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VO L . 5 3 N O . 6 | J U N E 2 0 2 1 | M C I ( P ) 078 / 1 2 / 2 0 2 0
Music and Medicine:
The Arts of Healing
Being Part of an
Asian Fraternity
news
CON T E N T S
Vol. 53 No. 6 2021
Editorial
EDITORIAL 04 The Editor’s Musings
BOARD Dr Tina Tan
Editor
Dr Tina Tan
Deputy Editor
Feature
Dr Chie Zhi Ying 05 Music and Medicine:
Editorial Advisors The Arts of Healing
A/Prof Daniel Fung Dr Joshua Hoe and Dr Stephanie Yeap
A/Prof Cuthbert Teo
Dr Toh Han Chong
Members President's Forum
Dr Ganesh Kudva 08 Continued Support Review
Dr Lim Ing Haan 20 Healing Hearts, Touching Minds
Dr Jipson Quah
for Our Fighters
Dr Tan Tze Lee Dr Tan Yia Swam Dr Suresh Nair
Dr Jimmy Teo
Dr Alex Wong
Council News 22 Tucking into Food and Culture
EX-OFFICIOS Dr Tina Tan
Dr Tan Yia Swam
10 Highlights from the
Dr Ng Chew Lip Honorary Secretary
Dr Ng Chew Lip
EDITORIAL Reflections
OFFICE 23 Requiem for Ah Leng
Senior Manager Insight A/Prof Cheong Pak Yean
Sarah Lim 12 Medicine and the Law:
Assistant Manager Telemedicine (Part 2) 24 Being Part of an Asian Fraternity
Sylvia Thay Jansen Aw and Dr Alex Cheng Wei Ray
Dr Jipson Quah
Editorial Executive
Daryl Lai
Opinion 26 Awake at 2am
ADVERTISING AND
PARTNERSHIP
14 Two Years into Medical Dr Tan Su-Ming
Li Li Loy School (Part 1)
Tel: (65) 6540 9174 Faye Ng Yu Ci
Allan Kuek 26 Visit from an Old Acquaintance
Tel: (65) 6540 9175 Dr Tan Su-Ming
Email: adv@sma.org.sg
Letter
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editorial
Dr Tina Tan Music and dance are not simply
forms of creative expressions. For
many, that heavy sense of deja vu
still felt unnerving nonetheless.
folks like me who can’t play a tune, I would draw your attention,
we certainly appreciate them and especially, to SMA President’s
Editor rely on them to soothe our souls, or column on voicing support for
even to let our imagination soar. In healthcare workers. While Tan
Dr Tan is a psychiatrist with the my practice, music especially has Tock Seng Hospital has thankfully
Better Life Psychological Medicine many benefits in calming emotional reopened, healthcare workers
Clinic, and a visiting consultant at distress as well as being an integral continue to bear the brunt of
the Institute of Mental Health. She part of reminiscence therapy in having to manage COVID-19
is also an alumnus of Duke-NUS patients with cognitive impairment. patients, adhere to stringent
Medical School. Between work and
This issue, we are very pleased infectious disease controls at
family life, she squeezes time out for
to feature doctors whose talents lie work and worry about their
her favourite pastimes – reading
beyond the practice of medicine, families when at home. On
a good (fiction) book and writing.
and who have dedicated their time in top of that, our usual clinical
the pursuit of their passion for music work carries on to a limited but
and dance. definitely essential extent.
At the risk of exposing my inner
nerd, who here likes the theme In addition, Dr Jipson Quah It is traumatising to be on
song of The Mandalorian? Don’t be kick-starts our humble attempt to the receiving end of stigma
shy – I unabashedly declare that draw in more readers by introducing and ignorance, and that has
I watch the show just to hear the SMA News’ first crossword puzzle. come in blatantly obvious
song play during the end credits. For those who enjoy such activities forms from scooting away on
Or have you ever swayed to the (especially since we can’t travel or an MRT train to, if I may say so,
tune of Handel’s Minuet? Or blasted socialise much and have to stay underhanded comments on
out that rock song to the great home more these days), please do social media disparaging some
annoyance of your children? For the have a go and enjoy yourselves. of our colleagues. #umbrage
record, that last example does not Our issue this month is truly I hope that our readers are
apply to me. I just happen to blast meant to lighten the mood, which aware that SMA is working hard
out other types of music besides comes amid Phase Two (Heightened for the profession, to represent our
rock, thank you very much. Alert), and hopefully we are in the collective voices at the appropriate
Despite being neither a musician midst of exiting that by the time of platforms and make a difference.
nor dancer, I appreciate good music, publication. However, the situation This is the way.
especially a musical piece that is remains fluid, or as one minister puts
strongly tied to a memory or evokes it, “on a knife’s edge”. That message
a powerful emotion. Have you ever truly sank in when home-based
had that experience? Such is the learning was announced for our local
power of music and dance. There’s schools yet again and people were
something innate in all of us that has only allowed to socialise in groups of
an appreciation for these art forms. two. We saw it coming, but I think for
04 JUN 2021 SMA News
Music and Medicine:
FEATURE
The Arts
of Healing
“Music can heal the wounds which medicine cannot touch.” – Debasish Mridha
Many would agree with the saying that music heals the soul. Surely then, music would be a great partner in
the practice of medicine and the art of healing. Here, two authors share their respective journeys of being
both a medical doctor and an avid musician, and how one practice complements the other in their lives.
Text and photos by Dr Joshua Hoe
I have loved music for a long time. In my
favourite Victorian romantic comedy
Pride and Prejudice, Elizabeth says to her
beloved Mr Darcy in an impassioned
speech at the climax of the novel: “I
cannot fix on the hour, or the spot, or
the look or the words, which laid the
foundation. It is too long ago. I was in the
middle before I knew that I had begun.”
Imagine me saying the same thing,
but about music. Perhaps you’ll see what I
mean more clearly through a few indirect
anecdotes. Some things are clearer by 1
illustration than telling.
