By Benjamin Oh
‘Life is inconvenient. Life is lumpy. A lump in the oatmeal, a lump in the throat, and a lump in the breast are not the same kind of lump.’-Robert Fulghum, Uh Oh: Some Observations from Both Sides of the Refrigerator Door (2001)
We are drawn to
tales of people dying in their prime. Lives cut short; candles extinguished
when the wicks are still fresh—these stories strike a chord in all of our
hearts, like the hollow sounds of dismal church bells at a funeral.
No doubt, you’d
have heard the story of the late Dr. Richard Teo, had you been on the internet
or within reach of a newspaper lately. Delivered at the Dental Christian
Fellowship, 8 months after his diagnosis, his story is a testimony of a
prominent cosmetic surgeon with a future of promising plans wiped out by a
small black-and-white section of an MRI scan; that day, he was revealed to have
stage 4 lung cancer, which had spread to his liver and adrenal glands. He had
three to six months left.
Dr. Teo had much
to live for. The nip-and-tuck jobs were raking in cash, and paid for fast cars,
nice houses, and the company of the beautiful and the connected. To be struck
with a disaster of this magnitude—that his life would be over in less than half
a year—is almost incomprehensible. One wonders if the day he received his
diagnosis he drove home in his slick Ferrari, walked onto the cold tiles of his
designer bathroom, and then disrobed and put his hand on his torso; perhaps
trying to feel the malignancy spreading and multiplying inside, chewing up everything
he had built. He concluded his testimony to his silent, sober audience, with a
lesson; a reminder to all that life owes you nothing, and that a life lived for
oneself may end sooner than you think.
As medical
students, we have much more to learn from Dr. Teo’s life story. We will soon be
doctors, professionals in a field unlike any other. A doctor doesn’t really
dispense services the same way a mechanic fixes cars or an engineer builds a
skyscraper. True enough, money changes
hands in medicine, and sometimes the money can be substantial. However, there’s
no denying that medicine represents an art and a field more complex and
profound than just a lucrative job. Perhaps Dr. Teo, at the pinnacle of his
career, saw himself as a glorified beautician, servicing the human need to
appear attractive and defy the onset of decay and degradation. But no doubt at
the beginning of his medical education, and most probably upon being struck by the
worst of bad news, he thought of his calling as being something else entirely.
To be a doctor
is to submit to a higher plane of conduct, competence, and professionalism.
Medicine deals with the most fundamental of human needs, the only
commodity—aside from time and life itself—with which we trade for other, lesser
things like money and influence. Medicine deals with health. It deals with the
human body, complex and sometimes confusing, springing new surprises that may
not always be pleasant. Almost seven billion human bodies populate the earth,
and every single one of them at some point will require a doctor. Not every one
of them gets access to one. To this day, no one has yet died from a lack of
accountants or finance managers. To be a doctor, then, is to submit totally and
unreservedly to doing everything humanly possible—and then some—to alleviate
pain, and bring relief and health to as many people as possible, most of the
time at great personal cost.
Small wonder
then, that so much is expected of us as medical students, even before we begin
our career. We are held to a code of ethics and professionalism to which we
commit our conduct and behaviour for thirty, forty, fifty years. People think
much of us, and expect much more in return; the rising popularity of
malpractice suits and litigation bear testimony to the gravitas of medicine in
today’s society, and the expectations that come with it. Today, we are taught
of ethical compasses the four principles by Beauchamp and Childress; we are
indoctrinated in words like confidentiality, informed consent, and primum non nocere (first, do no harm);
we are subject to guidelines and the rulings of ethics committees. All these
tell us what we are expected to do, and govern the actions of doctors around
the globe. They tell us what our job is to be.
None of these
guidelines, however, tell us the way we are to direct our future careers. It is
that inner drive, that spark of originality, that guides the way we direct our
careers and the manner we treat our professions. And there lies perhaps the
most important component of a medical career: our reason. What does being a
doctor mean to us? The reason we choose to pursue medicine; the reason we
subject ourselves to deprivation and a spartan lifestyle, to a field where our
hands never stay clean and our eyes will behold some of the worst the world has
to offer—that reason will dictate our values and our moral compass.
