Scaling beyond life's limit

Askmelah's Note: while I applaud Dr Lee's conscientiousness and righteousness and her genuity in wanting to help Jacqueline Woo, I shudder to think some powerful politicians or tycoons will be able to influence decision makers much like what is happening in other third world countries. Every tool has its two-sided uses, like the gun if use by cops, it may save lives, else it may become a killing machine. Had Dr Lee not the daughter of Lee Kuan Yew, I am not sure if the MGS principal will be quick to say "sorry, we have to go by the book. Otherwise it will be unfair other students who have better grades." Dr Lee has not revealed more in this article the decision making process, but the right thing for any school or any public funded organisations such as hospitals when encountered such requests, should get the approval of the Board of Directors or independent third parties (e.g. School Parents Volunteer Committee) to consider such request on a transparent basis rather than let the poor principal or CEO to shoulder all the pressure from a real or perceived powerful person. A lesser integrity person will be easy to say yes to such request. Of course no system is perfect, but more transparency will reduce such possibility by a great deal and genuine request be granted, just like in the case of Jacqueline Woo.

 Souce: The Sunday Times  12 Mar 2012

Scaling beyond life’s limits – by Lee Wei Ling

Source: The Sunday Times  Mar 11, 2012

By Lee Wei Ling

Unable to walk, talk or write by hand, this determined A-level girl still scores three As

I first saw Jacqueline Woo Pei Ling – or Jac as her family and friends call her – when she was three years old. Her walking was strange. All the doctors were puzzled, including the late Professor Wong Hock Boon, the father of paediatric medicine in Singapore.

Over the years, it became obvious that Jac suffered from abnormal and very strong involuntary movements. These became progressively worse, until eventually she could no longer walk, write or talk.

Her difficulty in speaking is due to her inability to voluntarily control the muscles involved, especially those controlling the vocal cords. The muscles around her trunk have also been affected and, as a result, her body is twisted almost like a pretzel.

Jac’s parents have dedicated their lives to caring for her. When she was in primary school, her mother would go with her to school and stay throughout the school day so as to be able to wheel her around in her wheelchair.

Before she took her Primary School Leaving Examination (PSLE), Jac told me that she hoped to do well enough to be admitted to Methodist Girls School (MGS). But as it turned out, her score was not quite good enough. If she had been from MGS Primary, she would have got into MGS Secondary, but the bar was set higher for those who came from other primary schools.

I happened to know the principal of MGS, my mother’s old school, and so called her to explain Jac’s physical handicap as well as her determination and intelligence. MGS would be good for Jac, and Jac would be good for MGS, I pleaded. After considering the case carefully, the principal decided MGS should indeed take a chance on Jac.

The principal never regretted her decision, for Jac flourished in the school. Socially, she found a community who took her into their hearts. Academically, she did very well, with her O-level results gaining her admission to Anglo-Chinese Junior College (ACJC) with no difficulty.

I am very grateful to the students and staff at both MGS and ACJC for befriending Jac and taking care of her. Her school friends took turns pushing her around in her wheelchair and helping her in the toilet. This speaks well of their compassion and gives one confidence that Singapore’s young will be conscious of their responsibilities to society as a whole.

Jac has always studied hard. She invariably completes her assignments on time and keeps up with her assigned readings. She e-mails or texts her teachers if she has questions, for she can hardly speak to them. She would sacrifice her sleep when necessary to complete her homework or study for tests and exams.

This determination and diligence always stood her in good stead, most recently in the A-level exams. Jac scored three As – for history, literature and Chinese, three subjects notoriously difficult to ace.

These are excellent results by any measure – and remarkable if one took into account her disability, which among other things, makes typing a slow and tedious process.

Jac is unable to write by hand and so has to type her answers on a laptop. As she is unable to sit up, she has to do this lying on her stomach, on a couch, with her upper body propped up on her elbows so she can type. Her typing is further impeded by the fact that her left hand is appreciably weaker than her right.

