26 Jul 2012


“Have you read L’s article in Fruit Daily?” PL asked us last Monday.

Seeing that none of us did, he told us the story. L has been writing for Fruit Daily for some time. Recently, the great surgeon wrote a provocative article saying that local people should not protest on 1 July. It should instead be a time to celebrate the return of Hong Kong to China.

The newspaper has a blog and claims to allow everyone to express their views. As expected, L’s article was met with numerous angry responses. A few days later, however, L received a letter from a reader. The gentleman said he actually supported L’s view and left a message at the blog. To his surprise, despite two attempts, his supporting message was soon deleted.

I have not verified his claims yet. But when I glanced through the response at the blog, there was indeed not a single message supporting him.

Voltaire once said, “I disapprove of what you say, but I will defend to the death your right to say it.”

To this end, I respect L’s freedom to express his view, although I see no reason why people cannot protest whenever they like.

As for Fruit, I sincerely hope that the allegation was untrue. The newspaper has already demonstrated its power to falsify facts and mislead readers on a number of occasions. Can it go even lower by upholding the freedom of speech on one hand and doing something more horrible than Communists on the other?

In any case, neither party understands the freedom of speech on this occasion.

19 Jul 2012

Cardiac Catheterization

In 1929, a 25-year old German surgical resident Werner Forssmann wanted to solve a clinical problem: How to improve the delivery of resuscitating medications to the heart? At that time, direct injection through the chest wall into the heart was an accepted practice, though it was largely ineffective and dangerous. On the other hand, cardiac catheterization was met with much skepticism. Dogma had it that touching the inside of the heart would lead to arrhythmia and death.

At that time, several groups had tried cardiac catheterization in animals, but no one was brave enough to test it in humans. Forssmann approached his boss with the idea of a human study and was immediately rejected. The senior surgeon knew he would not listen and even went at length to forbid everyone in his department to let Forssmann touch the surgical instruments.

Forssmann was not easily deterred. With much perseverance, he managed to persuade a surgical nurse named Gerda Ditzen to unlock the surgical instruments and offer herself as the first study subject. Forssmann tied her on a table and left the room. Ditzen waited and waited and wondered what was happening. Eventually, Forssmann reappeared with a catheter up his basilic vein and blood all over his body. The nurse angrily scolded him for betraying her. Yes, Forssmann only tricked her for the instruments and never intended to risk his colleague. He untied the screaming Ditzen and ordered her to take several x-ray pictures. That made history.

Looking at the bright and enthusiastic youngsters who were applying for the medical school, I could not help but wonder: Should we recruit people who would abide to the rule, or should we choose those who would challenge the rule? Can we afford to have doctors running around the hospital trying to tie up nurses?

P.S. Although Forssmann did not hesitate to risk his life, he never did the same thing on others. Serving in the German army during World War II, he was offered the opportunity to do experiments on prisoners. He promptly refused. “To use defenseless patients as guinea pigs was a price I would never pay for the realization of my dreams,” he wrote later. Unfortunately, his pioneering work was ridiculed by his colleagues as circus work. He was denied academic posts year after year and had to do urology instead. When he finally received the Nobel Prize in 1956 and was offered professorship in cardiology, he found himself cut off from the field for too long and could only serve as a “living fossil”.

12 Jul 2012

Outside the Box

Talking about thinking outside the box, I like this story from Fooled by Randomness.

“If you flip an unbiased coin 99 times and you get 99 heads, what is the chance that the next toll is a head again?” the author asked.

“The chance remains the same at 50 percent,” a PhD in statistics answered.

“Nah,” an investor disagreed, “I bet everything that this coin was biased. This next toll will still be head.”

Yes, the question was based on the assumption that the coin was unbiased. But why can’t assumptions be challenged? If our thinking is confined by dogma, how can we hope to make any progress?

5 Jul 2012

Light Bulb

This summer, we have to interview students applying for our medical school. GW suggested that I should ask the light bulb question. HC and RL were very curious and urged me to share it.

Here it goes.

There are 50 prisoners on life sentence at a remote island. Each of them occupies a separate cell in jail and cannot see or talk to each other. One day, the jail officer decides to play a game with them.

“From tomorrow onwards,” he explains, “I will reshuffle the cells you live in randomly every day. All but one cell are identical. In the special cell, which I would call Cell X, you are free to turn the light on and off at your will. You can only communicate with your fellow prisoners by switching the light bulb on or off, and are not allowed to leave other signals. If one day one of you can confidently claim that all 50 fellow prisoners have already been in Cell X at least once, I will set you all free. If, however, you make this claim but one or more prisoner has yet to enter Cell X, I will execute you all. Now, discuss the plan among yourselves. Good luck, gentlemen!”

Can you devise a plan to win this game?

After I had finished, HC and RL became very silent.

“We can draw lines on the wall,” RL finally muttered.

“Or we can leave our clothes in Cell X,” HC said.

“We’d better kill the officer while we are still together,” RL added.

And then they suggested 5 to 6 more possibilities.

“Hey,” I said, “neither of you are going to touch the light switch at all?”

“Can’t figure that out,” RL protested, “but shouldn’t the university encourage thinking outside the box?”