Ten

十年生死兩茫茫,不思量,自難忘,千里孤墳,無處話淒涼.

縱使相逢應不識,塵滿面,鬢如霜.

夜來幽夢忽還鄉,小軒窗,正梳妝,相顧無言,唯有淚千行.

料得年年腸斷處, 明月夜,短松岡.

(蘇東坡 - 江城子)

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You may wonder why I put this up. Tomorrow will be my 10th anniversary of taking up the academic post. Most people would sigh at this moment and say time flies and so many things have changed. For sure I have the same feeling ...

but I am also disappointed to find so many things have NOT changed.

Useless

Despite of my suggestion yesterday, let me be nostalgic for a while.

For historical reason, I had six years in the medical school - the first of which was called the "pre-medical year", when we were under the Faculty of Science by administrative regulation, and we studied traditional science subjects (physics, chemistry and biology).

Isn't that a waste of time ?

We all thought so at that stage.

But no in retrospect. I took a course on human biology in the first semester and was well-fed on the evolution of skeleton; I took microbiology in the second half of the year. There were also courses on organic chemistry (with some relevance to pharmacology), food chemistry, psychology, Chinese, and physical education.

Yes, what really matters is whether we (alas, students) make a good use of the time. Planning and administration merely plays a small role.

PS. If you still see no value of them, there was at least plenty of spare time for us to pause and think and enjoy university life.

As Zhuangzi (莊子) said: The use of useless (無用之用).

Six

To be fair to whoever planning the medical curriculum, there has been an explosion of medical knowledge in the past 20 years, and the timetable of our students would inevitably be tightly packed.

That's why many people are long for the new 6-year medical curriculum (as a result of the new 3+3 system of secondary school).

But apparently no. It seems more likely that the 5-year core teaching would be continued, and the extra year left for general education.

I must admit I have difficulty to understand why we don't just put some basic science subjects for the "year-zero" student. For example:

• biochemistry
• molecular biology
• immunology
• genetics
  
• statistics
• psychology
• health care and social welfare system
• English (and Chinese, I'm afraid)

Isn't this quite sufficient for an entire year ?

Packed

The next day I sent KL those antique timetables, we met again in the corridor.

He looked entirely satisfied, and made a wicked smile to me, "You see ?"

"See what ?" I was at a lost.

"The emptiness of the timetable !" He went on and explained, "In the old days formal teaching session was sparse. In my days it was once a month. It probably became once or twice a week by your time. Just before the change-over, students still had 4 or 5 free sessions each week. Now, you could hardly find any."

He was certainly right. We all need some time to stop and think. After all, we are probably training up people to act like cows and horses and do the donkey job. You don't just feed them with grass - you must give the some time to ruminate and digest.

But, isn't more teaching a good thing ? That's what we achieved over the years, after considering the feedback from our graduates. Alas, we actually changed from feeding livestock to poultry - we now put a tube under their throat and force the nutrient down.

No wonder we see many doctors of the new generation run around like chickens of no head.

And they just duck when anything happens.

Timetable

Met KL in the corridor.

All of a sudden he put up a difficult question for me, "Do you still have at hand some of our students' teaching timetable 10 or 15 years ago ?"

"How could I ? I was still a kid 10 years ago." I tried to be evasive.

I heard KL murmured the term "old cake" - he must be talking about himself only.

But I conceded, "Let me look it up, just in case."

Ten minutes later I sent him a few antique timetables. Oh, not 10 or 15 years ago. (I was young, serious.) But these are the ones we used 6 or 7 years ago - before we changed the final year teaching to the "new curriculum".

PS. Thank goodness KL didn't ask for the case list and marking scheme of our final MB examination 10 or 15 years ago - I do have a few !

Spring

The spring is coming; we hope it would soon be getting warm.

But no. It is actually the coldest time of a year: the earth heat from last summer has dissipated, the sun shine is not long enough to warm up the earth, and the melting snow takes up much of the thermal energy.

