Peaceful life I reside in a small city named Ann Arbor, which is merged with the University of Michigan. I love the place since the first day I came here. It is beautiful, peaceful,and noble.I rent an apartment here, it locates right beside a small river. I can hear the bird singing every morning and see people jogging along the river. That is a place that I dreamed several times when I was in China. When I come to my front door, squirrels will come around and ask me for sty to eat. They are so lovely and I named each of them like big tale, black nose, scar back... There are also ducks stay around all day busy with swimming and eating. Ann Arbor has a total of 113,934 citizenship. All most all the people here work for the UM, they are very friendly and politely. I used to live in Beijing, which supposed to have more than 20,000,000 residents. It is really hard for you to stop your eye in a place without an person there. People crowd everywhere in Beijing. they are so busy and they do not even have time to say sorry when they crash to each other. The most happy life here should be the wild lives. People can see them every where, but they do not want to hurt them. Given the literature of Chinese food, wild lives are very popular food sources. Once I was in Beijing, watching TV with my colleage comes from Guangdong Province. When we saw a leopard hunting a deer, I was impressed by the speed and strength it has. Then, my college said wow, if it was well cooked, it would be delicious. That what we thought! I can not imagine how could these wild lives be if they migrate to China. I do not want to say people in China are rude, they just think in a different way sometimes. I believe years later, we will change. I suddenly remember an public minded advertisement by Yao: No trade, no killing. At this movement, I do not want to kill any wild life, and I believe anyone who come here will not willing to. So, environment can change a person, but in the other hand, people can change environment too. I read a news said somewhere else have a heavier PM 2.5 load than Beijing. My god, how could this happen? Is that mean Beijing still has the ability to go deeper with the air pollution? I am gonna find a way out to practice for inhale the PM2.5, I guess I could not even respirate when I go back.

Cars and attitudes I was shocked when I first saw cars with lots of scratches or even a broken bumper were still in use in the US. In China, you almost could not see a car with one single scratch. Given the different wealth of the two countries, I doubt with my eyes that time. What is the reason? Even today, I can not exactly figure out the reasons, but in my opinion, I think there are two causes: insurance policy and life attitudes. First let us talk about some of the differences of auto-insurance in these two countries. I the US, if you are a new without enough credibility, just like me, the cost for a car may be $100 with $500 deductible. Which means that when you undergo a scratch or an accident, you have to pay the first $500 to fix the car. So, if the cost of the fixation were less than $500, it would be all yours. This is the reason why people leave their cars with various scratches or small defects. I know people who live in the US as a citizen could pay less than me, may be just half as I pay. In China, I used to pay the insurance yearly with 7000 RMB（$1200）yearly. There is always no deductible at all. People always fix the car immediately even there is only a small scratch. Ofcourse, there is always a fluctuate of the insurance rate next year, but it is tiny in contrast with the fixation fee. So, that is why people in China like to call the insurance company more frequently. May be that kinda wast of resources, but as a customer, no one cares about that. Another reason for that is the attitudes. My colleague wants to buy a porsche Cayan, he is keen on it for a long time, but he said he would not do that. The reason is very simple, the chief in our ward bought a new car a feww days ago. It was a BMW X5 which is cheaper than Cayan in that time. That sounds funny to American people I believe, but that is the truth. In China, cars is always used to reflect one's position and wealth, People in China change their cars not always because they are too old or they are out of work, they just want to change it to a new one which can indicate their dignities. In the US, my boss drives a truck everyday, and the resident drives porsche, that means nothing. People do not need cars to tell others who am I and how successful I am, they just themselves. I like the attitudes that American people always hold. It is the time for us to make some changes I think.

Life and money Chinese has a proverb: Money is not everything, but you can not do anything without money. In China, people are used to deposit money in the bank to leave themselves a lifeboat in case. I still remember when I was young, my grandpa told me that everyone should remember to stock money, because it is the most important factor to impact your whole life. In these years, China experienced a big inflation. My grandpa was once a rich man with thousands of RMB in his saving account, but when he getting old and old, the amount of his money remains the same. Twenty years ago, he can use his money to buy several houses, but he did not. Today, the money can not even buy a toilet in an apartment in Beijing. I heard a lot of similar stories. I start to doubt if it is reasonable for us to deposit our money in the bank. I noticed that most people in the US do not save their money into the account. Instead of doing that, they use the money for vacations, buying ships, and even gambling. One American student told me she did not have money for the college before his father sale his ship. I was impressed about this. If people in China buy a ship, probably they have ten plus as much money as the ship cost in the bank. They could not live even a day with a empty account, they do not dare to. So, I think this can explain the life attitudes of the people in China and the US, and also these two countries. The US is the most rich country in the world, and in the same time, has largest amount of debts; while China is a development country whose people are suffering from hungry and over-loaded jobs, but it still has a lot savings in different forms. I can not tell if it is a good thing or not. I just pray it will not get in the situations as my old grandpa did.

