Friday, April 24, 2015

Connected

I picked a Japanese restaurant to celebrate the fifteenth wedding anniversary this year. That's a restaurant with open kitchen, by itself a good place to keep my daughter amused. Jasmine spent more time watching the chefs than having her dinner. Within five minutes, or ten minutes, no more than that, the chef made a new dish from the teppan, the way a magician pulls a rabbit out of a hat. I stayed with her in front of the kitchen, delighted. That may seem hard to believe, but I forgot to pay the bill - my wife did that.

The beauty of an open kitchen, of course, is more than children's entertainment. Recently, an opinion piece in the Harvard Business Review caught my attention, and it was titled "Cooks Make Tastier Food When They Can See Their Customers." It was about a research carried out by Harvard Business School's assistant professor. The experiment is about diners and cooks in a real cafeteria. There are four scenarios. In the first, diners and cooks could not see one another; in the second, the diners could see the cooks; and reverse in the third; and in the fourth, both the diners and the cooks were visible to one another.

So what does the customer satisfaction survey tell us?

The food quality was rated better when the cooks could see their patrons. Peculiar indeed. And even higher rating when they saw one another. As it turns out, cooks appreciate the chance to see the diners - a human connection that seems to speak to the power of being appreciated. So much so, in fact, that transparency matters not only to the chefs, but many others. Not too long ago, we've heard about similar research on radiologists' earnest wish to connect with humans. The idea of the experiment is pretty similar to that of Harvard Business School. The story begins with 318 patients referred to a hospital for CT, or computed tomography, imaging examinations. The researchers took pictures of the patients and added their photographs to the medical images. In other words, the photograph appeared automatically when the radiologists opened a patient's CT file.

You should have guessed the study result by now.

Yes, the radiologists reported more empathy, read the medical images more meticulously, and ferreted out many incidental findings beyond the scope of the original examinations. The researchers then picked 81 CT scans with incidental findings and showed them to the same radiologists in a blinded fashion three months later, this time without the photographs. In the end, almost 80 percent of the incidental CT findings were not reported, simply because of omitting the patients' photographs.

Tuesday, April 14, 2015

Blush

The upsides of the blush or guilt have long been observed. Imagine the following question chosen by Dacher Keltner, a psychologist with special interest in positive emotions, when he had to choose his mate by asking a single question at a speed-dating event.

"What was your last embarrassing experience?"

It turned out that Keltner chose this question to watch for blushing, lip-presses, and averted eyes - all of them being surrogates of his mate's respect of others. Embarrassment reveals how much the individual cares about the rules that bind us to one another, he writes.

In case I'm being asked Keltner's question, my answer will definitely be my recent experience in Nara.

Would you be surprised if I told you that feeding deer around Nara-kōen isn't that much fun? Maybe not, when you consider the pushy table manners of those hungry animals. If you'd like to buy some deer crackers, please be forewarned that deer in Nara are second only to Jerry Mouse as a champion for pushing your buttons. They roam the park, and literally ambush anyone carrying deer crackers. But then it's often the poor little kid who is carrying crackers, and the kid could hardly compete with deer in terms of running.

This hungry deer had yummy cracker. That little deer had none. And this little boy cried wee, wee, all the way home.

Things got a lot more topsy-turvy once the number of deer exceeded that of the crackers. The very thought of deer kidnapping Jasmine's cousin set my heart aflutter. So when the poor boy cried louder, I began to get a little edgy. Okay, I panicked and followed my instincts, shouting and kicking at the deer.

Within minutes, my daughter froze, sucked in her breath, and broke into tears.

Shrieking with pain, guilt written all over her face, Jasmine exclaimed, "Dad, stop it. Stop it. That would hurt the little animals. You should be kind to everyone."

I looked at my daughter as long as I can without blush, and then hugged her, as if I'd made the silliest mistake. And it was.

Saturday, April 11, 2015

Kansai trip

Mention Osaka and most people think of Osaka Castle. For most of us, Kyoto means the UNESCO World Heritage Sites. Oh, and gracious geisha. But that's another story when we travel with kids.

This isn't to say I don't fancy those feudal castles and colourful shrines. Soon after my first few trips with my daughter (before the age of three), I simply discovered that there is no all-purpose definition of must-sees with children. It's worth taking a look at the Lonely Planet chapter, but a big part of getting the planning right is to keep the itinerary flexible.

When we travelled with Jasmine and her cousin to Osaka and Kyoto last week, we just made up our own version of holiday. The hotel in Osaka didn't take extra charge for kids sharing bed with us, and we're glad to know that. But then my daughter told us, upon arrival at the hotel, she wanted to create her own tatami (and there is another name for such arrangement: sleeping on the floor).

For most children (and, to be honest, for many adults), it's tempting to break the rules during holidays. The first rule, I'd say, is to withhold our judgements as long as we can - and then a little longer. For instance, when we went to the onsen in Kyoto, Jasmine asked to go to the men's baths (to make for a happier experience with her cousin).

If you love to travel with kids you can probably recall a time - plenty of times - when they come up with crazy new ideas. That's fine. One of the nicest things about travel is a break of the routine and letting the rules go out the window.

Friday, April 3, 2015

New Age

One of the thorniest questions that intrigued my daughter, when I borrowed the picture book Die neue Omi by Elisabeth Steinkellner, is the book's title.

My daughter didn't expect the title, which is translated as "my new grandma." That's a bit tricky - that grandma in her 80s is getting dementia. She forgets the way to take bath, not to mention the know-how of cooking. The theme is among a growing number of children books trying to guide the kids living with their forgetful grandparents.

