Professor Arthur Lim – A Giant, Ahead of his Time
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Professor Arthur Lim,
Mrs Lim,
Friends,
Ladies and Gentlemen
1 I can honestly say friends because I can see many familiar faces, people who have been part of my life, and that of my ophthalmic colleagues here.
2 Donald has already given you a brief summary of Professor Lim’s multiple achievements. I don’t think I need to recite that. But I do want to beg your indulgence for me to have some license to ramble on about the lessons that I’ve learnt from Professor Lim over the years.
3 I decided to entitle my presentation today – “Arthur Lim – A Giant, Ahead of His Time”. Let me explain. In the usual scientific way, you’ve got to give your evidence – data to back up your hypothesis. So bear these words in mind – “A Giant, Ahead of his Time”.
4 And I have basically seven data points. The first – Arthur always had big dreams. For him, life isn’t about counting a few pennies, timid plans, or lowering your ambition in order to improve your chances of success. It’s always been about the big really difficult and massive challenges out there. So this ability to dream big, is one key attribute that I hope leaders in medicine as well as beyond never lose sight of. That’s how Singapore has been created, and that’s how all the institutions that Arthur has created – the NUH Department of Ophthalmology, SNEC and SERI – have come about. Big dreams.
5 But the second point is that it’s not enough to simply have big dreams. You know, there’s a difference between big dreams, and delusions of grandeur. I think doctors here understand this point Prof Lim was able to translate dreams into reality by his sheer force of personality, his great persuasiveness, and his ability to make things happen.
6 Let me give you an example. We all say he was asked or tasked by the Minister of Health at that time, I think was Mr Yeo Cheow Tong and the Permanent Secretary, Dr Kwa Soon Bee to start the NUS Department of Ophthalmology and SNEC. But actually knowing Professor Lim, I don’t think they tasked him. I think he persuaded them to ask him to create these institutions. It speaks to the power of his ability to persuade people that these big dreams are worth investing in – and to entrust him with the resources and the responsibility to get it done.
7 And that brings me to the third point – that even if you have big dreams and even if you are able to persuade or convince or con someone to share this dream with you – you need to lead and make it happen in a real and practical way. This goes far beyond putting up buildings or raising funds,. It is really about persuading a critical mass of people to follow you and to make it happen in reality.
8 So the third point I’ve learnt from him is the need to have moral authority. In other words, it is not just about legislation or policy or grants, but that all of us feel the need to follow someone because he appeals to this innate desire in all of us to do something worthwhile, something bigger and larger than ourselves. That’s where moral authority comes in.
9 When Professor Lim wanted to start an eye department or an eye centre, or a research institute, he put his name on the line. Not because he wanted to see the Arthur Lim Professorship in Ophthalmology or name SNEC after himself but he put his reputation on the line and therefore, whether you’re a Minister or a Permanent Secretary, you’ll say “okay I’ll let you run with this” because you are the one putting your personal reputation on the line. It’s something which you start, you are not going to allow it to fail.
10 And the other point is, that he was always willing to put his money and his time where his mouth was. So it was not empty words. We can all recollect attending his tutorials in his private clinic. Many of us were in operating theatres in Mount Elizabeth with him learning with him even as he was taking care of private patients. He put his money, his time, and his effort to make these things happen. And because we knew that he was not doing it for himself, he was, in fact, taking considerable professional risk and putting in a lot of his own money and so much time to make it happen that we felt that this was a man worth following and an endeavour worth building. And I think this is a good reminder for all of us in our own small ways as we try to create things – to appreciate the importance of moral authority.
11 The fourth key lesson that I’ve learnt from him over the years, is that he always believed that patients deserve the best. Patients deserve the best – these are nice words, almost easy words to enunciate, but to live up to that ideal is not easy. Because he believed that patients deserve the best, he insisted on structured, rigorous training for ophthalmologists and for surgeons. In the past, surgical training was more of an apprenticeship-type system. Hence the old saying – “watch one, assist one and do the next operation”! But he believed that’s not good enough. You had to train properly, you had to learn to stitch in the lab, learn how to use a microscope, work on animal eyes, slowly move your way up so that by the time you reached a patient, you were sharp, and able and could honestly say you’re doing the best for the patient.
12 Because of that, he also insisted on video-taping, every single operation that we did. Mind you, this was 25 years ago. To insist that doctors record everything that they’ve done – complications, problems and everything – was a very tall order from a professional point of view.
13 Even today, I suspect that not every single operation done in every single operating theatre is video-taped. But he insisted. You want to all work with me, you all want to operate and learn from me, the video tape is on, it’s recording. 99% of the time we never look at the video tape again because it was uneventful, it was successful. But then occasionally when something went wrong, he would personally sit with us, go through it step by step and say “well, you could have done that differently, you should have done this differently, the next time how would you do it?” So this obsession with quality, with learning from mistakes and getting better always framed from his belief that our patients deserve the best.
