Afraid of growing old? Not with this doctor
Published on
11 May 2015
Published by
The Straits Times
Tending to the elderly has also helped shape doc's understanding of 'successful ageing'
Dr Ng Wai Chong's voice softens as he talks about an old woman he used to treat in a block of rental flats in the Kim Tian Road area many years ago as a young home care physician.
The widow's life was hard - she had two sons, one of whom was disabled - but she was always cheerful and ready to lend a helping hand to other needy folk in the area.
One day, he checked in on her and found her lying on sheets of newspapers under the kitchen sink, covered in faeces and urine. Her able-bodied son had left her there because he was going through a divorce, and was too stressed to know how to care for her, or where to turn for help.
Together with a social worker and a nurse, Dr Ng arranged for the woman to be taken to a hospital.
Years later, he met her again while volunteering in a home.
By then, she had lost her mind to dementia and did not recognise him. But she clasped his hands in hers, smiled and looked genuinely happy.
"I suspect how you live your life may have a bearing on how you age. If you've led an open life and have always been kind and caring, it will show, even when your higher faculties are diminished due to diseases," says Dr Ng, 46.
To lead one's life well all the way to the end, he adds, one needs to sort things out all the time - from health to finance to relationships.
"Successful ageing, to me, is really the work we have to do while journeying towards a good death, a death with a heart of contentment, acceptance, gratitude and clarity," he says.
The good doctor has thought a lot about ageing, because he spends a lot of time with the aged. He is the medical director of the Tsao Foundation's Hua Mei Centre for Successful Ageing, and has been a home care doctor with the Hua Mei Mobile Clinic since 2000. The Tsao Foundation is a non-profit group that specialises in ageing issues.
He decided on geriatric medicine very early on in his career. It is not the most glamorous or lucrative area of medical specialisation, but looking after the old, he says with a serene smile, keeps him wholesome and humble.
Soft-spoken with an affecting sense of calm, he is the second of six children of an insurance agent and a housewife.
Together with a coterie of uncles, aunts and cousins, he and his family lived with his paternal grandmother - a Chinese physician - in a shophouse which doubled as a traditional Chinese medicine (TCM) shop in the Nee Soon area.
"I'm sure TCM affected and influenced certain decisions I made in life, but I wasn't conscious of it when I was growing up," he says.
Although his father - who died about 10 years ago - had only Secondary 1 education, he was a self-taught man who filled the house with shelves and shelves of books, from tomes on science to Chinese pugilistic novels.
"We had a blackboard in the house. It was one of the main 'attractions' in the house, and he would use it to tell us all about the planetary system and the physical states of objects," he recalls.
The young Wai Chong loved to draw, and would use chalk to fill the floor of the house with drawings of fish, birds and animals.
"I took part in an art competition, and instead of painting the sea, I painted a swallow. I liked to draw things from my imagination, and they were very different from the ideas adults had about children's art," he says with a grin.
After completing his primary education at the Chinese medium Poi Eng Public School, the self-starter moved on to The Chinese High School and Hwa Chong Junior College, and later to medical school at the National University of Singapore.
Breaking into a hearty laugh, he lets on that landscape architecture or forestry in a university abroad were his preferred choices for a degree, not medicine.
But he was very stressed about starting national service, and when he heard that doing medicine meant doing NS only after graduation, he applied for medical school.
The irony, he says, is that he was selected for Officer Cadet School and ended up doing very well in NS. "I am someone who needs to be pushed, and if pushed, I can do anything," he says.
His interest in geriatric medicine was piqued when he was a houseman and one of his seniors in medical school was a medical officer in a hospice association.
"When he was on call, I would bunk in at his house and tag along. Most of the people he saw were suffering from end-stage cancer," he says.
Around this time too, he met a Buddhist monk, Reverend Xuehang, while volunteering at a big medical talk.
They started chatting, and when the monk talked about his wish to build a hospice, Dr Ng connected him with some of his medical seniors interested in hospice work.
That led to the founding of Code 4 Medical Services in 1995, and he was roped in as its first volunteer medical superintendent. The group, part of the Care for the Elderly Foundation, provides home care services for those who are home bound.
Through the stint, he met many doctors such as Dr Tham Weng Yew - now the medical director of Code 4 Home Care - who told him how inspiring geriatric medicine was.
So when he completed NS and finished his stint as a medical officer with the Navy in 1997, he opted for a posting with the geriatric department at Alexandra Hospital.
