A Passion for Elderly Care: Coffee Break with Dr Chen, Consultant Geriatrician
31 July 2024
Geriatric medicine, a specialised field dedicated to the care of elderly individuals, often flies under the radar in the broader medical community. It’s a niche area that demands not only deep medical knowledge but also profound compassion and patience. For Dr Chen San San, Consultant Geriatrician of Sunway Medical Centre, Sunway City, this field is not just a profession but compassion. As a dedicated consultant geriatrician, her mission is to provide the best possible quality of life for her elderly patients.
With a prestigious background, Dr Chen graduated from the University of Glasgow and completed her specialty training in general internal medicine and geriatric medicine in the northwest region of England. After obtaining her Certificate of Completion of Training (General Internal Medicine and Geriatric Medicine) in the UK in 2019, she did her housemanship and worked in the UK before returning to Malaysia to be closer to her ageing parents after spending 17 years abroad.
Adapting to the Malaysian Culture
Dr Chen’s return to Malaysia has presented unique challenges, particularly in navigating the language barrier and adapting to local medical practices. “In the UK, everyone speaks English, but here, it’s multilingual,” she explains. “Even within Mandarin, there are different dialects, which complicates explaining medical concepts.” Dr Chen finds herself frequently switching between Mandarin, various dialects, and English to ensure effective communication with patients and their families.
Dr Chen also mentions her efforts to reconnect with various languages and dialects she had learned in the past. “I can speak all three languages, but it’s been a while, so I have to re-practice,” she says. She is now working to refresh her skills in Mandarin, various Chinese dialects, and Malay to better engage with her diverse patient population.
Adjusting to prescribing medicine in Malaysia is also foreign for Dr. Chen. In the UK, she was accustomed to prescribing generic names, but Malaysia’s medical system often relies on brand names. “I know Panadol is paracetamol, but I had to get used to brand names and their corresponding generic names here,” she notes. This adjustment has required Dr Chen to familiarise herself with local brand names and their equivalents to provide accurate prescriptions.
Despite these initial hurdles, Dr Chen views this transition period with a positive outlook. “It’s a learning curve, but I’m confident that I’ll be able to navigate it soon,” she says.
Embracing the Complexity of Elderly Care
One of the most fulfilling aspects of Dr. Chen’s role as a geriatrician specialist is the opportunity to meet and connect with elderly patients. “I enjoy talking to older people because they are full of experience and can inspire me,” she says. The depth of their life stories and the wisdom they share are not only enriching but also deeply motivating for her.
Geriatric care, she notes, is uniquely intricate and demands a multifaceted approach. Unlike younger patients, who might present with clear and specific symptoms, older patients often require a more investigative approach. “I think of us geriatricians as detectives because older patients might not present with specific symptoms, so I have to investigate the underlying causes, which can be quite complex. It also involves understanding each patient’s unique functional baseline so that I can tailor individualised treatment plans for them,” she explains.
Navigating Emotional Challenges
Dr. Chen acknowledges the emotional toll of this aspect of her work. The challenge of balancing empathy with professional detachment is particularly evident in cases involving advanced stages of diseases. “When a patient is in the palliative care stage, it’s important to offer support and comfort while also making sure that I’m not too emotionally involved to the point where it affects my decision-making,” she explains.
Dr Chen’s approach also includes seeking support from colleagues and finding ways to manage the emotional demands of her role. “Having a good team of supportive friends and colleagues is essential,” she notes. She also emphasises the importance of engaging in activities outside of medicine to recharge and maintain her emotional well-being. “I need to find something away from medicine to clear my mind and recharge, so I can return to work with renewed focus and energy,” she says.
A Beacon of Hope
One particularly rewarding case involved a patient with delirium, a serious condition that causes confusion and agitation. “We had an elderly patient who came in with acute kidney failure, a chest infection, and a minor heart attack. They also developed delirium, which made them extremely agitated and combative,” Dr Chen recalls. “It was a challenging case, but with the support of the team and targeted treatment, we managed to stabilise the patient.”
Her approach to managing delirium involved a comprehensive strategy, including addressing reversible causes and providing cognitive stimulation. “We had to identify the underlying issues, such as infections or dehydration, and treat them accordingly,” she explains. “We also used medications and occupational therapy to help calm and engage the patient.”
The success of this case was particularly moving. “Seeing the patient, whom we initially feared we might lose, gradually recover and express a desire to see the sunlight again was incredibly rewarding. That motivated me to continuously do better as a doctor,” Dr Chen shares.
Advice to the Next Generation
Reflecting on her career, Dr Chen emphasises the need for humility and continuous learning. “I don't know everything, and I recognise that. It's important to stay humble and acknowledge my limitations. If there's something I know, I'll address it. If I don't, I'll make an effort to learn and understand it,” she advises. This shows her journey as a geriatrician is a testament to dedication and perseverance in a challenging yet rewarding field.
Her advice for those considering a career in medicine is straightforward: “Be consistent and persistent. This career can be challenging, but with dedication, it is incredibly rewarding.”
We extend our heartfelt thanks to Dr. Chen for her invaluable contributions to geriatric care and her unwavering dedication to enhancing the quality of life for elderly patients.
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