The Sunday Times Feb 14, 2010
It will take time but Singaporeans have the ability to forge an identity unique to us
By Lee Wei Ling
I circulated the draft of my article Handling The Influence Of The West, which was published in The Straits Times last Wednesday, to some friends for comments. One friend directed me to a Lianhe Zaobao Sunday article written by senior executive editor Lee Huay Leng, Why I Miss Beijing And London.
I was amused by the article. While I was struggling with my cultural identity, Ms Lee was bemoaning Singapore's cultural poverty, evidently overwhelmed by the cultural 'depth' of London and Beijing.
We are obviously on different wavelengths. I am 55, a balanced bilingual - Chinese-educated in terms of culture and English-educated in terms of my professional training. I have travelled extensively, and never felt a sense of cultural inferiority anywhere, including Britain and China, whose leaders and intellectuals I have met.
I am puzzled why an educated Singaporean woman should prefer Beijing and London to Singapore. Would she still prefer living in Beijing if she had to work there as a journalist earning PRC wages? To work for Zaobao in Beijing, as Ms Lee has, and be paid Singaporean wages, is not a true test, as she can then enjoy a standard of living much higher than that of her Chinese counterparts.
The foreign countries I know best are Canada and the United States, since I did my postgraduate training in these places. With some exceptions, their newspapers are parochial. The Straits Times is better than most American papers in terms of its sheer coverage.
The same is true of China, as a few nurses from China who are now Singapore citizens have told me. Our Chinese newspapers, they said, are comparable to those in China and their reports are more credible, which explains why Zaobao Online is read widely in China.
As for books and magazines, again Singapore is not inferior to China. Indeed, the nurses told me they can read Taiwanese publications here that are unavailable in China.
In the past decade, the Singapore Government has devoted more resources to the arts. But the fact is the majority of Singaporeans do not consider the arts to be their top priority. What bothers Ms Lee does not bother them much.
We are a pragmatic people. Most Singaporeans would place more emphasis on a good job, a comfortable home, good-quality health care and education, and a clean and safe environment. These are also the considerations that attract immigrants from China, India and other parts of Asia to Singapore.
When it comes to 'elite culture', I agree that cultural standards in Beijing and London are superior to Singapore's. But how can it be otherwise? These two countries have larger populations and richer histories than we do. Singapore is a young immigrant society.
In 1965, we had only two million people, mostly the descendants of illiterate peasants from China and labourers from India and the Indonesian archipelago. How many artistically talented people can we nurture in less than 50 years of independence?
As a multi-racial society, we never spoke or wrote in one common language. Even now, many Singaporeans write in one language but speak in two. In Britain and China, they have worked on only one language over hundreds and thousands of years, respectively.
China has had dynasties that lasted centuries, during which it became the most prosperous, productive and refined society in the world. Britain is less ancient, but over 200 years it conquered a large empire. That huge economic base provided it with considerable resources. Its elite enjoyed security and comfort and could devote themselves to the arts.
Singapore struggled to make a living from the 1960s until the early 1990s, when we became more secure and had sufficient resources to devote to the arts. We now have museums and art galleries as well as Western and Chinese orchestras, among other things. Even so, our social infrastructure is still not equal to that of the principal cities of China or Britain. It took many thousands of years in China and hundreds in Britain to develop the cultural resources they now possess.
Still, despite all those resources, it is American culture that is dominant worldwide today, including in China and Britain - a dominance that is likely to continue for a few decades. It is mostly popular American culture that is so influential, but do Americans feel culturally inferior to the Chinese and British for that reason - because they, like us, are a young people?
I was in Delhi last December. I saw scrawny, dirty children perform acrobatics in the narrow space between the cars at red lights, then gesture with their hands to indicate they were hungry.
Originally from Rajasthan, they belong to a caste that once travelled from village to village depicting in dances stories from the Indian epics the Mahabharat and the Ramayana. Now, as a result of television, they are jobless. So they have migrated to Delhi to work in construction and beg for food at traffic junctions.
Indians today prefer Bollywood to ancient, sacred dances. Does that make India less cultured? Can we not consider Bollywood India's new culture, just as rock 'n' roll and soap operas constitute America's new culture?
Ms Lee concluded her essay thus: 'Being able to go online wirelessly, and being able to watch cable television - these have nothing to do with our level of thinking. The strength of this island-state lies in its ability to connect to the world and circumvent its own weaknesses. This in fact deepened my sense of loneliness at the thought of going home (from Beijing).'
I cannot understand her logic. In Singapore, she can access culture from the entire world, including Beijing and London. Why claim a 'sense of loneliness' on coming home?
I have travelled often. Each time the plane lands at Changi airport, no matter what a wonderful time I have had overseas, I eagerly look forward to returning home.
More important than whether Beijing or London has a superior culture to ours is what keeps us rooted to Singapore. For me, home is where my emotional bonds are, where my close friends and nuclear family live. I choose Singapore as home, though there are many issues which I feel the Government has handled less than wisely. I am less enamoured of other societies, whether or not my ancestors came from them, because Singapore is the country to which I owe my loyalty.
I am confident that if we continue to thrive, we will eventually develop a uniquely Singaporean culture. That that culture will not have 5,000 years of history behind it is irrelevant. We must dare to go our own way, different from those set by our colonial master or our ancestral lands.
Dr Lee is the director of the National Neuroscience Institute.
Saturday, April 3, 2010
Time to reverse 'narcissism epidemic'
The Sunday Times Jan 17, 2010
The young today are more self-centred and less driven,
possibly due to their upbringing
By Lee Wei Ling
The principal of a mission school invited me to give a talk to his teachers recently.
'The purpose of inviting guest speakers to the school is to open up my teachers' minds about new possibilities and the demands of the real world,' he told me.
I was unable to give the talk but volunteered one of my doctors, an old boy of the school and a superb and compassionate doctor. I told the principal: 'My perspective on the education of these relatively elite boys is to teach them that they owe society a duty.'
The principal agreed, but observed: 'Unfortunately, given the changes in Singapore... my teachers are increasingly pushed by larger societal forces that worship the relentless pursuit of academic excellence as a means of material gain... While there is nothing wrong with pursuing academic excellence, it cannot be an end in itself.'
I and many other senior doctors have noticed that a significant percentage of newly graduated doctors are more self-centred and less hard-working than we were.
For example, there are more house officers with each passing year, and in some departments, there seem to be too many of them. The total work has not increased much, but this is divided among more house officers. Yet house officers complain that they are stressed out and they cannot cope with the work.
When I was a house officer, there was no payment for being on call. As a medical officer, I was paid $40 for the first four calls in the month, and $100 for each subsequent call. There were no mandatory maximum or minimum number of calls for house officers or medical officers.
But some time after 1990, house officers were not allowed to do more than six calls a month and medical officers were not allowed to do more than four calls. House officers are now paid $110 a call on weekdays and $150 on weekends. Medical officers are paid $210 a call on weekdays and $300 on weekends.
We used to have to do eight to 10 calls a month, and the number of patients I saw each time I was on call was considerably more than the numbers seen by house officers and medical officers today.