Because she is so severely handicapped, Jac was granted extra time in the examinations – 75 per cent more time for all subjects except mathematics, for which she was granted 100 per cent extra time. So she was given five hours and 15 minutes to complete each of her humanities papers, compared with normal students who had three hours, and six hours for mathematics.

On one day, she had two papers – mathematics and history. That day, her examinations lasted a total of 11 hours and 15 minutes, with just an hour’s break between the two papers.

She refused to take toilet breaks during any of her papers, though her mother waited outside the exam hall just in case.

Jac’s A-level results are good enough to win her a place in any Singapore university, but I am not sure where she will go.

The National University of Singapore, especially its Faculty of Arts and Social Sciences, is full of hills and staircases, and I don’t know if Jac will be able to navigate her way around the campus easily. Nanyang Technological University is a very long way from her home, and she would not be able to cope on her own if she had to stay in a hostel. Singapore Management University emphasises participation, and Jac cannot take part in discussions because she can hardly speak.

I am certain Jac will find a suitable university – and that each will try its best to accommodate her presence, as did MGS and ACJC. But these considerations underline how Jac, unlike normal students, cannot take anything for granted. Every step for her is a hurdle, every trip a perilous expedition.

Jac has been under my care for many years now, but I cannot cure her. All I can do is prescribe muscle relaxants to reduce the pain her powerful involuntary movements cause her. Brain surgery has a 50 per cent chance of improving her physical condition, but that means there is a 50 per cent chance the operation will not do her any good.

Still, I am cautiously optimistic about her future. She has already shown that she has a strong will to succeed despite her physical handicap. Her determination and resilience will help her overcome many obstacles. In addition, medical science is advancing rapidly, and a cure for her condition may be possible in the near future.

But whatever happens, Jac cannot and will not be disheartened. Life goes on, and she will be prepared to face whatever life deals her, just as all of us must.

Jac is the purest expression I know of a spirit that always triumphs over adversity, even the most dire. I am her doctor and she’s my patient, but I always feel humbled in her presence.

Close friends from all walks of life

Vital traits I look for in friends are empathy and compassion, not social status or wealth

By Lee Wei Ling


I am a member of a family that is perceived by many Singaporeans to be the most influential on this tiny island. As a result, I am always a little apprehensive when I first get to know someone new.

Those who know my family background may hesitate to show their true selves to me. Hence, I usually make an extra effort to assess each new person I have to interact with. My gut feeling or sixth sense of the truth behind the facade has often proven accurate, though I never act on gut feelings alone.

I observe the person's behaviour to determine if my sixth sense is right or wrong. If I know of others who are acquainted with this person, I ask their opinions of him.

I have friends in different strata of society and, often, my friends are people whom others among my acquaintances would not suspect me to be associated with. If a trusted friend gave me feedback about a particular person that does not coincide with my own perceptions, then I become sceptical of my own gut instincts.

I categorise people I know into enemies, acquaintances, friends, close friends and comrades. This is admittedly a rough and perhaps simplistic way of classifying people, but it serves my purpose.

People whom I consider to be evil, I classify as enemies, though they may not have crossed swords with me personally. If they have coerced, bullied or harmed someone innocent, I will try to right the wrong whether or not the victim is a personal friend of mine. Perhaps that is why some people think I am aggressive.

Acquaintances are people whom I know but have little feelings for because I do not know them well enough. I am polite to them, though occasionally I forget and am brusque. My friends understand and take no offence, but those who don't know me may well think I am rude or arrogant. I'm slowly changing in this respect but have to admit I often forget myself.

Friends are people I know fairly well and who I feel are good. Because I don't know them well enough, or don't have much interaction with them, they are not elevated to the category of 'close friends'.

Close friends are people whom I know well, and usually have considerable interactions with. They don't necessarily share the same values as I do.

