Sure, many of you flew out of town to celebrate the Christmas. We didn't.
Last night, we slept in a waterproof tent at a country park campsite. That's our holiday idea. Oh, and I should mention that our idea of wild camping started with two families, and ended up with the third family joining us impromptu. With that, the fun more than triples.
Call me a fox who doesn't need sour grapes, or just plain jealous, but I do think that the magic of wild camping can bring new angles of holiday option.
If you haven't camped as a family before, let me tell you our tricks.
Before you go, it makes sense to buy or borrow essential camping equipment. Sleeping bag is a must, and I learned this lesson twenty years ago when I was camping without sleeping bags with my classmates (one of whom being my wife now). We did not faint as the temperature dropped after nightfall, because we didn't have time to. We were busy shivering.
Next, prepare for the bedtime rituals, as what your kids would have brought - although we'll never know for sure - when they sleep over at the best friend's place. Our examples included milk bottle, story books, stuffed panda and elephant.
What about food? Never think about haute cuisine. Your best bet in the outdoors (and, remember, in case of torrential rains) is easy-cook food. You won't have much problem with an outdoor gas stove, as a rule of thumb. On that note, here is one of our recipes last night. We cooked some rice, and brought with us seaweed. Kids could then create their own version of sushi.
The lesson? We don't have to bring an oven to roast a turkey, but we need ideas to burn off the kids' excessive energy.
Saturday, December 27, 2014
Thursday, December 18, 2014
Age
It should come as no surprise that the most common introductory sentences in doctors' commentary are about the age. These opening remarks appear every now and then in the morning round: "This is a 75-year-old man who came in with a fever."
That's the way medical students have been taught to describe a patient, I know.
The at-a-glance knowledge of a patient's age is so important (universal, I might add) that nobody dares to skip it. Well, yes and no. Yes, that number on the top right corner of patient's case note might give you an inkling how fit the patient is, but never emphasize too much on the chronological age. I'm more interested in my patient's biological age, and I've taught my students so.
Biological age, as it happens, is imprecise and less scientific. To many, this kind of guesswork seems like counting the grey hair. In the hands of experts, like yourself, it is a window into your real age. Instead of magical formula, it refers to "how old do you feel you are?"
Time for a quick quiz: How old do you feel you are?
A simple question, but a meaningful one. That's what I just learned from a research publication of the English Longitudinal Study of Ageing. Researchers studied some 6500 adults aged 52 years and older, asking the exact question I just mentioned. Some of them perceived their age close to their actual age; some felt more than one year older than their chronological age. More than half (me included if I were recruited), in fact, rated their age at least 3 years younger than their actual age.
Take one more close look at the mortality rate after 8 years of follow-up, and you'll see the pattern. Alas, after adjusting for the baseline health, physical disability, and health behavior such as smoking and alcohol use, those who felt younger live longer than those who felt their actual age or older. It's not hard to explain the finding if the terminal ill patients rated themselves older. But the same conclusion was shown after excluding death within 12 months of baseline question. In short, feeling young gives you a phenomenal edge over longevity. The upshot is that we now better understand the merit of feeling young - a sense of mastery.
Although trite, the old saying still is true. "It's not how old you are. It's how you are old."
That's the way medical students have been taught to describe a patient, I know.
The at-a-glance knowledge of a patient's age is so important (universal, I might add) that nobody dares to skip it. Well, yes and no. Yes, that number on the top right corner of patient's case note might give you an inkling how fit the patient is, but never emphasize too much on the chronological age. I'm more interested in my patient's biological age, and I've taught my students so.
Biological age, as it happens, is imprecise and less scientific. To many, this kind of guesswork seems like counting the grey hair. In the hands of experts, like yourself, it is a window into your real age. Instead of magical formula, it refers to "how old do you feel you are?"
Time for a quick quiz: How old do you feel you are?
A simple question, but a meaningful one. That's what I just learned from a research publication of the English Longitudinal Study of Ageing. Researchers studied some 6500 adults aged 52 years and older, asking the exact question I just mentioned. Some of them perceived their age close to their actual age; some felt more than one year older than their chronological age. More than half (me included if I were recruited), in fact, rated their age at least 3 years younger than their actual age.
