Angry Doctor

Monday, July 23, 2007

"not the province of the uneducated or the foolish"

Last weekend must have been a slow news day...

Bath or bao makes or breaks one's day
Doctors are more superstitious than they realise, a study shows
Tan Hui Leng

THE next time you see an abundance of unsold bao at a hospital food court, put it down to a superstitious medical staff.

They are probably avoiding the steamed dumplings as it bodes for a bao ka liao (Hokkien for "have the lion's share of") situation while on duty.

In a survey of 68 medical staff members, a National University Hospital (NUH) team has found that medical personnel are more superstitious than they themselves realise. The respondents comprise 54 doctors, nine medical students and five nurses.

The paper, written in a tongue-in-cheek fashion under the title, Take a Bao if You Are Not Superstitious, was published in the March edition of the Academy of Medicine's Annals journal, which every year at this time brings out a humorous edition. The study was carried out by neurologist Dr Lim Chuen Hian Erle and three colleagues late last year.

"Rare is the fledgling Singaporean medic or nurse who has not been initiated into this cult of superstitious practices," the authors wrote in a section called "Cum Grano Salis", Latin for "with a pinch of salt".

"We are told not to mention how good one's night duty is, never to eat steamed dumplings, called bao, on the same day, lest we bao ka liao all the cases, or worse, have to bao (Mandarin for wrap) corpses in their shrouds later that night.

"Those with bad luck are told to 'bathe in the seven flowers' (a traditional Chinese ritual for cleansing), though which flowers to use in the concoction are never elucidated.

"Presumably, it is the fragrance which engenders good fortune, thus explaining the propensity for some doctors to bathe before every call."

Indeed, although 83.8 per cent of the respondents disclaimed having a superstitious nature, about half avoided having items purported to confer bad luck during a call and 24 of them admitted to acting on their superstitions.

Although only six believed in the powers of the "bath of the seven flowers", 14 made it a habit to bathe prior to a call — in the belief that this protected them against a bad one.

Also, eating mee siam, a Malay noodle dish, is purported to siam (that is, chase away) bad luck, while soon kuay — a type of Chinese dumpling — sounds like "shun" (or smooth in Mandarin), suggesting a smooth-sailing night.

Superstitions in medical institutions are not unique to Singapore.

In 2002, a survey of British doctors revealed the observance of several superstitious beliefs and practices, among which were the inadvisability of stating that a call was quiet (lest the word be taken as an invocation to the fates to supply work) and rituals to ensure a good call, such as laying out one's clothes for the next day prior to turning in for the night.

A junior doctor at a public hospital here told Today that the superstitions, particularly that surrounding bao, should not be taken lightly.

"I ate a small bao before a night call a few weeks ago, despite having been warned years ago by my seniors," the doctor said. "I ended up attending to 40 patients in one night! That was a really bad call, I've never had a similar bad call after a non-bao diet." The doctor declined to be named.

"There was another doctor on call that night and I was the one who jinxed it by eating a bao, so I haven't told anyone about it!" the doctor added with a nervous laugh.

It is not just newbies who stay clear of tempting fate.

A neurosurgeon in the NUH study reported that he avoided eating beef on the day of his call, because beef, or niu rou in Mandarin, sounds like "neuro", which would jinx a neurology or neurosurgical call.

Another respondent, an oncologist, reported his belief that eating bread, or mian bao, protected one from the danger of a bao ka liao situation, since mian is Hokkien for "no need".

The results, the study concluded, demonstrate that "superstitions are not the province of the uneducated or the foolish", and that "we are more superstitious than we care to admit".

Although seemingly lighthearted, the NUH study makes for an interesting sociological study of hospital personnel.

Future studies suggested by the team include a randomised study examining the disparity between a doctor's perception of what went on during a call and the actual workload — measured by the number of admissions and the number of bleeps received by a pager, for instance — after eating bao, mee siam or soon kuay.

You can read the original paper here.

angry doc is of course familiar with the superstitions - he has not eaten a bao since the day he became a doctor. Not, he hastens to add, because he thinks it really makes a difference to the quality of the call he has, but because he sees such traditions as part of the subculture of being a junior doctor in Singapore. The rituals of having an shower early in the call, avoiding bao or commenting on how the call has been 'good so far' are all little acts of bonding between people who have to share the same adversity that is an overnight call in the hospital. It's part of our collective identity.

His postulation on the persistence of superstitious practices in the medical profession aside, angry doc agrees with the authors' observation that "superstitions are not the province of the uneducated or the foolish". Ultimately, superstitions and beliefs in the supernatural, pseudoscience, and unproven therapies all stem from the same lack of critical and scientific thinking and the acceptance of flawed arguments based on logical fallacies, and an education is not always an effective talisman against that.

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  • Ultimately, superstitions and beliefs in the supernatural, pseudoscience, and unproven therapies all stem from the same lack of critical and scientific thinking and the acceptance of flawed arguments based on logical fallacies, and an education is not always an effective talisman against that.

    Well said, Angry Doc.

    I would also postulate that superstitions persist for these two additional reasons:

    1. A person has only one life. In our evolutionary past, individuals who run away from shadows survive better than those who wait too long for the tiger to become apparent.

    There is a strong innate tendency to err on the side of belief, even in ridiculous and easily disproved myths.

    To illustrate this, Mr. Wang said in his blog that:

    Throughout the history of mankind, people have known about the benefits of meditation for THOUSANDS of years, not as if it’s a DAMNED BIG secret or what. Is it my fault that modern science is so slow in catching up?

    He is irrational to to profess strong belief in ancient anecdotes rather than modern systematic inquiry, but he appears to make sense to most people.

    2. The healthy human brain has an incredible ability to compartmentalize, allowing a person to adjust to many different or even contradictory rules depending on the social situation.

    This is a strong reason why highly educated people can believe in bizarre things under certain circumstances.

    To avoid negative results, I know scientists who don't allow plants in the lab, or who play classical music to their cell culture.

    It's bizarre, but it's part of what makes us human, as individuals and as members of our social system.

    We need to actively guard against superstitious behaviours.

    By Blogger The Key Question, At July 23, 2007 8:45 pm  

  • Also, Richard Dawkins postulated that blind belief in authority figures is a trait that favours survival. Children who obeyed their parents when told not to play near the cliff lived to breed, those who didn't didn't.

    By Blogger angry doc, At July 23, 2007 9:20 pm  

  • Ah...brings back memories of the terible calls we had as housemen 20 years ago...Bathe early 'cos you won't get a chance later. Eat your dinner at 6pm cos' you will on your feet all night till 4am. If you get to sleep an hour, it's a bonus.

    And we did not even get paid for calls....

    By Anonymous Anonymous, At July 26, 2007 3:41 am  

  • Dear angrydoc,

    I'm glad that you read Richard Dawkins. (I only know of 2 other doctors in Singapore who read his books). I've half a dozen of his books but I've only just started reading the Extended Phenotype. Really heavy reading - damn "cheem". However, I was told that The God Delusion makes for "easier" reading.

    I enjoy your blog and your non-homophobic comments - makes a change from the comments I hear around me all the time.

    By Anonymous Anonymous, At August 02, 2007 3:51 pm  

  • beeblebrox,

    Thanks for reading.

    I haven't actually read any of Dawkins' other books - I've browsed them and found them technical and 'heavy'. I believe Dawkins deliberately made 'The God Delusion' an easier read because of his intended audience, but I found it a little 'uneven' in that some parts were too simplistic to me, while other parts were still 'heavy'.

    By Blogger angry doc, At August 02, 2007 5:53 pm  

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