By Nicole Lim, Assistant Director, Communications & External Relations
After being dropped off by their teacher, the teenaged Red Cross first aider would guide his injured schoolmate through the hospital’s maze of corridors to all the necessary departments from x-ray to orthopaedics. It was this experience that set the Raffles Institution alumnus Associate Professor Pang Weng Sun on his path to medicine.
A clavicular fracture, a couple of dislocated shoulders and a fractured forearm were among the injuries he saw. Assoc Prof Pang found the hospital environment stimulating and interesting.
Introducing LKCMedicine Vice Dean for Clinical Affairs Prof Pang Weng Sun
Upon entering medical school at the National University of Singapore (NUS), his volunteer activities once again played a key role in charting the course for Assoc Prof Pang’s choice of specialisation.
Volunteering with NUS’s King Edward VII Hall Welfare Society, the students adopted elderly residents living on their own in the Outram area. With a princely budget of $10, the students would buy daily necessities which they would bring along on their monthly visits.
He also volunteered in the Medical Society’s Community Involvement Project, which exposed him to nursing home care. The Society adopted two homes, visiting residents once a month on an alternate basis. “One was quite modern back then, but the other, the Singapore Christian Home, was a group of old huts in a remote area off old Upper Thomson Road. It had about 40 to 50 residents and we would bring food, small necessities and chit chat with them,” said Assoc Prof Pang, who some thirty years later is once again visiting residents at this home which has since moved into a bespoke building in Sembawang.
“These visits and interactions really started my interest in eldercare and geriatrics, although there was no such thing at that time in Singapore,” added Assoc Prof Pang.
Assoc Prof Pang was reminiscing about those times when he spoke to The LKCMedicine on what drove him to be a doctor. Today, the multihyphenate doctor is also Vice-Dean for Clinical Affairs at this medical School. In that role he focuses on establishing strong ties between the medical school and healthcare institutions across Singapore.
Pioneering palliative care for the elderly
While Assoc Prof Pang had developed an early interest in eldercare, it took a sliding door moment to launch him down this pioneering path.
After internship and National Service, Assoc Prof Pang was allowed to select his institution of choice for his next posting. He chose Alexandra Hospital (AH), where he’d spent most of his houseman year. His superiors told him that his friend had made the same choice and they could not send both there. So Assoc Prof Pang opted to join Medical Unit I at Tan Tock Seng Hospital (TTSH), where he had spent a short attachment after internship.
“If I’d gone to Alexandra, I may have been an endocrinologist today,” said Assoc Prof Pang, as AH’s Medical Unit was then known for its strength in the field.
From then on, he spent most of his postings under Dr Francis Jayaratnam, who was tasked by the Ministry of Health to start the first Department of Geriatric Medicine. Upon completion of his internal medicine training, he was sent on an 18-month overseas attachment under the Ministry of Health’s Healthcare Manpower Development Programme (HMDP) to Edinburgh and Newcastle-upon-Tyne, UK, learning more about eldercare and hospice services. With many of these services still in their infancy or non-existent in Singapore, the trip was an eye-opening experience.
Putting patients above all else
From the very ill in hospital to those on the road to recovery in rehabilitation or supported at home to those who needed daily care in nursing homes and those who spent their final days in hospices, Assoc Prof Pang saw the complete spectrum of care services offered to elderly and dying patients.
He said, “I saw how the elderly were respected, particularly in nursing homes. Residents could bring a piece of their own furniture and clothing to the nursing home to make them feel comfortable and at home. They were encouraged to make decisions, such as what to wear and eat. Even if a patient was demented, the staff would guide them to a decision.”
In the hospice, Assoc Prof Pang saw a different approach to ward rounds, which were not just about medical treatment, but focused holistically on working with individual residents on their goals for the day and a review of how well goals from the previous day had been achieved.
This emotional and challenging experience not only gave Assoc Prof Pang a new perspective on end-of-life care, but also taught him valuable lessons about his own character.
“There was a lady on whose door a sign hung saying ‘do not disturb’. When we followed the instruction, she’d scold us for not caring. When we did go in to see her, she’d tell us off for disturbing her. I was quite annoyed, but the hospice nurses remained unperturbed. I admire them for their patience and tolerance. For me, I learnt a little more about caring for patients.”
He came back full of ideas and a few years later set up the first hospital-based palliative care service within the Department of Geriatrics at TTSH.
