Kindergarten

I have been looking forward to the first day of bringing my kid to the kindergarten.

Well, really - how could you not?

I decided to take a half day off. The sun was bright, the traffic heavy. My daughter, still every inch of her a toddler, was excited and brought with her the picture book "Let's Go to School." We heard the sparrows chirping as we ran up the hill to the bungalow campus. It was the natural and lively outdoor environment I like most about the school.

Surrounded by uneven paths on the slope, riddled with holes (and some mosquitoes, too), the school looks as if it has been designed to teach and prepare for Tarzan. A good news for Tarzan, after the recent typhoon storm, is the school and most trees were not blown down. A bad news is that the tyre swing at the campus was damaged beyond repair.

No surprise we miss the tyre swing badly.

Luck

Go ask a doctor how it goes after the on-call day, and odds are that the doctor will tell you how lucky or unlucky he has been.

Some of us take solace, after a stormy night, by calling ourselves unlucky. To us, a peaceful night means luck.

But be not beguiled.

Now that I've got senior enough to be on call once in a while, what I look forward to is the luck (sort of) to see more difficult cases and learn. I remember reading once that medicine is knowledge, judgment, experience, and luck. With that in mind, I called myself lucky (I still do) when my pager was bleeping all night during my recent call days.

Lest I be misunderstood: I do not want to suggest that a good doctor is one who prays for a busy on-call day. Nor do I think it always proper to work nonstop. Yet, when I think about my two recent on-call days, I see that I was really lucky to come across patients that I can learn from them: first, I learned to stick a long needle into the pericardial sac around a patient's heart, and next, I learned to place a balloon pump into the aorta of a failing heart.

And I owe it all to a bit of luck.

Peer review

Few words are more likely to make one think of impartial judgement and idealism than that big term peer review. A beacon of justice for scientific knowledge. Almost all manuscripts submitted to biomedical journals are now sent out to reviewers, selected by virtue of their knowledge about the manuscript's topic, before any decision on publication.

Reviewers are obliged to return the review within two weeks. The deadline is not difficult to meet, unless I forget the request. When I returned from Berlin, I thought I'd finished all the reviews and didn't pay attention until a reminder appeared in my e-mail box yesterday.

"Oh man, I thought I had submitted my evaluation. Did I?" I asked myself as I quickly searched my files. I didn't keep track of the evaluation scores and decision of each manuscript reviewed, but I saved the written paragraphs that summarize for the editors (the reasons for my recommendations for disposition of the manuscript) and for authors (as requested by most, if not all, journals). Imagine that you had submitted the review over one week ago and yet the reminder was sent to you because of computer system error. Would you be able to submit an evaluation identical to the first one?

I shrugged; probably I blushed. It's odd. When we write the paragraphs, we make use of slow, deliberative, and more logical mode of thinking (the System 2, as what the psychologist and Nobel-winning economist Daniel Kahneman calls it). By the time we enter the manuscript's rating with respect to the originality, scientific accuracy, interest to the readers of a specific journal, recommendation like rejection or acceptance with major revision, we're switching to System 1, a fast, automatic, intuitive, and emotional mode with little sense of voluntary control.

I tried my best to recollect how I entered the score. But my answer came out in stammers and meanders. The situation is that I typed the paragraph in the hotel and then brought my computer to a bus station (a free wifi hotspot) for final electronic submission. I could have missed the last step when the weather turned bad, with a sudden flurry of heavy rain. And if I'm candid, I do believe that I could have entered a lower score at that time, simply because of the rainy weather.

Recess

Remember the good old days – you know, at school? I didn't go back to school but went to Berlin this week. I was there attending a medical conference on transplantation. Going to medical conference has a lot in common with sitting in classroom. There is plenty to learn in a day when the conference starts every morning at seven sharp. I learnt everything from a minuscule virus to ethics.

