In 2011, I had the rare opportunity to attend the Silent Mentor cadaveric surgical simulation programme at Tzu Chi University in Taiwan. I also did an elective posting at the Hualien Tzu Chi Medical Centre. It was an eye-opening experience, allowing me to have a taste of the Great Love and warm generosity of the Tzu Chi Foundation. The high and loving respect that the volunteers have for anyone who came through the doors of Tzu Chi was also in evidence. I was inspired and started to read up more about this 'humanistic' organisation and its founder, Dharma Master Cheng Yen.
As a doctor, I was rather perplexed when Master Cheng Yen invariably addressed doctors as 'Great Healers', and always gave us (doctors) her utmost respect and wholehearted praise. I must confess that I felt rather embarrassed about this title, and wondered if we truly deserved it. There is no doubt that the medical profession is noble, and doctors have the privilege of witnessing and journeying through some of people's most vulnerable times, and perhaps playing a part in alleviating their suffering. Much as one expects doctors to heal with great skill and a good heart, this expectation may not always be fulfilled. In recent decades, there has been much mistrust between patients and doctors. This results in undesirable coping mechanisms, for example, defensive medicine, which has led to a vicious cycle.
Joining the profession in these changing times of doctor-patient relationships, I was exposed to myriad ways of practicing medicine, some of which I absolutely cannot, in good conscience, concur with. I also soon learnt that it is entirely possible to go through a day’s work without emotionally or socially engaging with any patient. Perhaps this detachment may even make one more efficient at delivering the desired 'outcomes', for example, technical results like blood taking, or tangible outcomes like discharging patients from hospitals. Ultimately, don't we want patients to recover and go home soon? However, being too obsessed with achieving such tangible ends may make one a robot rather than a human being, much less a doctor.
During one busy resuscitation shift at the Emergency Medicine Department, I was preoccupied with treating each patient who came along, while trying not to look too stupid in front of the senior doctor, who managed to find time to quiz me amidst such chaos. Just when I was feeling overwhelmed by the seemingly endless work, one of the patients, randomly turned to me and said with utmost sincerity, “Thank you very much, doctor.”
For a moment, I stopped short as I simply could not believe that this 'body' in front of me, whom I was drawing blood from a moment ago, could actually talk! Not having a moment to waste, I quickly got back my momentum and continued striving through the crazy shift. Only after I left the hospital did I realise that I have forgotten that I was dealing with people all this time ─ people who are human beings, capable of experiencing emotions, no different from myself I suppose. How have I become so cold and indifferent? I do not have the answer. But deep down I knew that something had gone really wrong.
The question posed by Dr Patch Adams to his lecturers years ago came to mind:
At what point in history did a doctor become more than a trusted and learned friend who visited and treated the ill?
If this was the ideal, then I cannot imagine how it is achievable in my own practice.
When I first learnt that the Singapore chapter of the Tzu Chi International Medical Association (TIMA) was going to organize and hold a conference on humanistic medicine in early March, I was rather curious and secretly wished that I could be a participant to see what TIMA has to teach me. Never did it cross my mind that I would be given the opportunity to help in the planning of the conference programme. After all, I have not contributed much to TIMA, and do not know the members very well either. So it came as a surprise when Dr Chiang Liwei, the conference's programme team leader, invited me to be part of his team. My attempts at trying to 'taichi' my way out by giving excuses like lack of time (given that I will be in a busy hospital posting) had no bearing on his enthusiasm, as he finally convinced me with the reassurance that 'Bodhisattvas will bless me'. Looking back, I cannot help but marvel at how inconceivable karmic causes and conditions are.
Over the few months of preparations, I realised that my fears were unfounded. I soon quickly learnt that in Tzu Chi's big family of volunteers, one is never alone. With a common vision, everyone put in their best effort (in their own roles) to contribute to the success of the event. I realised that the ‘Bodhisattvas’ that Dr Chiang was so confident about were none other than the volunteers themselves. This can be illustrated by the sign language presentation of 'A Bodhisattva Indeed', during the Silent Mentor segment of the conference.
I had wanted to take the opportunity to show our gratitude to the silent mentors (body donors) and Professor Tseng, Director of the Tzu Chi University Medical Simulation Centre, who flew all the way from Taiwan to speak at the conference. Having minimal experience in sign language, I was pleasantly surprised when Tzu Chi volunteers specially took time off to guide us, and Dr Edwin Lim, the conference chairperson, made himself available for our practices to show his support. Also, among the 16 participants who agreed to partake in the presentation amidst their busy schedules, there was one who even came after a 30-hour hospital call just to present the song.
Isn't it amazing that so many 'Bodhisattvas' had made such sacrifices to make possible one simple sign language presentation, which I had no idea how it would work out at the start? Maybe this is what Master Cheng Yen meant by: 'Great vows beget great strength', which I think I am beginning to appreciate.
One of my biggest takeaway and satisfaction from the conference was none other than the four short skits. Having absolutely no drama background, I was surprised that I was 'roped' into the skit team. Yet again, I am thankful for the chance to participate as we had so much fun together, despite the intensive rehearsal schedule and stress levels running high nearer to the conference. I must confess that I was rather cynical initially. When have you heard of a medical conference with skits performed by medical professionals? Such absurdity, but we did it!
I remembered one of the initial brainstorm sessions which lasted for five long gruelling hours. Many ideas were brought forward, but there was a lot of uncertainty about how to bring across our messages, to link the scenes up and to give them entertainment value. Thankfully, we had amongst us the super humorous and dramatic Dr Chee Chen Sin, the visionary and full-of-ideas Dr Chiang, and the generous and down-to-earth Dr Ho Eu Chin; not to forget their other halves, who prepared such sumptuous vegetarian meals to nourish our brains, allowing us to press on. The laughter and engagement shown by the conference participants were my greatest comfort. And for myself, those exaggerated depictions of hospital life reflected some of my negative work experiences, perhaps helped me see them in a clearer light and hopefully come to terms with them too.
While listening to the conference lecturers share about how they practice medicine in a humanistic and humane way, I cannot help but be in awe of the 'humanistic aura' that these great healers exude. Even though I was unable to witness how they treated patients in their own medical practice, it was very clear to me that they were truly great healers who put people at the core of their practice. For example, during Taipei Tzu Chi Hospital Superintendent Dr Chao You-Chen's talk, I learnt about how he and his team of medical professionals and volunteers go to great lengths to gain patients' trust and fulfil patients' wishes ─ what I would have previously written off as 'non-medical' and thus not my concern.
Even more inspiring was how he patiently dealt with the technical glitches encountered during his talk, during which he even encouraged the AV team, who were frantically trying to troubleshoot them. As part of the organising team, I could feel the panic that the AV team experienced when problems cropped up. After all, we are not professionals in this field and this was probably the first time that most of us are organising a medical conference. The high tolerance for mistakes and inconveniences displayed by Dr Chao made me appreciate the importance of making others feel at ease and respected, regardless of how unfavourable circumstances may be.
The TIMA Conference made me realise that humanistic care is not only about patients, it is also about anyone who comes along the way, no matter who they are or what role they play. To me, it is about Gratitude, Respect and Love for every individual, and it can be manifested in every aspect of one's life.
I would like to express my heartfelt and deepest gratitude to Tzu Chi Singapore for the opportunity to learn and to contribute, and for giving me a direction and focus in these uncertain times.
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