班聚

與為家母祝壽同時，筆者的大學同學也正在安排畢業二十五年班聚。出乎意料，各同學為此事竟掀起了一段頗為熱烈的討論。

長話短說，各人爭論的事情可以用一個哲學題目來表達：假設經濟情況許可，我們是否應該多享受一下，抑或繼續克己的生活，而用多餘的錢去盡力幫助貧苦大衆？

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首先，要注意這個議題的措詞經常直接影響答案。試想，要是把題目寫成「我們應否過奢侈的生活，抑或繼續克己……」，答案是明顯不過。但如果把它寫成「我們是否應該先改善自己的生活，抑或只維持基本生活所需……」，大家也許便會有不同的意見。

你可能說，「奢侈」和「改善自己的生活」有明顯的分别，但是，用一個現成的例子，一餐每位千多元的晚膳，對一個實習醫生來說是奢侈，但從一個“星球”醫生看來，不過是“改善生活”罷了。

上梁

定係梁上――者候？

Note: Pictures copied from the internet.

策略

關於宣誓事件，泛民的最佳策略是：表面支持梁、游二人再宣誓，以爭取民心和道德高地，實則催化二人不能履新而致重選。經此一役，不少青年新政的支持者會轉投泛民，補選很大機會能重奪二席，增加在議會內的籌碼。

由於上述可能，建制派的最佳策略是表面排斥梁、游，卻令二人最終宣誓成功，以避免泛民籍補選壯大。縱使青政將來在政策上對抗，甚至在議會搞事，二人只是小學雞程度，不難駕御；更重要的是他俩俱是耳後見腮之輩，對泛民非但不會感恩圖報，反而偶爾與之對着幹，大可成為牽制泛民的後欄火種。

Grants

Recently read: Tori O'Neal-McElrath《Winning Grants Step by Step》

I must say I find it difficult to understand there is a fourth edition.

Specialization

I went on with my lecture, "Even for patients within the same department, the current trend is specialization rather than generalization."

"What do you mean?" My wife asked.

"For example, if a woman is under the care of a liver surgeon for gall stone, and, at the same time, she is also noticed to have a breast lump. Would the liver surgeon do the workup or refer her to a breast surgeon? There is nothing fancy about breast ultrasound, X-ray, or biopsy - all general surgeons should be fully capable. However, if there is any problem, his expertise would be challenged, and any pig-headed extraterrestrial would comment that the system never bar him from referring the patient to a breast surgeon."

"The attitude is wrong."

"Is it? I'm not entirely sure. On one hand we think generalization would save the trouble of multiple referral and improve the efficiency of the system. On the other, specialization certainly improves the outcome of many procedures - surgery, endoscopy, and what not. As Adam Smith said: The greatest improvement in the productive power of labour... have been the effects of the division of labour."

Education

"I think the idea of our extraterrestial friends is this: If a problem could be taken care of by a private doctor, why couldn't a junior surgical or medical trainee do the same thing?"

"Because a private doctor gets paid and therefore has the incentive to handle those simple problems. In contrast, a junior trainee in the Hospital Authority has no such incentive - their salary is fixed, they need to shoulder the responsibility, and, if anything happens, they get the blame. As I just said, extraterrestrial creatures are mostly mollusks. Moreover, expectations of the public - fueled by the mass media and, unfortunately, a few aliens in the Council - has also changed over the years. Em... you see, I use the word changed, not elevated."

"So, what is your conclusion - or proposal?"

"My conclusion is: More education is needed - but that's for the extraterrestrials and general public. The idea is simple: Tell them, for example, that a junior surgeon could manage a high finger prick sugar level."

PS. For new visitors who have not heard of the term mollusk, please refer to http://ccszeto.blogspot.hk/2008/07/benefit.html.

Educated

(Our discussion went on.)

"You don't agree, do you?" My wife asked.

"I'm afraid I do not. To begin with, all junior doctors are actually reasonably educated on every aspects of medicine and surgery, just that the current system prevents them from applying their knowledge - or, I dare say, from exercising their common sense."

"Dear, you are too cynical."

 

"Am I? Take your high finger prick glucose as an example. When I was a surgical house officer, I was allowed to take care of all those problems - not because I was a medical gold medalist, but because my consultant had the confidence that house officers had the capability, and he was willing to shoulder all responsibility for the consequence. Nowadays, on one hand the administrators say they encourage applying general medical knowledge. On the other, whenever troubles or complaints arise, all they would say is they have never prohibited frontline doctors from consulting experts of other specialties!"