Artisan of Medicine
Exclusive Interview and Cover Story of Dr Melvin Look, founder of Panasia Surgery Pte Ltd– February edition 2016
For somebody who claimed he didn’t have a calling to become a doctor, Dr Melvin Look – general surgeon at PanAsia Surgery Group specialising in onco-surgery and gastro-oesophageal cancers is doing a great job at being one. After working in Tan Tock Seng Hospital for 10 years, he went into private practice in 2004, hoping that he had imparted some important skills to the next generation of surgeons. His last 12 years in private practice has been equally rewarding have now built up a multi-specialty surgical group practice with experts in the whole spectrum of keyhole surgery all working together, and we hope to increase our size and reach in the next few years.
For Dr Look, taking up medicine wasn’t a conscious decision. His father was a General Practitioner and his mother was a nursing officer. “I grew up around medical talk and drifted towards opting for medical school at the National University of Singapore. He still remembered how he was in Officer Cadet School doing his National Service when he learned about the acceptance at NUS. “It was a no-brainer choosing disruption from National Service to start medical studies over digging trenches in the mud,” he laughs. But choosing to be a surgeon was an easy decision for the boyish surgeon.
“Treating patients with lifelong medication did not appeal to me. I would much rather be a Mr Fix-it that can cure a patient with his craft” During his housemanship in surgery and gynaecology postings, Dr Look discovered he was good with his hands, and enjoyed every opportunity to run to the operation theatre to assist the surgeons.
“There were so many new skills to learn and practice, which l did diligently every night on my own with whatever instruments and sutures I could get my hands on. Every new operation that I assisted and learnt was like an achievement unlocked!”
Interest in gastrointestinal surgery
After obtaining his Fellowship in General Surgery, Dr Look decided to further sub-specialise in Gastrointestinal Surgery. “The oesophagus and the stomach have intricate and complex anatomies. Surgery in these areas can be challenging and difficult, but rewarding if you get it right. Even after all these years l still come across new problems to tackle, or old problems to tackle in a newer and better way, he shares. One example, he explains, is in using endoscopy and laparoscopic surgery to improve outcomes by having only keyhole incisions or no incisions at all.Our gadgets and instruments are getting better all the time, and we can use these tools to treat not only cancers but also benign diseases and functional problems of the stomach, such as gastroesophageal reflux and obesity.
It was during the years he spent in subspecialty training that he considered to be the important milestones of his career. “I feel [those times] best define me as a surgeon, Dr Look shares. His interests lie in stomach and oesophageal cancer surgery, so in 1997 he spent a year at the National Cancer Centre Hospital in Tokyo on a Ministry of Health training scholarship. “The results of treating gastric cancer is far better in Japan compared to western countries.
The main difference is in the type of extensive surgery that they do that not only remove the stomach but also the surrounding lymph nodes that contain cancer spread, he explains. He was impressed by the Japanese’s purist approach to the careful dissection of anatomy and radical extirpation of cancer tissue. Dr Look also spent a year at the Royal Infirmary of Edinburgh in 2000 to learn laparoscopic surgery for the stomach to treat conditions such as gastroesophageal reflux. “It was around this time that advanced laparoscopic surgery was beginning to be used for treating a whole spectrum of abdominal conditions, and this opened up a whole new world for me In 2001, he also went on aTTSH scholarship to train in Laparoscopic obesity and Metabolic Surgery at the Mount Sinai Medical Center in New York, and another two months at the Washington Cancer Institute on a Union Internationale Control Cancer Fellowship to learn Cytoreductive surgery with Heated Intraoperative Intraperitoneal Chemotherapy for the treatment of peritoneal cancers.
As most medical practitioners, the hardest part of being a surgeon is the long and arduous road to learning how to do the right operation for the right patient. “The working hours and patient load we had during my early training years were tremendous shares Dr Look. “We hardly rested in between work hours, study time, and the very frequent night shifts There was no such thing as ‘protected hours’ for trainees in those days.
He remembers being overworked all the time, but says it was a happy kind of exhaustion for any budding surgeon. “It meant that we had many patients to hone our skills and we were ‘hands-on’ right from the start of our training career, moving on to more difficult cases at a far earlier stage than what trainees can do nowadays.
Dr Look sees himself as an artisan, with a daily challenge to do the same operation as simply and as perfectly as possible, over and over again. “I take great inspiration from the late Sam Maloof, who, despite being universally lauded as an influential pioneer of contemporary furniture design, considered himself as just a woodworker. When he had the chance to meet Maloof in 2001, the artist was already 85 years old but tremendously fit. “He moved and spoke with vigour and was still crafting his famed rocking chairs by hand with simple tools, and yet finding the perfect balance point for each individual piece of wood” Dr Look keeps a modern rocker in his clinic as an homage to the artists’ philosophy and humility.
Another big challenge for an onco-surgeon is curing the cancer itself. “Cancer is a deadly foe, but I would say that medical science has advanced so much that we can often offer a very reasonable chance of doing so, with good surgery combined with chemotherapy and sometimes radiotherapy, enthuses the good doctor.
Developments for Cancer Cure
Speaking of the deadly disease, Dr Look believes that the best development towards curing cancer is diagnosing and treating it at an early stage. “We are beginning to spend more efforts in this direction. Screening for digestive cancers with gastroscopy and colonoscopy is both simple and accurate” He explains that the majority of stomach cancers is caused by a bacterium in the stomach called Helicobacter pylori. Detection and eradication of this can potentially prevent stomach cancers.
“Likewise, 90% or so of colorectal cancers start as precancerous polyps which grow slowly in the colon for many years before turning malignant. Screening colonoscopy can potentially prevent colon cancers by removing these polyps before they become cancerous.
Dr Look spends a good part of each day doing endoscopy, but he says these procedures are usually for patients who have symptoms such as abdominal pain, bloating or change in bowel habits. “I would like to see more asymptomatic individuals coming forward for screening endoscopy. This can happen with better awareness and I hope to promote this by organising more public symposiums and increasing media publicity.
Achieving work-life balance
Lucky enough to have a wife who is in the same field and understands his long and irregular hours, Dr Look makes an effort to achieve balance between his work and family life. “My son is a Secondary 1 student in my Alma Mater St Patrick’s School, and I drop him off to school every school morning before heading to one of the hospitals for rounds.In between rounds at Mount Elizabeth, Mount Elizabeth Novena and Parkway East Hospitals, a couple of endoscopies in the morning, followed by clinics and minor surgeries, and major operations in the evenings, Dr. Look often gets called back at night or even on weekends for emergencies. “We take these unpredictable schedules in stride and plan our family life around such irregular hours. Family holidays are the only times I can truly get away, and we try to do that every few months to refresh and recharge.
Despite his busy schedules at work, however, Dr. Look still to pursue other passions. “I do enjoy music, both listening and playing mostly nonsense on the keyboards and guitars, as well as poetry (both reading and writing), he shares. A football fan and a lifelong supporter of Birmingham City, Dr. Look also plays futsal with friends on Friday nights and occasionally takes his longboard out for a skate. “But not often enough.” he laughs. “I definitely need to exercise more to lose some weight, because that’s what I tell a my patients to do.”
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