At the Department Research Day last Saturday, KL mentioned Good to Great by Jim Collins. He described great leader as one who builds a team rather than oneself.
Coincidentally, I read Excellence Without a Soul: Does Liberal Education Have a Future? by Harry R Lewis not long ago. In one chapter, Lewis explained why professors do not like teaching. Universities select them that way. Nowadays, universities focus so much on research output that they hire their staff based almost solely on their research track record. Along the same line, research performance is the main determinant of contract renewal and promotion, whereas the assessment of teaching performance is often reduced to a single average student evaluation score and scarcely discussed. According to Lewis, we should not ask why professors do not like teaching. Rather, we should ask why there are still professors who care about teaching. Using the same argument, we would not be surprised if professors only want to build their own fame (or in the jargon of the university administration, international reputation) through research.
When we look around the department, however, we can only be amazed at the number of people who care to teach and care to build the next generation. Many are even young academics who are themselves struggling. This is almost suicidal, but it is lovely to be surrounded by good people.
7 Mar 2013
28 Feb 2013
Debt
A while ago, GW asked me to sign on a pile of bills.
As I duly complied, I asked, “I am happy to pay, but listen. Your account has zero dollars. Mine has minus xx(*) dollars. Even my seven-year old daughter can tell I am poorer than you.”
“The university people say that you have earned money before and I haven’t. Therefore, they have more confidence in your ability to settle the sum.”
I began to understand the national debts.
* Omitted to protect the account holder.
As I duly complied, I asked, “I am happy to pay, but listen. Your account has zero dollars. Mine has minus xx(*) dollars. Even my seven-year old daughter can tell I am poorer than you.”
“The university people say that you have earned money before and I haven’t. Therefore, they have more confidence in your ability to settle the sum.”
I began to understand the national debts.
* Omitted to protect the account holder.
21 Feb 2013
Premium
At the final year medical students’ farewell party, JW told us a story.
A middle-age man attended the emergency department of a local hospital complaining of fever, jaundice and upper abdominal pain. Blood tests showed obstructive jaundice and high white cell count. The emergency doctor diagnosed common cold and sent the man away.
The man did not feel right and decided to seek second opinion at a hospital in Shenzhen. Magnetic resonance cholangiopancreatogram was performed on the same day and showed a small stone in the bile duct. The diagnosis of acute cholangitis was made. Eventually, the man was admitted under our team, and the cholangitis was successfully treated by endoscopy.
During morning round one day, the man talked about his experience. He did not really complain, but he could not help mentioning that he only spent RMB200 for the scan and was very satisfied with the service.
JW remarked that doctors in Hong Kong had been charging a premium of 5 to 20 times by claiming to deliver better service. He questioned if the performance of future doctors could still justify the premium. He anticipated keen competition from mainland 10 to 20 years later, but it appeared that the time had already come silently.
I rarely link money with medicine, but this is one of the few occasions in which I hope our students are worth the premium.
A middle-age man attended the emergency department of a local hospital complaining of fever, jaundice and upper abdominal pain. Blood tests showed obstructive jaundice and high white cell count. The emergency doctor diagnosed common cold and sent the man away.
The man did not feel right and decided to seek second opinion at a hospital in Shenzhen. Magnetic resonance cholangiopancreatogram was performed on the same day and showed a small stone in the bile duct. The diagnosis of acute cholangitis was made. Eventually, the man was admitted under our team, and the cholangitis was successfully treated by endoscopy.
During morning round one day, the man talked about his experience. He did not really complain, but he could not help mentioning that he only spent RMB200 for the scan and was very satisfied with the service.
JW remarked that doctors in Hong Kong had been charging a premium of 5 to 20 times by claiming to deliver better service. He questioned if the performance of future doctors could still justify the premium. He anticipated keen competition from mainland 10 to 20 years later, but it appeared that the time had already come silently.
I rarely link money with medicine, but this is one of the few occasions in which I hope our students are worth the premium.
14 Feb 2013
Proud
Recently, my friend TW was admitted to the hospital for chest infection. For a fit young man, that was quite an experience. It was so overwhelming that he reflected on his life and made the bold decision to buy an apartment to please his wife.
