Cleveland Clinic ― the next global brand?

As the world is getting more globalized, what we see is the creation of global brands: When we talk about burgers, we think of McDs, Burger Kings; cars - GM, BMW, Toyota; computers - IBM (Lenovo), Apple; shoes - Nike, Reebok, Addidas, Manolo Blahnik; iPod, Nokia, Motorola, Sony, Samsung, Louis Vuitton, Chanel, Gucci, Rolex, Cartier, Bulgari, Hermes et al, from everyday food to accessories, games software to high end fashions, we go for brands.
The same tendency is developing among services like higher education and healthcare. We talk about well-known schools like Harvard, Oxford or Qinghua... and worship them. Nowadays, healthcare is getting globalized as well. Harvard Medical International is aggressively expanding their brand outside the United States. John Hopkins has a center in Singapore (Johns Hopkins Singapore International Medical Centre), and recently had some affiliation with a Japanese Clinic. Cleveland Clinic has centers in Florida, Toronto, Canada, and will be opening the Abu Dhabi center in 2010. The current CEO and President of the Clinic, Delos M. "Toby" Cosgrove, M.D., recently indicated plans to expand into other markets abroad including Austria and Singapore (wikipedia). I came across this article, stating that Cleveland Clinic is considering building a center in Shanghai. (read the links 1 2 3 )
If that became true, it would be awesome.
In the very near future, I believe that there will be international brands of hospitals that will lead the healthcare service of the world, providing standardized, high quality medical services to the people. By then, you will start hearing people bragging about going to high end 'branded' hospitals. Hopefully, that will bring a new landscape to our world's healthcare system...

To become a Clevelander...

Another emergency surgery today.
There was this patient with this gigantic ovarian tumor. It was HUGE.
There was enough hair in the tumor (a teratoma) to make a wig. The creamy yellowish liquid that came out from the tumor, splated all over the place, looked totally like the french chou a la creme (cream puff). I guess I am not eating シュークリム for another few weeks.
I went to the gym, did 30 minutes of chest, and got home around 12am.
I was very excited when I received an offering letter from Cleveland Clinic, and I guess my future is sorta set for a new course.
Well, 3 more months to go, then sayonara land of sakura. Crazy-land... here I come!

海商の昼

Yesterday was incredibly crazy.
I slept for only 3 hours, went to work in the middle of a snow storm, ended up on a bus that was 30 minutes late, soaked wet.
Wasn't a good day to start with.
The snow was as high as my knees when I was crawling through my front door. It is my second year here in Sapporo, and never had I seen so much snow before.

I was the only doctor in the ward when I got there, and luckily not alot of time-consuming cases on the ward. Did some gauze changing, stitches-taking, wound-dressing, and my day was almost over. The weather was pretty bad outside, you could see right outside the window, where the snow just piled up like a thick whip-cream on top of the cars parked below. Nevertheless, it was a good day, for I have finally got my match result.

For my last 3 months in TKH, spending time with the residents are somehow high in my to-do-lists. Ikechan came out with his big black car, and Seki, Oilin, Mu-chan and I decided to go for a drive　――　a quest for a nice meal in the middle of the snow storm. Oilin is a 'local' local, and she knows every trees and every plants in this area. And immediately she was our best guide to consult. We decided to go for Gyouza(餃子) but eventually settled on a place call Umi-syou（海商）. Seki came here twice and was pretty impressed by the 'tension' (atmosphere) of this Seafood restaurant.

It was a nice sea-food buffet restaurant, with somewhat like Malaysian 'food-court' style kinda setting. Well, a bit more posh than that. Anyways, my day was not meant to be easy. My 10000 yen notes went into this ticket vending machine, where you pay for the meal in advance, and the whole machine broke down.

$#%"&$"&!'!!

And the whole restaurant staffs were running about, panicking. They came back with the change, and was consistently apologising for the corrupted machine. I think I am gonna miss this kinda scene after I leave Japan. We got to our table, and the buffet officially started. The sushi served there was marvellous; there were also all sorts of aquatic-beings, waiting to be grilled. I couldn't help serving myself with yakitori too. The desserts were superb as well.








