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JANUARY - MARCH 2013 a parkway pantai quarterly Parkway College nurtures its pioneer batch of Masters graduates Parkway Pantai s Long Service & Golden Years Service Awards Dr Esther Chuwa gets personal Our job is to ensure your road to recovery leads back to the things you love When choosing a hospital it s only natural to look for one that guarantees quality care specialist expertise and proven technology. But we also believe that a hospital is nothing without its people. At Gleneagles understanding our patients needs and building a trusting relationship with them is at the heart of our approach. After all things always look better when we work on them together. www.gleneagles.com.sg 6A Napier Road Singapore 258500 Phone 65 6575 7575 01 january - march 2013 EDIToR S NoTE Cover Image Thinkstockphoto Parkway Pantai Editor-at-LargE Lim Bee Ling EditoriaL advisors Ahmad Shahizam Janet Low Copy Editor Angeline Ang atelier oost Editor Caroline Chan CrEativE dirECtor Lien Vandeweghe contributors photographErs Henry Koh and Simon Chan Picture Communication Terence Tan IMG Pixels WritErs Evelyn Mak Jean Loo Satish Cheney Thava Rani stoCK imagEs we want your feedback Do you have an interesting story idea news or happening you would like to share with us Let us know and we will give you a special token of our appreciation. Write to grpcorpcomms parkway.sg or Group Corporate Communications Parkway Pantai Limited 16-02 TripleOne Somerset 111 Somerset Road Singapore 238164. Thinkstock Mosaic is published quarterly for Parkway Pantai Limited by atelier oost llp and printed by AlsoDominie Pte Ltd. All rights reserved. No portion of this publication may be reproduced without the written permission of the publisher. We take every care and precaution to ensure that information published in Mosaic is accurate at the time of publication but Parkway Pantai cannot guarantee its accuracy and we may change the information at any time without prior notice. The information contained in Mosaic magazine is not an invitation to invest in the shares or any other products or services or otherwise deal in these or enter into a contract with Parkway Pantai or any other Parkway Pantai Company. 02 contents CoNTENTS 04 NEWS BITES 08 AT youR SERVICE recipients of Parkway Pantai s Long Service Awards get candid Parkway College graduates share their experiences 18 SNAPSHoTS through the lens events and happenings around Parkway Pantai 03 28 PRofILE Dr Suresh Nathan shares his passion for work family and art get up close and personal with Dr Esther Chuwa 36 EN RouTE Pantai Hospital Kuala Lumpur s Wear It Pink 2012 campaign Pantai Hospital Ipoh gets busy outside of medical care 40 NEW SCIENCE pioneering advances in breast cancer treatment 42 SPoTLIGHT musical sensation D Nightingales and Frenz 44 RECIPE healthy tasty and easy-to-do recipes 04 news bites positive outlook healthier lifestyle According to Australian researchers personality and attitude seem to matter when it comes to living a healthy lifestyle with a brighter outlook on life leading to healthier choices. In addition they found that those who believe they are in control of their destiny are more likely to eat a healthier diet exercise more smoke less and drink less. The opposite is true for people who believe their destiny is in the hands of fate or that life is about luck. In conducting the study Deborah Cobb-Clark director of the Melbourne Institute of Applied Economic and Social Research and colleagues used data from the Household Income and Labour Dynamics in Australia (HILDA) Survey to examine the diet exercise and personality type of more than 7 000 people. Our research shows a direct link between the type of personality a person has and a healthy lifestyle said Cobb-Clark. The findings could help shape public health policies on certain conditions such as obesity the study authors suggested. The main policy response to the obesity epidemic has been the provision of better information but information alone is insufficient to change people s eating habits Cobb-Clark explained. Understanding the psychological underpinning of a person s eating patterns and exercise habits is central to understanding obesity. Men and women also appear to have different views on the benefits of a healthy lifestyle. Although men seek physical results women are focused on the daily pleasure they get from living a healthy lifestyle the results indicated. What works well for women may not work well for men noted Cobb-Clark. Gender-specific policy initiatives which respond to these objectives may be particularly helpful in promoting healthy lifestyles she suggested. The report was published by the University of Melbourne in the Melbourne Institute Working Paper Series. source MedlinePlus painless plasters 05 shed weight by fear eat your greens According to researchers at the University of Westminster watching horror movies can burn the same amount of calories as a half-hour walk. Viewers who put themselves through 90 minutes of adrenaline-pumping horror action can use up as much as 113 calories close to the amount burned during an hour of washing windows and the equivalent to a chocolate bar. The researchers measured the total energy expenditure of 10 different people as they watched a selection of scary movies. They recorded their heart rate oxygen intake and carbon dioxide output and discovered the number of calories used increased by a third during the films on the average. The research also found that films featuring moments designed to make viewers jump in terror are the best calorie-burners as they cause heart rates to soar. Each of the 10 films tested set pulses racing sparking an increase in the heart rate of the case studies said researcher Richard Mackenzie. As the pulse quickens and blood pumps around the body faster the body experiences a surge in adrenaline. It is this release of fast acting adrenaline produced during short bursts of intense stress or in this case brought on by fear which is known to lower the appetite increase the Basal Metabolic Rate and ultimately burn a higher level of calories he said. source IndianExpress 06 news bites magnetic resonance imaging (fMRI) machine. They found that when people with high levels of maths anxiety anticipated equations their brain reacted much like they would if they were in physical pain. The higher the person s anxiety the more the posterior insula what springs into action when someone burns their hand or stubs their toe flashed with activity. The researchers also found activation in the cingulate cortex which assists the brain s pain centre. While people do not actually feel pain the brain reacts as if the hand is being burned. We have this evolutionary ancient pain system that responds when we burn our hands on the stove and are in physical pain... when people are anxious and anticipating the maths test our brains activate the same system