But despite having to do less work, junior doctors apparently have less time for self-study today. Consequently, many training programmes now set aside 'protected time' during working days for them to study. In addition, most departments have structured teaching programmes for young doctors - a far cry from the bad (or good) old days when there was no time during working hours for structured teaching and most of us learnt from patients or senior doctors. And to reinforce our knowledge and ensure we missed no crucial information, we would read a standard textbook from cover to cover.
All of the above would appear to be exceedingly difficult for the present generation of junior doctors. For some years, I wondered whether this was the fault of our medical school or indulgent parents.
The parents often come from humble families themselves, but have made good because of our meritocratic system. Having experienced hardship, they feel that their children should have whatever they desire. Consequently, young Singaporeans are more self-centred and less driven than their parents, and have little sense of duty to society.
Perhaps this is not a problem unique to Singapore. As Jean M. Twenge and W. Keith Campbell note in The Narcissism Epidemic: Living In The Age Of Entitlement, it is a problem endemic to developed countries. They define narcissism as 'a very positive and inflated view of self'.
Narcissism is the reason five times as many Americans undergo plastic surgery and cosmetic procedures today compared to just 10 years ago. It is the inevitable result of parents teaching their children song lyrics like 'I am special. Look at me' - precisely the skill teenagers and young adults obsessively hone on Facebook and MySpace.
What is the solution to the epidemic of narcissism? We cannot artificially create hardship so that our children become resilient. In the past, it was family upbringing that determined how the child turned out. Now, the children spend most of their waking hours in school or with their peers. My view is that the school should at least share the responsibility once shouldered solely by parents.
As I was writing this article, I received an e-mail message from the principal of Methodist Girls' School (MGS), Mrs Shirleen Ong, to tell me that Ms Jacqueline Woo, a patient of mine, 'has done well for the GCE O levels with five distinctions'.
Anyone who has witnessed Jac's physical disability will know how remarkable it is for her to achieve what she has achieved. She has a rare condition called 'primary generalised dystonia', which has left her body twisted like a pretzel. Her family has been very supportive of her and both her parents give her a great deal of attention, but they have not spoilt her. And her school, MGS, has played a crucial role in nurturing her.
It has accommodated her special needs. For example, because of her dystonia, she cannot write. Even typing on a word processor is tedious. She was given double the normal time for each exam paper, which meant typing for four to five hours at a stretch.
Her mother stood outside the examination hall in case Jac needed to go to the toilet, but Jac was so determined to use every minute that she did not take a break. Her mother said to me in amusement that the invigilators had to change shifts waiting for Jac to finish.
Her determination in the face of her physical handicap has touched many hearts. Even the school cleaner asked how she did and was happy that she had done well.
Some readers may criticise me for basing my conclusion on just one instance. But I firmly believe that a nurturing school that not only teaches a child academic subjects but also builds her character, together with caring but firm parents, is the most practical way of reversing the narcissism epidemic.
We should try to cure this epidemic as soon as possible.
Dr Lee is the director of the National Neuroscience Institute.
The young today are more self-centred and less driven,
possibly due to their upbringing
By Lee Wei Ling
The principal of a mission school invited me to give a talk to his teachers recently.
'The purpose of inviting guest speakers to the school is to open up my teachers' minds about new possibilities and the demands of the real world,' he told me.
I was unable to give the talk but volunteered one of my doctors, an old boy of the school and a superb and compassionate doctor. I told the principal: 'My perspective on the education of these relatively elite boys is to teach them that they owe society a duty.'
The principal agreed, but observed: 'Unfortunately, given the changes in Singapore... my teachers are increasingly pushed by larger societal forces that worship the relentless pursuit of academic excellence as a means of material gain... While there is nothing wrong with pursuing academic excellence, it cannot be an end in itself.'
I and many other senior doctors have noticed that a significant percentage of newly graduated doctors are more self-centred and less hard-working than we were.
For example, there are more house officers with each passing year, and in some departments, there seem to be too many of them. The total work has not increased much, but this is divided among more house officers. Yet house officers complain that they are stressed out and they cannot cope with the work.
When I was a house officer, there was no payment for being on call. As a medical officer, I was paid $40 for the first four calls in the month, and $100 for each subsequent call. There were no mandatory maximum or minimum number of calls for house officers or medical officers.
But some time after 1990, house officers were not allowed to do more than six calls a month and medical officers were not allowed to do more than four calls. House officers are now paid $110 a call on weekdays and $150 on weekends. Medical officers are paid $210 a call on weekdays and $300 on weekends.
We used to have to do eight to 10 calls a month, and the number of patients I saw each time I was on call was considerably more than the numbers seen by house officers and medical officers today.
But despite having to do less work, junior doctors apparently have less time for self-study today. Consequently, many training programmes now set aside 'protected time' during working days for them to study. In addition, most departments have structured teaching programmes for young doctors - a far cry from the bad (or good) old days when there was no time during working hours for structured teaching and most of us learnt from patients or senior doctors. And to reinforce our knowledge and ensure we missed no crucial information, we would read a standard textbook from cover to cover.
All of the above would appear to be exceedingly difficult for the present generation of junior doctors. For some years, I wondered whether this was the fault of our medical school or indulgent parents.
The parents often come from humble families themselves, but have made good because of our meritocratic system. Having experienced hardship, they feel that their children should have whatever they desire. Consequently, young Singaporeans are more self-centred and less driven than their parents, and have little sense of duty to society.
Perhaps this is not a problem unique to Singapore. As Jean M. Twenge and W. Keith Campbell note in The Narcissism Epidemic: Living In The Age Of Entitlement, it is a problem endemic to developed countries. They define narcissism as 'a very positive and inflated view of self'.
Narcissism is the reason five times as many Americans undergo plastic surgery and cosmetic procedures today compared to just 10 years ago. It is the inevitable result of parents teaching their children song lyrics like 'I am special. Look at me' - precisely the skill teenagers and young adults obsessively hone on Facebook and MySpace.
What is the solution to the epidemic of narcissism? We cannot artificially create hardship so that our children become resilient. In the past, it was family upbringing that determined how the child turned out. Now, the children spend most of their waking hours in school or with their peers. My view is that the school should at least share the responsibility once shouldered solely by parents.
As I was writing this article, I received an e-mail message from the principal of Methodist Girls' School (MGS), Mrs Shirleen Ong, to tell me that Ms Jacqueline Woo, a patient of mine, 'has done well for the GCE O levels with five distinctions'.
Anyone who has witnessed Jac's physical disability will know how remarkable it is for her to achieve what she has achieved. She has a rare condition called 'primary generalised dystonia', which has left her body twisted like a pretzel. Her family has been very supportive of her and both her parents give her a great deal of attention, but they have not spoilt her. And her school, MGS, has played a crucial role in nurturing her.
It has accommodated her special needs. For example, because of her dystonia, she cannot write. Even typing on a word processor is tedious. She was given double the normal time for each exam paper, which meant typing for four to five hours at a stretch.
Her mother stood outside the examination hall in case Jac needed to go to the toilet, but Jac was so determined to use every minute that she did not take a break. Her mother said to me in amusement that the invigilators had to change shifts waiting for Jac to finish.
Her determination in the face of her physical handicap has touched many hearts. Even the school cleaner asked how she did and was happy that she had done well.