It was like a 90minutes binge thingy. Stuffing seafood into your stomach was not too fun. I would say we only need an hour to be filled, but we still went on for desserts. I guess it was pretty cheap for a seafood buffet, and the food was not crappy at all. I would definitely bring my family and friends here for buffet the next time. The only downside of coming to this restaurant is that the smell of seafood + BBQ just stays with you the whole day...

By the time we reach home, it was already late in the evening. Shortly after that, I was starting my night shift at the emergency room outpatient clinic. I did not get to finish until after midnight.

What a day.

I had a great time hanging out, though it was a long day for just a meal. It was a long day after 3 hours of sleep, and by the time I got back home, I was near unconscious.

Matched...??!!!

It was hell of a lie if I say I wasn't anxious about where I will be matched for my residency in the States. Yeah, hell that was a lie when I acted cool during the rounds and scrubbing in for operations, as if I did not give a shit about the match result. Hell yeah, I was bloody lying whe I tell you over lunch that I wasn't even worried...
I have been sneaking into my cubicle every now and then to check if I got any email or notification about my match...
from ANYBODY...
PLEASSSE....
It was Jan 25th 2008.
The match result should be out by Jan 24th, US PST.
But my email was only filled with junk mails, and some mailing list that I was subscribed to... No email about the match. Not even a single reply from anybody. Not even a word of condolences. Damn it. It was a very long day... More Cesaran sections, more laparoscopic surgeries, more vaginal deliveries... the day went on...
Still no mails from SF match... I was getting neurotic.
I was up until 2 AM in the morning... trying to find an airbed for Dad's friends who will be coming with my family for Chinese New Year.
Still... the mailbox looked empty.
I fell asleep eventually.
5:15 AM. Jan 26th Tokyo time.
I couldn't act cool no more.
So I decide to make a phone call to SF match and....
I was told that I matched with Cleveland Clinic!!



Yahoo......!!!!!

okay, now what???
oh... my NRMP... haven't done that ranking list yet...
okay, what next....??

.......

Still need to get my airbed. But damn, I am so sleep-deprived.
Need more sleep.

7:30 AM.
Yikes! Look at the time!! Too late for sleep now...
Needa clean up and go to work...!!!

今天不回家

今天（又）不回家。。。
没想到今天又是手术天。傍晚的回诊拖到晚上9点才结束，但是还是回不了家。急救外来有个紧急手术，过不久又得上手术室去，今天大概也是搞到三更半夜的吧！以前听人说妇产科的医生生活挺惨的，果然此话不虚。阿姐，阿姐！真佩服您！糟了，晚餐还没吃，还是早些到手术室去！

Tak Kasi Pulang...

It was almost 10 PM when I left my desk, ready to go home. The day was okay as I need not scrub in for all four surgeries. Evening round was disastrous: one of the post-surgical patient went into panic attack, and was hyperventilating. Her parents were not doing too well either. The mother was frantically hugging her, while the father was fanning everybody with a magazine, trying to cool things down. It was Grey's Anatomy came to life.
I decided to take a taxi home tonight, as it was pretty cold outside, and the snow was another layer thicker than before. As the taxi took a turn from the hospital, my phone started to rang. "There is an ovarian torsion (case) in the ER, and we need you in the OR right away..."(Shot...) Just when I was ready to go home... I was glad I wasn't too far from the hospital when they called. Eventually the taxi made another turn, and I am back to where I left a minute ago. So much of an easy day!
Since I haven't really scrub in for an ovarian torsion before, I am actually looking forward to the surgery. The phone rang. It is time to scrub in...

