Angry Professor – Part 2

As expected Prof Lee’s letter generated a few replies on the ST Forum yesterday and today.

I counted five letters, all criticising her point of view, some denying that Singaporeans who donated to the patients’ families were gullible, and all citing that heart and hope were more important that science in these cases.

They all seem to have missed Prof Lee’s points.

The truth of the matter is, from the onset Singaporeans were duped into donating money without being given all the facts.

Ask yourselves: how did they find out about the cases?

Answer: The press.

How much did they know about the clinical facts behind the cases?

Answer: As much as the press told them.

Would they have continued to donate so generously if they had known that these "were cases who would not benefit from surgery"?

I think many still would, but I also believe almost all of them donated out of the hope and belief that the poor children will benefit from the operations, and that many now ask themselves why the low chances of a good outcome were not explained to them by the press.

At the end of the day, the press had what they wanted - sensational stories, heart-warming tales of generosity, tales of the miracle of modern medicine, and a sense of the journalist’s duty well-done.

But that there were no miraculous recoveries that lasted. And worse still, there might not have been any miraculous recovery to hope for to begin with.

So yes, I agree that they were gullible, even if it was due to the goodness of their hearts.

The second, less explicit point that Prof Lee wanted to make, I believe, was the point about full disclosure, which was countered by the issue of ‘hope’.

As doctors, we often have to inform patients and their families about their diagnoses and the treatment options available to them. Most of the time it’s pretty straightforward, but in cases of cancer or neurosurgery, things can get more complicated.

It’s hard for patients and their families to accept that sometimes, no matter what we do, the outcome will not be what they hope for: a full and complete recovery.

Sometimes the treatment prolong life a bit more, but leave the patient in an uncommunicative state.

We understand how difficult it can be for the patient’s family to cope with having a relative in a vegetative state long-term. OK, we don’t fully understand, but we can see their pain.

One patient’s mother told my senior in neurosurgery, after seeing her son a vegetable for weeks, that he “tried too hard”.

But we had offered the operation to evacuate the blood clot from his head and explained the risks and likely poor outcome even if he lived, and she had given her consent for it. Now she thinks we “tried too hard”.

Offers of hope must be tempered with a healthy dose of reality. Sometimes all the heart and hope in the world is not going to produce a good clinical outcome.


Sure, at the end of the day it’s still your money and yours to throw away as you see fit. But try to have a better understanding of the medical facts in question before you decide, and if you choose not to, at least have the courage to admit that you were duped when you are.

Afterall, nobody seemed to be embarrassed by the fact that they felt duped by NKF.