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Three Perspectives of Silver: Part II
13 March 2013

“We were just responding to a need”

Last issue, we featured Sister Geraldine and her inspiring words on hospice and leadership.

This time, we move on to Dr Cynthia Goh, HCA’s founding President. She is currently Senior Consultant at the National Cancer Centre Singapore, and Chairperson of the Asia Pacific Hospice Palliative Care Network.

 

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I started off as a volunteer at St. Joseph’s Home. At that time, there were no palliative or hospice services in Singapore. Yet, we found that there were people in great need. When there was no further treatment for those diagnosed with cancer, they were told to go home and there was very little care or support, and no one to turn to.

 

Those of us at St. Joseph’s Home soon realised that it was people at home that needed the most care. And because people came to us to ask for help, we just went to their homes to help them. We started home care without even meaning to do so - we were just responding to a need!

 

There were patients in severe pain, and there were people who had financial and social need. No one knew how to manage that and we ourselves were not trained. We brought our skills from other areas, we read journals, we read books, and we had friends overseas who we could go to for advice.

 

But mostly it was learning by doing it. I always tell people that you learn palliative care by doing palliative care. We learn from our patients - they are our greatest teachers.

 

Our services just grew - people came to us in desperate need, and we had to respond to this need. We never turned anybody away. We weren’t like a nursing home or a hospital where you have a fixed number of beds. We couldn’t really say what was the limit of the people we could look after – it was really the limit of our manpower.

 

I have always been and will always be a fan of HCA. But in the last fourteen years, I was with the National Cancer Centre (NCC). My experience in HCA told me that if we wanted to have a sustainable source of doctors coming into this work, we needed to have palliative care recognised as a specialty. And we couldn’t do it while we were outside as a charity – we just didn’t have the credibility.

 

So I started the department of palliative medicine in NCC, and we started the service in SGH. Now, I see young doctors actually choosing palliative care as a career.

 

I think we should always go back to the basics and remember what we’re here for. We may build large organisations and all sorts of things but we must remember that the patients are the reason why we’re here. And we must keep our eye on the patients.

 

So whenever I get lost or don’t know what to do, I start thinking, what is important for the patient? And that’s what we need to guide us.

CELEBRATING LIFE WITH FAMILY KEEPSAKES

Mr Lim (not his real name) wanted to leave behind his thoughts with words of appreciation and advice for his family.

 

But because he was illiterate, he could not write letters to his wife and children.

 

Fortunately, a group of medical students helped Mr Lim to fulfill his wish. Students from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) recorded and compiled Mr Lim's messages before transferring them into CDs.

 

These undergraduates were part of a programme known as 'Project Legacy' which is supported by the Singapore Medical Association. About 40 medical students who are members of the Medical Society of NUS volunteered to join the programme.

 

Launched in early 2012, 'Project Legacy' saw 10 patients from HCA Hospice Care signing up for it.

 

"We call the volunteer group 'Project Legacy' as we hope to help patients celebrate their lives through various platforms," said Mr Daryl Chia, a final-year medical student and one of the coordinators of the project.

 

"This may involve art and craft work, making photo albums and, in general, getting creative with patients to help them produce a keepsake for their family and loved ones," added Mr Chia.

 

The project came about because the students saw that there was something they could do for people with terminal illnesses.

 

"While passing on is inevitable, how we can improve the manner a person passes on is sometimes forgotten," noted Mr Chia.

 

"From our short time making clinical rotations, we also realised that Asians tend to avoid talking about illness and death. We decided to volunteer to befriend and spend time with patients under hospice care, and help them celebrate life."

 

Apart from allowing patients to leave behind a 'legacy', working on these projects also benefit patients as the opportunity gives them a renewed sense of purpose.

 

According to one former patient, he said the experience helped him to recall memorable moments in his life. "In our case, the video biography is a celebration of my father's life," said one of the patient's family members.

 

"Sitting through the thousands of photos helped him to reminisce the good old times and to be thankful for all the blessings along the way."

 

The video which was eventually played during the patient's wake also provided others a glimpse into his life.

 

The students also proved themselves to be great company and support.

Another group of students made origami cranes with and for Mr Khing Rachmadi. They also went marketing with him and helped his wife to set up her mobile phone.

 

In return, Mr Khing shared his recipe for gado-gado with the volunteers.

 

According to Mr Chia, getting patients to talk about the inevitable was one of the key challenges that they faced.

 

"I think patients take time to open up to us as befrienders. As the relationships deepen, some patients start recounting parts of their lives and want us to help them document something for posterity," shared Mr Chia. "Others were quite happy to simply interact with us," he added.

 

While there are clear benefits from 'Project Legacy' for patients, the medical students also saw themselves as beneficiaries of the programme.

 

"For some of us, this project meant journeying with patients and sharing in both their lives and their passing. It reminds us that everyone has a story to tell, and that hospice care celebrates lives," said one student.

 

'Project Legacy' is an ongoing initiative by students from the Yong Loo Lin School of Medicine at NUS.

 

HCA Hospice Care hopes to reach out to more patients in 2013.