He could have left his brother to suffer from a life-threatening heart ailment.

But Mr Shanmugam Rajoo, 42, did not hesitate when doctors warned him of the challenges he would face if his mentally challenged older brother went under the knife for his damaged heart valve.

Surgeons at the National Heart Centre Singapore (NHCS) had been concerned about operating on Mr Muthu Rajoo, 48. Among other things, they were worried that he may not be able to keep taking important medicines or be co-operative during the pre-op preparations.

Mr Muthu had needed looking after all his life and the burden has been heavy on his brother, who has supported him financially for 22 years.

But Mr Shanmugam told doctors to go ahead, saying he would look after his brother.

Said Mr Shanmugam who has three children aged 14, 13 and 4: 'He's my brother, his blood is my blood.

'How can I say that because of this or that, his life and his quality of life are not as important as mine?'

Cancer-stricken mother

The assistant property officer took over physically caring for Mr Muthu last August when his mother was diagnosed with thyroid and oral cancer.

In the mornings, he walked to his parents' flat, a couple of blocks away from his, to give his brother blood-thinning medication.

At lunchtime, he rode home on his motorbike to bathe his brother. 'Luckily my home is quite near my workplace,' he said. And he took time off to accompany his brother for all his medical appointments.

It did not help that their mother, 61, had to undergo surgery to remove the cancer around the same time.

'During their hospitalisation, I was running between my mother and my brother the whole time. It was exhausting,' said Mr Shanmugam.

His elderly father, 82, is also a heart patient. 'My father suffered a fall and hit his head in December 2007. Recently, he's had lung and eye problems. I am the only one paying all my parents' and brother's medical bills. My Medisave and savings are all gone,' he said.

Despite his hardship, he would not have done anything differently. 'This is my family and through good times and bad, I should look after them,' he said.

Said Dr Chua Yeow Leng, senior consultant at the department of Cardiothoracic Surgery at NHCS: 'I had to explain to Mr Shanmugam about all the possible post-operative complications and risks, the high costs and that there would be much running around.'

But, after a couple of weeks, when Dr Chua saw Mr Shanmugam again, he was still 'clear in his mind about his decision to do everything possible for his brother'.

Whenever doctors and nurses at NHCS could not cope with his brother, they called him and he turned up. Sister Yap Yen Ping, an advanced practice nurse, was assigned to care for Mr Muthu.

He needed special care, especially at night when he might just get out of bed and walk out of the ward.

Said Sister Yap: 'We had to ask his brother for permission to tie him down at night as we did not want him to injure himself or get lost.

'He was always very helpful to us, allowing us to do our best to help his brother.'

By the time Mr Muthu underwent the operation, he was already in heart failure.

But the operation succeeded and Mr Shanmugam is delighted with his brother's recovery.

'Before this, his legs were swollen, he was breathless and he kept coughing. We knew he was not well. Now he's back to normal, smiling all the time,' he said.

'I'm extremely grateful to all the doctors and nurses who helped my brother.'

Source: The New Paper © Singapore Press Holdings Limited. Permission required for reproduction.