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In Houston.

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A garden-in-progress near my place

I think I’ve been away from North America for way too long. The brief exchanges with strangers and the helpfulness of the hospital staff in the past few days have begun to melt my heart. No longer do I have to fight for what I need – the right of way when walking on the road, the courtesy and friendliness when asking for directions, or simply taking too much time to pick out my American currencies. No more yelling, or conversations that turns into a scolding by middle-aged people, or incessant car horns on the street.

I simply have been far away for too long. But I have to say, I am still very receptive to big American breakfast. After all, the Founding Fathers fought the war so that people have the Freedom, freedom of speech and religion; freedom from persecutions and fear; freedom to high blood pressure, hyperlipidemia, and Type 2 Diabetes.

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Posted by on April 2, 2014 in Uncategorized

 

煩惱, 煩惱

Certainly much culture shock working at a Chinese hospital – though I have to say I enjoy the patient interaction. My patients generally enjoy my presence and work rate (have been at the hospital for twenty-one consecutive days now, with several over-day-and-night shifts), especially when I am not poking and draining some surgical wounds.

Quite a dilemma today, altogether with culture shock. I need to think this through.

 
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Posted by on January 26, 2014 in Culture Shock, School, Shanghai, Thoughts

 

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Colourless Tsukuru and His Years of Pilgrimage.

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從村上生日的那天--作家,而不是村上貓,雖然我仍未排除牠是一名作家,或壽司師傅--開始想讀《沒有色彩的多崎作和他的巡禮之年》,但在醫院內一整天值班工作(早上七時到次日上午巡房以後),到了凌晨以後才有機會翻開書本,但工作下來結果也只讀了十一頁。

後來幾天的人生時間較充裕,終於今天讀完了《多崎作》。

非常洗練而且真誠的一本小說,雖然性質上跟《After Dark》很接近,但沒有那種老人家說教的語氣,也沒有《1Q84》的(有時候)過分華麗的描述。自己畢竟只是村上的 longitudinal reader,沒有文學比較的能力。

故事主人公多崎作中學時跟四名同學組成完美不過的五人組,卻在他單獨到東京上大學第二年,「叭」的一聲莫名其妙被割離了。直至十六年以後的今天,在女朋友的鼓勵下,回去找他這四位朋友,為了補充內心缺乏的某種東西。

基本上沒有村上小說常見的二元世界,只是寫我們這邊的世界,我們正常人也 可能遇到的經驗,雖然是戲劇化的人生。每一次讀村上的新書都會覺得他更洗練,今次亦然。寫的是三十多嵗的角色,主角及思想有一定的成熟度,但也保持著年輕 的筆觸,也不是老鼠年輕的放任。故事構想得有蒼桑失落的感覺,但對於失去的友情,其後十六年的沉澱和找尋的過情,讓人覺得故事若不是這樣編絕對不會有如此 的效果。

而且,如果圍繞的不是友情,也不會有這樣的效果。相信每個人在中學成長時期都有影響人生的朋友,或至少把尷尬的成長階段變得更好過,讀到小說內的五人組引起自己的妒忌,雖然他們之後的經歷,卻又令自己慶幸有的是穩定少數的摰友。

但 《多崎作》寫的就是這種 if and only if 的邏輯,寫的若是愛情,分隔十六年後重建的也只能是另一次戀愛,不能像多崎作抽絲剝繭般找尋四名朋友。較接近的也許是親情,但那不一定有這麼樣的謎團,角 色也不是同學同輩同出發點的平衡光線,通過三棱鏡後折出來的色彩。

若只是三、五年後的重逢,大家也沒有足夠到成長;如果等到中年再解決這 個問題,找尋只會是念舊,不會是建立更新的故事。就因為是如斯的 if and only if,村上也真的更洗練,少用了誇張的描述或幽默,故事顯得更真誠。雖然書中隨便遇到的人(芬蘭人)都會發出饒有哲學性的對話(為什麼我人生從來未遇到 過?),有點兀突,但也就是讀村上的一種親切感。

這本書就像村上故事中常見的中壯年男人,沒有一點贅肉,是每天到游泳池標準地練習,晚上吃沙拉及啤酒或一手指的威士忌的角色。

自己人生也經歷過某種失落,也想尋求這種沉澱後的 closure(想不到適合的用詞),但我還沒有足夠的時間去沉澱,而將來的哪一天也沒有這個機會。所以才期盼可能在哪裡的天國。

在哪裡的時間。

 
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Posted by on January 19, 2014 in Books, Thoughts

 

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Once again, proof that Communism is the best system in the world.

