passage to go through before our maid's arrival is how to live with a newcomer. Well, adults and kids have a common affliction: stranger anxiety. I worried and moaned.

I used the past tense in the last sentence because my maid has arrived and we're having a good time living under the same roof. Several friends of mine sent me their recipes. No, they aren't talking about the recipes for cooking, but the rules to lay down for the domestic maids. An example of the rules is "to pay more attention to taking care of the baby rather than preparing the meal." That sounds reasonable to me. Next the rule states that "No kissing baby." Is there not something amiss when a maid must love our baby but not kiss her? We can only say, "It doesn't work for us."

Our baby hasn't arrived. We don't make particular rules in black and white, but seem to be doing well. She cooks dinner for us, and we treated her to a good seafood dinner at Sai Kung. My friends are stupefied to learn that we're even sharing the laptop (and broadband access) with the maid. But surely the time has come to ask: Why not?

Truth

When doctors speak casually to their patients, little do we realize our words mean an awful lot. Sometimes the truth hurts, and it pains me to say this, but there will be situations that challenge a prima facie duty for honesty. "A good speech isn't one where we can prove that we're telling the truth," Sir Humphrey Appleby once reminded James Hacker, "it's one where nobody else can prove we're lying."

Few, if any, moral philosophers would admonish us to always "tell the truth, the whole truth, and nothing but the truth." Telling a white lie might not do anybody harm. More often than not, it can do your patient a world of good.

Doctors are by no means having the monopoly to please their patients; the reverse also holds true.

Lately, I have been sharing a story about telling truth to doctor. It's a tale I wish didn't need telling. It all started when most of our team went to the States for a conference last week. I screened the referral letters to our specialist clinic for kidney problems. One of the patients had been seen in our clinic decade ago for the finding of heavy protein in her urine. She remained well after treatment but seemed to have the same problem coming back this month. I jotted down a note to expedite her care.

That patient was called back to see me yesterday. As she came into my room, she made a quick remark that she recognized me. "Indeed," I continued the conversation, rather superbly I thought, "I just realized that, after going through your case notes, I was the doctor who first saw you ten years ago." I was pleased to see her again, with pride written all over my face, because my patient remembers me after all these ten years.

"Yeah, yeah, you were young at that time," she replied.

I nodded reluctantly, as if my head was hanging over a guillotine. She is absolutely qualified, I know, to remind me I look older than ten years ago.

Nesting

Expectant cats, rodents, birds, and dogs develop a marvelous burst of manic energy to ready their "nests" just prior to childbirth. This may mean nothing to you, but means a lot to me.

By a quirk of evolutionary fate, human beings are often proud of being different from even our closest cousins in that chimps don't have the ability to reason. Hard as it is for us to imagine, nevertheless, the nesting instinct encoded in the nucleotides of our feathered or four-legged friends of the animal kingdom has been sealed in our DNA, too. There is simply no reasoning when the compelling nesting urge catches us.

I came to accept this shared nesting flurry among all members of the animal kingdom when we're expecting the arrival of our baby. My wife and I – oops, to be honest, the former – clean every crevice of the home, put together cribs without assistance, climb the ladder, go through all our cabinets, set up the baby's room, and do everything at an astoundingly effective tempo. Yeah, yeah. I know you might rightly scratch your heads, but I'm talking about Olympic gold level. Incredible.

Pregnancy folk lore and old wives tales have it that hammer and nails are strictly forbidden at home throughout the pregnancy. I couldn't see why that matters. In fact, I nearly lost my temper when the worker suggested not to carry out decoration last month. Call it superstition if you wish. Not that there will be anything wrong with your baby, I should emphasize, if you break the taboo. After I had shrugged off the spasm of temper tantrums, I started to think about the wisdom of the folklore. Well, it could have been meant to give us a brake to the nesting instinct.

Lecture

I have been giving a number of lectures recently. This is not to say that lecture is effective teaching. It almost never is. Some people like me, I have to say, don't do well during lectures and quickly doze off.

As far as education is concerned, nonetheless, lectures are forever the default mode and practicum little more than a footnote. Indeed, nearly 80 percent of college courses are simply lectures by professors, in a way that you may have been sleeping through most of the time. Only a saint wouldn't sleep during a lecture. Correction: only a dead saint wouldn't sleep in front of a bloody boring lecturer (and it's hard to see how I can be anything else).

