SINGAPORE: We are learning about the life cycles caterpillars. Our textbooks tell us that caterpillars spin warm, little cozy cocoons for themselves and eventually emerge as pretty butterflies.

But Mrs Chang, our science teacher details to 38 of us horrified but enthralled 9-years-olds how caterpillars digest themselves into a soup and how their cells work to reform that body-soup into a butterfly.

That, I think, without realising it, is the moment I first understand my love for poetry.

In early 2016, a National Arts Council survey found that fewer than one in two Singaporeans had read at least one “literary book” a year – obviously, a pretty dismal result.

As a working poet now, the questions I most commonly get asked are “why don’t Singaporeans read poetry?” and “why do you think the number of students taking Literature is declining?”

One of my favourite poets Audre Lorde says we need poetry because “it gives us the language to say what we do not know how to otherwise articulate.”

Poetry and literature exist to help us question, deconstruct and then rebuild, not simply reaffirm our worldviews. But what if there is no need for us to question in the first place?

DEVELOPED, ADVANCED, SAFE

Whenever someone asks what Singapore is like, we are likely to say “developed” or “safe” or “advanced” and we are all those things. As Singaporeans, the one story we all know best, is the story of survival. We know how vulnerable our little island nation is, how hard-won our stability and prosperity has been. But the unfortunate byproduct of that story is fear.

Fear that if we walk a road other than the one painstakingly laid out for us, that our destination will no longer be certain. Over time, we have developed a deep-set belief that the tried and tested path is always safer.

And it probably is. Stick to the road and you might never feel discomfort. And who wants to knowingly put themselves through tribulation?

We are not interested in the unknown, we are happy to be in our own cocoons of security. Poetry and fiction don’t allow for this.

“Literature isn’t easy to score!” we hear again and again, but the bigger question we should be asking is, why do we see that score as the real marker of success or learning?

Young people in this country are our future, but if we continue to lay out specific roads for them, then how will their dreams be any different from ours? If we keep dreaming the same dream, how will we ever see real growth?

Every few years, we hear concerns about how Singaporeans aren’t creative enough, how we need to instill more entrepreneurial dare in our children. But if we are a people afraid of discomfort or alienated from it, how can we fully develop social consciousness or the ability to navigate complexity or uncertainty?

The conversations on complex issues like race and sexuality have become more recurring as we evolve as a society and they are issues that threaten to divide us.

But if we cannot trust ourselves to have difficult conversations, if we have not acquired the vocabulary for them, or if we are believe it is easier to disengage, then how will we ever emerge better?

STRUGGLE TO TALK ABOUT DIFFICULT ISSUES

Young people of my generation seem more passionate than ever about ensuring our country is a reflection of all that we have to offer, but we are also struggling to talk about issues that are difficult and won’t fit into a neat box. We don’t know how to work with things we cannot easily define.

We are a society in love with pie charts, acroynms, data, neat slogans that help define and neatly explain our concerns.

I remember a particularly frustrating meeting when I was still a Head of Department where we were all held hostage for three hours in a board room while the school insisted we had to find a way to “measure” leadership.

But there are things in the world, in life and in the human condition, where the most real things – like questions of belonging, identity and loss – cannot be quantified, neatly packaged, or sometimes, even named.

This is also why Singaporeans don’t read poetry. Poetry demands that you suspend yourself in uncertainty, it asks for meaning to unfold in its own time and this can be incredibly uncomfortable if you are used to constant certainty.

I am guilty of that need for efficiency myself. On a rainy evening in Oxford, I find myself feeling a surge of anxiety because there is no app to tell me when exactly my bus will arrive. 

As Singaporeans, we are “your Uber will arrive is 3 minutes”, we are “tracking your order”, we are “but the message has been blue-ticked”. We are programmed to want to know outcomes.

But it is precisely in situations where we are forced to struggle with the unknowns of life when we tend to turn to poetry. It is no coincidence that poetry resurges in difficult times like war or times of complex human emotions, like weddings and funerals. Poetry exists to give us language where we have none.

Poetry demands that we feel instead of think, to sit in questions rather than rush for answers. It asks that we recognise no two people live in the world in the same way, the same poem can mean vastly different things to different people and neither meaning is “wrong” or “right”.