Trouble is, I get sleepy sooner than any schooler. My eyes fixed on the projector screen, where all the letters morphed into the alphabet z. Shoulders sagged, eyelids fell, and all my internal circuit went into hibernating mode. If ever there is a sleepiness illness, it's synonymous with getting old.

Yes, it's true. If you're like me, fear not. I'm getting old – I know that – but without getting too stubborn. I learn new tricks. Here is how.

Skip class. While it might seem naughty to skip class, I did enjoy the freedom of go-as-you-like in medical conference. Throughout this week in Berlin, I took one-hour break every afternoon. Bring the camera and jump on a train. I wasn't disappointed. A 5-minute ride from the conference centre lies a picturesque French-style Baroque garden around a legendary palace. A brief walk brought my energy back. Soon, I found myself refreshed and young again at the conference centre.    

Berlin

Upon return from Japan, I caught another flight to attend a conference in Berlin. The fact that I could find my daughter's diaper in my baggage proves that I didn't prepare much for the trip. I didn’t even check the whereabouts of the conference centre until I arrived at the city.

It's late in the evening on a rainy Friday, and I went into a bookstore to find out more about this city. The first sentence from a travel guide book reads like this: If New York is the city that never sleeps, Berlin is the city that never stands still. It didn't take long for me to find out how this is so. Before I went on to the second sentence, the sun came out of the blue. Sure, the weather changes every minute in this city, I thought. Excited as a teenager on a first date, I grabbed my camera and was to leave the bookstore. The sad truth is that I found the very bottom of my shoe get loose at that very moment.

Ouch.

My shoe simply flip-flopped with each step, like a broken castanet. I got no choice but to buy all-purpose glue and tried to fix it. I told myself to forget about the shutterbug business and stood still for the glue to work.

And no prizes for guessing that the sun disappeared before my shoe could be fixed.

Just to make sure you understand what is meant by a city that never stands still, let me tell you my shoe could not be fixed. I bought a pair of new shoes, and the sun came out again.

Holiday

It can't be stressed enough: if you bring up a kid with the help from a domestic maid - usually the case when both parents are working - be prepared to take leave when your maid is on leave too. That's the case for me over these two weeks.

It's hard to think of a better excuse to take vacation. Uh-oh! Don't forget to tell the kid that the nanny will be away. We did this over and over, each time giving our two-year-old a chance to accept and prepare for the separation. It can make a kid feel frustrated and left out.

After a few rounds of struggles, my daughter has learned to live without her maid. Of course, there are many ways to let her relax. Put our sandals on and bring her to the beach, and pretty soon, she was soaking herself in the water like a mermaid. To make this splashing experience even more a real standout, we brought her to Japan and plunge in an onsen. The first incredible thing my daughter knows about onsen is the ultimate freedom of going naked.

Relax. That's what onsen are all about. Ditto for being the parents.

Poo

It's hard to say how long it takes me to stop saying no when my wife makes a suggestion. Like going to the dentist, much depends on how long problems have been ignored.

I know that I'm hard-wired to maintain the status quo and I'm very stubborn; really, if you ask my wife, impossible to change. But saying no to the wife is forbidden; this I know, this I have learned in my lifetime. I've been learning to replace the word "no" by sounds like "humph," "uh-huh," and "hmmmm." Not that easy. I dare you to name one example of Martian who had ever heard of these sounds before arriving on Venus.

That admitted, I must further confess the shame I feel when caught saying no to my wife's idea - and then proved wrong. Many a time the idea is not a serious one. Sure, it makes saying no to a not-that-serious idea even more stupid. The question is not whether I'm wrong. The big question is, What's the big deal about who's right and who's wrong? A couple of months ago, my wife was looking for picture books to buy for our daughter. A second after she showed me the book about human digestive system, I heard myself say skeptically, "Uh-oh!" I felt the word no coming out of my mouth, and just in the nick of time I caught myself, before I made another mistake.

Okay.... okay... my daughter really loves that gorgeously gross picture book showing how the food journey comes to an end.