explained Beilock. She was surprised to learn that people reacted as if they were in pain only when they anticipated maths not while working on the equations. She believes that when people actually started the maths problems the pain and anxiety subsided because they focused on the task at hand. source NBC News fear of maths hurts brain A new study shows when number-phobic people anticipate maths their brains believe they are feeling physical pain. Sian Beilock psychology professor at the University of Chicago and doctoral student Ian Lyons asked 14 adults with maths anxiety to verify the results of an equation or work on word puzzles while in a functional no breakfast more fatty foods 07 raspberries While blueberries are often touted as the ultimate healthy food one cup of raspberries has more than twice the fibre of one cup of blueberries. They also have an antioxidant capacity a rating scientists use to determine the amount of antioxidants in foods greater than strawberries kiwis broccoli leeks apples and tomatoes. Research with black raspberries has shown that raspberries can fight DNA damage and the production of inflammation producing proteins in your body. Frozen raspberries contain levels of nutrients comparable to freshly picked ones. source livestrong.com app for anxiety excessive sweating Excessive sweating can be a mood killer but this problem is very common and happens to completely healthy people. While it can occur on the face sweating is usually more profuse on the palms soles and in the armpits. Treatment may include aluminum chloride antiperspirants botox injections oral medications mild electrical currents or even surgery. source WebMD hiccups 08 at your service reaping the rewards Veteran and exemplary staff received special recognition. 357 of Parkway Pantai s own were honoured for their steadfast dedication at the company s annual Long Service & Golden Years Service Awards Presentation Ceremony on 23 October 2012. These employees have been with Parkway Pantai for five years 10 years and some even 30 long years. 2012 also marked the fourth year the Group has presented the Golden Years Service Awards to honour the 26 staff who have decided to stay with the company beyond the official retirement age. For award recipients Sivaganam Komala Devi Mary Chiang Seng and Hamidah Fendi strong friendships and a strong desire to excel in their profession are some of the reasons why they decided to spend decades working for Parkway Pantai. The company s continued perseverance in medical and healthcare excellence keeps them inspired. Its ability to listen and grow in tandem to account for their needs and aspirations is another pull factor. come together right now It is common to hear from award recipients that they cannot bear to leave the company because of all the touching friendships they have made in Parkway Pantai. Mary says that besides having made lifelong friends working at the same establishment having the respect of your peers is a big factor as well when it comes to job happiness. It is important to grow professionally and personally in a job. If you continue to do so there are fewer reasons to move elsewhere. I also gained a lot of respect and recognition from doctors and my healthcare colleagues and patients keep coming back and they recommend others to see me also. This is good for flying the physio flag and the hospital she added. Devi and Hamidah having worked for so long know each other and speak fondly of each other as well. They feel they have grown up with Parkway Pantai. If anyone has a problem we share and try to solve the problem immediately. We are very close and we maintain our morale by helping each other says Devi about her 16-strong team. Besides good and strong bonds with co-workers good relationships are forged with patients too as they keep returning to the same and familiar department for the top-notch personalised service. 09 10 at your service By staying at Parkway I can do better and patients come back insisting on getting their blood taken only at our department. Sivaganam Komala Devi I ve been headhunted before and have had attractive offers but I can t bear to leave this place. By staying at Parkway Pantai I can do better and patients come back insisting on getting their blood taken only at our department reveals Devi. upgrade upgrade and upgrade They may all have a so-called job title but they wear many hats at any one time. And that is something the three women love though some would ponder Aren t you doing more work for the same pay But for someone like Devi that is just a way of saying the cup is half empty. She started out as a nurse. Along the way she picked up various skills some via training and some simply because she was keen and learnt from others. From microbiology to taking X-rays to lab techniques to physiotherapy I picked these skills up along the way. Even checking blood gas urine via microscopes she says. Yes some people would say they want more money if you ask them to do different things but for me it is important to learn new things and upgrade yourself. Such unique drive and the search for challenges might be a reason that compels the Long Service award recipients to be loyal to their company and still produce the best results possible. Indeed for others like Mary she thrives on challenges. Her creative streak and that twinkle in her eye when she speaks about how she varies her treatment to yield maximum results for her patients speaks far louder than any resume would. She calls her craft a mental chess game. You have to be good with time management and think on your feet. Treat diverse types of patients and juggle different kinds of people and situations all at the same time. People come in with pain and they leave smiling. We give them hope. People come in pain and they leave smiling. We give them hope. Mary Chiang Seng This is a profession that is more than just nursing it gives high satisfaction the rewards can be very overwhelming. Hamidah Fendi 11 Mary Chiang Seng Senior Principal Physiotherapist Mount Elizabeth Hospital 31 years with Parkway Pantai Becoming a top-notch physiotherapist in the region was not something Mary had planned. I didn t know what to do after my A-levels and during a medical check-up the doctor asked me what I wanted to do. He suggested physiotherapy. I couldn t even pronounce the word. But the next thing I knew I was in Liverpool training to be a physiotherapist and here I am now says the veteran who wears her heart on her sleeves. Flying the physio flag as Mary calls it is not just about work. It is something more deeply personal for her. She has volunteered in medical outreach missions at exotic places like Kathmandu where she says she had an enriching time partaking in work that required extreme teamwork as well as legwork. People from all over the villages showed up some had walked for many hours to come for help. However when you ask her how her fellow department workmates feel about her Long Service award she laughs and says in jest that there are mixed feelings. The young ones ask me why I am here for so long. The older ones like me we like a place we stay and continue. She admits her job can be emotionally draining at times especially when there are patients with difficult and complicated conditions. I do ask myself sometimes who motivates who We need both parties she explains the two-way seamless process between medical care provider and patient. While she encourages patients by creatively varying what they do during their physio session she also gets an overwhelming sense of achievement and motivation when she observes her patients getting better. 