Some readers may criticise me for basing my conclusion on just one instance. But I firmly believe that a nurturing school that not only teaches a child academic subjects but also builds her character, together with caring but firm parents, is the most practical way of reversing the narcissism epidemic.
We should try to cure this epidemic as soon as possible.
Dr Lee is the director of the National Neuroscience Institute.
Heavy cost of pursuing beauty
The Straits Times Jan 9, 2010
By Lee Wei Ling
HUMANS have always sought to enhance their appearance. Excavations have uncovered prehistoric skeletons buried with ornaments. Wearing gems in pierced ears and noses is still common practice in many cultures.
With improvements in medical science, more invasive methods of enhancing physical appearance have been developed. The number of such procedures has increased exponentially over the past two decades. Some pose risks to patients.
Many Singaporeans appear to be trying these methods without, sometimes, full knowledge of the risks involved. I was shocked to read in The Straits Times on Wednesday of a 44-year-old man, the chief executive of a property firm, who died after a general practitioner allegedly performed iposuction on him.
Liposuction is a surgical procedure to remove fat from different parts of the human body - ranging from the abdomen, thighs and buttocks, to the neck and arms. The more fat is removed, the higher the risk.
The procedure may be performed under either general or local anaesthesia. In a clinic setting - versus an operating theatre - the anaesthesia used is usually the local tumescent method.
It is ideal that the patient is as fit as possible before the procedure and has not smoked for several months. While almost all doctors know that general anaesthesia carries some risk, some may be unaware that local anaesthesia is also not without danger. If the injection of local anaesthesia into the fatty area gets into a blood vessel, there can be deleterious effects on both the heart and the brain.
Last year, the Ministry of Health issued guidelines for various aesthetic procedures. General practitioners are allowed to do liposuction if they have adequate training, and do not suction more than one litre of fat at any one sitting. I have often wondered how the ministry can check to ensure that only one litre is suctioned each time.
Even if liposuction is limited to one litre of fat per procedure, there is still the risk of being under anaesthesia - albeit low if the patient is in competent hands. Also, there can be other complications, such as perforation of the abdominal wall, which can be life-threatening.
Not everyone is a good candidate for liposuction. To be a good candidate, one should be over 18 years of age and in good health, have tried a diet and exercise regime, and have found that the last 10 or 15 pounds (4.5kg to 6.8kg) of excess fat persist in certain pockets on the body.
Diabetes, any infection, heart or circulation problems are contraindications for the procedure. In older people, the skin is usually less elastic, limiting its ability to readily tighten around a new shape. In this case, other procedures can be added to the liposuction, such as an abdominoplasty - or 'tummy tuck' as it is popularly known.
The irony of liposuction is that while the procedure has clear risks, it has no compensatory health benefits. The fat that is detrimental to health is the intra-abdominal fat, which can lead to Type 2 diabetes. This is the common type of diabetes associated with being overweight and not exercising. It used to affect adults mostly, but as the epidemic of obesity has extended to children, there are now children with Type 2 diabetes.
Diabetes can affect many organs. It may lead to an abnormal lipid profile, hypertension and vascular inflammation, all of which promote the development of atherosclerotic cardiovascular disease.
Liposuction can remove abdominal fat only from under the skin (subcutaneous fat). This does not reduce the risk of Type 2 diabetes or coronary heart disease. Those adverse health effects are mediated via intra-abdominal fat, which liposuction cannot reach.
Dieting and exercise are safer methods to reduce obesity. In addition, they have beneficial effects on health.
Exercise may be beneficial beyond its effect on weight loss by more selectively removing abdominal fat, at least in women. The standard exercise recommendation is a daily minimum of 30 minutes of moderate-intensity physical activity, such as a brisk walk.
The Government seems convinced, and the public has been repeatedly told, of the inadequate numbers of doctors in Singapore, given our population size. In fact, we have more than enough doctors. The problem is that not all our doctors are doing what we need them to be doing. And the way doctors are currently distributed, there are not enough doctors in certain specialities that are not lucrative.
However, there is an excess number of GPs. Often, people become GPs because they were not counselled properly on possible career paths after they had finished their one year as a house officer.
GPs who limit themselves to coughs and colds and writing medical certificates may not earn much, after having accounted for rental and the salaries of clinic assistants. Thus they dabble in aesthetic medicine, for that is more profitable than being a good family physician.
For example, a 20-minute session of intense pulsed light therapy, allegedly to beautify the skin, can bring in $400 in cash up front - and not many patients ask for a receipt. On the other hand, looking after a patient above the age of 65 with hypertension and/or diabetes and/or high cholesterol or a stroke patient for one year can earn a GP $300 - after he has submitted the necessary information via Internet to Medisave. This is a situation that can tempt many GPs to practise aesthetic medicine rather than look after the health of their patients.
Ideally, we should train our GPs to become competent family physicians, and allow them to charge a consultation fee that reflects their skill and effort. In that way, they can be good gatekeepers for the acute hospitals, and emergency departments need not be swamped with patients who don't need to be seen there. Indeed, the Ministry of Health found itself apologising just a few days ago because Tan Tock Seng Hospital could not accept more patients, and ambulances and patients had to be diverted to other hospitals.
While the financial benefits of practising aesthetic medicine are clear, I wonder how many of these doctors can live with their conscience. It seems to me that many have become inured to guilt.
The message I wish to convey is simple: Never do any unnecessary medical procedure. Any attempt to alter the body's function carries risk. Beauty - and health - is not a matter simply of surfaces.
Dr Lee is the director of the National Neuroscience Institute.
By Lee Wei Ling
HUMANS have always sought to enhance their appearance. Excavations have uncovered prehistoric skeletons buried with ornaments. Wearing gems in pierced ears and noses is still common practice in many cultures.
With improvements in medical science, more invasive methods of enhancing physical appearance have been developed. The number of such procedures has increased exponentially over the past two decades. Some pose risks to patients.
Many Singaporeans appear to be trying these methods without, sometimes, full knowledge of the risks involved. I was shocked to read in The Straits Times on Wednesday of a 44-year-old man, the chief executive of a property firm, who died after a general practitioner allegedly performed iposuction on him.
Liposuction is a surgical procedure to remove fat from different parts of the human body - ranging from the abdomen, thighs and buttocks, to the neck and arms. The more fat is removed, the higher the risk.
The procedure may be performed under either general or local anaesthesia. In a clinic setting - versus an operating theatre - the anaesthesia used is usually the local tumescent method.
It is ideal that the patient is as fit as possible before the procedure and has not smoked for several months. While almost all doctors know that general anaesthesia carries some risk, some may be unaware that local anaesthesia is also not without danger. If the injection of local anaesthesia into the fatty area gets into a blood vessel, there can be deleterious effects on both the heart and the brain.
Last year, the Ministry of Health issued guidelines for various aesthetic procedures. General practitioners are allowed to do liposuction if they have adequate training, and do not suction more than one litre of fat at any one sitting. I have often wondered how the ministry can check to ensure that only one litre is suctioned each time.