An example is a classmate from medical school who is almost the exact opposite of me. She is feminine, good-looking and cares about her appearance. She is always elegantly attired, and is willing to spend a fair amount of money on her clothes and accessories. But she also cares deeply about people and is a competent and dedicated general practitioner. Empathy and compassion are important traits I look for among close friends, and on that score she passes with flying colours.

Social status or wealth is not a criterion I use to classify anyone as a close friend. For instance, my personal assistant (PA) is also a close friend of mine, though our social backgrounds are quite different.

There is a Chinese proverb that describes two contrasting kinds of friendship: Jun zi zhi jiao dan ru shui, xiao ren zhi jiao gan ruo li.

It means: 'The relationship between two honourable persons (jun zi) is as understated as water (dan ruo shui). The relationship between two petty persons (xiao ren) is as cloying as sweet wine (gan ruo li).'

Between my close friends and me there is no account book of favours given or received. When help is needed, we render help even without being asked.

My close friends come from all walks of society, and I treat them all as equals regardless of how society categorises them. My 20-odd close friends thus include doctors, civil servants who work or have worked for my father, friends I made when I was undergoing rehabilitation at the Singapore Sports Council, my PA and my parents' security officers.

Comrades are people who share my aspirations. While most of my comrades are also my close friends, not all my close friends are my comrades.

Most of my colleagues at the National Neuroscience Institute are my comrades. Our common aspiration is to do our best by each and every patient regardless of their ability to pay. Medicine among my comrades is a calling first - and a business a distant second.

The closest friendship I have ever observed is that between my father and my late mother. Since she passed away in October 2010, my father has carried on stoically, but I can almost always sense the sadness in him.

Finally, I would like to quote a Tamil poem that a close friend (and comrade) once taught me. It describes what happens to a person when he dies:

'My wife accompanies me to the main door. My friends go with me to the main street. My children accompany me to the cemetery. Who goes with me to the end?'

I guess the reason I remember this poem so well is that I do not even have a spouse or child to accompany me even part of the way. Of course, to an atheist, there is nothing beyond the end. Once I die, I no longer exist. I hope my family and friends will not feel sad when I depart permanently, though of course I do when any of my own close friends or comrades depart.

Water is the element of my close relationships and the ripples remain long after my close friends have gone.

Confessions of an embarrassed omnivore

Source: The Sunday Times  29 Jan 2012

Written by Lee Wei Ling

A few months ago, a colleague of mine urged me to attend an event at Speakers’ Corner to protest against the cruelty of exhibiting dolphins at Resorts World Sentosa.

I have read extensively about dolphins in captivity, and have no doubt that that is cruel. But dolphins are also ‘celebrity’ animals. At every moment of the day, there are countless ‘non-celebrity’ animals around the world being subjected to cruel treatment without anybody protesting. What makes dolphins more worthy of our sympathy than cows, sheep or chickens (animals we eat) or crocodiles and minks (animals we skin)?

In 1995, when I was learning to use MRI (magnetic resonance imaging) to study which part of our brain controls which part of our body, and how we generate thoughts, I visited Beth Israel Hospital in Boston. There, I met a psychologist who was a Jew - and, to my surprise, a vegetarian as well.

At meals, he avoided beef, chicken, pork and fish, but strangely enough, not scallops. I knew observant Jews did not eat scallops, for they were not considered kosher. I asked him why, though he was a vegetarian, he ate scallops. He did not give me a satisfactory answer.

So I named a number of animals, asking him in turn what he would eat and what he would not. It was soon obvious that he would eat animals he had no empathy for. It is certainly difficult to feel empathy for scallops, so he had no qualms eating them.

A free-living scallop, though, swims by rapidly opening and closing its shell - a method of locomotion that is also a defensive technique, protecting it from threatening predators. That suggests scallops are capable of feeling distress. And yet the Jewish psychologist felt no empathy for them. Unlike dolphins, scallops are not cute.

Most Singaporeans eat meat. But how many among us are aware of the cruel conditions in which the animals destined for our consumption are reared or slaughtered?