谈“情”说“爱”

问世间情为何物，直教生死相许？—— 大概多数人看到这诗句，马上想到的是金庸《神雕侠侣》。我是读小6时开始爱上金庸的小说的,对这诗句印象可是特别深刻。其实少有人知，原文就出自元好问的《摸鱼儿-雁邱词》。我觉得里边的诗句写的蛮可爱的，用的字眼也很轻松，易懂，特别有意思：

问世间情是何物，直教生死相许。
天南地北双飞客，老翅几回寒暑。
欢乐趣，离别苦，就中更有痴儿女。
君应有语，渺万里层云，千山暮雪，只影向谁去。
横汾路，寂寞当年箫鼓，荒烟依旧平楚。
招魂楚些何嗟及，山鬼暗啼风雨。
天也妒，未信与，莺儿燕子俱黄土。
千秋万古，为留待骚人，狂歌痛饮，来访雁邱处。

元好问先生问得好，情到底为何物呢？

我有个奇想：情，不仅是上帝为人类设有的“传宗接代机能”，还是人类的“娱乐”中一个非常重要的元素。我虽然写Blog的时间不长，但是有个发现，就是凡是写一般有“情”有“爱”的文章时，得到的注目和回响是非凡的。可见人们的兴趣，总是和“情”有关。今天的娱乐新闻，不是阿狗和阿猫的亲密关系的，就是张三李四闹分手的，还真是离不开一个“情”字。又不见娱乐新闻谈些环保，科学类的东西。这些新闻只能在科技版里头读到；理由很简单，因为他们不够“娱乐”。要是能和元好问先生见个面，我应该会这么回答他。情是何物？—— 娱乐！！

当然，老子也说过，“有无相生，难易相成...”。有乐就有悲。有爱就有恨。“情”可以让一个人得到无限比的幸福，也可带来无限比的悲哀。当然旁观者只有无限比的娱乐。乐极生悲，爱极生恨，那都是“情”所带来的副产物。

天也妒，未信与，莺儿燕子俱黄土。
千秋万古，为留待骚人，狂歌痛饮，来访雁邱处。

到头来，还是得问一句：问世间情是何物？值得生死相许？

美丽的误会

今天从早到晚都呆在手术室内。4个手术，9个小时，身心疲倦。
突然来的电话，拨来的是没登录的号码。心想大概是病栋的护士吧！
“知道您忙，不好意思，我有东西交给你。我可以不可以过来找你？”—— 我捏了把冷汗。昨天也是接到同一个电话。大概电话另一头是同样的一个人。昨天的电话是叫我到某某病栋去，说是有重要的事要和我商量。我当时也没有理由拒绝，就答应有时间就过去。可是忙了一整天，早把这件事给忘了。
通常护士找医生谈私事，可不是什么好东西的。我以前也领教过了。不是找你出去吃饭，看戏，便是一些私下的约会。搞不好还有情书，告白的。
我也不是摆架子，更不是吊高来卖。
我对医院里这种事总是特别小心，尽量客气的拒绝她们的好意。一来，免得惹来不必要的麻烦。二来，没什么时间，也没什么兴趣。去年就是跟女同事出去吃饭，看戏了后，没想到对方却误解了我的好意，搞得赔了“男友”又折兵的收场，最终是又爱又恨的尴尬场面。好人难做，好男人更难做啊！
话说回来，接了这电话，我心想：糟了，麻烦又来了。我说我忙，可是如果是有东西给我的话，我在某某病栋里。对方说马上就来。果然没过多时，两个护士走了过来，说有封信要交给我。（冷汗）原来她们是来传话的。我也莫明其妙的把信收下了。
放工后，我打开信一看，里头写着：

林先生，
突然而来的信，失礼了。听说您将离开本院，某某病栋的护士们想为您搞个送别会（饮酒会），希望您的参与。

没想到一间大医院，消息还是传得蛮快的。也不知是谁把我将离开日本的这件是给传了出去。
但是看了这封信，确是万分感慨。真的谢谢大家的热心，也不好意思误会了这打电话来的小姐的好意。
想不到又是离别的时刻，正是“人分千里外，兴在一杯中”的季节。