Even if liposuction is limited to one litre of fat per procedure, there is still the risk of being under anaesthesia - albeit low if the patient is in competent hands. Also, there can be other complications, such as perforation of the abdominal wall, which can be life-threatening.
Not everyone is a good candidate for liposuction. To be a good candidate, one should be over 18 years of age and in good health, have tried a diet and exercise regime, and have found that the last 10 or 15 pounds (4.5kg to 6.8kg) of excess fat persist in certain pockets on the body.
Diabetes, any infection, heart or circulation problems are contraindications for the procedure. In older people, the skin is usually less elastic, limiting its ability to readily tighten around a new shape. In this case, other procedures can be added to the liposuction, such as an abdominoplasty - or 'tummy tuck' as it is popularly known.
The irony of liposuction is that while the procedure has clear risks, it has no compensatory health benefits. The fat that is detrimental to health is the intra-abdominal fat, which can lead to Type 2 diabetes. This is the common type of diabetes associated with being overweight and not exercising. It used to affect adults mostly, but as the epidemic of obesity has extended to children, there are now children with Type 2 diabetes.
Diabetes can affect many organs. It may lead to an abnormal lipid profile, hypertension and vascular inflammation, all of which promote the development of atherosclerotic cardiovascular disease.
Liposuction can remove abdominal fat only from under the skin (subcutaneous fat). This does not reduce the risk of Type 2 diabetes or coronary heart disease. Those adverse health effects are mediated via intra-abdominal fat, which liposuction cannot reach.
Dieting and exercise are safer methods to reduce obesity. In addition, they have beneficial effects on health.
Exercise may be beneficial beyond its effect on weight loss by more selectively removing abdominal fat, at least in women. The standard exercise recommendation is a daily minimum of 30 minutes of moderate-intensity physical activity, such as a brisk walk.
The Government seems convinced, and the public has been repeatedly told, of the inadequate numbers of doctors in Singapore, given our population size. In fact, we have more than enough doctors. The problem is that not all our doctors are doing what we need them to be doing. And the way doctors are currently distributed, there are not enough doctors in certain specialities that are not lucrative.
However, there is an excess number of GPs. Often, people become GPs because they were not counselled properly on possible career paths after they had finished their one year as a house officer.
GPs who limit themselves to coughs and colds and writing medical certificates may not earn much, after having accounted for rental and the salaries of clinic assistants. Thus they dabble in aesthetic medicine, for that is more profitable than being a good family physician.
For example, a 20-minute session of intense pulsed light therapy, allegedly to beautify the skin, can bring in $400 in cash up front - and not many patients ask for a receipt. On the other hand, looking after a patient above the age of 65 with hypertension and/or diabetes and/or high cholesterol or a stroke patient for one year can earn a GP $300 - after he has submitted the necessary information via Internet to Medisave. This is a situation that can tempt many GPs to practise aesthetic medicine rather than look after the health of their patients.
Ideally, we should train our GPs to become competent family physicians, and allow them to charge a consultation fee that reflects their skill and effort. In that way, they can be good gatekeepers for the acute hospitals, and emergency departments need not be swamped with patients who don't need to be seen there. Indeed, the Ministry of Health found itself apologising just a few days ago because Tan Tock Seng Hospital could not accept more patients, and ambulances and patients had to be diverted to other hospitals.
While the financial benefits of practising aesthetic medicine are clear, I wonder how many of these doctors can live with their conscience. It seems to me that many have become inured to guilt.
The message I wish to convey is simple: Never do any unnecessary medical procedure. Any attempt to alter the body's function carries risk. Beauty - and health - is not a matter simply of surfaces.
Dr Lee is the director of the National Neuroscience Institute.
The true nature of friendship
The Sunday Times Jan 3, 2010
Genuine relationships are built on more than mutual goodwill and exchanging of favours
By Lee Wei Ling
I had gone to bed at 7pm on Dec 30 from sheer exhaustion. I woke up at 2am and responded to e-mail on my Blackberry.
I noticed that I had missed two phone calls from two very close friends. It was obviously inappropriate to return the calls at 2am, so I e-mailed to say I'd return the calls during lunch time.
I then went back to sleep and have just woken up at 6am, trying to recall what day of the week it was because that would determine my schedule for the day.
For a moment, I thought it was Friday, New Year's Day. It was only when I went outside to pick up the newspapers that I realised it was only New Year's Eve.
I do not usually place any emphasis on 'special days' - whether it be Christmas, New Year's Day, Chinese New Year or birthdays.
These days are determined by the calendar, but to me they are no different from regular days.
In fact, they often are less pleasant than regular days as I dislike the noise and crowds of special days. I solve that problem by simply staying in my room at home on such days, clearing e-mail and paperwork. This applies even to the reunion dinner on Chinese New Year's Eve.
I am by nature not a sociable person. Indeed, I had become asocial by the time I reached pre-university in school. I do have friends and I have never neglected to help any of them when they needed help.
But for most of my adult life, I have not been willing to spend more time than necessary on conversations and social interactions with my friends. I felt that would be a waste of time - time that could have been better spent reading medical journals, analysing research data, exercising and other 'more important activities'.
It was only since 2001, after repeated bouts of illness, that I learnt that friendship does not just mean mutual goodwill, but also spending time with friends talking about things other than medical research.
Staying for months in hospital makes any friend dropping in to see one a welcome relief, though I was not bored as such as I could work on my laptop. As prisoners know, solitary confinement (even in a hospital) can be terribly punishing on the spirit.
Human beings are social creatures. We are social not just in the trivial sense that we like company, and not just in the obvious sense that we depend on others. We are social in a more elemental way: Simply to exist as normal human beings requires us to interact with other people.
There is a Chinese saying, jun zi zhi jiao dan ru shui, xiao ren zhi jiao tian ru mi (君子之交淡如水, 小人之交甜如蜜). The literal translation is: 'The friendship between two honourable people is as understated as water.'
Many of my English-educated friends have difficulty grasping this concept. They would often exclaim in surprise: 'Surely you have changed the saying. The relationship between two honourable people must surely be as sweet as honey.'
No, I have not reversed the idiom. The friendship between two good honourable people is understated. Each will help the other when help is needed even before a request for help is issued. And when one offers to help, the other would accept without feeling any obligation to return the favour.
The 'friendship' between two petty people, on the other hand, is as cloying as honey. When one offers to help, the other would feel that at some point the favour would have to be returned.
The simplest analogy for this saying is as follows: Between honourable friends, there is no account of how many favours I owe that friend and vice versa. The relationship between petty people, on the other hand, requires an accurate account, since for every favour accepted, a return favour would be expected. As far as I can help it, I avoid such friendships.
I am not in the habit of making New Year resolutions. We should change our undesirable behaviour and mend our ways as soon as we discover that our behaviour is less than honourable; there is no need to wait for the New Year to resolve to do so.
2009 has given me both suffering and happiness. I expect the same of 2010. But to all readers who feel a New Year represents a new chapter in life, I wish you a Happy New Year, filled with true friendship and good deeds. And may 2010 be a better year than 2009.
Dr Lee is the director of the National Neuroscience Institute.
Genuine relationships are built on more than mutual goodwill and exchanging of favours
By Lee Wei Ling
I had gone to bed at 7pm on Dec 30 from sheer exhaustion. I woke up at 2am and responded to e-mail on my Blackberry.