Take one more close look at the mortality rate after 8 years of follow-up, and you'll see the pattern. Alas, after adjusting for the baseline health, physical disability, and health behavior such as smoking and alcohol use, those who felt younger live longer than those who felt their actual age or older. It's not hard to explain the finding if the terminal ill patients rated themselves older. But the same conclusion was shown after excluding death within 12 months of baseline question. In short, feeling young gives you a phenomenal edge over longevity. The upshot is that we now better understand the merit of feeling young - a sense of mastery.
Although trite, the old saying still is true. "It's not how old you are. It's how you are old."
Saturday, December 6, 2014
Five
Jasmine turned five yesterday.
How do you know when your kid is five? That's the question I put up in the Facebook on my daughter's birthday.
What's so eerie about this question is that I don't quite know how to answer it.
Many parents have trouble with telling how five-year-olds should be different from those below five - some kids, too. I have no problem with the grey zone. What's wrong, I believe, is to prescribe the milestones and be obsessed with the yardstick.
What could be luckier for a five-year-old than to make the strides at one's own pace? I went to my daughter's school on her birthday, and found all those different traits. Some kids are mastering the monkey bar skills at a level that is supposed to be attained by gorillas. A few of them are even more skillful than great apes.
So what? We're not supposed to compare children to each other. And not even to our closest evolutionary cousin.
How do you know when your kid is five? That's the question I put up in the Facebook on my daughter's birthday.
What's so eerie about this question is that I don't quite know how to answer it.
Many parents have trouble with telling how five-year-olds should be different from those below five - some kids, too. I have no problem with the grey zone. What's wrong, I believe, is to prescribe the milestones and be obsessed with the yardstick.
What could be luckier for a five-year-old than to make the strides at one's own pace? I went to my daughter's school on her birthday, and found all those different traits. Some kids are mastering the monkey bar skills at a level that is supposed to be attained by gorillas. A few of them are even more skillful than great apes.
So what? We're not supposed to compare children to each other. And not even to our closest evolutionary cousin.
Saturday, November 29, 2014
Clarity
"We don't always have to be clever, thank goodness. Often simply being clear is enough." So says the linguistics expert Christopher Johnson in his book Microstyle.
Apply this maxim to crafting the 140-character tweets. It works. Or, if you like, Facebook updates. And prayers too. As a doctor, I know that should also be the code for writing patient's discharge summary.
Neat summary leans heavily on the writer's efforts to distill the real important messages. Oh well, that won't happen if the computer allows us to copy and paste with ease. The first doctor jots down ten lines. The next copies them and adds some more. The third builds on that. The fourth joins. The discharge summary simply grows like the very hungry catepillar, eating one apple on Monday, two pears on Tuesday, three plums on Wednesday ...
Why bring up this overfed caterpillar and longer-and-longer discharge summary? Let's consider a case in more detail. One of our patients had a recent heart attack, and the cardiologist propped open the clogged coronary arteries with metal cage-like tubes, or stents. To keep these stents from blockade, our patient had to take two anti-clotting medications that stop platelets from sticking together. The price to pay for such "double anti-platelet" medications is a higher chance of bleeding.
Soon, the patient suffered from a stroke. A stroke is no joke; it means a clot is impeding the flow of the blood to your brain, wreaking havoc in your ability to talk or to walk. Doctors can't fix that, but can stop another blockade by adding a blood-thinner drug. In other words, that patient ended up taking an anti-clotting cocktail of three drugs. The bleeding risk of such "triple therapy", as you might imagine, is even higher.
Just don't expect the doctors to know (we don't) the best way to handle the tricky situation. The doctors discussed and decided to whittle down the time of taking triple therapy.
To cut the long story short, the resolution goes something like "drug A plus B plus C for 3 months, then A plus C for another 9 months, followed by B plus C forever." This is complicated, I know. The most complicated part of the story, alas, is how the discharge summary was written. That simply looked like a diary with one event after another, one medical decision after another - so much so that the summary ran for two whole pages. The last paragraph, under the heading of management plan, (where you expect to see the concluding remark) was "Home. Clinically stable and fit for discharge." Finding the crucial drug cocktail details within that two-page discharge summary is tough. Or at least, it's like finding a needle in a haystack.
I don't think I need to tell you the ending of the story: the patient ended up receiving the drugs in wrong way.