多情自古伤离别，更那堪，冷落清秋节。
今宵酒醒何处？
杨柳岸，晓风残月。
此去经年，应是良辰好景虚设。

《古离别》云：“离恨如旨酒，古今饮皆醉。”

看来酒会是免不了的吧！

Tues., January 15, 2008 - Match Deadline

Gee... after months of sending applications, gathering documents, and flying half the globe to attend interviews, finally, the day when everything comes to an end. Today is the SF Match deadline!! It is always hard to make a decision that would actually change your future infinitely. Been getting lotsa helpful advice and suggestions, and eventually, like many have suggested, I shut down my brain and followed my heart. I finally made up my mind and sent in my list. Now it is up to fate to decide. (finger crossed).
I could not have come so far, if it wasn't for the friends and mentors around me, helping me and guiding me in many ways. I am glad to be surrounded by these folks, and really appreciate the every little thing that they have done for me. No matter what the outcome would be, the adventure and the experience that they have given me, worth so much more.
For this, I could not be more grateful.

Back to Sapporo...

Been traveling a lot lately. Guess that is what I do best -- Travel.
I went for an interview, and then made a brief visit to another hospital near by. Everything went pretty well. Met up with some old friends and it was great to be back in Boston.
Travelling was something I never thought I will be tired of. This time, it was kinda exhausting. I guess I am tired of rushing from place to place, trying to keep up with schedules. Love those days when there aren't responsibilities and tight schedules, when u just go places u like without the care in the world.
For some reason, I decided to check into a hostel instead of a hotel. It was great being able to meet travellers from around the globe, and listening to all the adventures these folks have been through. Every individual is like a story book with stories that could take your breath away. I do miss that a lot.
3 more months to go and I will be coming to another cross-road in life. I guess it is time for me to do some rethinking about life and my future goals. It is always nice to take a step back, reorganize yourself, before wandering off to a new journey.
But for the time being, I need some good rest for tomorrow's surgeries.

这一两年内，接到的结婚请柬还真的多得怕人！
国内国外的朋友，家乡的死党，一个两个纷纷成家立业，私定终生。
我这王老五可苦了，不但要把身边的兄弟，朋友，干妹妹们一个个送走，还对单生生活依依不舍的我，还得忍受社会，家人和朋友的压力。
我爸妈也没正面催我结婚，但是不时会给我一些暗示，我也装疯卖傻，当作不知道。
人，总是被社会影响和支配。
我，还能耐多久呢？...

I will follow you into the dark...

I wasn't too eager to go back to work after 3 days of new year holidays. All the wild parties and feast had turned me both brainless and lazy. Sometimes I wonder if that is why they tend not to give us vacation here in Japan. It does make you less wanting to go to work.

Today turned out better than I thought. The day was sunny and bright, a pleasant weather to cycle across snow-covered town to work. Since I only left with one patient in the ward, my pre-round was brief and simple. We got to watch my long-waited 'epilepsy syndrome' video during the noon conference. It was awesome, but for the time being, I am still skeptic about the idea of spending 30,000yen on the DVD.

Our hospital had a new year party during the evening. As underpaid residents, it is only natural for us to turn up at any hospital events tagged with 'free food'. The dining hall, not to my surprise, was already infested with hungry residents. Seki and I made an early exit, and we decided to head for the gym.

While I am more of a work-out person, Seki -- my colleague who only comes to the gym once in a blue moon, was eager to try out new stuff. He talked me into joining the gym class, and without a single clue what I am getting myself into, we signed up for the Body-Combat class. There were lots of jumping, kicking, boxing, and martial art moves. The 60 minutes class was crazier than I expected. For someone who have been reluctant to join gym classes, I actually enjoyed it very much.

My friend sent me a YouTube video today. It was a song called "I will follow you into the dark" by Death Cab for Cutie. I immediately love the song. It is about sharing your life with someone you love, and being together for eternity. On top of that, the drawings are damn cute!! The brown bunny was very sad when the white bunny died, and waited for death to come so they could meet again. Pretty touching. So, wouldn't you hope for a white bunny whom you can follow into the dark...?