As the old Chinese sayings: 下雪不冷融雪冷.

For the same reasons, the most difficult time of the tsunami is not during the collapse of many financial tyrants, but the lingering torture when the surviving companies (and countries) try to write off the loss and clear up the bill.

Nonetheless, the warm weather would always come. Let's have some faith.

Happy lunar new year.

PS. It is entertaining to read many of the so-called Chinese astrologists to predict the future by the date of Li-Chun (立春) - they don't even know there is something called the timing of Li-Chun.

For this year of Ox, the time is 11 AM, 4 February. The proper translation to Chinese astrological character would be 己丑,甲寅,庚辰,壬午. Alas, don't be too exited. There isn't even a superstitious theory on the use of this timing to predict the future of a country.

Glass

Just received my new pair of glasses; I'm still trying to adapt for it.

My previous pair was in use for nearly 9 years. You know what, during this time I developed quite a bit of presbyopia. While discussing what type of lens I preferred, my optometrist subtly suggested I needed something with a variable focus. (Yes, the type that you could focus on a distant object when you look straight ahead and on a close one when you look downward.)

I looked horrified and waved off the idea.

The friendly specialist then gave me a choice, "Do you want to preserve the ability to look far ahead, or the one to focus on objects near by ?"

That's an easy question for me, "Jove, I am only interested in the problem at hand."

Friends, next time when you find me at a distance, stare at your face and appear confused, don't feel offended.

People

Following my discussion yesterday, you may think, "That's not a big deal. Next time when I need some simple procedure, I would just find an appropriately junior staff."

On the whole that's right, but there are other implications.

You may see the immediate problem, and a very practical one for our recent VIP incident. The problem is: What should you do if the procedure you need is plain simple but you happen to be a friend of the division head ? (That brings us to a common error in logic: If a person can do the complicated things, he would do well in simple ones.)

But let's take even the social hiccup aside, and focus on something more profound: People doing simple things would not feel satisfied for long. We all believe, and it is usually true, that if they are good, they should have been promoted to handle more complex stuff. There is, therefore, pressure from within as well as environment for them to seek for something more complicated.

That's one of the major reasons why I am always against population screening of any medical problem by a technique that requires a low level of operator skill - a seemingly primary requisite for a screening to be justified. By human nature, we can never keep staff who are good at a simple procedure to stay - without moving froward in their career.

Technique

You may consider my concern yesterday rooted from the prejudice against administrators. I must admit I do - but my worry was actually more extensive.

Let's take aside the existence of administrator and consider purely from the perspective of a front line worker: What should the boss do for an outstanding bank teller ?

Get this staff promoted to a "more important" position, such as loan and mortgage, investment or private banking, of course.

For the same reason, house officers who could insert a drip well would try to learn putting in a central line, cardiology trainee moves from simple echocardiogram to angioplasty, and surgeons from appendectomy to liver transplantation.

The very problem is: a cardiologist proficient in invasive things would inevitably do less echocardiogram - and be less excelled in the latter. The same problem would happen for a professor of transplant surgeon to remove an appendix. (As Sherlock Holmes rightly pointed out, our brain has limited space for a working memory. After all, there is only 24 hours for all of us - you can never practice everything.)

You can always name some who are exceptionally gifted for many things. I agree there are many genius around - but there's just an over-supply of mediocre.

And no genius is perfect in every aspect - and the risk is we could hardly know which particular aspect is he less gifted.

Specialist

You may consider my previous worry irrelevant. Any organization could employ people well trained in administration to do the task.

(After all, Steven Green was not promoted from a junior bank teller; he first worked for the Ministry of Overseas Development of the British government and joined HSBC in 1982 to take charge of the corporate planning activities.)

Therefore we find creatures living in Pluto leading people on earth; the former always wonder why we sweat so much with just a little work. Oh, how could you sweat if living on a planet with a surface temperature of -230°C, or feel the weight of anything if the gravity is 1% of the Earth ?

