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The Call To Heal

Everyone, it is believed, has a specific purpose to fulfil in their lifetime. The trick is to know it when you find it. For most people, this is much trickier than it seems, when so many directional arrows appear, each seeming to promise fulfilment, happiness, more money, purpose. Hence the critical questions so many are faced with at different times: Why am I here? What am I meant to do? How will I know? What am I meant to believe in?

Dr Luke Tan, 50, is a man of deep faith. And becoming a doctor was an act of faith, a calling. “I came into medicine in the search for meaning and purpose, and I am still on the quest.”

“My work in cancer today ties back to my days as a 15-year-old with my grandmother who raised me. She had stomach cancer and I helped tend to her.”

It’s not that he had, as a child, dreamed of being a doctor. It was about witnessing a loved one coping with what was, for her, an incurable illness. Growing up in a mainly Teochew kampong near what is present-day Hougang, life was tough and lacking in role models who were professionals. You coped as best you could, against serious odds. Like growing up in a blended family, losing his father when he was 11 and being raised by his grandmother while his mother worked full-time as a seamstress to make ends meet.

And beat the odds he did. “I gave tuition from the time I was in Sec 3, and worked in a factory assembly line for $6 a day during the school holidays. In junior college, I gave lessons in conversational English to Japanese managers from the nearby Matsushita factory for $60 per month. It was tough.” He applied for the Public Service Commission scholarship but didn’t get it, so his brother-in-law sponsored him and he gave English and Maths tuition throughout medical school. That meant a gruelling runningfrom-pillar-to-post schedule which he can smile about now.

Then came one of life’s ‘learning moments’. “I failed surgery in final year.

Of the roughly 200 students in my batch, 66 of us failed. It was my first failure and it was painful to see my friends progressing forward towards being doctors while I was just a failed final year student.”

He passed on his second try, and the rest, as they say, is history.

Empowering overseas colleagues

Having grown up in a village, he is no stranger to icy-cold baths by the side of a well, mud floors and an attap-roofed home. And he grew up with the built-in immunity that comes from not living with antibacterial soap dispensers around every corner.

Against this backdrop, an experience of overseas mission work in East Malaysia as a youth planted a seed in him. Years later, while pursuing training in the US for head and neck surgery, his mentor, Dr Byron J Bailey, M.D., inspired him and fertilised that seed. “Dr Bailey had been leading overseas missions to Asian and other countries for a long time when we met. I was inspired by his example, and realised I could be more effective from here.”

A/Prof Luke Tan - ENT Specialist

So when the Singapore International Foundation was putting together an ENT team for a capacity-building project in Vietnam, he signed up. This led to a 12-year commitment in which he led several mainly ENT teams of doctors from Singapore to Hanoi, to train and work with their counterparts there. It also led to a training programme in Singapore which allowed the Vietnamese practitioners to come here for training. “We conducted surgeries, saw patients, lectured. We wanted the Vietnamese to build their own residency programme, and they have started one.”

He recalls that this involved rallying friends from the profession to join the effort. It involved bringing in equipment and teaching aids, including human skulls. Cultural exchange was a big part of the experience. “The Vietnamese are very big on ceremonies to honour guests and mark milestones. Like Singaporeans, food plays a very important part.”

“They are so hungry to learn and also tremendously resourceful,” he points out, showing me a photo of a roughly hewn hole in a wall between two rooms. “This is an instant “split-unit” aircon! They can outdo Singaporeans any time at coming up with practical solutions to challenges.”

He recalls especially a trip to a community in Ha Giang, seven hours from Hanoi. Five ENT trainees from Singapore and five from Hanoi formed the team led by Luke. “These people live too far away from Hanoi to come in for treatment, and are very poor, two patients to one bed. We brought in equipment and conducted 35 ear operations over three days. It was so great to see the teams working together.” The other part of the programme revolved around the Vietnamese residents he was training. “Language differences aside, many were very, very good.” The missions to this hospital have ended; “the training is being done very nicely by locals, which is as it should be.”

Building teams

Teams and trainees in National University Hospital

There is a recurring theme that harks back to Dr Bailey. First it was about those privileged to be medical practitioners using their skills to treat anyone, anywhere, especially those without access to medical assistance. Not to give handouts but to build capacity, build teams and transfer knowledge. For Luke, that took shape not just in Vietnam, but also in Singapore.

“I started the national ‘rotating’ residency programme among the public training hospitals in Singapore. Historically, hospitals train their own people. Dr Bailey inspired me to create a national training programme. I managed to get the hospitals to agree to be part of it. It was tough to get buy-in at first.”

This wasn’t surprising. Administrators saw genuine challenges in releasing their people to conduct training, for instance. And as each hospital was doing its best to raise its own standards, it was a tough call to look beyond and be open to being part of a national effort.