Did I mention the guilty lecturer (who has no excuse not to)? To please myself and make the students feel less miserable, I decided to put up my first PowerPoint slide quoting Derek Bok, a former president of Harvard. By the end of a lecture, according to his book Our Underachieving Colleges, a student remembers just less than half of what was taught. Only a week later, that number is down to a stunning rate of 20%.

Taxi

Of all teachings given by the emotion intelligence guru Daniel Goleman, none is more important than that of the almond-shaped amygdala in an area of the human brain called the limbic system. Disgust, fear and anger, it is said time and again, come from the amygdala which acts like a central alarm system calling for a full-fledged "fight or flight" response.

My recent lectures in Beijing brought back the nineteen-year-old memory of my first (this is my second) visit of Beijing. As so often happened to tourists in mainland China, I found my amygdala sending messages of apprehension, making me edgy and easily startled, say, on a bus or at the train station. I am not sure if you've heard those stories of tourists being mugged and robbed of their kidneys, but I was stupefied to imagine myself coming back with single kidney.

The extent to which our neural circuitry overwhelms us with fear is no news to us. Fear and anger, on the other hand, can be reshaped or relearned. After attending the dialysis conference in Beijing, I traveled around on my last day there. When I went aboard a bus yesterday, I found out there wasn't conductor. That means I had to tender the exact fare – which I didn't have. It seemed clear to me that I should get changes with the passengers on the bus. I tried it sheepishly with my ten-yuan renminbi banknote. You can imagine how nervous I must have been as my Mandarin skill won't allow me to utter more than a few simple sentences. In hindsight, I realized that I had undoubtedly made myself look stupid enough, and I was thrilled when the passenger volunteered to pay for me!

When I headed for the airport in the evening, I took a taxi. I ended up paying 70 yuan while the taxi meter stated 60 yuan. Only a foolhardy gambler would bet that I didn't protest when I had been shortchanged. But no, I didn't. Just why I didn't fly into a fury and quarrel with the taxi driver, to be sure, had nothing to do with my poor Mandarin. Good mood, which lasted after the pleasant experience on the bus in the morning, had probably got my amygdala rewired, short-circuiting the path to irritability and hostility.

A postscript to my story of taxi ride: It is not the case that I was shortchanged, I reckoned afterwards, because the extra ten yuan went to the toll fee.

Emotion

This month, a special issue of Science magazine published over 10 papers, written by a total of 47 authors from 10 countries, covering the discovery of an extraordinary 4.4 million-year-old hominid fossil skeleton known as Ardipithecus ramidus.

Of course, I don't have a whiff of paleoanthropology knowledge to discuss how our ancestors ended up walking on two legs. Still, I must admit, evolution is always a fascinating subject. I've been reading recently about the evolutionary root of our emotional life. I am impressed by the way Daniel Goleman chronicles how our primitive brain evolved to have new layers of brain cells endowed with intellect and emotion. It is not that we have improved a lot in terms of emotional intelligence when compared with our ancestors – trust me, we haven't – but many of us are doing not enough.

An account by a subject in one of the very first scientific studies of anger done in 1899 captures the heart of it:

Once when I was about 13, in an angry fit, I walked out of the house vowing I would never return. It was a beautiful summer day, and I walked far along lovely lanes, till gradually the stillness and beauty calmed and soothed me, and after some hours I returned repentant and almost melted. Since then when I am angry, I do this if I can, and find it the best cure.

The same had certainly happened to me. Once, during my teen years, my mother broke my table tennis racket. That made my hair stand like porcupine quills. Alas, I behaved exactly like what that child did – and, remember, back in 1899. My eyes watered. My heart took flight. I exploded. I grabbed my bag and stepped out of the door: I wasn't coming back. The cooling-down walk left me feeling less angry, not more. The memory of this maiden runaway from home has stayed with me for close to thirty years.

Seeing how the history repeats itself – so much so that the narrative looks exactly the same with my own – speaks to a sense of déjà vu. And let's face it, we are no better than our ancestors a century ago.