By Dr Desmond Wai (Class of 1994)
I graduated from the NUS Yong Loo Lin School of Medicine 21 years ago, when it was formally known as the NUS Faculty of Medicine. As I reflect on my past journey through medical school, I recall many memorable quotes from seniors and patients I think young doctors and students may find useful even today.
1. “I graduated from the NUS Yong Loo Lin School of Medicine 21 years ago, when it was formally known as the NUS Faculty of Medicine. As I reflect on my past journey through medical school, I recall many memorable quotes from seniors and patients I think young doctors and students may find useful even today.”
– Dr Ngoi Sing Shang, 1992
During our third year surgical posting back in 1992, we were attached to Dr Ngoi. In one particular session, there was a patient with hematemesis. We went to the Endocenter to watch Dr Ngoi perform therapeutic gastroscopy.
We have seen diagnostic endoscopies before but that was one of the few times we saw a real time emergency endoscopy and we were all excited.
The old Endocenter at the National University Hospital (NUH) was at level 2 of the Main Building, and the room was really small. Dr Ngoi found active bleeding from a duodenal ulcer during gastroscopy. We found it so exciting that we were crowding around the patient, obliviously blocking the endoscopy nurses from passing the instruments to Dr Ngoi. Dr Ngoi then kindly but firmly told us off.
Students or junior doctors must balance their eagerness to watch and learn from senior doctors so as not to obstruct the real action. As much as students would like to stay close to the senior doctors in action, we must always give way to the nurses.
Therapeutic endoscopic procedure always take a longer time to perform, as the nurses need to prepare special equipment like adrenaline and injectors, and the endoscopist needs more time to do his job. The sedative effects weaned off during that particular session and the patient started to struggle. As the nurses were busy looking for the extra equipment, Dr Ngoi looked to us to help restrain the patient.
I remember what Dr Ngoi taught us till today: never add burden to the staff, and always be ready to help. With this attitude, wherever you go, most doctors and staff will love to work with you.
2. “Go and buy some supper for everyone.”
– Prof Low Cheng Hock, 1992
We were third year students attached to the Tan Tock Seng Hospital surgical department. During the night calls, we followed the on-call registrar and medical officers (MOs) around to observe new emergency cases.
During one of the night calls, Prof Low, then-Chief-of-Surgery, suddenly showed up and passed a S$50 note to one of us to go buy supper. Back in 1992, S$50 was quite a lot of money, as a cup of coffee cost S$0.5, and a plate of chicken rice S$1.5. One of us drove to Whampoa hawker center and bought loads of food including oyster omelette, hor fun, Hokkien mee, fried rice and satay. There was more than enough food for the whole on-call team, including us students. Prof Low also stayed and chatted with us.
Dr Desmond Wai together with Prof Low Cheong Hock (second and third from left respectively) at the Singapore Medical Association Annual Dinner 2015.
3. “Ha, now then you start to read? I know, step one, stab the patient.”
– a patient with pleural effusion, 1992
During one of the medical night calls in third year, we were fortunate to have a chance to watch Dr Tiong Ching Yeo, the MO on call, inserting a tube into the chest of a young man with pleural effusion. We were all very enthusiastic as we watched our first chest tube insertion.
We crowded around the bedside and were trying to read the chapter on “How to insert a chest tube” in our little pocket handbook on clinical medicine.
The patient, an educated young man, looked worried when he saw us reading our handbook. He assumed we, the students, were doing the procedure and was alarmed that we only started reading the manual before the procedure.
Dr Yeo reassured the patient that he was doing it and we were just watching. The procedure went well eventually.
From this incident, I learnt two lessons. First, when we wear the white coat, patients recognise us as a medical staff and we are expected to behave like one. Reading a manual in front of a patient tells him we do not know about the procedure. Second, as we could not possibly predict what emergencies or procedures we were going to encounter, so we have to read and learn as much as possible before going for night calls.
It is important to look confident in front of patients. And the best way to appear confident is to be well prepared. Students cannot predict what cases they will encounter in the wards, so they should learn everything as much as possible, as early as possible. Davidson is a must-read for students, and should be read from cover to cover early in their postings.
More so as a qualified doctor, we ought to always keep ourselves updated as we cannot predict what patients or what type of diseases we will see in our clinic.
Dr Desmond Wai (centre) with his fellow classmates Dr Ong Kiat Hoe (left) and Dr Christopher Khng (right) at their Medical Class of 1994 20th anniversary reunion dinner.