Sharing

"What's the agenda of this meeting ?" I asked Irene.

"Eh ... there's no agenda. Dr. X just want everyone sit down and share what they think." My secretary explained - with some hesitancy.

I did not go further. It's not within her control. Nonetheless my limbic system rang a bell upon the word "share". (Oh, nothing to do with the stock market. Don't be paranoid.)

I am neither a Christian attending a religious gathering nor a French existentialist discussing the (abstract) purpose of life in a salon. There seems little point to have a few dozens of people sitting around in order to so-called share their opinion by what actual is talking to themselves. Worse still, if your opinion does not conform to the unspeakable pre-determined decision of that whoever, you would receive a good lecture to explain why your opinion is not satisfactory. The torture would linger on forever, until you express a desirable opinion.

I used to be puzzled what those Red Guards from the Cultural Revolution become when they grow up. Oh, they're all around.

Or is there reincarnation of Gestapo ?

Price

While planning to go to Osaka in the middle of this week, I made some exchange for Japanese Yen.

I did it in a small shop of the shopping mall next to where I live. Well, the charge was considerable, but I was more than happy to pay that extra bit: it opens till late hours, and the attendant appears quiet and studious.

That's how small shops - without the advantage of scale - survive. After all, price is not everything. Many of us are willing to pay for convenience and service.

And that's the thing some Mr. Tsang went wrong. What's the point of (using government subsidy for) setting up an elaborated system to compare the price of every bread-and-butter need between various supermarkets and local stores ? Would that help to bring the price down ? No, don't be silly. That simply makes the price uniform - and exactly because the information on price is readily available and your competitor could easily follow - no one would have the incentive to lower the price.

(This argument is not my invention; it is something taught in the first month for any introductory course on game theory.)

Further, a policy of this kind is a subconscious advertisement that customers should focus on price and nothing else. Because large business has a higher bargaining power with the supplier, they make a better profit (or have a better chance of survival) when the price is fixed.

In other words, it encourages monopoly (or oligopoly).

Oh, maybe he's not wrong - that's what he aims for after all.

Interview

Went to the kindergarten admission interview with Euterpe.

The meeting took 15 minutes in late afternoon, but it needed quite a bit of planning and preparation. You know what, we've been busy from the morning: arranged a proper dress, had lunch, took a nap, opened the bowel, and packed up for outing. Although the kindergarten was just a 5-minute-walk from my home, I don't think I had more preparatory work for a trip to America.

The classroom was full of children and parents. (I learned later the day that there were 600 kids but 60 vacancies.) In spite of all the effort, my worry turned into reality and Euterpe didn't say a word with the teacher - she was just interested in the toys at hand.

The teacher gave me a polite smile; I returned an embarrassed one.

And off she went.

Alas, I suddenly remembered what LS told me: A professor of a medical school is nothing when compared to a kindergarten teacher.

I shouldn't worry that much, I know.

PS. Time has changed. Kindergarten was nothing important when I was a kid. In fact, I had merely 3 months of K-2 and a year of K-3 before entering primary school. Thank goodness my mother was a full time housewife and took the trouble to teach me language and arithmetic. After all, that's all you have to learn.

Slow

You may find my comment yesterday that HP-12c calculator is deliberately slow somewhat unbelievable. Nonetheless, it is ordinary psychology. We tend to put more trust on people who say things slowly - because they probably have a more thorough consideration of the problem (even though that's actually the result of a slow CPU).

This is, in fact, not the only application of slowness.

You know what, all Intel chips are made of one computing speed - the fastest one of course. All the other versions on the market are deliberately slowed down. In fact, the cost is actually higher for those slower chips. What's the point ? Well, it creates a desire on your side to buy (and pay more) for the "most advanced" version.

The same is true for Microsoft Office. We know very well there are the Professional version, Standard one, and Microsoft Work. You could easily guess now all three are made from the same base - just that some valuable parts are removed (suppressed ?) from the CD for the latter two versions. Again, it is a bait.

PS. My friend TW made a similar comment a few days ago on my blog about how quick we see cases in the out-patient clinic. She's perfectly right.