3贺日の初詣

从元旦到1月3日的“3贺日”，日本人都会到神社去参拜。因为是年初头一回的参拜，所以就称为“初詣”。这三天里，神社周边都是人山人海，车水马龙。人挤人，挤死人。我家在手稻区(Teine-ku)内，这里有个手稻神社。听说明治时代中，这手稻区还不是札幌市(Sapporo)的一部分，是个村。当时要到札幌神社参拜实在是太麻烦的关系，人们就在当地建了一个神社。当时建神社也不是要建就可建的，还得通过什么神社组织，政府官员什么的。（注：我的日本史和当地史都是热心“的士佬”(Taxi driver)教的，作不作准我也不晓得）——这神社就是现在的手稻神社。这几天，我都是夜间生活，一天的开始竟是晚上的“爬地”，也没机会到神社去走走。今天回医院去取单车，刚好路过手稻神社，就顺便进去凑热闹。


手稻神社建在一个小山上，周围都被建筑物给包围着，与世隔绝。要是不留意，可不知道这里也有个神社的存在。神社虽然规模不大，却清幽美丽。不过一分钟的路程，黄土小徑变成了石階步道。石階步道两边都是一尊尊刻有名字的石碑。半山上是一个“鸟居门”，门旁有一个祈愿绘马挂，挂着一片片写有心愿的薄木片。


祈愿绘马的来源我也不是那么清楚。据说原先的日本人是牵一匹马到神社祈福的，后来马牵来的越来越多神社里放不下，就改在木板上绘制一匹马图像，作个象征，就成为了祈愿绘马。再后来，人们不只在木牌上绘制马匹，还可以画各种图案，然后写上具体的祈愿文字，挂在外边的挂板上。


过了“鸟居门”，就可以看到手稲神社的“奥宮”。这便是大家合掌祈拜的地方了。“奥宮”前是一条长龙。日本果然名副其实的礼邦之国，拜神也得排队。神社里还设有许多卖神符的档口。还有悬挂着无数雪白的小纸条的木架。 这小纸条就是所谓的“占神符”。拿到吉签的，一般都把它带回家。拿到凶签的，都把它牢牢地绑在木架的绳子上，好让这些凶兆留在神社里头，不带回家。


我拿着手机到处拍了一拍，肚子也饿了，就拿了我的单车，准备回家。那神社里除雪的老头子，看我采上单车，呵呵一笑，说我冰天雪地还能采单车，真行啊！我笑说这是脚车滑雪运动，最近开始流行的。(胡扯)

分享

“与你分享的快乐，胜过独自拥有，至今我仍深深感动，好友如同一扇窗，能让视野不同。。。”

1月2日早上。iTunes里播放着伍思凯的《分享》。

窗外下这鹅毛般的大雪，纷纷扬扬。看起来蛮漂亮的，但是外边的冷，可想而知。今天要是能一整天呆在温暖的棉被里不用出门的话，可有多好！从除夕晚直到今早，节目是接一连三的，好像还没有真正休息过。今天难得不用上班，能躲在棉被里赖床。真过瘾！

昨晚虽然刮着大风，下着大雪，医院里的同事还是带了日本酒和各种吃的到我家来陪我过元旦。独在异乡为异客，每逢佳节倍思亲。在外边呆了近十年的我，可以说深深体会到了这种感受。这班同事也蛮有心的，知道我没回家过年，都纷纷建议元旦晚搞“爬地”。有个同事是个日本米酒“通”。当晚更不惜把家中“美酒”带来和我们分享。

太多感受，绝非三言两语能形容。

昨晚谈到临晨4点多，越谈越起劲。其中有一个同事今早还得上班。真替他可怜。我想今年离开日本时，是会很怀念这帮朋友。还有三个月时间，得好好珍惜这难得的友谊。

今天又是“爬地”天。今晚和另一班朋友有了约会。坐在电脑前的我，还有点儿疲困。唉～!看来今晚也多数是通宵——还是躲回被窝里头，过我的1月2日。