Hens reared for their eggs are usually kept in very cramped battery cages and are beak trimmed, all of which makes their life an awful misery.

There are rules as to how animals are to be slaughtered in all First World countries. The aim is to kill the animal in such a way as to cause minimal suffering. This is often done by electrical stunning, after which the animal is bled. But stunning does not always eliminate suffering for the animal.

To begin with, the stunning may not have been properly performed, in which case the animal would still feel pain as it is cut up.

Also, the other animals waiting to be slaughtered become terrified, for they can smell the ‘fear pheromone’ secreted by the agitated and frightened animals as they are killed.

Interestingly, when it comes to laboratory animals like rodents, it is mandatory to euthanise them in separate rooms so as to minimise the distress other animals nearby might feel.

Many people protest against the cruelty laboratory animals are subjected to in the interest of medical science. But don’t the abattoir and the meat trade inflict greater cruelty on animals?

In 2008-09, Resorts World Sentosa purchased 27 wild-caught dolphins from the Solomon Islands. In 2010, two of the dolphins died.

It is undoubtedly cruel to keep dolphins in captivity. But to return captive dolphins to the wild, without first training them in survival tactics, would expose them to dangers.

Dolphins kept in captivity for some time would no longer know how to fend for themselves in the wild. They can be attacked by sharks, or become entangled in the massive amount of rubbish that humans dump in the ocean.

Now that the 25 dolphins at Resorts World Sentosa have been in captivity for so long, releasing them into the wild would not be a good idea. If the dolphins can bring Singapore tourist dollars, I am not entirely sure we should release them.

Recently, sharks have also received much sympathy, with the consumption of shark’s fins in particular being condemned by some. Animal welfare groups oppose finning on moral grounds and also because it is a major cause of the rapid decline of the global shark population, they argue. I object to finning because of the suffering experienced by sharks whose fins have been removed.

I confess I might appear hypocritical; condemning cruelty to animals and yet still eating meat. It is possible but difficult to have a balanced diet as a vegan - which means not just omitting meat but also all animal products, including eggs and milk, from one’s diet.

I have tried a diet free of meat and eggs, with milk and soya products as my source of protein. I can manage such a diet for a few days but I do not find it particularly palatable.

So I remain an embarrassed omnivore who tries to minimise unnecessary suffering to animals where possible. And I dream of a future when we can grow meat and even body organs in cell culture so that our dietary as well as medical needs can be met without subjecting any sentient organisms to pain.

Flood woes: A balancing act

[Askmelah's note: While I do have very high respect for Dr Lee, She is wrong this time round. With the benefit of hindsight, the Jul 2010 flood is not a "one in 20 or 30 (or 50?) year event", we have three floods in Orchard Road in the space of less than 2 years. Can't blame her, engineering is not her area of expertise, neither is it the expertise of ex-PM. Sorry to see him having to defend for the PUB engineers which backfires on him. Flooding was acceptable in the 60s when we were still in the third world era, the situation is very different now with our per capita income surpasses many first world countries especially when you are paying the highest pay to both the Ministers and the Civil Servants, you are expecting them to deliver rather than coming up with excuses.]

Government decision to balance drainage with roads and other land uses makes sense
Lee Wei Ling

Source : The Sunday Times 27 Mar 11;

This is already the end of March. The north-east monsoon should have ended. Yet I was awakened by torrential rain at 6am on a recent morning.

After a few minutes, I decided to go back to sleep and chase my dream. This was a technique I had developed myself. I found that if I could get back into the dream that I had woken up from, I could fall asleep again.

So I mentally went over my dream and indeed fell asleep, and the dream continued.

In my dream - which consisted more of recollection of my actual past rather than dreams - my bro-ther Hsien Yang and I were still pupils at Nanyang Primary School. To get to school, we were driven along Bukit Timah Road, which of course was next to the Bukit Timah canal.

