He inspired me to become a doctor and became my patient one day

​Dr V inspired me to be a doctor.

In the 1980s, when I was in my second year of Junior College, my classmate C invited me to join him and his uncle, Dr V for lunch.  Dr V was a highly respected General Practitioner and one of the first graduates of the Master of Medicine in Internal Medicine from the National University of Singapore. At that time, I was deciding what to study at university. At lunch, I took the opportunity to ask Dr V, "So, why are you a doctor?"

He smiled and replied, "There is nothing else I could imagine myself doing!" It was such a simple answer, but I was awed - not by his words, but by the absolute delight and excitement he expressed when he said it. With those few words, he conveyed the joy and meaning he found in his work, and I decided I wanted that too.

I became a doctor in 1991 and found my calling in Haematology, specialising in blood cancers and blood stem cell transplants. Over the years Dr V referred some of his patients with cancer and blood disorders to me.

Inspired by his mentor Dr V, Professor William Hwang became a doctor.

(Credit: iStock.com/NanoStockk)

Then one day in April 2021, he messaged me about his own blood test results. He noted that his haemoglobin and red cell count had been getting lower over the years and that his red blood cells were larger than usual (macrocytic anaemia). After excluding the other common causes of anaemia, I proposed to do a bone marrow biopsy for him, which I performed with much care to minimise the pain.  

Unfortunately, the marrow biopsy showed that he had myelodysplastic syndrome, a disorder of the bone marrow where the blood forming stem cells had become abnormal. Patients with this have varied prognoses depending on the subtype of the disease. Dr V started on treatment because of his anaemia but the response was suboptimal, so he also had to have regular blood transfusions.

Feeling disheartened about his poor response to treatment, he asked me, "How much longer do you think I have?"

He was 85 years old with multiple medical problems, so treatment options were limited. I told him of the statistically expected median survival based on his blood indices and explained that those were only statistics and that some patients might outlive that. Furthermore, statistics are only good to help decision making, but they do not determine the outcome for any individual person.

He pressed on, "Do you think I can still have another two years?"

I looked at him and said, "We will try our best to get you there. But if there is anything you need to do or resolve, try to do it."

Over the next two years, I saw Dr V's health gradually deteriorate. But he loved life and held on tenaciously, so during this time, we worked together to ensure he was adequately transfused, vaccinated, and equipped with enough standby medications and medical referral letters for his many trips overseas. He loved to travel and wanted to do it for as long as he could.

One Monday morning in 2024, he came to see me in clinic looking very unwell and upset. He told me his wife had just been admitted for what looked like a stroke. The close-knit couple had no children, and he was worried about her care.

Later that week, as his health got progressively worse, I had to arrange for him to be admitted to hospital.

Over the next two weeks, his condition continued to deteriorate. He had heart failure although there was no clear cardiac cause. I did wonder if he was suffering from "broken-heart syndrome" (takotsubo cardiomyopathy), a condition where the heart fails under conditions of extreme stress. In this case, perhaps it was brought about by his wife's health condition.

It was apparent that Dr V was terminally ill, so I activated a referral for Advanced Care Planning and asked my colleagues from the Supportive and Palliative Care team to see him.

The Palliative Care team was professional and caring. They addressed his physical, mental, emotional, and social needs even though his clinical condition continued to deteriorate. They asked him about his care preferences and noted his wish to see his wife "one last time" as they were both in hospital. They managed to arrange for both of them to be in the same ward so that he could see her regularly.

When Dr V became terminally ill, the Supportive and Palliative Care team helped him with his physical, mental, emotional and social needs.

(Credit: iStock.com/Bavorndej)

His condition continued to deteriorate while in hospital. One day, I sat by his bedside, and we talked about his current condition and symptoms.  I then asked, "Dr V, if these are the last few days of your life, are you ready?"

I could barely hear his voice through the constant hiss of the oxygen mask, but he said, "Almost, not fully... but almost... Please give me a hug?"

The man who inspired me to become a doctor had such a simple request I could not refuse. I leaned over his bed to gently hug him and could feel the bones under his skin. He gave me a few soft pats.

There were no words, but he seemed to be saying, "It's ok, I'm ok, thank you."

I fumbled for words, then softly whispered, "Thank you … love you … rest well."

I spoke to Dr V's niece and suggested that his extended family overseas should be informed to come to see him.   

Two days later, with his family members surrounding him, Dr V passed away peacefully.  

I remember sitting down with a few of my colleagues later that day. I was quiet and they asked me what was wrong.

"My patient just died."

I showed them a picture of Dr V and said, "He inspired me to become a doctor."

Then it was as though a dam broke and my tears started to flow. My colleagues offered sympathy and understanding.

Did he live well? If the many family members, friends and former patients who came to visit him are any testimony, indeed he did.

Did he leave well? As I recall how he passed peacefully without pain, surrounded by his loved ones… he certainly did.

I will always fondly remember Dr V and feel privileged that I could be of service to the person who inspired me to become a doctor all those years ago.