What sort of role model do we want our kids to have? Woffles or Vincent?

Over the last week 2 characters have emerged from mundane Singapore life that exemplify very contrasting personal values and characters. To me, they are lessons for us as to what our noble values should be. In today's world our kids are in great danger of being lured into the fast road to wealth, fame and self-centredness.... at all costs. We need to take a pause in our mad rush to wealth to think about what values we should want our kids to have.

On one hand we have a uber-wealthy and influential cosmetic surgeon and socialite, Woffles Wu, hiding behind an old employee just to get out of 2 speeding summons. Whether he pulled strings to get off with a mere slap on the wrist is not the issue here.


On the other side of the coin, we have a working class tour guide, Vincent Toh, leading a group through the deserts of Sinai. When the tour group was unexpectedly attacked by Bedouins, Vincent selflessly offered to be the hostage so that his tour charges could go free. To everyone's relief, Vincent was released after 8 hours of captivity. Two contrasting characters with very different personal value systems. Who do we want our kids to emulate?

Prof Khoo Oon Teik - Requiscat in pace

Khoo Oon Teik (Dr) (1921-2012)

Very belated condolences to the family of the late Prof Khoo Oon Teik. It's the passing of a generation. For Gigamole, Prof Khoo had always embodied the most noble values of the medical profession. A true visionary, teacher and mentor.

Toh Chin Chye -Requiscat in Pace

Toh Chin Chye 杜进才 
10 Dec 1921 - 3 Feb 2012 


 Requiscat in Pace

Mdm Kwa Geok Choo, requiscat in pace

No doubt she was the pillar of strength behind MM Lee, but I think Mdm Kwa truly distinguished herself in not doing the one thing that many women in her position are most prone to do, id est, self-aggrandizement.

My heart goes out to the family.

Mdm Kwa, requiscat in pace.

Prof R Kanagasuntheram - why we cannot recognize the inspirational amongst us.

Last Saturday, an ex-teacher of mine from medical school passed away. He was in many ways an inspirational teacher of Anatomy - knowledgeable, always caring about his science, and especially of his students. Although he had retired from academic life many years ago, many came forward toexpress their condolences.

But the University and Medical School have remained fairly silent. I am not surprised.

Our institutions here find it very difficult to recognize greatness in our midst. They prefer to laud the highly visible achievers from the West who never contributed anything significant to our development. Or big 'Johnny come lately' donors. So you will find not find any lecture theatres, or buildings called after local heros.

So sad.

Why are we so afraid to be gracious? So reluctant to recognize our own people?

Dr Goh Keng Swee - Requiscat in pace

Dr Goh Keng Swee, Robert, 吴庆瑞

6 October 1918 – 14 May 2010

The passing of a great Singapore leader. Requiscat in Pace, Sir.

Richard Feynman - What can we learn about the science in Climategate?

Richard Feynman was a bit of a hero to me when I was first getting into science. He was a great physicist and Nobel Prize laureate, and possibly one of the great scientist of our times. Although not a physicist I was drawn to his writings for that rare and genuine love for science he shared, and the honesty and integrity that he expressed in the science that he practiced.

The following are some of Feynman's quotations that are instructive to us:

"No government has the right to decide on the truth of scientific principles, nor to prescribe in any way the character of the questions investigated. Neither may a government determine the aesthetic value of artistic creations, nor limit the forms of literacy or artistic expression. Nor should it pronounce on the validity of economic, historic, religious, or philosophical doctrines. Instead it has a duty to its citizens to maintain the freedom, to let those citizens contribute to the further adventure and the development of the human race."

"The first ... has to do with whether a man knows what he is talking about, whether what he says has some basis or not. And my trick that I use is very easy. If you ask him intelligent questions — then he quickly gets stuck. It is like a child asking naive questions. If you ask naive but relevant questions, then almost immediately the person doesn't know the answer, if he is an honest man."

