28 Apr 2011

Fairy Tale

Following our friends’ advice, we bought Angelina a Barbie doll and said it was a present from her newborn brother. This was supposed to be a good method against sibling rivalry.

Angelina opened the present and was delighted. “Wow,” she exclaimed, “how did baby brother know what I like?” The plan worked!

The next day, Grandma asked, “How come your brother had money to buy you a present?”

“Oh,” Angelina answered, “I guess Mummy bought it and told me it was from brother.”

That marked the end of another fairy tale, after Santa Claus and Tooth Fairy.

21 Apr 2011


Five years ago, I was waiting outside the operating theater, preparing for the arrival of Angelina. My mind wandered, though I was unable to think about anything in particular. Then I spotted a computer in the waiting room. I checked my e-mail account but everybody was so kind as to stop sending me anything. Like most people in apprehension, I resorted to things I used to do. I visited the website of New England, only to find that I had already read the issue the week before (it was a Tuesday).

Fast forward five years. If technology had changed, I didn’t change much. This time there was no computer in the waiting room. Alas, I took out my wife’s iPhone and did just as fine. I dutifully deleted a dozen of e-mails on seminars, investment opportunities and how to grow tumors. It was possible to have an idle e-mail account in 2005, but it would be a miracle in 2011. When I turned to Lancet, I finally realized I could not take in anything.

Soon afterwards, the baby cried and kicked his legs. But he slept peacefully in our arms as soon as he was wrapped in a clean blanket. We know it would be another chance to learn. The Lord taught us to love and to serve. Is there a better way to learn this than to have a child?

14 Apr 2011

The Last Lecture

It is a tradition at Carnegie Mellon University that professors take turn to deliver ‘the last lecture’. The speakers are asked to imagine that they are going to talk to students for the last time, and may discuss any topic they like. We can only guess that most of those lectures must be enlightening.

On 18 September 2007, Dr Randy Pausch made the program world famous. His lecture was entitled ‘Really Achieving Your Childhood Dreams’. After a humorous introduction, he told the audience he was suffering from recurrent pancreatic cancer and only had a few more months to live. But no, there was no time for sorrow and self-pity. When the days were numbered, Randy trimmed down trivial things and only considered what was important. He demonstrated the vigor, passion and love of life.

Last week at the medical grand round, TL came close to that. Unlike others, the neurologist spent the first half of his talk discussing what quality a doctor should have. He wished future doctors to be responsible and knowledgeable. They should be patient, have empathy and work as a team.

At the back of the lecture theater, our colleagues were deeply moved by his effort. The qualities he mentioned were more important than the medical facts we taught. On the other hand, we felt it disconcerting that those had to be spelled out. What would you think if a bank manager has to tell the clerks it is wrong to steal?

7 Apr 2011


One thing the student representative brought up was the logbook system. “It is often hard to find teachers to sign the logbooks because they are engaged in clinical duties,” she said. “Can we abandon it?”

A few years ago, the Faculty administrators informed us that we were the only department without a formal record of students’ attendance during clinical attachments. In response, we gave each student a logbook and asked them to obtain signatures from teachers after tutorials. Our secretaries, however, never kept any record. The logbook system was more to satisfy the administrators than to check attendance.

“It is unfair to introduce the logbook system without clear instructions,” commented KL. “We should state clearly what level of attendance is acceptable. For example, students may need to attend a certain number of tutorials before they are allowed to take the year exam.”

I startled. That reminded me of the Haifa experiment. At day care centers, some parents pick up their kids late from time to time. Teachers have to stay behind and this can be frustrating. In a study in Haifa, Israel, researchers tested the effect of charging parents for extra service if they came late. The result? The number of latecomers increased. Worse still, after the additional charge had been removed, the number never decreased back to baseline level. By paying for the service, the parents no longer felt guilty for burdening the teachers.

When I worked in Beijing, the medical school there introduced an interesting rule – All PhD students must publish one paper with an impact factor of 2.0 or above before they could obtain the degree. The policy was to ascertain a minimal quality of the research work. Before that, some students were able to publish papers in high-ranking medical journals, while over half actually did not have any publication by the time they graduated. What happened after the adoption of the policy? You bet. All students ended up publishing a paper with an impact factor of 2.0, not more.

If we state the required level of attendance at tutorials, will we be taking away the moral incentive?

In the end, while we decided to abandon the logbook system anyway, GC asked the student representative, “What is the reason for asking to abandon the logbook? Is it really because it is difficult to get a signature, or is it because your classmates want to skip tutorials and do not want to be recorded?”

Now, that is a more fundamental question. If the students do not want to come, why force them?