A musical epiphany are in an undesirable artifact caused I cannot tell you where that power
by driving a tube amplifier too hard. By comes from, but it is there and almost
I recently found out why I love the subtle applying too much gain the audio signal universally loved at that, so I know it’s not
“break-up” distortion on an electric guitar is clipped, introducing harmonic and a peculiar taste of mine (like drinking Milo
so much. inharmonic overtones, sustain and that without sugar).
When you push the gain and tone oh-so-lovely face-melting warmness.
knob into the right position and attack But really all those words don’t mean The nature of music
the guitar strings just enough at the much when I hear that overdriven Let me give another example of a
right moment, that distortion on a big guitar tone in my favourite song after a powerful experience I’ve had with music
sweeping chord on a chorus can take you bad day at work, and it hits somewhere recently. I was innocently surfing YouTube
places. That same distortion on a phrased inside at the crossroads between mind, (as one does), and came across a series of
melody up the neck of the guitar can tell body and spirit (I think that localises videos that really helped me understand
you exactly how beautiful life can be, or to the thorax region in Netter’s Atlas the harmonic series for the first time. I was
perhaps how tragic love lost really is. of Human Anatomy). That dangerously floored when I realised that the twelve-
And now, in the words of Monty gritty, warm and blooming sound tone equal temperament system that
Python, for something completely makes me think of bittersweet pain, a we use almost universally in music, and
different: that familiar “distortion” sound thunderstorm, frustration and catharsis the intervals between these notes, are
is really a technical accident – its roots all at once. It’s lovely. found naturally occurring as a principle
JUN 2021 SMA News 05
of physics in the harmonic series. (The Music and medicine Text and photos by
harmonic series describes a series of Dr Stephanie Yeap
When I get asked occasionally about
overtones created after a fundamental
how music relates to medicine, to my What is your favourite post-call activity?
is played on a resonating instrument. I’ll career and to caring for patients – I get For some, it may be going home to take
stop here as I can hear an army of much an odd anxious feeling that I have a lot a good nap, meeting friends for a meal,
better trained musicians typing furiously and yet very little to say at the same or even catching a movie – things that
to email the SMA News Editor about equal time. I really want to say “I love music” our long work days would preclude us
temperament as they read this.) and proceed to elaborate on that in from enjoying regularly. For me, my
The mind-bending upshot to all that a long-winded way that would make best post-call moments would be spent
music-geekery is that music is fundamental Gandalf ask for a toilet break. singing at one of my favourite bars,
to the reality we live in, and to life really. But really, I could not hope (or even under the starlit sky.
I may even go so far as to say that attempt) to begin to summarise the My journey as a singer-songwriter
when these mere oscillating waves of power and joy of music – but I hope that
began when I was in junior college,
sound travel through the air and slap your in those meandering paragraphs above,
having been part of the school’s rock
eardrums unceremoniously, and you can you begin to understand what I mean
band co-curricular activity. Entering
feel your spirit lift and soar during your when I say: “I really love music”.
medical school, one of my biggest worries
favourite song – that’s a hint of the divine I would defer to my many far more was not being able to play music as a
and the mind of God right there. That’s life experienced colleagues on this, but working doctor, and hence with every
and joy, really. (I hope that was enough insofar in my personal experience as a opportunity to perform, my mantra was
payoff for having to read through that.) hospitalist in an acute medical speciality, “this could be my last chance”.
I have seen a fair amount of suffering.
The experience of music, I think, sits This mantra stayed with me through
Death is always a sobering reminder
squarely at a meeting point. The meeting the years, where I’d eagerly contribute to
that life is unthinkably fragile and finite.
between mind, body and spirit, between school events, or take part in the Medical
Fatigue and weariness at the seeming
the technical and sublime, between Society’s annual Open Mic, which led to
randomness of illness and suffering are
listener and musician, between one me taking big leaps in my music career
always ready to set in. I do my best to
person and a thousand, between hours of remind myself that the goal of medicine including joining the National Arts
chair-warming practice and ten seconds is really to support life, the experience of Council’s prestigious Noise Singapore
of spontaneous improvisation that scares life and the joy of living, and music has mentorship programme and taking part
your pants off, between science and art. always unfailingly reminded me of that. in Sing! China auditions. This idea that
There’s a pathway from motor cortex I had to seize every gig opportunity, or
to spinal cord, alpha motor neuron, To indulge in some of Dr Hoe’s music risk regretting declining gig offers when I
muscle fibres and to the movement of and recordings, visit began work fuelled me as I juggled both
the vocal cords and fingers, but really, https://www.youtube.com/joshhoe music and medical school.
where does the music come from? Where or follow him on Instagram
What initially began as little stints
does it go? What does it do when it leaves @hoestudios.
on stage as a Year 1 student grew into
the musician and causes an audience
an exciting journey – including singing
full of strangers to feel the same feeling Legend
live on radio, playing for the President of
at the exact same moment? Is there 1. Original illustration by Joshua and his wife Singapore and helming my own show on
a rule for having too many questions 2. Joshua and his wife cover the song “Love is an the grand Esplanade waterfront stage.
in a row in an essay? Who knows? Open Door”, available on his YouTube page
Perhaps the greatest joy, however, was
marrying my love for music with my work
in medicine. This manifested in reaching
out to others through music, as well as
Dr Hoe is, at the age of 32,
still trying to decide if he
writing songs about my experiences.
is really an arts or science
stream student. He works Connections through music
at Singapore General
Hospital as a senior resident One of my most distinct memories was
and makes music at home during my Year 4 psychiatry medicine
almost compulsively after posting in the Institute of Mental
work. He has just picked up Health. We’d been assigned to the A&E
digital art and photography.