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One remarkable incident is our recent encounter of one of these lovely creatures, who tried to argue that beds in the ward are furniture but chairs should be under the category of equipment (and, as a result, we could not use the money allocated for the former to purchase the latter).

I wished to remind him some chairs should be regarded as weapons according to Stephen Chow (周星馳), and I would like to try on some extra-terrestrials to see if that's right.

Criteria

You may realize the point I made yesterday was not new - very true.

The real problem is, even taking aside the risk of promoting excellent bank tellers and ward physicians to do an inappropriate job of administration, the system does not work in the way you wish in the real world.

Let's ask ourselves: What is a good bank teller ?

We know just too well.

But, what is the criteria of a good teller in the eyes of his boss ?

No, not being efficient and friendly to customers and colleagues - but the very ability to sell valuable products (funds, ELI, or any new financial gimmicks) and boost up the business of the bank.

That's not totally wrong. After all, it is not the objective of a bank to serve the customers - we go and buy their service, and they are there to make money.

But the situation becomes slightly more tricky when we ask: What is a good physician ?

We know even better.

But, what would impress his boss and bring him a promotion ?

PS. The embarrassment becomes even more drastic if I ask: What is a good teacher ?

I shouldn't say any more.

Promotion

My friend JW rightly pointed out that we shouldn't expect Steven Green to give us a perfect teller service if we just want brand new 10-dollar notes for CNY from him.

But, the implication of this observation might be more profound and skip your eyes.

Let's go back one step and consider: Where does a CEO, or any administrator, come from ?

One traditional way is to promote some junior staff with an excellent performance. We make a good teller to be the branch manager, or a good resident to be the ward physician.

Well, if the branch manager and ward physician continue to do well, they become the CEO and COS. (There's no need to put down the word "respectively"; I see no difference between the two.)

And there comes the whole problem: you shouldn't really expect a good bank teller or physician to be a brilliant administrator. They ask for different characters and capabilities.

As the old wisdom in business says: In an institute, everyone would be promoted to a position that he could not handle and would result in catastrophe.

Star

Went to the campus on a Friday afternoon. I do go there two or three times each year for various reasons, but every time I am surprised with all the constructions and new buildings.

We see a dramatic expansion of the university over the years. Yes, that's by and large a good thing. I still remember the vivid picture of my classmates catching snakes along the road between the student hostel and the lecture theater, or I seeing hundreds of cockroaches on the grass behind the RRS Hall.

Now, you see only the same number of suspicious looking teenagers who called themselves university students over that place.

A sordid place it was, we did enjoy much happy moment. Many of the evenings we just stood or sat on the grass when we passed by and appreciated the starry night - the sky was often clear and there were not many tall buildings around to obscure the view.

And now you just could not affording looking up the sky while walking over there, for you would sure be stepping on some other's foot, or falling into a hole left behind by some construction workers.

As Franz Kafka said: 在有增無減的群眾中,愈來愈孤獨了.

PS. To be fair to whoever, it is not only the cement forest that blocks the stars: it is the heavy smog, the fuzzy orbit, and the uncountable electric currents underneath the wrinkled forehead.

16.2

Another 16 items related to medicine:

1. I planned to be a journalist if I could not get into a medical school.
   
2. During my final year of medical school, I deliberately modify my biological clock: I slept from 7 PM to 1 AM and work for the rest of the time.
3. I did not finish studying Harrison before I sat for final MB - I skipped the whole section of infectious disease.
4. The only medical book that I read cover-to-cover in clinical years (and till now) is Lecture Notes on Clinical Medicine by Rubenstein and Wayne.
5. When I do not know the answer of an MCQ, I always guess.
6. The only procedure that I wish I have learned but didn't is rigid sigmoidoscopy. When I was given that chance during internship, I chose to learn rigid cystoscopy.
   
7. I did not have to say anything when I interviewed for a medical officer job; I was the only applicant (and there were two posts).
8. I planned to do pathology if I could not get a job in medicine.
   