The result: elevation of standards across the board. “Everyone realised that they had to do their best and not let their side down. Trainees got a national perspective instead of a perspective only of their own situation.”

At the National University Hospital (NUH) at that time, the ENT team was led by Professor Yeoh Kian Hian with the help of a group of private ENT doctors. “He had a vision to staff his department with well-trained people, and he encouraged and facilitated our overseas stints. I joined his department after my NS. That’s how I could go away on no-pay leave for five years, doing ‘local’ training jobs in the UK and US. I committed to coming back to help the department and he kept the jobs for us to come back to. I can now appreciate how tough it was for him to juggle private practice and building a department. He opened doors that allowed me to do what he could not in the academic world.” Luke took over as the first full-time head of ENT at NUH, and by the time he left in 2007, there was a team. He is also credited with building the first ENT team at Khoo Teck Puat Hospital.

“I like to build teams and empower people, and have worked very hard to build the philosophy of practice,” says Luke, who still teaches medicine. He cites his overseas training – along with strong mentors – as forces that shaped his professional ethos. “When you have such a major mentor, you see things very differently. I met many people who shaped me. It was hard to come home.”

Points of inflexion, points of crisis

Come home he did, but not before crisis paid a visit. In 1997, six weeks after his wife Carol delivered their son Elliot in the US, she was diagnosed with thyroid cancer. She recovered fully, but that brush with mortality spurred his interest in head and neck cancers. “It’s not work for me,” he says today, as he continues to deepen this specialty and draw in patients from around the region who seek him out.

Back in Singapore, Luke dived into the work of a head and neck specialist, sharing expertise and building teams that would be able to more effectively manage this area of specialty in a fast-growing cancer-incidence scenario. It meant long intense hours of work teaching, mentoring, organising, detailing SOPs, setting up documentation procedures and the whole gamut of necessary components of building anything sustainable.

In 2007, burnout struck. It arose, ironically, from professional success. Having trained intensively locally and overseas, and then set about building pioneering ENT teams and a national training programme, Luke experienced a state that assails many game-changing professionals: depletion.

“By 2007, I felt empty and drained, and as if I had nothing left to give.” He interviewed for a post on the other side of the world, and considered emigration. He was offered the job overseas but changed his mind. “It was hard to give up the dream of heading a major educational institution and mentoring so many young people. I stayed focused by believing that I was most effective where I already was.”

The third and most recent crisis point came when a patient developed a drug allergy reaction which led to a cardiac event. The patient lodged an official complaint, Luke was cautioned. The patient escalated the complaint, and a disciplinary enquiry was convened. “This experience has made it hard to completely trust the patient in all cases. There are patients I love as fellow human beings. All my patients know that I care for them, but this painful episode made me ask – how much should I give of myself?”

Points of inflexion, points of crisis

If that instance caused existential doubt, another took it away. Last year, a patient from overseas, desperate and with serious complications, asked him to help. Dengue-related complications had led to her being intubated, and needing to use a feeding tube. A stroke had paralysed her on one side. Luke and his team performed a complex and high-risk surgery. After a month of recovery and therapy, the young newly-married woman could talk and breathe on her own. Three months later, back in her own country, she began to eat normally, without the feeding tube. “With such complicated surgeries, you are tied in emotional knots for months, worrying about the patient and praying they recover, because they are fellow human beings.”

Life and the pursuit of meaning

A/Prof Luke Tan, Wife and Children

Luke’s faith and career have always run on parallel tracks. “If you took away my calling, everything else would not make a lot of sense. The challenge is to remain focused on the belief that this is what I am meant to do.” At the end of the day, he says, “you have to live your life such that you can walk away from it. If tomorrow, I am called to work somewhere else, I can do it. That’s one of the beauties of staying simple.” he says. Luke and Carol’s first date included watching the movie ET, a walk and sharing a bag of mangosteens near the Esplanade. “I told Carol that I might be called away to do mission work, and if so, I needed her to support me fully. She agreed. “There isn’t a lot that I need. I enjoy the practice and the ability to help, and being around for the boys,” he says, speaking fondly and with humour about Carol and his sons, Elliot and Ethan.

“Carol is a gifted singer with a beautiful voice, Elliot hopes to teach at international schools and travel the world, while Ethan wants to be a lawyer and eventually own his own restaurant because of his passion for cooking. Both are international-minded and love things outside their own culture,” he says, citing this last as a necessary part of growing up and living effectively in as multiracial and multi-religious a country as Singapore. “Living here offers a fantastic opportunity to develop a openness and understanding, but I am no longer sure that it is happening as it used to.

At the time of this interview, he is reading The Life of A W Tozer by James Snyder, a book about faith, and the depth and focus required in the search for meaning and purpose. It reveals something about this understated and eloquent healthcare professional. His search for meaning is not over.

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