Calculator

Downloaded an electronic version of the HP-12c calculator for my computer. You know what, this pocket-size gadget is HP's all-time best-selling product, and is still in production since it was first introduced in 1981.

Well, for those who are brought up with CASIO 3600p, Americans are difficult to understand - there is not even an "=" button on the keyboard. Nonetheless it is a superb instrument to work on mortgage and bonds and compound interest payments. Although similar calculations could be achieved - and in a more speedy way - by spreadsheets (such as Excel), many practising professions in the financial sector still find this little piece of metal handy and user-friendly.

Talking about speed, the original HP-12c was actually rather slow in calculation - as compared to other newer models. Nonetheless, to be quick is not always good. In the late 1980's, the HP's market research actually found that the users (alas, thick-head financial analysts) did not trust results obtained too quickly, and so - despite rapid advances in the computer chip technology over the years - the CPU speed of HP-12c was not improved for nearly 20 years.

PS. Many general physicians have the romantic idea that nephrologist always carries a calculator for electrolyte and acid-base problems. Well, I have one in my office - it is a Texas Instrument BA-II-Plus professional financial calculator. By looking at the name you could imagine how often I use it for serious acid-base computations.

Fairness

One major reason for the down-grading of the college examination - and to a large extent examinations in (our) medical school - is the obsessive passion for fairness.

"Why do I have a long case who speaks this funny dialect while my friend had one who volunteers to regurgitate the whole history in five minutes ?" Well, let's have a few standard scenarios for history taking.

"Why do I see three short cases in 20 minutes but the other candidate sees seven ?" OK, let's fix the number of case and the time for each.

"Why does the examiner give me such a vague instruction - I don't even know which system to examine." Oh, our apology. We shall specify the system and standardize the instruction.

But, nothing would happen exactly the same twice. The same patient could behave differently. Even the mood of the examiners may change. And, after all, most patients in real life could not tell you which system do they have the problem.

At the end of the day, we change a smart test that picks up bright candidates to a dense examination for dumb doctors.

Change

Had a brief chat with MN - the chief local examiner - on the upcoming change in the format of MRCP examination.

As organizers and host centers, our attention were of course directed to the difficulty in recruiting English-speaking patients with suitable physical signs. As an experienced on-looker, it seems a pity to see how a respectable examination disintegrated rapidly in less than 20 years.

The new move of the college is to put more emphasis on an integrated skill of history taking and physical examination for endocrine and rheumatology cases. I asked MN, "How about fundi cases, which usually do not have much history in it ?"

The senior consultant said with some hesitancy, "They would probably no longer appear in the examination."

He may be right. Many of our younger generation doctors do not know how to use an ophthalmoscope, and fundi examination is often left to specialist.

Well, you may say my feeling is merely deja vu of those Song (宋) and Qing (清) emperors, who saw their kingdoms melt away after giving out piece by piece to some barbarians.

PS. Towards the end of the day, the chief external examiner asked if I had passed my MRCP. I took that as a compliment on my lack of grey hair. Nonetheless, I must say the glory of passing this trying examination dimmed down a lot since the system changed at the turn of the millennium.

Fantasia

Just a random collection of some weird thoughts:

1. Dinosaurs got extincted because their size became so big that nerve signals from their tail never reaches the brain.
2. Neither the university nor hospital authority would arrange professional examination (i.e. final MB and licentiate examination) in the future - because there is a complaint from the Patients' Right Association that doctors should use their time to treat patients rather than organizing examination.
3. Don't worry. There would not be a shortage of doctor. Since 80% of the medical practice involves common sense rather than any specific knowledge, the medical council concluded that 80% of the medical curriculum is not necessary. In other words, you need just one year of medical education.
   
4. Mr. Tsang takes away the fruit money from our senior citizens so that the latter could not throw banana or other vegetables to the CE in the future.
5. Yung Chi Kin (榮智健) would be awarded the Gold Bauhinia Star Medal (金紫荆星章) next July - for successfully diverting all public attention and possibly colourful languages away from Mr. Tsang.
   

Overhead

What's the difference between boosting the economy by paying the bread-and-butter needs of our senior citizen and building a grandiose theatre ?