12 at your service Hamidah Fendi Nursing Manager Parkway East Hospital 25 years with Parkway Pantai Being a Nursing Manager means Hamidah not only has to ensure the smooth running of her ward and impress upon the nurses the importance of excellent service she also trains junior nurses on the job. And her advice to younger nurses is Never give up. This is a profession that is more than just nursing it gives high satisfaction the rewards can be very overwhelming. Family always comes first for Hamidah. Once her department head made flexible arrangements for her to come in a bit later during the morning shifts so that she could send her child to a day care centre first. Small things like these have helped her bond with the company and fellow employees at a more emotional level. Her 28-year-old daughter used to ask her why she is still working at Parkway Pantai after all these years. But now my daughter understands after she has seen the enjoyment I get from working here says Hamidah. Friendly and warm Hamidah is also one who takes her job very seriously. I can be a friend but when you are at work you have to conform to what the hospital requires you to do. When new nurses come in here I talk about ASK . A for attitude S for skills and K for knowledge. If you have all these you are safe in my department. 13 Sivaganam Komala Devi Principal Phlebotomist Mount Elizabeth Hospital 31 years with Parkway Pantai If they ever needed a consultant for the Hollywood blockbuster vampire series Twilight then Devi would be the right person. She is no vampire but she could teach Robert Pattinson a thing or two about collecting blood realistically. As a Principal Phlebotomist blood is well in her blood. Blood taking is a talent and it s not just straightforward work. You have to feel the veins and also ensure you get the right sized needle. One wrong move and you might upset some patients who may already have a mind-set of fear even before you poke them with the needle explains Devi. As if having a full-time job and being a mother to three children and grandmother to four were not demanding enough Devi wows you with this information she also volunteers for her local grassroots organisation as well as for the police force doing door-to-door visits in the evenings. And to top it off she also represents the staff of ParkwayHealth Laboratory as their Union Chairman since 1991. She gets her energy from the belief that if you are happy with your work work and life will not be a chore a simple and true philosophy that most of us find hard to adopt. She puts more weight on job satisfaction over money and says she hates job-hopping. I love this job because it is my passion. The longer you stay at a company the more people you will know from the wards reception or theatre etc. And if you do good work you get good recognition from the people who know you. If you jump to a new place you may have to start from scratch reasons Devi who maintains a work-life balance by never allowing the two close realms to interfere with each other. 14 at your service shaping the future of healthcare Parkway College celebrated its pioneer batch of 10 graduates in Masters in Health Administration a professional two-year course developed in collaboration with Flinders University of South Australia. Together with 138 other graduates and close to 500 proud family members friends and colleagues the mood was festive at the college s second graduation ceremony on 5 November 2012 at the RELC International Hotel. Associate Professor Fatimah Lateef Deputy Chairman of the Singapore Government Parliamentary Committee for Health was the Guest-of-Honour. Healthcare is an important pillar of our society that has been facing a severe shortage of manpower in Singapore for some years said Mrs Nellie Tang Chief Executive Officer of Parkway College. I am proud to see so many have committed to taking on this noble profession and others already in the sector going the extra mile to upgrade their skills. The part-time Masters in Health Administration saw a doubling in enrolment numbers since its launch in 2010. Its flexibility allows healthcare professionals which include those in medical nursing healthcare as well as administrators in related fields hoping to hone their management skills to continue their day jobs while pursuing the degree. Among the other graduates 53 will graduate with a Diploma in Nursing 25 with an Advanced Diploma in Critical Care Nursing and 33 with an Advanced Diploma in Perioperative Care Nursing. The remaining 27 will graduate with Diplomas in Healthcare Management and Graduate Diplomas in Healthcare Management. This new cohort of graduates from Parkway College will support the need for qualified healthcare professionals in Singapore at private and public healthcare institutions. An alumni network formed in August 2012 allows graduates from Pantai College of Nursing and Health Science and Gleneagles College of Nursing and its sister colleges in Malaysia to stay connected and share ideas for best practice. 15 16 at your service For me the key takeaway from the programme was this that the passion to serve and to make a difference in the healthcare field knows no boundaries professional or organisational. administering change While many of her peers were considering or pursuing a Masters in Business Administration Celene Ting chose to take the less travelled path and applied to pursue a Masters degree in Health Administration instead. I was confident that the additional insights that I would gain on healthcare management through the course would give me an added advantage said the 27-year-old. Celene discovered her keen interest in healthcare during a stint at an advertising and public relations firm where she was servicing several healthcare accounts. Having been trained in the field of journalism and public communications she wanted to do something with a greater purpose and decided to put her professional skills to good use by serving and supporting those in need. The Masters in Health Administration course became the perfect complement to her existing skillset enabling her to gain practical experience and interact with like-minded people who share the same motivation and passion for healthcare. The rigour of the curriculum the dedication of the lecturers as well as the ample opportunities we were given to exchange knowledge and insights with fellow healthcare professionals strengthened our competencies and capabilities in our respective areas of work said Celene. Upon graduation from Parkway College Celene joined the hospice care sector as Assistant Manager for Community Relations. The ground exposure to home hospice care has really opened my eyes to a piece of reality that most people would rather shy away from she said. I am confident of making a meaningful difference in hospice care and research which are growing areas that need greater public attention and support. 