I noticed that I had missed two phone calls from two very close friends. It was obviously inappropriate to return the calls at 2am, so I e-mailed to say I'd return the calls during lunch time.
I then went back to sleep and have just woken up at 6am, trying to recall what day of the week it was because that would determine my schedule for the day.
For a moment, I thought it was Friday, New Year's Day. It was only when I went outside to pick up the newspapers that I realised it was only New Year's Eve.
I do not usually place any emphasis on 'special days' - whether it be Christmas, New Year's Day, Chinese New Year or birthdays.
These days are determined by the calendar, but to me they are no different from regular days.
In fact, they often are less pleasant than regular days as I dislike the noise and crowds of special days. I solve that problem by simply staying in my room at home on such days, clearing e-mail and paperwork. This applies even to the reunion dinner on Chinese New Year's Eve.
I am by nature not a sociable person. Indeed, I had become asocial by the time I reached pre-university in school. I do have friends and I have never neglected to help any of them when they needed help.
But for most of my adult life, I have not been willing to spend more time than necessary on conversations and social interactions with my friends. I felt that would be a waste of time - time that could have been better spent reading medical journals, analysing research data, exercising and other 'more important activities'.
It was only since 2001, after repeated bouts of illness, that I learnt that friendship does not just mean mutual goodwill, but also spending time with friends talking about things other than medical research.
Staying for months in hospital makes any friend dropping in to see one a welcome relief, though I was not bored as such as I could work on my laptop. As prisoners know, solitary confinement (even in a hospital) can be terribly punishing on the spirit.
Human beings are social creatures. We are social not just in the trivial sense that we like company, and not just in the obvious sense that we depend on others. We are social in a more elemental way: Simply to exist as normal human beings requires us to interact with other people.
There is a Chinese saying, jun zi zhi jiao dan ru shui, xiao ren zhi jiao tian ru mi (君子之交淡如水, 小人之交甜如蜜). The literal translation is: 'The friendship between two honourable people is as understated as water.'
Many of my English-educated friends have difficulty grasping this concept. They would often exclaim in surprise: 'Surely you have changed the saying. The relationship between two honourable people must surely be as sweet as honey.'
No, I have not reversed the idiom. The friendship between two good honourable people is understated. Each will help the other when help is needed even before a request for help is issued. And when one offers to help, the other would accept without feeling any obligation to return the favour.
The 'friendship' between two petty people, on the other hand, is as cloying as honey. When one offers to help, the other would feel that at some point the favour would have to be returned.
The simplest analogy for this saying is as follows: Between honourable friends, there is no account of how many favours I owe that friend and vice versa. The relationship between petty people, on the other hand, requires an accurate account, since for every favour accepted, a return favour would be expected. As far as I can help it, I avoid such friendships.
I am not in the habit of making New Year resolutions. We should change our undesirable behaviour and mend our ways as soon as we discover that our behaviour is less than honourable; there is no need to wait for the New Year to resolve to do so.
2009 has given me both suffering and happiness. I expect the same of 2010. But to all readers who feel a New Year represents a new chapter in life, I wish you a Happy New Year, filled with true friendship and good deeds. And may 2010 be a better year than 2009.
Dr Lee is the director of the National Neuroscience Institute.
Uneventful day is not a bad thing
The Sunday Times Dec 20, 2009
By Lee Wei Ling
A Peanuts cartoon caught my attention the other day as I was scanning the newspaper.
As he brings Snoopy a bowl of dog food, Charlie Brown wonders: 'Can you believe it? Another day gone by, and it's supper time again! I don't know where the time goes. You get up in the morning, and you go to bed at night, and another day is gone...'
The next picture shows Snoopy eating his food and thinking: 'Someday I'm going to buy my own can opener.'
For a doctor, an uneventful day is often not a bad thing. It would mean the day had passed without major disasters, but contained sufficient intellectual challenge to make it interesting.
Memorable days on the other hand can mean one among several different happy or tragic scenarios. Of the happy scenarios, there can be no greater joy for a doctor than to know she had helped a patient and brought comfort to his family. Sometimes that knowledge can keep one going even in the face of one's own miserable personal circumstances.
My list for memorable unhappy events that can ruin the day for me as a doctor include the following:
•Being confronted with a patient with a puzzling and serious problem; or a patient whose disease progresses at such a rate that he deteriorates before we can do anything. I am sure many among my peers have had the experience of driving home from work at the end of the day with a sense of unease, still mentally going over our patients' problems.
•Making a mistake in our diagnosis or treatment of a patient, perhaps making a wrong call when we have to make a decision urgently before adequate information is available.
An example was related in an article published in The Straits Times recently. A pathologist, based on the evidence of a frozen section of a specimen taken from the lung, reported cancer; and based on that information, the surgeon removed part of the affected lung. The paraffin section came back a few days later showing that there was no cancer.
Such 'errors' can occur in medical practice when decisions have to be made based on the information available at that moment. Indeed such 'errors' are not really errors but the result of calculated risk.
If there had been indeed cancer, to have closed up the incision and waited for the paraffin section, which would have taken several days to be ready, would have reduced the chances of a good outcome for the patient. Frozen sections can be made ready quickly for the pathologist to review but the details it reveals cannot match that of the paraffin section.
Performing an operation based on the information provided by the frozen section is a calculated risk. The doctor has to balance the possibility that early treatment might be life-saving against the small but real risk of resecting more tissue than necessary.
•Having a patient, especially a young patient, with a fatal disease associated with much pain and suffering, but for whom one can do little more than keep him as comfortable as possible - that is a particularly heart-breaking situation, especially when one has to break the news to the family and sometimes also to the patient.
When breaking such news, I often also warn the family of the futility of consulting Chinese sinseh or spiritual healers, and explain how we - medical professionals as well as the family - can together make the last days of the patient's life as comfortable as possible.
If some of my readers are wondering how doctors can stay sane in a profession that demands compassion and empathy and yet at the same time exposes us to such heart-rending circumstances, I do so as follows: I make myself feel detached from the patient when I am physically separated from the patient and treat the medical issue before me as an intellectual problem requiring a solution.
Over the years, I have found that adopting a similar strategy when I am the patient helps me cope with my own illnesses. I cannot be physically separated from myself, of course, but I have learnt to treat my medical predicaments as problems to be solved. That is certainly preferable to feeling sorry for myself or thinking of myself as a victim of fate.
I have been able to discipline my mind in this fashion at most times, and when I do so, I remain calm in the face of disaster, and not infrequently, I eventually do manage to find a solution to my own medical problems.
There are other events that may make a day memorable in an unpleasant way: For example, a loved one suddenly becoming seriously ill, unlikely to recover. It is difficult to achieve mental detachment under these circumstances. But calm acceptance and the passage of time can take the edge off the sharpness of emotional distress.
Time is indeed a great healer. For example, my mother's stroke on May 12 last year made me feel like my world had been turned upside down. But over the months, I have been able to accept her disabilities and carry on with life as normally as possible, although when I am with her, I still feel a sense of sadness.
A day passed without something memorable is a day passed without a major disaster or triumph. It is not a bad thing not to have too many memorable days.