The overhead.

By this poetic term I mean the amount that is spend on areas that are not for the support of local economy. It includes:

1. Imported material, such as (for Hong Kong) iron and other raw material for the flesh and blood of a white elephant.
2. Administrative charge, manifesting as the profit of those intermediate agency (say, the building contractors).

You may argue the profit of a company represents a plus for the economy. That's true - but that "economy" falls to the pocket of a different group of people...

... the group that could murmur at the side of our (retiring) government officials, so that the latter choose to buy fruits for some white elephants rather than elderly people.

PS. Right, money gives only fruit and flesh and blood to an elephant - not the soul of it.

Allowance

I was puzzled for a while why our Mr. Tsang proposed to introduce the Mean Test for applicants of the Old Age Allowance - he could have many better ways to ask for colourful languages if not vegetables.

Is it because we are expecting so many senior citizens that we should limit our expenditure on them ?

No, don't be silly. Old people would not vanish into thin air and their basic need won't go away just because our government turns a blind eye to them. If we don't support them by tax, we've got to pay for their living in one way or another. After all, if our life span is 80 and we retire at 60, it is a mathematical certainty that we have one senior citizen for every four of us. You can do nothing about it - unless certain Mr. Tsang or one of his delegates is courageous enough to put some poison into our drinking water.

Well, on a first glance it is incredible for a keen follower of John Keynes to take such a step. You know what, giving Old Age Allowance is a highly effective way to boost the local economy: they would spend most of the sum to support (mostly small) business.

At least it seems better than building a cultural center.

Then, why ?

Expenditure

On our way back from Macau, I noted the ferry passed a big chunk of land before we arrived at the TST pier - it was the (later-to-be) West Kowloon Cultural Center.

"You can't promote the cultural standard of a society by simply building a grandiose theatre." I said to myself, "After all, there may not be a sufficient number of art performers - not to say audience."

But I was completely mistaken. The Cultural Center was not built to promote cultural activity but economic ones. No, it's not the center, but the construction per se which was the point. With the recent tsunami, our government is more eager than ever to keep the rate of unemployment down (especially amongst the group with low technology). It is also the classical Keynesian teaching that increasing government expenditure - in construction, for example - would give a kick on to the local economy in the period of depression.

For once I seem to understand what our Mr. Tsang means. It is probably also because of that British economist, our CE goes seriously for the legislation of minimal wage. As pointed out by John Kaynes, in order to boost employment, wages had to go down. However, that would reduce consumer demand, which would in turn reduce business sales revenues and expected profits. Investment in new plants and equipment would decline. In short, instead of raising business expectations, wage cuts could make the matter worse.

It all sounds incredibly simple, so much so I (almost) have a hallucination that our government could solve all problems of the society by following every line of John Kaynes' teaching.

Alas, do you know why did Zhao Kuo (趙括) die ?

Speed

Went to Macau with LS - we were both invited to give a brief talk in a scientific conference there.

We chatted on almost everything and somehow our discussion fell on to the out-patient clinic:

"Some residents are just too slow. If we have 80 cases and 5 doctors, and you see just five or six cases in a clinic, how could we survive ?" She sighed.

"But could you ask them to speed up ?" I suggested.

She asked back, "Can I ask you to slow down in your clinic ?"

"No way. That would cost my life. But I could speed up no problem !" I must admit, on average, I spend 7 to 8 minutes for each out-patient, and I could do it in 5 minutes if necessary, but it would be an intolerable torture if I have to face the same patient for more than 15 minutes.

"Exactly !" The rheumatologist explained, "You are the quick type and you could speed up further. They are the slow type and could go only slower ..."

Alas, I see her point. It is in fact the Newton's First Law.

And it reminds me of the teaching by the King of the Round Table: A quick surgeon may not be a good surgeon, but a slow surgeon must be a lousy one.

Letters

Wrote a lengthy letter for certain bureaucratic problem. This is not my cup of tea, but, as people often say, part of my salary pays for it.

Many of my friends know that I have dyslexia and could not stand any letter with more than three lines. Nonetheless this disability reminds me to keep most of my letters short and comprehensible to any recipient with a similar medical condition - which means the majority of our general population.

