In this three week stint, I followed physiotherapists, occupational therapists, nurses, and even a music therapist in inpatient and outpatient settings as they worked together to bring about in patient recovery in the community hospital. Through my observations and conversations with the staff and patients, I learnt how important community care is as a step down from acute hospitals, where more time and attention is able to be devoted to each patient as it is less busy. 

I also had the chance to visit St. Andrew's Nursing Home. Interacting with the elderly, they would express that they felt useless as they were unable to do what they used to, or doubtful about their recovery. This sparked in me the desire to be able to bring light into their lives and sincerely care for them, even if they might not remember it very well (eg. dementia).

At St. Andrew's Senior Care Centre, I managed to play Rummikub with the seniors at the centre and even some chinese chess, also helping out with the making of wanton noodles as one of the elderly used to be a wanton noodle stall holder. I realised that the elderly all have their skills and experiences which they have to offer, and instead of viewing them as old people who cannot take care of themselves, we should endeavour to learn from them as they used to be professionals in their own rights.

In my time at NNI, I saw first-hand the busy and stressful life of the med students, junior doctors, registrars and everyone else working in the acute hospital. I followed the neurologists on ward rounds in TTSH, joined in outpatient clinics, and even followed one of the neurologists (registrar) on her on-call duty at night for a few hours, where she rushed around the hospital to deal with all patients that needed help whenever she received a call. Yet, at the same time I saw the care and concern that the doctors had for each patient; that even though they were very busy, they treated each patient with care and not just another task to be gotten over and done with. 

Sitting in at multi-disciplinary team meetings (eg. Parkinson's Disease team meeting), where there were doctors, nurses, therapists, dieticians and medical social workers present, I also saw the partnership and teamwork that existed between the different healthcare professionals and even across campuses (eg. staff from other hospitals and senior cares in the SingHealth group joined one of the meetings over zoom).

I also followed Dr Rebecca Hoe (the neurologist I shadowed) to a neurocognitive symposium on the last day of my internship. I saw how the doctors had to keep learning and absorbing new information about the new medical advancements and findings/studies even though they already were experts in their own field as specialists. This also showed me the responsibility that the doctors had to keep up with all the new information in order to treat their patients as best as possible. 

In this internship, I was able to witness the medical system in a country outside of Singapore. During this one week, I was able to shadow a cardiothoracic surgeon, Dr Ho Chon Hoo, and a general surgeon, Dr Muthiah Kumar in Regency Specialist Hospital in Johor Bahru. Apart from following the doctors on their ward rounds, I was also able to enter the Operating Theatre and watch them carry out their surgeries! I realised how important the work of the nurses were, as they did a lot of the preparation and were crucial in helping the surgeon during the procedure. I also saw the skilfulness of the surgeons and thought about how much time and effort they must have spent in the Operating Theatre to improve their skills. 

A continuous learner, I also wrote down my experiences every day after my internship, and would go and research the medical terms mentioned and procedures during my break. (it was very interesting to me, but when I told my family about it they were grossed out by the blood and "gore")

Joining the outpatient consultations in a Malaysian hospital, I had to deal with a language barrier as many of the conversations that the doctors had were in Malay. In Dr Kumar's clinic, most of the conversations were even in Tamil. I was inspired by the doctors' ability to connect with patients in their native language by being multilingual. The moment the doctor started speaking in their language, I could immediately sense a deeper connection formed between the doctor and patient. 

For our first day, we sat in Dr Chin's office and watched as he asked his patients about their condition. He would refer to theirs and their family's medical history, and then ask questions about their condition -- lifestyle, exercise, family conditions, and then carry out various simple tests (BP, eye movement, nose, mouth, ears, steadiness of arms by tapping). 

During the first break we had, Dr Chin was so kind as to specially bring us on a tour of the 11 floored centre, showing us around. (eg. Level 11 - Migrant Workers, Level 10 - Short-stay medical suites, Level 9 - Orthopaedic & physiotherapy, Level 8 - Endoscopy Centre + Theatre and rooms for patients to recover, Level 7 - Surgery Centre, Level 6 - Radiology Centre (X-Ray, Mammogram, BMD, Ultrasound, CT Scan, MRI), Level 5 - Specialist Centres)

Apart from patiently explaining to us whatever we had questions about, Dr Chin also taught us useful tips like, to see the patient's face and behaviour when he/she comes in, to see if the medical problem is serious or not. He also cautioned us to not do too many tests on a patient if we are not sure what is wrong with the patient, as this would waste resources and it might potentially cause harm to the patient. This made me think about how doctors really have to take responsibility for their patients, and though doing the tests might be a daily affair to them, they still have to think twice before prescribing medication/ advising their patients to take tests. 

Dr Chin also let us try using his auriscope, ophthalmoscope and stethoscope which was a novel and fun experience, as my friend and I were allowed to take turns examining each other's nose and ears, and hearing the other's heartbeat! Using the sphygmomanometer to measure another's blood pressure also proved to be more challenging than it looked when Dr Chin did it, reminding me of the amount of experience he must have had, doing these tasks for years, that a simple (yet challenging) task such as taking blood pressure using a sphygmomanometer can be second nature to him, yet to my friend and I, it was like a puzzle that could not be solved in the days we were there. I think I only managed to successfully measure it once, but when I did it, I also did not know if I had done it correctly...)

Today, we were able to watch a patient do the treadmill test, which measures the heart's response to physical stress. The patient is hooked up to an electrocardiogram (ECG), which measures his blood pressure every 2 minutes, and the treadmill machine moves on to a higher stage every 3 minutes (total: 7 stages). The nurse who explained all the features to us, told us that once the machine reaches 220 BP, she would have to stop the machine regardless, for the safety of the patient. I learnt that the work of the nurses are equally important, as they carry out all the tests for the patients which are critical in understanding the condition of the patient, without which the doctor would not be able to give an accurate prognosis or prescribe the right medication. 

Through Dr Chin's conversations with his patients, I also saw how useful it is to be able to speak at least simple medical terms in different languages with patients. As Dr Chin can speak Chinese, he was able to diagnose many of the older Chinese-speaking patients who preferred to speak in Chinese. For those who were Malay-speaking, he was also able to use simple medical terms in Malay to find out what their problem was and to explain their condition to them. There was a greater sense of understanding and connection when he spoke in a language they were familiar with, which a doctor should try to have as much as possible with their patients. I was also able to learn many medical terms in Chinese through listening to him converse with patients (eg. 青光眼、痰、抗生素)

I also realised how much the doctors can learn from their patients, as some of the patients that came in would be eager to tell us about their field of expertise (eg. a marathon runner was very happy to tell us about the 5 running zones in marathon runners' training, or a Mongolian man came in to get treated as well and it was interesting to hear his accent.)

As it is our last day here, Dr Chin allowed us to try out all the different tests on the first floor, with the guidance of the nurses: