Farewell

It has been seven years since I first started this blog, and it seems an appropriate time to draw it to a close.

Since it is almost the New Year Eve, I'm afraid it is also a good idea to share with you the classic song So Long, Farewell from The Sound of Music:

(All children)
There's a sad sort of clanging
From the clock in the hall
And the bells in the steeple, too
And up in the nursery
An absurd little bird
Is popping out to say coo-coo
(Coo-coo, coo-coo)

(Brigitta, Gretel, Marta) (Fredrick, Leisel, Kurt, Louisa)
Coo-coo Regretfully they tell us
Coo-coo But firmly they compel us
To say good bye
Coo-coo
(All)
To you

(Children)
So long, farewell
Auf Wiedersehen, goodnight
(Marta)
I hate to go and leave this pretty sight

(Children)
So long, farewell
Auf Wiedersehen, adieu
(Fredrick)
Adieu, adieu
To you and you and you

(Children)
So long, farewell
Au revoir, Auf Weidersehen
(Leisel)
I'd like to stay
And taste my first champagne
(talking to the captain) yes?
(Captain) no!

(children)
So long, farewell
Auf Weidersehen, goodbye
(Kurt)
I leave and heave
A sigh and say goodbye
Goodbye

(Brigitta)
I'm glad to go
I cannot tell a lie
(Louisa)
I flit, I float
I fleetly flee, I fly

(Gretel)
The sun has gone
To bed and so must I

(Children)So long, farewell
Auf Weidersehen, goodbye!

You can find the actual video in https://www.youtube.com/watch?v=Qy9_lfjQopU

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Alas, just like what you have in the movie, the song could appear in the middle of an enchanting party, or before Nazi took over Austria.

It depends on your point of view.

Merry Christmas.

List

It is close to the end of the year and a good time to plan ahead.

There are a few books on my (electronic) shelf that I have not read, and a few more in my wish list that I have not bought for my shelf.

Here you go:

(To read)

• David and Goliath by Malcolm Gladwell
• One Summer: America, 1927 by Bill Bryson
• The Brave New World by Aldous Huxley
• Capital in the Twenty-First Century by Thomas Piketty
• The Pig That Wants to be Eaten by Julian Baggini
• 9 Algorithm That Changes the Future by John MacCormick

(To acquire)

• Sapien: A Brief History of Mankind by Yuval Harari
• Cloud Atlas by David Mitchell
• One Hundred Years of Solitudes by Gabriel Marquez
• The Book of Laughter and Forgetting by Milan Kundera

Considerations

In addition to inflation, there is another factor that we did not consider in the calculation yesterday: If everything goes according to the plan, you will be leaving the principal (and the apartment) as legacy when you die.

Is this what you prefer?

Let's consider the answer no first. In that case, you can take away a portion of the principal for your living - plus the investment return from the principal, and minus the inflation. The target of this scenario is to leave no money at the end.

It becomes immediately obvious that if your investment return is the same as the inflation, the two factors cancel out each other. In that case, you can calculate by simple arithmetic. If you have 50 years to live and you need $30,000 each month, an original principal of HK$18M is necessary.

PS. In this simplified calculation, I actually borrow the concept of discounted cash flow valuation. In reality, the amount you take each month increases with time according to the inflation rate, but the discounted present day value equals HK$30,000 today. That's how you maintain the standard of living in a moving world.

PPS. The real motto of the above discussion is: Investment of your savings is always necessary, not because you want to earn money, but you need to negate the effect of inflation.

Income

Before going on with my calculation, I pushed forward a further question to PC, "Can you elaborate what you mean?"

"Very simple. I have a place to live. That's settled. All I need for retirement is a sum of money that could generate a sufficient amount of income - as interest, dividend, or whatever."

"I see..."

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On the face of it, the calculation is straightforward. There are only two variables in the equation: the monthly income you need, and the interest rate.

Say, if we assume HK$30,000 each month and 4% per annum as the rate, we need HK$9M to start with. Similarly, if you need HK$50,000 each month but the interest rate is 2%, you need HK$30M before submitting the resignation letter. If you do not own an apartment, then you need to add the cost of renting to the monthly expenditure.

But, the critical question is: How about inflation?

Retire

PC and I went on to talked about our daughters and other personal matters. A moment later, he suddenly made a curious remark, "You know, I just worry I do not have enough money to retire."

I was surprised. PC is a consultant in another department and his wife is a senior doctor in another hospital. They have a daughter - studying in a private school - and, as far as I know, no other expensive hobby. He is close to finish with the mortgage of his apartment in Kowloon Tong, of which the price actually goes up drastically after he bought it some ten years ago.

