“Two roads diverged in a wood and I took the one less travelled by, and that has made all the difference.”
These words from famous American poet Robert Frost are clear reflection of the life of cardiologist Dr Low Lip Ping. For 50 years and counting, from founding member to Chairman Emeritus, Dr Low devoted much of his time as an active volunteer of the Singapore Heart Foundation (SHF), sacrificing family time. In commemoration of our Golden Jubilee, heartline speaks with Dr Low about his career and the rewarding moments he had from helming the Foundation.
SHF: Dr Low, how did your career as a doctor begin?
Dr Low: My father was a dispenser (pharmacist assistant) in the General Hospital and we lived in an apartment or flat in the staff quarters within the hospital campus, where I was born. You can say that I grew up in a hospital or medical environment. Additionally, it was common in the community at that time for parents to want their children to become doctors as the first choice for a career. I was of course happy to have done well in school and then in medical school as my parents had looked forward to having the first doctor in the family (and the Low clan!). I am also proud that my daughter and grandchildren have followed my footsteps.
Why did you choose cardiology?
I must confess that being a cardiologist was not my first option, in fact I was hoping to be a paediatrician! I had done 6 months of housemanship in paediatrics and found that I enjoyed dealing with children. But as a medical student under government bursary, I had to accept whatever posting the Ministry of Health had given me. In 1967, I was persuaded to take up a pilot research fellowship and was tasked to help run the first Coronary Care Unit (CCU) in Singapore and collect data on patients admitted with cardiovascular problems, particularly those with coronary heart disease. That was the start of my career in cardiology and I have no regrets as it proved to be an interesting and challenging discipline.
What were some of the memorable events in your career?
In the early days, the challenge of running what was then a new system of looking after patients with acute cardiovascular problems was both daunting and exciting. Nowadays we take for granted the various gadgets for monitoring and treating patients in intensive care units, but for us then it was learning from scratch how monitors, defibrillators, central venous lines, ECG recorders and respirators worked.
At the start of the CCU, I was assigned two young patients who had very slow heartbeats and were not responsive to medications. So, I decided to learn to insert pacing leads (special wires connected to a pacemaker to keep the heart beating). It was a new technology in Singapore then; I borrowed a new book on cardiac pacing from the medical library and read from cover to cover many times before I inserted the pacing leads into these two patients. The procedure was a success, but due to the short lifespan of these temporary wires which had to be removed after a while, both patients eventually died. After this experience, I decided to source for implantable “permanent” pacemakers that would last longer. With the help of the Singapore National Heart Association (the then-SHF), we were able to purchase an implantable cardiac pacemaker for my next patient. This was the start of the cardiac pacing programme in Singapore.
In June 1968, our first President of Singapore, Mr Yusof Ishak developed atrial flutter-fibrillation, a cardiac arrhythmia while he was in Australia. On return to Singapore, he was admitted to the Singapore Hospital. His doctors asked if I was prepared to use the defibrillator on President Ishak, as I had successfully used it to treat other patients with the same cardiac arrhythmia. I must say that this initially put me under a lot of stress as I could not imagine what the consequences of failure would be. But it was a request coming from all these senior physicians I knew I could not refuse.
I explained the procedure to the President and his wife. They appeared calm and this gave me some reassurance. When the moment came on 27 June 1968, I said a silent prayer. The two most senior anaesthetists administered a short acting anaesthetic. I administered a single shock of 100 joules. There was a short pause in the heartbeat… then relief as normal heart rhythm started! There were smiles all around. The patient was discharged after a few days. A year later the atrial flutter-fibrillation recurred, and I administered another DC shock successfully. Unfortunately, in Nov 1970, he died from cardiac and respiratory failure after developing shingles as he had underlying chronic lung disease related to heavy cigarette smoking in his younger days.
In an eulogy in parliament, then Prime Minister Lee Kuan Yew stated:
“During a sea voyage from Singapore to Australia in April 1968, the rhythm of his heartbeat was upset, and he had to be flown to Melbourne for treatment. We were grateful to the Australian Government, and the doctors and nurses in Melbourne who treated him. The prognosis of the Australian specialists was not encouraging. But, with skill and devotion, our doctors and nurses who took care of him, stretched what could have been a matter of a few months into 2½ years. Their professional competence made this possible………”
You have been with Singapore Heart Foundation for 50 years since its founding and was Chairman for 16 years. What were the changes that you have seen?
We moved from occupying a cubby hole in the Red Cross building, which had space for only one table, to a small office in the National Heart Centre with two tables and a cupboard, to the basement of the Institute of Health where we had space for significantly more tables but no windows. Now we occupy a whole floor in Bishan Junction 8. The expansion of hardware, while substantial, is only a minor aspect of our development. More important has been the reconfiguration of our “heart ware” which has 2 components viz. our mission and vision, and our programmes. From organising one day and one theme a year National Heart Weeks, SHF now runs programmes around the year and across the spectrum of the cardiovascular continuum.
In the 16 years of my chairmanship, SHF went through a long journey with several storms including increased accountability towards the public. We must constantly review our operational procedures with the help of the National Council of Social Services and other regulatory bodies to strengthen ourselves.
It is my great fortune to have received unstinting support from the Board of Directors, staff members, volunteers from our various programmes and our honorary advisors. I also have my wife and family to thank for being patient and understanding for the little time I have with them due to my involvement in the Foundation. It has been a long but rewarding journey at the helm of SHF.
Reducing the burden of cardiovascular disease requires the co-operation of many individuals and disciplines, not just the contribution of cardiologists. Whether my grandchildren become cardiologists or not I would still encourage them to participate in and support the work of the Singapore Heart Foundation, in whatever role they find challenging and rewarding.
SHF has made many achievements in its 50 years. Which milestone left an impression or is the most significant to you?
SHF should be congratulated on all records. I think the most significant in terms of the benefit are the 2011 and 2012 National Life Saving Day. SHF has an important role in promoting heart health in Singapore. It needs to constantly review its work to ensure that it abides by its mission statements and that it keeps on improving on what it does.