This is the third in a series of heart-warming and sometimes painful stories from our medical social workers. They work quietly among other health professionals in S’pore’s public sector hospitals, helping patients deal with difficult issues including financial hardship and impending death.

By Ng Wan Ching

A MOTHER dying of cancer, a dad whose family was totally dependant on him, and a lonely woman who feared death.

All three people found hope in one woman: Senior medical social worker (MSW) Goh Chiang Choo of Changi General Hospital (CGH).

The first patient was twice married with young children and she was dying of cancer. Ms Goh would not reveal more details of the patient’s family, citing patient confidentiality.

What was to become of the patient’s children? How was she to cope?

Her courage touched Ms Goh, 38.

“I saw how she managed to survive through her chemotherapy and radiotherapy,” said Ms Goh, who became a familiar, friendly face to the woman.

In the last few days in her life, Ms Goh visited her in the ward whenever she could. The patient had become weak and needed oxygen to breathe. Yet when she saw Ms Goh, she would take off her oxygen mask and use all her effort to thank Ms Goh.

“Her children were her lifeline. She managed to survive for a few years and even returned to work. Being a mother, I could feel her sadness for not being able to continue life’s journey with her children.”

To cope with her own emotions and to encourage her patient, Ms Goh asked her own young daughter to draw a card for the patient. Unfortunately, when Ms Goh next visited the patient with the card, it was too late.

“She had slipped into unconsciousness. By the next day, she had left the world,” said Ms Goh.

His troubled family

Then there was the second patient, a 75-year-old father with a troubled family.

Mr Nicholas’s wife and younger daughter are both mentally ill and unemployed. His elder daughter committed suicide. They all depended on Mr Nicholas.

But one day, he suffered heart failure and an ulcer that would not heal. He had to be admitted to CGH. He became delirious. The man’s condition deteriorated and doctors eventually had to amputate his right leg to save his life.

It is not clear if the ulcer was growing on his right leg. Ms Goh could not give more details of his condition because of patient confidentiality. His mentally-ill daughter was unable to cope with her father’s deterioration. She was overwhelmed by thoughts of how she would cope without her father.

The pressure led her to have a relapse and she was admitted to the Institute of Mental Health. Her mother was able to remain at home with community support services.

“With Mr Nicholas’ amputation and his prolonged delirium, I had to make arrangements for him to go to a nursing home to be cared for,” said Ms Goh.

Every one in the family had to re-adjust, said Ms Goh.

“I look forward to Mr Nicholas’s recovery to continue managing his life’s journey,” said Ms Goh.

While the first and second patient had to cope with caring for their families, Ms Carol had a different problem. She was in her 50s and all alone.

Ms Goh first met Ms Carol when she was referred to the MSW department because of her frequent visits to the A&E for unspecified symptoms.

“After a few meetings, I learnt that she was a lonely lady who was fearful of death. She had suffered from cancer for many years and she did not know when her days would be over,” said Ms Goh.

Ms Carol lived with a distant relative and interaction with her own family was minimal.

“Over time, we built up a good rapport. She would drop by the department whenever she had a follow-up with the clinic,” said Ms Goh.

When Ms Goh was pregnant with her first child, Ms Carol even offered to help babysit, said Ms Goh.

But after a while, Ms Carol stopped dropping by the department. “I made a call to her relative’s family and was told that Ms Carol died a few months earlier.

“Though I did not get to say goodbye to her, her offer to help me despite her own medical condition will always remind me that regardless of any adverse situation, there is hope,” said Ms Goh.

She treasures these experiences, emotionally draining though they may be.

“Working with grief and loss is part of an MSW’s daily work. I learn from my patients and they have taught me how to treasure what I have and live life to the fullest,” said Ms Goh.

TAPESTRY OF CARE

You can read more of such stories in the book 'Tapestry of Care – Voices of Medical Social Workers'. The 47 stories in the book offer a glimpse into the lives of medical social workers and the multi-faceted journeys they take with patients.

The book, conceptualised by medical social workers at Singapore General Hospital, was put together by the publishing team of SingHealth Academy.

In addition to the stories, told from a first-person perspective, practice pointers have been included to make it a reference guide for other medical social workers.

The stories are about abandonment; abuse; awaiting death; grief; hope; suicide and the MSW’s role.

You can buy the book ($14.90 including GST) at selected retail pharmacies of public healthcare institutions, the National University of Singapore Co-operative bookshops and Kinokuniya.