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PHUA KONG BOO & PHUA GHEE CHEE

As head of the Department of Respiratory and Critical Care Medicine at SGH, Associate Professor Phua Ghee Chee plays several leadership roles in Singapore’s fight against the coronavirus. Professor Phua Kong Boo is a highly-respected clinician with an illness, the PKB Syndrome, named after him as well as many years of university teaching experience.


FAMILY LESSONS

Professor Phua Kong Boo and Associate Professor Phua Ghee Chee are father and son. Conversations about Paediatrics were part of family life when A/Prof Phua Ghee Chee was growing up. So were visits to SGH Campus.

‘I was left here quite a bit, sometimes on public holidays,’ A/Prof Phua Ghee Chee says, chuckling as he reminisced about his childhood spent at the offices in Bowyer Block and Mistri Wing. ‘It was definitely before I went to primary school. I remember sitting in the department secretary’s office in Bowyer Block whilst my father did his ward rounds.

He also remembers playing squash and tennis with his father on SGH Campus during his high school and college days. The courts are long gone, but those happy memories remain vivid. Prof Phua Kong Boo’s father had wanted to be a doctor, but he didn’t have the financial means, so he made sure his son fulfilled his dream. ‘He brainwashed me,’ Prof Phua Kong Boo says.

'I thought he forced you,’ A /Prof Phua Ghee Chee quipped.

The small room in Academia, where this interview is taking place, is suddenly filled with laughter. It is mid-April 2021 and all present are wearing face masks.

As head of the Department of Respiratory and Critical Care Medicine at SGH, A/Prof Phua Ghee Chee plays several leadership roles in Singapore’s fight against the coronavirus. He is a picture of calm and resolve. Later on, he will speak about his experience during the SARS crisis and how the wall board in the COVID-19 isolation ward was all red (during the time of the second COVID-19 wave). Not once does his voice waver. His gaze is steady and his tone, measured and confident.

The Phuas on a family holiday.


Like his father, A/Prof Phua Ghee Chee excelled in Paediatrics at university.

Eventually, he chose a different specialty even though he did his Paediatrics posting at KK Women’s and Children’s Hospital (KKH) after he graduated in 1997. Paediatrics at SGH had just moved to KKH, a brand new hospital that year.

In 2003, A/Prof Phua Ghee Chee was on the cusp of becoming a Registrar (a Senior Resident these days) when SARS broke out. He was gravitating towards specialising in Respiratory Medicine. After SARS, his mind was made up:

“NEVER AGAIN” WAS ONE OF THE THINGS THAT STUCK IN MY GENERATION’S HEAD FROM SARS. WE ARE MUCH BETTER PREPARED AND MUCH BETTER ORGANISED THIS TIME.


‘I was a young d octor then. Whilst working at the ward, I spoke on the phone to one of the doctors who had SARS. He passed away the next day. I also knew other people—friends and colleagues, all healthcare workers—who came down with it. Some had to be warded in ICU.

Initially, there was fear because we were facing something unknown. Later on, everyone was just working hard, to the point that there was a sense of mission. We got too tired to feel scared.

I saw the Respiratory ICU teams working very hard during the SARS time and that inspired me. After SARS, I was even more certain I wanted to do Respiratory Intensive Care which is my specialty now.’

A/Prof Phua Ghee Chee traces the preparedness of SGH in the current pandemic to the lessons learnt from its handling of SARS.

One way in which the SARS experience has influenced how SGH has coped with COVID-19 can be seen in the safeguarding of the staff’s mental health. The Division of Medicine held a town hall before restrictions were imposed on mass gatherings. This happened at the start of the pandemic. A/Prof Phua and his colleagues who had been through SARS spoke about their experiences 17 years ago: ‘We told the junior doctors to be prepared. We talked about how they would feel, we talked about the possibility of healthcare workers dying from it. Because our entire generation went through it once, we provided a stabilisation force. It’s not like this is something we’ve never faced before. I t hink that helped to a llay their worries.’

