I decided to keep this post here as a reminder of the important things in life.
The Impermanence of Life
A reminder that we are all the same.
One of my favourite quotes:
"Once you learn how to die, you learn how to live"
- Tuesday with Morrie
- Tuesday with Morrie
Below is the transcript of his speech to a group of graduating dentist:
Hi good morning to all of you. My voice is a bit hoarse, so please bear with me. I thought I'll just introduce myself. My name is Richard, I'm a medical doctor. And I thought I'll just share some thoughts of my life. It's my pleasure to be invited by prof. Hopefully, it can get you thinking about how... as you pursue this.. embarking on your training to become dental surgeons, to think about other things as well.
Since young, I am a typical product of today's society. Relatively successful product that society requires.. From young, I came from a below average family. I was told by the media... and people around me that happiness is about success. And that success is about being wealthy. With this mind-set, I've always be extremely competitive, since I was young.
Not only do I need to go to the top school, I need to have success in all fields. Uniform groups, track, everything. I needed to get trophies, needed to be successful, I needed to have colours award, national colours award, everything. So I was highly competitive since young. I went on to medical school, graduated as a doctor. Some of you may know that within the medical faculty, ophthalmology is one of the most highly sought after specialities. So I went after that as well. I was given a traineeship in ophthalmology, I was also given a research scholarship by NUS to develop lasers to treat the eye.
So in the process, I was given 2 patents, one for the medical devices, and another for the lasers. And you know what, all this academic achievements did not bring me any wealth. So once I completed my bond with MOH, I decided that this is taking too long, the training in eye surgery is just taking too long. And there's lots of money to be made in the private sector. If you're aware, in the last few years, there is this rise in aesthetic medicine. Tons of money to be made there. So I decided, well, enough of staying in institution, it's time to leave. So I quit my training halfway and I went on to set up my aesthetic clinic... in town, together with a day surgery centre.
You know the irony is that people do not make heroes out average GP (general practitioner), family physicians. They don't. They make heroes out of people who are rich and famous. People who are not happy to pay $20 to see a GP, the same person have no qualms paying ten thousand dollars for a liposuction, 15 thousand dollars for a breast augmentation, and so on and so forth. So it's a no brainer isn't? Why do you want to be a gp? Become an aesthetic physician. So instead of healing the sick and ill, I decided that I'll become a glorified beautician. So, business was good, very good. It started off with waiting of one week, then became 3 weeks, then one month, then 2 months, then 3 months. I was overwhelmed; there were just too many patients. Vanities are fantastic business. I employed one doctor, the second doctor, the 3rd doctor, the 4th doctor. And within the 1st year, we're already raking in millions. Just the 1st year. But never is enough because I was so obsessed with it. I started to expand into Indonesia to get all the rich Indonesian tai-tais who wouldn't blink an eye to have a procedure done. So life was really good.
So what do I do with the spare cash. How do I spend my weekends? Typically, I'll have car club gatherings. I take out my track car, with spare cash I got myself a track car. We have car club gatherings. We'll go up to Sepang in Malaysia. We'll go for car racing. And it was my life. With other spare cash, what do i do? I get myself a Ferrari. At that time, the 458 wasn't out, it's just a spider convertible, 430. This is a friend of mine, a schoolmate who is a forex trader, a banker. So he got a red one, he was wanting all along a red one, I was getting the silver one.
So what do I do after getting a car? It's time to buy a house, to build our own bungalows. So we go around looking for a land to build our own bungalows, we went around hunting. So how do i live my life? Well, we all think we have to mix around with the rich and famous. This is one of the Miss Universe. So we hang around with the beautiful, rich and famous. This by the way is an internet founder. So this is how we spend our lives, with dining and all the restaurants and Michelin Chefs you know.
So I reach a point in life that I got everything for my life. I was at the pinnacle of my career and all. That's me one year ago in the gym and I thought I was like, having everything under control and reaching the pinnacle.
Well, I was wrong. I didn't have everything under control. About last year March, I started to develop backache in the middle of nowhere. I thought maybe it was all the heavy squats I was doing. So I went to SGH, saw my classmate to do an MRI, to make sure it's not a slipped disc or anything. And that evening, he called me up and said that we found bone marrow replacement in your spine. I said, sorry what does that mean? I mean I know what it means, but I couldn't accept that. I was like “Are you serious?” I was still running around going to the gym you know. But we had more scans the next day, PET scans - positrons emission scans, they found that actually I have stage 4 terminal lung cancer. I was like "Whoa where did that come from?” It has already spread to the brain, the spine, the liver and the adrenals. And you know one moment I was there, totally thinking that I have everything under control, thinking that I've reached the pinnacle of my life. But the next moment, I have just lost it.