Poetry demands that we examine all the contradictions, even the ones within ourselves. We cannot hate without the capacity for love, we cannot grieve if we do not feel joy, and we cannot build if we do not first tear down.

DEFINING SUCCESS

It will do us no good to look away from our messy selves, however much temporary comfort that brings us. To look away means to deny and to silence large parts of who we are as a people. It means to allow ourselves to be reduced to numbers and fiscal growth and rankings.

All of these are valuable but are not enough. We cannot define success as scores and profit over and above human need, over and above possessing the language we need to build real bridges to make us genuinely stronger.

Real growth will only come when we allow ourselves to experience all our feelings, even the ones that make us profoundly uncomfortable. Because that’s where the most important lessons are to be learnt. And we can realise these lessons through our poetry, our stories, our writers who are a lens to our anxieties, our alienations, asking the difficult questions.

Audre Lorde also said: 

If what we need to dream, to move our spirits most deeply and directly toward and through promise, is a luxury, then we have given up the core – the fountain – of our power.

Metamorphosis isn’t just some beautiful physical transformation. It’s a stunning display of evolutionary mechanisms. It’s a testament to what it truly takes to grow.

Butterflies and caterpillars don’t just look different, they behave differently too. One lives in trees, the other flies. And everyone knows, the most diverse ecosystems are the most resilient ones.

We need poets as much as we need scientists if we are going to finish the 21^st century stronger than we started it. 

Pooja Nansi is the author of two collections of poetry. She is also Singapore’s first Youth Poet Ambassador.

SINGAPORE: It is eight in the morning on Sunday and cabbie Simon Ng has just ended his graveyard shift. He is not heading for Woodlands where he stays for a much needed rest. Instead, the 57-year-old is making his way to Willing Hearts’ soup kitchen in Eunos.

There, packets of food numbering in their hundreds are waiting to be distributed. The fare is simple – white rice with two servings of vegetables and a serving of meat. Mr Ng admitted they are not very tasty.

But he knows many look forward to them every day. He carries them into his blue Hyundai cab and drives to Block 521, Woodlands Drive 14. The void deck serves as a distribution point for this free food for the elderly and underprivileged seven days a week from 10am to 11.30am.

“Mostly, I take care of the old people first,” he said. “The young ones must wait. If there are extras, then they can take.”

Mr Ng set up the distribution point – ‘We Care at Woodgrove’ – more than two years ago after he found out that there’s a large number of elderly and wheelchair-bound residents living in his neighbourhood.

It started small – 20 packets of food for 10 people. But the number has grown because of posters advertising the free meals at the lift lobbies of surrounding blocks.

He now distributes more than 200 packets of food for about 70 people. They include foreign domestic workers and aging cleaners working at a nearby shopping mall. Some take more than one packet of food to have them for dinner as well. Everyone registers so that Mr Ng can keep track.

“I’m not only giving to those who stay nearby,” he said, referring to an 80-year-old man who lives 20 minutes away but makes the journey on foot to the void deck every day. “As long as you can walk and come here, I will give it to you.”

Demand continues to grow Mr Ng said, but he has had to put a cap on it.

“You cannot put so many packets of rice in one taxi,” he explained. “Sometimes, they bring fruit and bread from the kitchen also.”

Mr Ng can only guess why there is such a big demand for the free meals. 

“To me, the economy is bad,” he suggested. “Sometimes, people try to save money, maybe for their children’s education or marriage. Or they want to buy a new house. You don’t know.”

Everyone is treated equally. “Everybody is the same,” he added. “We are not judges; we cannot stop them and say you are not entitled to take food.”

A WELL-OILED OPERATION

Mr Ng is there every day. But he does not need to personally oversee the food distribution at ‘We Care at Woodgrove’. He has recruited about 30 volunteers to help. 

They are familiar with the drill. A taxi comes to a stop at the distribution point. Its boot flings open. Volunteers flock to the vehicle to take the food packets. They are repacked into bags of twos and threes and made ready for distribution.

“They do their own thing,” Mr Ng said. “Everything is arranged; I don’t need to shout around.”

The volunteers go the extra mile too; they make door-to-door deliveries for those who cannot make their way to the distribution point for one reason or another.

