Difference

On my way home after the training day, I was still reflecting my conversation with CS. All of a sudden, a recent discussion with TW flashed through my mind.

It took place on the recent annual scientific meeting of our society:

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

"You know, there's a huge difference between physicians and surgeons in the public hospital," TW began.

"Which aspect are you referring to?" To be honest, I was not sure what she meant.

"Just imagine, if you are a senior surgeon in a government hospital and you are tired of what you are doing, the temptation of joining the private market is huge: You either earn twice as much if you work equally hard, or you have the same earning but are just working half-time," my friend explained, "And, therefore, they do move, creating vacancies for the juniors to be promoted. In short, the system is relatively healthy because most of them sees a future."

"Quite right." I nodded.

"In contrast, senior physicians are a different story." She went on, "They don't have to do much clinical job under the government's umbrella. If they become private physicians and keep the same workload, their income would probably be the same as a medical officer. In contrast, the middle grade physicians - I mean the new fellows - have all the incentive to go for private, because they are the most hardworking group. If they keep up with that workload in the private, they would have a consultant paid."

"The outcome is obvious: A fault - or a gap - forms inevitably. Very senior physicians are high up and stagnant, and they only have very junior trainees all the time," I was forced to agree.

Responsibility

Later that week, we held the College membership examination.

I shall not elaborate on the running. Our secretaries and nurses are highly experienced, and things were always smooth under the organisation of RM. The only difference we had this time was, on the Saturday after the examination, the College asked us to organize a "training day" for those candidates who planned to sit for this examination in the next year or two.

CS, the representative from the College, came and visited us that morning and saw to the things.

After the program started, we had a leisured moment of casual chat.

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

"You know, I'm slightly fed up with arranging this," he began.

"Oh...!" I put up an inviting smile.

"Alas, this program is entirely for the benefit of the candidates, and it's practically free - the small amount of application fee is almost always covered by their department training fund. However, few of them applied. We actually had to extend the deadline of the application and keep reminding department heads of every hospital to encourage their own trainees," the professor of rheumatology finished without a second breath.

"Time has changed," I murmured, "It's now not the responsibility of a trainee to learn, but a duty of us - consultants and the College - to teach. It's quite like teaching our own children: Unless we do away with our own sense of responsibility, they own take up theirs."

Apps

(Our dinner conversation with CM continued.)

"You know, as a rule, I do not allow medical students come to my clinic - there's very little to learn anyway," our visitor, who was actually a senior lecturer of his own medical school, remarked.

"Well...?"

"And I was slightly disappointed when I found a final year student sitting in my consultation room last month - he obviously did not ask his classmates which doctors not to follow," he continued.

"Was he just very keen to learn from you?" We asked.

"Quite the opposite," CM smiled, "In fact, he didn't even look up when I entered the room; he was just absorbed in playing with his iPhone."

We all chuckled, "So, did you ask him to leave?"

"No. I sat down, picked out my iPhone, and pretended to press the button eagerly."

"What's the point?" We were curious," and, did the student notice that?"

"Well, after two or three minutes, the student obviously found things were not going in the right direction, and he asked what I was doing." Our friend said.

"What did you tell him?"

"I told him that I was looking for an Apps to make a medical student disappear!"

Touch

In the next afternoon, CM (our research collaborator from England) actually came around and visited our unit. It goes without saying we dined together that evening.

I must say he was most entertaining in social chats:

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

"You know, not too long ago, the infectious disease control people came to our dialysis unit and did a hygiene check and all that to all of our staff - doctors, dialysis technicians, hospital amah, et cetera." He said.

"How about the nurses?" One of us asked.

"Oh, they were not screened - our nurses never touch patients. They just do documentation and paper work."

"In that case, many of our colleagues could be excused if we have such an infection control screening!" I said to myself.

Host

It proved to be an exceptionally busy weekend. In the next morning, I took the earliest flight to come back from that crooked universe, and, before lunch, I was safe in the function room of a five-star hotel in Kowloon.

It was the annual scientific meeting of our society.