After all, why do you need three pages for a trivial matter if a president of the United States (alas, that's Richard Nixon) wrote his resignation letter in just one line:

"I hereby resign the office of President of the United States."

It also reminds me of our sister department in the era of the Knights of the Round Table. In one incident, the King wrote the following letter to fire one of his professors:

"Because of well known reasons, Professor X will leave the XX University with immediate effect."

And his Highness had sufficient foresight to provide a Chinese translation of the letter for his faculty staff:

"基於人所共知的理由,X教授已離開X大學."

What else do you have to say ?

PS. The latter letter was shown to me by the man who still had his moustache, when I was his trainee - as an example of how to write simple letters.

LKS

TW asks whether we should invite LKS to be our Financial Secretary - that's an idea (hopefully not in the sense of Baldrick in The Black Adder).

In that case we may expect our government buying all the Lehman minibonds at hell low a price and sell them (back to the current owners !) some years later - when the price is three or five times higher.

Based on the past record, our new Financial Secretary would also approval building new hospitals in every district - provided that the government pays only for the chairs and tables.

And our senior citizens will have their Old Age Allowance (生果金) increased to HK$1000 - but paid in supermarket coupons. (Well, that's at least better than the current proposal of some Mr. Tsang, whose scheme would certainly bring him many sunny days with a clear sky - because there's no more that kind of cloud [浮雲].)

PS. The most famous Chinese businessman who turned Financial Secretary was Soong Tse-ven (宋子文). For those who are not familiar with the history of our country, Soong was once considered the richest man on earth - after he became the Financial Secretary of the formerly Republic of China (not People's Republic). Would you consider that good news ?

Munger

If not because of his age, Charles Munger would be a better choice of the next United States Treasury Secretary than Warren Buffett.

For those who are not familiar with the financial news, Munger is the Vice President of Berkshire Hathaway, and is the business partner of the famous investor for decades. Contrary to Buffett, who devotes his time almost exclusively to business, Munger is not involved in the day-to-day operations of Berkshire for many years.

The more important character of this right-hand man of Buffett is that he is a generalist - investment is only one of a broad range of his interests. He would certainly have a bird's view on the financial country of America (and probably of the world).

One famous piece of his work is Elementary, Worldly Wisdom, which is a speech he gave in the University of South California in 1994. It is no doubt an ideal syllabus of general education.

PS. Before writing this blog, I had the romantic idea that Munger is much younger than Buffett. It just came as a surprise when I looked up the Wikipedia and realized that the former is actually 84-year-old.

As Martin Ruth said: You will find it very good practice always to verify your reference, sir.

Secretary

On the point of giving the public hope in the middle of a financial crisis, Barack Obama is certainly more creative than any of our local officials:

"(If I am elected to be the president,) I would ask Warren Buffett to be the Treasury Secretary of the United States."

It creates a hallucination that the US government could be run like Berkshire Hathaway.

In that case you should expect the government grows with time, but, as a stockholder (or stakeholder), you would hardly receive any dividend.

PS. John McCain made the same suggestion for the next Treasury Secretary a few days later. It reminds me of the sayings that the first man who compared woman to flower was a genius; the rest of us using the same tactics are nothing but Mohohan.

Tactics

Another recent example of how our officials chose inappropriate words was this:

"The SAR government would exhaust the last penny in order to maintain the stability of the financial system of Hong Kong."

No, there's nothing wrong in its literal sense, but it's just against the principle of public speaking (or advertisement). The above declaration, despite of its noble intention, just create an impression that our government is about to, or has a real risk in, spending the last penny.

That's not what (or how) you want to be reassured with in the middle of a crisis.

For those who are not familiar with standard tactics for this problem, here they are:

1. Appear to be confident and know more than the others.
2. Emphasize you have more than one way to deal with the problem (without specifying what these methods are).
3. Point out a simple practical way for the public that could help protecting them.

For the last point, it doesn't matter if the way you advise has no genuine value - no one could (nor would anyone have the courage to) disprove it. One excellent demonstration by our own officials was the advice to clean the floor and furniture with 1% hypochlorite solution during the SARS epidemic. It does not work - the thing was transmitted by droplets, not fomites. Nonetheless it worked well in terms of soothing the public and prevent further panic.