It proved eye-opening in more ways than one. Caring for an elderly person, he learnt, went beyond treating his medical conditions. "You look at other areas, their cognitive functions and their social circumstances," he says.
He was so energised by geriatric work that he applied to specialise in this area. Unfortunately, he did not get it.
He decided to get a diploma in geriatric medicine at NUS instead. In the meantime, he served the rest of his bond with the Ministry of Health as an Accident & Emergency doctor.
"But even in A&E, all the nurses knew I liked geriatrics so they referred all the geriatric cases to me. I just liked to sort out their complex problems and sometimes I couldn't help it and would give them a hug," he recalls almost bashfully.
A one-year stint as a general practitioner in a clinic in Taman Jurong followed. "I spent a lot of time doing assessments for geriatric patients, but even after I came up with really good care plans, there was no one I could count on to help them with the follow through. It became a bit of an academic exercise," he says.
It was meditation that provided the decisive nudge into geriatric care.
Dr Ng took up meditating while in university, and when he started working, he began attending meditation retreats.
The first was a week-long retreat that was so austere that he left after 11/2 days.
He fared a lot better at his second retreat in Penang, not long after. "In the middle of it, I had a strong sense of clarity and what my priorities should be," he recalls.
At the time, he was volunteering as a home care physician for Hua Mei Mobile Clinic. As luck would have it, he was tasked the next year with treating a Buddhist monk whose disciples had organised the Penang retreat.
"After he recovered, I went for his forest retreat in Myanmar, and I've been going almost every year," he says.
Held in remote forests or hill tops in Myanmar, these retreats last at least a month or more. In 2006, he spent about five months helping to build a meditation centre atop a barren hill.
Accommodation at these retreats is usually a spartan hut.
"You wake up at 3.30am for your first sitting, and there are many sittings in a day, each lasting between one hour and 90 minutes. You cannot talk, but that's really nice. It makes me very happy," he says.
Because he found them beneficial, he decided he should work in a place which would allow him to take unpaid leave to attend these retreats annually.
That was how he ended up in the Hua Mei Centre in 2001. It was a perfect match because by then he was very sure he wanted to work with old people.
Caring for the elderly keeps him humble, he says.
"If you are really sincere in caring for a person, you cannot just stop at the 99th step, you have to complete the 100th step," he says.
So besides dressing their wounds and prescribing medication for their conditions, he doubles as cleaner, confidante and counsellor.
"If you do a home visit and a nurse is not with you, you cannot leave your patient there if he's lying in bed, lying in his faeces. You have to clean him up, change the linen. You have to counsel them, tell them where to get help, and what are the social services which could help them.
"Sometimes, the diabetes and hypertension are the least of their problems. If you can't solve their bread-and-butter and loneliness issues, you can't really connect with them. And if you don't connect with them, you won't heal them," he says.
What he does helps his meditation, he says, in the same way that meditation benefits his work.
"In meditation, the mind becomes pure and engrossed until there is nothing bothering it. And when you come out of that pure state, your mind is very clear."
That clarity makes him more empathetic.
"It makes you very intuitive and helps you to work through issues, both good and bad; it helps you to listen deeply. You try and appreciate the person for who he is and that's when respect occurs. When that happens, you can connect and deliver on something which is meaningful to the other person. For a healer, that's really useful," he says.
Eyes twinkling, he lets on that his boss, Dr Mary Ann Tsao - founder and president of the Tsao Foundation - always says that those working in community aged care often eat frustration for breakfast.
"Meditation helps me eat frustrations and be nourished by them," he quips.
His path in life, he says, is clear.
"I hope to be an inspiration for successful ageing and to be inspired by successful ageing," he says simply.
Background story
Holistic model needed
"The first is primary care. Our system encourages disease-focused, episodic problem-solution kind of care. But the conditions of older people are often linked to their psychological states and their social connections. We need a model which is more holistic, where physicians work in a team, with other people such as social workers and nurses. Care management also needs to be more multi-directional. You not only become an educator to the patients and tell them what the doctors, nurses and healthcare committee recommend for them, but you also become the patients' advocate. And lastly, you need an inclusive community which embraces ageing, and which pushes for infrastructure and facilities for elderly care - from housing to day centres to home based care."
DR NG WAI CHONG, on three areas which need improvement in geriatric care in Singapore
Keep working on issues
"If you want to lead your life well all the way to the end, you need to sort things out all the time; you need to work on relationship issues, income security. You also need to exercise and take care of your health. If you take care of your health, you'll have a much better time in your old age. You also need to remain curious; life-long learning is very important."
DR NG, on how to age well
Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.
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