14 There was another lesson that I learnt. Early in my career he told me, “Look, leave the most difficult, the most complex, the most hopeless cases to the most senior person.” And this is not a matter of ego, of the most senior person saying that “I can do the most complicated” but because he said "Look, having reached a level of seniority, and built a reputation, I can afford to take the hit, if this case doesn’t do so well. Even if the patient does not do well, he/she knows that we have done our best, and we have put the best surgeon to deal with this complication. And if things went well, we could all celebrate. Even if things didn’t go well, this assurance that everything had been done and that the best had been offered to the patient, made a real difference. So this willingness to put himself on the line, on the firing line, literally, to protect his juniors and at the same time, give us opportunities to learn. This again, was another sterling attribute and is something which I hope we will all be able to emulate in our own professional lives. So that’s the fourth point – that patients deserve the best care.
15 The fifth critical lesson was about the importance of research, and mind you, we are talking about 25 to 30 years ago, way before research became fashionable in Singapore. Way before we were building research institutes, way before the National Research foundation was set up, way before we valued the impact of research. But he was a man ahead of his time and persuaded the Ministry of Health and the NUS, probably against their own conventional thinking at that point in time, “take a bet, invest more money into research”.
16 Today, no one bats an eyelid at the establishment of research centres and the investments of serious money into research but I think the so-called conventional wisdom today owes a great debt to the pioneering efforts of Professor Arthur Lim. At the time when it was considered extra-curricula activity, it was considered a hobby-horse, it was considered something not essential. But he knew, it was essential for medical progress. He also realised instinctively that if we wanted to make an impact globally, we had to have a presence in research. You saw the video just now when Professor Lim referred to Singapore’s impact regionally and globally, potentially being fantastic.
17 Well, he understood even back then that it’s not good enough to just be the best technical surgeon unless you are actually breaking new grounds, raising new techniques, producing new products, new tools, new instruments, new implants, new technologies. Unless, you are actually doing that, you will never make a global impact. And equally, Professor Lim also understood, we have to invest in research because the best and the brightest minds in medicine and science want to do research. He understood that this was also about talent attraction and nurturing.
18 The sixth lesson I’ve learnt from him is about devotion and loyalty to your juniors. Professor Lim was a tough boss to work under. All of us from time to time have had to be on the receiving end of appropriate corrective measures. So he’s not an easy man to work with, but unique amongst many men, this was the man who was completely secure and comfortable in his own skin. He would never suppress or keep down a junior because he was worried that you would compete or surpass him. He had this generosity of spirit, born out of confidence in his own ability and the keenness to make sure that his subordinates could go beyond him.
19 This is still a rare attribute,, this is still an attribute worth celebrating. He gave us all enormous opportunities. Everyone in this room – Donald (Tan), (Ang) Chong Lye, (Wong) Tien Yin – I can literally say everyone here. We have had professional opportunities which we would never have achieved, never have gotten close to if it hadn’t been for Professor Arthur Lim and his willingness to use his extensive network in order to give us opportunities to learn, to grow, to build and to establish Singapore’s position in ophthalmology.
20 And there’s another element which is also under-recognised. Way before his time, he realised, this rigid separation between the public sector and private sector was wrong. In the public sector you were supposed to be paid small amounts, work very hard, serve a lot of patients, teach a lot of junior doctors and then retire quietly as opposed to the private sector where you can charge a lot more, treat fewer patients, own your clinics and achieve material success. And well ahead of his time, he recognised the fallacy of having two separate sectors where there was very little interaction. And he tried to break that barrier down.
21 First, by leading by example. He himself, coming back, sacrificing lots and lots of time and opportunity costs, to lead and build up a public sector organisation. He donated every single cent of the allowances that he received. He also, ahead of his time, set up the ambition that we have to retain a sufficient mass of the best doctors in the public sector. Because it is only the public sector that can build the next generation of doctors, not the private sector. In all humility, how do you keep the best, and the most generous spirited doctors within the public sector? He was willing to break the mould and pay us wages when we were in SNEC, which were off the scale of the public sector. But it’s really not just about money, but it’s also about the opportunities for training and making an impact for the long term. That’s why he made it fashionable for a generation of us, including Chong Lye, Donald and Tien Yin to commit your entire life to service in the public sector, instead of seeing that the natural evolution is for you to retire from the public sector and go out to the private sector. I’m not trying to create tension between public and private sector. The point I’m trying to make is that again in this field, Prof Arthur Lim was ahead of his time and willing to do unconventional things in order to get people to commit the rest of their lives to the public sector.
22 The final point I want to make is that the most important measure of a man’s lifetime achievements is actually not just the sum of all the work that he himself has done – of the thousands of cataracts that he has removed, or the hundreds of thousands of patients that he has seen. The real test of man’s legacy is who are the people and the institutions, and the systems that will persist, after that giant is no longer in the scene. Professor Lim is still on the scene so it’s premature to discuss that but for all of us in this room who are part of that legacy, it’s worth reflecting. That he has given us so much and it is our duty to emulate him by paying it forward and to make sure that this legacy grows.
23 So Professor Arthur Lim, from the bottom of my heart and that of everybody here and beyond Singapore, of the thousands if not millions, of the many patients whose lives have been transformed by your ability to dream big, to be persuasive, to assert moral authority, to your steadfast belief that patients deserve the best care, for your investments in research, and for the way you’ve taught us to pay it forward by looking after our juniors. On behalf of patients and doctors, I say a big thank you. Thank you very much, Professor Lim.