Someday he could possibly where, as many of us know, patients
2 be skilled in at least one of with suicidal intent are often sent. I
the above things. was to clerk a young man who’d just
06 JUN 2021 SMA News
come in – with a stoic face he revealed
that he’d come from a strict family with 1
high expectations for his career. He
eventually caved and broke down,
sharing that he’d been contemplating
taking his life because his father
threatened to disown him if he pursued
what he loved: music. As opposed to
continuing the “nine-grid” history-
taking template we’d been taught to
Photo: Benghui Eu
administer, I paused and explained,
“Actually, I’m a musician too.” We then
went on to discuss the struggles of
being passionate about music, amid the
pressures of more “traditional” priorities
like good grades and a professional
job. At the end, the patient appeared
comforted and was encouraged to Legend
it was heartening to know that my
talk things out with his father. In that
music connected to others’ personal 1. Steph launching her original music album at
moment, it felt almost serendipitous. the Esplanade Outdoor Theatre (August 2020)
experiences and further inspired their
Of course, now as a working doctor expression of art.
and especially with the cessation of
What would be my biggest advice
live music during COVID-19 times, my
to peers or juniors who feel driven to Dr Yeap is a medical officer working
nights playing gigs have dwindled.
pursue a passion outside of medicine, in Singapore General Hospital, and
Nonetheless, being a doctor has put me be it music, photography, crafts, gaming also a singer-songwriter in the local
in a privileged position to encourage or even cooking? Sometimes the best music scene under the moniker
others through music. One such thing we can do is to just take a deep
“Stephycube”. With the release of
opportunity was collaborating with her album Most Of All (2019), she was
breath and make the plunge, reminding highlighted as one of “Singapore’s
Creative Nation Singapore (a collective ourselves that “this could be my last Top Acts” on Spotify and on Apple
by the National Youth Council) to curate chance”. Because if not now, then when? Music’s “The A-List: Singapore Music”.
a Spotify playlist entitled “Stockpile
When the pandemic gets better, and
of Love”, which features songs to
you’re heading to your favourite bar for
encourage front-line workers and
a drink after work, don’t be surprised
COVID-19-stricken patients recovering
if you see a bleary-eyed but smiley
in the wards.
singer providing background music for
the evening. Just give a little smile and
Reaching out over distances wave, for that could be me post-call!
Writing original music has also allowed
me to document my experiences in lyric
and song, and connect with others. One
amazing encounter I had was receiving
an email from a listener in the US – she
shared that her daughter, a competitive
dancer, survived a harrowing bout of
supraventricular tachycardia earlier that
year. Having chanced upon “Emergency
Room” on Spotify, an original song I
wrote about my grandfather, she was
inspired to use it as her contemporary
solo piece, relating it to her own
experiences in the emergency room. For
one, it was incredible to realise that my
music had reached somewhere so far
away from home, but more importantly,
PRESIDENT'S FORUM
Continued
Support for our
Fighters
Illustration: Dr Justinian Zai
Text by Dr Tan Yia Swam
Throughout the months of May and Those with family members working in I urge all our Members to exercise self-
June, like me, many of you must have Tan Tock Seng Hospital (TTSH) who had care. Take a break from work and from
followed the reports of local COVID-19 to endure “self-isolation” or even move worrying about COVID-19.3,4
outbreaks very closely. The tracking out into temporary accommodations This June issue carries some light-
of the progression of cases depends to abide by the “Segregation Order” hearted articles on the arts. The arts
on where you get your facts from, as would have felt the pain of having to be soothe the soul, whichever medium you
the style of reporting may bias one to a broken family, even if temporarily. Yet may prefer – be it theatre, music, visual
certain conclusions. there are doctors who mock this, calling arts and/or other genres. I personally
After 16 months of battling COVID-19 it a “Government-paid staycation”. choose music to match my mood.
in Singapore, some consistent social I have family and close friends If you are feeling very stressed,
elements that impede our fight include: working in TTSH, and I can see that consider taking a half-hour or short
1. Lack of timely and accurate the relentless stress, continuous work break to get something to drink and put
information (eg, the limitations and mounting fear is taking its toll. on your favourite music. Let your mind
of testing). The fatigue and burnout experienced wander and not think of anything in
by these doctors are real. But I am also particular. Live in the moment.
2. Inability to disseminate factual news relieved that there is some awareness
fast and securely. of discrimination against healthcare
3. Proliferation of speculations. workers (HCWs), and that many are
speaking up on this. These HCWs are References
Varied comprehension on the front line and they make the 1. Barron D. Health Care Workers Don’t Want to Be
most personal sacrifices. I have heard Heroes. Scientific American. Available at: https://bit.
It seems that everyone interprets the some opine that, “This is what they ly/33WS3mI.
severity of the COVID-19 pandemic 2. Bobak A. Medical Ethicist on the Problems with
signed up for, they should know.” The
based on what they know, and in truth Calling Healthcare Workers ‘Heroes’. Mad in America.
narrative of “healthcare hero” might
– no one has a complete picture. Some Available at: https://bit.ly/33YLL5U.
need to be changed somewhat.1,2 While
have gotten very relaxed, because they 3. Gov.sg. Tips for Battling Stress and Anxiety during
it is a calling to be in healthcare, there
have not known of anyone getting COVID-19. Available at: https://bit.ly/3fp04WO.
should also be an understanding and
COVID-19 within their social circles 4. Centers for Disease Control and Prevention. Coping
appreciation that we too are humans
and news of faraway places do not with Stress. Available at: https://bit.ly/3frSqeg.
and this is a job, just like any other.
affect them. Yet there are others who
have lost loved ones to this virus and Social media is always a double-
might be living in fear that they might edged sword – on the one hand Dr Tan is a mother to three kids, wife to
lose more family members to this providing fast information and a surgeon; a daughter and a daughter-
updates, and comic relief in the form of in-law. She trained as a general surgeon,
pandemic. The majority of the people
and entered private practice in mid-
would perhaps have a situational memes, but also capable of spreading
2019, focusing on breast surgery. She
reaction, depending on context. falsehoods fast and inviting much treasures her friends and wishes to
casual and callous comments, maybe have more time for her diverse interests:
Even within healthcare, I realised
even deliberate cruelty. I hope that cooking, eating, music, drawing,
that doctors practising in different writing, photography and comedy.
my friends here will exercise your
areas and/or subspecialties can have
professionalism, empathy and basic
very different perceptions as well.
decency to be thoughtful and kind. The
whole world is suffering together.
Means to recharge
I dare say everyone is battling some
form of COVID-19 fatigue. People have
lost lives and jobs to this. Everyone
has lost their freedom to some extent.