"How could that be?"

"My wife and I put much of our income for settling the mortgage. We also plan to send our daughter overseas for schooling. And, you know, we are rather hopeless when it comes to investment."

"I see - but I suppose it depends on what kind of life you want to lead after retirement, doesn't it?"

"Oh, my. I just want to keep my current standard of living." He sighed.

In no time, I could see that is a mathematical question.

Address

Met my friend PC during lunch. Somehow, our conversation came to the topic of social mobility in Hong Kong.

"I could understand very well why the youngsters nowadays become frustrated." He began.

"Yes...?"

"Take doctor as an example," he explained, "You know, any doctor graduated thirty years before I became a doctor could afford living on the Peak."

I nodded.

"And, doctors graduated twenty years before I do live in the Mid-Levels. For those ten years more senior than me, they settle comfortably in the North Point or Tai Koo. When it comes to me, only a small apartment in Kowloon Tong."

"Or Lam Tin, like me," I laughed and added. 

"Now, from what I heard recently, new fellows could only afford buying second-hand flat of the Home Ownership Scheme."

I must say I don't think PC's apartment is anything small, but he did make an important point.

Plan

For some inexplicable reasons, I was asked to attend a meeting with a dozen of extra-terrestrials.

The topic for discussion was simple: How should we plan our clinical service 10 or 15 years down the road?

Sounds grandiose, eh?

In fact it was grandiose. Instead of a small meeting between three of four key persons, I found myself in a conference of some two dozen people - representatives from duke to dustman, or from professor to (literally) porter, each voicing out their view or vision to the future.

Alas, how could we all have our own vision? Are we seeing mirage?

And, as I always say, if the The Grand Council (軍機處) of Emperor Yongzheng (雍正) had five members and the Politburo Standing Committee (中央政治局常委會) of our great country has nine, what's there to be so important to have a committee of more than a dozen?

PS. You may want to ask a philosophical question: If we have no idea what Hong Kong would become 10 or 15 years later, how are we going to plan the medical service accordingly?

Determining

During a casual conversation, my friend WS expressed his concern on the next generation academic clinicians.

 “Very true,” I said, “Some are good clinicians but simply cannot take care of a project. Others just focus on research and have no interest to take care of patients.”

“Alas, they have to think of their contract…”

“And there is a third domain that we have not touched on – teaching! Unfortunately, it carries very little weight in the equation.”

“My worry is, quite a few budding academics are interested in too many things.” WS sighed, “They start one project after another, without being able to complete with any.”

“Very true. When it comes to medical research, it is more a test of self discipline than talent. You don’t really have to be innovative. All you need is organization and being able to execute the project.”

Alas, it also applies to many other aspects of our life.

情書

My recent bedtime reading is Funeral of Flowers (花葬) by Renjo Mikihiko (連城三紀彥).

I get this paperback within a pile of detective fictions that my friend AL gave me before she set off to Zhuhai for her new post. It does not appear to be particularly attractive and, as a result, I put it towards the end of my reading list. Nonetheless, the name Renjo seems familiar - just that I couldn't figure out when and where I encountered it in the past until I started reading it.

Yes, he wrote Koibumi (戀文), which is also known as Love Letter (情書).

The all time classic of Miho Nakayama (中山美穗)!

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But, as I realize later, I was wrong. The story between the two Itsuki Fujii (藤井樹) does not come from Renjo, who wrote, with the same title, a rather cruel story between a broken couple.

What's in a name? That which we call a rose. By any other name would smell as sweet.

Cost

“You know, it doesn’t feel good to abandon a trainee if they don’t perform well. We should give them a chance and see if they could improve. After all, we have a moral responsibility to them.”

“You have a point there,” I nodded, “Nonetheless, it really depends on how you see it. If you take the perspective of a trainee, you are entirely right. However, the benefit of trainee should be taken care of by themselves.”

“What do you mean?”

“I mean, as a leader, you should consider the matter and think of the benefit of your team or department.”

“Which means… what?”

“Which means, as the provider of training, it is more cost effective for a department to give up a problematic trainee and find a more promising one to take up the post. The effort you need is much less, and the risk of any medical incident is much lower.”

My words are bitter to taste and difficult to swallow – I know from the face of my friend.

Train

Shortly after discussing the issue of medical manpower with VW, I was engaged in another conversation with HM, a friend of mine who is working in another hospital, on a similar topic.