9. The first patient who died under my hands (when I was a trainee) had indomethacin-induced GI bleeding; I avoided this medicine for nearly 10 years afterwards.
10. I wrote my first paper (a case report) nearly a year after I passed my MRCP. In fact I took three weeks of annual leave and wrote three all at once.
    
11. I had my elective training in Bristol, UK - that's the first time I took a plane.
12. If not because of the mortgage of my house, I would have stayed in Bristol to finish my PhD.
13. I study medicine every morning for 30 minutes before work.
    
14. I wished to be a cardiologist when I was a medical student.
15. I wished to be a hematologist when I was a junior trainee.
16. I ended up in nephrology because there was a post !

Sixteen

There is a recrudescence of the habit on the Facebook to invite people writing 16 things about themselves. I shall try to be trendy.

1. I love oily and chilly food but almost always have diarrhea after taking them.
2. I began drinking tea at the age of 2; in fact I drink very little water since then.
   
3. I have very bad hand-sweating.
   
4. The first three Chinese words that I learned were "鮮雞蛋".
   
5. I began reading the finance section of newspaper at the age of 15.
6. My IQ was 142 when tested in primary school - not really that high.
7. I learned cookery at the age of 9, when my mother got a part-time job.
   
8. I spent two years in secondary school studying Chinese astrology and fortune-telling.
9. I wrote newspaper columns for a short while during that time.
10. I got 6A1B1D in my HKCEE examination: B for Chinese and D for bible study.
    
11. I took a course of gymnastics during my university study.
    
12. I learn most of the philosophy (that I know) during the second year of medical school.
13. I never read The Valley of Fear of Sherlock Holmes.
    
14. I have very bad skin allergy; for some time my serum was used by the laboratory as the positive control of many allergens.
15. I always have one US$100 and one 50-Euro note in my purse - I believe they would bring me good luck.
16. I visited the same barber for the past 30 years.
    

VIP

One of my senior colleagues developed a drastic VIP syndrome recently.

The story went like this: This friend of mine needed a simple procedure - purely for screening purpose. Being a millionaire as well as a well-educated physician, whom should he choose to do that procedure ?

He chose the head of the unit concerned.

In a sense my friend was right. The division head was not an administrator and was in fact well known for his exceptional skill in doing complex procedures.

But my friend wanted just a simple stuff.

And the rest is history.

PS. After all, a professor of medicine does not give you a faster recovery from a flu - he may give you a slower one, and possibly more blood tests.

Long

On a casual conversation, AL asked me, "Why does everyone think that I've around for ages, although I actually join this department for three years ?"

"Oh, that's because you do such a good job that we all feel the time flies - and that's a sign of happiness and satisfaction." I said, trying to please our chairman's secretary.

On a second thought, isn't that exactly the literal meaning of the Chinese phrase "快活" ?

Alas, therefore, the antonym is "難過".

I never came to realize before Chinese is sometimes very expressive.

And Albert Einstein was completely correct when he commented on the experience of time.

PS. You think there's honey in my mouth ? I'm just practising what Zhuang Zhou (莊周) advised.

Improve

For those who are green to the skill of administration, you may find my argument yesterday unbelievable. It is easy to tell if someone is trying only to appear to be doing something, rather than actually doing anything.

On that, you are wrong. It is always possible to prove that what you are (appearing to be) doing has a material benefit. Even for a naive thick-head academic, I know of two strategies:

1. See the short term effect. (When everyone is paying attention to a particular problem, there would be some transient improvement.)
2. Juggle with the statistics. (As Mark Twain said: There are three kinds of lies - lies, damn lies, and statistics.)
   

That's why we saw an improvement in language capability of our secondary students with the Media of Instruction (母語教學) scheme, more competent graduates after some new curriculum, or a shorter hospital stay after changing the position of some beds. (For the last scenario, any benefit could also be attributed to the effect of a better Feng Shui [風水].)