The Chinese communism system is so very amazing; it breeds better consumerists and capitalists than the Americans!

The BBC has a short blog piece stating how China is another Number One! Chinese people top the list of measuring success by the things they own. At a whopping 71%, it is more than double the global average, and the second-placed India doesn’t even come close at 58%.

Yeah, take that American Imperialists! American Imperialists with malignant Capitalist agendas!!!!!@!! Communism with the best capitalists and consumerists in the world!

Here is the original press release from Ipsos, a global marketing research firm. And the table (I measure success by the things I own) is here:

source: Ipsos, 2013

While on a similar topic, here is one of my favourite pictures on the internet, from the BBC no less. The BBC keeps publishing this map whenever it mentions water dispute in the south.

The hilarity of the red line doesn’t need much explanation. “Your eraser is touching my side of the desk, Brunei!”

 
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Posted by on December 19, 2013 in Culture Shock, Shanghai, Thoughts

 

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Start of another year.

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It is now another year, eh? Nothing feels so near yet far concurrently. In time it is getting further, but the feelings and reflections remain and continue to grow. No, I would be lying to admit that the feelings are always close or near hand; but the proximity of the feelings, whenever they emerge, is always painfully acute and heighten my senses. Its being both near and far; the paradox of proximity and distance is inexplicable yet true. The other day I tried to explain to a friend the idea of the Holy Trinity, that it is both Three and One at the same time; I guess it can only be as confusing. What’s life except for series of paradox and contradictions that often befuddles logic, yet remains true to the heart? Logic is extremely important, but we are limited by our existence and the course of human history is rarely rested on logic. (If that was true, there would be a lot less conflict in the world, no?)

The thought and episodic memory has faded to the far regions of my thoughts, but nothing feels as vivid or as enabling in the realm of the living. Enabling is not the correct word either; but the awareness has yanked and pushed me to the forefront of appreciating and valuing life – our current state of non-mortality, the suffering and contribution of life, and being (becoming?) that is captured by Caro Emerald, of “love, lust, and paradise.”

What a beautiful combination; we are all human, mind and body.

Here is what happened to me last year. I watched “the Man without a Past.” It is the sort of movie that I would recommend to you, and probably bug/force you enough to watch it; and you would give me the nonchalant response of “cool beanz” or something like that. You never age, that is probably the language that I will continue to associate you with.

I just realized how little we wrote to each other. No, I am not bemoaning not the quality or length of our communication; but the medium. Our medium that was mostly living together, phone calls, or instant messaging when MSN was still the mainstay. Correspondence in lengthy and well though-out letters would be nice, no? I find it wonderful in how much we both read and write, considering that our household and extended families are never avid readers. It was never planned nor laid out, but we coincide in our propensity for language and both love language not as a means, but often as ends (though I would still rank philosophy higher.)

I also set foot on the old country this past year. I was in the Czech Republic, and would’ve bought you souvenirs no less – they have a cute little mole, Krtek, which has been a product under communist rule now turned consumerist-souvenirist. It was interesting to visit a place that has impressed me so much, and the Czech people continue to amaze me – not their development or technology or ease of access, but the resilience of their people and certain humour, or perhaps routine and normal things that to me becomes an oddity. In the past I mentioned that if I did not visit Europe before thirty I might commit suicide – at least I don’t have to uphold that statement now.

It is easier to write well a research essay than writing something close to one’s heart. When I try to write what is closest to me, in me, I always am at a loss for words, that I am not articulate enough, my word choices are horrible and they do not completely express what I think. But if you read this, you will probably understand what I mean, or at least what I have meant to say.