Apply this maxim to crafting the 140-character tweets. It works. Or, if you like, Facebook updates. And prayers too. As a doctor, I know that should also be the code for writing patient's discharge summary.
Neat summary leans heavily on the writer's efforts to distill the real important messages. Oh well, that won't happen if the computer allows us to copy and paste with ease. The first doctor jots down ten lines. The next copies them and adds some more. The third builds on that. The fourth joins. The discharge summary simply grows like the very hungry catepillar, eating one apple on Monday, two pears on Tuesday, three plums on Wednesday ...
Why bring up this overfed caterpillar and longer-and-longer discharge summary? Let's consider a case in more detail. One of our patients had a recent heart attack, and the cardiologist propped open the clogged coronary arteries with metal cage-like tubes, or stents. To keep these stents from blockade, our patient had to take two anti-clotting medications that stop platelets from sticking together. The price to pay for such "double anti-platelet" medications is a higher chance of bleeding.
Soon, the patient suffered from a stroke. A stroke is no joke; it means a clot is impeding the flow of the blood to your brain, wreaking havoc in your ability to talk or to walk. Doctors can't fix that, but can stop another blockade by adding a blood-thinner drug. In other words, that patient ended up taking an anti-clotting cocktail of three drugs. The bleeding risk of such "triple therapy", as you might imagine, is even higher.
Just don't expect the doctors to know (we don't) the best way to handle the tricky situation. The doctors discussed and decided to whittle down the time of taking triple therapy.
To cut the long story short, the resolution goes something like "drug A plus B plus C for 3 months, then A plus C for another 9 months, followed by B plus C forever." This is complicated, I know. The most complicated part of the story, alas, is how the discharge summary was written. That simply looked like a diary with one event after another, one medical decision after another - so much so that the summary ran for two whole pages. The last paragraph, under the heading of management plan, (where you expect to see the concluding remark) was "Home. Clinically stable and fit for discharge." Finding the crucial drug cocktail details within that two-page discharge summary is tough. Or at least, it's like finding a needle in a haystack.
I don't think I need to tell you the ending of the story: the patient ended up receiving the drugs in wrong way.
Saturday, November 15, 2014
Teddy
Every so often we hear about a kid who can't separate from his or her teddy bear. The kid views the teddy bear the way an atom needs a proton - you simply become negative after losing one single proton.
A much overlooked teddy bear is another wet teddy bear that we all keep one at home. If you haven't heard of your wet teddy bear, you ought to read the picture book Cheer Up Your Teddy Bear, Emily Brown by Cressida Cowell and Neal Layton. I read this book with my daughter recently, and found out about the very wet teddy bear hidden in a toy-box. The toy-box belonged to a little girl named Emily Brown.
Emily Brown had been having great fun camping and then picked up this wet tearful teddy bear. What follows is classic contrast between Emily Brown and Tearful Teddybear. Emily first invited Tearful Teddybear to the Outback of Australia, and thought that lighting campfires and spotting kangaroos would cheer up Tearful Teddybear. They didn't. So Emily took Tearful Teddybear to the wild woods of Yellowstone Park, where they saw small bears and large bears and black bears and grizzly bears.
"But there is no teddy bears," wept the Tearful Teddybear.
Emily Brown tried many ways, but each time Tearful Teddybear repeated, "Po-o-o-o-o-o-or ME ... po-o-o-o-o-oor ME ... Poor little sad little wet little ME ... I'm a Lonely Only Bear and I'm feeling very blue, I've got no teddy friends and there's nothing here to do ..."
Emily Brown talked over and over again about the magic power of overcoming the weather and gloomy thoughts: that in the hands (or heads) of cheerful boy and girl, the drippy, drizzly, wet weekend will never be too wet to enjoy life. If you're a believer that the story should finish with the sun coming out, think again. What impresses me most in this book is how Emily beats the weather, and be happy. The moral here is simple: No one can make sew our mouths upside down without our consent.
A much overlooked teddy bear is another wet teddy bear that we all keep one at home. If you haven't heard of your wet teddy bear, you ought to read the picture book Cheer Up Your Teddy Bear, Emily Brown by Cressida Cowell and Neal Layton. I read this book with my daughter recently, and found out about the very wet teddy bear hidden in a toy-box. The toy-box belonged to a little girl named Emily Brown.