JUN 2021 SMA News 09
council news
Report by Dr Ng Chew Lip
SMA’s published survey on impact of COVID-19
To understand how our Members are doing during the Dr Ng is an ENT consultant in
pandemic, SMA conducted a survey to evaluate the impact public service. After a day of
of COVID-19 on doctors in the private sector, specifically on doctoring and cajoling his two
income and practice patterns. princesses at home to finish
their food, his idea of relaxation
The majority of respondents, in both GP and specialist is watching a drama serial with
groups, reported income loss and a decrease in patient his lovely wife and occasionally
load, with a small percentage having to retrench staff or throwing some paint on a canvas.
cut wages.
The article, published in Annals, Academy of Medicine,
Singapore, can be found at https://bit.ly/3bJhj47.
WSH toolkit for healthcare workers Passing of CMAAO President Dr K K Aggarwal
The Workplace Safety and Health (WSH) Council has The SMA Council informs with regret the news of Dr K K
developed the “WSH Orientation toolkit for Healthcare Aggarwal’s demise on 17 May 2021 in New Delhi, after a
Workers”. The course aims to equip participants with lengthy battle with COVID-19.
WSH knowledge, such as the WSH Act and its regulations,
Dr Aggarwal was President of the Confederation
common hazards at their workplaces, and control of Medical Associations in Asia and Oceania (CMAAO)
measures, so that they can protect themselves and from 2019 to 2021. SMA is a member of three regional/
prevent injuries and ill health. international bodies, namely the Medical Association of
Adapted from the “Basic WSH Healthcare Online South East Asian Nations (MASEAN), CMAAO and the World
Course”, the toolkit can be used by healthcare institutions Medical Association (WMA).
to conduct orientation and training for their staff. The In his short tenure as President of CMAAO, Dr Aggarwal
toolkit includes enhancements from the online course turned CMAAO into a vivid institution of organised
such as: medicine with daily discussions, weekly – mostly
• Updated content in alignment with recent educational – online meetings and friendly cross-border
regulatory changes (Workplace Safety and Health exchange of facts and opinions.
[Incident Reporting] Regulations 2020); SMA wishes to extend our deepest condolences to
• New fire safety and response module; Dr Aggarwal’s family during this time of grief.
• Facilitation tips for the slides; and
• Enhanced comprehension questions at the end of
Passing of Dr Yeo Khian Kiat
each module.
The toolkit was reviewed by the WSH Council The SMA Council informs with regret the news of SMA
(Healthcare) Committee, which consists of stakeholders Life Member Dr Yeo Khian Kiat’s demise on 28 April 2021.
in the healthcare industry, to ensure that the content is Dr Yeo was a GP at Drs Horne & Chin before he retired,
accurate, relevant and useful to the healthcare community. and he has been an SMA Member since 1969.
The WSH orientation toolkit can be downloaded from We wish to extend our deepest condolences to Dr Yeo’s
https://bit.ly/3u8a1xg. family during this time of grief.
10 JUN 2021 SMA News
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To sign up, please visit https://bit.ly/SMAapplication.Medic in e and the Law
INSIGHT
TELEMEDICINE
(PART 2) Text by Jansen Aw and Dr Alex Cheng Wei Ray
This is the second article of a two-part series. In this, the authors delve deeper into the legal-technological aspects surrounding the use
of telemedicine. Part 1 (https://bit.ly/5305-Insight) discusses issues where law and technology converge in the realm of telemedicine.
Due diligence and One solution would be to implement to prevent unauthorised access to the
authentication issues a two-factor authentication system, telemedicine application and patient
where not only the patient’s iden- records and to prevent any identity
It is not often that a doctor is faced
tification document is verified, impersonation where possible.
with considerations of due diligence to
but the patient’s identity can be
be carried out with regard to a patient. Additionally, there are
verified using their mobile number.
These belong more commonly to a confidentiality issues surrounding
Additionally, as a government-wide
corporate setting. Nevertheless, there telemedicine. Although the NTG
initiative, it may make sense if Singpass
is a need to carry out due diligence guidelines state that doctors should
can be integrated into telemedicine
and authentication of a patient in the not record the contents of the tele-
apps during the initial registration
context of telemedicine. Given the consultation to respect the sanctity of
to automatically verify a patient’s
remote environment in which the doctor-patient confidentiality, there
identity, similar to how some banks
doctor comes into contact with the is nothing stopping the patients from
are getting information from the
telemedicine user, it may be difficult doing the same thing on the other
MyInfo platform to verify new account
for a doctor to verify the identity of the end, which may make some doctors
signups.1 Alternatively, an NRIC/FIN
patient and the information provided, uncomfortable in providing care via
verification platform can be created to
and this may lead to a risk of abuse. tele-consultation. A proposed solution
grant doctors the right to check if the
For example, a user may provide in future, once the Healthcare Services
identification number is genuine. This
false information to a doctor over Act kicks in, is that tele-consultation
will in turn prevent issues regarding
the telemedicine platform in order to should only be conducted on
phantom patients and any potential
obtain a payout under an insurance approved applications with all these
drug abuse cases.
policy, and it may be difficult for the considerations taken into account.
doctor to verify such information given
that they are not in direct contact with IT security and
confidentiality issues Data protection
the patient.
At the moment, tele-consultations are If telemedicine is the engine driving
The current National Telemedicine the way forward in providing medical
Guidelines (NTG) stipulates that a performed across various platforms.
