29 Mar 2012


Earlier this month, I had the honor to give a talk at a surgical conference in Taiwan. After the talk, we had lunch with the organizers.

One of the overseas speakers was a retired professor from Japan. The discussion somehow turned to the history of medical schools.

“When the first medical school was established in Japan, there was much debate on the system we should adopt. We were to choose from the British system and the German system. In the end, we decided to follow the Hannover model. In essence, the professor had supreme power in the department,” he explained.

The organizer nodded in agreement. Then he told me a story about his mentor, to whom my named lecture was dedicated.

“One day during ward round, Professor L was displeased with my case management. He threw the case notes out of the door of the room. Our ward was on the second floor, and the chart fell right down to the ground floor. Without a word, I ran down, picked up pieces of the notes and tied them with a string. When I returned, I bowed, apologized and handed the notes back to Professor with both hands. The next thing I knew, the notes flew out the door again.”

22 Mar 2012


“I shall not alter a single word. I shall publish the work exactly as it is!”

As I glanced through the four-page comments by my reviewers, how much I hoped I could just return these two sentences! But no. I first wrote a note of thanks to the reviewers, and then prepared a list of point-by-point response. Along the line, the manuscript was modified bit by bit, until it was no longer the same.

Unlike Tchaikovsky, I am not the one who decides to publish. Currently, scientific journals are run largely according to the peer-review system. Manuscripts are sent to other researchers with similar interests for review. Many reviewers are helpful and suggest ways to improve the presentation. Others, however, write comments only because it does not look good to admit that they have nothing to add. Do more experiments. Redo the whole work using another animal model. While it is an easy comment that can be applied to all research works, the time and resource it implies are tremendous. This also delays dissemination of scientific findings.

Only once in my life was my manuscript accepted directly without any revision. My mentor described that as a modern miracle.

Tchaikovsky also received much criticism when his Piano Concerto No. 1 and Violin Concerto were first played at concert. Vulgar, unmusical, showing off technique like in a circus, you name it. Nutcracker was too symphonic for ballet. Maybe they were correct. It goes without saying, however, that these masterpieces continued to be played 130 years later. On the other hand, hardly anyone remembers who the critics were.

For this reason, I am more interested in producing good works than publishing angry letters criticizing other people.

15 Mar 2012


Recently, a group of experts wrote a regional guideline and submitted it for publication at the official journal of their society. The handling editor sent it out for external review. One reviewer returned several dozens of recommendations and suggested a number of major modifications in the guideline.

The chairman of the guideline committee was furious. “This is humiliating! The guideline represents the results of thorough discussion and voting by the committee members. How can it be modified by a single outsider who did not join the discussion?” He went on to threaten to withdraw the manuscript and send it to another journal, which he was sure would eagerly accept it as it was. After all, a guideline on a major topic would guarantee several hundred citations.

This reminded me of another story. After Tchaikovsky had completed his Piano Concerto No. 1 in 1875, he showed it to the pianist Nikolai Rubinstein, hoping that he would perform the work at concert. Rubinstein listened as Tchaikovsky played the piano part. He remained silent throughout the performance. When Tchaikovsky finally finished and asked for his opinion, he stated that the work was vulgar, unplayable and should be largely rewritten. “I shall not alter a single note,” the angry Tchaikovsky answered. “I shall publish the work exactly as it is!” And he did. (Interestingly, Tchaikovsky actually revised the work in 1879 and again in 1888. This later also became Rubinstein’s favorite piece and one of the world’s most popular piano concerti.)

But medical science is different from art. I look forward to reading the final version of the guideline.

P.S. According to the Six Links Rule, any person can be linked to any other person on this planet through a chain of no more than six different people. Amazingly, as the story unfolds, I actually know the chairman, handling editor and both reviewers personally. It is a small world after all!

8 Mar 2012

A minor

More about Sonata No 8.

The Sonata in A minor was the first of Mozart’s only two piano sonatas in minor key. It was written at a time of great emotional turmoil. The composer left his comfortable job in Mannheim for the first time and took up unstable freelance work. That was compounded by the recent death of his mother and his affair with Aloysia Weber.

When you want to understand a person, you’d better watch what he does at difficult times.

Mozart was an expert in expressing a wide range of emotions in a single piece. Though the Sonata was deeply melancholy, one could hardly ignore the interception by passages of playfulness. Similarly, the second movement was expressive and romantic, only interrupted by a tense and dissonant passage in the middle. The swinging emotions make you feel that the composer was trying hard to pull away from the sadness and bitterness, as if it did not matter; as if it had not occurred.

This contrasts sharply from Beethoven. When Beethoven became increasingly deaf, he wrote the Symphony No 5 in C minor. The four-note motif at the beginning of the Symphony was one of the most well-known phrases in music. As the composer later revealed, “Thus Fate knocks at the door!” The four-note motif would appear in many different forms throughout the entire Symphony.

So, what was the Symphony about? Was it about the cruelty of Fate and the hardship of Life? Yes and no. To Beethoven, C minor was his special key. He always portrayed himself as the Hero whenever he wrote in C minor. The Symphony, for instance, finished with the triumphant fourth movement. The greatness of Man conquered Fate.

1 Mar 2012


- 蘇軾〈題沉君琴〉

Lately, I have become a one-handed pianist.

When Jonathan is sleeping, I have to keep quiet. When he is awake, Angela would not let me play. “Aren’t you going to take care of your son?”

So, I decided to carry Jonathan to the piano. My main difficulty, however, was that he wiggled a lot on my laps. To keep him from falling down, I had to hold him with at least one arm.

Today, I played Mozart’s piano sonata No. 8 in A minor. During the most symphonic passage, I could only choose to play either the quick notes by left hand, like the flow of oil as Mozart loved to describe, or the majestic chords by right hand. In the end, it really did not matter. Though I could only play a fragment of the great piece, music was complete in my heart.

I am never too fond of expensive hi-fis. My sweetest memory was from the days when I only had a rather primitive cassette player. Though the sound was just discernable at best, I played and played the same recording on Tchaikovsky’s Swan Lake, overwhelmed by the elegance and harmony.

If Liszt could insist on performing on an old piano in a small church and Beethoven could conduct his Symphony No. 9 without hearing a single note, the most beautiful music exists in our mind rather than any equipment after all.