A/Prof Phua Ghee Chee is candid in his reflections about SARS: ‘During that time, I worked with the seniors to re-organise the way work was scheduled. I felt we weren’t as well prepared as we should have been. Seeing healthcare workers come down with the disease made me realise—it must never happen again. “Never again” was one of the things that stuck in my generation’s head from SARS. My friends and colleagues who went through SARS are now directors and heads, so we’ve been there, we understand what it feels like. We are much better prepared and much better organised this time.’

The courage to confront past mistakes and to speak openly about the changes that had to be made so that those mistakes aren’t allowed to recur is revealing. There is trust in the organisation and trust in one’s colleagues.

Trust smooths the gears of teamwork, allowing everyone to chip in and move ahead together. Although doctors are distinguished from the time of their medical studies by titles and qualifications, for a hospital to deliver quality patient care, teamwork must take precedence over hierarchy.

ONCE YOU THINK ABOUT THE PATIENT, YOU CANNOT DO WRONG.


Prof Phua Kong Boo is a highly-respected clinician with an illness, the PKB Syndrome, named after him as well as many years of university teaching experience. He is kindly and mild-mannered, which must make his students and mentees feel at ease. He mentions the impression that one of his mentors, late Professor Chan Kim Yong, had made on him when he was a junior doctor: ‘Prof Chan never lost his temper when you asked for his help, not even if it’s in the middle of the night. He was very supportive. He made the junior doctors feel safe. If you don’t know something, you can call him.’

Today, following the example set by his mentor, Prof Phua Kong Boo is a similar role model for young doctors: ‘You don’t have to be a Consultant to call me. If they are happy to ask, I am happy to help.’

This is probably his philosophy as a father too, judging from the rapport between him and his son at the interview. Although both Prof Phuas are soft spoken and reserved, their affection and respect for each other is palpable.

In 1972, Prof Phua Kong Boo began to teach at NUS. He had been recommended by Prof Wong Hock Boon, the acclaimed paediatrician whom Prof Phua calls ‘a walking encyclopaedia of Paediatrics.’ The reverence in his voice when he mentions the late Prof Wong is unmistakable. He tells this writer: ‘Prof Wong spent many hours in the library, reading and writing. He had volumes and volumes of his writings which we always studied.’

Like his mentor, Prof Phua Kong Boo is deeply committed to teaching and training the next generation of doctors. He has turned down the offer to become associate dean for this reason. ‘I don’t like meetings,’ he says wryly. Over the past few years, he has been involved in the teaching of medical students at the Duke-NUS Medical School and the Lee Kong Chian School of Medicine. Presently he teaches at the National University of Singapore Yong Loo Lin School of Medicine. What does he focus on in his classes?

‘I want my students to know what’s important. First, they must try to acquire the clinical skills. Nowadays, ordinary communication they have no problem. But when it comes to talking to parents (of child patients) they may have to be more careful. They have to be more empathetic. They should always think about what they can do for the patient. Once you think about the patient, you cannot do wrong.’

Role models and mentors are embodiments of virtues. Such lessons can’t be found in books or online. When Prof Phua Kong Boo is asked to name the teachers who’d left an impression on him fifty years ago, he is able to say who they are almost instantaneously. 

A sombre look appears on his face as he mentions their names slowly, deferentially.

He is particularly grateful to Dr Chan Sin Kit who had accepted him into Paediatrics when she was the Head. ‘She imparted to me the importance of fairness, humility, sincerity and work c ommitment,’ he says.

A/Prof Phua Ghee Chee has extensive teaching experience at the various medical schools in Singapore. Prior to heading Respiratory ICU, he’d spent a decade in postgraduate education as Programme Director of the Internal Medicine Residency Training, the training programme attended by all adult physicians.

