Surgeon Dr Tan Hiang Khoon reminds us that in the process of treating the patient, we must not forget to have empathy.
Dr Tan Hiang Khoon wears many hats at SGH and SingHealth. He helms a wide and diverse range of institutions and programmes, including overseeing our collaboration with international partners.
There’s also his work as a surgeon, meeting cancer patients and their caregivers to provide counsel about treatment and care options.
The most formative experience that led to his choice of career happened when he was 14. His father, who had never had any health issues, fainted one day and was sent to Tan Tock Seng Hospital (TTSH). Even though he regained consciousness and seemed to be his usual self, walking, standing and speaking with ease, the doctors had him admitted and scheduled for a CT scan. But the hospital had only one CT scan machine at that time and his appointment for the scan had to be postponed twice as other more urgent trauma cases came in and those patients had to be scanned first. Just one day before his appointment, Dr Tan’s father slipped into a coma.
‘He never recovered. I remember at that time it was a complete shock to the system. We didn’t expect this and in fact, to this day, we don’t know how he died.’
Apart from grief and shock, there was bewilderment:
‘It’s the sense of helplessness, that you weren’t expecting this and then it happened and there was nothing you could do about it. Just nothing. The doctors couldn’t do anything and we couldn’t do anything. I remember thinking that I cannot let this happen to my family again. I need to ensure that this doesn’t happen to my family or to any family for that matter.’
The experience led not only to his decision to become a doctor. The help that his family received from relatives, friends and charitable organisations in the aftermath made it possible for Dr Tan and his mother and sister to get through those challenging times emotionally and financially.
‘I am grateful to this day for the help rendered by so many and I can only hope to pay forward what I have received, hence my passion for helping those in need through philanthropy.’
That childhood tragedy is also the well-spring of his empathetic approach towards patients and their families. He shares openly:
‘I often can relate to patients and how they feel. Perhaps by nature, I find it relatively easy to identify with somebody else’s problems and difficulties and being empathetic about their challenges. But I do think that what my family went through has influenced how I talk to patients and engage with their family members.’
Dr Tan’s sub-specialty is in Head and Neck Surgery. He has treated many patients over the years, but to this day, he remembers the patients under his care during his first houseman posting in Paediatrics at TTSH. The plight of one particular patient sparked his decision to start the Children’s Cancer Foundation.
“We had a 14-year-old leukaemia patient who was very challenging to manage. She can come across as moody and would kick you if you tried to give her an injection or take blood from her.’
He had noticed that she was alone most of the time, sometimes going without visitors for days at a time. This was unusual in the children’s ward. He also knew that the patient’s mother had two other children from her second marriage to the patient’s stepfather.
‘One time, I saw the patient looking out of the window of the Isolation Room at another kid who was just outside, playing the electronic game Tetris. I went to that kid and asked if I could borrow the game for three days and passed it to the girl. During those three days, her behaviour changed completely. She accepted help and was cooperative with treatment. After the third day, she gave the game back to me. She continued to be friendly with the medical team but sadly, she passed away a month or two later.’
The encounter left a profound impression on Dr Tan.
‘At first glance, I thought she was a difficult and rebellious kid. But, if you knew about her family and medical history, you could see she was in an extremely difficult situation. She showed us how a simple act of caring can make a big impact.’
The experience taught him that ‘there’s a lot about Medicine that’s not just about the doctor treating the disease’:
The importance of rapport with patients and their families and caregivers is something that comes up repeatedly during this interview—rapport built on a bedrock of trust. Dr Tan says that he always makes it a point to spend time developing rapport with patients and their families:
‘Head and neck surgery deals with cancer in the oral cavity, in the face, in the salivary glands, in the throat. It involves removing organs that have got very important functions—speech, swallowing, breathing.
There is also the aspect of social frontage, the aesthetic part of it. The impact to the patient is immense. Despite the best of our efforts, things may not go well, and that is when the rapport between patient and doctor is critical. For the same reason, you need the support of the family members.’
For someone who jokes that he isn’t good at time management, what he says about always taking the time to connect with his patients and their caregivers seems to offer evidence to the contrary. Empathy for others was embedded in the promise he made to his 14-year-old self. Listening to him today, it is abundantly clear that Dr Tan has done his best to keep that promise.
Excerpt is from Volume Two of SGH’s commemorative book “Sanctuary and Stronghold: SGH at 200”, authored by Dr Yeo Wei Wei.
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