PS. Well, you can fool a small group of people forever, and you can fool everyone for a short while, but you cannot fool everyone forever. Fortunately, no one is going to audit your performance forever !

Recommendation

To be fair to those living on Neptune, they have their own difficulties.

You know what, a group of extra-terrestrials outside the solar system came to visit the Earth recently and commented that the faculty should put up more support to the students.

(I must admit the real difficulty for us is to support, in its Cantonese sense, the ones who made such an report.)

For those who are familiar with the tactics of administration, you may be aware of this trick: When you are asked to give some recommendations but cannot think of any, it is always possible to say "It would be nice to have ..." and name something you heard of from Utopia.

And the receiving end would run like chickens of no head. (Well, it's quite a bit of fun to watch - if you're not involved in the running.)

The wiser man would obviously see through the thing and understand nothing could be done to actually improve the situation.

But, he simply cannot declare publicly that nothing useful could be done.

Therefore, the best strategy is - thanks to the teaching of Humphrey Appleby - to appear to be doing something.

Alas, our friends in Neptune know the tactics. Let's be less critical.

Weak

Many of us received an email recently from Neptune. It says:

"One of the (first-year) students under your name of the mentorship program did not do well in the examination. Please see if you can do anything (so that he or she would not be the next one to jump)."

It seems unbelievable to have suggestion of this kind coming from a group of extra-terrestrials who are so keen on (talking about) critical appraisal of medical literature and evidence-based practice. What it assumes are:

1. Students jump because they do not do well in the examination.
2. Our intervention could improve their performance.

Once you consider this, it becomes obvious that the two observations of point #1 are merely associations. (Isn't it more likely to have a student with underlying psychiatric disease or social problems, resulting in both phenomenon ?)

As to point #2, does anyone seriously think that practising physicians with senile dementia could help some students studying anatomy ?

PS. If you think you could, please name the 8 branches of the external carotid artery and the 8 pieces of carpal bone without referring to your textbook.

學奕

While talking about chess, a few classical texts came to my mind.

The two most popular ones on various strategies and tactics of (Chinese) chess playing are 《橘中秘》 and 《梅花譜》. However, the one traditionally suitable for beginner is 《夢入神機》.

The difference between them is drastic: The latter is a collection of scenarios towards the end of a game (殘局), while the former two starts from the beginning and go through the entire game.

You may consider logical to learn from the beginning. Nonetheless, it is the end of the game that has a limited number of pieces on the board and would be more easy to comprehend for a new comer.

As Zhu Jin Zheng (朱晉楨), the author of 《橘中秘》, said:

"全盤子多而難明，殘局子少而易悟，尤可取法，況得其一訣，便可觸類引伸。"

Isn't there much similarity to learning medicine ?

Specialize

There is in fact another bit of history related to the specialization of queen and bishops as the pieces for defence in the Chinese chess.

For over one thousand years in the history of China since the Warring States Period (戰國時代), government officials were not classified into administrative (文官) and military (武官) groups. To be specific, there were positions for either, but officials simply took turn on a somewhat rotation basis - obviously depending on the actual need of the empire at that moment. Therefore you could find Zhou Bo (周勃), Zhuge Liang (諸葛亮), Li Jing (李靖) and many others taking up the position of an army general at one time and the prime minister at another.

This is what was known as "出將入相".

The system, however, was abolished in the middle of the Tang (唐) dynasty.

To be specific, this rotation program was banned by the famous (for being malicious !) prime minister, Li Linfu (李林甫). Yes, the one who was well known for the honey in his mouth and dagger in his heart (口蜜腹劍).

(Rumours said that he banned the system because he was so much a coward that he could not stand leading an army. That's for sure the romantic idea of some naive Chinese historians. The more likely reason was he could not afford the risk of his position as the prime minister being taken up by others - who might discover how his sweat mouth ate up a large part of the government expenditure !)

Well, whatever the cause was, from the very point onwards, the central government lost touch with the army leaders at the front line - the latter was inevitably forced either to die of negligence or to rise in rebellion.