My daughter will face an even greater grandparent gap, I was reminded by the Time magazine columnist Susanna Schrobsdorff. She was almost 39 when she had her child. Me too. If Schrobsdorff's daughter has a child at the same age, she'll be over 80 when that grandchild enters pre-kindergarten.

My unease doubled after I'd read the special health double issue of Time magazine. The baby in the recent magazine front cover was predicted to live to be 142 years old. That means our lives are getting longer. With that trend of longevity, alas, I'm going to live till 100.

Try as you might, it's very hard to take the news with aplomb. Even as we look forward to more years ahead, the idea of becoming a centenarian is not as funny as we might wish. At least three things dwindle as our body ages: our wallet, hard disc memory space, and muscle mass.

Think of the pectoral muscles that are going to sink with age. Gosh. I was also told that men tend to be less flexible and carry more abdominal weight (which can strain the lower back). The new age is worth preparation. And prepare I did, doing push-up and superman exercise every night since this week.

Tuesday, March 24, 2015

Cinderella

What do we mean when we call something a "Cinderella story"?

The short answer is a metaphorical expression of rags-to-riches, especially if there is an against-the-odds miracle - but there are plenty variants (as I recently learned from a blog). Origins of Cinderella go all the way back to 1967 (French version) and as early as the 9th century (Chinese version). For now, a Cinderella story refers to a good thing happening to someone nice, concludes the blogger.

Here, then, is my definition of the fairy Cinderella story: Have courage, and be kind.

For those of you who have watched (and go if you haven't) Disney's new live-action Cinderella movie (I went with Jasmine two weeks ago), you should remember this great secret. A secret taught by the mom of Ella, the main character in the movie: "Have courage and be kind, that will see you through all trials life has to offer."

And thanks to this movie directed by Kenneth Branagh, Ella jump-starts my daughter's cinema experience. That's her first time in the cinema. She had enjoyed the pumpkin carriage journey with Ella. Obviously I'm happy that my daughter remembers the lesson to have courage and be kind.

We watched the second movie two days ago. Not a Disney movie this time. No fairy or godmother there, and no magic spell to turn a pumpkin into a magnificent carriage. A local movie titled Little Big Master, based on a true story of an inspirational teacher (think Robin Williams in Dead Poets Society) who takes up the job of a village school principal-cum-janitor. Alas, with merely five students and on a salary of HK$4,500 a month. Dicey though it may be, the village school principal didn't cut back on how much she loves the kids; she cut their school fee instead.

There's no medium like this movie to let us know the pleasure of teaching, and the exemplary way to have courage and be kind.

Monday, March 23, 2015

Pharmacy

When I was asked to teach pharmacy students in the medical ward this weekend, I took them to see patients and talked about the way we used drugs. So we started looking at the drug chart of one patient after another. It wasn't surprising that the vast majority of us teach in this way.

A medley of case examples, in essence.

The method notwithstanding, seeing a few cases can be misleading. The plural of anecdote, as many scientists can tell us, is not data. An anecdote is something that happened to my current patient, or any patient I could remember. Alas, it's more often an outlier than not.

That's where statistics comes in.

After talking for more than an hour, I moved to stories with more patients. Those are the stories of many many patients, instead of an anecdote. I digressed and talked about how we discovered new drugs or devices that often fall short of the oh-so-wonderful promise: the oral direct renin inhibitor aliskiren and renal denervation (that had once been thought to be a breakthrough for treating people with stubbornly high blood pressure) are two "good" examples that didn't work out.

Now, move on to name those old-fashioned drugs that were dug out of the cobweb closet, but with new purpose. Think spironolactone, thalidomide, colchicine and pentoxifyline. The ideas range from a new indication of treating blood cancer by a banned pill for morning sickness to, as if by magic, using colchicine (an ancient drug known to curb joint inflammation) to damp down inflammation of a sac surrounding a sick heart. And the list goes on. They all work wonder for new indication!

It's a testament to the mantra why we need old friends.

Tuesday, March 17, 2015

Rock or Scissors

Not every child is interested in the game of Simon Says or Duck Duck Goose, headstand or cartwheel, hopscotch or thumb war. But nearly every child is born with a preference to play rock-paper-scissors.

A typical kindergarten kid should be able to follow the simple rules of "rock crutches scissors, scissors cut paper, paper covers rock." Of course, when your kid is small, be sure she has enough chances to win. Wait until she's mastered the game (and you have congratulated her) before giving her the chance to be a loser. Chances are your toddler will throw a tantrum when you beat her for more than three consecutive games. Hey, let's face it, that's an important lesson for the children to learn. Put on a happy face, but don't laugh at her.

And there is so much to observe how your kids play the game rock-paper-scissors. Now, if you have little kids, you already know that there are times they'd rather win the rock-paper-scissor game than a lottery. Even if we don't teach them the tricks to win - and generally, we don't - they made up their own strategies to beat you. I still remember Jasmine giving me "hint" to choose scissors (so that she can play rock on the next throw) when she was four-year-old.

Playing the game fairly isn't always easy. But understanding the reasoning to outsmart the opponent is what I keep to myself. I learn a few tricks to gain the upper hand. First of all, the throws are not equally common; scissors is the least popular choice, and men favor rock. Another pattern is the stereotype of loser; a player who loses is more likely to switch to a different throw the next time. Many of them even unconciously "copy" the sign that just beat them. The third trick is trash talk; announce what sign you're going to throw, and then do exactly what you said. Most players would have thought otherwise.

But I just keep my mouth shut. Teaching my five-year-old daughter these tricks simply makes me feel bad. The little voice in the back of my head reminds me how it sounds like passing on the hacking software to crack passwords.