Infectious disease doctor talks about her bug fighting job

SINGAPORE - Head of the department of infectious diseases at Tan Tock Seng Hospital and deputy clinical director at the Communicable Disease Centre Adjunct Associate Professor Lim Poh Lian counts English doctor Edward Jenner, French chemist and biologist Louis Pasteur and Poland-born scientist Marie Curie as her first heroes.

The 47-year-old read about them as a child and was inspired to be a doctor like them.

She studied biochemistry at Harvard University in the United States after completing her O levels in her native Kuala Lumpur.

At Columbia University as a medical student afterwards, she spent six weeks in the acquired immunodeficiency syndrome (Aids) unit. The experience sealed her interest in infectious diseases.

She received her master's in public health from Tulane University in 1999.

In 2003, she started work at Tan Tock Seng Hospital.

Her husband is a 55-year-old architect turned stay-at-home dad. She has two sons and a daughter.

I specialise in infectious diseases because...

This is a wonderful area to spend your professional life in.

In the United States, we call infectious diseases "bugs and drugs" or "worms and germs". The whole microbial world is fascinating as new bugs keep getting discovered all the time, almost as if one is discovering a new planet.

In the early days of a disease, we are not sure how it would progress and what its impact on patients would be.

The immune system is fascinating because...

It is like the Singapore Armed Forces with different groups of immune cells in charge of different functions of defence.

The immune system is incredibly complex and capable of handling so many different pathogens - something which I try to explain to patients who are worried about getting more than one vaccine on the same day.

The immune system is certainly capable of handling the vaccine antigens, though most of the time, it is the injections that patients are afraid of.

If I were to give an analogy for what I do, I'd be a...

Medical detective.

I have to figure out what kind of infection patients have or if they have an infection at all.

Not every fever is caused by an infection, so we have to cultivate an openness to consider other causes. For example, one of the symptoms of the autoimmune disease, lupus, is fever.

I have come across all types of cases...

With patients ranging from Cabinet ministers to cab drivers, from pastors to prostitutes and prisoners.

I've seen children with dog bites from Indonesia who needed rabies shots and the elderly coming for vaccinations in preparation for their trips to Timbuktu and Machu Picchu.

Travel medicine is fun as patients are generally happy to go off to interesting places.

Common infections I see include dengue fever, chikungunya, malaria, rat-borne typhus, typhoid fever, human immunodeficiency virus (HIV) and tuberculosis.

A typical day for me would be...

To wake before 6am to read the Bible and pray, before waking the children so we can be out of the door by 6.40am.

I drive one child to school every day, alternating among the three to spend time with each of them.

My usual workday starts around 7.30am with the checking of e-mail. Ward rounds start at 8am and go on till 10 or 11am.

I spend the rest of the day in clinics, at meetings or giving lectures.

Over the last decade, my work has shifted from HIV clinical research to more of travel medicine and education.

I'm also spending 20 to 30 per cent of my time on outbreak preparedness, serving in the Ministry of Health and World Health Organisation.

My workday ends around 6.30 or 7.30pm. I go home to a family dinner, help my children with their homework or play a game of chess.

We enjoy movies, food and travel, like most Singaporeans. We love reading - social psychology, science fiction, the Economist and novels.

I love patients who are...

Kind to health-care workers. There is an unusual quality in a patient who can ask how the doctor is that day when he is struggling with illness.

Patients who get my goat are...

Those who make frivolous complaints and threaten lawsuits. Thankfully, many patients are understanding and appreciative and all caregivers need that.

One little known fact about the human immunodeficiency virus (HIV) is...

HIV has become a chronic viral disease like hepatitis B. It does not have to be a fatal diagnosis as people can live for at least another 20 to 40 years now with good treatment.

We have to get the word out to the man in the street that people with HIV are just like you and me.

You cannot catch HIV from a person with HIV by eating food they have cooked or giving them a hug.

Things that put a smile on my face are…

My husband and children.

It's easy to over-invest in your career, but the true measure of your life is how you have loved God and loved others.

In medicine, as in other jobs, there are good days and bad days. A hug from my husband or my children is still the best medicine for me after a bad day.

It breaks my heart when…

Patients struggle to afford medical treatment.

I wouldn't trade places for the world because...

Being in medicine allows me to serve people, many of whom are in crisis.

Each patient has a story. Listening to their poignant, tragic or uplifting accounts, and trying to make a difference are what keep me here.

My best tip...

Is to get your vaccines updated as a way to invest in preventive care.

From the age of 18 onwards, one should get a flu vaccine every year.


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