Finding true happiness

Looking back at all these years in my twenties, what have I learned about myself and about life?

That life goes on whether you like it or not
‘The trouble is, you think you have time’ – the adult life has become a reality and we are no longer seen as kids. We need to shoulder responsibilities and take all the consequences of our actions – and frankly things are sometimes ugly and there is often no way to reverse a mistake that you have made, a scar that you have inflicted, and the havoc that you have created.

I certainly made a handful of mistakes over the years – big or small, and both consciously and unconsciously. And no matter how much I regret doing it, be it at the moment or soon after it happened, there is hardly anything left but to accept the consequence. it doesn’t take a lot to destroy something important and forgiveness is not always granted. Once something is done, you could only ask for forgiveness, but people would not forget whatever it is done.

Our specialty, unlike majority of my companions, rarely deals with life-and-death situations. Yet working in a team that performs corneal transplants every now and then, you get to receive these gifts from the departed and help transfer them to people who have lost their vision. And one day you’d realize how young some donors were when they left this world, most of the time it happened quite suddenly, but occasionally the pain lingered on and you could never imagine how hard it was for them to be living through that last period of their lives.

I don’t know who is more unfortunate – the one who deceased or the one who lived in darkness hoping for a second chance to see again.

Seeking meaning and happiness
I have the opportunity to meet and talk to some of the smartest, most brilliant and diligent people in the industry over the past few years. And there are a lot of things that I wish I could learn from these people.  And most recently, I have been watching interviews on Youtube of people who are very passionate in what they are doing and how these people have come to that stage in their career.

Discipline –
I think exercise – takes a lot of discipline – especially if you want to do it in the morning, or in summer. You sweat a lot, your feet hurt and you need to constantly fight off your wish to lie in bed for just another 30 minutes. But I have tried jogging once in the early morning- and before that I was jogging nightly for roughly two months before the rain season came – and then I stopped because of the rain.

You really come to learn more about your weaknesses when there is such a thing that demands a lot of discipline. And when you look back at all those years, you realize how not disciplined you were in almost everything you did in your life. that’s a big realization and I guess it’s also a good motivation for you to really change.

Turning to almost 29 in slightly more than a month’s time, I still can’t get away from the thought I haven’t completed growing yet – what I mean is, I haven’t completed my evolution yet, like a Pokémon I guess. there are so many things that I haven’t learned, that I haven’t achieved, or just tried. And before I feel right with my progress, I find it very hard for me to embark on something, or someone else.

Back to discipline – I think there are several things that perhaps I should start to change in my life, like waking up early, going to bed early, doing exercise regularly, and hopefully in the morning, eating healthy, and that’s it. What’s more important than keeping oneself healthy and in shape?

If you know me for a long time, I suppose you know I have never been a big fan of any sports – not even a spectator of any kind of sports games. But I have had a period of time in the past year where I would go jog for at least 3 kilometres every night – and what drove me to do that was my perception that my health was below average of my peers. And I also had this fear that if my health became an issue, my work would then be affected and all these efforts put to training would go to waste.

Ultimately, we come to this world as individuals – and as individuals, we should learn to be independent and not reliant on somebody else for happiness or convenience. Now that I’m approaching my next decade, I hope to see some of these changes happen in the coming years. I’m positive that these changes will bring a lot more benefits than simply worrying about everything, or entertaining all these ‘what if’ thoughts that are harboured somewhere in my crowded mind.

 

Chilly November!

IMG_0346.JPG

不經不覺又到了十一月!

萬聖節過後,氣溫乍暖還寒,出門口都係最好帶定件風褸穩陣D!

HKU Medical Alumni Association 今年推出左呢件風褸,送俾所有校友會嘅會員,假若你係剛剛畢業嘅朋友,記得趁住我地校友會推廣期間,以優惠價(半價)加入成為我地嘅永久會員啦!

與此同時,亦請大家留意校友會來年嘅Young Alumni 活動,多多支持啊!

The one with two pupils

One morning post-call, I was in the ward reviewing some of the patients I admitted the night before. And after I finished my duty, I ran into two medical students examining one of our patients by her bedside.

Driven by curiosity, I approached them and introduced myself, and they told me they were in their final year of med school. I didn’t ask for their names, because that’s not my intention to walk up to them in the first place.