Dr. Teo testified that his reason was to gain
prestige and financial security. To an extent, he succeeded. And by his
testimony, none of it was worth it. Only too late did he discover his true
calling: to help others in want. The genuine joy and purpose he gained in
rendering compassion to those who needed it desperately was only tempered by
the regret that he had spent the bulk of his years chasing after an entirely
different agenda. ‘True joy comes from helping others in hardship,’ he had
said. ‘When you start to build up wealth and when the opportunity comes, do
remember that all these things do not belong to us.’ In pursuit of material
wealth and fast cars, it is sobering to remember that the last car you will
ride is a hearse.
If we truly
decide to leave lasting legacies and dedicate ourselves to the service of
others, there is no better place to start than in medical school. We may not
have opportunities to perform complex medical procedures, or to have patients
open themselves up to us in the same way as doctors; that will come in many
years’ time. But the values to which we commit ourselves, the drive and
direction we muster to attain our goal to be good doctors—we have plenty of
opportunities to put these values to the test. We earn trust and develop
reliability by doing things as simple as turning up to classes on time and
handing in assignments punctually. We hone our ability to work well with others
by cooperating with the members of our small group and doing our best to ensure
that the entire group succeeds—even if we need to clean up others’ messes to do
so. We learn humility and respect, vital qualities in our future careers, by
doing things as simple as giving our lecturers a smile and a greeting. Most
importantly, above any and all things, we must learn compassion; not only to
know it, but to so embrace it as to make it inseparable from who we are and
what we do. Skills can be taught, knowledge can be crammed in before the
exam—but compassion takes years to understand and longer still to practice. It
must be evident in the way we speak to and interact with our study patients or
families; it must remind us that we deal with people, with lives and stories
and hopes and dreams, people that feel and people that are just like us. Our
studies and our lectures, seminars and projects—all of them prepare us for the
real thing, when we finally don the white coat and stethoscope as true doctors
and not simply observers or students. Lives will be in our hands. Happiness and
dreams rest upon our efforts. Do we owe our future patients anything less than
our full effort to excel, to learn all we can?
As a Christian,
like Dr. Teo, I feel drawn to his profound observation that the most enduring
legacy one can leave is to have lived a life in service of others—‘he who would
be greatest among you is to be the servant of all’. Life is
fleeting, death is sure, and, as someone has remarked astutely, the mortality
rate for being born is one hundred percent. The path to becoming a good doctor starts
right from day one of medical school. Were that journey suddenly cut short—were
the examination suddenly halted and your half-finished test paper
collected—what would you be left with? Would you be found to have lived your
best and given your all to the accomplishment of a worthy goal?
I am reminded of
story as poignant as that of Dr. Teo. As the 1980’s dawned, one commercial
giant arose among others in the microcomputer market—Eagle Computer. Its CEO,
Dennis Barnhart, steered his company towards great repute and high praise,
earning rave reviews in computer magazines with the company’s cutting edge
operating systems. On June 8, 1983, Eagle Computer’s initial public offering,
the shares closed at 7 million dollars by the end of the day. That same June
afternoon, Dennis Barnhart drove his Ferrari off a cliff.
What do we have
in our hands? Dreams, ambitions, hopes. Goals to accomplish, wishes we are yet
to fulfill. But when death seizes us by the collar and our plans suddenly
become irrelevant, what remains of us? How have we lived our lives so far, how
much have we adhered to the altruism and selflessness so required of us in this
profession? (Com)passion and the heart of a servant—they are not simply words,
they are the core of what we do. Dr. Teo found his true calling months before
his passing. God willing, we will find ours far, far sooner.
‘What we have done for ourselves alone dies with us;
what we have done for others and the world remains and is immortal.’
-Albert Pike
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