Dr Lee is the director of the National Neuroscience Institute.
By Lee Wei Ling
A Peanuts cartoon caught my attention the other day as I was scanning the newspaper.
As he brings Snoopy a bowl of dog food, Charlie Brown wonders: 'Can you believe it? Another day gone by, and it's supper time again! I don't know where the time goes. You get up in the morning, and you go to bed at night, and another day is gone...'
The next picture shows Snoopy eating his food and thinking: 'Someday I'm going to buy my own can opener.'
For a doctor, an uneventful day is often not a bad thing. It would mean the day had passed without major disasters, but contained sufficient intellectual challenge to make it interesting.
Memorable days on the other hand can mean one among several different happy or tragic scenarios. Of the happy scenarios, there can be no greater joy for a doctor than to know she had helped a patient and brought comfort to his family. Sometimes that knowledge can keep one going even in the face of one's own miserable personal circumstances.
My list for memorable unhappy events that can ruin the day for me as a doctor include the following:
•Being confronted with a patient with a puzzling and serious problem; or a patient whose disease progresses at such a rate that he deteriorates before we can do anything. I am sure many among my peers have had the experience of driving home from work at the end of the day with a sense of unease, still mentally going over our patients' problems.
•Making a mistake in our diagnosis or treatment of a patient, perhaps making a wrong call when we have to make a decision urgently before adequate information is available.
An example was related in an article published in The Straits Times recently. A pathologist, based on the evidence of a frozen section of a specimen taken from the lung, reported cancer; and based on that information, the surgeon removed part of the affected lung. The paraffin section came back a few days later showing that there was no cancer.
Such 'errors' can occur in medical practice when decisions have to be made based on the information available at that moment. Indeed such 'errors' are not really errors but the result of calculated risk.
If there had been indeed cancer, to have closed up the incision and waited for the paraffin section, which would have taken several days to be ready, would have reduced the chances of a good outcome for the patient. Frozen sections can be made ready quickly for the pathologist to review but the details it reveals cannot match that of the paraffin section.
Performing an operation based on the information provided by the frozen section is a calculated risk. The doctor has to balance the possibility that early treatment might be life-saving against the small but real risk of resecting more tissue than necessary.
•Having a patient, especially a young patient, with a fatal disease associated with much pain and suffering, but for whom one can do little more than keep him as comfortable as possible - that is a particularly heart-breaking situation, especially when one has to break the news to the family and sometimes also to the patient.
When breaking such news, I often also warn the family of the futility of consulting Chinese sinseh or spiritual healers, and explain how we - medical professionals as well as the family - can together make the last days of the patient's life as comfortable as possible.
If some of my readers are wondering how doctors can stay sane in a profession that demands compassion and empathy and yet at the same time exposes us to such heart-rending circumstances, I do so as follows: I make myself feel detached from the patient when I am physically separated from the patient and treat the medical issue before me as an intellectual problem requiring a solution.
Over the years, I have found that adopting a similar strategy when I am the patient helps me cope with my own illnesses. I cannot be physically separated from myself, of course, but I have learnt to treat my medical predicaments as problems to be solved. That is certainly preferable to feeling sorry for myself or thinking of myself as a victim of fate.
I have been able to discipline my mind in this fashion at most times, and when I do so, I remain calm in the face of disaster, and not infrequently, I eventually do manage to find a solution to my own medical problems.
There are other events that may make a day memorable in an unpleasant way: For example, a loved one suddenly becoming seriously ill, unlikely to recover. It is difficult to achieve mental detachment under these circumstances. But calm acceptance and the passage of time can take the edge off the sharpness of emotional distress.
Time is indeed a great healer. For example, my mother's stroke on May 12 last year made me feel like my world had been turned upside down. But over the months, I have been able to accept her disabilities and carry on with life as normally as possible, although when I am with her, I still feel a sense of sadness.
A day passed without something memorable is a day passed without a major disaster or triumph. It is not a bad thing not to have too many memorable days.
Dr Lee is the director of the National Neuroscience Institute.
Subsidised or not, treat all patients equally
The Straits Times Dec 16, 2009
By Lee Wei Ling
Those who have been reading my columns regularly will know that my health has been uncertain. Perhaps for that very reason, I feel keenly the ill fortunes as well as triumphs of my patients.
Today, as I write this, I feel like a “104-year-old”, a term that my friends would understand. It means I feel 50 years older than I really am.
But I have patients to see. Many among them would have taken leave or made special arrangements to be accompanied by a parent or caregiver in order to see me.
I could, of course, get another doctor in my department to see them, for most of my patients are subsidised and thus not allowed to choose their own doctors. But I treat my subsidised (B2 and C class) patients no differently from my full-paying (A and B1 class) patients, and provide all with the same quality of care. I also insist that all the doctors at the Singapore National Neuroscience Institute (NNI) do the same.
This ethos of caring for patients regardless of whether they are subsidised or not is sometimes absent in our hospitals, even in cases of subsidised patients with complex problems. Sometimes such patients are assigned to junior doctors.
Recently, a friend telephoned me one evening, very distressed. Her husband had had a severe head injury. I asked her who was the doctor in charge. She said she did not know. I told her to write down my name and mobile number on a piece of paper and pass it to the most senior doctor there and ask him to call me.
The moment the doctor saw the note, he telephoned his head of department. My friend had never seen or heard of the head of department before that. Other doctors in the hospital asked my friend: “Who are you and how are you related to Professor Lee Wei Ling?”
An hour later, the head of department called me to give me the medical details, sounding as though he had been in charge all along. The next day, a bouquet of flowers from the hospital appeared in the room of my friend's husband. A senior doctor took care of my friend's husband and performed every operation on him personally. My friend's husband had been admitted as a subsidised patient because all emergency admissions are categorised as “subsidised”.
Our system must find an effective way of ensuring that senior doctors also treat subsidised patients. At present, it is in the economic interests of senior doctors to focus on paying patients rather than subsidised patients — and it is not always the case that doctors look beyond their economic interests. Thus we get incidents like the one I have just described. My friend's husband should have been treated by a senior doctor as a matter of course, without my intervention.
At NNI, a subsidised patient with a complex medical problem would be seen by a senior doctor, or at least a junior doctor under a senior doctor's supervision. My doctors know that I would come down on them like a tonne of bricks if I found they were not providing the same quality of care to subsidised patients as they were to paying ones.
Back to today: I had four glasses of ice-cold kopi-o and made it to the clinic to see my patients. I have just finished seeing all my patients and decided that doing so was the best medicine I could possibly have.
Two of my patients were young men who had been under my care for about 20 years each. One was an engineering graduate of the National University of Singapore, and the other, a polytechnic graduate; both are now gainfully employed. Two other patients were severely handicapped, and seeing them reminded me that I had no right to whine about my fate.
Another patient came with her mother. She continues to have seizures but less frequently now compared with her previous visit.
Three patients did not come. Instead, their elderly parents came and I asked the parents how the patients were doing. I knew all three well and their parents knew me well. I understood the difficulty of elderly parents having to take their handicapped adult children to the hospital by public transport.
