And then Family Medicine

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I had forgotten that William was in a wheelchair.

I’m not certain I truly forgot, as I had never met William, but once I received the photo of him waiting for me at Raffles Place train station via Whatsapp, what I knew of William returned to my consciousness.

My brother mentioned William and his wife, Stephanie, while I was in Boston this past April. William competed in the wheelchair portion of the Boston Marathon and my brother and sister-in-law were meeting William and Stephanie the following night for dinner.

I chalked my forgetfulness up to jet lag (which has been a persistent struggle of mine during the past 3 weeks), though I also considered the inherent differences in visual-spatial and auditory memory.


 

Several weeks before I was to begin this trip, my brother offered to put me in contact with two friends who live in Singapore, both of whom are physicians. William was one of them.

At dinner I learned William and Stephanie knew my brother through his wife, who grew up in Singapore, as Stephanie and my sister-in-law were related by marriage.

As I wound my way through the multi-level railway station at Raffles Place, I couldn’t help but try to rack my brain for why William, a family physician living in Singapore per my memory, was in a wheelchair. I had a sneaking suspicion my brother had told me, but as I ascended the final set of stairs at Exit A of Raffles Place, I decided it likely had no bearing on anything I needed to know.

Similar to several other suppositions I’ve made on this trip, that thought was wrong.


 

By the end of dinner with William and Stephanie over 3 hours later, I had learned again why William was confined to a wheelchair, how he had struggled to become a physician, his years caring for Oncology patients, and then Family Medicine.

During our conversation, William mentioned in passing that he had been afflicted with polio at the age of 2; my foggy neurons started creating electrical impulses between them again, triggering my memory.

The truth of the matter though, which led to quite a lively discussion on medical education between William and I, was that polio had nearly kept William from becoming a physician.

Not because the polio virus had paralyzed him below the waist, ravaging the neurological circuitry as it ascended proximally from his feet, but due to the biases and cruelty of a generation of physicians before him, as well as the ones he found himself amongst when he finally started medical school at the age of 49.

The ignorance, cruelty, and lack of a sentient purpose allowed the polio virus he came in contact with as a child to rob him of his ability to walk.

The ignorance, cruelty, and lack of a sentient purpose of innumerable medical professionals, who are in many ways tasked with caring for society, had nearly robbed William of his ability to become a Family Medicine physician.


 

As I became engorged with our discussion about medicine, life, purpose, and the future, the pieces of William’s life I had heard before from my brother coalesced: family physician, paralyzed by polio, competes in triathalon’s in his wheelchair, lives in Singapore.

Truthfully, those four things are a staggering amount of information from which to re-create a person’s life story. Obviously, there are layers beyond layers of things which construct an existence, but those are four things with quite a robust amount of detail on which to base a 3-hour dinner.

But the ignorance and cruelty which nearly kept William from becoming a physician is one of the more memorable things we ended up discussing.

Though William never directly used the word, prejudice is sometimes hard to put a finger on, as it can be subtle; it does not have to be right up in your face.

William’s experience of applying to medical school 21 times in his home country before being finally admitted in a country outside of his own, demonstrated that prejudice can be subtle, and only when someone decides to make it blatant, will all of the subtle occurrences from the past begin to take their proper context.

Despite having studied as a young man at two of the most prestigious American universities after completing undergraduate work in Singapore, and then working as a neuroscientist for years, when he finally received acceptance to medical school in Australia, he heard things like, “you are taking up a spot” or “how can you assist in surgery?”

Never one to give up, those comments only caused him to prove himself and his capabilities to those with whom he was training, as well as those meant to be training him.

I can imagine after working so hard to become a medical doctor in his home country, and being rejected despite his obviously robust academic achievements, it became clear in those moments that polio may not have paralyzed his lungs, but it quite nearly prevented him from taking a breath as a physician.


 

William described this past year, his first as a family physician, as “a calling”. He had been working as what amounts to an intern in an Oncology unit, caring for cancer-stricken countrymen, for the past five years while he applied for Residency in Singapore. He hoped to become an Oncologist himself.

But again, likely due to his paralysis and age, he had been passed over every year; in all honesty, based on my own experiences, I doubt the process would have been any more favorable and the prejudice any less obvious if he had been in the US.

Yet, William beamed with joy in describing the relationships he had built in the last year as a Family physician; something he had inadvertently become, as his belief that he would become an Oncologist as he neared 60 caused him to reconsider his professional options.

And he was intrigued to hear about my own training as a Family physician, sharing our bond as guardians of our patients, from the cradle to the grave.


 

As he wheeled himself around the heart of Singapore after dinner, he and Stephanie pointing out places I should visit during my stay, we were reminded some parts of our world had not adapted to him.

There were literal barriers preventing a non-ambulatory man from getting to certain physical locations, which I had first witnessed by him needing to take a subterranian entrance to the skyscraper we had dinner because there was no ramp for him to climb in his wheelchair that reached the above-ground entrance.

Fittingly though, for a man whom I have come to learn is a national hero, he was no longer bound by those barriers, as he simply found another way.

Quite the example from which his patients and colleagues to learn.

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