17 the thinking nurse It is uncommon to find a job where one can marry two diverse interests but for 28-year-old Aung Htet Htet nursing was the perfect opportunity to pursue her passion in medical knowledge and teaching. Htet Htet who is from Myanmar was first exposed to the medical field while handling specimens and chemical reagents during her undergraduate years in Yunnan China. She then spent five years as a secondary school teacher in Mandalay Myanmar before joining Parkway College s School of Nursing in 2009. Nursing is an art said Htet Htet who was one of the 53 who graduated with a Diploma in Nursing. Not only do we need to know how to care for patients we also need to know how to think and prioritise in order to be a good nurse. Over the last three years Htet Htet not only learned medical-related knowledge like microbiology and pharmacology but also about communication and collaborative management as part of an all-rounded course. A clinical attachment with Mount Elizabeth Hospital (MEH) exposed her to real situations where she learnt to keep calm in the face of emergency. Although the workload was tiring and stressful Htet Htet enjoyed the interesting modules and lecturers who inspired through their teaching methods. It is their patience and support that helped us become what we are today she said. Equally memorable was the companionship of her course mates who shared a passion for healthcare. Like Htet Htet they came from other cities across Asia. Balancing the Let me take this golden opportunity to thank all the lecturers in Parkway College for their help and guidance. We would not have made it without YOU demands of school and bouts of homesickness also brought them closer as friends. We studied together missed home and cried together she said. Most importantly we worked towards our calling as nurses together. Since April 2012 Htet Htet has been working full-time as a nurse in MEH. She has been enjoying every moment of her job and learning to apply nursing theories to real situations and building rapport with patients and their family members. While little actions like a simple thank you from patients and encouragement from the doctors make her day the joys of nursing has impacted her life in more ways than one. Nursing has inspired me to be systematic and thoughtful in my daily life. I am proud and glad to be a thinking nurse she said. 18 snapshots IHH wIns Most transparent CoMpany award IHH Healthcare Berhad (IHH) which owns Parkway Pantai Limited (PPL) received the Most Transparent Company Award in the New Issues category at the SIAS Investor s Choice Awards 2012. Receiving the award on behalf of IHH at the 3 October 2012 Awards Ceremony was Dr Tan See Leng Executive Director of IHH and Group Chief Executive Officer and Managing Director of PPL. The Investor s Choice Awards recognises public-listed companies which have demonstrated exemplary corporate governance and transparency practices throughout the year. Since then IHH has been given eight more awards from five other financial publications. The awards are Best IPO 2012 and Best Malaysia Deal 2012 [FinanceAsia Achievement Awards] Best Equity Deal Best IPO 2012 and Best Deal 2012 (Malaysia) [The Asset Triple A Regional Awards] Best IPO [Asiamoney Awards] Malaysia Capital Markets Deal Of The Year (2012) [International Financing Review (IFR) Asia Awards] Best Dual-Listed IPO 2012 and Best Equity Deal 2012 Southeast Asia [Alpha Southeast Asia Awards] parkway pantaI aCHIeves JCI aCCredItatIon Parkway Pantai hospitals have achieved a JCI triennial re-accreditation hat trick Congratulations to the Mount Elizabeth (MEH) Gleneagles (GEH) and Pantai Kuala Lumpur (PHKL) teams for passing with flying colours despite the more stringent standards. Impressively both MEH and GEH scored full compliance in several important areas such as International Patient Safety Goals Quality & Patient Safety and Medication Management & Use. PHKL is now the first hospital in the Klang Valley and the second in Malaysia to achieve re-accreditation. 19 GleneaGles JpMC Celebrates 10tH annIversary Parkway Pantai s joint venture tertiary cardiac centre in Brunei has turned 10. On 20 October 2012 Gleneagles JPMC marked the special occasion with a celebratory dinner graced by Guest-of-Honour Pehin Orang Kaya Seri Kerna Dato Seri Setia (Dr) Hj Awg Abu Bakar bin Hj Apong Brunei s Education Minister and Chairman of the Brunei Investment Agency and Pehin Orang Kaya Seri Utama Dato Seri Setia Awg Hj Yahya Minister of Industry and Primary Resources. In his welcome speech Dr Tan See Leng Group Chief Executive Officer and Managing Director of Parkway Pantai Limited (PPL) lauded the close partnership between Parkway Pantai and the Government of His Majesty the Sultan and Yang Di-Pertuan of Brunei Darussalam. Dr Tan was proud to note that Gleneagles JPMC has been consistently at the forefront of medical technology and has helped thousands of heart patients over the decade. According to Dr Peter Tay Chief Executive Officer of Gleneagles JPMC annual clinical audits by world-renowned cardiac specialists show that treatment modalities at Gleneagles JPMC are appropriate and the outcomes are equal to or better than those of large international cardiac centres. He added that Gleneagles JPMC is the third centre in Asia to use bioresorbable stents among its many accomplishments. The 21-licensed bed hospital located in Jerudong Park provides clinical services such as cardiac inpatient and outpatient specialist services health and cardiac screening coronary angiogram and interventional cardiology open heart surgeries and cardiac rehabilitation. 