Speech

On behalf of of this graduating class of 2022, I would like to thank Prof Malcolm, DIO at NUHS, program directors, faculty and senior colleagues, for your unwavering support to see us through our residency.

It is a great honour for me to deliver this valedictory address. I stand here knowing that there are giants among my peers not only in orthopaedics but also in other fields of medicine and surgery who have achieved much more during their residencies. But I hope that the little I will share with you tonight will help us as we begin our careers in our specialties.

As I reflected on my journey in orthopaedics, 3 words came to mind - grace, truth, and fear. We do not often hear such words in our conversations, but we still experience them in one way or another.

GRACE

Let me begin with grace. What is grace? A simple definition of grace is to receive something we did not deserve. If we get a speeding ticket, grace would mean that we not only get the fine waived, but we get another $100. That $100 is something we did not deserve, and that is grace. I am sure you have experienced it as well. Think of the moments when you received help when you least expected it - that's all grace.

Residency truly makes grace a necessity. It teaches us that we cannot work in silos, no matter how good we are as individual clinicians. We are each other's agents of grace, and the COVID pandemic was a great test for us. The uncertainty of exam dates, the fear of not completing enough surgeries, or simply the frequent change in rosters was enough to throw us off track. We were pushed to cover one another in our duties, in order to avail manpower for pandemic wards. Yet, we survived.

As I thought about it, my last 6 years have been especially marked by God's grace. I got married in my first year as a resident in 2017, had Emma, my first child in my third year, and Caleb in my fifth year. Each milestone was more difficult than the last, and there were moments of regret - regret about being in such an arduous program and sometimes even regret about having children. I am sure many of you have had the same experiences, perhaps seeing your batchmates not in medicine working from home while you still come to work every day. But something that made me stronger was seeing my colleagues working hard alongside me, offering their help when things got tough, and supporting one other when the unexpected happened.

Often we take these things for granted. The grace that people show us is harder to remember than the things that people do to hurt us, whether intentionally or not. We tend to focus on the bad and not the good. But at the end of this chapter, let us sit back and reflect on the grace that the people around us, especially our seniors, have brought into our lives when we least deserved it.

Truth

Truth. Truth is a word that is being undermined in our culture today, which indulges in relativism. But the truth I speak of today is objective truth. Grace is inevitably linked to truth; they are two sides of the same coin. There can be no grace without truth.

I have benefited most during my stints from teachers who spoke truth into my life. Let me share my personal experience. During the COVID pandemic I was assigned to my trauma posting under our programme director Dr. Gavin O'Neil. During my 6 months under him, I felt like I was the only junior working. The reason was that while most elective surgeries were cancelled, people do not stop falling and bones do not stop breaking. So our team still had fractures to fix, while I felt like my colleagues were having a good time. Of course, when I tell you this, I may be exaggerating, but you get my point.

Simply put, the many changes in my life and the bitterness that had built up inside me led to problems in my work. These problems probably existed before the pandemic, but as we know, stress exposes more holes in our lives. I remember well the day Dr. Gavin pulled me aside outside the operating room at the medical centre and told me I was not performing up to standards. The truth was hard to bear. But in hindsight, it was good for me. I had to undergo the Performance Improvement Plan, which consisted of several assessments and interviews to get me back on track.

Why am I sharing with you this dark period in my residency? Well, the reason is that I know that it is difficult even for me to look at a junior and truthfully tell him or her that change is necessary and that things are not satisfactory. I tend to be non-confrontational by nature and I don’t like having enemies. To some extent, all of us have a “people-pleasing” part in us which stops us from being honest with one other. But it was Gavin who got me out of my rut by telling me the truth.

As we now step into our new roles as consultants, we now have the privilege and opportunity to speak truth into the lives of our juniors. Will we, for the sake of benevolence, neglect the truth that can correct the path of our juniors or even seniors? Or will we learn to speak the truth? But at the same time, truth without grace can be brutal. Let us not kid ourselves - medicine has a bad reputation in this regard, perhaps even more so in surgical specialties, and if we want to know the sentiments on the ground, we need only turn to UpdateMePRN.

(we may laugh now but) Really this should drive us to deeper reflection personally and collectively.

To speak the truth with grace, there must be humility in us. On one level, we must know that what we have, even the knowledge we possess, was not invented by us, but given to us. Therefore, we should not be harsh toward others who may not have the same knowledge. This applies not just when we are making and taking referrals from another speciality; but also within our specialties when discussing management options for our patients. To quote one of my seniors, he often says in department meetings that, "The truth lies somewhere in the middle" - and if we are honest, that is true of much of medicine. We need to have the humility to hold loosely what we believe to be true, such as when it comes to questions about which there is no consensus in the best scientific literature. This means that we must learn to respect the opinions of others, knowing that much of medicine is unpredictable, even when we think we believe something to be true. Words have consequences and the words we use will either change or propagate a culture that is already in existence.

This brings me to my final point - which I know to be true. And that is the fact that the path ahead of us can be a daunting one.

Fear

We are quick to admit that 5 years of medical school does not really prepare us to become a doctor. And the same should be true of residency training. Residency does not really prepare us to be a consultant.

There is an inherent risk to the lives of our patients in our profession. During our residency, we are always in the shadow of our supervisors. We may be accountable for our actions and patients, but it is different when patients are directly under our name.

There's also anxiety about what subspecialties you want to pursue. Are there options? Or will they ask you to get involved with something the department lacks but you are not really interested in? What if you end up not enjoying the work you have worked so hard toward? These are the fears we all face at some point. It's unfortunate that our culture does not approve of sharing our fears with others, because few of us know how to articulate them, let alone share and live through them. It's not surprising that depression rates are rising even among senior physicians because we do not know how to process our fears and end up suppressing or repressing them. Perhaps I would like to tell you that we should and can be honest with our fears, and I would urge you not to keep them to yourself.

Love

So what is the solution to fear? The Bible says that There is no fear in love, But perfect loves casts out all fear. Our experience truly points us to the fact that it is indeed love that casts out fear. The love we have for our patients and the love we have received from our seniors and colleagues, friends and family members is the antidote to fear. As we move forward, we may no longer have the love of program directors watching over us, making sure we are moving in the right direction. But we still have the love that others have for us. Our identity should never be rooted in our career. You are a son, a daughter, a father, a mother, a brother, a sister, a husband or a wife before you are a doctor. And it is this love that sustains us, and your love for your patients, that will ultimately triumph.

Conclusion

Remember that it is tempting to pursue the world of wealth, fame and glory. But in the end, only love will remain, whether you like it or not. May we continue to show each other grace, tell each other the truth, and share our fears and burdens with each other. And last but not least: May love continue to be the fuel for our careers.

Thank you