‘The culture of mentoring the next generation —that’s something we’re quite proud of and quite strong in in SingHealth, SGH and KKH,’

A/Prof Phua Ghee Chee says, emphasising the need for doctors to possess a combination of hard and soft capabilities—technical skills and knowledge plus soft skills and attitudes. His focus as mentor and teacher is on the latter: ‘Values are different from technical skills in that they require role-modelling and mentoring. The right attitudes are critical to transmit to the next generation. If we don’t promote and preserve them actively, those values might be diluted or lost over time.’

He believes in developing a pay-it-forward mindset in young doctors: ‘It’s about guiding others through peer help, peer teaching and resident to medical student teaching. This is what keeps the cycle going.’

The cycle he’s referring to goes all the way back to 1905 when the first medical school was set up in Singapore and the pioneer cohort of medical students were trained and mentored by their teachers and clinicians at SGH. The cycle is about connecting the past and present to the future, passing on best practices and values to the students who will become junior doctors, and junior doctors who will become senior doctors and consultants in due course.

It is heartening to hear A/Prof Phua Ghee Chee’s praise for the current generation of junior doctors who are in the midst of tackling the worst global healthcare crisis since the 1918 flu epidemic. They’ve formed self-care groups and a welfare committee ‘with the gentlest of nudges’ from him. He also shares that he’s had to turn medical staff away from the Isolation Wards and Respiratory ICU: ‘We are never short of volunteers.’

JUST YESTERDAY I RECEIVED A BIRTHDAY CARD ALTHOUGH IT WASN’T MY BIRTHDAY.


Both Profs have worked in SGH and KKH, SingHealth institutions that can be described as parent and child organisations. KKH was formed when Paediatrics was transferred over from SGH in 1997. Prof Phua Kong Boo, who is based at KKH, mentions collaborations between the Gastroenterology and Hepatology departments in both hospitals. When patients become young adults, they are transited to SGH.



Once the subject of patients comes up, both doctors relate anecdotes that underscore the human aspect of  Medicine.

A/Prof Phua Ghee Chee had a patient in ICU who had just survived the worst and was still very weak when the medical social worker found out that it was going to be his young daughter’s birthday soon. The Supportive Care group in his department organised a joint celebration for the patient and his family by setting up a Zoom call: ‘We got a cake here and there was a cake in his home country and both sides sang the birthday song.’

Prof Phua Kong Boo’s story involves a birthday too: ‘I still have quite a few patients who stay in touch with me. Just yesterday, I received a birthday card although it wasn’t my birthday. It was from a patient whom I’d looked after in the early 70s. When I saw it, I didn’t know what to say.’

This writer had to ask: ‘ When is your birthday?’

‘Not for a couple of months.’

Everyone in the room laughs.

ABOUT PHUA KONG BOO

Professor Phua Kong Boo studied in Chung Cheng High School before matriculating from Brisbane Grammar School and graduating from University of Queensland in 1965. After completing his housemanship in Brisbane, he returned to Singapore and joined SGH in 1967. He moved to KK Women’s and Children’s Hospital when it opened in 1997.

He is a paediatrician and a clinician with more than 50 years of public service. He is interested in education, mentoring and research. When the largest Phase IIb Human Rotavirus Vaccine Trial in the world was conducted in Singapore, Prof Phua was the Principal Investigator. He
was invited by the World Health Organization to give a presentation on vaccine research in June 2004 in Switzerland. His awards included the Superstar in 2008, Outstanding Asian Paediatrician Award and Emeritus Consultant in 2016.

ABOUT PHUA GHEE CHEE

Associate Professor Phua Ghee Chee graduated from the National University of Singapore in 1997. He did his postgraduate training in Internal Medicine, Respiratory and Intensive Care at SGH and Duke University Medical Centre, US. Prior to his current role as the Head of the Department of Respiratory and Critical Care Medicine at SGH, he was the Programme Director of the Singhealth Internal Medicine
Residency Programme. During the ongoing COVID-19 Pandemic, he leads the SGH Campus ICU Committee and also serves in the National ICU Committee. He has a strong interest in medical education and has received many education awards.