Some GPs and even polyclinics are services, then data (or more specifically,
doctor should request for the patient’s
conducting them through the use the patient’s data) is the fuel that
photo identification with NRIC/FIN
of video-conferencing software, powers this engine. It is through the
number clearly shown on the video
which may pose a security concern. collection and use of such patient data
screen before the consultation to
It would be wise for a telemedicine over remote means that the doctor
verify their identity. However, a colour
provider to have in place the proper is able to come up with the relevant
photocopy of an edited identity
infrastructure and IT security to ensure diagnosis, treatment and advice for the
card will look exactly the same as
that information transmitted between patient in telemedicine.
a real one on screen, as the doctor
will not be able to feel the texture the doctor and patient is secure from In this regard, it is critical that a
of the card. Furthermore, since the intruders or hackers. doctor providing telemedicine services
various telemedicine apps operate In line with the above, telemedicine be well versed in the requirements to
on their own servers, there are also providers should also ensure that protect personal data of the patient
no alternative avenues for a doctor to there are proper Identity and Access under the Personal Data Protection
check if an NRIC/FIN is genuine. Management2 mechanisms in place Act (PDPA). These include ensuring
12 JUN 2021 SMA Newsthat the patient’s consent is obtained their medical condition. In our view, Jansen is a partner with the Litigation
and Dispute Resolution Practice, and
before collecting, using or disclosing the market for smart tele-monitoring
Technology and Data Protection Practice
his/her data; ensuring that there are devices with incorporated AI technology in one of the oldest law firms in Singapore,
reasonable security arrangements to is set to grow. Donaldson & Burkinshaw LLP. Jansen is
protect such personal data; ensuring However, these come with an advocate and solicitor of the Supreme
that the personal data of the patient Court of Singapore.
challenges too. Deepfakes, which
is accurate during collection; and refer to manipulated videos or other
ensuring that the personal data of digital representations produced by
the patient is not retained for an sophisticated AI that yield fabricated
unreasonably long time.3 It should images and sounds that appear to be
be noted that the PDPA will be real, may also pose a problem in the
undergoing changes in the future, and arena of telemedicine.7 Doctors may
a public consultation has recently been have problems verifying a patient’s
carried out to seek comments on these identity, giving rise to phantom patients.
proposed changes.4 It may even be exploited as a loophole
by patients with ill intent to manipulate Dr Alex is a family physician who works
The future of telemedicine the tele-consultation process. as a locum medical doctor during his free
In a recent McKinsey survey, healthcare time. He is currently pursuing a Master of
Recently, Singapore’s Infocomm
Laws with the University of London. Aside
leaders interviewed cited remote Media Development Authority and from his medical qualifications, he also
monitoring as a key area for future Personal Data Protection Commission holds the degrees of Bachelor of Laws,
investment and up to $250 billion (PDPC) produced the second Master of Professional Accounting and
worth of current US healthcare edition of the Model AI Governance Master of Business Administration. He is
spending could potentially be an incoming practice trainee lawyer at
Framework (Model Framework) to
Donaldson & Burkinshaw LLP.
virtualised.5 If devices can be created regulate the use of AI technology.8
to replicate a doctor’s physical The Model Framework’s strength
examination and provide accurate and unique contribution to the
information to the attending physician global discourse on AI ethics lies in
remotely, even telemedicine’s translating ethical principles into
staunchest opponents may be practical recommendations that
converted to embrace it. Some of organisations can readily adopt to
these technologies already exist but deploy AI responsibly. The barrier to
cost issues prohibit their widespread entry of AI adoption is hence lowered
adoption in telemedicine. It may and users have the confidence
just be a matter of time before such to implement AI to improve their References
production costs are lowered, making processes. This framework is sui 1. GovTech Singapore. MyInfo. Available at:
telemedicine more accessible to generis, which means that the https://bit.ly/35EnOhv.
patients. For example, oDocs Eye Care framework can even be applied in 2. Gittlen S, Rosencrance L. What is identity and
invented an add-on device that can the field of medicine. Therefore, access management? Guide to IAM. TechTarget
turn any smartphone camera into using the PDPC’s Model Framework SearchSecurity [Internet]. Available at: https://
as the foundation, we hope that the bit.ly/3mrITqz.
an ophthalmoscope, which can aid
doctors in diagnosing eye conditions Ministry of Health comes up with 3. Personal Data Protection Act 2012. Available
through tele-consultation.6 Electronic guidelines specifically for telemedicine, at: https://bit.ly/31SrX39.
stethoscopes which can wirelessly accompanied by a compendium of 4. Personal Data Protection Commission. Public
transmit recordings of auscultation use-cases, to guide practitioners in their Consultation on Personal Data Protection
(Amendment) Bill. Available at: https://bit.
sounds back to the computer via practice of telemedicine.
ly/3fTgJUf.
Bluetooth are also available in the
5. Bestsennyy O, Gilbert G, Harris A, Rost J.
market. Perhaps in future, every Conclusion Telehealth: a quarter-trillion-dollar post-
telemedicine patient can have an
Telemedicine has the potential to COVID-19 reality? McKinsey & Company
electronic stethoscope at home to reshape the way in which medical [Internet]. 29 May 2020. Available at: https://
complement the tele-consultation. practitioners practise medicine. Just
mck.co/3cW5mZR.
Artificial intelligence (AI) is like how Uber disrupted the transport 6. oDocs Eye Care. About us. Available at:
also becoming more pervasive in https://bit.ly/3usH0N7.
sector, how AirBnB disrupted the
telemedicine. There are currently tourism industry and how blockchain 7. Shao G. What ‘deepfakes’ are and how they
several online self-diagnosis programs technology disrupted the banking sector, may be dangerous. CNBC [Internet]. 13 October
2019. Available at: https://cnb.cx/3wJWjDk.
available (eg, Symptom Checker by it would be interesting to see whether
WebMD and the Mayo Clinic Symptom telemedicine will become the next 8. Personal Data Protection Commission.
Singapore’s Approach to AI Governance.
Checker), which taps into AI technology disruptor in the practice of medicine in
Available at: https://bit.ly/3fJiYcO.
that allows patients to self-diagnose the age of the COVID-19 pandemic.