Emily Brown had been having great fun camping and then picked up this wet tearful teddy bear. What follows is classic contrast between Emily Brown and Tearful Teddybear. Emily first invited Tearful Teddybear to the Outback of Australia, and thought that lighting campfires and spotting kangaroos would cheer up Tearful Teddybear. They didn't. So Emily took Tearful Teddybear to the wild woods of Yellowstone Park, where they saw small bears and large bears and black bears and grizzly bears.
"But there is no teddy bears," wept the Tearful Teddybear.
Emily Brown tried many ways, but each time Tearful Teddybear repeated, "Po-o-o-o-o-o-or ME ... po-o-o-o-o-oor ME ... Poor little sad little wet little ME ... I'm a Lonely Only Bear and I'm feeling very blue, I've got no teddy friends and there's nothing here to do ..."
Emily Brown talked over and over again about the magic power of overcoming the weather and gloomy thoughts: that in the hands (or heads) of cheerful boy and girl, the drippy, drizzly, wet weekend will never be too wet to enjoy life. If you're a believer that the story should finish with the sun coming out, think again. What impresses me most in this book is how Emily beats the weather, and be happy. The moral here is simple: No one can make sew our mouths upside down without our consent.
Friday, October 24, 2014
Language
When it comes to the how of English language, there is a genuine thrill of discovering and decoding kids' lingua franca.
Before my daughter entered kindergarten, she coined words like "mouses." With time, she made fewer grammatical mistakes and observed new rules from her teachers. One of the classic clues that she was making (some) progress comes from her question: "Daddy, who is the beautifulest princess?"
Remember, my daughter goes to international school, and has been exposed to a rich verbal environment full of native English-speaking teachers. Many a time her spoken English is better than me. Much better. In time, my little one learns English faster than I can imagine.
Just a few days ago the two of us watched a drama adapted from the book Stick Man by Julia Donaldson and Axel Scheffler. That's one of her favorite books. We love to replay the story as if on stage, "I am not a stick. I'm a Stickman, can't you see?"
"Oh, well," my daughter added, "you're Miss Stick Man, daddy."
"Excuse me. Why do you call me Miss Stick Man?"
"Hey, 'cause you're silly and make lots of mistakes. You're Mistake Man."
Before my daughter entered kindergarten, she coined words like "mouses." With time, she made fewer grammatical mistakes and observed new rules from her teachers. One of the classic clues that she was making (some) progress comes from her question: "Daddy, who is the beautifulest princess?"
Remember, my daughter goes to international school, and has been exposed to a rich verbal environment full of native English-speaking teachers. Many a time her spoken English is better than me. Much better. In time, my little one learns English faster than I can imagine.
Just a few days ago the two of us watched a drama adapted from the book Stick Man by Julia Donaldson and Axel Scheffler. That's one of her favorite books. We love to replay the story as if on stage, "I am not a stick. I'm a Stickman, can't you see?"
"Oh, well," my daughter added, "you're Miss Stick Man, daddy."
"Excuse me. Why do you call me Miss Stick Man?"
"Hey, 'cause you're silly and make lots of mistakes. You're Mistake Man."
Buddies
For most parents, the choice of travel destination matters a lot.
It is not really that important. The real question is find the right playmates.
My daughter is one of the fortunate girls who has good friend's family whose company we enjoy. We traveled to Taiwan this week, and went with the family of Jasmine's best friend met in kindergarten. That's the best part of our trip.
Affectionately called the twins, the two girls look alike, smile alike, play alike, and talk alike. Almost the same as the Latina girl Dora and her companion Boots. When we announced that we're traveling together, my daughter's "wow" showed me that it's much more important to load the "luggage" with the close friend than packing anything else.
A huge difference.
And a guarantee to do away with the spell of "Are we there yet?"
It is not really that important. The real question is find the right playmates.
My daughter is one of the fortunate girls who has good friend's family whose company we enjoy. We traveled to Taiwan this week, and went with the family of Jasmine's best friend met in kindergarten. That's the best part of our trip.
Affectionately called the twins, the two girls look alike, smile alike, play alike, and talk alike. Almost the same as the Latina girl Dora and her companion Boots. When we announced that we're traveling together, my daughter's "wow" showed me that it's much more important to load the "luggage" with the close friend than packing anything else.
A huge difference.
And a guarantee to do away with the spell of "Are we there yet?"
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