The event was so so. (I needed to attend because CM, one of the invited overseas speakers, was our research collaborator.) In that evening, I went to Aberdeen for yet another meeting: It was the briefing session for the membership examination of the College in the coming week. I went there to represent the hospital, which was going to be one of the host centers.

You may ask: Isn't it a meeting for the examiners (and I am not)? True, but, the sobering fact is, amongst the 6 legitimate examiners within the department, none of them came for the briefing - and none actually did the examination held in our hospital.

And, ironically, every time when we hold the department board meeting, we always say the college examination is a big thing. "We should do this" and "we should do that". In this very Sunday evening, I suddenly had a déjà vu feeling of reading Gongsun Long (公孫龍), who claimed that a white horse is not a horse (白馬非馬).

Very true, because I am not one of the we either.

Universe

I stayed in Chicago for two days and was back Hong Kong on Friday evening. In the next morning, I was summoned to the universe that has a different set of law of physics.

I must say my bias against the other parallel universe of ours is quite well known. The man from Pluto used to suspect my name was blacklisted. KL simply thinks that I am over-reacting.

Nonetheless, I still believe my bias are entirely justified. To say the least, it is rather disheartening to work with those apparently lovely creatures: They could not keep a promise, and therefore they would not believe you could keep a promise. They do not give you genuine respect, because they don’t actually respect themselves. When you say a scientific paper or clinical trial shows some particular result, they would tell you their octogenarian division head has a different personal experience. In this world, the way is full of bush, truth is fake, and life pennyworth.

And, therefore, don't blame the landlady - it's all problem of the tenants themselves. Don't look down upon that 18 persons who did not help the girl after she's knocked down by the car - just look at what the others did on the old woman who tried to help.

Alas, pudet esse unus ex eis.

Defensive

You may say that’s no big deal. It could even be considered as an advance – improving public scrutiny or what.

But I was horrified. For newspaper is not law court, events are not reported according to objective facts but presented as stories seasoned with emotion.

(Do you still remember that famous quote from one of our soap operas? “This is not the law court. We do not have to talk about evidence. My eyes are the evidence.” Yes, sometimes you could do the justice easier, but, just imagine you are an innocent suspect.)

And, to make things worse, the test is a self-conflicting paradox: When it is on the newspaper, they don’t really give you the chance of defending. As a result, we don’t actually ask Can you defend your action if it is reported on the front page of the newspaper tomorrow? but, rather, What should I do to avoid the remote possibility that it would come up to the front page of the newspaper?

Alas, welcome to the era of defensive medicine.

Newspaper

My dinner conversation with SP continued.

“You know, we are in business and are not free to do whatever we want – even if something is legal. Our legal advisors often ask: Can you pass the newspaper test?” The company president sighed.

“What’s that?” I asked.

“Simple. Before you do anything, just ask yourself: Can you defend your action if it is reported on the front page of the newspaper tomorrow?” She explained.

I was chilled. All of a sudden a piece of classical teaching on clinical practice flashed across my mind.

If you are not sure what you do is correct or not, just ask yourself: Can you defend your action if it comes up to the court?

In no time I realize medical practice has also moved to the era of doing this newspaper test to ourselves. After all, we are really at risk of having what we do on the front page of morning papers.

Market

In that evening, I happened to dine with a group of people from all corners of the world.

The host was SP - an obviously well-to-do business woman, who had the special capability of entertaining all her guests throughout the night by, as people often say, talked the talk.

“We got to listen to what the others say – customers, legal advisers, and experts such as you guys.” The company president said.

I suddenly thought of Steve Jobs.

“And it’s absolutely necessary!” She continued. “We all know the story of Motorola Razr, don’t you? After the initial success of their first model, the engineers put all their effort to enhance the function and add new gadgets into the next model –they just didn’t listen to what the customers said! And the rest is history. The new model was a disaster, its market share dropped by more than half, and Motorola almost got bankrupted.”

I was speechless. For a moment I was not sure if there exists a fine line between insightful leader and an arrogant dictator without judging their outcome from hindsight.

Choice

You may say the fall of Borders and other conventional bookstores is the inevitable consequence in the era of on-line shopping.

Quite true. In fact, I just bought my new edition of Harrison's from Amazon two weeks ago.

