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Lighting the Lamp of Humanism in the Medical Field

During the second day of the 2015 TIMA conference held in Singapore, many real life stories of the interactions between healthcare workers, volunteers, patients and their families were shared. The 340 participants gained a deeper understanding in the holistic approach of “treating patients, their illnesses, and their hearts,” the very tenet of patient-centric care.

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Singapore TIMA members came up with four short skits that not only entertained the conference participants but also facilitated their absorption of the programme contents. (Photo by Wong Twee Hee)

“Was I wrong? All I get in return for the pains I put into my healthcare job is the cold shoulder from my wife and family……” Through short skits, Singapore TIMA members re-enacted real life snippets from the lives of healthcare workers. Trying hard to quickly clear the long queue of patients, rushing in-between meetings and tied down with many miscellaneous matters in their daily job, the doctor in the skit illustrated how one can quickly lose the passion for a job in the medical field.

After the first day’s programme “Kindle the Fire Within,” the second day’s contents aimed to urge healthcare professionals to “Be That Beacon of Light” in their profession. The second day’s programme was at a slower pace as participants attended the series of workshops and talks lined up. With great interest, they attentively listened to touching anecdotes that had arisen in the course of healthcare workers “treating patients, their illnesses, and their hearts”. While some busily took notes, others would frequently use their phone cameras to capture both notes and scenes of interest.

Treating Ailments and Hearts With Sincerity and Empathy

In his topic for the first and second day, Dr. Chien Shou-Hsin, Superintendent of the Tzu Chi Hospital in Taichung shared how he lead his healthcare team in an experiential session of ploughing land and planting rice, so that they could better appreciate and empathize with what ailed their farmer patients, such as swollen or inflamed feet, caused by the hard work in the fields. This exercise served to change the attitude which they used to treat their patients.

“Volunteers are commonly seen in the Tzu Chi hospitals; they perform with musical instruments, bringing joy to patients and show concern for the healthcare professionals,” said Dr. Chien as he explained how volunteers bridge the gap between doctors and patients. In reciprocation, the healthcare staff prepare small gift bags for volunteers.

The Da Ai TV station runs a medical health programme hosted by Dr. Chien, and there are currently close to 4,000 episodes already recorded. Dr. Chien has persevered on with the programme in the hopes of equipping the public with useful health information and encouraging them to be responsible for maintaining their own health. As he explained the stories behind every picture he presented, it seemed to participants as if during those two days, the programme had been brought into the conference venue.

In particular, “The Story Behind a Slice of Cake” spoke of the wholehearted efforts put in by Tzu Chi doctors. A patient who had previously been turned away by many doctors was able to regain hope and confidence in his life after the care shown by Tzu Chi’s healthcare staff and volunteers. In addition, the patient was influenced positively and became less prone to losing his temper.

This patient subsequently bought a cake for his doctor with his first pay cheque after making a complete recovery. The cake tasted especially delightful because of the mutual gratitude of both doctor and patient. The creation of such beautiful memories require healthcare professionals to take the first step of showing sincere concern towards their patients; during interactions with the sick, humanistic treatment benefits them to a large extent.

Dr. Chien stressed that doctors must not only take note of their patient’s progress, but also be aware of the influences of society. As time passes, people are seldom left untouched by the trappings of modern society; a humanistic medical culture enables doctors to rediscover the purity within their hearts and gives them the strength to face the challenges in their job.

Together with community Tzu Chi volunteers, healthcare staff from the Tzu Chi Hospital visit the homes of patients to help them clean their houses, and in the process, gain a better understanding of their living environment, medical consumption habits etc., all of which are helpful in pinpointing the cause of their ailments. Dr. Chien left his audience with some food for thought with a quote of Albert Einstein’s: “Try not to become a man of success, but rather try to become a man of value.”

Passing on the Baton of Love

Master Cheng Yen once said that if the sick cannot find their way in, healthcare professionals should seek them out. Superintendent of the Tzu Chi Hospital in Taipei Dr. Chao You-Chen thus shared a story of one of his patients named Mr Huang, who suffered from a degenerative spinal condition. The disease caused his hip and knee joints to atrophy, leaving him with only the use of his hands and effectively confining his activity to the bed and chair.

Over eight years, he was unable to venture out to seek medical treatment but Tzu Chi volunteers were undaunted; they donned a safety helmet on Mr Huang and with mechanical help, hoisted him from his home on the third floor down to the first floor. After a series of treatments by medical teams from different departments, Mr Huang was finally able to stand upright on his feet. From the video, conference participants were able to see his gratitude as he thanked the volunteers and hospital staff for giving hope to him once again.