"The exception tests the rule. Or, put another way, "The exception proves that the rule is wrong." That is the principle of science. If there is an exception to any rule, and if it can be proved by observation, that rule is wrong."

"Religion is a culture of faith; science is a culture of doubt."

"Looking back at the worst times, it always seems that they were times in which there were people who believed with absolute faith and absolute dogmatism in something. And they were so serious in this matter that they insisted that the rest of the world agree with them. And then they would do things that were directly inconsistent with their own beliefs in order to maintain that what they said was true."

"Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool."

"Learn from science that you must doubt the experts. As a matter of fact, I can also define science another way: Science is the belief in the ignorance of experts."

"The only way to have real success in science, the field I’m familiar with, is to describe the evidence very carefully without regard to the way you feel it should be. If you have a theory, you must try to explain what’s good and what’s bad about it equally. In science, you learn a kind of standard integrity and honesty. "

He also related an interesting account of the now infamous oil drop experiment which was also associated with 'tricks' that scientists use:

"We have learned a lot from experience about how to handle some of the ways we fool ourselves. One example: Millikan measured the charge on an electron by an experiment with falling oil drops, and got an answer which we now know not to be quite right. It's a little bit off because he had the incorrect value for the viscosity of air. It's interesting to look at the history of measurements of the charge of an electron, after Millikan. If you plot them as a function of time, you find that one is a little bit bigger than Millikan's, and the next one's a little bit bigger than that, and the next one's a little bit bigger than that, until finally they settle down to a number which is higher.

Why didn't they discover the new number was higher right away? It's a thing that scientists are ashamed of - this history - because it's apparent that people did things like this: When they got a number that was too high above Millikan's, they thought something must be wrong - and they would look for and find a reason why something might be wrong. When they got a number close to Millikan's value they didn't look so hard. And so they eliminated the numbers that were too far off, and did other things like that. We've learned those tricks nowadays, and now we don't have that kind of a disease."

As it is, the physicists of the American Physics Society are themselves embroiled in the Climategate controversy, with charges of interest conflicts. Quite obviously they do not consider the sciences as being settled in any way. See here and here. They physicists in the APS should learn from Feynman.

Anthony Yeo - in pace requiscat ...

Anthony Yeo passed away on Saturday at the age of 60, from Burkitt's lymphoma. ST has a well written very fitting orbituary for the man.

A mouse who became a lion. How true. Someone we could have easily dismissed as an academic failure, proved himself through his compassion for the marginalized and the down-trodden, to become the Father of Counselling in Singapore, has set an almost impossible example for us to follow.

It does not matter if we do not always agree with him. But we must recognize his greatness during the time he walked with us on this earth.

Mr Yeo, in pace requiscat.

Ms Ho Ching to leave Temasek!

Image 'curi-ed' from Asia1

I was truly surprised by the announcement that Ms Ho Ching was leaving Temasek Holdings.

I haven't been particularly enamored by the fact that the wife of our Prime Minister, and daughter-in-law of the MM was running our nation's biggest business holdings. Eighth most powerful woman in the world! Not that there was anything dishonest about it but it just didn't make good sense to perpetuate the suspicions that this was just part of a business as per normal for the Lee dynasty.

But the announcement yesterday put all that to rest. And I celebrate it.

I further celebrate the fact that the transition of power was done in such an open, objective, professional and dignified manner. In a world where ruling elites secretly and not so secretly amass great wealth for their families through corrupt dealings, this public transition deserves to be applauded.

Thank you Ms Ho for all that you have done and accomplished on our behalf.

Nadal and Federer - two great champions

I saw something beautiful yesterday. In the most unlikely of places and moments.

The Australian Open Tennis Finals between Roger Federer and Rafael Nadal.

It was an exciting match, even for someone not too accustomed to tennis. Here were two great proponents of the game, perhaps two of the greatest, slugging away at each other for 4 hours and 23 minutes. And in the end someone had to lose.

