On neurosurgery, education and patient trust with Dr Goh Chun Peng

This article is part of the Public Health People series where I meet with different public health professionals from all around the globe. Join me in exploring the greatest insights from their fields, their passion projects and their principles for both work and life.

Chun Peng is in his second-last year of neurosurgery residency at the National University Health System and is currently working in Ng Teng Fong General Hospital. I met Chun Peng through a mutual friend, and he was so kind  to meet with me over an afternoon coffee even after completing a 36-hour shift. He enjoys a good cup of mocha and switches easily between lighthearted jokes and deep, insightful explorations of his career. What struck me the most was his commitment both to individual mastery of his own craft as a physician, and the collective nurturing of healthcare workers in his team.

Armed with the dream of one day working with Médecins Sans Frontières as a trauma surgeon, Chun Peng decided to pursue one of the toughest and most competitive residency programmes in medicine. It has been a most arduous journey, but Chun Peng would not have it any other way. After all, his job brings him great fulfilment: his hours take him closer to mastery, he forges important connections with his patients and he gets to create an impact doing what he loves.

Read on for best practices you can try, insider insights from his field and a glimpse into his own personal journey into medicine.

BEST PRACTICES TO TRY.

Don’t become a doctor for the money. If you’re considering becoming a doctor for the money and prestige, think again. On top of his regular working hours, Chun Peng says, “I have ten on-call shifts (24-hour shifts) every month, and the remuneration is certainly not lavish.” While the pay drastically improves after your traineeship, you need more than that to tide you through the years of toil. “You’ll see your peers advancing in their careers especially as a medical specialist,” he says. “What keeps you going really is the meaning you find in your work. This is why passion is so important.”

Pay it forward. What could be more important than saving patients’ lives? If it’s one thing that comes close, it would be nurturing the doctors of the next generation. It can be easy to brush teaching and mentoring aside in favour of personal advancement, or just to get much-needed rest. But not for Chun Peng. As busy Chun Peng is with ward rounds, clinics and operative procedures, he places the utmost importance on nurturing his team. “As doctors, our other role is really to be educators.” As with any profession, the deeper he dives into his own specialisation, the more he realises the importance of sharing the knowledge he has accumulated. Chun Peng is currently a registrar, with several house officers and medical officers under his wing. “You want them to care too, and the best way is to teach, share, and hopefully inspire them.”

Find a mentor. Mentors can guide, teach and inspire. Chun Peng had fallen in love with surgery many years ago because his supervising attendant extended a rare opportunity for him to enter the operating theatre. “As medical students, we don’t even get to enter the operating theatre at all,” he says. “I was lucky to have a supervisor who let me enter theatre and that’s where it happened.”

Be human. How do you connect with your patient and their families in times of crisis? Establishing a much-needed connection when confronted with issues of life and death simply asks for one thing: empathy. But accomplishing this is no easy feat. “You must put yourself in their shoes and truly try to understand their points of view,” Chun Peng says. The job of a neurosurgery doctor is really, in such times of stress, be a stabling and comforting presence. “The stress on the family is huge. Our job is to work with them to come up with a decision we both think is best for the patient. And that also involves eliminating the sense of guilt from family for whichever decision that was made,” he says.

Lead with respect. It takes an entire village to raise a child. In healthcare, it takes an entire health system to ensure a patient’s recovery. And multidisciplinary teams are at the core of this. At a hospital, a team can comprise of doctors, nurses and allied health members. In the operating theatre, the team comprises the surgeon, the anaesthesiologist, the nurses and technicians. Everyone brings a different set of skills to the table. “You need a team to make things work,” Chun Peng says, and the keyword here is respect. ”As the doctor, you’re ultimately responsible for the patient. It then boils down to how you lead and engage everyone in the team to form a cohesive plan that ensures the best outcomes for the patient.”

AN INSIDER’S LOOK.

On the beauty of surgery. Two things drew Chun Peng to surgery. First, it was the calm it extended amidst the flurry of the hospital. “In the operating theatre, everything is quiet and under control. Everybody- the anaesthesiologists, nurses, and technicians have their role to play,” he says. “You just focus on what you’re doing.” Second, it’s being able to see the immediate impact you have on your patients. Chun Peng still recalls his life-changing surgery posting when he was still a medical officer. “This man came in with a hole in the stomach- it was absolutely ruptured. It was amazing how, the day after surgery, he was like a normal person again, ready to go home.”

On mastery and sacrifice. The privilege and prestige that comes with being a physician come at what some may perceive as too great a price. The hours, academic and technical rigour as well as the weight of expectations can be overwhelming. “I’m currently working at least 80-90 hours a week,” Chun Peng says. “That’s the standard for my neurosurgery training. “ In order to bear the noble responsibility of saving lives, sacrifices must be made, sometimes at the expense of welfare. “We can hire more trainees and cut down our working hours. But there’s a trade-off: we wouldn’t have the skills to be good enough,” he says. Training is crucial and the hours are necessary to attain the level of professional proficiency required by the job. When you put your life in the hands of a doctor, you want nothing but the best. “It is what it is. We chose the profession for a reason, and we have to accept it and do our best.”

On having a support system. We often overlook the role of family, culture, social support and mentors in an individual’s success. For Chun Peng, he credits it all to his wife, children and parents-in-law. “I’m thankful that I have an understanding wife. Not only is she looking after the kids, but she’s also working as well,” he says. “Without her support, there’d be no way I could’ve survived.” He is also grateful to his neurosurgery team. “At the hospital, we are one another’s main source of support,” he says with a laugh. “You know that you won’t die alone because you’re dying together.”

On death and palliative care. If your family member has a life-threatening stroke and is comatose, do you decide to let them go, or to agree to an operation that could leave them unable to feed themselves for the rest of their lives? Families may have to confront such difficult decisions in the most unexpected times. In his line of work, Chun Peng has cried together with families as they make such difficult choices. Unlike other chronic conditions such as COPD or cancer, the patients that he sees often have to make decisions on matters of life or death in a matter of minutes. After all, who can predict a stroke or an accident? “One way prevent the crippling guilt and burden that family members have to bear,” Chun Peng says, “is to start talking about advanced care planning and dispel the taboo that surrounds issues of death.”

On the sacredness of trust. Doctor-patient relationships are perhaps one of the most precious, delicate things in the world. When you relinquish some control of your own body over to a doctor, you are entrusting him or her with a great deal of faith. This trust is something Chun Peng deeply cherishes. In no other profession, he says, does someone willingly share their deepest secrets with you. “This privilege and trust is something that we cannot take lightly,” he says. “As a doctor, if you maintain that as your core and always put patients first, you won’t go wrong.”

READ.

Here are some of Chun Peng’s recent favourite reads:

• Admissions by Henry Marsh

• Do No Harm by Henry Marsh

• When Breath Becomes Air by Paul Kalanithi