20 snapshots a season of Hope and love Christmas descended early at Parkway Pantai s four hospitals with Mount Elizabeth Mount Elizabeth Novena Gleneagles and Parkway East bringing festive cheer to patients and staff alike. Mount elIzabetH HospItal 21 Mount elIzabetH novena HospItal 22 snapshots GleneaGles HospItal 23 parkway east HospItal 24 snapshots doCtor wHo Used to looking after people s health 24 7 over 300 of Parkway Pantai s accredited doctors from its four hospitals comprising Mount Elizabeth Novena Mount Elizabeth Gleneagles and Parkway East found themselves well taken care of on the evening of 14 November 2012 in appreciation of their dedication. For a relaxed t te t te between the healthcare luminaries and Parkway Pantai s board of directors the doctors were treated to a luxurious evening of fine food and wines at the Four Seasons Hotel. Established a cappella group Budak Pantai gave a rousing performance as the icing on the cake. 25 26 snapshots sIx stronG years Parkway Cancer Centre (PCC) celebrated its 6th year anniversary at the Goodwood Park Hotel on the evening of 2 November 2012 with the theme Stay Connected . Within the short span of six years PCC has had centres in Mount Elizabeth and Gleneagles hospitals including a spanking new one that opened this year in Mount Elizabeth Novena Hospital. More than half of PCC s patients are referred to by friends or family through word-of-mouth. PCC Co-founder and Medical Director Dr Ang Peng Tiam noted that beyond celebrating the anniversary the dinner also brought together for the first time the different groups responsible for PCC s success such as the Singapore staff the regional network of CanHOPE counsellors partner doctors and the pharmaceutical companies. 27 28 profile no sacrifice big enough To orthopaedic surgeon Dr Suresh Nathan serving his patients and being there for his family trump everything else. Suresh has a way of identifying the contradictions that exist around us which we take for granted. Truer words could not have been spoken by his mentor Dr John Healey in New York explaining the philosophical underpinnings of orthopaedic surgeon Dr Suresh Nathan s early success. work and interact with her patients. A polio patient who was in an iron lung became his constant playmate at one point. The hospital was essentially our playground. The smell of disinfectant was always in the air. The clanging of the equipment the things I touched. All of that was severely imprinted into my psyche recalls Dr Nathan. Exposed to that kind of sensory bombardment it became only natural for him to gravitate towards a career in medicine. the hospital a playground Growing up with a nursing officer mother it was quite common for Dr Nathan to accompany his mother to 29 30 profile Orthopaedic surgery was also a decision he made without wavering. The carefree words of a child wanting to be a bone doctor was realised when he specialised in orthopaedic surgery which offered him structure and precision. There s a certain amount of fuzzy logic that goes into soft tissue operations such as a bowel surgery they are not as anatomically defined. I love how the results in orthopaedics are always reproducible shares the 44-year-old who sub-specialises in limb salvage joint replacement and tumour surgery at his recently set up clinic at Mount Elizabeth Hospital. could be derived from fat. Back then the whole theory was debunked. But I wrote the paper anyway because that s the truth and I was not shy to present it he asserts. That paper eventually earned him numerous accolades but that did not give him the satisfaction he craved. He went on to do a fellowship in oncology in New York which not only exposed him to a whole new level of joint replacement techniques but also an entirely new realm of self-fulfilment. Upon his return he was appointed as professor at the National University of Singapore a position he had been coveting since young. His research delved deeper into cancer. A little quirk he discovered about six to seven years ago though initially dismissed began to gain momentum and is now believed to be quite real. I found a pattern in how tumours regulate their blood flow. Though there were many detractors I continued developing it and now it is a very robust thing. I have a PhD student who has finished her thesis on it and if my theory is true and I think it is it may explain why a certain type of therapy in cancer doesn t always work he explains. But none of this is very orthopaedic is it discovering new knowledge An academic at heart Dr Nathan also got into research rather early in his medical career. In fact he wrote his first scientific paper as a first year medical officer. With that he was hooked to the entire process of discovery and sharing. These days he has made inroads into molecular research an aspect of research not usually considered the domain of an orthopaedic surgeon. I was one of the first researchers in the world certainly in the region who discovered that stem cells big responsibilities His double interest in orthopaedics and oncology (cancer) may be new here but orthopaedic oncology is an accepted term in the global stage. There are a few of us around the world and some of us have become so far ahead of the curve that the systems are not ready to accommodate us. The energy that goes into implementing many things actually rests on our shoulders he reveals. Another huge responsibility he takes seriously is the raising of his two young kids a commitment he feels Although moving was a tough decision each and every day I sit in this clinic and I create something new I know I made the right choice. was worth giving up his professorship for. I made professorship at a very young age and I was given many leadership positions but if I were to take them up I think I d be doing a great injustice to my kids. I won t be there for them in the years they most need me says the father of a 10-year-old daughter and a seven-year-old son. 31 After mulling over it for a few years he decided to move from an academic career to private practice. So now he is able to spend most of his time with his kids even if it means simply driving them to tuition piano classes or swimming lessons. Married to his junior college sweetheart who is a family physician with her own practice Dr Nathan could not be in a happier place. All that s left now is for me to get back to painting again. I have projects on the shelf at home right now that were started a year ago. I have been very lucky because my wife is very tolerant. I actually have a room at home dedicated to my art says the highly technical painter whose clinic walls showcase his talents. One of the things that has been rekindled is the joy of giving the maximum possible time to each patient. It s like being a doctor again. As I talk to the patients now I feel like a friend I feel the warmth he says with a contented sigh. Being in private practice has also allowed him to implement his visions without any constraints. He now does consultations over Skype and has patients emailing him from across the globe from Pakistan the Middle East and even Russia. He is also able to purchase the equipment he believes are necessary to best treat his patients. His patient-centric attitude was also the biggest reason for choosing Mount Elizabeth Hospital to set up his clinic. A patient especially someone who has had limbs or pelvis removed can t be going from centre to centre for his problems. It is simply not practical. Limb salvage needs a very mature institution that is able to provide all the services under one roof. I did my homework and I knew this is where I needed to be. being a doctor again And he has no regrets about his move. Although moving was a tough decision each and every day I sit in this clinic and I create something new I know I made the right choice. Knowing that there is an immediate impact in all I do really keeps the fire in me burning. 