“To have doctors from different specialised fields come together to discuss a patient’s case is truly rare!” said Ho Foong Nun, a nurse from the National Heart Centre who was touched by Mr Huang’s story. She was impressed by the spirit of cooperation shown by the doctors across the differing medical specialties in the Tzu Chi Hospital. Seeing how healthcare staff spared no efforts in ensuring that a patient like Mr Huang could receive treatment, the strong sense of mission of the healthcare staff was clearly evident to her. This has also inspired her to think of ways to bring warmth to her patients.

Dr. Chao and his medical team have always subscribed to the belief of not resorting to amputation procedures where possible. He spoke of how in many cases of blocked blood vessels where wound healing is difficult, doctors would usually suggest amputating the limb in order to save the patient’s life. However, when Taipei Tzu Chi Hospital cardiologist Dr. Huang Hsuan-Li is faced with cases of serious festering caused by a diabetic condition or blood vessel blockage, he may perform a PVI (peripheral vascular intervention) procedure – that is, opening up blockages in blood vessels in the patient’s leg to save it from being amputated. While doctors treat the ailments of patients, volunteers lend their support with follow up care. Borrowing the description of a stanza from the “Sutra of Innumerable Meanings,” Dr. Chao spoke of his wish to see healthcare professionals from all across the world treat their patients with the attitude of a “great captain who steers over the river of life and death and delivers sentient beings safely ashore to Nirvana”.

Compassion From Within

“Tzu Chi and myself are looking for someone and that person could be you.” The superintendent of the Tzu Chi Medical Centre in Hualien Dr. Kao Ruey-Ho shared a promotional clip of superstar Jackie Chan calling for bone marrow donors in his segment which traced the beginnings of the Tzu Chi Stem Cells Centre.

More than 20 years ago, Tzu Chi sought to eradicate misgivings that the general public had towards bone marrow donation with the slogan that bone marrow transplant can save lives without causing lasting harm to the donor. Tzu Chi volunteers are always on hand to accompany donors through the initial blood test and health checks, up until the post-donation follow ups. To date, the Tzu Chi Stem Cells Centre has the world's largest Chinese bone marrow data bank, and has benefitted bone marrow recipients from 29 countries.

When Dr. Kao presented the facts and figures, he also brought to his audience heartwarming clips of bone marrow donors and recipients meeting each other again after many years, hugging each other tightly in gratitude.

Priyantha who hails from Sri Lanka, and a TIMA doctor himself, commented cheerily that as the conference was conducted in English, he could understand the entire programme. After his participation in the 2008 Taiwan TIMA conference, he became the first TIMA member in Colombo. He feels it is a pity that Sri Lanka does not have a bone marrow donor registry, thus while wealthier patients who suffer from blood diseases usually seek treatment in India, the majority of such patients are resigned to their fate.

To attend the conference in Singapore, Priyantha had to take leave from work. He also made use of the time he had to look for audio-visual equipment which he plans to use back in Sri Lanka to promote healthy living habits among the locals. With the skewed ratio of doctors to patients back home, he commented that most of the Sri Lankan doctors who have their hands full treating patients still have some way to go in learning how to interact with them.

Green Health Care

Green Health Care was one topic which captured the interest of many during the conference. Merci V. Ferrer, the Asia Director of international organization Health Care Without Harm (HCWH), Dr Lin Chin-Lon, CEO of Tzu Chi Medical Mission, and Mr Chen Fan Lun from Taiwan’s Industrial Technology Research Institute spoke unreservedly about the philosophy and implementation of green health care.

Ms. Ferrer traced the beginnings of the “green health care” concept back to 1996; at that time, American studies showed that pollution from mercury, dioxin and other poisonous chemicals were invariably produced during the provision of healthcare services. Lives are saved, but at the expense of the earth, thus hospitals must not only provide patient care but maintain healthy environments as well. In practice though, this is fraught with many difficulties.

Dr. Lin shared that in his hospital, they took a six-pronged approach in the areas of conviction from management, employee buy-in, environmental protection, community development, patient-care and strengthening the belief in the green health care philosophy. The hospital has invested thoroughly in efficient equipment, and has implemented various measures to reduce the hospital’s carbon footprint and recycle resources. These include encouraging employees to use the staircase instead of the lifts, promoting the use of bicycles, being self-sufficient in the hospital’s food requirements, growing organic vegetables, serving vegetarian food in the premises etc.

The understanding and support of the hospital’s staff is crucial, hence the management ensures that they communicate their philosophy down to their staff and also encourage them to attend regular classes on this topic.

Taiwan’s Industrial Technology Research Institute’s Mr Chen talked about how hospitals can leverage on technology for environmental sustainability. He gave the example of how we can reduce resource wastage by choosing to install energy-saving light bulbs. Apart from economizing on expenditure, he also explained that we must actively look for new resources. The hospital for instance, has installed solar panels for electricity generation. It has also developed a water saving system to recycle waste water produced during normal usage to be reused for washing purposes. While acknowledging that waste management in the hospital is a most difficult task, he explained that with the help of advanced technology, it is possible to identify the toxicity levels of the various chemicals in the waste water and then manage them accordingly.