And the process was plain sailing! Fast, simple, and quiet - I didn't have to talk to anybody. (Think of that for someone with an autistic personality disorder like me.) More, there are literally millions of books for you to choose, hundreds of times more than that you could find from any brick-and-mortar shop.

But, I tell you, this is the worrying bit.

For, with that seemingly vast number of choice (and without physically displaying them in front of you), the list for our consideration is, ironically, more limited.

Take my recent purchase as an example, I did not look around and find a book - I knew what I wished to buy right from the start. If there's actually another good one around, I would never know it, and, if that were the situation 25 years ago, my initial romantic encounter with Tinsley Harrison would never happen. (For that story, see http://ccszeto.blogspot.com/2008/04/harrison.html)

And, even if you have no particular book in mind and go to, say, Amazon for on-line "shopping", as their old customer, a number of titles would be automatically recommended - largely based on what you bought previously. Yes, it is very much more convenient. Nonetheless, it also means we are channeled to our own small world.

Borders

My trip to Chicago was entirely business. Thank goodness I arrived a few hours before the meeting started, and I took the opportunity to have a short walk.

After a while, I found a familiar name on the wall of a tall building around the corner.

It was Borders.

For those who'd not been to America, Borders was one of the largest retail bookstores. For a moment I was confused, because it is my usual practice to check for bookstores nearby my hotel every time I go for an overseas conference, and I could not remember I found Borders in this place.

Naturally I moved forward, and, before I tried to push the door and entered, I found that the shop was empty.

Why, I suddenly remembered. Borders filed for Chapter 11 earlier this year, and all stores were closed down two months ago.

Right. It has lost its business to information technology - not Steve Jobs this time, but Amazon and other on-line bookstores.

I kept reflecting this unexpected encounter on my way back the hotel, and, all of a sudden, a sense of coldness passed through my back.

Let me explain tomorrow.

Chicago

Shortly after I held the birthday banquet of my mother, I went to Chicago for a meeting.

This was the second time I came to this famous capital of economics, and I must say my first experience was far from satisfactory:

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

It was probably 1999 (I did not check with my written diary, but i t was shortly after I joined the university), when I was flying back from Buenos Aires to Hong Kong after an international conference. There was a transit of 7 or 8 hours in Chicago, and, naturally, I took the opportunity and went for a walk (under the pressure and leadership of WK, a highly respected consultant from another hospital).

Alas, to put it simply, the weather was horrible. It was mid-April but the atmosphere was freezing, and we obviously did not prepare for this because, in Argentina, summer was just over.

And, the most annoying bit was, the entire city was, by coincidence, holding a kind of flower show - because the weather was so good!

PS. That was, of course, my prejudice. The weather was remarkably warm and comfortable this time, and I had the opportunity to appreciate this beautiful city. There was, unfortunately, a jungle of mortgage bankers in my hotel holding a conference, and, you see, inevitably, another crowd protesting over the other side of the street.

They should actually go to Little Rock, in my opinion.

Erratum

(To those students who attended my bedside teaching yesterday, when we saw a woman with visual problem.)

Please accept my apology for giving some mistaken remarks on Marcus-Gunn pupil.

In short, the Marcus Gunn phenomenon (relative afferent pupillary defect) refers to the observation that the patient's pupils appear to dilate when a torch is swung from the normal eye to the diseased one. In traditional case, the affected eye still senses the light and produces pupillary sphincter constriction but is delayed, typically due to a slower conduction as a result of optic nerve demyelination.

It should be observed at the diseased eye - although the same happening could be found in the other eye (as stated in our discussion yesterday), but is more difficult to be seen.

PS. I try not to talk about medicine here, but I find no better place to show this correct piece of information to my students (since I do not know there whereabouts), and it is important to say I am sorry.