We should write more. We could write more.

 
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Posted by on November 23, 2013 in Thoughts

 

Van Gogh’s Farmhouse in Provence, 1888.

You won’t begin to know how much seeing and picking up the letter meant to me. Or how my eyes well up without even know what the envelop contains.

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Posted by on November 22, 2013 in Shanghai, Thoughts

 

Respectable medical advertisement…. not.

This has probably lost its significance because of its age. I attended GASTRO 2013, a medical congress focusing on the digestive system, in September. “Focus” isn’t particularly a good word, since it was a huge congress with numerous subspecialties. There were 1700+ poster sessions, and this congress is not about posters.

Anyway, what I meant to talk about isn’t the congress nor any of its contents, but it’s weighty program. It is a 200-plus-paged behemoth handed out along with the bag, nametag, sponsor stationery, and advertising booklets.

I briefly flipped through the program on the first day, first having a look at the introductions – the who’s-who in the expert world and the sponsors of the congress.

Not counting the acknowledgement (sponsor) list, the first ad that appears in the program was this:

gastro ad

How disappointing. It is almost like watching a Martin Scorsese movie that features a mafia-subplot directed by Michael Bay 5 minutes into the movie.

Yes, some whatever medical equipment that has a “long life pump,” “manufactory by Wellcare.” I am almost disappointed that it wasn’t distributoried either. And the elephant in the room ad – the “nurse” that poses closer to an adult-movie star than medical professional. I wouldn’t be surprised if it is actually a screengrab from porn or related posters.

gastro ad distributory

Professionalism much? Or just professionalism with Chinese characteristics?

Or perhaps, the company is the biggest winner with such insightful marketing towards middle-aged Chinese men; and I am just a sore loser complaining to no one.

That being said, GASTRO 2013 is an amazing congress with great content and I learned a lot from it as a small potato medical student.

 
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Posted by on November 20, 2013 in Culture Shock, Shanghai

 

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Just an ordinary day in China.

There is a bike rack that I walk by on the way to school everyday, but there was something a little different today.

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So I walked closer….

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and closer….

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Nope, just an ordinary day in Shanghai on the campus of one of the best-equipped medical centres in the country. Nothing to see here, move along….

But the achingly red underpants with good fortune Chinese characters after a few days.

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I guess I meant “ordinary days in China”

 
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Posted by on November 7, 2013 in Culture Shock, Shanghai

 

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Bell Chimes

Castle tower at Cesky Krumlov

Offender #1: Castle tower at Cesky Krumlov

I have a pet peeve about the bells about the school bell at my lecture hall. (Yes, if you can get past the idea of having a bell at a university; our classes are organized on a 40-minute duration with 10-minute breaks in between.)

The bell here is a digitized (midi?) version of the bells from a grandfather clock – which is precisely where my pet peeve comes in.

We used to have a grandfather clock – made in West Germany – at home. In the beginning, it was eerie living with a clock that, from my young recollection, only existed in horror movies striking midnight. For the first few months, I would wake up in the middle of the night feeling scared, partly because that period also coincide with my immigration to Canada and enjoying (suffering?) a large room all by myself. The chimes of the clock would permeate into all corners of our house, though hopefully I did not derive any nightmares from it.

Nonetheless, I grew to love the grandfather clock. Its lovely chimes every quarter-hour, the telling of the hour, and the tick-tocks that became the background music in the house. However, the clock is now sold to a family friend, and I still miss the beautiful craftsmanship or gears and chimes that accompanied me for part of my formative years.

Perhaps it was such my endearment to a grandfather clock that predisposes my dislike for the current bells from my school.

Firstly, it is a midi-synthetic tone of a grandfather clock. From the warm, organic voice of a clock, which could also foreshadow death in horror movies; it became a tonal arrangement of the mundane and bored. This I can still accept; it is just a tune broadcast over the PA system, not a state-of-the-art acoustic system.

But what drives me nuts is this: the tune broadcast is always the hourly chime, regardless of the time of the hour, and whether it is at the beginning or the end of class.