My best reward of the day was a lady with epilepsy who has been under my care for 12 years. I casually asked her whether she was still employed.
“Yes,” she replied, “I am in the same company I was working for when I first saw you. Don't you remember, when the person in charge of me asked for a medical report from you, you said that she could contact you personally? She never did, perhaps because she was frightened of you, so I am still working in the same company. During the recent retrenchment exercise, she lost her job and I have been promoted to take over her duties.”
If that superior had contacted me and the patient had granted me permission to release her medical information, I would have done so. Since her seizures had been brought under control within six months of her coming under my care, and since there is still much social stigma attached to epilepsy, I would have told the superior that the seizures were well controlled and would not affect my patient's ability to carry out her duties.
When I walked out of my clinic after attending to all my patients, I felt psychologically like a 44-year-old, 10 years younger than my actual age. Which medicine can make you feel 60 years younger? More importantly, I felt I had contributed, in a small way, to human welfare.
Today was worth living though it had started badly and I am still stiff and tired. I will do my best, though at times my best is not good enough, for my patients' medical conditions are too severe for current medical science to cure.
Dr Lee is the director of the National Neuroscience Institute.
By Lee Wei Ling
Those who have been reading my columns regularly will know that my health has been uncertain. Perhaps for that very reason, I feel keenly the ill fortunes as well as triumphs of my patients.
Today, as I write this, I feel like a “104-year-old”, a term that my friends would understand. It means I feel 50 years older than I really am.
But I have patients to see. Many among them would have taken leave or made special arrangements to be accompanied by a parent or caregiver in order to see me.
I could, of course, get another doctor in my department to see them, for most of my patients are subsidised and thus not allowed to choose their own doctors. But I treat my subsidised (B2 and C class) patients no differently from my full-paying (A and B1 class) patients, and provide all with the same quality of care. I also insist that all the doctors at the Singapore National Neuroscience Institute (NNI) do the same.
This ethos of caring for patients regardless of whether they are subsidised or not is sometimes absent in our hospitals, even in cases of subsidised patients with complex problems. Sometimes such patients are assigned to junior doctors.
Recently, a friend telephoned me one evening, very distressed. Her husband had had a severe head injury. I asked her who was the doctor in charge. She said she did not know. I told her to write down my name and mobile number on a piece of paper and pass it to the most senior doctor there and ask him to call me.
The moment the doctor saw the note, he telephoned his head of department. My friend had never seen or heard of the head of department before that. Other doctors in the hospital asked my friend: “Who are you and how are you related to Professor Lee Wei Ling?”
An hour later, the head of department called me to give me the medical details, sounding as though he had been in charge all along. The next day, a bouquet of flowers from the hospital appeared in the room of my friend's husband. A senior doctor took care of my friend's husband and performed every operation on him personally. My friend's husband had been admitted as a subsidised patient because all emergency admissions are categorised as “subsidised”.
Our system must find an effective way of ensuring that senior doctors also treat subsidised patients. At present, it is in the economic interests of senior doctors to focus on paying patients rather than subsidised patients — and it is not always the case that doctors look beyond their economic interests. Thus we get incidents like the one I have just described. My friend's husband should have been treated by a senior doctor as a matter of course, without my intervention.
At NNI, a subsidised patient with a complex medical problem would be seen by a senior doctor, or at least a junior doctor under a senior doctor's supervision. My doctors know that I would come down on them like a tonne of bricks if I found they were not providing the same quality of care to subsidised patients as they were to paying ones.
Back to today: I had four glasses of ice-cold kopi-o and made it to the clinic to see my patients. I have just finished seeing all my patients and decided that doing so was the best medicine I could possibly have.
Two of my patients were young men who had been under my care for about 20 years each. One was an engineering graduate of the National University of Singapore, and the other, a polytechnic graduate; both are now gainfully employed. Two other patients were severely handicapped, and seeing them reminded me that I had no right to whine about my fate.
Another patient came with her mother. She continues to have seizures but less frequently now compared with her previous visit.
Three patients did not come. Instead, their elderly parents came and I asked the parents how the patients were doing. I knew all three well and their parents knew me well. I understood the difficulty of elderly parents having to take their handicapped adult children to the hospital by public transport.
My best reward of the day was a lady with epilepsy who has been under my care for 12 years. I casually asked her whether she was still employed.
“Yes,” she replied, “I am in the same company I was working for when I first saw you. Don't you remember, when the person in charge of me asked for a medical report from you, you said that she could contact you personally? She never did, perhaps because she was frightened of you, so I am still working in the same company. During the recent retrenchment exercise, she lost her job and I have been promoted to take over her duties.”
If that superior had contacted me and the patient had granted me permission to release her medical information, I would have done so. Since her seizures had been brought under control within six months of her coming under my care, and since there is still much social stigma attached to epilepsy, I would have told the superior that the seizures were well controlled and would not affect my patient's ability to carry out her duties.
When I walked out of my clinic after attending to all my patients, I felt psychologically like a 44-year-old, 10 years younger than my actual age. Which medicine can make you feel 60 years younger? More importantly, I felt I had contributed, in a small way, to human welfare.
Today was worth living though it had started badly and I am still stiff and tired. I will do my best, though at times my best is not good enough, for my patients' medical conditions are too severe for current medical science to cure.
Dr Lee is the director of the National Neuroscience Institute.
Simple holidays, rich memories
The Sunday Times Dec 13, 2009
Sun, sand and sea in Changi made for great school breaks during childhood
By Lee Wei Ling
It is December now, and the rain is pouring like water gushing from a fire hydrant as I write this. For some strange reason, I like this kind of weather - perhaps because the time of the north-east monsoon coincided with the long holiday when I was in school.
Today, I tried to fix an appointment for a patient to see another specialist. Two out of the three specialists I tried to contact were holidaying overseas. This brought back memories of my own school holidays more than 40 years ago.
My childhood holidays were much humbler than what the children of my colleagues enjoy today. Most of my holidays were spent with my paternal grandmother. Before August 1965, my family would also spend a portion of the holidays on Fraser's Hill or Cameron Highlands in Peninsula Malaysia.
Indeed, we were on Cameron Highlands in the days before Separation. I remember my mother, my brothers and I driving back to Singapore in a hurry on Aug 8, 1965. My siblings and I discovered the reason only the next day.
After 1965, we would spend part of our school holidays at Changi Cottage or the chalets next door, bungalows by the sea that government officials - civil servants as well as elected officials - could use.
We did the usual things that children did on seaside holidays. I would rise early to watch the sun rise and meander along the beach. After breakfast, my brothers and I would build sandcastles, dig for clams and search for starfish and hermit crabs. When the tide was in, we tried our luck at fishing with hook and bait or swam in the sea. If it was raining, as it often did in December, we would read or play games indoors.
I remember playing a memory game using cards with the young Lee Chuen Neng, who was staying then with his father K.C. Lee and his family in a neighbouring chalet. More than 40 years later, we are still good friends; he is a cardiothoracic surgeon and head of the department of surgery at the National University Hospital, and I'm a neurologist and director of the National Neuroscience Institute.
These holidays were the rare occasions when my brothers and I had our father's company for the entire day. He would sometimes join us on the beach and swim with us. My mother would watch over us children whenever we went swimming. Without saying so, she was our lifeguard.