Mr Ng’s taxi is not the only one that is used to transport food from Willing Heart’s kitchen. He has roped in some 80 taxi drivers from the CabbyCare Charity Group, where he is a member, to help. “I can combine the two and help a lot of people,” he said.

While Willing Hearts has its own van, it needs more wheels because of the sheer number of distribution points islandwide. “They don’t have enough people,” he added. “For weekdays, they only have taxi drivers and a few volunteers.” 

Weekends are when Mr Ng personally handles the deliveries. He does not feel his well-oiled initiative is special. It is just something that takes two hours a day, he said humbly. “It’s nothing.”

But things were not always this smooth.

When Mr Ng started out, he could not find enough volunteers. He also did not have a permit to use the void deck space. Staff from the town council soon approached him and said he cannot carry on.

“I said this only goes on for two hours,” he recalled telling them. “After that, I will clean up. If the floor is dirty, I will clean also.” But they insisted that the rules had to be respected, he said.

Because the permit costs S$10 a day, Mr Ng said, he did not think he had enough money to sustain the daily operation. So, he approached Member of Parliament (MP) for Marsiling-Yew Tee GRC Ong Teng Koon for help.

“He settled it for me,” he added. “The MP knows I’m helping the elderly here. If the elderly face welfare issues, I will bring them to see the MP also.”

HIS FATHER’S DEATH WAS A JOLT

At the distribution point, elderly residents mill about, chatting with each other. A toddler waddles over to Mr Ng and looks at him with puppy eyes. “I treat the small kids like my own children,” he said. “If I wasn’t talking to you, this kid would have asked me to carry her.”

For Mr Ng, this is more than just a place to get free meals.

“I encourage all the old people to come down to meet people and exercise, and not to stay at home,” he said. “If they are alone at home or they have to cook, I ask them to come down.”

It is a one-stop centre for their needs. “If they need anything, they have my phone number and I can ask my volunteers to attend to them straight away,” he added. “No need to call your son to come all the way from work.”

Mr Ng’s love for helping the elderly was sparked by his father’s death more than 20 yeas ago.

His mother died when he was two. Growing up, he was never at home and frequently skipped school.

“I always lived with my friends; I seldom went home to eat,” his voice breaking as he told me. “My father always had to look for me.”

When he was 30, his father died from a fall in the toilet. His father’s death came too suddenly, he lamented. “I never took care of my parents.”

Now, Mr Ng tries to make up for it by treating the elderly like his “own relatives”. He began more than a decade ago by helping out at grassroots events, before joining Willing Hearts in 2014 to help with the food deliveries. “I never chose places,” he said. “I just sent to wherever they wanted.”

He decided to set up the distribution point in Woodlands after three months of volunteering at Willing Hearts. He has never missed a day there since, staying for the entire one and a half hours each day.

By the time the father of two girls gets home at around lunch time, he is exhausted. But does not go to sleep just yet. He helps out with the housework because his wife works till late. Mr Ng washes the clothes, squeezes in an hour’s nap, then cleans the house.

Mr Ng is also an active member of several community groups. His evenings are filled with meetings. It is 10pm by the time he goes to bed. He wakes up at midnight and goes to work again.

There is a neck pillow in his  taxi – a gift from his youngest daughter so he can get some sleep while waiting for his regular passengers. The punishing schedule has taken a toll on him.

“My medical report just came out,” he said. “I have high cholesterol and high blood pressure. The doctor says I don’t have enough sleep.”

Mr Ng does not know if he can carry on manning his distribution point.

“I’m only trying to see how long I can continue,” he added. “I’ll try to find someone to take over because my medical problem is quite bad.”

PERSEVERANCE AND PRAISE

Until then, Mr Ng continues to give. He sends the elderly to traditional Chinese medicine and dialysis sessions for free, raise donations to buy them adult diapers and organise get-togethers with live music and free food.

“If I can get enough support, I want to organise an eight-course dinner for them,” he said.

Mr Ong, the MP who oversees the Woodgrove division, said residents are “very appreciative” of Mr Ng’s work.

“He’s been going around corralling resources to help these poor people not only in terms of food, but also in terms of adult diapers,” Mr Ong told Channel NewsAsia. “He’s doing all this out of his heart – it’s all goodwill and he’s got nothing to gain from this.

“So, I’m very supportive of his work, and I think he’s a great example for a lot of us in the community who are trying to help people.”

