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A Day In The Life Of... A Radiation Therapist

“So… what does a radiation therapist do”? I asked the question that Sheng An has been asked countless times. Despite the repeated requests to reiterate his repertoire, Sheng An smiles patiently and invites me to join him on a typical day as a radiation therapist (RT) to see what he does every day.

Since becoming a Radiation Therapist in 2013, Sheng An has rotated to cover all work scopes: simulation, planning and treatment. He is currently posted to “the very awesome treatment room 6”, where the team treats patients receiving radiotherapy to the prostate. 

7:40am: Sheng An walks into the department and greets patients who have arrived for their treatment as he passes through the waiting room. He heads towards treatment room 6 and greets his team mate, Atiqah, who is finishing up the safety and quality assurance checks for the linear accelerator (treatment machine). Team mate Wei Jie also arrives and cracks a joke. Everyone is in high spirits as Sheng An and Atiqah head off to fill their water bottles.

7:50am: The entire team gathers for the first team huddle of the day. The team sets the mind set and tone for the day by reciting NCCS’ purpose and the quality standards. I notice the stark difference once this is done:  jokes are put aside and almost like a switch being turned on, everyone is driven and focused on what needs to be done . Updates, patient compliments and operational information is then shared with the team.

After the briefing, I quietly ask Sheng An about the superhero posters along the corridoor. "A young boy's coming in for treatment later", he explains, with a wistful look. The posters were put up by the boy's play therapist from SGH. The team also bought a few extra 'Iron Man' stickers to decorate the walls, and even the treatment area. "It can be very scary for a young boy to be alone when treatment is given. But we're going to help him imagine that this is like the scene in the movie 'Iron Man', and make it fun."

8:00am: Sheng An pauses for a quick sip of water from his huge bottle, which all the team members seem to have. “Bigger bottles mean fewer trips to the pantry for refills”, shares Sheng An. Sheng An and the team meet up and spend some time looking through the patient list of the day and taking note of special instructions. Patient care at NCCS centres around team-based care. Sheng An works closely with the nurses to make sure that patients are fit for treatment. The first patient is called in for treatment while Sheng An and I excuse ourselves from the treatment room. 

8:10am: I follow Sheng An into a meeting room as we settle in the morning wave 2 huddle, this time with the managers and representatives from each team. The discussion allows senior team members to bring up any issues which require the department’s collective effort to resolve. 

8:20am: Back at  treatment room 6, Mr Tan is here to receive radiation therapy to the prostate. “Hello Mr Tan, how are you feeling today? Have you finished 3 cups of water?” asks Sheng An. “We’ll be ready for you soon,” assures Sheng An. Patients require a full bladder as it help in reducing gastrointestinal side effects, they often need a little time and encouragement to drink more water.

9:05am: Mr Tan is brought into the room with a full bladder, and the team works fast to make the treatment quick and snappy. Even though there’s a flurry of activity, Sheng An and his colleagues speak calmly to reassure Mr Tan. Mr Tan’s body is aligned to the treatment position using green lasers to perform a scan to check his internal anatomy. The image is matched to a reference image and Mr Tan is adjusted to the best treatment position. Mr Tan has received treatment for the past few weeks and is familiar with the drill. Though nervous, he’s cooperative and cheery, as he chats with the team about his weekend outing to the zoo with his grandchildren before treatment begins. 

“Not all patients are as calm and cheery as Mr Tan,” Sheng An explains. “Some patients may be anxious or moody with what they’re going through. We always try our best to encourage them or at least make treatment a positive experience with positive energy.” 