Resident Training There is a huge difference between China and the US in resident training program. I am a attending now, just went through the hard part of my career in China, as a resident. In the US, doctors are also good teachers, and they have to be. In the so called teaching hospitals, teaching is an important part of doctors' daily work. Senior doctors have the responsibility to teach their residents basic theories, clinical skills and operative tips. I talked to a surgeon several days ago to discuss the operation method he used to a patient. I just wondered why he chose that simple technique instead of an advance one, which I though would be better. He told me the truth, basicly the differences caused by those method were not that obvious, and the other reason is he has to teach the resident with this kind of technique. I was shocked by his words. In China, no one cares what the resident wants. Surgeons Do what they want to do, and they are too tiered to avoid being suit by the patients. I still remember when I first enter the OR, I was scared, I made a lot of mistakes which let me being blame all day. No one teach me how and what to do there. When you get in, you are a surgeon and you supposed to know everything they think you should know. You have to work really hard to watch, try to understand every steps other people do. Finally, we grow up, but we still make mistakes, maybe the same mistakes our teachers have make. In the US, teachers will tell you how to perform, how to avoid complications, what mistakes they experienced. I am a little bit jealous here. Residents deserve this training, they really need someone to tell them the key points of every single procedure. So, I hope I can be a good resident trainer in China. To teach them, let them know everything I know, and everything I learned here, that should be helpful to them.

Billing in Hospital Yesterday I write something about the difference between the doctors in China and the US. However, those are not significant compared to the billing differences. In China, doctor is almost the most dangerous job, even compared with corps. There were lots of news about doctors hurt by patients or their relatives. People abroad may not aware why this happens. Doctors are the most polite persons in the country, they always like to help others, and others always love them back. This is what we usually think about, and this is the relationship exists in the US. Even Chinese themselves do not understand why they hate doctors so deep. Yesterday I asked what is suppose to happen when doctors in China and the US switch their places? I guess you should have the same answer with me, they will change themselves. My point is: The reason why doctors being hurt is not come from the doctors, nor the patients. The billing decides everything, simply speaking , money is the reason. People in China always complains about how expensive and hard to fix a disease in hospital. Actually, the cost in China is far more cheaper than in the US in medical care. In the US, insurance company covers the majority of the cost; In China, in most of the condition, every penny comes from their own pocket. For instance, one person spent $ 1000 in the US in hospital, but doctor said the treatment is not appropriate, he need a new method, and they will offer him this treatment immediately. I believe the patients would say ok, because the insurance will cover all the cost. In China, if the same thing happened, the patient would think this is a cheat. The doctor wants to get more money from me! I have already spent that much, ,, Maybe he would chose to accept, but you can imagine if the same things happen again to him, what will happen? The relationship between doctors and patients is very important to every one, not matter you are a patient or a doctor. In my opinion, the innovation of medical service in China is totally a failure. If we want to improve the medical care, we need to figure out how to build a reasonalble billing system.

How to avoid choking when communicate with someone in English? My reading English is not so bad, but I always choke when I talk to someone in person or on the phone. Please, tell me how to improve this.

One day in Clinic Today is Monday, the day of my montor's clinic day. He is pretty busy today. There are a lot of patints waiting for him, including the new patients, patients with postoperative problem and some patients in their routin follow-up. All the patients come here in the appointed time and wait in a assigned waiting room. Doctors know exactly who are those patients and what are their problems need to be fixed. The inspections are tiny and not in a hurry. That is quite diffrent from that of China. In China, doctors may encountered dozens of patients with unknown conditions, and the waiting room is messed up every time. They come randomly to the hospital, crowed together, try to get to the front of the line and even crowed to the doctor's office. Doctors are busy asking every patients conditions, let them do the related examinations and make priscriptions to some of them. Normally, each doctor will see twenty to hundreds of patients in a morning. They are so busy, every patients can probably get 3 to 5 minutes, the doctors even have no time to thinking carefully about the disease. I have been asked for several times about the difference between Chinese doctors and American doctors, I would say, the difference between doctors in the two countries is tiny, but the ways they are working in are so different! I do not want to say further, but there is a funny suppose, what do you think if the doctors swithch their works between China and US. I will laugh all day and talk to the patients about my dog walking experiences in the park. Thank you very much for have patients to read and correct this. I am gonna write sth about the billing things tomorrow. Thank you again!

How to use the "," and "." correctly in English sentences? That is really bother me!