A Paediatrician's heartache
Award-winning doctor has to deal with dying children daily

WITHOUT life support, the three-day-old baby had not much longer to live. Wanting to make his last moments more comfortable, Dr Irene Chan cradled the baby boy for 25 minutes until his heart stopped beating.

There was little else she could do - the baby had a congenital heart problem and surgery would only prolong his suffering. His parents had opted to withdraw treatment.

“ When we pulled out the breathing tube, the father was quite emotionally wrought. He could not bring himself to touch or carry the child. The mother was in another hospital,” Dr Chan recalled.

“ A nurse and I took turns to cuddle the child until his heart stopped. We just wanted him to feel some warmth towards the end.”

Such heart-wrenching cases of critically ill children are encounters that Dr Chan - who founded the concept of paediatric intensive care here in 1994 - has to deal with in her daily work.

“ Death is always very painful because we don’t expect young children to die,” she said.

As only one of eight fully trained paediatric intensivist in Singapore, Dr Chan has to provide not just medical expertise, but also emotional support for distraught parents who make difficult choices for their kids, like pulling the plug.

“ As doctors, we are trained to treat and try to cure our patients. But when help does not cure them, and suffering is prolonged, I am quite comfortable to have the life support system discontinued or further care withheld,” she said.

Withdrawal of care, she explained, is considered when the child is brain dead, in a persistent vegetative state, or when treatment is futile. This is always done in consultation with the parents and the other team members.

" The final decision is up to the parents and the team will support them in whatever they decide,” she added.

It is this support that has earned Dr Chan a nomination for this year’s Healthcare Humanity Awards yesterday, one of 49 recipients this year. In its third year, the award recognises healthcare workers who exhibit traits such as courage, dedication and compassion.

The awards are under the endowment of the Courage Fund, set up in 2003 after the Sars crisis.

Dr Chan, who set up the paediatric intensive care service at Singapore General Hospital, and later at KK Women’s and Children’s Hospital, is now in private practice.

Even then, several of her former patients still keep in touch with her.

Mdm Noryasma Mat Yaacob, whose 10-year-old son, Aslan, has cerebral palsy after suffering a severe brain haemorrhage when he was four months old, is appreciative of Dr Chan’s care.

“ When Aslan was sick and we were rushing him to the hospital, we would give Dr Chan a call and she would make sure that we were well taken care of. Even though she was head of the Intensive Care Unit then, she still made time to see us and even explained our case to other doctors who were not so familiar with us,” said Mdm Yaacob.

Although Aslan is no longer under the care of Dr Chan - now that she has moved on to the private sector - Mdm Yaacob can still rely on her during trying times.

“ My husband and I trust her and she knows we want what’s best for Aslan. When the time comes, we will accept it,” she said.

Copyright 2006 MediaCorp Press Ltd.
Article first appeared in TODAY 28 June 2006