ErveS on ElvEs, sisyphus and Gandhi - Singapore Medical Association
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OPINION
S
eek
ave
erve
on Elves, Sisyphus and Gandhi
Text by COL (Dr) Lo Hong Yee, CPT (Dr) Russell Lim, MAJ (Dr) Teo Kok Ann Colin
and CPT (Dr) Tabitha Ang Xue Qi
Colonel (Dr) Lo has been Introduction Over the past few months, I visited
serving as Chief of Medical areas affected by the pandemic. I saw
As I drank from the tap, I thought about
Corps since 11 October the people at the water works, keeping many little elves in action; from public
2019. He is a general
a close watch in real time, and about and private sectors, from hospitals,
surgeon by training, but polyclinics and ministries, from the
much of his work now is the pioneering work that put fluoride
into our water.1 It prompts me to think Singapore Armed Forces (SAF),
focused on public health
and people development. about things that happen While We Singapore Civil Defence Force and the
He takes a keen interest Were Sleeping,2 so that in the morning, Singapore Police Force. They came, did
in medical education things work. their work without fanfare and left each
because he was taught by place a little better than they found it.
many inspiring teachers. Like the shoemaker who left pieces
of leather in his workshop and woke up This is an invitation to peek at three
to find a perfectly made pair of shoes, I such little elves. One from the Army who
am curious about the many little elves was thrown into the deep end, to set up
working tirelessly away from the public a hitherto unheard-of “swab isolation
eye, keeping COVID-19 infections at bay. facility (SIF)”; another from the Navy,
Ostensibly, this article is about pre- plucked from his neurosurgical residency
paredness in the healthcare community and plunged into the world of isolation
for such crises. Truth is, swooping in like at a “community care facility”. The third,
the cavalry is glamorous. Preparedness from the Air Force, reminded us that
is not. Preparedness is endless hours of despite COVID-19, other medical
menial, repetitive, and often unnoticed emergencies, including those on
and unappreciated work. This article is a the high seas, continue unabated.
tribute to the many who are involved in Each accomplished much by way of
the business of preparedness. preparedness and rose to the occasion.
AUG 2020 SMA News 15
Isolated in place, yet united transforming the idyllic resort at Civil nights were spent fine-tuning
against adversity Service Club @ Loyang into a full- processes on the ground and
fledged SIF, ready for battle. gathering information.
CPT (Dr) Lim: The concept was elegant
– swab all suspect cases, house them SIFs bore the brunt of isolation Our efforts bore fruit, and SIFs
in Quarantine Order-level facilities, patients, with hundreds arriving by mushroomed throughout the island,
then disperse them based on swab the busload daily. They came from modelled after our processes. I am
results. The execution was anything dormitories, hospitals and clinics immensely proud of our medics and
but. Cherryloft Resorts was set up with island-wide. It was a challenge being the Army’s efforts in safeguarding our
plans to be operational by week’s end. commander, doctor, counsellor and nation from this invisible threat.
But with burgeoning spikes in cases, liaison officer all in one. Handling
the call was issued to stand up Loyang anxious, unstable patients, food
Captain (Dr) Lim currently serves as
by day three. and security concerns made SIF Brigade Medical Officer, 3rd Singapore
Constant readiness ensured that management uncertain and stressful. Infantry Brigade and Staff Officer, Centre
logistics, manpower and support Daily, even hourly changes to policy of Excellence for Soldier Performance.
meant that ground processes had to He was awarded the SAF Medicine
was prepared within half a day, Scholarship in 2013. He served as
be updated frequently, sometimes Commander of CSC@Loyang SIF, and
with incomplete information – a real Deputy Head HQ SIF. He was subsequently
challenge when wearing personal deployed in CCF@Expo as Deputy Head
protective equipment (PPE). The Medical Operations Cell.
experience harkens back to house
officer days when one’s phone would
be ringing constantly – from superiors,
peers and employers requesting for
information. Unfortunately, the volatile
situation meant that answers were
Russell in action anything but certain. Many sleepless
Standing on the shoulders of In the COVID-19 “fog-of-war”, we had
Harvey Cushing to draw clear boundaries for safety,
be punctilious with our processes and
MAJ (Dr) Teo: I have been inspired by
engender trust in our men through our
senior neurosurgeons to mould myself
decisions.
in the likeness of Harvey Cushing – the
father of modern neurosurgery – as the Similar to Cushing’s fight in the
epitome of excellence in medicine. I “Battle of Boston Common”,5,a we faced
anticipated similarities in our journeys, challenges mobilising our fight for
featuring obsessions with the pituitary. preparedness. While Cushing’s solo
Colin briefing Senior Minister of State Dr
However, I never imagined being effort failed, “we” as a team succeeded.
