29 Jan 2009

Philosopher Ruler

When we saw some consultations last week, a few high-ranking officials were visiting the ward. “The Earth is invaded by extra-terrestrials!” I exclaimed. All my teammates laughed.

This stems from the language in Szeto’s blog, which almost all frontline staff in our department read regularly. In his blog, our Boss is called the man from Pluto, while other hospital administrators are extra-terrestrials outside the Solar System. Although they control everything on Earth, they do not understand how people on Earth think and do things. Clearly, Szeto has a strong distaste for administrators.

I admire Szeto in every aspect, but cannot share his feelings on this point. If administrators cease to exist, who are going to hold endless boring meetings, meet the press for hospital mishaps, and explain to the government why a hospital spent nearly twice its original budget? We probably all need to share some of these. One reason why we are writing blogs so happily now is because some people love administrative work.

In an idealized society described by Plato in The Republic, the best ruler should be a philosopher. A philosopher is in love with the truth. When a man’s desire flows towards the acquisition of knowledge, his pleasure will be in things purely of the mind, and physical pleasures will pass him by. Money and fame would not be his concern. However, he fits the job as a ruler because of his good memory, readiness to learn, breadth of vision and grace, and that he is a friend of truth, justice, courage, and self-control. Interestingly, the best ruler should not want to be a ruler at all.

Of course, we are not in an ideal world, and I have to say our Boss is great after all. Just out of fantasy, LY will be an interesting candidate who can double our department’s value every year and turn our frontline staff into shareholders. Szeto is closest to the philosopher ruler described by Plato. Under his rule, I expect every senior staff can not only recite Harrison’s Textbook of Medicine, but also quote a New England paper with the correct page number during ward rounds.

22 Jan 2009


Szeto once commented that I appeared content and happy all the time. I take that as praise.

When I was 10 years old, I joined the recorder ensemble in my primary school. For some reason, my teacher did not ask me to play the recorder or other wind instruments, but assigned me to a humble percussion instrument - two pieces of wood you could hit with a stick. Anyway, I practised and tried to create different sounds out of it. I also concentrated on the rhythm. Our team eventually lost in a local competition. To my surprise, the adjudicator specifically discussed my percussion and spoke highly of me. This has been an important lesson over the years. It does not matter where God places me. If I work faithfully, the result is always fruitful.

Lately, Szeto recalled that he did not plan to do nephrology during his college days and basic training. In retrospect, I realize I did not have much planning at all. When I had the opportunity to apply for a scholarship at the Royal College of Music, my Dad felt that was a really bad idea and I entered the medical school instead (of course I would never reveal this in any interview). When I was wondering whether to do internal medicine or science, KL took me to his room exactly one week before the Professor of Chemical Pathology phoned me up. Since my first year of basic training, KL asked me not to consider other specialties.

Many would think this is a silly way of handling one's career, but I am thankful to God for letting me do these wonderful jobs all the same.

15 Jan 2009

Role Model

One day, AJ asked a question suddenly. "What does 'xxxxxxx' mean?"

We were all confused by the seemingly ancient language. AJ took us to the endoscopy center, and showed us a work of Chinese calligraphy. Alas, he not only read a few words incorrectly, but also started reading from the wrong side! It should be '但開風氣不為師'.

'We do not teach. We set examples.' No one in our team ever claimed that this was our motto or core value, as some enterprises love stating. However, this is exactly what our predecessors did.

When I became a medical student, I only wanted to become a good doctor. I believed that first-class research did not exist in Hong Kong, where government support was little. Later, I found out that many people in the medical school conducted cutting-edge research despite limited resources. Many studies even radically changed clinical practice worldwide. These dedicated clinician-scientists also keep their role as competent clinicians. They are great role models for students and young doctors. They open a window for youngsters so that they dare dream big.

In my tutorials, I used to teach short-case examination. In essence, a candidate has to perform physical examination on a patient and try to figure out what the underlying diagnosis is. These are vital techniques for passing any professional examination. Last year, when a medical student requested an extra tutorial from me, I half-jokingly asked. "Do you want to learn how to pass the examination, or how to become a good doctor?" Much to my surprise, the answer was firm. "We want to learn how to become good doctors."

I was so ashamed on hearing the response. What was I doing? Why should I waste time teaching students how to pass an examination with over 90 percent passing rate, when many patients may die because of foolish judgements, and many more could not receive the love and attention they deserve? Since then, all my tutorials have become teaching rounds. We see patients together, greet them, chat with them, and discuss the proper clinical decision and management.

For students wondering why I have a different mode of teaching, this is my answer.

8 Jan 2009

Black Hole

Our team head, KL, is well known for his black hole policy.

You may ask, "Isn't Stephen Hawking the leading expert in black holes instead?"

True, but Hawking is a theoretical physicist. As clinicians, we favor translational research.

According to KL, there are just too many junk mails and unreasonable requests everyday. These will just bar us from achieving our own goals. Instead of responding to the requests faithfully, he just gently presses the 'delete' button. In the last few months, he took a step further and stopped pressing the 'delete' button. He just leaves thousands of mails unopened, which, of course, resembles a black hole more.

This policy may not work every time. Once, a very famous professor requested him to write a chapter for his new textbook. This time, KL could not just press the 'delete' button. Instead, he pretended to be his secretary and answered the e-mail. "Dear Professor DG, I am Prof KL's secretary. Prof KL is on long leave and will not be back till August. I am afraid he might not be able to do it."

The big professor was undeterred. "August is fine. Please ask him to return his chapter in August." For once, KL had to comply.

The victims of the black hole policy will probably protest. "How can you do this to me?"

KL is not alone. Richard Feynman, who received the Nobel Prize in Physics for his work in quantum electrodynamics, was also famous for rejecting administrative work so that his research would not be interfered. He taught us how to respond to the Dean's request - "Let George do it."

1 Jan 2009


During a casual chat, GW mentioned how difficult it was to delegate job to young colleagues. This reminded me of an interesting story.

A few years ago, our Boss was working both as a Chairprofessor and a hospital administrator. Everyday, he need to see patients, teach students, do research, and attend numerous administrative meetings. In an international meeting, he met Prof AL in the United States and complained about his hard work.

Prof AL was not sympathetic. "Why don't you ask other people to do the jobs?"

"Who can I turn to?" our Boss answered.

Prof AL casually pointed at one of his younger colleagues. "He can do it," she continued. "You feel it difficult to delegate jobs to others because you think you do those things better. Doing everything yourself is not kindness. It is arrogance. Think about it. Probably any of these guys can do a better job than you because they have time and you don't."

I do not know how much influence this conversation had, but our Boss did quit his job as a hospital administrator several months later. Many local people were worried that this would be a great loss to our hospital. However, our Boss achieved much more than any of us could imagine afterwards. The one who took over the post as the department head also turned out to be a great leader.