This is a CT scan of the lungs itself. If you look at it, every single dot there is a tumour. We call this miliaries tumour. And in fact, I have tens of thousands of them in the lungs. So, I was told that even with chemotherapy, that I'll have about 3-4months at most. Did my life come crushing on, of course it did, who wouldn't? I went into depression, of course, severe depression and I thought I had everything.
See the irony is that all these things that I have, the success, the trophies, my cars, my house and all. I thought that brought me happiness. But i was feeling really down, having severe depression. Having all these thoughts of my possessions, they brought me no joy. The thought of... You know, I can hug my Ferrari to sleep, no... No, it is not going to happen. It brought not a single comfort during my last ten months. And I thought they were, but they were not true happiness. But it wasn't. What really brought me joy in the last ten months was interaction with people, my loved ones, friends, people who genuinely care about me, they laugh and cry with me, and they are able to identify the pain and suffering I was going through. That brought joy to me, happiness. None of the things I have, all the possessions, and I thought those were supposed to bring me happiness. But it didn't, because if it did, I would have felt happy think about it, when I was feeling most down..
You know the classical Chinese New Year that is coming up. In the past, what do I do? Well, I will usually drive my flashy car to do my rounds, visit my relatives, to show it off to my friends. And I thought that was joy, you know. I thought that was really joy. But do you really think that my relatives and friends, whom some of them have difficulty trying to make ends meet, that will truly share the joy with me? Seeing me driving my flashy car and showing off to them? No, no way. They won’t be sharing joy with me. They were having problems trying to make ends meet, taking public transport. In fact i think, what I have done is more like you know, making them envious, jealous of all I have. In fact, sometimes even hatred.
Those are what we call objects of envy. I have them, I show them off to them and I feel it can fill my own pride and ego. That didn't bring any joy to these people, to my friends and relatives, and I thought they were real joy.
Well, let me just share another story with you. You know when I was about your age, I stayed in king Edward VII hall. I had this friend whom I thought was strange. Her name is Jennifer, we're still good friends. And as I walk along the path, she would, if she sees a snail, she would actually pick up the snail and put it along the grass patch. I was like why do you need to do that? Why dirty your hands? It’s just a snail. The truth is she could feel for the snail. The thought of being crushed to death is real to her, but to me it's just a snail. If you can't get out of the pathway of humans then you deserve to be crushed, it’s part of evolution isn't it? What an irony isn't it?
There I was being trained as a doctor, to be compassionate, to be able to empathise; but I couldn't. As a house officer, I graduated from medical school, posted to the oncology department at NUH. And, every day, every other day I witness death in the cancer department.
When I see how they suffered, I see all the pain they went through. I see all the morphine they have to press every few minutes just to relieve their pain. I see them struggling with their oxygen breathing their last breath and all. But it was just a job. When I went to clinic every day, to the wards every day, take blood, give the medication but was the patient real to me? They weren't real to me. It was just a job, I do it, I get out of the ward, I can't wait to get home, I do my own stuff.
Was the pain, was the suffering the patients went through real? No. Of course I know all the medical terms to describe how they feel, all the suffering they went through. But in truth, I did not know how they feel, not until I became a patient. It is until now; I truly understand how they feel. And, if you ask me, would I have been a very different doctor if I were to re-live my life now, I can tell you yes I will. Because I truly understand how the patients feel now. And sometimes, you have to learn it the hard way.
Even as you start just your first year, and you embark this journey to become dental surgeons, let me just challenge you on two fronts.
Inevitably, all of you here will start to go into private practice. You will start to accumulate wealth. I can guarantee you. Just doing an implant can bring you thousands of dollars, it's fantastic money. And actually there is nothing wrong with being successful, with being rich or wealthy, absolutely nothing wrong. The only trouble is that a lot of us like myself couldn't handle it.