新同樂

母壽誕，設小酎於新同樂為之賀。

菜單為區區所訂。前菜乃百花釀乳豬。皮酥化而蝦膠彈牙，甚為配合，惟略嫌油膩，較之傳統全體做法，也少了點原始肉香，這倒是個人口味問題矣。

湯品是原鼎燉海中寶。平心而論，此名不盡副實，蓋作料除花膠響螺瑤柱，亦有老雞赤肉火腿。如此陣容，兼且火候不吝，焉有失敗之理？

熱輋是玉簪帶子蝦球。玉簪者，露筍雲腿各一條，穿於帶子之中，頗能添其爽嫩而吊其鮮味。蝦球近於傳統玻璃做法，肉質清脆兼不失原味，較之舊式須靠蝦醬提味，技巧是更勝一籌。唯可置啄者，大概是琉璃獻略厚，然乘熱而食，倒也無傷大雅。

繼之是野菌方利球。此乃老式油泡的改進版。方利肉滑，非一般蘇眉龍躉厚實，以嫩油浸熟，功夫不錯，只是一如坊間各店，油膩不免，似乎也是無可奈何

。

之後是奇香珍寶蠔煲。奇香者，似乎是醬油米酒再加九層塔。墊底的粉絲當然是精華所在，反而蠔身甚巨，並非各人吃得消。

再上是燒汁乾煸牛肋骨。此實為西菜(braised short rib)中做而青出於藍者。入味而肉質酥化。儘管此時各人大家已有飽意，仍多有知音之人。

之後琵琶豆腐鋪有金箔，倒平平無奇。海鮮什菜煲用料足而味清鮮。只是此時是十二分飽，已無力細嚐。單尾鮮蝦炒飯，也唯有打包留用。

押軸壽包是水準之上，然較之福臨門的麻蓉包，便少了些驚艷之感。此非其不足，實對手太強也。總的來說，此處食物、服務俱臻上乘。是否值米芝蓮三星，見仁見智。然要算本地粵菜而出其右者，卻也屈指可數。

Follow

Take aside the very point that I was contradicting myself, a side track that may skip your eyes is the ability to follow is an advantage that we retained during evolution.

The idea is simple, and is very well tested in animal behavioral studies. Imagine, if a group of mice or fish is directed to the bifurcation of a road, on the end of one there lies some danger (for example, a predator), which could only be detected by some excellent capability (say, a good eyesight). What characteristic would maximize the chance that all of the mice, or the most of them, survive?

No, not when most of the fish or mice had an excellent vision. The most efficient scenario is when a few leaders have the vision and the others could quickly follow. (In fact, the group would not be as efficient even if they all have a good vision, because they are crowded together and everyone needs to move to the front and take a look.)

Things seem illuminating, eh?

The sobering truth is, in real life situation, there's often no deadly predator lying ahead of our choice, and many decisions have no objective answer right or wrong. In that situation, when most people follow the leader, their choice becomes the correct opinion. As George Soros put it, truth depends sometimes on our subjective opinion, some statements could be true because most people believe it is so and act accordingly - it is a self fulfilling prophecy. The classic examples are fashion and the stock market.

But, in that case, what special capability would make a leader?

None, except they are arrogant enough to come out and show the followers the way.

Go read http://vwswong.blogspot.com/2011/09/confidence.html

By the way, the above discussion also explains why, although being confident and becoming the leader is advantageous, there remains a whole lot of sheepish people around after millions of years of evolution.

Lead

While I was thinking of all these, a shocking news came up from my morning paper.

Steve Jobs died.

I shall not elaborate my opinion on the Apple; it's been talked about not too long ago. (See http://ccszeto.blogspot.com/2011/09/resign.html.) Nonetheless, a remarkable practice of this founder of a computer kingdom is worth mentioning.

He never did market research.

His argument was simple and came directly from Henry Ford: If I had asked people what they wanted, they would have said faster horses.

If Jobs did ask, we would have said more handy Discman and faster laptop computers.

And, for the same reason, it may be quite useless to ask for student feedback on a medical curriculum. Or, to put it in another language, they shouldn't think in an area that they do not have the complete information or capability to judge.

Alas, I am contradicting myself.

I have schizoid personality disorder, I know.

Personality

You may say what I said was the same as the traditional approach of teaching according to aptitude (因材施教) by Confucius, and I was making a big fuss on a slightly silly but entirely benevolent statement of the Council.

Well, you are probably right in the first half, but, as to the latter consideration, it actually involves a deeper water.