In short, he was complaining about the performance of a trainee in her department, "You know, we are really disappointed. She did well in every aspect as a house officer and junior trainee. But, when she turned into a higher trainee, you really think that's a different person. Her knowledge is deficient, and her professional attitude is far from acceptable."

"Is she having some problem with her family?" I suggested.

"No, I don't think so. She keeps putting up photos of her exquisite dinning almost everyday on her Facebook. My god, what time is left for studying if you dine with your friend every evening?"

"In that case, why don't you give her some warning? I believe there are mechanisms to discontinue her training, aren't there?"

"In theory, yes, but we don't want to..."

"Why?"

Over-supply

(My conversation with VW continued.)

“In a sense that may be a good news for us working in the government hospital,” my friend said, “We can easily fill up all vacant posts, and our house officers would certainly be more hardworking – the competition is fierce and they need to outshine the others in order to get a good training post.”

“That may be true. However, from the perspective of our society, that may not be a good news.”

“Why?”

“Because we will soon find a lot of unethical and ruthless doctors around.”

“Because the market is fixed but competition has increased?”

“Exactly. Moreover, many fresh graduates will not have any training post after finished with their internship. They would be forced to join the private market – rather prematurely I dare say.”

Manpower

Shortly after I heard about the behaviour of students from the other side of the harbour, we held the clinical examination for the medical council.

As always, I shall not tell you what happened in the examination. However, during the coffee break, my friend VW made a succinct comment: Are we expecting many new doctors in the near future?

No, I don't think it was a question. I nodded and said, "Absolutely. There are more and more graduates from overseas coming back for practice. Two years later, we are expecting over 200 graduates from each local medical school. Moreover, our government is beginning to defer the age of retirement from 60 to 65. I am fair sure the Hospital Authority will follow suit, and many senior clinicians will hang around for 5 more years.”

“Could HA hire so many doctors?”

“That’s the question,” I said, “I suspect our government would put the money on infra-structure and construction, and the expenditure in health care would thin out..."

Reverse

If you have read Metamorphosis, you may think the story does not have a happy ending. Gregor Samsa died, and the family felt relieved.

However, while I was reading Beetle Boy with Euterpe, I came to realize Kafka did not consider the most horrible scenario: After his family decided to give him up, Gregor woke up the other day and became an ordinary person again.

And that's all too common. His view may have changed, there are basic human needs to satisfy, or he just couldn't stand the loneliness of being regarded as different. His Will (as defined by Arthur Schopenhauer) defeats his Reasons (of Immanuel Kant) and decides to turn himself back to human - rather than enduring the pain before he turns into a butterfly.

The irony is, if he does become a butterfly, he would no longer be regarded as a kind of disgusting bug. All worldly people like him. Unfortunately, that's a rare occurrence. Most of the vermin just take a U-turn to be human again. Others, including Gregor, die as an wounded bug. A few go on and hide themselves forever as pupa.

Different

What would happen if we suddenly appreciate a piece of truth that contradicts with the common belief?

It could be anything, depending when and where you are. The Earth is moving around the Sun, The Garden of Eden is a figurative existence, China was a colony of (forgive my language) barbarians much of the time in the past 800 years (not sure the tense of this clause is correct), or, most recently, democracy is a basic human right. These views may not be correct; many a time it depends on your point of view and there is no absolute right or wrong. (As a matter of fact, the Earth does not simply move around the Sun; both of them move around the Milky Way galaxy.) Nonetheless, your life becomes difficult when everyone believe in one way and you think of the other.

You become a vermin - the gigantic monster that Gregor Samsa turned into.

PS. Of course, many bugs do not have a bad feeling. As Jonathan Davis says,
You laugh at me because I'm different, 
I laugh at you because you're all the same.

Beetle

While writing the exceptionally short blog on metamorphosis, I was actually reading Beetle Boy (卡夫卡變蟲記) by David Lawrence.

The book is a gift from my friend KM, and the story was based on Metamorphosis of Franz Kafka. I met the original version when I was a medical student and has always been puzzled about what the legendary novelist was trying to tell us. Believe it or not, there are no fewer than a handful of sensible but rather complicated explanations around. I must say I am not satisfied with any. My gut feeling is, as his first full-length novel, Kafka must have a critical but simple message.

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I read it with Euterpe as part of her regular reading project. For obvious reasons I am not going to discuss my princess's homework or the story told by Lawrence, which is primarily written for children. However, when Euterpe read it aloud, I saw light.

I mean I suddenly understand the message that Franz Kafka was trying to convey.