啟蒙

You may find my feeling to PT somewhat unexplainable - he was merely my anatomy tutor and not even a medical doctor.

Nonetheless, those were the very primitive days when I first entered this profession, and this early teacher of mine showed in a brilliant manner - with his knowledge and, more so, what he did - how we should face our life.

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While I was admiring my previous anatomy teacher, Vivian and I were preparing Euterpe for her last day in pre-nursery.

My daughter will move to another kindergarten to continue with her study.

Yes, you may think what big deal. There's nothing eternal on earth and we all move to the next stage of our life when the time comes. Nonetheless, Euterpe likes her pre-nursery class very much and I find it a pity to leave.

But, that's life.

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但願人長久，千里共嬋娟。

Gurudakshina

While thumbing through the pages of Nature, I found a familiar name.

That's PT.

(For our relation, see http://ccszeto.blogspot.com/2010/02/prosector.html)

My feeling is difficult to describe. What a happy surprise to find your previous teacher - and a highly respected one - to be in good health, excel in his field, and be invited to write a review article for that very journal ! It has been over 20 years since I last saw him, and he has moved from London to another corner of the globe - pursuing the same topic of research, and in a much more sophisticated manner. (I look up in the PubMed and found many brilliant articles of his team, in almost every good journal, you name it.)

Maybe I could express what I wish to do with a word that I newly learnt: Gurudakshina.

OTM

Although I usually buy medical books on-line, it remains a pleasure to walk through a jungle of medical books in a traditional book store.

The problem of searching what you want in Amazon or places alike is you must have some idea what to look for. Depending on how you choose the key word, it is very easy to miss an entire topic or group of books. (Not to say very often we have little idea what we want - until that very volume flashes across your visual field.) That's the beauty of going somewhere flesh-and-blood: Everything available is there. Using the jargon of Bernard Woolley, you are shown with every details of the unknown unknown.

(The same argument also holds for our digital PDA: The amount of data stored is huge, but they would only appear when you look for them. With a Moleskine, I could see everything any time I flip through the pages - whether I like it or not.)

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This time, I find the new edition of Oxford Textbook of Medicine.

I still remember in his preface to the first edition of the Textbook, Sir David Weatherall tried to convince his readers that textbook of medicine would not become a dinosaur.

“Certainly, the basic and clinical sciences are moving so fast that no textbook of medicine can hope to be absolutely up to date. However, relatively few of the advances in these fields lead to major changes in patient-care, and those that do require several years of critical evaluation before they become an integral part of routine clinical practice.”

I shall leave it to you to decide whether OTM has become a dinosaur.

Bookstore

It was raining like hell on Saturday and Vivian was on-call. I bought some hamburgers and french fries from our favourite restaurant in Hung Hum and we ended up having lunch together in her office.

The weather was less horrible when I left Vivian's hospital, and, almost guided by my basic instinct, I went to that nearby medical bookstore at Jordan - it was at least one year since I was here last time.

The place has changed very little since I first set my feet here 25 years ago, when it was first open. Alas, that was also the time when I entered the medical school.

(Before it was opened, there was actually only one small medical bookstore around the whole colony - at another corner of Jordan. This little place is still there, just next to that renown diary company.)

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The only book I bought was the new 59th edition of British National Formulary. The original one on my shelf was the 38th edition, published in September 1999 - soon after I joined the university. The world has changed so much; things become more chaotic (as predicted by the law of thermodynamics) - the book has expanded from 750 pages to over 1000.

The cover has changed from green to purple, but the content remains very much the same - although a bit more complicated.

Rather symbolic, I believe.

Readings

(Two more emails that follow.)

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Thank you very much Professor... Oh by the way, since our CUHK accounts will be expired very soon and I will not be able to read most medical journals online later (well, honestly, I stick to BMJ and NEJM only..). I know we can assess many free texts with eKG. Do you recommend me to have a personal account of the journals mentioned?

Best regards,

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It seems advisable to first test if you could handle the information load. You may sign up for the table of content by email or Google reader (both are free), and download the full text from eKG if you find any particular piece interesting. You may then decide on formal subscription a few months later.

Sincerely,

Communication

(Some recent communications with a young colleague. I suppose it is timely to put them on my blog.)

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... I find that even I have recited the houseman handbook for MB and still retained some of the content, I have difficulty in real life application. I wonder how and what I can do to improve as soon as possible? ...

Best regards,

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... Seriously I have no concrete answer. My advise on tactic is, after seeing each patient, to ask yourself to state your conclusion in the case notes before writing down treatment order. That would usually clear up your mind and avoid many illogical doings.

From a strategic point of view, it would be useful to remind yourself: If this is something I have to do a year later as a junior MO, I shall make sure I could do it now...

Szeto

Predictable

Do you see where we are getting at ?

Right, we treat our enemy by doing things at random (or, using the mixed-strategy according to the game theorist), but we use a clear pattern of behaviour to our ally.

Or, if we turn the table around, our friends have a predictable response, while foes often caught us by surprise.

To go one step further, our evolution has brought us to use the information and make the decision subconsciously: Things or people that have a recognizable pattern of behaviour are friends; those that are not that predictable, enemies.

That's why we find such a comfort in science, or are so disappointed when we read the Book of Job.

I shall not elaborate further.