You see, the call to achieve everyone being all-rounded (and, therefore, inevitably, the same) means putting an end to personality. Each and every individual would see the same, speak the same, and "think" the same - leading to the inevitable road of serfdom and dictatorship. (I consider the statement in our Council's booklet, therefore, a horrifying Freudian slip.)

To put it simply, in a world with freedom, we must accept everyone being different and each should have a reasonable opportunity to cultivate and develop what they are good at.

PS. I put the word "think" in quotation marks and deliberately downgraded its definition to any neuronal activity within the skull. By its very nature, all genuine thinking - in the conventional meaning - has the potential of coming up with something different.

Quality

While I was thinking of the responsibility of a doctor, a friend of mine showed me the aim of undergraduate medical education, as laid down by our Medical Council:

In essence, the undergraduate medical education aims to prepare graduates to fill the roles of medical practitioner, communicator, educator, humanist, collaborator, health advocate, resource manager, scientist and scholar.

Once again, I was so impressed that I lost my nerve.

For a moment I tried to reflect which doctor I knew ever achieved such a degree of holistic perfectionism.

Of course you may argue we must set a high target if we want to achieve a result of mediocre. But no. We do not ask every member of an orchestra to be proficient with every instrument - this target is not high, it is unrealistic. A high but appropriate aim would be asking the violinist to achieve the standard of Niccolò Paganini or Antonio Vivaldi, rather than requiring him to learn some piano or clarinet. Similarly, we should be more than happy if we have most graduates being able to competently fulfill the role of medical practitioner, a few become educators, another few scientists, and some (hopefully not many) resource managers.

PS. By the rule of geometry, only sphere is good at all dimensions. As pointed out by Wang Anshi (王安石) long ago, a sharp spike would come out from a leather bag - exactly because it has an edge rather than being all-rounded.

Responsibility

At this point, it becomes clear why the ROAD to success becomes so popular as the choices of career for the new generation of doctors.

Their job is, to a much greater extend, more sort of time rather than task based. As soon as you finished with the consultation or procedure, there is hardly any continuous responsibility or relation with the patient - not to say their family.

For that consideration, internal physician and family medicine are no doubt the least attractive of all specialties. For surgeons, after an operation is successful and the patient walks out of the hospital, they could call it an end. (In fact, this very happening brought the most of the satisfaction to most surgeons.) For physicians, general or family ones, there is hardly any end of responsibility until the patient becomes bone and ash.

PS. Of course many surgeons hold enduring responsibility for their patients. Similarly, some medical sub-specialists try their best to do away with their patients as soon as an intervention is completed. It is often a matter of their mindset and personality rather than a problem of the specialty.

PPS. The old fashioned way we called surgeons who dump their cases to us as soon as their patients came out from the operating theatre was Mr. Toothpick (牙籤大少). I must say the origin of this term was quite a harassment. I shall leave it to your imagination what that tiny little piece of wood signify.

Task

You may say it is not entirely satisfactory if an academic staff could only focus on some serious work when there's a typhoon. I felt the same on my way home.

But, the root problem is actually more subtle.

It goes like this: There are, in general, two kinds of job; one being task based, the other duration based.

For canteen cashiers, security guards, or, really, nurses, the duty is defined by the length of time - there's no responsibility as soon as they're off work. (I'm sure our nursing specialists and department operation manager would stand up and object because they have duty after hours. I consider that as the necessary pain when a job transform into a profession.)

On the other hand, many jobs count by task. A clinician has a number of patients to take care of, a lawyer or accountant has their own cases to follow, and university academics have an endless list of research and teaching projects to accomplish. No one would really care if you work for only four hours a week - as long as you can finish with all tasks assigned. (Of course, in that case, by the Parkinson's law or other doctrines in physics, your boss will give you more tasks to occupy your time.) For this kind of job, it is quite meaningless to say you would limit your work to 50 or 60 hours a week. No one asks you to work longer - it is your own inefficiency.

PS. A little friend of mine cited my previous blog on working hour (see http://drterryma.blogspot.com/2011/09/quality-of-life.html). I must say I never meant to pretend to be saint and did not advocate giving up personal quality of life. Unfortunately, the very nature of a clinician's job is not suitable to be counted by the length of time, and it is unrealistic to believe there are ways to limit the working hour without fragmentation of care.

