Published on 28 April 2024

Being a Patient Myself

Professor Joseph Sung
Dean, Lee Kong Chian School of Medicine

Having been a doctor for most of my life, last year was the first time I went through a surgery requiring anaesthesia. I have a few reflections.

As far back as I can remember, I always promoted bowel cancer screening. International guidelines state that anyone above the age of 50 should have a check-up to rule out cancer and remove what might eventually develop into cancer, even if he/she has no bowel symptoms. So, over the years, I was devoted to the work of promulgating screening by faecal blood test annually or a colonoscopy once every 10 years. I have done this examination for patients thousands of times, and I have been talking on TV, in newspapers and at conventions telling people that colonoscopy is safe, effective and … almost painless. Deep down, however, I felt embarrassed to ask my colleague to do this examination for me and I was worried about the one-in-10,000 chance of a complication.

Several years ago, I decided that I could not put it off anymore. But instead of submitting myself to colonoscopy, I took capsule endoscopy which is designed to examine the colon “painlessly”. Secretly, I took the awful medicine to cleanse my bowel (it was a torture), and then I swallowed the capsule. “Technology should solve my problem,” I told myself; “I can escape the embarrassment and there is absolutely no risk of swallowing the endoscope!” Unfortunately, the capsule video showed that I did have something in my colon that needed to be removed for the prevention of cancer. Having struggled with the idea for two months, I finally resolved to undertake the real colonoscopy and polypectomy.

On the day of the examination, I began to realise that once I lie on a hospital bed and become a patient, I have lost control. I knew that I would be fully asleep under the effects of medicine – oxygen cannula in my nose, blood pressure cuff on my arm and pulse oximeter on my finger. I would not be aware of what was happening until I woke up, that is, if I ever woke up again. Putting my life in somebody’s hands was a new experience for me. It was a scary experience though, even for me as someone who has seen this millions of times. What if I don’t wake up? Where am I going? What will happen next? For the first time, I realised that I wouldn’t open my eyes until my doctor stopped the anaesthetic medication, provided that my heart was still beating and my lungs still breathing.

As I grappled with the uncertainties about life and death, I started questioning my values and my priorities. In the two days prior to the test, as I was preparing for it (to drink the awful medicine to cleanse my bowel), I kept thinking, “What if they found that I have cancer?” “What should I do with my family?” “Who should I hand my job to?” “What other duties must I finish before I leave?” I might have been over-thinking and over-worrying, but this was not without reason. Recently a senior professor at our university was diagnosed with cancer in the head. Then there was another colleague from my previous medical school who never smoked but was diagnosed with lung cancer. He was just one year older than me. I said to my wife, “It is funny, I can feel that Life is really like the four seasons of Mother Nature. And we are now in Autumn. In just a blink of our eyes, you and I will enter the cold Winter of Life.” So I promised myself: Make every day count. Spend every day as if it is the last day of my life.

“Wake up, Professor, wake up!” I heard a distant voice calling, and I opened my eyes. I immediately saw my wife and my daughter, together with my surgeon and anaesthetist, all smiling. Thank God, I am back.

“Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything – all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important.” (Steve Jobs)

I also remember words from Paul Kalanithi’s book When Breath Becomes Air. “Science may provide the most useful way to organise empirical, reproducible data, but its power to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue, is limited.”