“I am, at heart, someone who develops services,” said Assoc Prof Pang, who over the course of his career helped set up services not just at TTSH, but also at AH and Khoo Teck Puat Hospital (KTPH) and is currently Chairman Medical Board of Yishun Community Hospital.
With colleagues coming up through the ranks, he was soon joined by a very capable team of doctors, nurses, allied health professionals and medical social workers.
“I’ve never told them this, but one of my happiest moments was at a hospice conference in Osaka in 2003. On one side, sat Dr Angel Lee and on the other, Dr James Low; in other words, I had my two best people on either side of me. Thanks to them, I’ve seen palliative care grow,” said Assoc Prof Pang. Dr Lee set up TTSH’s Department of Palliative Medicine and currently chairs the Singapore Hospice Council, while Dr Low took over from Assoc Prof Pang as Head and Senior Consultant of Geriatric Medicine and set up palliative care at AH, before moving to KTPH.
There for everyone
Besides setting up new services, Assoc Prof Pang instilled in each service a teaching culture that has remained to this date. His colleagues describe him as an impeccable mentor for medical students and senior doctors alike.
Despite the praise, the humble and soft-spoken clinician is reluctant to accept such accolades, stating he’s just doing his part. But that includes the occasional home visit for patients who are too ill to travel to the hospital (or as Assoc Prof Pang puts it, “If they’re on the way, I’ll just drop by, see how they are”) and, according to one of his junior colleagues, the generous sharing of his time, wisdom and knowledge (“If there’s someone who needs a bit of help along the way, then I’ll help, pass on what we know”).
It is particularly the hard life lessons that Assoc Prof Pang shares so readily with his juniors that have made him a role model for many; lessons, that he reminds himself of to this day.
Prof Pang amongst his friends and colleagues from LKCMedicine at the National Medical Excellence Awards
For example, he makes a point of keeping obituaries of his patients to remind him of what he has learnt from them. One such case occurred 30 years ago - a young patient, who died of blood cancer within a few days of admission. Having seen him in A&E, Assoc Prof Pang had left follow-up instructions with the ward. When he next went to visit the patient, his crying family was congregated in the corridor.
Assoc Prof Pang reflected saying, “Today, we would have diagnosed his problems much earlier. While I’ll never know whether it would have made a difference, I could have been more aggressive with the instructions for the ward.”
While he has countless achievements to his name, it is perhaps the hard lessons like these and personal challenges that have influenced Assoc Prof Pang and made him an inspiring mentor to many juniors. He said, “My housemanship was challenging. It showed me the importance of seniors who are there to guide and support you.”
This belief guides his actions to this day. He adds, “I’ve learnt to be kinder when I see people make mistakes. But one must be able to pick up and learn from there. I’m also mindful that if mistakes happen because of carelessness, then you need to be very firm.”
With time for everyone, he laughingly suggests that it was perhaps his wife who drew the shortest straw. But that doesn’t mean that family is not important to Assoc Prof Pang.
When it was his wife’s turn to go on her HMDP to the US, Assoc Prof Pang took a break and accompanied her with their toddler, playing house-husband for three months and caring for their daughter.
“I became very attached to my daughter, a bond that has remained ever since. I told her I’m going to bring a chain to her wedding day, I’m not letting go,” he confessed.
Returning to his “old home”
When he was called back to his “old home”, TTSH, in 2010 to support the development of the new medical school, Assoc Prof Pang was ready to take on a new role. His wisdom and ability to inspire and engage his clinical colleagues have been critical to the progress of the School, bringing clinicians from healthcare institutions across Singapore together. On top of being a Vice-Dean, he also co-leads the Professionalism, Ethics, Law, Leadership and Patient Safety course that runs throughout the five years of the MBBS programme, drawing on his experience as Chairman Medical Board of dealing with patient complaints.
Minister for Health Mr Gan Kim Yong presenting the National Outstanding Clinician Educator Award to Prof Pang
With colleagues and patients alike praising his willingness to make time for them, it comes as little surprise that Assoc Prof Pang received ringing endorsements when he was nominated for the National Outstanding Clinician Educator Award earlier this year.
On receiving the award, Assoc Prof Pang said, “I am grateful to the many senior clinicians who taught and inspired me, and helped shape my career. It’s my responsibility to do the same for my younger and future colleagues.”
“I want to see our students not only good academically, but retain the heart for medicine they first had on entering medical school. Too often, doctors get caught up with the pressure of work, distractions of the world and after a while, you find that the altruistic ideal starts to fade. I do feel if you start them on the right note, they’ll still carry the right attitude, the right heart,” he added.