JUN 2021 SMA News 13OPINION
O Y E A R
TW al School S
into Medic Text by Faye
N g Yu Ci
1
Part 1
Parallel histories from Kent Ridge MRT to UTown. In
place of the library, I studied at the
When I was a child, my mother loved
common area outside Starbucks,
to tell me stories from her university
the vast patch of green in front of
days. She said those were the most
me, the view and weather sublime
radiant years of her life, ones she
on wind-rimmed days. While my
enjoyed to the fullest. There was the
mother ran for desserts, I ran from
thrill of unbridled youth, coupled with
the anatomy hall to the histology
the freedom of academic enterprise.
laboratory, and for the MD6
With independence came the liberty to
tutorial rooms when my clinical
allocate and repurpose time, pre-curated
group detoured too far away for
school days a relic of the past. University
lunch. On that day, we lost track of time Singapore at the Southeast Asian Games,
was the semi-autonomous rite of passage
in between full-bellied laughter and impassioned environmentalists driving
to adulthood, with only a portion of its
honest conversation, enclosed in the sustainable efforts and aspiring artists
responsibilities. It was the place where
warm-coloured walls of La Nonna. producing Spotify soundtracks. There
you discovered and found yourself.
are friends living in Hall whose gamut of
As a university student, my mother Getting into medical school co-curricular activities all but take them
weaved through the campus on her away from the studying of medicine,
steel-framed bicycle, squeaky wheels When my juniors asked me for advice on
friends who strike a good balance
and wooden box laden with books at applying to medical school – questions
between work and play, and friends who
its rear. Swerving around the tree-lined on how to write their personal statements
swear by the hardcover Robbins Basic
bends, the lake next to the Central and prepare for interviews – I thought hard
Pathology textbook they lug to school
Library glimmered, its lotus pads dark about what I could share. It prompted me
every day. We have our class clowns and
circles under the relentless sun. During to consider what made for a successful
opinionated vocalists, gym jockeys and
examination season, my mother’s medical school candidate, and by
food bloggers, diehard nerds and old
study group took turns to save seats extension, what my friends in NUS Yong
soul poets… Though few might expect
for each other in the library, where Loo Lin School of Medicine are like. I
it, medical school is variety and diversity
students camped out overnight between thought about their personalities and
– there is a place for everyone.
shelves of books, brushing their teeth attributes, lingering on unifying features
that made them alike. Nevertheless, there Another truth I discerned in retrospect:
by the sinks in the mornings. On lazier
was nothing definitive I could arrive on. most of us made it into medical school
afternoons, she leafed through pages
because we were lucky. We were lucky
of jotted notes lying on her dormitory Besides the usual character traits
to have performed well at the multiple
bed, the ceiling fan overhead whirling. of integrity, diligence and persistence,
mini-interview stations and encountered
When the scent of freshly made desserts along with a prevailing code of moral
faculty who believed we would make for
wafted up from a floor below, she was conduct, there are few other qualities
good doctors. We were privileged to have
always one of the first in line at the that can encapsulate or represent our
come from educationally advantaged
canteen. With her roommates, she raced class. Everyone has idiosyncrasies of backgrounds and systems that gave
towards what would later become one of his or her own, and it is impossible to us the circumstances to succeed. We
her fondest and most vivid memories of pinpoint why each of us made the cut had teachers who impressed upon us
youth, strangely yet gently beckoning. for medical school. the value of hard work, developed our
By the time I entered university, it was Similarly, the interests and pursuits ability to think for ourselves and invoked
a different campus, a different dream. of medical students range far and our curiosity for the subjects we learnt.
Instead of a bike, the orange and blue wide. Among my classmates, there We met seniors who served as our role
university shuttle buses ferried me are national players representing models, demonstrating, by virtue of who
14 JUN 2021 SMA Newsbuns, full and eased into perfect domes. mechanisms. Our greater overall breadth
On occasions, there would even be and depth of knowledge helped us to
the fragrance of turmeric, the auntie draw connections between concepts,
behind the counter folding potato filling allowing us to keep the bigger picture
into pastry dough, crimping the edges in mind instead of getting caught up
together deftly to form the braided rims in the details. The year passed in quick
of curry puffs. footsteps, steady hearts and opened
As first years, there was a lot to adjust books in libraries.
to and take in. We studied anatomy,
physiology, histology and biochemistry The medical school experience
with vigour and exuberance. All of a Unlike other faculties, medicine is
sudden, we were medical students, relatively self-contained due to the
doctors to be, and the idea was surreal. way our degree is structured and
As much as the newfound knowledge organised. We have our own campus,
was overwhelming, our freshness and academic calendar and curriculum, in
eagerness kept us going. Only later in the addition to a curated set of electives
year did we run into each other streaming and exchange programmes.
2
lectures from the library, exchanging
Instead of a modular system, we have
knowing glances as we hid rueful smiles.
a fixed syllabus whereby everyone goes
they were, what compassion and humility By second year, we had formed our through the same series of lectures
looked like, and what responsibility and close circles of friends and acquired a and tutorials. Although I was initially
an unwavering work ethic meant. clearer idea of what we hoped to achieve disappointed by the inability to choose
in our pre-clinical years. Things became or customise classes, I gradually grew to
Then, there were those who went the
more comfortable and manageable, as appreciate the routine and predictability
extra mile for us. I am indelibly grateful to
we gained familiarity over the various medical school offered. It was a relief
my General Paper teacher, who sacrificed
aspects of medical school. Second year that I did not have to arrange my own
her lunch breaks on Fridays to discuss
was a continuation of the first year’s timetable or strategise over how to
extra essay plans with me, and Mum, who
endeavours, our days filled by the usual bid for modules. More importantly,
made sure I always had hot piping food
array of lectures and tutorials. What a common curriculum strengthened
on the dinner table to return home to.
was different was the new mala stall at our solidarity by giving us a shared
These people supported us in tangible
Frontier canteen, that made our noses run experience and memories we could all
and intangible ways, believing in us when
when we felt brave enough for another relate to. It felt reassuring to go through
we struggled or lost faith in ourselves.
notch up the spice-tolerance scale. medical school in tandem with the rest
While we were zealous and ambitious, we
were more so enabled and blessed. Academics wise, the curriculum of my batchmates, as we learnt, revised
was heavier, but counterintuitively, and took our examinations together.
In replying my juniors, I urged them
everything made more sense. Perhaps Despite the standardised curriculum,
to be themselves, relax and, most of
this was because the Year 2 curriculum there is no lack of options or opportunities
all, enjoy and learn from the process of
was built upon our Year 1 foundation: for co-curricular activities in medical
applying to medical school. Medicine,
pathology was derived from anatomy school. We have our annual Rag and Flag
after all, is a science and an art. In many
and physiology, while pharmacology (RAG), Inter-Faculty Games, as well as local
instances, it is also serendipity.
acted upon the body’s physiological and overseas community involvement
Pre-clinical years
The first year of medical school was a
flourish of new beginnings, friendships
and experiences. Like flowers, each was
a bloom inching and spreading open,
with some shutting earlier, and others
maturing to full-laden density.