It is no surprise then that everyone in the neighbourhood seems to know Mr Ng. Just after 11.30am, a garbage truck pulls in on one of its regular rounds. The driver waves at Mr Ng, who in turn signals that the food has finished. “He came too late,” Mr Ng said, laughing.

For Mr Ng, it is never too late to start contributing to society. He was in his 40s when he started, but admitted that “the more I did it, the more I got into it”. “Now, I spend most of my time doing charity work,” he said.

Indeed, Mr Ng says he does not drive a taxi to earn a salary, but to help others. He spends about S$70 a month on diesel and car park fees for his food distribution.

“My friends ask how I am going to earn money by helping people,” he added. “But I told them never mind, as long as I am happy.”

SINGAPORE: If you have been travelling this holiday season, you may have noticed a new taxi stand in operation at Changi Airport’s Terminal 1.

Located at basement one, the taxi stand opened on Tuesday (Dec 19) and replaces the old facility at the terminal’s first floor arrival hall. 

The move is part of the Terminal 1 expansion and is in preparation for the opening of Jewel Changi Airport in 2019, which will be directly linked to the terminal. 

Passengers Channel NewsAsia spoke to noted the new taxi stand is slightly further away, but said it was not difficult to find.

“All the way there’re a lot of signs,” said 36-year-old Kai Ng, who was catching a cab from the new taxi stand. “I mean, our opinion is that it’s so easy to find your way around here.”

“Location wise it is quite good. I think the design is very nice, comfortable. Looking forward to taking more taxis here,” said 25-year-old Ian Goh, another taxi commuter. 

There are 21 taxi bays available at the new facility and a new taxi dispatch system is being used. 

Through sensors and other algorithms, the system is designed to dispatch an appropriate number of taxis from the holding area to meet demand at the Terminal 1 taxi stand.

It also prompts drivers to the clusters where there are passengers.

Chang Airport Group (CAG) said this has automated some of the job processes of its roadway managers. 

The system was first trialed at the airport’s Terminal 3 in July, before being implemented there as well.

CAG added that development works at Terminal 1 are about 60 per cent complete. Passengers can expect a more spacious arrival and baggage claim hall, as well as a revamped departure hall.

In early 2018, the new Terminal 1 arrival pick-up facility at the first basement will also be ready. Currently, the pick-up area is located at level one. 

Other new ground transport facilities expected include the new Terminal 1 and Jewel carpark and coach stand.

SINGAPORE: Piling, excavation and structural works for the five basement levels and five above-ground levels of Jewel Changi Airport have been completed, with the S$1.7 billion mixed-use development on track to opening in 2019.

Set to host a range of shopping and dining options, Changi Airport Group (CAG) told Channel NewsAsia that to date, 65 per cent of Jewel’s overall construction has been done.

Currently, other major works taking place include the building of link bridges to connect Jewel with Terminals 2 and 3, as well as the installation of Jewel’s glass and steel façade.

Starting from the first quarter of next year, play attractions like the Sky Nets, Discovery Slides and Canopy Mazes will be installed.

Trees, ferns and other plants that will make up the 22,000 square metre Forest Valley will start being moved into the complex in the second quarter of 2018, when the building’s façade and air-conditioning system are fully fitted.

“(Jewel Changi Airport) will change a lot in terms of passenger experience, it will draw some of the local crowds as well,” said Assistant Professor Terence Fan, a transport analyst at the Singapore Management University.

“That is going to be a major shift in itself because typically we used to see airports as solely related to travel, but with Jewel being such a retail destination in itself, we can certainly even see locals going there not just for aviation-related activities.”

With the development of Jewel, Changi Airport’s Terminal 1 has also been undergoing an expansion.

CAG noted that development work is about 60 per cent complete, with more spacious arrival and baggage claim halls, as well as an upgraded departure check-in hall expected.

Some manual check-in counters are also being replaced with automated systems.

When completed, the expansion will allow Terminal 1 to handle 3 million more passengers per year, bringing the annual capacity to 24 million in 2019.

TERMINAL 4 RECEIVES CLOSE TO A MILLION PASSENGERS

Jewel Changi Airport is the next major project on the horizon, following the opening of Terminal 4 on Oct 31.