Lying in bed and overcome by myalgia, he also made some interesting observations. He noticed that some nurses were in traditional uniforms. They wore dresses and caps. The attire originated from that of nuns, who used to be the ones taking care of the sick in the past. In fact, we still call senior nurses ‘sisters’. Nowadays, some other nurses dress in tunics and trousers. TW remarked that the nurses in traditional uniforms were more caring and professional. He asked me for an explanation.
I answered that there were several possible explanations. First, the ones in trousers might not be nurses. There are different types of healthcare workers in the hospital. Second, the observation could be biased due to sampling variability and/or prejudice of the observer.
“Suppose your observation is correct,” I continued, “there is one more possibility. The nurses who continued to dress in traditional uniforms might be more proud of their job. This may have affected how they treat their patients.”
Outfit is of course trivial. The important thing is whether we are proud of what we are doing. Another day to declare myself a proud husband and father.
Lying in bed and overcome by myalgia, he also made some interesting observations. He noticed that some nurses were in traditional uniforms. They wore dresses and caps. The attire originated from that of nuns, who used to be the ones taking care of the sick in the past. In fact, we still call senior nurses ‘sisters’. Nowadays, some other nurses dress in tunics and trousers. TW remarked that the nurses in traditional uniforms were more caring and professional. He asked me for an explanation.
I answered that there were several possible explanations. First, the ones in trousers might not be nurses. There are different types of healthcare workers in the hospital. Second, the observation could be biased due to sampling variability and/or prejudice of the observer.
“Suppose your observation is correct,” I continued, “there is one more possibility. The nurses who continued to dress in traditional uniforms might be more proud of their job. This may have affected how they treat their patients.”
Outfit is of course trivial. The important thing is whether we are proud of what we are doing. Another day to declare myself a proud husband and father.
7 Feb 2013
Flag
Last month, I opened my drawer to get a certificate for photocopy. Something deep inside caught my eyes. I have forgotten it for a decade.
Then was the time of my basic training. I had just diagnosed liver cancer in an old gentleman and held a family meeting to discuss the condition. Yes, there were various treatment options, but no, the outlook was poor. His age and liver function would preclude him from most invasive treatments. The family was most understanding.
A few weeks later, the gentleman called me and asked where I was. When we finally met, he presented me with a flag, the kind you get if you win a race. It was crimson red, almost 3-foot long and bore my name and his praise. I told him I really did not do much. He just told me that if I continued what I was doing, he was sure I would do great things.
I have to confess that I did not put up the flag in the ward. It just did not seem right to take credit for what was supposed to be teamwork. At the same time, I also feared that the gentleman would find out and I might hurt his feelings. In any case, the flag ended up in my drawer and I soon forgot the whole thing.
When I looked at the flag again after all these years, I could no longer remember what the gentleman looked like. What I could vividly remember, however, were his earnest eyes, full of expectation, almost flashing with excitement. I may have forgotten the flag, but the blessings from my patients were always in me. I wish he is proud.
Then was the time of my basic training. I had just diagnosed liver cancer in an old gentleman and held a family meeting to discuss the condition. Yes, there were various treatment options, but no, the outlook was poor. His age and liver function would preclude him from most invasive treatments. The family was most understanding.
A few weeks later, the gentleman called me and asked where I was. When we finally met, he presented me with a flag, the kind you get if you win a race. It was crimson red, almost 3-foot long and bore my name and his praise. I told him I really did not do much. He just told me that if I continued what I was doing, he was sure I would do great things.
I have to confess that I did not put up the flag in the ward. It just did not seem right to take credit for what was supposed to be teamwork. At the same time, I also feared that the gentleman would find out and I might hurt his feelings. In any case, the flag ended up in my drawer and I soon forgot the whole thing.
When I looked at the flag again after all these years, I could no longer remember what the gentleman looked like. What I could vividly remember, however, were his earnest eyes, full of expectation, almost flashing with excitement. I may have forgotten the flag, but the blessings from my patients were always in me. I wish he is proud.
31 Jan 2013
Risk
At recent journal clubs, we discussed 2 articles from the New England Journal of Medicine. The first was a trial on rectal non-steroidal anti-inflammatory drugs to prevent pancreatitis after endoscopic retrograde cholangiopancreatogram (N Engl J Med 2012;366:1414-22). The other tested how aggressive transfusion should be given in patients with acute upper gastrointestinal bleeding (N Engl J Med 2013;368:11-21). Both were multi-center studies involving hundreds of patients.