In medical school, we had an intense
curriculum. Our first few weeks of school
already had our calendars brimming,
packed with back-to-back lectures,
tutorials, anatomy hall and histology
laboratory sessions. During the lecture
breaks, my friends and I would wind up 3
at Dilys by the bread racks, enamoured
by the scent of coffee and assorted
JUN 2021 SMA News 154
5
projects (LCIPs and OCIPs) to participate programme under Frontier Danceland. I Legend
in. We also have organising committees choreographed as well for the first time 1. Being inducted into the medical fraternity at
for events like Freshmen Orientation in medical school, putting together a the White Coat Ceremony
Programme and Dinner and Dance, piece for the Silent Mentor Appreciation 2. Celebrating our birthdays for one another
apart from Medical Society directorates, Ceremony. and being each others’ pillars of support in
medical school
ad-hoc book clubs and interest groups. My time in the community service 3. Day trip to Johor Bahru with my M2 clinical
As an incoming freshman, the projects that I was a part of left a group, where we tried out the amazing banana
plethora of experiences presented by deep impression on me. My fondest cakes from Hiap Joo bakery
university can be overwhelming. This recollections are of the people – the 4. Striking a pose in front of one of Angkor Wat’s
temples, which we visited for our L25 trip
gives rise to FOMO – the fear of missing residents and villagers I served,
out. At the start of orientation, these together with the friends I worked 5. Colour coordinated with my M1 clinical group
in our Patient-Based Programme attires, each
exclamations were familiar: “I’m FOMO alongside with. Sometimes, it is the of us in a different shade of the rainbow
I’m not in dance for RAG”, “I’m FOMO most mundane and minute of details
because I can’t make it for the house you remember: how dim the corridor
gathering tonight”, and “I’m FOMO about of the rental block was as it extended Faye is currently an undergraduate
not signing up for OCIPs”. I think back down into more sets of metal-hinged student at the NUS Yong Loo Lin
to walking around the multi-purpose gates… the throb of the granny’s pulse School of Medicine. In her free time,
hall during CommServ, a day where as you measured her blood pressure. she writes, bakes and dances. Her
poems have appeared in Cha: An Asian
community service projects convene I recall staying up till the wee hours of Literary Journal, Quarterly Literary
to put up an exhibition for incoming the morning sorting through health Review Singapore, Raven Chronicles,
juniors, and being inundated by the records on Excel and those long van and Bookends Review, among others.
sheer spectrum and number of projects rides in Cambodia from Phnom Penh Her poetry is also forthcoming in the
spanning the room. When everything to deep inside the villages. When I Annals of Internal Medicine.
seems possible, paralysis in decision- dozed off on my friends’ shoulders,
making occurs. I remember waking up to the most
Personally, there was also the comical expressions of them sleeping.
impulse to take hold of these offerings. Through these experiences, I gained
After considering which causes most insight into my strengths, weaknesses
resonated with me, I joined Project and dispositions. When there were
Lokun, a biannual humanitarian health difficult decisions to make, I also
service project to Pursat, Cambodia, and realised what I loved and cherished.
the Neighbourhood Health Service, a It takes time to sort through all the
local health screening project reaching shimmer and the clutter, to figure out
out to elderly residents in rental blocks. and understand yourself. Growth is
Beyond medicine, I continued dancing never a linear process – it is important
in NUS Synergy and the PULSE scholars’ to be patient.
16 JUN 2021 SMA NewsRene w a l
Letter
A T I M E F O R
In the month of April, the air warms as spring arrives
in the UK. Golden fields of daffodils carpet the ground
and pink buds of cherry blossoms grow on what was
once bare branches. Spring is a time of rejuvenation
and renewal. As vaccines continue to be rolled out
across the nation and the number of COVID-19
cases fall, life in the UK is slowly regaining a sense of
normalcy. Before the UK eased out of lockdown on
12 April, the Singapore Medical Society of the United
Kingdom (SMSUK) organised a slew of springtime
events to engage our members and enhance their
learning. Below are some of our highlights since the
last column.
On the last Saturday of February, SMSUK members Dental composite class
and alumni from all over the UK and Singapore came
together to celebrate the month of love and friendship SMSUK also launched our new “Grassroots Events”
in our online social event “Crazy Rich Palentine’s”. initiative, where members had the opportunity to
Inspired by the massive box office hit romance organise events together with the SMSUK committee.
Crazy Rich Asians, participants were encouraged to We kicked off with a talk on “Shaping the Future of
come dressed in their fanciest first-date outfits for General Practice in Singapore”, organised by SMSUK
the session. The event featured our popular “speed- member Cornelius Tan in collaboration with the
friending” sessions facilitated in Zoom breakout rooms, Singapore Medical Societies of Australia and New
a short Valentine’s Day trivia quiz and a segment Zealand, and Ireland. The talk was attended by over
where participants had fun creating and presenting 50 members from the three societies who listened to
“Palentine’s Profiles” for their friends. It was an event insights from Prof Doris Young, Dr Wong Tien Hua and
filled with warmth, laughter and banter. Dr Ruth Lim, three prominent figures in Singapore’s
general practice scene.
The COVID-19 pandemic brought about much
disruption to clinical teaching for medical and dental As the above events were the first of their kind in
students in the UK. To address this, SMSUK got creative our society, we are heartened by the strong support
and spearheaded events such as our first ever hands- from our alumni and mentors who volunteered to
on virtual dental composite class in March. Over 50 organise and conduct the sessions, enthusiastic
participants were tutored on various composite filling participation from our members and overwhelmingly
techniques by volunteer mentors and alumni. The positive feedback we have received.
hugely successful event was also joined by members of For this month’s prompt, we asked our members to
our affiliated societies from Malaysia and Hong Kong. share how they have spent their Easter break.