In those days, the canal was much narrower than it is now, so whenever there was heavy rain, Bukit Timah Road tended to get flooded. If the heavy rain occurred at the same time as a high tide, flooding was certain.

Near Nanyang Primary in the 1960s were attap houses. The boys from the kampung would wade through the dirty flood water and offer to push stalled cars for a fee.

Readers under 30 years old would probably have never seen these attap houses for they stood on what is now prime land. Property prices near Nanyang Primary have gone up stupendously since the 1960s. Many ambitious parents move to be within 1km of Nanyang Primary to ensure that their children have a good chance of getting into the school.

Yang and I were in a car along Bukit Timah Road trapped in the flood. Our older brother Hsien Loong was attending Catholic High School and so was not around to chastise us.

Our car stalled because water had got into its engine. The canal had overflowed and one could not tell where the canal ended and where the road began.

It is amazing how daring one was before fear robbed us of the fun of childhood. Yang and I got out of the car, ignoring our driver's protests and tried to push the car. But we were too small and did not have enough strength to move the car. So, bashfully, we got back into the car, wet and muddy. Then three big boys came along to push our car in exchange for a fee.

Then I woke up and peered out of my window. It was too dark to see the rain, but the sound of heavy rain confirmed I hadn't just dreamt about it.

Now awake, I recalled clearly those days when Singapore flooded often. After the car was pushed to where the road was dry, the driver would open the bonnet, and remove the five cables attached to the distributor cap and dry them all with emery paper. I can remember this technical detail because the five cables attached to the cap were nicknamed sotong, which means cuttlefish in Malay.

We would eventually get to school, but less than half the pupils would have made it. So we would be told to go home.

Going home promised more fun. We would fold paper boats and place them in the drain which flowed away from our house. Now much older and a little wiser, I wonder whether the paper boats would have added to the obstructions in the drain further on.

Last year, we had exceptionally heavy rainfall over a very short period of time. Many roads which had never flooded before flooded. Some houses and shops were damaged. There was much complaining among those who were concerned about the losses they incurred.

My father Minister Mentor Lee Kuan Yew explained recently the Government's thinking on flood control:

To guard against a super-heavy rainfall that would occur once every 20 to 30 years, we would have to build more and bigger drains. But no amount of engineering can prevent floods. Also more and bigger drains would mean less space for roads. As it is, even the high cost of cars has not dissuaded people from wanting cars.

I don't always agree with the Government, but in this case, I do: It is better to have drains capable of coping with the usual rainfall, rather than invest in a system that can cope with the giant floods that occur only once every 20 to 30 years.

According to the PUB, there are currently 32 rivers and more than 7,000km of drains and canals in Singapore. They are part of PUB's flood management approach, which also involves:

Providing adequate drainage ahead of new developments;

Raising road and building levels, and getting building owners to implement flood protection measures; and

Making continual drainage improvement in areas affected by floods.

As a result of investing some $2 billion over the past 30 years in an extensive drainage system, our flood-prone areas have been significantly reduced by 98 per cent - from over 3,000ha in the 1970s to 56ha today. Singapore has achieved this despite increased urbanisation, which would usually have resulted in more floods. The flash floods that still occur tend to be localised affairs that subside within an hour.

Every decision comes with an opportunity cost. The wisest decision is one that minimises this cost. The public needs to understand the Government's logic. Unfortunately, grumbling is our favourite pastime.

Comfortable with the face I've earned

No purpose served in being attached to one's looks; instead, being able to let go helps ease suffering

Source: The Sunday Times  Dec 4, 2011

By Lee Wei Ling

I had had a busy week so I decided to relax and scan the Lifestyle section of The Sunday Times. The photograph of a man and a pretty woman holding a string to which many mussels were attached caught my attention.

The man in the story, a Mr Lim, aged 45, managed to earn a living growing mussels after some trial and error. It was a hard life. Partly in jest, he told the reporter: 'I have already lost my youth. When I started at 31, I was so handsome but now I look old and I have lost at least 12kg.'

