S'pore cardiologist on why he is like a high-class contractor

SINGAPORE - At his interview to gain entry into medical school at the National University of Singapore in 1994, Dr Lee Yian Ping was asked to name the organ he thought was the most important.

Without hesitation, the 18-year-old said "the heart", which he thought sustains all the other organs.

His interviewers smiled and exchanged glances. He later realised they were a neurologist, an orthopaedics professor and a lung physician. Dr Lee thanked his lucky stars that they did not disagree with him and let him into medical school.

Upon his graduation in 2000, he trained in cardiology at the National University Heart Centre, Singapore (NUHCS), following which he received a Ministry of Health scholarship to train in interventional cardiology at the Liverpool Hospital in New South Wales, Australia.

The specialist in interventional cardiology and consultant at the Raffles Heart Centre at Raffles Hospital was previously the programme director for cardiology training at Khoo Teck Puat Hospital and is now a visiting consultant at NUHCS.

The 39-year-old is married to a 32-year-old chemical engineer. They have two sons aged four and two and are expecting a daughter in December.

I sub-specialise in interventional cardiology because...

I am fascinated by how the human heart can sustain life by working effortlessly every minute, every day.

Yet a heart attack can jeopardise all this in the blink of an eye. The heart can fail or succumb to dangerous rhythms because of blocked coronary arteries.

The difference between life and death lies in how quickly the cardiologist reopens the blocked artery. Therefore, interventional cardiology is certainly not for the faint-hearted (pardon the pun).

The heart is fascinating because...

It is like a four-room HDB flat with doors (valves), electrical wiring (nerves) and water pipes (coronary arteries).

The heart pumps oxygenated blood through the aorta to every organ in the human body. Despite the complexity, every structure works in synchrony to get the job done.

One little known fact about interventional cardiology is...

Two key procedures, angiogram and angioplasty, are essentially pain-free.

A coronary angiogram is an X-ray taken by threading a catheter - akin to a straw - with a camera along the blood vessels to the opening of the heart artery. This takes 15 minutes.

Angioplasty uses a balloon to widen narrowed blood vessels of the heart. This takes under an hour.

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

A high-class contractor, akin to sitcom character Phua Chu Kang, for four-room HDB flats.

I ensure that the water pipes (coronary arteries) are not clogged; the electrical wires (nerves) of the heart are conducting electricity well; the doors (valves) open and close properly; and the walls (heart muscles) are strong. Any malfunction in the renovation works will affect the integrity of the heart so everything has to be fastidiously looked after.

To quote Phua Chu Kang: "Don't play play."

A typical day for me starts...

At 7am. I reach Raffles Hospital at 7.30am and start seeing patients in the intensive care unit and in the general ward.

By 8.30am, I am in my clinic, where I see patients until noon. Procedures, such as angiograms and angioplasties, are performed from noon to 2pm.

I continue to see patients at the clinic until 5.30pm, after which I check on my patients in the wards before going home.

The "real" work starts at home after dinner, chasing after my two boys and getting them to bed. I take Aikido classes to relieve stress and to keep my weight in check.

I have come across all types of cases...

They include people who arrive at the emergency department with heart attacks, often with severe chest pain and dangerously low blood pressure.

I also see younger patients with heart problems, ranging from weak heart function to excessively thickened heart muscles that cannot contract efficiently. These conditions may be hereditary.

Most of my patients are middle-aged and elderly people who just have to manage their cardiovascular risk factors, such as high cholesterol levels, hypertension and diabetes.

I love patients who are...

Optimistic.

Most heart conditions can be treated nowadays, and blocked arteries can be stented safely.

Things are never as bad as people imagine them to be and optimistic patients do cope better.

Patients who get my goat are...

Those who have little faith in medical science. There are some patients who decline treatment although they could have benefited from it.

This can be as simple as taking tablets or undergoing angioplasty, which is very safe.

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

The naughty acts that my two children are capable of. They like to showcase their drawing skills on the sofa and bed and would feign total ignorance when I ask for the culprit.

It breaks my heart when...

A young patient suffers a massive heart attack and makes it to the hospital too late. This happened not infrequently when I was practising in a public hospital. The patient may not pull through despite our best efforts and the sight of the grieving family is heartbreaking.

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

I feel I do make a difference to my patients' well-being. A well-executed procedure or even a simple act of reassurance can mean the world to them. Seeing the relief and joy on a patient's face is the best reward for a doctor.

My best tip...

Seek medical advice if you experience chest discomfort. A medical opinion is invaluable to rule out life-threatening heart conditions, which are mostly treatable.

joanchew@sph.com.sg

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