Protected

When I got up in the morning after I prepared my little series on Xinhai Revolution, I noted that the weather seemed terrible.

Yes, it was typhoon signal #8.

As usual, my mum got up even earlier. She asked, "Still need to go to work?"

"I'd better go," I nodded and murmured.

Well, most of you know I don't drive. And it is quite impossible to fetch a taxi under that weather. Nonetheless, the underground and railway are still at work, and it took me no more than 45 minutes to arrive at the hospital, safe and intact.

You may ask, "Is it necessary for me to come back and do the round?"

Of course not. Our registrars are quite capable, and I'm sure my colleague BK would be around. Nonetheless, it was entirely for my own benefit to stay in the office: There's no clinic or meeting or other minutiae to distract my attention, so that I could sit down and focus on things that are important though not urgent. (Please refer to Stephen Covey if you are not familiar with such a term.)

This is really the protected time.

世凱

The sobering fact that we have to face was, unfortunately, the Xinhai Revolution was finally successful not because of Sun Yat-Sen, or Li Yuanhong, or anyone I discussed in the past nine days.

It was Yuan Shikai (袁世凱).

I shall not touch on the controversial subject of Yuan's political career, or his deal with the Japanese. Nonetheless, it is certain enough that he forced the Xuantong (宣統) Emperor to step down.

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

I would end this little series here.

It is, of course, not a complete account of the history - my blog is never intended to be so. Nonetheless, my humble ambition is to introduce a few notable figures during that era, whose importance may be obscured in a history written by the winners. After all, as demonstrated by Sima Qian (司馬遷), history is most interesting when we tried to understand the life of each individual person, rather than memorizing a series of events.

元洪

Although there were many careful plans and excellent plots, the final successful move of the Xinhai Revolution came from an unexpected angle. (As one of our senior professors used to say, life is not always predictable.)

Wuchang Uprising was, in essence, an accident. (The original plan was an uprising on 9 October, which was abandoned because of an accidental bomb explosion early in that morning. The event in the next evening actually began as a trivial quarrelling between two junior military officers.) At that very moment, none of the famous leaders was physically around. Nonetheless, mutineers needed a visible high-ranking officer to be their figurehead.

And they chose Li Yuanhong (黎元洪).

Li was at that moment a senior military officer in Hankou (漢口). He was well respected. Just a year before the Uprising, he discovered some subversive activities in his army, but he simply dismissed these people rather than arresting them. An additional edge of Li was most people in the army believed he knew English - which would be useful in dealing with foreign concerns.

By the way, Li was actually hiding at the home of his friend (alas, a woman) when the rebellion army found him and invited him (by gunpoint) to be their leader.

元培

Another important person who may skip your eyes but took an important part early in this drama was Cai Yuanpei (蔡元培).

Both brought up by the traditional education system, Cai was a close friend of Zhang Binglin, and, together with a few others, they established the Guangfu Club (光復會) - another major anti-Manchuria force at that time.

Cai joined the Tongmeng Group soon afterwards, and actively toke part in several uprising activities. In fact, there are slightly conflicting records about his hand-on involvement in those incidents. Nonetheless, his contribution must had been substantial, because, although he was not officially wanted, he had to left for the Qing Empire in 1907 and spent his time in Germany as a part-time student until the Xinhai Revolution was successful.

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

Of course, with hindsight, Cai played a critical role in the history of modern China, not for his work in the Tongmeng Group, but for a few seemingly irrelevant decisions when he was the president of the Peking University: In 1917, he invited Chen Duxiu (陳獨秀) to join the university as a professor of Chinese literature. Next year, he recruited Li Dazhao (李大釗) as the chief librarian of the university, and another young man from Hunan as a junior helper - rather than some more important position - in the library.

Under the pressure of Cai, Chen was forced to resign from the university in 1920 - not for his support to communism, but his frequent appearance in the red-light district.

The influence of the latter two incidents was profound - albeit Freudian.

少白

Many of you know that Sun Yat-Sen studied medicine in our sister medical school.