PS. In the Tang era, Chinese chess board had no river or palace, and every piece could go around just like the international chess nowadays. The "modern" chess board appeared in the Sung (宋) dynasty - when the rotation system had long been forgotten.

Chess

When you look at it seriously, chess is a lively demonstration of the society.

You know what, Chinese chess is the only one with boundaries of the palace and river. The king is supposed to stay within the palace and enjoys being protected (and attacked !); the queen and bishops are specialised for defence (alas, internal affairs). The international chess (國際象棋), in a sense, is much more democratic: it has neither of the boundaries; every piece on the board - including the king itself - could go around and attack the others. In fact, the king can "exchange" its place (not completely, of course) with a rook - the so-called castling.

And the pawn of the international chess could be promoted to a higher rank when it advances to the opposite side of the board: There's no glass ceiling in this world and one would be awarded for his hard work - irrespective to his upbringing and social class in origin. In Chinese chess, the same outstanding pawn has a small benefit (it is allowed to move horizontally) but its fate remains unchanged ...

It just goes ahead and never returns.

PS. In theory, modern chess roots from the Gupta empire of ancient India, which has four kinds of pieces: pawn, knight, bishop, and rook - representing the four divisions of their army: infantry, cavalry, elephants, and chariotry respectively. In reality, it seems a more close mimic of their four social classes: sudra (labours), vaisya (peasents and merchants), kshatriya (warriors), and brahmin (teachers and priests).

士象

It is an eye-opening experience to hear some Mr. Tsang use the analogy of chess as the aim of our society: to keep the queens and bishops (士象全).

For those who are not familiar with the rule of Chinese chess, the queens (士) and bishops (象) represent a class that goes around the king and protect (and lick the ass of ?) His Highness. Donkey jobs are left to the rooks (車) and knights (馬).

How about pawns (卒) ? They are supposed to go ahead with no return - alas, they are meant to be sacrificed.

You find it quite an analogy of the senior government officials ?

I see it a Freudian slip of tongue.

PS. Experienced players of the Chinese chess would know well that keeping the queens and bishops is the worst of all strategies - for sure you would lose the game. There is only one way not to lose a game of chess: to win by keeping the rooks and knights (the working hands !) to attack your opponent.

Promising

"It looks promising !" I read the plan of our competitor and remarked.

"So ... what can we do ?" AL asked, notably anxious.

"Well, I mean ... we can sleep well."

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And I suddenly realize how playful this very word is:

Oh, it could be promising to any malicious adversary, promising to be a laughter to any onlooker, or promising to fail.

After all, men do not often keep their promise.

Their chairperson is a woman, I know.

But all the same.

來鴻

Received a belayed Christmas card from Detroit - it's from my cousin.

In fact I never met her. This was the first time she sent us a greeting; it used to be my uncle - who passed away last summer.

His story (history !) was all too common in those days but drastic to experience: He and his wife - the elder sister of my father - left the mainland in 1950s and went to the States. Parents, friends, country life, communism ... they wrote off everything, material and spiritual, and turned into another form of existence.

In an era without email and MSN, it was conceivably worse than migrating to Mars nowadays.

PS. My father left China a few years after his sister arrived at the States. His original plan was to work for my aunt in Detroit but, because of the corrupted emigration officer in those days, he could only manage to come to Hong Kong. Alas, this is probably the only time I have to thank a corrupted official - otherwise I will not exist to tell this story.

Technology

You may find my discussion yesterday not new - Charlie Chaplin made an elaborated demonstration in the Modern Times.

But there are more things popping out from the Pandora box.

With James Watt and the first industrial revolution, only the most masculine jobs were affected. There was in fact still a huge need of semi-skillful workers to handle the machines. Productivity was greatly increased and the effective price of many daily needs did come down. On the whole there was actually an improvement in the quality of life, and most people with an average (or average minus one standard deviation) intelligence could make a living - that's how a society could be sustained.