I asked if I could see how they would examine our patient. And one of the girls proceeded, and tried to demonstrate the abnormal pupil reflex that they probably knew from reading off the charts.

But apparently they failed to show everybody the sign that they wanted to. And I asked them,

‘What are you trying to show us’

‘mm.. a Marcus Gunn pupil?’

‘so, what does it mean if there is a Marcus Gunn pupil?’

‘it means…mm the vision is bad?’

‘do you know how bad was her vision on the right side?’

‘….hmm she’s lost her sensation to light?’

‘very good, so how do we grade this sort of vision using appropriate medical gradings, i.e. using Snellen charts’

She thought to herself for a while, and eventually she uttered..

‘ zero over twenty..? ‘

I said, ‘No, there’s no such thing as 0/20 on the Snellen chart. it’s in fact something much simpler, that is…?’

‘hmm sorry I don’t know?’

The other girl also remained silent

‘it’s No Light Perception or NLP, some people use NPL, or no perception to light’

The conversation moved on to the reflex pathway, I asked

‘ Why does the pupil constrict when you shine light onto it ?’

‘ It involves a pathway that travels from the eye ….all the way to the occipital lobe..?’

‘ Is that where you think the reflex arc reaches? the occipital lobe?’

‘…hmm I don’t know..’ She smiled, in embarrassment

‘ So do you expect to see pupils that constrict in a patient with stroke in occipital lobe?’

‘ Yea! ‘

‘ So if the reflex arc traverses the occipital lobe, would you expect the reflex to be present?

‘ No! ‘

‘ So, again I ask you, do you think that reflex pathway travels across the occipital lobe?’

‘ No! ‘

‘ Good!’

There are still many more questions that we go over, and it’s all the basic stuff. And I was even told that a Marcus Gunn pupil would suggest a second nerve palsy, which is not a right nomenclature that I would expect to hear in describing dysfunction of a pure sensory nerve. What do all of these findings reflect about our current medical education?

(And let’s NOT take into account that this is only but ONE single sample, and that there’s bias, and these are NOT ultimate truth but only personal opinions.)

I. We follow our teacher and follow what they do, without first knowing why and how. 

It’s not uncommon to see that no matter what we do in life, we are constantly being fed a lot of information. As medical students and doctors alike, we face endless examinations and sometimes we would have this feeling that ‘I’ve already known enough’, but that, unfortunately, is only the most superficial layer that covers up a deep deep well of knowledge. There’s no limit to the boundary of knowledge, but we should keep reminding ourselves, let’s understand what our capacity allows us to, and minimize our reliance of meaningless regurgitation that can be unreliable at times.

 

II. Without knowing why, we can’t achieve what we want to achieve.

This happened when the ladies failed to show us the Marcus Gunn pupil, because they were doing this test right in front of the patient’s face, hence activating another stimulus-driven response – the accommodative reflex. Without the knowledge of an accommodative reflex, and by standing right in front of the patient, it’ll only make it harder for them to detect an abnormal pupil response to the light stimulus. And if this happens in the examination setting, it’ll lead to an entirely different, and incorrect diagnosis.

III. We think we can regurgitate, but the fact is, our memory is not reliable all the time.

Knowing how things work might involve reading an extra two-pages from a textbook somewhere on the shelf, or nowadays on the wikipedia links, it certainly takes more time (in reading) and effort (again, in reading), but knowing a full story helped me reduce my reliance on short-term memory, which failed me so many times in the past.

IV. These students have been smart and scoring high grades all their lives, and been spending hours in the library studying, studying, studying and studying. They’re sacrificing their pastime, their fun, and been reading about medicine for so long, and yet, the fundamentals are missing. Calling dysfunction of a sensory nerve a palsy, reflects that fact that the right meaning of palsy has never been truly understood in the first place. And not knowing why the third nerve can develop palsy but not the second nerve, is a lack of knowledge in identifying that the third nerve is a MOTOR nerve that innervates muscle (carrying efferent impulses), and that the second nerve is a PURE SENSORY nerve that transmits afferent signals from the end organ towards the brain. These are the fundamentals, yet it’s not the first time I’ve come across students having troubles in these fundamental ideas.

On one hand, we are asking our students to study top of the notch, frontier research science topics, but on the other hand, they are not fully understanding even the most basic. Are we pushing too much advanced stuff and pushing too hard on our students? Or have we not put enough emphasis on the fundamentals?

