Written by Dr. Ruey-Ho Kao, Superintendent of Hualien Tzu Chi Medical Center
In my early school days’ writing composition, my future career choices were either to be an engineer or a scientist. Never did I dream of becoming a doctor. I never had a good impression of a hospital and I did not like the smell of disinfectant. As a child, what I found the most unpleasant was doctors and their syringes. But when I entered my eleventh grade in high school, my attitude towards medicine changed.
In the eleventh grade at Chien-Kuo High School, students were making career decisions by choosing one of the four academic groups (A, B, C, D) in the college entrance examination. Sciences and engineering fields were categorized in Group A, Medical science and related fields as well as life sciences were placed in Group C. I scored very high in biology at school. However, it did not change my interest in science and engineering. One day, my mother said to me: why don’t you consider the life science group? A doctor can be a scientist too! I thought about it for a few days and I was convinced by my mother’s idea. So, I signed up for Group C. This career decision was, of course, a combination of my young dream and the wishes of the family
As I recall my days at Taipei Medical University, I still remember the cramming days of the medical terms. I used to carry the bible of anatomy, Sobotta everywhere, and memorize the name of each bone, each nerve and each muscle of the human body. Yet I really had no idea what a doctor really does. The turning point came when I entered the fifth year of medical school. That year, I became a clerk in a hospital. I went to Linkou Chang Gung Hospital for training. The first day when I reported to the hospital, I was shocked by the size of the hospital. The large number of doctors and the enormous number of patients surprised me. I met the director of cardiology at that time. He was slightly bald, chubby, with buttons of his uniform left open, and followed by a group of doctors and students. He walked by me like a Mongolian kahn. From that moment on, I told myself that this is the type of doctor I would like to be.
Later, I realize that a doctor should not be judged by his appearance. It’s all about his enthusiasm towards his patients, his professional devotion and the knowledge and experience he accumulated. The confidence and character of the director that I saw were results of these elements.
Superintendent Ruey-Ho Kao (right), his wife and mother (left). Kao entered the medical career because of his mother’s encouragement.
In my seventh year at medical school, I became an intern. That was the time when I really grasped the true meaning of medical science. All of a sudden, I jumped out of the textbooks and utilized the text information on real patients. Charcot triad, for example, if a patient has a temperature, with pain around the upper right abdomen, and shows symptoms of jaundice, then the first guess would be cholecystitis. In this circumstance, I would arrange the patient for an abdomen ultrasonic scan and order a blood test to confirm the diagnosis. From that point on, I was deeply attracted by clinical medicine and the previous unpleasant impression of hospital and doctors was altered; from then on, an image of a great and knowledgeable doctor gradually came to form in my mind.
Superintendent Ruey-Ho Kao (second from left) accepts the position of superintendent from Chief Executive Chin-Lon Lin (second from right). In the transition ceremony, Superintendent Kao and Vice Superintendents Hong-Wen Liu (left), Peir-Rong Chen (third from left) and Wen-Lin Hsu (fourth from left) present the “Concentric Circle”, the pictures of the entire medical team of the hospital, to Chief Executive Lin for his leadership and inspiration. First from right is Tzu Lien, wife of Chief Executive Lin.
My original career plan after military service was to return to Chang Gung Hospital as a resident doctor. However, I changed my mind and went to the newly established Cheng-Kung University Hospital, where I was a first year resident doctor. Later in my career, I made several changes in career decisions. Luckily, each decision I made turned out to be right.
The most important career decision I made was to join Tzu Chi in 1993 when I finished my oncologist specialist training at Cheng-Kung University Hospital. The initial plan was to go back to Taipei and work for Mackay Memorial Hospital. That was the wish of my parents. My teacher, Dr. Chao-Jung Tsao, had already arranged a position there for me. It seemed all natural to start my medical practice at Mackay Memorial. But, I had my eyes on the other side of the mountains – the Buddhist’s Tzu Chi General Hospital. At that time I knew very little about the hospital other than the name and Dharma Master Chen Yen.