Why do I say that? Because when I start to accumulate, the more I have, the more I want. The more I wanted, the more obsessed I became. Like what I showed you earlier on, all I can was basically to get more possessions, to reach the pinnacle of what society did to us, of what society wants us to be. I became so obsessed that nothing else really mattered to me. Patients were just a source of income, and I tried to squeeze every single cent out of these patients.
A lot of times we forget, whom we are supposed to be serving. We become so lost that we serve nobody else but just ourselves. That was what happened to me. Whether it is in the medical, the dental fraternity, I can tell you, right now in the private practice, sometimes we just advise patients on treatment that is not indicated. Grey areas. And even though it is not necessary, we kind of advocate it. Even at this point, I know who are my friends and who genuinely cared for me and who are the ones who try to make money out of me by selling me "hope". We kind of lose our moral compass along the way. Because we just want to make money.
Worse, I can tell you, over the last few years, we bad mouth our fellow colleagues, our fellow competitors in the industry. We have no qualms about it. So if we can put them down to give ourselves an advantage, we do it. And that's what happening right now, medical, dental everywhere. My challenge to you is not to lose that moral compass. I learnt it the hard way, I hope you don't ever have to do it.
Secondly, a lot of us will start to get numb to our patients as we start to practise. Whether is it government hospitals, private practice, I can tell you when I was in the hospital, with stacks of patient folders, I can't wait to get rid of those folders as soon as possible; I can't wait to get patients out of my consultation room as soon as possible because there is just so many, and that's a reality. Because it becomes a job, a very routine job. And this is just part of it. Do I truly know how the patient feels back then? No, I don't. The fears and anxiety and all, do I truly understand what they are going through? I don't, not until when this happens to me and I think that is one of the biggest flaws in our system.
We’re being trained to be healthcare providers, professional, and all and yet we don't know how exactly they feel. I'm not asking you to get involved emotionally, I don't think that is professional but do we actually make a real effort to understand their pain and all? Most of us won’t, alright, I can assure you. So don't lose it, my challenge to you is to always be able to put yourself in your patient's shoes.
Because the pain, the anxiety, the fear are very real even though it's not real to you, it's real to them. So don't lose it and you know, right now I'm in the midst of my 5th cycle of my chemotherapy. I can tell you it’s a terrible feeling. Chemotherapy is one of those things that you don't wish even your enemies to go through because it's just suffering, lousy feeling, throwing out, you don't even know if you can retain your meals or not. Terrible feeling! And even with whatever little energy now I have, I try to reach out to other cancer patients because I truly understand what pain and suffering is like. But it's kind of little too late and too little.
You guys have a bright future ahead of you with all the resource and energy, so I’m going to challenge you to go beyond your immediate patients. To understand that there are people out there who are truly in pain, truly in hardship. Don’t get the idea that only poor people suffer. It is not true. A lot of these poor people do not have much in the first place, they are easily contented. for all you know they are happier than you and me but there are out there, people who are suffering mentally, physically, hardship, emotionally, financially and so on and so forth, and they are real. We choose to ignore them or we just don't want to know that they exist.
So do think about it alright, even as you go on to become professionals and dental surgeons and all. That you can reach out to these people who are in need. Whatever you do can make a large difference to them. I'm now at the receiving end so I know how it feels, someone who genuinely care for you, encourage and all. It makes a lot of difference to me. That’s what happens after treatment. I had a treatment recently, but I’ll leave this for another day. A lot of things happened along the way, that's why I am still able to talk to you today.
I'll just end of with this quote here, it's from this book called Tuesdays with Morris, and some of you may have read it. Everyone knows that they are going to die; every one of us knows that. The truth is, none of us believe it because if we did, we will do things differently. When I faced death, when I had to, I stripped myself off all stuff totally and I focused only on what is essential. The irony is that a lot of times, only when we learn how to die then we learn how to live. I know it sounds very morbid for this morning but it's the truth, this is what I’m going through.
Don’t let society tell you how to live. Don’t let the media tell you what you're supposed to do. Those things happened to me. And I led this life thinking that these are going to bring me happiness. I hope that you will think about it and decide for yourself how you want to live your own life. Not according to what other people tell you to do, and you have to decide whether you want to serve yourself, whether you are going to make a difference in somebody else's life. Because true happiness doesn't come from serving yourself. I thought it was but it didn't turn out that way. With that I thank you, if you have any questions you have for me, please feel free. Thank you.