32 profile full circle From being on the receiving end of a cancer diagnosis for a family member to being the one giving the diagnosis Dr Esther Chuwa has dedicated her life to making recovery easier for breast cancer patients. It was just about 20 years ago when Dr Esther Chuwa then a student in junior college sat with her family across the table from her mother s doctor listening to him tell the family that her mother had been diagnosed with colon cancer. That was a turning point in my life when all of a sudden I had to grapple with such a diagnosis in the family. At that point of time I didn t fully understand what cancer meant. I just knew that it was a disease that you can die from she remembers. It was then that I realised what a powerful position doctors are in and that the job could affect not just the lives of their patients but of their families as well. That was when the dream of becoming a doctor was birthed in Dr Chuwa s mind. And after years of hard work and dedication this dream has brought the 37-year-old back full circle to Gleneagles Hospital the very place where her mother was treated for her cancer. 33 34 profile close to the heart After medical school Dr Chuwa underwent surgical training before choosing her specialty in breast surgery. I chose general surgery from the start because I found that I was quite good with my hands. And my choice of breast surgery came about because I discovered during my training that as a woman I was able to identify with the patients she shares. Many come to me with the idea that breast cancer can kill you which isn t always true... and they are always very concerned about their breasts which are a very important symbol of women s femininity Dr Chuwa says of her patients. And as a fellow woman I can hold their hand or give them a hug if they need comfort. And as somebody who is trained I can offer information about surgeries or treatments instead of believing the myths about the disease. To help give her patients a better quality of life after breast surgery Dr Chuwa chose to sub-specialise in oncoplastic breast surgery which incorporates plastic surgery techniques into breast surgery to produce better surgical results. Many people think that surgery for breast cancer means you either take out the whole breast or a part of it. But if you give a woman a choice rarely do they choose to remove a breast if they don t have to because that leaves them flat-chested she explains. With oncoplastic breast surgery part of the breast is removed and the breast is reshaped so the shape of the breast is retained. So even if they have to suffer from cancer they don t have to be reminded of it when they look in the mirror. Some of my patients even say that they feel that they look better after the surgery. shaping a patient s future While there are less people dying of breast cancer Dr Chuwa finds that their quality of life after breast cancer is often lacking. When a diagnosis is first made or when the patient is undergoing treatment many of their friends and family will rally around to support them. But after treatment there is a void that leaves the patient helpless she shares. They are not sure if 35 they can go back to their previous roles and that is the point where they need a lot of support. In a bid to help breast cancer survivors embrace all that they have gone through on the road to recovery Dr Chuwa became active in the breast cancer support group Alpine Blossoms at KK Hospital in 2008 where she was formerly practising. Being doctors we are always proud of having a new drug or new surgical procedure to help our patients we often forget about the psychosocial effects such an illness can have where they may feel lost as wives mothers and daughters she reveals. The support group helps them to embrace what they have gone through and to go on to live productive lives. We hope to empower them with knowledge so that they can debunk the myths surrounding cancer. In return the older members become living testimonies and are able to help others who have been newly diagnosed. Now that Alpine Blossoms has become selfsupporting Dr Chuwa is no longer involved in their activities. But she continues to help breast cancer survivors as one of the doctors on the Breast Cancer Foundation panel speaking at workshops and talks aimed at helping the patients cope with cancer and survivorship. role also comes an even bigger challenge time management. This is the very reason why I decided to enter private practice to allow me more time with my family she says. And the choice of opening her clinic in Gleneagles Hospital was easy not only is her older sister a senior nurse manager at the hospital Dr Chuwa also saw that there was a lack of female breast surgeons in the hospital. When she needs to unwind Dr Chuwa takes time out to run or swim and she also loves to bake. These days my daughter has become my little helper when I m baking so it s a lot more fun. And she absolutely loves it she laughs. We also like to go out as a family to the beach or the park anywhere with wide open spaces for us to relax and to spend time as a family. Dr Chuwa has two big motivations in life to be with her family at the end of the day and to send her patients home healthy. It s a constant d j vu when I m on the job seeing my patients recover brings me back to the time when I was the patient s family when I saw my mother recover her health. That s what I want at the end of the day to ensure that their life isn t totally changed by cancer. You may have to change their lifestyle but beyond that they are still the same person. And as a fellow woman I can hold their hand or give them a hug if they need comfort. And as somebody who is trained I can offer information about surgeries or treatments instead of believing the myths about the disease. maternal instincts Outside of the hospital Dr Chuwa is happily married to a lawyer and is a mother of two young children a two-and-a-half-year-old daughter and newborn son. And she has quite an epic love story to tell. There were only three female doctors in my batch and I listened to my professor s advice back in training that I was not to be in a relationship or get married until I completed my surgical training and became a specialist after I turned 32 she laughs. I knew my husband from our Junior College days. However because our parents didn t allow us to date at that age we only got together later. And he patiently waited eight years to marry me and even took no-pay leave from his job to come with me when I had to go overseas for my sub-specialty training. Being a wife