So far, almost 900,000 passengers have passed through the terminal, which boasts a unique slew of self-service and automated systems from check-in to bag drop and immigration.

CAG says operations have been smooth but the organisation is mindful that passengers will need time to get familiar with the new facilities.

“Many of the latest technologies we have seen in Terminal 4 haven’t quite been incorporated in most places around the world,” said Professor Fan.

“So even though other airports around the region could in time catch up, I think that would at least give Singapore a bit of time – lead time – in terms of it having a suite of advanced technologies.”

Terminal 4 – Changi Airport’s smallest terminal – is expected to handle up to 16 million passengers per year.

 “That itself is not going to be a big change in terms of capacity, but what it would do is take away some of the existing operations of the terminals which are getting slightly crowded and so that will give more breathing room and room for growth for the carriers in the other terminals,” said Professor Fan.

Mr Abbas Ismail, course manager of Temasek Polytechnic’s diploma in aviation management and services, added that testing out new technology at T4 could also go a long way when planning for the upcoming mega-Terminal 5.

“If it’s successfully implemented in T4, then Terminal 5 would be something totally different than what we could see at terminals in the rest of the world,” said Mr Abbas. 

“That’s also to address some of the issues in managing our manpower for the future.”

MORE THAN JUST BIGGER TERMINALS TO BE COMPETITIVE: ANALYST

Set to be ready by the late 2020s, T5 will be able to handle about 50 million passengers per year and will be bigger than Terminals 1, 2 and 3 combined – which will make it one of the largest terminals in the world.

It’s part of CAG’s Changi East project, where groundwork is ongoing.

But analysts are quick to note that having more or bigger terminals is not enough.

“The competition is not just about having big terminals, we need to continue to ensure we are providing capacity, efficient services, (and) ensure this cost is kept to a minimum for the user, especially for the airline. In order for us to attract airlines that bring in passengers, we also have to ensure airlines keep their cost low,” said Mr Abbas.

Another challenge will be attracting and training enough manpower to run an expanded airport in the future.

But experts said there is no doubt that expanding will take time and noted Singapore must continue to tap new markets to remain competitive in the nearer term.

These include the growing North Asia and China markets, as well as exploring long-haul budget travel to maintain Singapore’s status as an aviation hub of choice.

SINGAPORE: From Phase 3 of the Downtown Line to the Tuas West Extension, new sections of rail lines opened this year to bring more convenience to commuters. But 2017 may be remembered by Singaporeans for two major rail incidents instead.

Despite this, industry experts Channel NewsAsia spoke to said there are lessons to be learnt and noted that rail reliability could improve in 2018.

MRT TUNNEL FLOODING: “STORM IN A TEA CUP”

On Oct 7, a heavy downpour resulted in the tunnel between Bishan and Braddell MRT stations being flooded with rain water.

Train services were disrupted on the North-South Line for over 20 hours, affecting more than a quarter of a million commuters.

Investigations later revealed that a group of staff working for operator SMRT had falsified maintenance records, resulting in a water pump system to fail.

Eight staff were fired, and during a media conference to address the incident, SMRT’s CEO Desmond Kuek pointed to “deep-seated cultural issues” in the company.

​​​​​​​

“For it to be revealed only in recent times is a bit surprising,” said Dr Lawrence Loh, Director of the Centre for Governance, Institutions and Organisations at the National University of Singapore’s business school.

“It’s a bit like tea – culture needs to brew and I think what is surprising is it takes a storm in a tea cup for this matter to surface.”

Addressing the incident in Parliament on Nov 7, Transport Minister Khaw Boon Wan said SMRT’s management is responsible for building the right work culture.

Though, Dr Loh noted, that turning a company around could be a long-drawn process, with some consultants suggesting it may take about three years to do so.

“You need to have very committed management engagement of all the employees,” said Dr Loh. “With that engagement as a sign, then you can actually get a sense of what the real thinking of the people are and if there are any areas you may want to further develop.”

This could be done by sending staff for training or technical classes, or helping them develop in other areas like communication and supervision of staff.

“I think we need to drill in as well as create this sense of urgency, sense of belonging,” said Dr Loh. “Everyone will have to do it not only for the organisation per se, but it’s also in the employee’s interest.”

EAST-WEST LINE TRAIN COLLISION

But Singapore’s rail woes did not stop there.