– Chin Sue-Kay, Editor, SMSUK
18 JUN 2021 SMA NewsText and photo by Ryan Chen
Ryan is a Year 1 medical student at University of Leicester.
Spring was here. Since I would be spending Easter British icon! Together with some friends from junior
in the UK this year, I decided on visiting Cambridge college (JC), I let my mind wander on the stroll down
and London. Southbank, tracing the Thames as it unveiled various
Cambridge was charming. The solemn, overcast landmarks – the Tower Bridge, St Paul’s Cathedral, Big
clouds that greeted me there soon gave way to Ben and the London Eye. The day I visited coincided
clear, spotless skies that rained generous pockets with His Royal Highness The Prince Philip’s passing. As
of sunshine onto those hallowed, ancient streets I witnessed the crowds gracing Buckingham Palace’s
and college buildings. Punting down the River Cam, stately gates, laying flowers and paying their respects,
passing various landmarks I couldn’t help but be reminded of the spirit of British
like King’s College Chapel unity amid trying times, especially during COVID-19.
and the Wren Library, under On my second trip to London, I met with an old
the famed Mathematical JC friend. We visited Portobello Road Market before
Bridge and the Bridge of adjourning to Notting Hill, which was adorned with
Sighs, I couldn’t help but colourful houses and bespoke luxury cars. In contrast,
marvel at this Eden that Chinatown toyed with my senses with the smell of
spoke of eras of grace and Asian cuisine, the sight of red everywhere and the
academic prowess. pockets of spoken Mandarin I overheard in various
London – where do I conversations. It really did not feel like I was in Europe!
start? My two day trips Despite spending Easter abroad with trips and
down South would not do activities, I still miss Singapore dearly; the occasional
justice to the beauty of this tinge of homesickness is real.
Buckingham Palace gates
Text and photo by Ravanth Baskaran
Ravanth is a Year 3 medical student at Cardiff University.
A long Easter break is not something that exists for us I have attempted to
at Cardiff University, as we carry on with our Student explore the beautiful land
Selected Component (SSC) block during this period. of Wales as quarantine was
Due to the nature of my SSC, I spent my bank holiday slowly being lifted. From
doing night shifts, helping the surgical registrars with mountains to beaches, my
their duties while learning a whole lot. Through this housemates and I have
Easter period, I also embarked on many new projects trekked mountains, swam
– one of which was founding the online Objective in the sea, ran (or walked)
Structured Clinical Examination (OCSE) teaching a marathon for charity,
platform, OSCEazy. With help from my fellow SMSUK and much more. As we
friends, we gained an outreach of over 4,000 medical look ahead, apart from the
professionals across all platforms! I embarked on this looming examinations, we
project with the aim of providing a quality online OSCE hope to be able to follow Nature trekking
teaching tool to address the difficulties in learning local guidelines and explore
brought about by the pandemic. With the success the country – something that we have not been able to
of OSCEazy, we have branched out to include finals do for the past year. We hope to be able to travel back
and Membership of the Royal Colleges of Surgeons during summer to our respective home countries in
examination teaching as well. order to spend time with our families and friends and
Easter has also served as a time to recuperate enjoy the good home-cooked meals that come along
and relax from the stress of being a medical student. with being back home.
JUN 2021 SMA News 19H eartinds
s, Healing
REVIEW
M
Touching
Review by Dr Suresh Nair
Preface VP – firstly, for his friendship of over 30 Murder Is My Business (published in 1990)
years; secondly, being invited for the book served as a forerunner, recent editions
Sometime in late December 2020,
launch; and thirdly, for being the chosen include Dr Lee Wei Ling’s A Hakka Woman’s
I received a video invitation card from Dr
one to write his book review. Indeed, Singapore and Dr Charles Toh’s Heart
VP Nair (VP) to attend his book launch. I
humbled but supremely honoured to Heart. On 15 January 2021, another
felt humbled that he had “hand-picked”
because of who VP is and will always be medical luminary joined the book club –
me to be one of his 50 guests for the
– to his family, friends, patients, and the VP – with the launch of his book Healing
launch as he was a man known to
grassroots, Malayalee, global Indian and Hearts, Touching Minds – The Journey of an
hundreds. At the launch, I congratulated
global Rotary communities, and to me Interventional Cardiologist (HHTM).
VP and suggested that he get the book
personally – a man of distinction.
reviewed for SMA News, to which he HHTM is perhaps unique in its
replied: “Fantastic, good idea! It will be Please indulge me in reading my multi-dimensional effort, weaving
even more fantastic if you wrote the first book review as I ponder writing a into a single canvas the ambitious and
review.” I couldn’t rain on his optimism, biography of VP – the man who overcame determined doctor’s socio-cultural
yet looking around the hall, I saw more struggles on many fronts but always rose background, education, practice of
competent writers waiting in line for above the din with his bright, broad smile medicine and in particular cardiology,
VP’s autographed book. Suddenly, I felt and pure heart of gold. and a bunch of thoughts that ranged
that he had in his characteristic manner from the Tiananmen incident to a
humbled me a second time and I should Book Review woman President for Singapore. It is
not refuse him; I had to do it. even cheekily contradictory as VP argues
The Singapore medical fraternity’s
Why? Simply because VP is a giant of a contribution to the written word is a case of women empowerment and
man who is not just a doctor but a person noteworthy. While Prof Chao Tzee Cheng’s yet sallies up to the belles of beauty
of sterling qualities, and who carries with
him the charm of disarming anyone with
his smile, laughter and genuineness.
Here is a man, doctor, friend, mentor and
“uncle” who goes the extra mile for all and
sundry, and often much more than that,
especially for people like me with whom
there is a connectedness based on care,
respect and affection. So, in my earnest
quest to do justice to VP’s publishing
endeavour, I researched on how to
write a book review and gathered a few
friends to guide me through the process.
I know that no effort will honour VP
adequately for his heart of gold. Instead
of daunting me, it made my effort at
writing the review more earnest, exciting
and interesting. I adhered to uphold his
commitment to always aim high and
learn from the journey. After writing
the book review, I felt trebly blessed by Dr VP Nair with Minister Dr Tan See Leng during the book launch
20 JUN 2021 SMA NewsYou can also read
