Academic Medicine In Conversation:

Associate Professor Chow Wan Cheng
Group Director, Academic Medicine, SingHealth
Senior Associate Dean, Academic Medicine, Duke-NUS Medical School

Associate Professor Anantham Devanand
Director, Medical Humanities, Medicine Academic Clinical Programme
Head, SingHealth Duke-NUS Lung Centre
Senior Consultant, Respiratory & Critical Care Medicine, Singapore General Hospital

Panellists:

Professor Fong Kok Yong
Seah Cheng Siang Professor in Medicine
Medicine Academic Clinical Programme Deputy Group CEO (Medical and Clinical Services), SingHealth
Senior Consultant, Rheumatology & Immunology, Singapore General Hospital

Professor Christopher Cheng
Surgery Academic Clinical Programme
Chief Executive Officer, Sengkang General Hospital
Senior Consultant, Department of Urology, Sengkang General Hospital and Singapore General Hospital

Dr Lee Guozhang
Medicine Academic Clinical Programme Consultant, Internal Medicine, Singapore General Hospital

Ms Ang Shin Yuh
Surgery Academic Clinical Programme
Deputy Director, Nursing Quality, Research and Transformation, Singapore General Hospital

Ms Dian Handayani
Senior Art Therapist, Department of Psychology, Singapore General Hospital

Ms Kayla Wong
Music Therapist, KK Women's and Children's Hospital

​Medicine with Compassion and Camaraderie

Delving into the narratives of SingHealth Duke-NUS Academic Medical Centre (AMC) staff in an unfolding pandemic, the panel swopped firsthand experiences that reminded of what it truly means to serve.

• Reliving the connection crisis when serving in the isolation wards, providing the human touch from a distance.
• Healthcare system gaps presented in managing COVID-19, which highlights the importance of Medical Humanities
• Caring for a community at large inclusive of migrant workers; examining clinical dilemmas, practices for public health and safety amidst managing a pandemic.
• Recognising and addressing vulnerabilities of healthcare professionals and patients through humanistic approaches.

When distance was safety, how do you help patients and families separated due to the pandemic, physically removed from their beloved fighting to survive? The answer was timeless: To serve with compassion and empathy, especially so in a crisis.

Addressing healthcare gaps

"Our usual ways of providing human touch have been affected," Dr Lee Guozhang shared of his own connection conundrum, recalling of ICU nurses working around social distance measures, cradling phones to bridge quarantined families and isolated patients.

Dr Lee also witnessed colleagues from the AMC rallying for migrant workers in Community Care Facilities (CCFs), volunteering time, translating information, donating SIM cards, and providing culturally-appropriate resources for migrant workers' wellbeing.

COVID-19 was a valuable lesson in intimately identifying the gaps of healthcare, where "standard" healthcare just did not quite cover it all.

COVID-19 accelerating focus on healthcare humanities

With pandemic public health policies set up to protect the healthcare system from collapsing due to the growing numbers of infected individuals, hard choices had to be made.

The circuit breaker's effect was widely felt. Professor Christopher Cheng described a hawker who had turned up for his medical appointment, malnourished. Previously labelled as non-compliant, the patient's state indicated deeper reasons for his absence. He had lost his job due to the circuit breaker and had fallen on hard times.

Prof Cheng questioned: "We are all trained to be very professional, but do we have time, resources and open-heartedness to take in all of the patient's needs, not just his medical needs?"

"Perhaps, the future of healthcare is social because technical knowledge is now a given. I will say that due to COVID-19, the future is already here," he said. "It is an accelerator. And it's high time that we take care of not just the hard science or the intellect in medicine, but also the soft or heart part of medicine."

Addressing dilemmas and impact of COVID-19

Many healthcare workers experienced various degrees of anxiety, worry or burnout, including staff deployed to CCFs.

Reflecting on her three months at Expo CCF as "a steep learning curve", Ms Ang Shin Yuh was thankful for the active pursuit of improvement on processes, so all staff activated at the CCF could receive some relief in turn as work stabilised.

"There was this united front whereby nurses, allied health professionals and doctors were not differentiated. We were all CCF staff," Ms Ang shared.

Due to the extensive nature of CCF where it serviced large numbers of patients over an expansive and temporary physical area, it was vital to mitigate confusion. In establishing a medical board for the unprecedented situation in terms of the high patient load at the CCF, Professor Fong Kok Yong took heart that "medical humanities at work were the most important".

Guided by Prof Fong, the CCF medical board had prioritised three top working principles to support all individuals passing through the CCF: Patient safety, staff safety, and facilitating the patient's journey to the CCF.

The clear framework was important for the CCF in achieving balance for patient health, academic medicine, research touchpoints and staff safety despite its massive patient load.

Humanistic solutions for a new normal

Associate Professor Chow Wan Cheng emphasised the importance of seeking solutions to support healthcare personnel and patients for living in the new normal affected by COVID-19 .

In discussing self-empowerment and consciousness to seek balance, Ms Dian Handayani and Ms Kayla Wong offered common therapeutic practices that can assist to soothe the emotional turmoil experienced in a pandemic.

The art and music therapists recommended connecting with others for presence and support, acknowledging the pandemic as a shared human experience, seeking restful silence to evoke a safe space within ourselves, and using breathwork to refocus. Ms Handayani reminded that "wellness is a state of conscious action" and that we needed to take actions to actualise health.

Associate Professor Anantham Devanand rounded up the session, prompting healthcare professionals to be mindful of the human narratives behind the numbers in a pandemic. He advised trainees and learners to listen attentively and reflectively to the narratives the way master clinicians do, stating that as the only way one will understand the internal world of the patient.

"The stories that we have heard will rescue us from what can otherwise become a series of disconnected events," he shared.

"Medicine is more than a medical problem, and that shifts our mission from seeking clever solutions for diseases and symptoms to helping our patients live well-lived lives."