As Franz Kafka said: The lie is made for world order.

團結

With the tsunami our senior officials have been running like chickens with no head.

One said, "Hong Kong citizens must come together and do not lose our unity in order to tackle the worst financial crisis in our history." (Come together for what ? Jewish people did so in the Nazi concentration camp - it just made them easier to be exterminated.)

The other said, "Hong Kong has a small and open economic system; we are prone to hiccups of financial tyrants overseas." (Translation to modern layman English: It all depends on the others; we could do nothing about it.)

And the third commented, "What's going on is just a prodrome - the worst is yet to come." (Do you mean the Hang Seng Index is going to touch the floor, and we're heading level B18 ?)

But, on a second thought, I shouldn't really be too harsh to them. At least they are honest. What they are trying to tell us are:

1. The stock market will continue to fall,
2. and we can do nothing about it.
3. You guys should stay where you are and meet your fate.

I'm sure if anyone says a similar thing north to the Shenzhen river, he will be at once arrested for spreading rumour - with a possibly malicious intention to disturb the order of our financial system. (By the time the case comes up to the court, of course, they will instead be found guilty for leaking national secret. That's another story.)

Question

Went to the college's annual meeting on Saturday - I was asked to do a small part of a symposium.

The talk was so so. As usual, after the three of us (I mean ST, SL and myself) finished with the deed, we sat around a table and tried to take some questions.

A senior private physician put up one - primarily for ST, and the latter gave an orthodox answer.

To our surprise, the president showed his hand, stood up and made further comments. Oh, we realized very soon the man with a wig was all confused with the definition of orthostatic proteinuria. As a previous student of this local giant in nephrology, my horror was no less than finding Albert Einstein could not tell the difference between mass and weight. (Eh ... you may not either, but you have not been awarded with the Nobel Prize in Physics.)

We sat quietly. The comment seemed to last for ages. ST and I exchanged a quick glance: What should we do ?

In no time our neuronal activities were in phase: We did not hear anything. It's coffee time, let's have a break.

****************************

Don't take me wrong. I do not think our president was a shade less brilliant than what he demonstrated over the years. Every man has some loopholes in his knowledge.

It's just because of his position my teacher who lost his moustache could no longer hear an objective comment or have someone to point out where he is deficient.

Alas, friends, don't put me into such a position for once, and I shall be all too thankful.

Iceland

It is sad to hear the government of Iceland is on the verge of bankruptcy - I always consider the country as one of the most successful few in the world.

You know what: Although this small island on the edge of Europe (so much so it is considered negligible on the map of the board game Diplomacy) and has a population of merely 300,000 (smaller than Macau, and just half of that of Kwun Tong), it is the fourth most productive country in the world by gross domestic product per capita, and the most developed society in the world (ranked first on the United Nations' Human Development Index).

Yes, Iceland lacks natural resources (except some hydro-electric and geothermic power), but over the centuries her inhabitants made an exceptional achievement in preserving their natural environment - while making their country fully modernized at the same time.

As a case control study in history, have you heard of the Norwegian settlers in Greenland around the 10th century ?

PS. Ronald Reagan and Mikhail Gorbachev met at Reykjavík, the capital of Iceland, in 1986. For that single event, which signified the end of the Cold War, this lovely island should be awarded with the Nobel Prize in Peace.

Meal

Had some cookery experiments during the public holiday.

In the morning I made some steam rice with fresh shrimp and dried Japanese scallop (brought by my mother-in-law from Osaka) for Euterpe. We - I mean my mother, my maid, and myself - tried very hard but our boss just took a mouthful or two. (I begin to realize that other than KM, my muse of music is the second one who could live against the physics law on the conservation of energy.)

Well, I ended up taking the rice as my own lunch - the taste was not bad at all. Yes, females are always difficult to understand, I know.

***************************

In the evening I tried and made some Padaeng beef (巴東牛肉) - again from ingredients brought by my in-laws from Indonesia. While I was looking for coconut milk from the shelf, I found a bag of vegetable instant soup for hot pot - we bought it last Christmas for my family gathering.