There, a notable classmate of his was Chen Shao-Bai (陳少白).

Chen was actually two years more junior than Sun, and he quited the medical school at the third year. Together with Yau Lit (尢列) and Yang Heling (楊鶴齡), they were known as The Four Bandits (四大寇) - for their famous frequent meetings inthe shop Yang Yiu Kee (楊耀記), owned by Heling's family, at Gough Street of Hong Kong.

To put it simply, Chen was a dedicated supporter of Sun. He joined the Hsing Chung Club, and became the chairman of its Hong Kong branch. Following the advise of Sun, Chen started a newspaper China Daily (中國日報) in 1900, with an aim to broadcast Sun's idea of revolution.

In addition to the Hsing Chung Club, Chen was asked by Sun to join The Triad (三合會), in which he became a key member and served for quite some time as the White Fan (白扇) - a romantic name of the Secretary for Finance.

As one of our country leaders used to say, there are patriots in The Triad.

PS. There is an entirely different China Daily nowadays. Don't be mistaken.

衢雲

Many of us have the romantic idea that Hsing Chung Club (興中會), the predecessor of Tongmeng Group (同盟會) and later Chinese Nationalist Party, was first set up by Sun Yat-Sen.

In fact, the first one who put these all up was Yeung Kui-Wan (楊衢雲).

It was 1895. Yeung was the first president of the Hsing Chung Club - Sun was the secretary.

The relation between the two men was intriguing. In the following four or five years, Sun gradually became more powerful within the Club, and Yeung was edged out. At last, Yeung resigned as president in 1899 - obviously succeeded by Sun.

And Yeung continued to pursue his ideal and started at least one other (unsuccessful, of course) uprising. In the evening of 10 January 1901, he was shot in the head and chest, while tutoring students at his home, by an assassin sent by the Qing government.

Yeung was buried in the Hong Kong Cemetery in Happy Valley; his tombstone remained unnamed and inscribed with only the serial number 6348, in order to avoid being recognized and desecrated by ... whoever.

嘉澍

If we consider Ma Junwu provided the first literacy for the Xinhai Revolution, Charlie Soong (宋嘉澍) gave the seeding money.

Soong was born in Hainan and emigrated to Boston as a child, being brought up by a group of Methodists. After graduated from the Vanderbilt University with a degree in theology, Soong moved to Shanghai in 1885. He set up a printing company there and, according to formal records but not without suspicious remarks, accumulated a good wealth by selling bible. In 1894, Soong met Sun Yat-Sen and was soon taken in by the mission of the latter. In the subsequent years, Soong funded Sun’s travels in search of support for the revolution.

Well, to most of us, Soong was better known for his famous children, including Soong Ch'ing-ling (宋慶齡), Soong May-ling (宋美齡), and Soong Tse Ven (宋子文). The reality was Charlie Soong actually broke up with Sun when Ch'ing-ling ran away with the revolution leader.

That's quite understandable; Sun was already married and merely three years younger than Charlie Soong.

PS. The name Charlie Soong was, in itself, an interesting story. When born in Hainan, he was actually called Han Jiaozhun (韓教準). After emigrated to America and when baptized at the age of 15, his name was changed to Charles Soon - presumably a clumsy pronunciation of Jiaozhun (教準), his original name, by some Hakka dialect.

君武

When the Tongmeng Group was first established, another key person in the drama was Ma Junwu (馬君武).

In short, Ma wrote the first draft of the Constitution for the Group.

Contrary to many of his contemporary part members, Ma had a remarkable western education. He studied French in Guangzhou. Next he obtained a Bachelor in Science from the University of Kyoto (his major subject was chemistry). After a few years of work, he then moved to Berlin and got a doctor degree in engineering.

As to the modern China, Ma played a curious role. Being a founding member of the Tongmeng Group, he did not take much part in the Xinhai revolution, but he was responsible for writing the Provisional Government Memorandum (臨時政府組織大綱) and the Provisional Constitution of the Republic of China (中華民國臨時約法) in 1911. Some years later, however, he left Nanjing and joined the Beiyang Government (北洋政府) to become the Chief Justice and then Minister of Education - a decision for which he was dismissed from the Chinese Nationalist Party immediately.

