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First impressions of Taipei Veteran’s General Hospital? It is huge (3,000 beds) and busy (10,000 outpatients per day)!

Second impression - staff wearing face masks must hinder communication, especially with those who are hard of hearing and to some degree, reliant on lip reading.

Contributing to the Geriatrics Fellowhip Training Program in Taiwan in November last year, Finbarr Martin, David Oliver and I competed to make our seminars more understandable across cultures (jargon free and delivered at a slower pace than we were used to speaking). David Oliver lost hands down - we have that from the Taiwanese mouth, so to speak. We soon realised that the fellows had had more than enough on osteoporosis and falls, and that polypharmacy is a major problem for older people in Taiwan. Future BGS trainers (and there will be more programmes of this nature), should certainly be asked to cover medicines in old age and it will be suggested to the fellows that they consider the pharmocogenetic differences in drug metabolism and side-effect profiles betwwen Taiwanese, Chinese, Europeans, etc) .

I particularly enjoyed the trip to Ban Ciao Veteran's home. I realised that the veterans offer a unique opportunity for epidemiological and observational research. I was also fascinated by how their military background made it possible to billet all diabetics together to facilitate better diabetic care. On a social note, I found the practice of celebrating birthdays by organising one birthday celebration each month for everyone whose birthday occurs in that month) a remarkably practical way of acknowledging a personal event without having the home lapse into daily chaos.

A substitute for war?
What I found completely incongruous was to have Chiang Kai-Shek's veterans teaching me how to play croquet! I still do not understand how this game came to Taiwan and challenge the “general knowledge anoraks” at the BGS to answer this for me. 'Croquet: The complete guide to history, strategy, rules and records' states that “the origin of croquet is obscure. The game has been played in its present form for about one hundred years”. The game was played in the 14th century in France and was called “paille maille”. It was called 'pall mall' when it was introduced into England in the 1600s. A similar game called 'crooky' was introduced from Ireland to England in 1852 or 1853, it has been suggested that the game had been introduced earlier to Ireland by French nuns. The English then spread croquet throughout their colonies, I can not find any reference to the French having done likewise (but suspect they did). Croquet was introduced to the US in the 1870's.
So, I am left wondering how did this game become popular with Taiwan’s veterans? Is there any relevance in the fact that "Captain Mayne Reid, a hero of the Mexican War saw croquet as a healthy, and presumably safer, substitute for war"?

Does it taste like chicken?
David and I were introduced to snake soup by two of the fellows who, upon hearing us announce that it tasted like a cross between chicken and fish, our guides responded, “so we’ve heard” - implying that they had never actually eaten it! It was not too ghastly an experience, unlike the stinky tofu. I would strongly recommend both experiences to our colleagues who will be conducting future teaching courses. Just one word of recommendation - fast for a week or two before you go. In Taiwan, hospitality equals food, and more food.

Our Taiwanese hosts will be coming to England on 21st April, attending the Scientific conference in Brighton. We are arranging a reception for them at the Taiwanese embassy and hope that we British can return just a little of their wonderful hospitality.

Duncan Forsyth