In the photograph, his face looks tanned and gaunt. He seems 20 years older than his pretty 32-year-old wife.

Background story

I have put on 20lb (9kg) as instructed by my doctor. But my face is more angular and gaunt and I have prominent eye bags. In the 2001 photograph, I could easily have passed for a teenage boy. Now I look my age, or older than my age.

I have said in this column before that I myself am aesthetically challenged, and I meant it in all honesty. But there was a time when I looked reasonably attractive - average, I would say. The past 10 years, however, have been somewhat unkind to me, and my current appearance reflects the health difficulties I have had.

Recently, I needed to get a new passport photograph. When I compared the new photograph with the one I took in 2001, I realised how much my face had aged.

I have put on 20lb (9kg) as instructed by my doctor. But my face is more angular and gaunt and I have prominent eye bags. In the 2001 photograph, I could easily have passed for a teenage boy. Now I look my age, or older than my age. No matter how short I cut my hair, I can no longer pass for a young androgynous teenager or man.

Some readers may wonder why I needed a new passport photograph to realise how much my face had changed for the worse. The answer is simple. I rarely spend time looking at myself in the mirror. My hair is short, so I comb it without looking at a mirror.

Comparing the photograph of myself aged 46 with a photograph of myself aged 56 - and verifying that the 'now' photograph was accurate by looking carefully at myself in a mirror - I felt a little sad for a while. Then my common sense was back in control.

Indeed, a few months ago, when I wrote about my graduation at the age of 23, I showed the photograph of myself in my graduation gown and mortar board to one of my friends. I asked him: 'Can you recognise me now from that photograph?' He knew I wanted a frank answer and replied: 'No.'

I knew my face had aged, but I did not realise how much I had aged. Still, I have no right to complain. That I am still alive and relatively healthy now is already a near miracle. Furthermore, I don't depend on my looks to earn a living.

When I scrutinise myself objectively in the mirror, I realise that the part of my face that has changed the most are my eyes. They are slanted and slit, closely resembling my father's eyes in his old age. The lower part of my face looks angular and gaunt despite my weight gain, for most of my extra weight consists of muscle.

Recently, at the World Orchid Conference, two women separately asked me if I was Dr Lee. I asked the first woman who questioned me how she had guessed, since no recent photograph of me had appeared in the press. 'You look like your father,' she said.

(Incidentally, I avoid photographs of myself in the press not because I look old and unattractive. Rather, it is because I want to preserve my privacy. I am the only member of my family who can walk down Orchard Road and not be readily recognised - which was why I was somewhat surprised I was recognised at the World Orchid Conference.)

I thought of the Chinese phrase nadechi, fangdexia, which means literally 'what you pick up, you should also be able to let go without clinging to it'. In a previous article, I had used this phrase in relation to an elegant glass ornament my mother had given me, and which I had accidentally broken. But the phrase applies not only to objects but also to fortune, fame, prestige, success, appearance, youth and many other things or attributes to which we are attached.

I have not yet developed the ability to be totally detached from life's vicissitudes, but I have learnt to remind myself that desire of and attachment to worldly things bring suffering. I have thus become fairly successful in curbing some of my attachments.

If I believed in reincarnation, then I would feel that I had many more lives to struggle through before I attained nirvana. But I don't believe in reincarnation, and I am convinced that I am a transient on this planet.

This means that if I don't want to suffer too much in this life, I must continually remind myself that while I should aspire to help other humans, I must also be willing to be detached when detachment is the only option.

I don't resent the misfortunes that fate has brought me. I accept them as lessons in life that only personal experience can teach. Indeed, I believe I am fortunate rather than unfortunate to have learnt these lessons.

And one small lesson I have learnt is that there is no purpose served in being attached to my face - or what used to be my face. George Orwell once wrote that after the age of 50, we all have the face we deserve. I, for one, am quite comfortable with the one I have earned.