Satisfaction in the rush to save lives

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DR GOH E SHAUN

Age: 36

Occupation: Specialist in emergency medicine and consultant at Raffles 24 Hour Emergency at Raffles Hospital

His first day at the accident and emergency department of Changi General Hospital in 2004 was "pretty much like being thrown into the deep end" of the pool.

His first resuscitation case was a 60-year-old cardiac arrest patient. While another doctor focused on clearing the airway of the patient, he was lost and did not know where to begin, and was pushed aside by the nurses who were tending to the patient.

However, that encounter made him learn fast, albeit the hard way, he said. Twelve years on, he now calmly handles patients in various situations. He has learnt to be alert to quiet or low-key patients, as they may suffer from more serious conditions than patients who complain a lot. He is married to a 33-year-old IT analyst. They have a three-year-old son and are expecting another son next year.

Q I specialise in emergency medicine because...

A This is where every second counts and doing a little bit can mean a lot to patients- such as giving patients painkillers while they wait for their test results.

Though my workplace is often chaotic, that is the kind of situation and challenge I enjoy.

Q The body is fascinating because...

A There are many ways the body can be injured or even harm itself.

Certain diseases or infections prompt the body to defend itself, but this reaction can be so strong that it makes the body more ill.

Q One little-known fact about recovering from a stroke is...

A Only time can tell how a patient will recover.

Patients who arrive at the emergency department with an abrupt onset of stroke may show improvement over the next 48 hours and beyond. So the initial presentation may not always determine a patient's outcome.

Q What I do is like being...

A A captain in a battlefield.

I can be deep in the trenches with my platoon in a chaotic environment, but we try to find and fight our way through it all, in order to achieve a positive outcome.

Q A typical day for me starts...

A With waking up at 6.30am and getting to work by 8.30am.

I probably see about 15 to 20 patients a day. This includes reviewing patients who were seen by the emergency resident physician, but who may require further expert opinion or assistance in formulating a management plan.

I usually end work at 5.30pm but I have, on several occasions, stayed on well past 7pm. This happens when I am managing very ill patients who require constant medical care.

After work, I generally end up at the gym and spend the rest of my evening with my family.

Occasionally, I have to take calls from the emergency department for help in various situations.

I also help to provide training to resident physicians and I am a member of two research workgroups that deal with resuscitation and trauma.

Q I come across all types of cases...

A From simple coughs and colds, or food poisoning to heart attack or stroke and major physical injuries.

I recall a patient in a car accident whose heart stopped shortly after he arrived at the emergency department.

We had to resuscitate him immediately.

I had to cut open his chest on the spot to access his heart and other organs to stem the internal bleeding from an injury to his lung.

There was simply no time to wheel him to the operating theatre: The brain is not a forgiving organ and if circulation stops for five to 10 minutes, there would certainly be brain damage.

We brought the bleeding under control before sending him to the operating theatre later for more definitive repairs.

Q I love patients who are...

A Grateful, and who treat me and my staff politely, with mutual respect and understanding.

Q Patients who get my goat are...

A Those who complain about waiting too long to see a doctor at an emergency department.

I do not believe that any emergency department would intentionally make a patient wait for long periods of time.

Often, things are happening away from the public eye - such as resuscitating a patient in cardiac arrest.

I hope the public continues to be understanding of the constraints in an emergency department, especially when a patient arrives in a critical condition.

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

A Receiving thank-you notes from patients or their relatives.

Emergency doctors are often at the front line and they do quite a lot to keep patients alive.

Most of the time, this is forgotten because the patients are usually drowsy or asleep, and wake up in intensive care units, where they see another group of doctors and healthcare workers.

Q It breaks my heart when...

A I need to stop trying to resuscitate a young person.

I have seen 20-year-olds and infants as young as a month old fail to respond to resuscitation efforts. Nothing is more tragic than the loss of a young life.

Q My best tip...

A Learn more about managing your health and that of your loved ones.

Find out about the types of situations that warrant emergency attention so that you know when to go to the emergency department.

Also, learn how to perform cardiopulmonary resuscitation (CPR). You never know when you need to step up to save someone else's life.

joanchew@sph.com.sg

This article was first published on October 20, 2015.
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