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Where can we take the Resilience “Booster” Shot?

Just as the vaccination booster is key to our fight against the pandemic, healthcare professionals around the world have probably wished that there is a resilience ‘booster’ shot to face an ever-evolving healthcare landscape. Adj A/Prof Melvin Chua, who is the ADIO of SKH and Senior Consultant in Geriatric Medicine / Internal Medicine with over 20 years of experience in healthcare, shares his thoughts on how we can seek to ‘boost’ our resilience as one medical community.

1. You have been a doctor for more than 20 years. Can you share with us an unforgettable encounter at work that has shaped your medical journey?

This incident happened early in my career as a Resident in the UK. Being a medical Resident, I was tasked to accept referrals from the community GPs in a busy medical unit. Referrals to the medical unit from the GPs and ED were constant and sometimes, overwhelming. One day, I received a call from one of the GPs who had referred his elderly retired ex-GP colleague for admission to the acute hospital with a stroke. 

When the patient arrived at the medical unit, he presented with low GCS and a right sided weakness. After evaluating the patient, I had to break bad news to his wife about the poor prognosis of the patient. I took her into the NOK room and sat her down but to my surprise, she spoke first.

“Primium non nocere”. I know he has had a massive stroke. We were classmates in medical school, got married and set-up the GP practice together. Please keep him comfortable.” She said with tears in her eyes but with a smile, telling me indirectly that she was ready to let him go and aware of her husband’s poor prognosis. 

Like many of you, I think in the hustle and bustle of our daily work, we tend to forget that the patient in front of us is a parent, sibling, child or friend to someone who holds the patient dear. We get frustrated and overwhelmed with the clinical load and amount of referrals we have to make coupled with the multiple phone calls we have to return to NOK asking for updates concerning their loved ones. Sometimes, we are curt with our replies or show our frustrations in the tone of our voice. However, always remember the patient in front of you.

2. The journey in Medicine isn’t easy and undoubtedly comes with plenty of challenges. What has kept you going in Medicine over the years?

Whenever I feel overwhelmed with work, I take a short break and reflect on these experiences (like the one above) I have had over the years. I recall the reasons and purpose of me entering the medical profession. These reasons may sound cliché but these were the same reasons I gave the medical school interviewer all those years ago. These self-reflections get me through the darkest of days, realigns and reinvigorates the passion I have for my patients. Lest I (or we) forget.

3. How do you bounce back from setbacks? 

I learn about my limitations through setbacks and learn from my experiences before I “go again”. In life, we face various adversities or life’s hurdles. We can choose to either allow these setbacks to derail our life’s journey or we can arrest the downward spiral, work through the “pain” and start again.

“The brick walls are there for a reason. The brick walls are not there to keep us out. The brick walls are there to give us a chance to show how badly we want something. Because the brick walls are there to stop the people who don’t want it badly enough. They’re there to stop the other people.” – Randy Pausch

To our Residents, I would like to assure you that the “brick walls” are but mere hurdles in your life’s journey and careers.

4. In the face of the ever-evolving future healthcare landscape, what is a key issue that our junior doctors are facing now?

I think over the years as Medicine has progressed, there are increasing pressures from all aspects of training and clinical work. The Residents and junior doctors of yesteryears did not have to contend with the myriad of rules and regulations or the extra-clinical learning objectives that govern training these days. We were all focused on being clinicians and providing care for our patients. 

5. So, how can we boost our resilience as one medical community? Where can we take the resilience ‘booster’ shot?

Healthcare will forever be changing and evolving. We must learn to embrace change and adapt otherwise the change will engulf us. I wish there is a resilience booster shot that all healthcare professionals can take too but unfortunately, there is no quick fix to building resilience amongst the system. 

It will need to be a multifaceted approach both from a systems and individual point of view. As we gradually metamorphose healthcare over the next few years, we will require patience from everyone as we find a balance between clinical load, manpower, medical training and work-life balance. 

I think each of us in healthcare need to realign and rediscover our passion for medicine and our patients. That has certainly kept me from burning out in my career especially over the last three years. If we can reignite and flame the passion we have for patients amidst the hustle and bustle of clinical work, resilience amongst the medical community will grow.

“To cure sometimes, to relieve often and to comfort always.” …enuff said.