Maliki Osman on the automated Vital Signs
thrust into the command team for “We” comprised Tri-Service (Army, Monitoring station
the “field hospital” effort at the SAF Navy and Air Force) Full-time National
Community Care Facility (CCF) @ Expo3 Servicemen, Regulars and Operationally
Major (Dr) Teo currently serves as Head,
in the fight of my generation against Ready National Servicemen who Medical Doctrine and Training Branch,
COVID-19, just like Cushing did in stepped forward on the back of earlier Navy Medical Service, the Republic
World War I of his generation.4 deployments (within SAF and/or in of Singapore Navy. He assumed the
public hospitals) and readily threw appointment of Hall Commanding Officer
When the call of duty came, we in CCF@Expo as part of SAF’s efforts
our weight behind our teams to keep
were ready to serve at short notice. against COVID-19. He is concurrently
each other motivated and focused on Senior Resident in Neurosurgery at the
But the realities of the challenges that
the tasks ahead, as well as our partner National University Health System. He
lay ahead were daunting. Mission also holds post-graduate qualifications in
agenciesb who provided the resolute
success meant providing a robust Underwater Medicine.
“tail” to our “teeth”.
standard of care to patients while
achieving zero safety incidents, I may never be as accomplished as
including zero healthcare-acquired Cushing in my lifetime, but I consider
infections. Leading the team in the myself far more privileged to have
“trenches”, we needed to provide witnessed our sense of common purpose
our men with the information, and commitment to the nation’s defence
training and resources to succeed. play out before my very eyes.
16 AUG 2020 SMA News
Flying over seas – one life saved milestone. I have always felt that
women are given equal opportunities
CPT (Dr) Ang: I had just taken over
the Search and Rescue (SAR) duty to serve in all roles in the SAF. For
from my colleague on 8 June 2020, that, I am truly honoured for the
when the call came for the day’s opportunity to serve in 1 Medical
duty team to respond. A severely ill Squadron, to be able to provide
individual on board a commercial medical assistance to people in
vessel within our flight information distress out at sea and ensure the
region had radioed for medical help. continued safety of our aircrew as
they take to the skies.
I was filled with both excitement The Search and Rescue team
and apprehension. This was my
maiden SAR mission. It was also Captain (Dr) Ang currently serves as
hand what team excellence was – the Operations Officer, 1 Medical Squadron,
the first time the newly developed collective desire to ensure mission Republic of Singapore Air Force. She holds
COVID-19 protocols would be carried success and safety outcomes, from both a post-graduate Diploma in Aviation
out in a live SAR mission. Prior to this, the medical professionals and aircrew, Medicine. She was awarded the SAF
we had identified the risk areas when was evident. It was no surprise that Medicine Scholarship in 2012 and joined
conducting winching operations and the Air Force Medical Service in 2018.
the SAR mission was completed safely,
medical resuscitation on board a without much fanfare.
helicopter, while in full PPE. We
recognised that performing a When I was informed that I was
helicopter-medevac was already the first female medical officer to be
challenging, and doing it in full PPE involved in a SAR operation for the
makes it a lot harder. Throughout Republic of Singapore Air Force, I was
the preparations, I witnessed first- pleasantly surprised at this significant
Conclusion
References Notes
The reward for their good work is more 1. National Institute of Dental and Craniofacial a. The “Battle of Boston Common” was Harvey
work. Some people see it as a curse, like Research. The story of fluoridation. Available at: Cushing’s effort in rallying national support for
Sisyphus, but I see it as merely our lot https://bit.ly/30xx1J9. military medical preparedness in the US prior to
– eternal vigilance, as a way of life. Not World War I. He faced significant challenges in
2. Hemenway D. While We Were Sleeping. Success
a siege mentality per se, but certainly mobilising support for this need, and considerable
Stories in Injury and Violence Prevention. Berkeley:
public outcry for his efforts in attempting to
not resting on our laurels. At the time of University of California Press, 2009.
exercise the setup of a field hospital in a large
writing, there is neither a second wave of 3. Lim MZ. 100 soldiers from SAF Medical downtown park known as Boston Common.
infections nor the prospects of a repeat Corps deployed to care for COVID-19 patients While the setup never happened, he was widely
circuit breaker. Crossing fingers doesn’t at Singapore Expo. Available at: https://bit. credited for facilitating the US military’s medical
ly/3fLT5X2. preparedness going into World War I.
work, preparedness does.
4. Doyle NM, Doyle JF, Walter EJ. The life and b. Examples of partner healthcare agencies
And to our healthcare colleagues work of Harvey Cushing 1869–1939: A pioneer of include Woodlands Health Campus and
who toiled in the past months and many neurosurgery. J Intensive Care Soc 2017; 18(2):157-8. SingHealth.
who are still facing the drudgery of the 5. Rutkow E, Rutkow I. Harvey Cushing and the c. The Singapore Armed Forces Medical Corps was
pandemic work, it is cliched but certainly battle of Boston common: military medical founded in 1967. Its motto is “Seek Save Serve”, a
timely and timeless to quote Gandhi: preparedness for World War One. Ann Surg 2010; testimony to the men and women who did exactly
“Every worthwhile accomplishment, 252(1):191-8. that over the years.
... has... a beginning, a struggle and
a victory.” We cannot decide the
beginning, nor are we ever confident
of the victory, but we can certainly own
every bit of the struggle.
Seek Save Serve.c
AUG 2020 SMA News 17
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