Published on 03 Nov 2021
“Be careful, I am not clean…”
Professor Joseph Sung
Dean, Lee Kong Chian School of Medicine
During the calamity of SARS in 2003, I was Chief of Medicine at the Prince of Wales Hospital in Hong Kong, the hospital where the first outbreak started. Over 300 hospital staff, doctors, nurses, allied health workers, clerical and medical staff, came down with the illness. As healthcare workers, they knew their conditions. They were cognisant that they were facing the threat of a deadly disease day and night. Every day, they checked their fever chart, their chest film, blood counts, serum chemistry and oxygen saturation levels in their blood.
One day, during a morning round, I saw a medical student who contracted SARS. I took my stethoscope out to listen to his chest. Honestly it was a bit unnecessary but I just wanted to stay a bit longer and showed him I cared. Coughing and fevering, he said “Professor, don’t listen to my chest, lest I get you infected if I cough into your face. Listen to my back if you must.” Pausing for two seconds, I then told him, “Trust me, I know how to protect myself. Breathe normally and let me examine your chest.” At that very moment, I saw tears trickling from his eyes. He was touched.
Six weeks later, he recovered and was discharged home. Before he left, he gave me a letter and a poem. “Professor, initially when I came down with the illness, I was very upset. What have I done to deserve this? I was just seeing patients in the wards, as any medical student would do. As a result, I contracted the virus from a patient and developed such a serious illness. Instead of preparing for my final MB examination, I become a patient myself. Why me?”
“Then I saw you, and others, taking care of us (patients) day and night, putting your safety aside. As a patient, I saw how you and others discharged your duties as doctors. I learned that patience and kindness is as important as medicine. Many said they saw angels in the hospital wards. On looking back, staying in hospital as a patient for six weeks, I received my most precious lesson of the five-year medical curriculum. Now I know what it means to become a doctor, a nurse and a healthcare provider. Thank you, Professor.”
In many patients, there is a psychological ailment behind their sickness, particularly in patients suffering from infectious diseases. In ancient times, leprosy was an incurable condition. All lepra were considered contagious and dangerous. They were driven away from home and forced to live in caves or the wilderness, to be separated from family and friends lest they spread the diseases (despite the fact that they know nothing about Mycobacterium leprosy). When the lepra saw people passing by, they had to shout “Unclean, I am unclean” to avoid being in contact with others. In the Middle Age, when Europe was plagued by “Black Death”, a disease caused by Yersinia pestis, patients and their family were also driven away from home, with their dwellings burned down in fire. Infectious diseases often carry a stigma, a symbol of uncleanliness.
The Bible said when Jesus miraculously cured a lepra, he touched his hand and said “you are cleansed”. His action would have removed the stigma in his mind. Now I understand why when I insisted on listening to the SARS patient’s chest, his tears fell. His dignity was preserved.
Today, in the midst of the COVID-19 pandemic, how do you treat your patients, your neighbour or even your family member who might have contracted the disease? I strongly support social distancing. I believe in the protective effects of masks and gloves. I wear my gears and take every necessary precaution before I examine a patient or take a blood sample from him/her. But I will not give him a “look” that “you are unclean and dangerous”. I will not avoid responding to his/her questions and requests. I will not turn away if I see him/her coming towards me. We have to be sensitive to our patients’ feelings.
There is often a psychological illness behind sickness. Can you see it? Are you willing to heal, not just the diseased body, but also the injured soul?