Never giving up on children

I specialise in paediatric surgery because...

Children are special. They trust you wholeheartedly, and they have pure motives and so much untapped potential. Correcting a congenital anomaly in a child can provide him with a new lease of life.

Children's bodies are fascinating because...

Behind all the tears and fears, they actually heal better than adults. For instance, a child who has undergone major abdominal surgery may be sitting up and playing three days after the surgery. Most will be back on their feet within five days while most adults will have very restricted movements for a week or more.

One little known fact about children's cancer is...

They are usually very treatable and have excellent outcomes compared with adult cancer cases.

In most types of paediatric cancer, the child is expected to live for at least five years after diagnosis in more than 75 per cent of cases though this will differ according to tumour type and stage. That is why we should never give up hope on an ill child.

If I were to give an analogy for what I do, I would be...

A carpenter who fixes a broken walking doll and brings it back to life.

A typical day for me...

Starts at 6.30am when I wake up. I am out of the house by 6.55am with my elder daughter. My husband and I take turns to fetch her to school and the younger one to childcare.

I reach my workplace by 7.40am and do my ward rounds, if any, at 8am. For the rest of the day, I run outpatient clinics, perform surgery, complete medical reports or memos and review post-surgery patients.

On days when I'm off in the afternoons, I head home to be there for my daughters when they tackle their homework, or ferry them to their enrichment classes.

My husband and I try to do some form of exercise at least once a week with the girls. It can be jogging, swimming or playing tennis. I have come across all types of cases...

From a day-old newborn, sometimes weighing as little as 400g, to 18-year-olds who may weigh more than 100kg. Not every child who gets referred to me ends up going under the knife. Some conditions, such as gastroesophageal reflux, can be managed with medication before surgery is considered.

I love patients who are...

Motivated and can identify with our treatment goals; who are positive and determined to get better.

An 18-year-old girl with advanced bone cancer amazed me with her tenacity and passion for life.

Despite losing a large part of her right leg to cancer and having gone for more than 12 surgical procedures, she remained upbeat.

Knowing that her prognosis was poor, she used her time wisely by returning to school as often as she could, taking examinations and catching up with her friends. She even found the time and energy to encourage fellow cancer patients.

Caregivers who get my goat are...

Parents who are overly possessive and too trigger-happy to ask for investigative tests, such as blood tests and scans, for their children after arming themselves with Internet knowledge.

While I acknowledge that all children are precious, I think parents sometimes need to trust their children's bodies and the doctors' clinical acumen. It is difficult for a treatment to proceed positively if there is a lack of mutual trust and respect. Having said that, a parent's gut instinct is a powerful factor which we should never ignore.

Things that put a smile on my face are...

When sick children get better, and smile and wave goodbye to me.

When my daughters display initiative and extend compassion to my patients - particularly the underprivileged ones or those battling childhood cancer - when they accompany me on my rounds.

It breaks my heart when...

A child whom I have journeyed with over months or years earns his angel wings. Despite dedicating a large part of my practice to paediatric oncology and having encountered deaths on many occasions, I do not think I handle this final farewell very well.

My best tip...

Trust your gut instinct when you sense that your child is unwell or that a prolonged cough is making you worried. If you are unsure, seek advice from a general practitioner or a paediatrician. Children do not need to take a lot of medication to get better, but if there is one too many misses - diagnoses and symptoms - they can fall seriously ill.

BIO BOX

Dr Joyce Chua Horng Yiing

AGE: 40

OCCUPATION: Specialist in paediatric surgery and consultant at Raffles Children's Centre at Raffles Hospital

Dr Chua said her A-level grades were not good enough to secure a scholarship to pursue zoology at Oxford University. So she ended up studying medicine at the National University of Singapore at her father's insistence.

Her attachment stint at the Children's Hospital of Philadelphia in 2002 made her realise how a single speciality of paediatric surgery could treat so many conditions.

When she returned to Singapore in 2003, she pursued a five-year advanced surgical training programme at KK Women's and Children's Hospital. In 2008, she completed a fellowship in paediatric surgical oncology at the Memorial Sloan Kettering Cancer Centre in the United States.

Her parents were her biggest fans in her early years as a surgeon at Tan Tock Seng Hospital. They would bombard her with questions about the accidents they had read in the newspapers.

"My dad would ask if I had saved the accident victim while my mum often inspected my clothes for signs of my involvement in the care of the accident victims," she said.

In 2001, she and her colleague tried in vain to save a teenager who had jumped to her death. The girl had carved, with a penknife, numerous Chinese characters onto her body, depicting her desperation.

Dr Chua said: "I will always remember this teenage girl who chose to give up on life. I constantly remind my young patients that life will always give you back much more, as long as you do not give up living."

She is married to a 43-year-old civil servant and they have two daughters, aged 11 and six.

joanchew@sph.com.sg

This article was first published on Nov 06, 2014.
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