There was no doubting the passions that each brought to the tournament, and their commitment to win. And in the end, tragically, one had to lose. And there was that incredible scene of the past champion bawling away like a baby on the podium in full view of a globalized television audience of perhaps millions. It wasn't easy for him to lose. And there was that incredible scene of these two grown, beefy men, sweaty from their herculean effort, with their arms around each other, almost snuggling up like lovers. No hint of homophobia there.

And most beautifully, in that vital moment, when one had to give way to the other, ....when a champion had to step aside for a successor, there was grace and sportsmanship like never seen before in any other sporting occasion.

We have been treated of late to so much childish, petulant and temperamental behaviour by sporting stars. Me first, and damn the rest! But here was sport at her best.

Two real champions.

Barack Obama - A President for the world

So it happens tonight - the inauguration of the first black President in US history. My family and I will stay up and watch this historic occasion. I don't particularly like the US. In fact I find many aspects of it quite off-putting. But even I have to admit that this unlikely event of a black african man being crowned as the President of a white anglo-saxon world,where once africans were mere slaves, can only happen in the US. And for nothing else, this is worth celebrating. So whatever my sentiments about the US, and whatever our feelings about US failed global leadership, I am going to stay up and celebrate this historic occasion with my family.

This man is a strange and unique personality. I don't know of anybody else who has that charismatic appeal who can command such a strong global following. It has been reported that some 2 million people will be present at the ceremony. But beyond that the whole world watches. And it doesn't matter one bit what nationality you are, what race, colour or creed, the global community celebrates tonight.

A girl could easily fall for this tall, virile young man. Smart, sensitive and principled, he stands head and shoulders above his peers. A distinct lack of stuffiness that characterises most politicians, he is both serious and hip at the same time.

But what a burden he carries upon his shoulders. Easily the hope of the whole world...that somehow under his leadership the world may be ushered into an era of peace and tolerance, where the colour of one's skin does not matter. President Obama, you have our prayers, and I am sure the prayers of the world as well. Be strong for us. There are not many opportunities to make the wrongs right again. If there is anyone can humanly do this you can.

President Obama, jia you!

Emeritus Professor Wong Hock Boon - Requiescat in Pace

Just over a week ago, while I was travelling, Emeritus Professor Wong Hock Boon passed away. He was 85.

His orbituary can be found here. There is also a very nice tribute to the late Professor by Dr Huang Shoou Chyuan here.

If anyone who would merit the title "Father of Paediatrics" in Singapore, it must surely be Professor Wong. But Professor Wong was an towering and inspirational figure who had a presence and enduring influence beyond the field of Paediatrics. He was a role model par excellence for all that was good and noble in doctoring, whether for kids or adults. On top of this, he was an excellent teacher and clinical researcher.

One of the sad facts of today's world is the lack of clear leadership in the field of Medicine, and the paucity of role models. Our generation, though soon passing, had been very blessed because we had role models such as Professor Wong.

I fully agree with Dr Huang's sentiments that "The authorities should honor Professor Wong in a way befitting his immeasurable contributions to our nation." I certainly second that motion.

In Mid 2007, a group of his ex-students got together and honoured him with a $250,000 endowment gift to the National University of Singapore Yong Loo Lin School of Medicine, which enabled the setting up of a Visiting Professorship in Paediatrics. This endowment which was matched dollar for dollar by the government, will be administered as part of the Wong Hock Boon Professorship in Paediatrics, which Prof Wong had established with a contribution of $1.5 million to NUS in 2005.

But beyond this, there has sadly been precious little done by the NUS to honour this gentleman. Too often we are more than ready to honour the foreign talent who grace our shores,...or the wealthy patron with deep pockets. But the NUS apparently balks at honouring our own homegrown role models. Jesus aptly pointed out that "A prophet is not without honor except in his hometown and among his own relatives and in his own household." (Luke 6:4). How true...how sad.