and mother has given Dr Chuwa a new outlook on what it means to be a woman allowing her to relate to her patients better. But with her new 36 en RoUte the good fight The Wear It Pink campaign is one of Pantai Hospital Kuala Lumpur s most sustainable campaigns with over 10 years of pro-active public outreach. The 2012 campaign highlight was the charity gala musical night. KUALA LUMPUR Deputy Minister of Health Yang Berhormat Datuk Rosnah Shirlin Binti Haji Abdul Rashid Shirlin launched Pantai Hospital Kuala Lumpur (PHKL) s Wear It Pink 2012 campaign in October. This campaign was part of PHKL s initiative in conjunction with the International Breast Cancer Awareness month to raise awareness on breast cancer through health education prevention early stage diagnosis and effective treatments. I truly admire Pantai Hospital Kuala Lumpur s effort over the years in educating the society and reminding the public on the importance of early detection and prevention of breast cancer. It takes strong commitment and unfading enthusiasm to constantly deliver an informative platform such as the Wear It Pink campaign for over 10 years said Yang Berhormat Datuk Rosnah Shirlin. Encik Khairil Anuar Abdullah Chairman of Pantai Holdings Berhad said in his speech With the unified efforts and smart partnerships of various support groups NGOs breast cancer survivors medical practitioners and members of the public we are able to reduce premature deaths from non-communicable diseases such as breast cancer. 37 At the launch PHKL also donated RM20 000 in the form of breast prostheses to Dr Shoba Nainani Vice President of Breast Cancer Support Society Negeri Sembilan recipient of the Wear It Pink 2012 campaign. The support group is a non-profit organisation established in Negeri Sembilan to address the lack of peer support for women and men diagnosed with breast cancer. The Wear It Pink 2012 campaign activities included a two-month subsidised mammogram to the public and talks at several corporate organisations culminating in a charity gala musical night at the Malaysian Philharmonic Orchestra Petronas Twin Towers. This musical Spanish Sensations featured renowned Spanish guitarist Rafael Serrallet and proceeds of the ticket sales were channelled to Negeri Sembilan. Present at the gala musical night were H.E. Madam Maria Bassols Ambassador of Spain H.E. Mr Luc Vandebon Ambassador and Head of Delegation to the European Union H.E. Mr Marco V Balarezo Ambassador of Peru and H.E. Madam Lyudmila Vorobyeva Ambassador of Russia. 38 en RoUte from high tea to air rescue Pantai Hospital Ipoh (PHI) navigates from event to event with ease. It is all in a day s work for the healthcare provider. IPoH pink october charity high tea In conjunction with Pink October celebrations last year PHI and Persatuan Pink Champion Perak (PPCP) a breast cancer support group with the collaboration of Baiduri Puspanita Soroptimist International and Kelab Bakti Gunung Kledang organised a fund raising charity high tea in October 2012. Guest-of-Honour YB Dato Dr Mah Hang Soon State Executive Council Member said in his address Breast cancer continues to be the most predominant cancer amongst women in Malaysia. One in 19 women will be diagnosed with breast cancer by the age of 85 and about 4 000 women are diagnosed each year mostly between 35 and 60 years old. The key to prevention is early detection and local research has shown that Malaysian women are more likely to go for breast cancer screening if the men in their lives are supportive he added. He stressed that it is important that the patient s support network especially men are equipped with adequate knowledge about the disease and how to help their female loved ones cope with breast cancer. The charity high tea also saw dance performances and a highlight fashion show by breast cancer survivors as well as a guest appearance by Y Bhg Dato Mohd Nor Khalid (DatoLat) a renowned Malaysian cartoonist. The event raised about RM60 000 with Dato Dr Mah pledging another RM3 000. The funds will be channelled towards breast cancer awareness activities social outreaches campaigns and running of a recently established PPCP resource centre at PHI for patients and relatives. 39 2nd concepts in retrieval medicine Pantai Holdings and PHI lent their support to the 2nd Concepts in Retrieval Medicine Course an international medical symposium supported by the Commonwealth through the Australia-Malaysia Institute under the Department of Foreign Affairs and Trade. Held for the first time in Perak from 22 to 25 November the symposium drew 156 participants from Malaysia Singapore Thailand Brunei Australia and USA. They comprised mainly medical professionals such as doctors paramedics and nurses and non-medical staff such as pilots police fire and rescue personnel and air crew. Through lectures and skill stations the participants were taught best practices in retrieving sick patients including cardiac patients with a specific focus on aeromedical transportation. medical partners appreciation night PHI organised a Medical Partners Appreciation Night in November 2012 to recognise its strategic partners and doctors for their longstanding support and cooperation. In his welcome speech Encik Anwar Anis CEO of PHI said Together we see ourselves as a team who have become of paramount importance for the general public. We have come a long way as partners in health bringing quality care to those in need. Pantai Hospital Ipoh has become one of the preferred healthcare providers in the state due to the support of doctors as its integral partners. Encik Anwar also shared about the latest upgrades in hospital facilities including the Cardiac Catheterisation unit and purchase of a bone densitometry machine and a lithotripter in December. He added that PHI was refurbishing its wards in stages and recently had a new coat of paint on the building exterior. 40 new science locate remove recover Introducing Radioisotope Occult Lesion Localisation a pioneering method that improves and simplifies treatment for breast cancer now available at Mount Elizabeth and Mount Elizabeth Novena hospitals. The word cancer brings fear and trepidation to the minds of many with the common misconception that all cancers will lead to death. But there are cancers that you can recover from with early detection and treatment. Breast cancer is one of them. present there are two common surgical methods of treatment. The first is the mastectomy which is the removal of the entire breast and sometimes muscles in the chest wall and lymph nodes that surround the area. If the cancer is detected in its early stages it is also possible for surgeons to conduct Breast Conserving Surgery. This is when the surgeon removes only the cancerous lump and some normal tissue around it while leaving the rest of the breast tissue intact. breast cancer in Singapore Though breast cancer is the cancer that claims the highest number of lives of women in Singapore