Should we really expect our students to read the fundamentals by themselves and teach their the advanced stuff? Or should we teach the fundamentals and let them explore what lies in the frontiers when they eventually get there?

This is perhaps two schools of thoughts, and embracing two different kinds of philosophy. I’m more pro- for the second mode of learning, what are your thoughts?

And at the last bit, it is always a good reminder to myself – dig deeper, work harder!

awl-solo-thresholds blooms_cognitive_domain

 

知識傳下去了,但教育呢?

讀了這麼多年的書, 考了這麼多次的試,卻到了二O一四年的四月今天晚上聽了一場TED Talk之後,才忽然明白了…

 

﹣何謂教育。

education

 

本港的教育制度不完善,乃師奶老師學生專業人士N無人士人所共知的事實。公開考試的歷史,造就了「成王敗寇」最血淋淋最寫實的一面,十優狀元被捧到上頭條,中大港大科大爭崩頭零學費卑躬屈膝地招收;考零分的呢,一句報導了總人數達某某某也就如此呢,夾在中間的,要嗎憑自己努力兼父母的前半生供養荷包的努力,拼了IVE再拼副學士,要嗎就默默地走進一科自己毫無興趣毫無認識的學科裡去,再不然叫爸媽找一個海外只要有名字的大學,然後就當起一個「大學生」來了。

 

在香港功利的社會風氣之下,一個行業能否賺錢往往左右了入學的選擇,這是無可厚非的。許多大學生進大學,為的只是一張沙紙,出來行走江湖找份人工起點高些少的,已經劏雞還神。對本科有否興趣這回事,倒是很少在本地大學生口中聽見。

 

不單是成績平平的一輩無心求學,就連這群得著考試名列前茅的「王者」,亦不見得都自己選擇的學科表現出濃厚的興趣。他們在意的是在考試中拿到最好的成績,他們在意的是為了自己將來有一份相對穩定的收入,而作出今日的投資。別怪他們,他們也是被我們這個教育制度訓練出來,歷年戰績最優秀的戰士;還有我們資本社會利益掛帥的口號,潛移默化了這一脫腦袋靈敏的人。

 

他們當中,有人就是因為懂得考試,精於考試,所以早早就懂得各處張羅歷屆試題答案,什麼雞精啦、model answer/tutor guide啦、上年師兄師姐的答案啦等等諸如此類的,心想「反正當年會考/高考,我就是這麼熬過來的!」然後繼續肆無忌怛地維持以往中學年代一貫的習慣:被編要上沒那麼有名氣的tutor的堂的時候就毫不客氣地擅自離席,反而爭奪班上其它被編去上名教授的課的課室裡 (請問這裡是大學抑或是補習社?);雞精書、舊試題第一時間務必要到手,什至收歸己有絕不分享(知識這回事,能到你阻止別人嗎?);Tutor Guide 背好了然後在小組討論狂風掃落葉式搶答導師的提問,甚至乎無理取鬧說:「Tutor都不懂的教呢,明明就應該要怎樣怎樣問,根本不依Tutor Guide問的,氣死我了,還讓我背了一整晚!」

 

這些人,可能曾經有你的影子,又或者是你身邊的人,但這些都已經過去了,不重要了。最重要的是﹣

 

 

﹣這就是你期待的教育嗎?

 

 

聽罷人家TED Talk 邀請了發明手術機器人 ‘ DaVinci ‘ 的女醫生兼工程師,短短十八分鐘的分享,感動得很。聽罷她帶領我們由人類起源最早期手術的歷史,到了麻醉藥的發明,再進一步到了術前消毒,大傷口剖腹手術到如今微創,再進化為機械人手術、單一傷口手術 (Single Port ) ,她說得對,她的隊伍、她的發明正正在改變外科手術的風景。她的前景很厲害,她在總結裡說:「人人總會經歷生病的時候,生病能帶給人們一個重生審視自己生命的一個好好的機會,我不奢望亦不願意去剝削你們這個機會,只希望能夠在接受手術之後仍保持健康、完整,然後再去為這個世界帶來更多的啟發!」(原文: And the prospect I’m offering you, of an easier surgery … is that going to make that diagnosis any less terrifying? I’m not sure I really even want it to. Because facing your own mortality causes a re-evaluation of priorities, and a realignment of what your goals are in life, unlike anything else. And I would never want to deprive you of that epiphany. What I want instead, is for you to be whole, intact,and functional enough to go out and save the world, after you’ve decided you need to do it. And that is my vision for your future.)