On both occasions, our Dean remarked how brave the investigators were. “The studies will change clinical practice,” he explained. “However, if the results were negative, the authors would have a hard time publishing their work despite their huge efforts.”
I felt deeply with his remarks, not least because I was the unfortunate investigator he described who invested much resource to produce a negative study last year. We made a bold move to a human trial because of very promising results from our own animal studies. Unfortunately, since the trial results were negative and the compound was new to the field, most journal editors considered the findings irrelevant.
During a meeting in Taiwan, I chatted with WC and mentioned my experience. “Do you think it is foolish to invest one’s time and energy this way? If I used the same study design and chose another compound that other doctors had been using, the results would be important even if they were negative.”
The Singaporean professor kindly advised, “How else can breakthroughs in medicine occur? Keep working, and remember to send me your paper when it is published.”
Under the current climate, it is easy to forget that our primary aim is to contribute to science rather than to have just another big paper. It is lucky to be reminded of what we are doing.
On both occasions, our Dean remarked how brave the investigators were. “The studies will change clinical practice,” he explained. “However, if the results were negative, the authors would have a hard time publishing their work despite their huge efforts.”
I felt deeply with his remarks, not least because I was the unfortunate investigator he described who invested much resource to produce a negative study last year. We made a bold move to a human trial because of very promising results from our own animal studies. Unfortunately, since the trial results were negative and the compound was new to the field, most journal editors considered the findings irrelevant.
During a meeting in Taiwan, I chatted with WC and mentioned my experience. “Do you think it is foolish to invest one’s time and energy this way? If I used the same study design and chose another compound that other doctors had been using, the results would be important even if they were negative.”
The Singaporean professor kindly advised, “How else can breakthroughs in medicine occur? Keep working, and remember to send me your paper when it is published.”
Under the current climate, it is easy to forget that our primary aim is to contribute to science rather than to have just another big paper. It is lucky to be reminded of what we are doing.
24 Jan 2013
Fortune
“I have a job for you,” the boss said.
When I went to the company, they played a CD. It was a 5-minute recording of a Disney parade song. “We have to make a demo to illustrate what we are capable of,” he explained. “The presentation is tomorrow.”
Mozart was said to be able to recite the whole symphony after listening to it only once at a concert. I was no prodigy. I had to listen to the CD for around 20 times, but yes, I could arrange the music. The computer chip was ready the next day.
The American customer was impressed. After this, I got another offer to prepare a Christmas package. The daily wage, to say the least, was double my current pay even before adjustment for inflation.
Whenever I reached this part of the story, the listener would invariably ask why I left the industry. I never really thought about this seriously. Perhaps one important factor is that I gave all my part-time earnings to my mother then, so money meant little to me. With this, I have never been financially competent, but most of my decisions could be dissociated from the money issue.
Another point is I would certainly be out of job if I kept doing the same thing over the years. The simple musical chips have been eliminated by technological advance long ago. You may argue that if I stayed, I would have learned new tricks and survived time and again. This is probably true, but learn we must. At that point, I simply decided it was time to learn something else that was closest to my heart.
When I went to the company, they played a CD. It was a 5-minute recording of a Disney parade song. “We have to make a demo to illustrate what we are capable of,” he explained. “The presentation is tomorrow.”
Mozart was said to be able to recite the whole symphony after listening to it only once at a concert. I was no prodigy. I had to listen to the CD for around 20 times, but yes, I could arrange the music. The computer chip was ready the next day.
The American customer was impressed. After this, I got another offer to prepare a Christmas package. The daily wage, to say the least, was double my current pay even before adjustment for inflation.
Whenever I reached this part of the story, the listener would invariably ask why I left the industry. I never really thought about this seriously. Perhaps one important factor is that I gave all my part-time earnings to my mother then, so money meant little to me. With this, I have never been financially competent, but most of my decisions could be dissociated from the money issue.
Another point is I would certainly be out of job if I kept doing the same thing over the years. The simple musical chips have been eliminated by technological advance long ago. You may argue that if I stayed, I would have learned new tricks and survived time and again. This is probably true, but learn we must. At that point, I simply decided it was time to learn something else that was closest to my heart.
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