Part of the beauty of living with a grandfather clock is the anticipation of the hour. That it chimes every fifteen minutes, starting from the shortest and simplest tune at the first quarter, adding subsequently, and ending with a flourish at the top of the hour with a number of chimes representing the hour of the day.

The clock became a background furniture in the house, it carried on in the background often without my noticing. But once in a while I would hear the start of the grinding gears, and I would peel my ear for it, listening for the time through the music.

It is the idea that the tune represents something, however humble, but that is ignored and transformed into a bastardized tool used at my classroom. Such is my angst, and peeve about the sound.

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Offender tower #2: church tower

One of my most pleasant experience with time and clock chimes was in Cesky Krumlov, a small town two-hours away from Prague. We explored the idyllic town in the middle of winter, whilst also complaining that my Canadian Olympic mittens weren’t warm enough.

And I heard it, a chime from the local church tower, ringing, chiming, telling the time. The chimes were not particularly beautiful nor impressive, but it filled and permeated the air. At that moment I imagined locals and tourist alike, all pausing for a few seconds and shared the communal time. The thought that came to my mind was, “it would be pretty nice to live in a town with a permanent clock tower.”

However, I was proven wrong, for a few minutes later there was another chime from another clock tower. I could not enjoy the chime or the atmosphere from that time piece; for at least one of the clock towers have the wrong time. I crosschecked with my watch (recently synchronized with the CBC radio time signal), and realized that both were off by minutes. And unless I become the mayor of the town, I probably cannot change or synchronize the time.

That would also drive me nuts.

 
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Posted by on September 17, 2013 in Culture Shock, Czech Republic, School, Shanghai, Thoughts

 

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Bits of liver. (or lobes and segments to be precise)

I could certainly put on an intraoperative photo. But that might disgust some of you?

(posted started July 18) Random bits of what I learnt about liver transplant by observing one.

Right hepatetomy for the living donor.

J-incision was made on the upper abdomen; skin, subcutaneous fat, muscles (rectus, oblique externus, oblique internus, transversus) transected.

Liver exposed; falciform ligament and ligamentum teres transected. Liver reflected, cystic duct and artery dissected and cholecystectomy performed.

The common bile duct is cannulated with an inflated balloon. A cholangiogram was then performed in the operating room to assess bile duct anatomy (and variant). This is to complement the portal and hepatic arterial and venous anatomy inferred from pre-op CT scan.

Further dissection of the portal tract is performed (while minimizing the dissection of bile duct from hepatic artery, since the former is supplied by the latter). Exposing the main and right hepatic portal vein; IVC is also isolated and protected.

The right liver is mobilized and vessels in the portal tract and part of the right hepatic vessels are dissected.

The right hepatic artery is temporarily clamped to demarcate its supply region; surface of the liver is marked with diathermy.

The demarcated right liver is resected with an ultrasonic scalpel. The connective tissue from the resection are either coagulated with diathermy, ligated with titanium clips, or tied off, depending on their diameter.

Another cholangiogram is performed and the site of bile duct transection is marked with a metal clip. The right hepatic duct is transected and the cholangiogram immediately repeat to ensure the left and main hepatic ducts are not affected, ie. stenosed.

The right liver is totally mobilized, and caudate lobe resected and mobilized, if needed.

Sequentially, the hepatic artery, portal vein, and hepatic vein are transected and are ligated adjacent to the remaining liver. Liver graft is removed, perfused and soaked in HTK solution (histidine-tryptophan-ketoglutarate). Vessel calibre are measured and sutured when required.

The remainder of the donor’s liver is anchored to the diaphragm and abdominal wall through the remnant falciform ligament. The muscle layer is sutured with thick suture, and the skin closed.

Total hepatectomy and implantation of the recipient

Didn’t see much of this. Perhaps I will write something about this next time.

Whatever. Here is a photo of my actual perspective in the operating room (or theatre as they call it here).

Whatever. Here is a photo of my actual perspective in the operating room (or theatre as they call it here). The remaining left lobe on the donor after the right hepatectomy.

 
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Posted by on August 3, 2013 in School, Thoughts

 

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