it is also considered one of the most treatable cancers. At 41 Precise localisation of the abnormal tissues is critical as it allows the surgeon to better plan the skin incision for better cosmetic outcome as well as optimising the results in breast conservation surgery. ROLL also allows minimal removal of healthy breast tissues while ensuring that the tumour is entirely removed easier. better for surgeon and patient In order to improve the accuracy of surgeons locating a non-palpable tumour the European Oncology Institute in Milan invented the Radioisotope Occult lesion Localisation (ROLL) method in 1996. Dr Felicia Tan a specialist in breast surgery who practises at Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital first introduced this technique to Singapore in 2011. She also pioneered ROLL in the region. In this method surgeons first use image guidance to locate the tumour and place a radioisotope marker in the centre of the occult lesion. A manual gamma probe is then used during surgery to locate and remove the lesion and any cancerous tissue around it. Aside from improving the accuracy of locating an occult lesion ROLL allows for faster surgery. The patient also spends less time under anaesthesia as compared to other surgical methods. ROLL has been found to cause The advantage to this surgery is that the cosmetic appearance of the breast is maintained and both physical and psychological recovery from the surgery is easier. minimal discomfort to the patient and no additional radiological protection is required for surgical staff during the procedure. According to Dr Tan Precise localisation of the abnormal tissues is critical as it allows the surgeon to better plan the skin incision for better cosmetic outcome as well as optimising the results in breast conservation surgery. ROLL also allows minimal removal of healthy breast tissues while ensuring that the tumour is entirely removed. ROLL has been accepted as the alternative to wireguided localisation in patients with non-palpable breast tumours undergoing biopsy leading to easier lesion excision and greater patient comfort. present technology As breast conserving surgeries are best conducted when tumours are non-palpable or too small to feel physically one of the biggest challenges surgeons face is precisely locating the tumour before removing it. At present the most commonly used procedure is the hookwire localisation method. A highly experienced radiologist is required not just in reading breast imaging but to insert the wire using image guided by ultrasound to the precise location of the tumour. Radiologists use ultrasound MRI image or stereotactic mammogram to first locate the tumour and then insert a hookwire into the breast as a guide to mark the location of the tumour before the surgeon can remove it. But a major problem with this method is the possibility of the wire slipping or breaking during the procedure thus causing injury to the area surrounding the tumour and making it difficult for the surgeon to accurately identify the location of the tumour. Radioisotope occult lesion localisation (Roll) 42 spotlight hidden talents Gleneagles resident doctor-nurse band has released its first original album. Working on this album was a dream come true for the band. Now that we It is said that music soothes the savage beast helping one to relax and calm down. At Gleneagles Hospital there is a group of over 10 doctors nurses and staff known as D Nightingales and Frenz - who use their musical talents to unwind after a hard day s work and connect with one another. In a short span of four years from casual jamming sessions as hobbyists who bonded over a shared passion for making music and singing they have since evolved to getting paid gigs at medical conferences corporate dinner and dance events and even collecting awards along the way the latest being the runner-up of Live-O-Rocks a nation-wide live band competition in July 2012. have undergone professional recording we have set higher standards and expectations of one another and together as a band. We thank Gleneagles for their encouragement and turning our dream into reality. Now we can hopefully realise other people s dreams through the album sales as 100 per cent of the proceeds go to charity said Dr Patrick Goh a full-time specialist sports physician who wrote composed and produced all 10 tracks in the album. We are very happy to be funding this album for a good cause. It is inspiring that our healthcare professionals have taken the initiative to harness their talents to improve lives beyond providing quality care and service to our patients said Dr Kok Mun Foong Chief Executive Officer of Gleneagles Hospital. One thousand copies of the album entitled Will You charity album D Nightingales and Frenz embarked on a new challenge last Christmas launching their debut music album of original songs for charity. This original album was entirely funded by Gleneagles Hospital as part of its ongoing corporate social responsibility initiatives and features 10 of the band members. Remember have already been on sale since December for S 10 a copy at Parkway Pantai s four hospitals in Singapore Gleneagles Mount Elizabeth Mount Elizabeth Novena and Parkway East. All proceeds from the sale of the album will be donated to Mercy Relief an independent non-governmental humanitarian charity which seeks to provide assistance to disaster-stricken communities in Asia. 43 44 recipe Vegetable Medley by CHeF JaNICe WONg This recipe is adapted with kind permission from Parkway Cancer Centre s Awakening the Appetite. This dish is full of nutrients especially protein from the beans low in fat high in fibre and delicious to boot. It can be eaten as a main course or a cold salad. ServeS 4 1 tablespoon olive oil 1 teaspoon curry powder 8 ladyfingers (okra) cleaned and cut on the diagonal into chunks 6 quail eggs 50g long beans cut small cup frozen peas thawed 1 bunch watercress washed large stems removed and chopped 2 teaspoons balsamic vinegar 1 cup canned kidney beans rinsed and drained 1 cup canned lentils rinsed and drained small white radish (daikon) peeled and diced small 1 small beetroot peeled and diced small Salt and pepper to taste teaspoon basil seeds soaked in water (optional) DIreCTIONS Heat a wok until very hot and add the olive oil. Next add in the curry powder and cook for about 30 seconds till the smell of curry hits you in the nose. Add the ladyfingers and stir-fry until slightly softened about 5 minutes. Set a very small pot of water over medium heat and gently cook the quail eggs until hard boiled about 5 minutes. Let cool and remove the shell. Cut in quarters. Cook the long beans and peas in salted boiling water for about 3 minutes. Drain and let cool slightly. In a large bowl toss all of the ingredients together and mix well. Season to taste with salt and pepper. When ready to serve sprinkle the basil seeds (if using) over the vegetable mixture.