On Nov 15, 38 people were injured when two trains on the East-West Line collided at Joo Koon MRT station – the second such incident in the MRT’s 30-year history.

Authorities said this was caused by a glitch or “software logic issue”, as a faulty train switched between old and new signalling systems.

As a follow-up measure, 19 stations along the North-South and East-West Lines saw shortened operating hours and two full-day closures in December.

While this left commuters in search of alternative modes of transport, it also allowed more time for staff to carry out works, accelerating the upgrade of the signalling system on the East-West Line.

This will now be completed by mid-2018, instead of the end of next year.

“I think the operator and government side tried their best to minimise the disruption to commuters as much as possible,” said Dr Zhou Yi, Deputy Chairman of the Rail and Transportation Technical Committee with The Institution of Engineers.

“But I think due to the incident of the Joo Koon collision, it really warned us that maybe we should play it in a more safe way rather than be too brief. If there is really another accident, I think it would be much more painful to the country.”

IMPROVEMENTS IN 2018?

Prior to the two major rail incidents this year, work to renew Singapore’s rail assets have been ongoing from as early as 2013, as part of overall efforts to improve reliability,

So far, two out of six projects have been completed – with upgrades to the signalling system, power supply, trains and track circuits still taking place.

In addition, there are also plans to double the rail network by 2030 – which Dr Zhou said is likely to play a major part in improving reliability.

“With much more choices or alternative lines in operation, then it should ease or relieve some of the load in the traditional or old lines,” said Dr Zhou.

“By the middle of next year, we are expecting the resignalling project to be complete and maybe we give it one or two months for teething issues … I am very positive to see by end of next year, we would see much better reliability in our system.”

SINGAPORE: Most just want to be near their family, while others may have more unconventional wishes, like taking an overseas trip, or holding their very own art exhibition.

But when patients near the end of their lives, it’s important that the utmost be done to ensure that they can go gently into that good night, those working in palliative care whom Channel NewsAsia spoke to stressed.

The key, they say, is to do it as quickly as they can, because their patients’ days are already numbered.

Whether it is wishes fulfilled, or last words spoken, these are some of their stories.

 “MY HEART BREAKS EVERY TIME A PATIENT DIES”: NICOLE PENG, HCA HOSPICE CARE

It might seem strange or morbid to some, having to deal with death or work with dying patients on a daily basis. But palliative care nurse Nicole Peng is attracted to the intimacy of the experience.

“We do home visits, so we get to speak to patients at our own pace, at their comfort level and at their own familiar environment,” said Nicole, who is with HCA Hospice Care. “I realised that most of the time when they are in their familiar environment they are more open and comfortable.”

She works primarily with terminally ill children through HCA Hospice Care’s pediatric programme Star PALS, where teams of doctors, nurses, social workers and counsellors work together to help children in the comfort of their homes.

And it is in the comfort of their homes, she says, that patients are willing to tell her about their last wishes. Most of them typically want to be free of pain, and to spend their last days at home with their family members with them.

But she has received several unusual requests from patients she said and one of them came from Sharon, a nine-year-old girl with bone cancer who wanted to star in a personal music video.

“Initially, we thought she could do a catwalk in a wheelchair, but she decided that she wanted to do a music video, so we brought her to the River Safari to do it,” she said. “Her favourite artist was Britney Spears.”

Another memorable request came from Khairul, a 19-year-old art student with colon cancer who wanted to have his own art exhibition. “He became my friend, and one day, he told me he was very sad that this had to happen to me,” she recalled. “So I asked him what his wish would be.”

“He worked very hard, did some new paintings, and came up with a theme for the exhibition, which was Hope,” she said, adding that she was grateful for the help of her team members in making the exhibition happen.

“The public exhibition was at NAFA, and one of the MPs even came to attend it,” she added.

“He passed on one or two months later.”

But the intimacy of nursing patients in their own home and getting close to them also means a deeper emotional bond for Nicole, who admits having to deal with grief when her patients passed away. “My heart breaks every time a patient dies,” she said. “By the time they are about to say goodbye, my heart will usually be very broken, so I can’t say much, but I will always hold their hands very tightly.”

“My youngest was a baby just a few days old, and I remember I was choking with grief.”