PS. In addition to writing the Constitution, Ma was also the first who translated The Communist Manifesto (共產黨宣言) of Karl Marx and Friedrich Engels into Chinese.

克強

Zhang Binglin was one of the founder of the Tongmeng Group (同盟會), which was the predecessor of the subsequent Chinese Nationalist Party (中國國民黨).

In addition to the Hsing Chung Club (興中會) of Sun Yat-Sen, the other major branch of the Tongmeng Group was the Huaxing Club (華興會), established by Huang Xing (黃興), nicknamed Huang Keqiang (黃克強).

Huang met Sun Yat-sen in Tokyo in the summer of 1905. In order to focus all anti-Manchu parties, Huang proposed to merge Huaxing with Sun's Hsing Chung. When the two first put together the Tongmeng Group, Sun became the president - nominated by Huang. The famous slogan of the Group (驅逐韃虜，復興中華), was designed by Huang. In fact, in the following six years before the Xinhai Revolution, after a series of unsuccessful campaigns, Huang was proposed on half a dozen of occasions by other Tongmeng members to take over the Group as president - for Huang was a pragmatist and physically took part in almost every event, while Sun was an idealist and kept traveling around to broadcast his own idea.

One notable example was the Second Guangzhou Uprising, commonly known to us as the Yellow Flower Mound Revolt (黃花岡之役), Huang was the last survivor to leave the battlefield, and sustained a major injury in his right arm; two fingers were broken.

By the way, he escaped to Hong Kong, and was operated in the Nethersole Hospital at that time.

PS. Huang died at the age of 42 because of recurrent variceal bleeding. His medical history was equally interesting as his political career, for his liver problem apparently developed together with symptoms suggestive of myocarditis or cardiomyopathy, and he's not an alcoholic.

It sounds a good MRCP grey case.

太炎

The most vivid anecdote about Kang Youwei that I remember is related to a couplet Zhang Binglin (章太炎) wrote:

國之將亡必有；

老而不死是為。

Zhang's sentiment was easily understood; he was the most outspoken anti-Manchu in that era. His whole political idea was described in Qiu Shu (訄書), which, unfortunately, was exceptionally incomprehensible. (It was deliberately difficult because the book could be looked as a PhD thesis on the theory of anti-Manchuria. Zhang was jailed for three years for this book, but, if the Qing government did appreciate the whole of the meaning of this book, as well as it's influence, he would certainly be beheaded.)

But, notably, Zhang did not really support Sun Yat-Sen and was very skeptical about the Xinhai Revolution. To put it simply, Zhang was a strong believer of the Spring and Autumn Annals (春秋) and its teaching of if they are not of my race, their heart must be different (非我族類，其心必異). He longed for a country with the Han (漢) people and preferred doing away with all the barbarians.

PS. Besides being an industrious philologist and textual critic, Zhang was an expert in traditional Chinese medicine, on which he wrote two books: Synopsis on Cholera (霍亂論) and A New Treatise on Acute Diseases (猝病新論).

有為

It seems timely to talk about the Xinhai Revolution (辛亥革命).

However, to begin with, not everyone preferred China to be modernized in such a manner.

The notable example was Kang Youwei (康有為).

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

Kang's idea was described in his masterpiece, Da-Tong-Shu (大同書), in detail. But, to put it simply, he was a strong believer in Constitutional Monarchy (君主立憲) and wanted to remodel China as Meiji Restoration (明治維新) in Japan.

As a result, he supported the Guangxu (光绪) Emperor.

Along with his student Liang Qichao (梁啟超), Kang was the principal leader in the Hundred Days' Reform (戊戌變法), which failed miserably under the influence of Empress Cixi (慈禧). The meaning was obvious: The Manchu people did not want to give up their power. You could try any reform as long as it involved enhancing the efficiency of administration or improving the economy. But, if you try to affect the political structure or take some power out of the Forbidden City, to hell you go.

(This declaration sounds familiar, eh ?)

For that reason, the road to revolution was determined, and Kang faded away without much notice in 1927.

He might not be timely, but he did make a brilliant blaze.