May 28, 2009
The Pro
ER: the real deal
From treating heart attack patients to assault victims, Dr Mohan Tiru, 43, chief of the accident and emergency department at Changi General Hospital, never has a dull moment on the job. POON CHIAN HUI reports
I decided to specialise in emergency medicine because...
The pace of work and the variety of patients are unpredictable. Cases range from minor colds to heart attacks, assault, food poisoning and road accidents.
Unlike other branches of medicine where investigation often precedes treatment, emergency medicine works the other way round - treatment is first given to stabilise the patient's condition before a full medical examination is done to determine the cause of the problem.
The human body is fascinating because...
An illness that affects a particular part of the body can deteriorate to multi-organ failure within a short time. For example, a high fever can escalate to fits, which in turn can lead to multi-organ failure if medical treatment is not received.
If I were to give an analogy for what I do, I'd be...
Mark Greene in the medical drama ER. The character is a mediator and an occasional authority figure. However, my work does not have the soap opera element. There's a lot of tension involved in my work - ambulances come in every five to 10 minutes - so there is no time for any drama.
There are, however, a few love stories in the emergency department. I, for one, met my wife, who is a gastroenterologist, at Tan Tock Seng Hospital's emergency department in 1995. We were medical officers then.
I have come across all types of cases...
I encounter them even when I'm off work. I have resuscitated people on a plane and in a shopping mall. I've also intubated (a procedure to clear the airway) a road accident victim.
At work, the recent Geylang Serai rojak food poisoning event was a dramatic episode. Usually, we see about 15 diarrhoea patients a day, but we had about 50 cases in a single night shift. People were moaning and vomiting and some urinated on the floor. It was not a nice scene.
A typical day for me would be...
I never have a typical day. I work an eight-hour shift either in the morning, afternoon or at night. I spend 80 per cent of the time seeing patients. The other 20 per cent is spent on administrative work like meetings. I also teach medical students and junior doctors.
At home, I'm a hands-on dad. I do my fair share of chores and taking care of the children. I have two daughters, aged four and five. My hobbies are gardening and cooking. I also exercise for 45 minutes daily to reduce my tummy.
I love patients who are...
Considerate. They come to the emergency department for the right reasons - when there is a medical emergency. This helps us to focus more of our resources on people who really need our attention.
Patients who get my goat are...
People who upset others because they are upset. For instance, patients who verbally and physically abuse medical staff, other patients and even their own family members.
One little known fact about cardiopulmonary resuscitation (CPR) is...
It's not as easy as what you see on television. For one, you have to keep your elbows straight and do about 100 compressions in a minute - CPR has to be done forcefully and quickly. And the person has to be lying flat on the ground. I've seen a show where CPR was done on a person seated on a chair.
Things that put a smile on my face are...
When a patient who comes into the emergency department crying and moaning leaves feeling comforted, happy and satisfied.
It breaks my heart when...
A child dies in my arms. No matter how much experience you have, you cannot save everyone. It is tragic when you fail to resuscitate a child - sometimes, medical and nursing staff require emotional counselling after such incidents.
I wouldn't trade places for the world because...
I never have a dull moment in the emergency department. Plus, I have been able to participate in overseas humanitarian work, like the Asian tsunami in 2004 and the 2005 earthquake in Kashmir, Pakistan.
My best tip...
Learn CPR and how to use a defibrillator. Get your family to learn these too. They are skills that can save the life of a loved one. The likelihood of death increases by 10 per cent for every minute delayed in using a defibrillator.
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