9:20am After saying goodbye to Mr Tan, we walk to the patient waiting area to meet Mr Rashid and his son Rahfee. It’s Mr Rashid’s first treatment today. All new patients are briefed before starting radiation therapy. This helps lessen their anxiety as patients get an idea of what to expect. Mr Rashid will be receiving treatment to his right lung and is worried after hearing different things about radiotherapy. Sheng An takes the time to correct some of the common misconceptions and explains that radiotherapy is painless, almost like taking an X-ray, but requires more time. He also tells Mr Rashid that the machine will rotates around him. “Like that scene from the movie ‘Iron Man’,” says Sheng An, as both father and son smile. Mr Rashid has many questions about side effects of the treatment. His son, Rahfee, has questions about the treatment schedule as he would like to accompany his father for his treatments. As I observe the discussion, I notice that Sheng An’s demeanour hasn’t changed, it is calm and soothing as he explains the treatment journey ahead.

Sheng An then brings Mr Rashid and Rahfee to the treatment room and introduces the team members: Adeline, Jason, Jairia & Asri, who will also be caring for Mr Rashid throughout the 6 weeks of treatment. Sheng An brings Rahfee into the treatment room to have a look at the linear accelerator and gives a brief explanation of howit works. Both father and son are reassured by the positive attitude of the team. Rahfee takes a seat outside the room as his father’s treatment begins.

9:40am: Treatment for first-time patients is detailed with many parameters to be checked, and time taken to put the patient at ease. Observing the interaction between Sheng An and Mr Rashid reminds me how many patients may feel nervous, fearful, and uncertain.  The team works quickly and calmly while speaking to Mr Rashid to take his mind off the million things he must be feeling. Outside, at the system console, it looks like pilots going through a pre-flight checklist. “Yes, 280 confirmed.” Numbers, readings and the status of both Mr Rashid and the linear accelerator are read out aloud and confirmed. “Ready.”

10:00am:  The treatment is delivered successfully and Mr Rashid is brought out of the room to be reunited with his son. Father and son say thank you to the team and leave for Mr Rashid to go home to rest, and for Rahfee to head back to work. 

12:00pm: Lunchtime is a welcome reprieve. We go to a crowded meeting room where one of Sheng An’s colleagues will be presenting a new radiation therapy treatment technique. We have sandwich while catching up with a colleagues before the presentation starts. 

12:45pm: Sheng An nudges me. It’s time to head back to work to relieve his colleagues so they can go for their lunch break. The rest of the day passes in a flurry of activity. Every patient has different treatment instructions, different positions and different moods. Yet Sheng An and the team don’t waver and keep the atmosphere positive and energetic for every patient. 

4:50pm: Sheng An and the team are finished treating the last patient, but work hasn’t ended. He finishes paperwork while the rest of the team shuts down the machine.  

We start talking about why he became a Radiation Therapist. Sheng An was very sure that he wanted a career in healthcare, but radiation therapy stood out to him the most because of the amount of patient interaction – an area that he thoroughly enjoys. I ask him what makes a good RT. He lists three important attributes:
  • A strong passion for helping others; 
  • a keen eye for detail because radiation treatment is irreversible and there is no room for error;
  • and a cheery and positive attitude to encourage patients as they go through a difficult time in their lives.

5:20pm: We pack up and walk to Outram MRT bathed in the crimson glow of the setting sun. I ask Sheng An what his most memorable interaction with a patient was. “Too many to remember”, he answers, smiling. “The one that made the most impact on me was having a patient personally thank me for cheering him on during his treatment. He told me that he would have given up halfway through treatment if not for my encouragement, that really reminded me that I can really make a difference”.

Conversations with Sheng An and his colleagues throughout the day highlighted to me how much warmth lies underneath the shiny exteriors of a medical facility. Even though high-tech machines have become the standard for many medical treatments, the human to human connection can never be replaced. Healthcare, at its heart, boils down to one human being helping another. Being a RT is not easy, after my day with Sheng An I find myself having renewed respect for my radiotherapy colleagues. Cancer can be a difficult journey, but meeting passionate, compassionate healthcare professionals like Sheng An can be a soothing balm.

Author’s note: All patient names in this story has been changed for privacy.