Every evening, my father would play golf at the nearby Changi golf course. We would walk with him, sometimes pulling his golf trolley. Sometimes, I would walk ahead to the next hole and roam in the thick vegetation nearby. Those trees and undergrowth were probably left there to increase the chances of a golfer losing his golf ball.
Among the bushes and trees, I would pretend that I was a soldier on a topographic march. I had a good sense of direction and never got lost, although I was often scratched or poked by sharp twigs and thorns. But that merely made the game more realistic, so I didn't mind.
Often, at least once a year while we were in Changi, my father would take us to Pulau Ubin. We would visit the Outward Bound School there. It was then rather under-developed by today's standards, but knowing no better, we enjoyed it, as we tried out the obstacle course.
I still have black-and-white photographs of my elder brother Hsien Loong climbing a net-like structure with parallel rows of horizontal ropes attached to parallel rows of vertical ropes. In the photograph, Loong had made it to the top, while I was trying very hard to catch up with him, as indicated by the determined expression on my face. My younger brother Hsien Yang was then too young to try the obstacle.
All three of us enjoyed our holidays in Changi and the quality time we had with our parents. I doubt we would have enjoyed ourselves more if our parents had flown us off to more exotic and expensive destinations overseas.
In the late 1970s, I remember one doctor friend deflating the ego of another doctor when the latter was boasting about his skiing holiday. My friend feigned ignorance and asked: 'Where did you go skiing? Off Coney Island (also known now as Pulau Serangoon)?' I chortled, for I shared my friend's attitude towards downhill skiing.
It is a chance for the rich to show off their ski costumes and stylish sunglasses. Equipment and ski lift passes are expensive, and skiing accidents are common. In the late 1970s, if you could afford to travel overseas to ski, you had to be very wealthy.
Now my younger doctors, with children in primary school, routinely fly their entire families to Australia, New Zealand, Britain, Europe, the United States or China during the year-end school holidays. A few with larger families may opt to drive up to Malaysia. But on the whole, the children of the upper- middle-class are growing up with expectations that expensive holidays overseas are the norm.
My readers can probably guess what I think of this trend. It is a waste of money to travel vast distances for a holiday when there are many interesting places near Singapore one could visit for both fun and education. It doesn't make sense for well-off Singaporean children to be more familiar with Vail or Aspen than with Borobudur or Angkor Wat.
But the festive season will be soon upon us and I don't want to sound like Scrooge. So I will end this trip down memory lane by wishing all my readers a happy year ahead - and by reminding them that misfortune can occur at any time and it is best not to get used to luxuries.
Dr Lee is the director of the National Neuroscience Institute.
Sun, sand and sea in Changi made for great school breaks during childhood
By Lee Wei Ling
It is December now, and the rain is pouring like water gushing from a fire hydrant as I write this. For some strange reason, I like this kind of weather - perhaps because the time of the north-east monsoon coincided with the long holiday when I was in school.
Today, I tried to fix an appointment for a patient to see another specialist. Two out of the three specialists I tried to contact were holidaying overseas. This brought back memories of my own school holidays more than 40 years ago.
My childhood holidays were much humbler than what the children of my colleagues enjoy today. Most of my holidays were spent with my paternal grandmother. Before August 1965, my family would also spend a portion of the holidays on Fraser's Hill or Cameron Highlands in Peninsula Malaysia.
Indeed, we were on Cameron Highlands in the days before Separation. I remember my mother, my brothers and I driving back to Singapore in a hurry on Aug 8, 1965. My siblings and I discovered the reason only the next day.
After 1965, we would spend part of our school holidays at Changi Cottage or the chalets next door, bungalows by the sea that government officials - civil servants as well as elected officials - could use.
We did the usual things that children did on seaside holidays. I would rise early to watch the sun rise and meander along the beach. After breakfast, my brothers and I would build sandcastles, dig for clams and search for starfish and hermit crabs. When the tide was in, we tried our luck at fishing with hook and bait or swam in the sea. If it was raining, as it often did in December, we would read or play games indoors.
I remember playing a memory game using cards with the young Lee Chuen Neng, who was staying then with his father K.C. Lee and his family in a neighbouring chalet. More than 40 years later, we are still good friends; he is a cardiothoracic surgeon and head of the department of surgery at the National University Hospital, and I'm a neurologist and director of the National Neuroscience Institute.
These holidays were the rare occasions when my brothers and I had our father's company for the entire day. He would sometimes join us on the beach and swim with us. My mother would watch over us children whenever we went swimming. Without saying so, she was our lifeguard.
Every evening, my father would play golf at the nearby Changi golf course. We would walk with him, sometimes pulling his golf trolley. Sometimes, I would walk ahead to the next hole and roam in the thick vegetation nearby. Those trees and undergrowth were probably left there to increase the chances of a golfer losing his golf ball.
Among the bushes and trees, I would pretend that I was a soldier on a topographic march. I had a good sense of direction and never got lost, although I was often scratched or poked by sharp twigs and thorns. But that merely made the game more realistic, so I didn't mind.
Often, at least once a year while we were in Changi, my father would take us to Pulau Ubin. We would visit the Outward Bound School there. It was then rather under-developed by today's standards, but knowing no better, we enjoyed it, as we tried out the obstacle course.
I still have black-and-white photographs of my elder brother Hsien Loong climbing a net-like structure with parallel rows of horizontal ropes attached to parallel rows of vertical ropes. In the photograph, Loong had made it to the top, while I was trying very hard to catch up with him, as indicated by the determined expression on my face. My younger brother Hsien Yang was then too young to try the obstacle.
All three of us enjoyed our holidays in Changi and the quality time we had with our parents. I doubt we would have enjoyed ourselves more if our parents had flown us off to more exotic and expensive destinations overseas.
In the late 1970s, I remember one doctor friend deflating the ego of another doctor when the latter was boasting about his skiing holiday. My friend feigned ignorance and asked: 'Where did you go skiing? Off Coney Island (also known now as Pulau Serangoon)?' I chortled, for I shared my friend's attitude towards downhill skiing.
It is a chance for the rich to show off their ski costumes and stylish sunglasses. Equipment and ski lift passes are expensive, and skiing accidents are common. In the late 1970s, if you could afford to travel overseas to ski, you had to be very wealthy.
Now my younger doctors, with children in primary school, routinely fly their entire families to Australia, New Zealand, Britain, Europe, the United States or China during the year-end school holidays. A few with larger families may opt to drive up to Malaysia. But on the whole, the children of the upper- middle-class are growing up with expectations that expensive holidays overseas are the norm.
My readers can probably guess what I think of this trend. It is a waste of money to travel vast distances for a holiday when there are many interesting places near Singapore one could visit for both fun and education. It doesn't make sense for well-off Singaporean children to be more familiar with Vail or Aspen than with Borobudur or Angkor Wat.
But the festive season will be soon upon us and I don't want to sound like Scrooge. So I will end this trip down memory lane by wishing all my readers a happy year ahead - and by reminding them that misfortune can occur at any time and it is best not to get used to luxuries.
Dr Lee is the director of the National Neuroscience Institute.
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