The Catholic Medical Guild of Singapore

“who are you, where am i?” Posted on 12th Oct 2014, 11:12pm by admin

Mr E asks the above on a daily basis and very often more than 3x/day. I never understood what the word perplexed meant when I saw my colleagues in psychiatry writing it down as part of the examination of a patient – but after the last three months, I finally did.


They wake up truly confused. The look of bewilderment every morning meant they understood what was happening but had no control over the sequence of events that was happening. Can u imagine, waking up everyday not knowing where you are, who are the strange people around you and worst comes to worst, can’t even remember your own name?

Dementia is an awfully cruel disease, and there is no cure.

It robs a person their identity, self-worth and everything that makes a person, whole.

The hardest is when one has insight:

“dr, i never meant to spit at you, i am sorry, but my brain is no good, i don’t know why i do things, i don’t mean to do”, Mdm C says, tears brimming in her eyes, and I for once, am lost for words to say.

I was in church the other day reflecting on the patient’s that I have crossed paths with, and I came to a realisation on the many beautiful events that my eyes have been allowed to witness throughout these 3 months.

The filial son who comes daily to feed his father even though his father no longer remembers him.

The dutiful wife who loves her husband despite him not remembering her name and continues to love him even though he has become a totally different individual.

The nurses who dedicate their lives in caring for these patients with utmost patience, they get bitten, slapped and spit at and yet they try again and again to care for them.

Then those who recover from delirium, those who come in kicking screaming and once the precipitating factor is treated, become a whole new gentle human being, one patient of mine became so polite, I was pleasantly surprised the next day: “pardon me dr, what were you saying?”

The disease may be cruel. Despite all that, there is much beauty that comes out from it. The medical books never teach you this aspect of dementia, always going through methodically – epidemiology, pathophysiology, presentation, diagnosis, treatment, but never has it, or can it, tell you the reality of it – how a trained engineer slowly loses one’s mind, grasping so hard at all the memories that are fleeting. This patient of mine, writes and writes, everything that happens he writes it down because he knows he cannot remember even though he so badly wants to. It is very sad because I have come to realise during his stay in the hospital, he can no longer read what he writes because he has forgotten he has written them and it is out of habit which he asks me for his pen and paper.

I have come across many difficult moments in my short career as a junior staff, but the hardest for me to this date was telling a wife that it was no longer possible for her to care for her husband, and that it is dangerous for him to go home. She is weighing in at around 40kg, compared to her husband of 60kg, who has severe Alzheimer’s with BPSD, he unknowingly hurts her and hurts himself, posing a great danger if left alone at home with this small aunty.

These three months have been tough both physically and emotionally, but it has taught me what love is, and brought out in me this great deal of patience and understanding that I never knew I was capable of. This is alas the tip of an iceberg, hopefully one day we will have a cure for this disease but till then we can only pray that those stricken with this disease cross paths with people who have enough grace to love them and extend to them the patience that is needed to get through life here.

Towards the end of his stay, one fine day, Mr E looked up from his papers, there was recognition in his eyes and he called me by my name, for that brief moment, I saw him as a person he used to be and truly, it has been a long time since I felt that way, that the hours spent orienting him TDS, was worth it all.

May God grant them peace in their hearts and in the hearts of their families. Thank you for all that you have taught me.

~ by Dr Jennifer Guan

One Comment

  1. Dr Eileen Tham Wai Fong says:

    God bless our medical system in Singapore.

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2015 Jul: May You Rest in Peace
2015 Jan: Happy New Year 2015

2014 Dec: A Prayer for Deliverance 2
2014 Oct: Who are you, Where am I?
2014 Sep: A Prayer for Deliverance
2014 May: Behind Those Clothes
2014 Feb: The Red Packet(s)
2014 Jan: God Loves You

2013 Dec: Caroling Reflections of an Expired M
2013 Nov: Scripture Reflection for Physicians
2013 Oct: Hang on. We haven’t beat this thing yet.
2013 Sep: Me and My Ride
2013 Aug: A Gift of Life
2013 Jul: Finding Happiness in a Land of Plenty
2013 Jun: A Beeline
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2013 Apr: The Healthcare Debate
2013 Mar: A Doctor’s Prayer
2013 Feb: Project Battambang ’12
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2012 Dec: The Lost Art Of…
2012 Nov: Rome Sweet Home – Short Reflections
2012 Sep: He Keeps Falling
2012 Aug: God Decides
2012 July: Am I To Blame?
2012 June: Saving Fragile Lives
2012 May: Ruminations On Love
2012 Mar: The iPhone

2011 Dec: The Red Cross
2011 Nov: Give Thanks!
2011 Aug: Ashes – The Epilogue
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2011 May: Notes From Salzburg On Good Friday
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2011 Feb: Clothes, A Person Doth Maketh
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2010 Dec: A White Christmas
2010 Dec: A Medical Christmas Carol
2010 Nov: Saying Goodbye
2010 Oct: I Am Always With You
2010 Sept: Be Joyful Always
2010 July: Managing Expectations
2010 June: But They Are Our Masters…
2010 June: Driving: A Means of Personal Formation?
2010 May: HO Welcome Tea
2010 May: The Rain
2010 May: A Missed Lunch
2010 May: Man In The Mirror
2010 May: Reflections At The End Of The Day
2010 Apr: Finding God In All Things
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2009 Nov: Batam: Beyond A Mission
2009 Oct: The Broken Rosary
2009 Sept: Love Note To God, Father
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2009 Aug: The Prequel: The One About Graduation
2009 July: The Sequel: The Later Months
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2009 May: “The House of God” by Samuel Shem
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