Citing the Confucian analect that “He who practices virtue is sure to have like-minded companions,” Ms Ferrer pointed out that there are many partnering hospitals around the world like the Sambhavna Clinic in India, which have implemented green building concepts and reduced the impact that man has on the environment. In a similar vein, a hospital in the Philippines has also implemented many environmentally-friendly initiatives, such as replacing the use of mercury in its processes, reconfiguring waste products for other use, using compost to fertilize crops etc. just to name a few. The National Cheng Kung University Hospital in Taiwan on the other hand, has implemented a large-scale revamp and switched to the use of energy-saving systems. This saves the hospital some 5,000 tonnes of carbon emissions annually. These examples illustrate how hospitals not only focus on treating patient ailments, they also put in the extra effort to do their bit for the environment.

The second day’s programme brought the programme’s focus outward onto the global medical world. Many heartwarming, real-life examples that were shared during the sessions resonated in the hearts of participants. Teo Tse Yean, a medical student from the National University of Singapore presented a paper entitled: “Beyond the Clinic ─ Our Learning Experiences with an Elderly Patient with Multiple Chronic Diseases.” During the year-long medical review of the patient, Teo discovered that the elderly female patient loved singing and thus accompanied her to watch a singing competition of top hit songs. Not only did Teo enjoy an improved relationship with the patient, he also benefitted from learning from the life experiences of the old granny.

Shen Xin Yue, a nutritionist from the Tan Tock Seng Hospital commented that she was most impressed by how Tzu Chi members would practice what they preach. In the past, she had attended meetings on the topic of nutrition where invariably, participants would advocate a balanced nutritional intake during their discussions. Yet, lavish banquets would follow after the meetings ended. Upon seeing that all the vegetarian meals provided at the TIMA conference were nutritionally balanced and tasty, she was impressed.

Shen who had been introduced to the conference by her colleague, spoke frankly of how jaded she had become after three years of working. She had lost her initial passion and could only think of completing her rounds of patients every day. The conference had inspired her with its many touching stories and provided much food for thought; remembering the reason why she had chosen the profession in the first place, she said that the passion that had been deeply buried in her heart had been revived and she would henceforth bring that spirit back into her work.

How does one manage the twin demands of medical professionalism and humanistic care, and how can the culture of humanistic healthcare be sustained? This was the question raised by an Indonesian student during the Q&A session.

“It can be achieved with just a smile and some kindness. Actually, humanistic culture is part of medical care. They are two sides of the same coin and cannot be viewed in isolation,” was Dr. Lin’s answer. Dr. Lin himself had a story to share; when making his rounds of the wards, he would rather go back again two hours later than to shake awake a sleeping patient. His story illustrates how a medical worker too can have a bodhisattva’s compassion; the spirit of humanism is thus the key to cultivating and maintaining relationships between us and our fellow human beings.

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On Day Two of the 2015 TIMA Conference, 340 participants gained a deeper understanding in the holistic approach of “treating patients, their illnesses, and their hearts,” the very tenet of patient-centric care. (Photo by Huang Ti Ying)

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Dr. Chien Shou-Hsin, Superintendent of the Tzu Chi Hospital in Taichung, shared “The Story Behind a Slice of Cake” that spoke of the wholehearted efforts put in by Tzu Chi doctors which resulted in a patient regaining confidence and hope in life. (Photo by Chai Yu Leong)

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Dr. Kao Ruey-Ho, Superintendent of the Tzu Chi Medical Centre in Hualien, explained how volunteers are on hand to accompany bone marrow donors from the initial blood test and health checks, up until the post-donation follow ups. (Photo by Chai Yu Leong)

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Dr. Chao You-Chen, Superintendent of the Tzu Chi Hospital in Taipei spoke of the hospital’s philosophy of exhausting other means of treatment before considering amputation in order to preserve the limbs of patients. (Photo by Chai Yu Leong)

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Speaker Ms Merci Ferrer advocates “green healthcare” whereby hospitals protect the environment from toxic chemicals produced in the course of their medical operations even as they treat patients. (Photo by Chai Yu Leong)

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Taiwan’s Industrial Technology Research Institute’s Mr Chen talked about how hospitals can leverage on technology for environmental sustainability. (Photo by Chai Yu Leong)

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Priyantha (second from right), a TIMA doctor from Sri Lanka, took leave from work to attend the conference in Singapore. (Photo by Chai Yu Leong)

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Nutritionist Shen Xin Yue raised a question, seeking to understand the measures Tzu Chi took to conserve the nutritional value of the food during transportation. (Photo by Chai Yu Leong)

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Teo Tse Yean, a medical student from the National University of Singapore, presented a paper about his learning experience with an elderly patient with multiple chronic diseases. (Photo by Li Tan Bin)

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