 

 

試問問周邊的醫學生,又會有多少人知道醫學洪流裡這麼重要的歷史,盤尼西林的發現又會有多少今時今日的醫學生有興趣知道的呢?或會還有人會舉手問(更多只有竊竊私語然後抱怨):這個…要考的嗎?

又會有多少人寧願選擇去背誦了「Advantages & disadvantages of Robotic Surgery」裡第一到二十項,而非真真正正知道當初背後的理念?

 

 

 

為什麼外國的教育在中小學階段,並沒有刻意鼓吹追求更艱深更繁多的作業,而最終這群人能夠在各個領域中脫穎而出?

為什麼我們常聽到說如今的老師們只要求知識的傳遞 (把要考的範圍以內的知識,能塞的都塞到學生的腦袋裡去!),而卻起不了教育當中啓發思考,啓發興趣的作用呢?

有時候甚至乎聽過有些老師連把自己知識都傳達不下去,一心只想著這群學生背後都有外出補習,便連當老師最基本的功能都廢掉了,那麼試問學生又該如何再從這師生關係當中繼續得益呢?

香港的語文老師,一次的基準試,通通打跨了,英文的、普通話的、肥佬了的呢,竟然跑去投訴考試太難? 倒不如「賴地硬」?這也實在是太不要臉了吧!試問一群學生看在眼裡,便有樣學樣,學校裡考試不及格,噢!這考試太難了吧! 然後一班愛仔女如命的家長們,又會替子女出頭說:「不公平,重考!不公平,重考!」如此惡性循環底下,負責教的則更垂頭喪氣,負責學習的卻大有藉口不學也罷,家長只會心疼子女讀書辛苦卻又不會想想學習一回事究竟最終得益的又會是誰?

 

 

香港的教育前景? 我看還容不下我的一點樂觀呢。

 

 

 

 

 

獨處的時候

攤在自己的心上
攤在自己的……

獨處的時候 夜容易特別黑
獨處的時候 心容易悄悄破碎

冷冷的手發抖 熱熱的淚墜落
獨處的時候 好想有誰能出現

獨處的時候 像跌進了深淵
獨處的時候 想拆穿全世界的謊言

時間不肯快走 細節不停穿梭
獨處的時候 好怕有誰會出現

啦啦啦 髒髒地收我的愛
讓自己慷慨的痛太不堪
拖著傷口飛越了桑田滄海
剩自己慢慢地還

啦啦啦 長長地嘆我的愛
沒有人願意丟下你不管
若世界說穿了只剩下春去秋來
擁有再多也會太難耐

啦啦啦 髒髒地收我的愛
讓自己慷慨的痛太不堪
拖著傷口飛越了桑田滄海
剩自己慢慢地還

啦啦啦 長長地嘆我的愛
沒有人願意丟下你不管
若世界說穿了只剩下噓寒問暖
擁有再多也會太難耐

獨處的時候 夜特別容易黑
獨處的時候 心特別容易崩潰

獨處的時候 儘管所有情緒都逃逃逃不開
獨處的時候 還是要勉強自己想得開

不一樣的中秋

中秋回父母家吃飯,到家樓下已過晚上七點,花園裡的中秋晚會剛剛開始,人潮擠滿了一地。天空仍是一片紫藍,黑幕還未完全垂下,羅馬廣場就早已化身為大舞台,台上的大叔大嬸雀躍地拿着咪高峰邊放着喉嚨唱着五音全、難以辨認的曲子,台下的鄉里街坊有些像看傻了眼目定口呆,有些卻陶醉其中自得其樂。路縛上三五成群的朋友聚在一起,有人自備了小几子,有人索性席地而坐,有人還帶了幾個月餅,歡笑聲此起彼落。偶爾傳來誰家小孩追逐之間的尖叫聲,別過頭去找,卻發現實在有太多的小孩子,刻意尋找卻只會是徒然。興奮的聲音來自四面八方,我站在人羣當中,像是被海浪重重包圍了,這些熟悉的影像和聲音,好像年年都是一個模樣,但今年這個中秋,我卻發現缺少了些甚麼…