I checked on the label; it read: Best before 16 October 2008.

God, that's next week - and we certainly have no intention to have a hot pot meal in the coming seven or eight days.

An idea came to my mind. I continued my search in the shelf and found some bags of Korean instant noodle. What's better than using the soup for them ?

This chimera worked out well. The problem is: there might be nothing suitable for my girl's dinner. As soon as I realized this, she looked at the noodle in a wicked smile. (Yes, that's the time when she looked like me.)

And, she finished a good deal of it.

Oh, females are not only difficult to understand but could never be predicted; I had a lesson.

Dream

I sat at a corner with JW during our recent department dinner.

This was a gathering to celebrate the promotion of some of our colleagues. (It gave me an excellent opportunity to listen to an expert's view on world economy and investment strategy. That's beyond the point.)

In the middle of the evening, the man from Chaozhou suggested each new medical officer to come out and have an one-minute introduction of themselves. Well, that sounded a good idea because demented beings like me always have the difficulty to recognize new colleagues.

But the introduction show made a sharp turn when we began to hear penance and confession and career plans with an agenda. Yes, with an agenda.

JW gave me a weird smile.

I replied in a wicked one.

And an old Chinese saying came through my mind: 皮裡陽秋.

書空

On a few occasions recently Vivian and myself were each asked about what our dreams, or birthday wishes, are. (I have a deja vu feeling of being asked to write an essay with the title "我的志願" in my primary school days.)

Here are some sample answers:

"Able to be off work at 6 p.m. each day."
"Retire at the age of 50."
"Have more time with my family."
"脫貧."
"但願生兒愚且魯,無災無難到公卿."

***********

You may find my recent writings somewhat obscure. Oh, I am in no way trying to imitate Franz Kafka (although I would love to).

殷中軍被廢,在信安,終日恒書空作字. 揚州吏民尋義逐之,竊視,唯作‘咄咄怪事’四字而已.
[世說新語-黜免]

Privacy

One thing I learn from this Debate is about the privacy ordinance.

The scenario is simple: If you wish to hire someone to take care of your children, should you be allowed to check on the criminal records (especially those related to paedophilia) of the applicant ?

To my (and probably your) surprise, many of our senior officials say no - this is the privacy of the applicant.

What about the two sides of the argument in this book ?

Of course one side say yes: there is a strong security consideration which overrides the need to protect privacy. The potential employer should have the right to check on the information - without the need of a consent.

How about the other side ? Well, you can choose not disclosing any information of this kind - that's your privacy. The trade off is your potential employer would have the right to, and inevitably will, not hiring you - assuming that you have a positive record of that kind.

And, you see, this logic also applies well to the recruitment of medical students and employing doctors - potentially avoiding the embarrassment of having a pin-hole-camera peeper as our graduate.

Debates

Having a book called "Contemporary Debates in Applied Ethics" as my bedtime reading.

Yes, it sounds dull. I bought this 350-page text some years ago from the Eslite Bookstore (誠品書店) of Taiwan, but did not have the courage to thumb through it until very recently.

Most of my friends know just too well I have little interest in discussions of this kind. To my surprise, the book turns out to be highly interesting. (A substantial portion of the topics are somehow related to medicine, but that's beyond the point.) This is, I must admit, the first time I read serious logical arguments for and against stem cell research, euthanasia, free immigration, privacy ordinance, and so forth.

You may wonder why I bought this book in the first place. The truth is rather a nuisance: I find this paper-back volume lying next to a copy of the original English translation of Franz Kafka's The Castle - which was what I looked for.

PS. By original English translation I mean the text has not been edited by Max Brod or others before it is converted into English. The part-time insurance officer is famous for writing stories of obscure meaning, but much of the difficulties in interpretation roots from his friends and followers who try to explain what the Czech novelist was trying to say.

Bailout

What could be achieved with the US$850 billion bailout package ?

For sure that's not enough to take away all the questionable loans from the market. We know very well the arrangement is meant to stabilize the system, rather than solving the whole problem all at once.