Prof Wong, rest well in God's embrace. We will ever remember you as the servant doctor and teacher you were. Even if the University or the medical fraternity may forget.

Human Organ Trade - Thank you Chris and Lay Guat!!

I reproduce for you here a letter to the Straits Times on 18 December 2008 by Dr Chris Cheng and Dr Ng Lay Guat. What a great letter from 2 wonderful transplant surgeons who are prepared to their values up front!

The thing that taints the organ transplantation programme is the prospect of it degenerating into a crass commercial trading activity. The sacrifice of ethics and human value for profit. If we want to justify the reimbursements of non-relative oran donors, then we must strip away the associations with trading and exploitation that almost invariably will accompany it.

But here are 2 transplantation surgeons who are prepared to step forward and condemn this trade, at the expense of losing professional business opportunities. Chris and Lay Guat, I take my hat off to you!

I wish there were more transplantation surgeons of their mold. But I suspect there will be few.

Here is a challenge to transplantation surgeons and the institutions that house them, to do the right thing. If you are truly concerned about the renal deaths, and wish to see more ethical live donor organ transplantations, show us how genuinely altrusitic you are. Forgo your professional fees. Waive the institutional charges. Let's not do this to fatten your wallets.

Let us see how genuine you are in your compassion for the terminally ill organ failures.

-----------------------------------


High price of compensating donors
By Christopher Cheng & Ng Lay Guat, For The Straits Times

EVER-LENGTHENING waiting lists for kidneys is an old problem not unique to Singapore. Almost every country in the world has a waiting list that is growing longer faster than the number of transplants done per year. The solution to this problem is of course to increase the number of transplants performed. Singapore is on the right track in encouraging live donor transplants, and the opt-out system of the Human Organ Transplant Act will increase the number of deceased donor transplants. Other measures such as raising the donor age limit and paired donor transplants can help shorten the waiting list to an extent.Compensating donors is another means the authorities have suggested to shorten the waiting list. We feel that this would be an overly zealous measure.
We do not object to reimbursing altruistic donors so they do not suffer from having only one kidney. As transplant surgeons, we have come across many families with several potential donors. The ones who finally come forward tend to fit a certain profile. We have seen many instances of sister-to-brother, wife-to-husband and sister-to-sister donations. This is not because women are more generous than men, but rather because they tend not to be the sole breadwinners in their families.
For example, we recall a young patient with end-stage renal failure who had nine siblings. We couldn't help but remark that she was, in a way, luckier than many patients with smaller families. However, the only sibling who came forward to donate was an older sister. When we examined the matter, we realised that the donor was single, whereas all the other siblings were married and were breadwinners.
The worry that their own families may suffer if they chalk up large medical bills years after donating a kidney is valid. But giving such donors a lump sum may not be the answer to their worries. Not all are shrewd fund managers. Assurance of help in the event of future medical problems relating to the donation would probably be more helpful.
Another potential problem with compensating donors is that it may turn away truly altruistic donors. Already, we are seeing potential donors delaying their decision because of pending legislation on this matter. The feeling is: 'If the patient can get a kidney by paying for it, why should I run the risks of donating my kidney?' People may also refrain from offering to donate a kidney for fear of being called greedy.
The most unacceptable effect of compensating donors is that such compensation may slip into organ trading. Some have argued that the poor have the right to decide what they can do with their bodies, and if they choose to 'commodify' their bodies so that they and their families can benefit financially, so be it!
Only people driven to desperation will consider parting with parts of their bodies. They are either in desperate need of money or in great debt. The money they might save from the organ sale may be very meagre indeed.
The Government should consider giving donors medical coverage so their fears of possible medical problems later in life might be allayed. The cost of such coverage is potentially high, but we suspect it would be affordable. This is because the criteria for selecting donors are stringent, and the people who qualify to be kidney donors tend to be fit. The possibility of their developing end-stage renal failure is very low.
A rich person with end-stage renal failure should not have the automatic right to buy spare parts from another person just because he can afford to do so. This would amount to causing bodily harm to another, not unlike in slavery.
Performing kidney transplants is a joy. Watching an end-stage renal patient recover from surgery and seeing a happy family leave the hospital is a blessing no money can buy. Legalising organ trading in Singapore will just degrade this wonderful experience into a purely commercial transaction.
Differences in opinion on this matter depend on one's point of view. For someone suffering from renal failure, almost any means to obtain a kidney would appear permissible. For those desperate enough to sell their body parts as the only available means of clearing their debts or bettering their lives, organ trading may also be considered permissible. However, from a society's standpoint, we must examine the moral implications of the new rules we are considering. We should as a community put rules in place to protect the poor, the weak or the otherwise underprivileged.
The rich already enjoy many privileges in our society. Allowing them to purchase an organ legally would be crossing a dangerous line. We are sure our system will ensure that there is an equitable, innovative and highly regulated set-up such that the donors will be protected. However, as Dr Lee Wei Ling, who is in favour of legalising organ trading, has acknowledged in these pages, it will not be the rich who will come forward to donate their organs. It will be the poor and the desperate. We have always championed the underprivileged in Singapore. Selling organs, whether the sellers be Singaporean or foreign, should not be the means to a better life.
How much is life worth? Transplanting kidneys is relatively safe but it has definite risks. While it may be acceptable to run the risks for a relatively young person to undergo a transplant from a relatively healthy donor, it will be difficult to justify a rich, aged individual suffering from renal failure (and possibly other illnesses) getting a kidney from a young individual just because both parties are willing. It will be even more difficult to extend the argument for kidney trading to live liver or cornea trading. Should we allow someone to buy a face? It is now medically possible to do face transplants. This is a slippery slope; we should not place ourselves on this slope.
Yes, Singapore has dared to blaze its own trail in many areas, as Dr Lee pointed out. Medisave, Newater and HDB - these have all proved to be the right things to do. However, organ trading is fundamentally wrong. It should not be legalised because it empowers the already powerful and exploits the vulnerable. It will not lead to a more moral, sustainable society.