The unfortunate truth is, however, machines and information technology make a much faster evolution than our genome. With the advance in computers and artificial intelligence, more and more jobs could be handled by cold-blooded gadgets - leaving only the top niched tasks for human brain. The result is simple: a small group of gifted people gets the control and therefore the lion's share of all social resource, while the majority with normal intelligence struggle between unemployment and under-paid. The gap between the two ends of the society widens, and less than ever the environment is suitable for the survival of normal human beings.

Employment

Maybe I was not completely clear yesterday, and the real Pandora box may skip your eyes. Let me take you one step further.

Do you know what's the minimal wage in a free society ? In the days of Adam Smith and before the two industrial revolutions, it was the amount of money that could sustain the living of a small family - a couple and two or three children. If the wage goes below this limit, the size of the working population shrinks, and the unmet demand of labor would drive the salary back up. (Unfortunate for the followers of Karl Marx, the reverse also holds true.)

The problem is, this equilibrium could sustain only if there is no competition in the employment market of labor force. Traditionally, competition could only be a problem in small economic systems - new immigrants provide cheap manpower because they only ask for the minimum that could sustain their own life.

By the law of biology, this species won't last.

But, when the laboring force is facing competition with machines and artificial intelligence, things are different because the wage (alas, the wear-and-tear and maintenance cost) of the latter is way lower.

And, machine does not (have to) follow the law of biology - they do not need a family or reproduction.

That's why we see such an unacceptably low salary amongst workers with minimal technical skill - a sum that is difficult even to sustain their own life.

Machine

You may consider my explanation yesterday weird.

But not at all. Many hospitals actually have now that touch-screen gadget next to the Information Desk. My real worry is, with time, this type of technology would largely reduce the need of receptionist (not only in hospitals but also many other facilities).

Alas, it means another type of job being taken up by machines - from the hand of human beings.

In other words, we lose yet another competition to the machine in the market of employment.

For sure we would lose. How could Homo sapiens be compared to machines and computers in doing repetitive tasks ? (In fact, with the development of artificial intelligence, we may not be better in terms of making simple decisions.)

That's the real Pandora box.

Explanation

When I told Vivian my suggestion to move that Information Desk next to the Emergency Department, her eyes just popped out.

"How could you do this ? What would the general public think ?"

"Don't be silly," I reassured her, "Of course we never tell the people that we move the desk in order to prevent the receptionist from handling all sorts of urgent medical problems. It is just that the headquarters actively promote electronic information system and has a long track record of applying cutting edge technology, the hospital decides to use a new interactive touch-screen gadget to replace the original information desk. The new CPU has a speed of 256 GHz and could answer any of your query much faster than a receptionist."

(Well, most of us could not tell the difference between computers with CPU of 1 MHz and 256 GHz - the rate limiting step is us.)

"And because the triage nurse of our Emergency Department continues to face a large number of queries from patients and relatives," I continued to explain, "we decide to add a small Help Desk that and there to facilitate communication and information dissemination."

I'd better find a surgeon to fix up Vivian's jaw dislocation.

Delay

For those who visit this blog regularly, you may well notice there is often a delay between the time something happens and my comments appear.

The reason is simple: I follow the practice of most columnists and write my blog a few days in advance - so that a new post could appear everyday on time (I hope). I learn this trick when I was in secondary school and wrote (briefly) for newspaper columns. Many professional writers do this to avoid the embarrassment of leaving their column blank when they fall sick or some other accident happens.

(In reality the editor would solicit a backup author to fill up that column. I knew how chaotic it is when I became a journal editor some years ago.)

Well, you may consider it not a good idea to publish when an argument has cooled down. On the other hand, it gives me time to reflect and avoid making emotional remarks. When the environment is hot and one is excited, all the blood goes to the skin and muscle - it's no good for neuron to function.

PS. Of course that may equally well be an excuse of someone with a slow CPU, but I shall not try to pretend having a fast one and give a haphazard answer.