Nonetheless I feel that the World Police would be forced to cut down the number of her people in Iraq. You know what: the "operation" costs around US$750 million each day. In three years, the federal government could save the money back. (Unless the new president is a keen follower of John Keynes and believe that overseas military action would stimulate local industry and economy.)

Oh, don't try to imagine we would have a peaceful world tomorrow. With a government highly in debt, Uncle Sam is more eager than ever to sell weapons to other places ...

... not to say creating a need of those weapons in some countries.

Formosa ? US$6.2 billion ? What else could be a more profitable industrial export ?

Trading

For those who are not familiar with our system, you may be puzzled why I felt sorry for our chairman.

The very fact is: although there was a good sum of donation and he got a fancy dressing on his title, the gastroenterologist was not the one who pocketed (most of) the money.

Who ? The economist, of course.

**********************

Oh, I just had an absence seizure.

A scene comes through my mind: 秦淮兩岸,六朝金粉. We see the fireworks and neon lights - but, behind the scene there hide the pimps.

Title

Receive an "invitation" to attend certain endowment lecture - to be given by our man in Pluto.

You may be puzzled: He had an inaugural lecture some years ago; what's the purpose of all these ?

That's simple: there is a sum of donation and the name of certain billionaire is attached to the professor title as a prefix. What's better than a lecture to publicly announce the benefactor's name ?

And what's better than involving medical students to ensure an adequate number of Homo sapiens sitting around ?

You see, the lecture is therefore not for the benefit of the audience, but the donor. Any successful dissemination of knowledge is a fortunate by-product. (This is, well, one step further than what I mentioned about writing our own textbook some days ago.)

And, with an elaborated prefix in his title, our professor is raised to the level of 文武大聖大廣孝皇帝 (the official name of Li Shimin [李世民]) and 合天弘運文武睿哲恭儉寬裕孝敬誠信中和功德大成仁皇帝 (the official name of Emperor Kangxi [康熙]).

For once I feel sorry for my chairman.

Hope

On a second thought, not all waiting is a waste.

We wait in vain if, and only if, there is nothing to hope for. In fact, many of the best hours in our life are the time that we are expecting something good to happen, not when that good thing is happening.

In the latter case, the stone falls down from the hill, and we King Sisyphus do not feel happy - we've got to search for something else to exert ourselves again.

As Count Monte Cristo said: All human wisdom is contained in these two words - Wait and Hope.

Yes. If we have to keep the others waiting, give them some hope.

PS. Again, once we eat the apple of wisdom, open our eyes and see through the nature of what we're waiting and hoping for, we have to leave Eden forever.

Life

"How to prolong the life expectancy of this patient by one day ?" Some years ago I asked myself this very question.

My answer at that time was: If this patient has to waste one day of his life in the hospital and wait for nothing, get him discharged a day earlier - he could enjoy one additional day, probably in the prime of his life rather than an extra day for him when he is terminally ill with tubes and drips around.

And the number-needed-to-treat of this tactic is ONE - everyone would benefit.

Of course the scope could be broaden: If you could save the patient from waiting nothing for an hour (say, in the consultation room, pharmacy, or - for relatives - interview room), you are prolonging an equivalent duration of useful life expectancy.

PS. It is exactly for this reason I take it a serious crime to keep the others waiting. If you take the cumulative sum, more lives are ruined each day by unnecessary waiting than any disease, poison, or warfare.

Saved

"How many lives have you saved today?" someone asked.

My friend K was completely taken aback with this question.

Well, if you take it in the strict literal sense, there should hardly be any. As I often tell our younger colleagues, of all patients that we encounter, 60% will get better irrespective to what we do (or what we not do), 10% will get worse whatever we do, and 29.9% will improve with treatment that any doctor could offer; in other words, they do not have to see you.

It is therefore fortunate to see every year one that 0.1% type of case whose recovery is because of your exceptional skill - if there is any.

And even for that 29.9% type of case, you do not save their lives. At most you hasten the recovery (say, from an acute episode of some chronic disease) or alleviate the symptoms.

*****************************

On a second thought, however, I become less pessimistic.

Let me tell you how we save (or persuade ourselves to be saving) lives tomorrow.