The writers are consultant kidney transplant surgeons at a public general hospital in Singapore. The views expressed here are personal.

A moment in history - President Barack Obama

President Barack Obama

Never liked the Americans. Liked them a lot less when George Bush was president. But if they can overwhelmingly elect a black man to be President, especially one with a middle name like Hussein, I can give them another chance. So President Obama, don't let us down!

Rev Henry Khoo - Requiescat In Pace

Rev Henry Khoo, retired Chaplain at the Changi Prison has passed away at the age of 76, after a long battle with cancer.

I never really knew the man, but our paths crossed many years ago. I knew of his work with the inmates. A saintly man, whose life has always been a source of inspiration to me. In today's crass commercial world, so corrupted with calculative, mercenary selfishness, Rev Khoo's life of selfless devotion to his charges in prison, must remind us of a life beyond this world, and values higher than what the world offers.

The Straits Times today carried a wonderful obituary of the man, written by KC Vijayan.

Rev Khoo, May God bless you. Thank you for showing us the face of God. Rest well in the Father's arms.

Nobel laureate

Dr. Harald zur Hausen

So this year's Nobel Prize for Medicine has gone to 3 scientists working with viruses. Two for the discovery of the HIV virus and one for the discovery of human papilloma virus as a cause of cervical carcinoma.

To my thinking, the one that stood out in this award was really the physician-scientist Dr. Harald zur Hausen of the German Cancer Research Center in Heidelberg for his work on the human papilloma virus. What impressed me most was his dogged perseverance, believing in his cause even when no one else would (a 2005 review of his struggles can be found here). How he eventually succeeded despite being largely out of alignment with much of the thinking of his peers, should be an inspiration to all budding biomedical scientists. So here's to you, Dr Hausen!! Congratulations, and thank you for teaching us how to believe in ourselves.