Senior Resident Physician Dr Teoh Ren Shang contemplates his journey in palliative care thus far.
I consider myself a newbie to palliative care even though my interest in it developed 17 years ago when I was a first-year medical officer in Medical Oncology. For the past four years, I have been a doctor working in home hospice.
I vividly remember the intense pressures of work from before, as a medical officer in Medical Oncology, and how often the oncology specialists would task me to refer their cases to the Palliative Medicine Department once the disease has progressed beyond the ability of chemotherapeutics to treat. Thus, a routine of taking Professor Cynthia Goh down the corridors of the hospital ward developed, whenever I referred her to the patients of such need. I was amazed at how time seemed to slow down, as she spoke slowly and gently to each patient, often holding their hands, and painstakingly going through details of their life story that I had assumed were unimportant details. Perhaps most significantly, I was struck by how much patients were touched by the inpatient consults — they were affirmed as individuals with their own story beyond just a cancer diagnosis. That itself touched me deeply, such that it seeded the idea of exploring palliative medicine in one form or another.
That aspiration took me on quite a journey over the next decade and a half, including a one-year posting in HCA Hospice Care as a medical officer. This experience opened my eyes to the wonders of home visits. It is always a privilege for a healthcare worker to be allowed into someone’s home as a visitor; to be hosted rather than being the host, which is usually the case when patients visit healthcare premises such as the clinic and hospital. At the patient’s home, you truly start to understand the patient in their natural environment. This gives much insight into how they behave and live. We understand better how to manage their symptoms well, why they may not be compliant with their medications, hazards at home that may cause accidents, and challenges that caregivers face. Thus, years later when I was offered a place in the Singapore Cancer Society (SCS) to take on home visits on a full-time basis, I took it on enthusiastically without hesitation.
Having spent four years in SCS as a Senior Resident Physician, there have been challenges on various fronts. The job itself does take an emotional toll that can creep up insidiously, as one deals with physical deterioration and emotional grief over and over again as we face patient after patient. Despite various other unavoidable challenges that come with the job, it has been a fulfilling journey, nonetheless.
We all share similar stories of hardship and need to support each other, so we do not feel alone. Let us take a little time to remind ourselves, that we are engaged in the extraordinary job of caring for the dying, even as we acknowledge how ordinary and mortal our daily lives are at the same time. That is how I continue to find meaning and purpose in what I do, despite the challenges ahead.