Before I went to Hualien, I did a little research about the hospital. I discovered that there was not a single hematology and oncology specialist in the entire eastern part of Taiwan at that time. I then told myself that they need me badly. On the contrary, Taipei did not need an extra specialist. I remember when I first met Tzu Chi Foundation’s Vice Director Pi-Yu Lin, she looked at me with her firm chin and confident eyes and explained the ambitious future of the hospital. I felt my heart was burning with a clear picture of her ambition, so I signed my contract on the spot.
To run a department single-handedly is not an easy task, but my life was enriched by responsibility. People in eastern Taiwan, as compared to people on the west side, are simple and honest, and quite so often, they are more polite. With frequent contact with my patients, I found a deeper meaning of life. I started to understand the meaning of “great kindness”, “feel other’s suffering as our own”. I also realized why Master Chen Yen calls doctors “the Great Healers”. Finally, I found the last piece of the puzzle: a medical doctor is not just a specialist; he or she must possess an empathetic heart, and be able to relieve pain and offer comfort. This kind of medicine can only be achieved in Tzu Chi. If I had decided to stay in Chang Gung, or go to Cheng-Kung, or move to Mackay, I would have an entirely different picture of life.
People often asked me the reasons behind my career selection to become an oncologist. The answer is simple: its mysteriousness, its tenacity, and the fact that it is a respectable enemy. To better prepare myself for the capricious disease, I went to England and further studied oncology for a doctorate program in the Royal College of London University in 1996. This trip greatly broadened my view of the world. Not only did I find the true meaning of “science”, more importantly, I realized the close interwoven relationship of all human beings. People with different cultural backgrounds, ethnicity or races, and religious beliefs must learn to humbly live together so we can all thrive together.
After finishing my studies in London, I returned to Tzu Chi in 1999 and continued practicing medicine, in addition to medical research. It was still a one person team in the Hematology and Oncology Department. One year later, Dr. Chi Cheng Lee finished his training in Taiwan University and joined me in the department. From then on, we could afford to serve more patients. Meanwhile, oncologists gradually moved away from the traditional approach of ‘doing without knowing”. Advancement in biological sciences greatly unveiled the mystery of tumors. “Targeted Therapy” became a branch of the traditional chemotherapy.
In 2003, in order to establish a complete bone marrow transplant center, I went to the Fred Hutchison Cancer Research in Seattle, Washington, U. S. to study transplant technology. Bone marrow transplant is a highly labor intensive new technology but offers the best chance for leukemia patients. From the doctor’s perspective, even though the procedure is exhausting, each successful completion brings hope, joyfulness and gratitude to life, which is worth every drop of effort. Not only that, the process also bonds doctors, nurses, patients, and family and friends into a big family. Every year, they get together to see each other, to share their experience and celebrate their hard fought victory. As a doctor, I thank the patients for their trust without any reservation; their courage and persistency has taught me the true meaning of life. To our medical team, I appreciate the team spirit and shared principle of “humanity medicine” which never gives up on any patient.
As time progressed, I started to assume some administrative responsibilities. These experiences gave me the opportunity to observe the complexity of operating a hospital. Like a machine, any untied screw will lead to problems in patient safety and/or quality of services. Each medical field has its own standard procedure. Besides their medical specialty, communication skills and cooperation with team members are all required to serve patients more efficiently.
Throughout the twenty three years of my medical career, my biggest discovery is that a sincere heart is the most important element to be a good doctor. It is the sincere heart that determines whether one is willing to get up in the middle of the night to perform an operation, to stroll all night to check on patients, to search for the best course of treatment for patients, to spare time to listen to patients, and to hold hands with patients whose lives are near the end to offer a blessing. This is great kindness of a great healer; only a doctor with the heart of bodhisattvas can become a good doctor.
Now, the image of a medical doctor in my mind is no longer the one I knew when I was young. Now, when I think of a doctor, my mind quickly associates with Superintendent ShihMien Tu, Superintendent Wen-Bin Tseng, Superintendent Yin-Ho Chen, Dr. ChaoJung Chiu, and, Chief Executive Chin-Lon Lin , and behind all of them, the backbone of our support – stands Dharma Master Chen Yen.
Hualien Tzu Chi Hospital celebrates its 25th anniversary. Superintendent Ruey-Ho Kao leads the entire medical staff (doctors, nurses and pharmacists) with a sign language performance to signify: unity, harmony, mutual love and joined effort.
