Thursday, July 3, 2008

Now I See.

The Cleaning Lady. That Girl Who Had An Abortion. The Blind Man Selling Tissue Paper. That Uncle. That Auntie. The Stingy Stall Owner At The Mee-Pok Stall. That Guy Whom I Saw Dig His Nose When He Thought No One Was Looking. Patient 4702- Ward 47, Bed 2. He Who Is Not To Be Named.

We’re all guilty of it. Labelling, and forgetting the lives, the Stories behind the labels we casually stick like post-it notes on the people who form part of our lives everyday. People whom we see every day, who are more than a face and who have names, families and Stories, but whom we never take the effort to smile at or ask how their day went or what their names are.

We all do it. Even in medicine, perhaps even more so.

I find myself reminding myself all the time, sometimes spending more effort than I ought to, telling myself to ask every patient for their name. My logic is- if we can remember a six syllable bacteria growing in somebody’s mid-gut, surely we can remember his last name.

But as the days go by, Mr Lim becomes the Liver Cancer Guy, and Mdm Yap becomes The Lady Who Died From a Gastric Bleed After They Failed To Resuscitate Her.

As we try hard to carry out the technically challenging aspects of examining patients physically, scramble for diagnoses in our heads, strain to elicit the relevant signs and symptoms of diseases, and talk with them all at the same time, I finally understand why doctors can seem disengaged at times. A million cogwheels are spinning within their heads while they proceed with the conversation, and it is like trying to hit a bull’s eyes while balancing a wedding cake on your head and riding a tricycle on a tight-rope above a boiling furnace.

“Go back and examine THE ABDOMEN of Patient At Bed Six,” my tutor says. “Feel his aneurysm, and make sure you read up about it. ”

I find myself at Bed Six talking to Uncle Chin*, asking how he is feeling but listening only to the gist of his answer because I have to take in a maximum amount of information about his vitals and physical findings in a minimal amount of time, and as he looks into my eyes, my mind is consolidating clues about his physical status and mental well-being and I'm distracted by the white rims encircling his eyes.

White haloes, commonly found in the elderly and commonly associated with high cholesterol. Arcuate senilis. Investigate his co-mordities, get his family history, check his weight-there could be a link between his high cholesterol, hypertension and the development of an abdominal aortic aneurysm- are just some of the things running through my mind like a train. Please pardon the mish-mash of medical jargon.

And I am annoyed with myself for the thousandth time because I am disconnected once again. There is a job to be done, but have we forgotten to live?


We need to buy something from the lady over the counter, but have we forgotten she has a name, a Story and deserves a smile too? Do we demand too many things from too many people? I know I do.


My ticking mind is suddenly interrupted. “All you need… …. is FAITH!” As I look at the white haloes in Uncle Chin’s eyes, I am abruptly jolted by his intense stare into my eyes and his whispery, hoarse voice.

“Faith. Do you know what Faith is? Jesus said that we’ve nothing to fear as long as we’ve faith,” he tells me, just out of the blue, in simple Mandarin. I’m not even done asking for his medical history. All I know is that he has a dangerous condition that could put him on the brink of death.

I remember once reading about a heated discussion on the papers, over strict rules about not breaching the professional code, not taking advantage of a privileged position and about not bringing religion into the workplace. A rule was eventually put in place, allowing discussions about faith only if patients themselves expressed their desire to share their spiritual hopes and needs.

But even as we ourselves walk the tight-rope of adhering to rules and regulations and constantly fight the million battles within each of our hearts each day, I’m constantly amazed by how many patients have already held my hands and voluntarily told me about God, Jesus and how He changed their perspectives on Life.


It’s when they open those doors that I find them eagerly welcoming me in, with a banquet to share and a Story to tell, hungry for spiritual nourishment and emotional comfort, far more than a glucose intravenous drip.


“Thank you so much for coming to talk to me," he says. His eyes pierce into mine. They are glassy, and deep, etched against a tired canvas on a worn-out face graced with deeply carved lines. I slip my hand into his, and for the first time since our conversation began, I see beyond the two white haloes, straight into his being.

In that moment, he becomes real- Uncle Chin.

“You see,” he continues, painfully slowly and softly, “ Good things always happen when you guys come... I had just prayed to God for comfort... and then you guys came along! I'm not afraid, I have Jesus... !” I remember the last time he thanked us profusely for visiting him, as the nurse happened to serve him a slice of buttered white bread and a cup of milo on his rounds during our conversation- “Oh look, I’ve food! You must have told them I was hungry! See, you bring good tidings!” He held the bread like a little child, in great care and gratitude, “I haven’t eaten for such a long time,” he had said.

"I will pray for each and every one of you, " he tells my two other team-mates with me and myself. “ For your futures as doctors, for your families… Thank you all so much for coming to talk to me. I feel so happy. Do you feel it? God is amongst us right now.”

“God is amongst us right now, ” he repeated. A smile broke out across his face like a sunray through a cloud.

How precious a smile that was.


How precious.


He, coveting our prayers, eagerly expressed his thanks to us.

He had opened the door. There was no liberty for me to take except that which he had already generously placed into my hands. A rule is a rule, until the patient expresses otherwise, because the Patient is always of utmost importance, our top priority. Supposed to be and should be.

So as I placed my hand on the bony prominence of his half-naked shoulder, his eyes half-shut in reverence, smiling peacefully, he exclaimed enthusiastic words of spiritual victory as we said a simple prayer for him. My eyes were closed- it was such a special moment. My greatest privilege.

It was just when he exclaimed a hearty “Amen!” when a voice jolted me.

“What are you doing?” I opened my eyes to see another medical student walking toward us, piqued and curious. He was our classmate and an acquaintance, who, as far as I knew, didn’t believe in God. He had seen us. From his tone, I wondered if he was offended, angry even.

After a brief explanation, he said appreciatively, “I see. Thanks so much- you see, he’s my granduncle. I was just worried. Thanks.”


One by one, my friends each cleansed their hands with the antiseptic handrub at the foot of Uncle Chin's bed. Hospital protocol. I walked to the next one further away, reminding myself to wash my hands away from the sight of the patient lest the patient might, in a state of depression and sensitivity, be hurt or offended. As I turned back for a last peek at Uncle Chin, he winked at me and rubbed his hands together, mouthing the words, "Don't forget to wash your hands!"

I almost felt as if he knew what Washing my hands meant to me, and was reminding me not to worry for him, that God is in control, that he would be all right because he had faith in God and that was all he needed.


It reminded me, that every person is more than a patient, more than a number or a statistic. For all our preoccupations about status, ability, results and numbers, we are more than a performance index, more than an identity card number, more than a digit in a vast population contributing to a national census.

We are children of God, each and every one of us, special in our own rights, wonderfully created. The lady at the reception desk, the elderly man holding the metal pole on the train, the fellow colleague, teacher, cleaner… each one is someone’s mother, grandfather, son, daughter and loved one.

And they each have a name, one worth asking and remembering.


It is a daily consecration we must make, one where we need to constantly look to God to open our eyes to help us see beyond a face, to see names, and Stories and lives. For our senses have been dulled, and we have become blind.


Grandpa Chin- my very own classmate’s granduncle.

More than another stranger, more than another old tired face, more than another disease case presenting with a medical problem for us to solve.

More than The Abdomen at Bed Six. More than another old man whose voice was so hoarse and whispery you would have thought he was mumbling in a senile fashion had you not been a little more patient.

More than two white haloes encircling two old eyes.


More than just your hands, have you washed your eyes too today?





" He (The man who was formerly blind) said to them,
' God put clay on my eyes, and I washed, and I see."
-John 9:15

*name changed for privacy

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