Despite the grief, Nicole is certain that she is in the right place. “To be human, our heart has to be broken at some point of time, and we need to love and be loved,” she said. “So here in palliative care, I know I am being human.”

“I DON’T NEED WORDS TO KNOW HOW THEY FEEL”: CAROL TOH, HCA HOSPICE CARE

When patients know they only have a few months to live, their biggest fears are usually related to death and going into the unknown, according to palliative care nurse Carol Toh. So she always makes it a point to lend them a listening ear, and let them express their fear.

“We don’t tell them what to do, because everyone has different fears. We usually ask them how they feel about it, and when they talk, we know where they are coming from,” said Carol, who is from HCA Hospice Care. “The more they talk about it, the more they realise this is part and parcel of the life cycle, and they get a release at the end.”

In general, Carol noted that when it comes to patients’ last wishes, there are usually two groups: The first will just want to die quietly, in dignity and without being a burden to anyone, while the second will want to see all their relatives and old friends before they die.

“We usually talk, and I will ask them if they have any unfinished business,” she said. “Because if they have any wishes, I will encourage them to do it earlier rather than later.”

She recounted one instance when an elderly man wanted to return to Malacca to visit a big plantation he owned there, meet the caretakers and say thank you. “He told me, and he told his son and his daughter-in-law,” she said. “But he was already bed-bound and not even eating, and the son was in a dilemma as to how to make it happen.”

“I told the son that the longer he delayed, it will be zero chance already. So one weekend, we really pushed for it.”  

Working together with the patient’s son and daughter-in-law, Carol and her team made the arrangements for the patient to make the trip. This included preparing things like letters for customs clearance, and arrangements in case the patient passed on in Malaysia. “I had to keep assuring them not to worry, and to call me if anything happens or you don’t know what to do,” she said. “So with that, they went, took a stretcher and brought him around the plantation.”

“He suddenly had more energy and was more alert.”

The patient passed on the next morning, she said. “But his son told me he was smiling. That was the message to me, that he has finished all that he wanted to do.”

“Usually towards the end, patients are very weak and they have lost the ability to talk,” she added. “But they will give me a last look, or stretch out their hand to hold mine just one last time, no matter how frail, drowsy or tired they are.”

“I don’t need words to know how they feel.”

WORKING AS A TEAM TO MAKE THINGS HAPPEN: LIM HWEE HWEE AND SINI ANTO, ST ANDREW’S COMMUNITY HOSPITAL

For occupational therapist Lim Hwee Hwee, it was not just any other excursion.

A dying patient had expressed a wish to pay her last respects to her late mother, who was at Mount Vernon Columbarium, and the palliative care team at St Andrew’s Community Hospital swung into action to make it happen.

“She told the doctors, and they conveyed it to us,” said Hwee Hwee. “So before the visit, we wanted to find out more information about how wheelchair-accessible the place was.”

“She told us there was a flight of 13 steps she had to conquer every time she goes there, and at that time she was not very mobile,” she added. “But she was very determined.”

Hwee Hwee and a colleague practiced stair-climbing with the patient in the hospital, assisting her and holding her up as she mounted the stairs. But thankfully, as they went by car to the columbarium, the patient did not have to climb any stairs.  

“We just had to push the wheelchairs to the urn, where we met her brother, who brought some fake flowers to offer to the mother,” she said. “So we let them spend a few moments with their mum.”

But making this visit happen, she stressed, was truly a team effort, with nurses, therapists, and even doctors chipping in. The patient’s doctor, she added, had driven her to the columbarium for the visit.

Senior Staff Nurse Sini Anto remembered showering the patient on the day of the visit, giving her pain medication to ensure she would be comfortable throughout, and even helping her choose a suitable outfit to wear for the visit.

“She was so happy when she came back,” she said. “She told us she never thought she would have the chance to pay her last respects to her mother.”

“She passed on a few days after that.”

It is evident that teamwork underpins much of what they do in fulfilling patients’ wishes. But both also stressed the importance of each of them doing the best they can, especially given that the patients they work with know their days are numbered.

“We are not sure if we will see our patient tomorrow,” said Sini. “So if I am on this shift, I will do my best to do whatever I can to make them more comfortable, even if it’s little things like wetting their mouths and giving them small sips of water.”

“We know that when they pass on, we have done our best, so we are fulfilled.”