Valinor* Beckons

And just like that, we are into 2026. Another year of joy, achievements, sadness, failures, and abuse by IP insurers.

This hobbit really feels that age is catching up with it, despite all the health-giving properties of beer and clean air in the shire.

You know you are old when you remember the days when your home telephone number had only 5-digits. Then it went to six, then to seven (1985) and then to eight digits (2002). Finally, now, I do not have a home telephone….

You know you are old when you remember when your postal code went from 2 digits to 4 digits (1979) to the current 6 digits (1995).

On the medical side, I remember the days of the long and very high-ceiling “Nightingale” wards in old colonial buildings where patient privacy meant the nurses and doctors had to pull a movable screen to shield the patient from other folks when you examined or performed a procedure on the patient. There were no curtains.

Things got a bit better when the new hospitals were built. By this I mean the “new” SGH that was built in the 70s which we are still using. This hobbit still reminisces the gentle breeze that percolated SGH’s first floor, because in those days, the first floors of Blocks 4 to 7 were largely empty. They were void decks. But most importantly, the happy memories of Houseman Canteen, which was the nexus of true knowledge and fount of medical news until it was replaced by this ghastly architecture called the Academia. Compared to the Academia, Mount Doom in Mordor looks more alluring.

Things have gotten better since the bad old days in certain ways. Houseman calls were unpaid calls and MO calls allowance was $40 until the 5^th call, when the call allowance was raised to $100. I remember the undying gratitude I felt when my registrar handed me fifty bucks and asked me to buy supper for the on-call team. I half-suspected that one of the metrics HOs and MOs were assessed by was the quality of supper you could come back with. These were the days before there was food delivery. You, the HO or MO, was the food purchaser and deliverer.

The HO was also the IV medication deliverer, along with being the hypocount performer (which took 120 seconds). The good news is that consent-taking was a lot easier and that the entire process often took place faster than the hypocount. Being informed was not one of our priorities. (And I mean the HO or MO being informed, not the patient or his NOK). Did I really know the benefits, alternatives and risks of a TURP when I took consent?

I did my first locum in a clinic in Jurong at night at $40 an hour. Which is a princely sum if you remember I was also paid $40 for an MO call. There was no EMR. Actually, there was no computer in the consultation room. Everything happened on patient record cards.

Which was also the way things were done in the polyclinics. Polyclinics or its predecessor the OPD (Outpatient Patient Department) clinics were interesting places. I once worked in an OPD which had a NCC (National Cadet Corps) Camp next to it with chickens running around in the fenced compound.

Another polyclinic had 2 levels. Patient records were transferred between the two floors by putting the files in a basket that was attached to a pulley hung from the ceiling of the building atrium. The pulley system transported stuff rather efficiently between the two floors.

Yet another polyclinic had the best patient care assistants (otherwise known as “amahs”) I had ever experienced. They were dressed in pristine white “samfoos” (bajoo tops and slacks) and were very experienced in queue management. By this I mean when the patient was a little more loquacious than desired, the amah would cut him or her off and intoned in Hokkien or Cantonese, “Doctor is too busy, don’t talk so much!”. In addition, she will helpfully put on the BP set cuff and semi-inflate it for me, so that I only had to pump the cuff two or three times more before the BP was taken. How is that for service? And oh, did I forget to mention? The OPD, including the consultation rooms, did not have any air-conditioning, and that BP sets and thermometers contained real Mercury so that if you broke them, cleaning up had to be done very carefully.

Well, I could go on and on like an old hobbit who has gone through one too many quests, rambling off yarns of yore to younger folks in the shire.

But as is the way of most things good or bad, this must come to an end.

I would like to use this post to announce that as of 2026, this column will be slowing down quite a bit. For many years, since it was a column in the SMA News, and then going on its own as independent Facebook posts and then now as a blog, this hobbit has largely tried to adhere to a format of a monthly column. Sometimes when there are issues to comment on in a more timely fashion, the posts may be more frequent. But the frequency of posting monthly has been the norm since this column started; and if you haven’t noticed or realised, this hobbit has been here since the last century/millennium.

It’s been that long and save for a few columns written by other guest hobbits, everything has been spun out of one single small halfling brain. It has been an equally exhilarating and exhausting journey all these years. And it is time to take a slower pace. From 2026 onwards, this column will be an occasional column instead of a monthly one. If you hear from me, well and good, but if you do not, it is not to be unexpected.

Eventually, maybe sooner rather than later, this column will cease, unless a successor is found soon.

I wish to also take this occasion to thank the readers of this column. It is you that have kept me going.

Over the years, I have tried perhaps to achieve too many things all at once. Admittedly, it is difficult to be funny and informative, relevant and irreverent, sarcastic and sincere all at the same time; all too often failing in my efforts.

Many issues continue to bedevil the profession today. These include low morale, mental well-being of doctors, the scourge of IP insurers, the weight of excessive regulation in some areas and the dark void when there is little or no regulation in other areas, forging satisfying career paths and training opportunities for younger doctors, as well as just simply keeping up with the rising costs of living and meeting the (realistic) material expectations of doctors.

This list goes on. This hobbit has concluded that even though the fight must go on, others have to take over. Because Valinor beckons and the ship is already waiting to take me there.

Thank you once again. I hope all of you had as much of a good time reading this column as I had writing it.

*Valinor – also known as the Undying Lands or Blessed Realms located in the West, across the seas and far away from Middle-earth, where immortal elves longed to go to. Some non-mortals were given this privilege of going to Valinor too in the Lord of the Rings trilogy, At the end of the trilogy, Frogo Baggins was given this privilege to sail with the elves to Valinor.