Director of the Medical Simulation Centre at Tzu Chi University’s medical school Prof. Tseng Guo-Fang speaks of Tzu Chi’s efforts in promoting and implementing the silent mentor programme. (Photo by Wong Twee Hee)
“You may make ten or even twenty wrong cuts on my body, but may you never ever make one wrong cut when operating on patients.” This is the compassionate wish of all body donors for aspiring medical professionals. Such a spirit of selfless giving deeply moved all present at the Singapore TIMA Conference.
Prof. Tseng Guo-Fang, Director of the Medical Simulation Centre at Taiwan Tzu Chi University’s medical school, and Assoc. Prof. Ng Yee Kong from the Anatomy Department of NUS medical school each gave an inspiring talk on the body donation programme of their respective institutions on the first day of the TIMA Conference. During a visit to Tzu Chi University’s medical school in Taiwan seven years ago, Assoc. Prof. Ng had first-hand experience of its “silent mentor” (body donor) programme, which places a strong emphasis on the humane treatment of donated bodies for medical education and research. After that, he initiated a similar programme at the NUS Yong Loo Lin School of Medicine.
A New Look at Body Donation
Body donation contributes greatly to medical education and has a significant influence on medical students’ learning. However, such an admirable act of selflessness is uncommon in Asian societies, where many people still have deeply rooted beliefs that their bodies should be kept whole after death. Such beliefs pose the greatest challenge to the promotion of the benefits of body donation to medical education.
In his talk, Prof. Tseng Guo-Fang shared that most of the cadavers used in Anatomy courses in the past were the bodies of criminals, unclaimed bodies or stolen bodies. In most medical schools, it is unnecessary for students to concern themselves with where and how the cadavers were obtained, who they were when they were alive, and what their last wishes had been. These lifeless bodies are regarded as mere teaching tools that help medical students learn more about the workings of the human body.
At the medical school of Tzu Chi University, however, the whole concept of body donation takes on a new meaning. There, donated bodies are respectfully and fondly referred to as “silent mentors”. Inspired and moved by the selfless giving of the body donors, medical students at the University learn to develop the values of compassion and empathy, and aspire to serve as humane doctors after they graduate.
Integrating Humane Values into the Anatomy Course
How does Tzu Chi University promote its body donation programme to the Taiwanese public? How does its medical school integrate humane values and practices into its Anatomy course?
Prof. Tseng said that shortly after the Tzu Chi College of Medicine was set up in 1994, Master Cheng Yen began promoting body donation for medical education in Taiwan. He revealed that currently, all the cadavers used in Tzu Chi University’s medical school are willed body donors and Tzu Chi volunteers constitute more than 60 percent of the donors. One may ask, “How is this noble feat accomplished?”
In her appeal for body donation, Master Cheng Yen said to all that “one does not have ownership over one’s body, but only the privilege to use it” and that by signing up as a body donor, one’s body could still be put to good use after death. Tzu Chi volunteers in Taiwan worked hard to promote the cause and many of them even signed consent to donate their bodies after their passing. Through their continued and persevering efforts, the idea of body donation gradually gained public acceptance. By the end of 2014, nearly 36,000 people in Taiwan have registered to be body donors.
Prof. Tseng highlighted that Tzu Chi University’s medical school aims to train medical students to provide patient-centred care with a focus on the needs and well-being of patients. He further shared that unlike a typical Anatomy course which emphasises more on the imparting of knowledge and skills, the medical school’s Anatomy Department integrates humane values and practices with academic instruction. Accompanied by Tzu Chi volunteers, the students visit the families of their silent mentors before the Anatomy course commences, to show their concern and appreciation. Through interactions with the family members, students learn more about the lives of the mentors and what their last wishes were. “The students are always reminded that it is due to the efforts (and sacrifices) of many people that they are able to be successfully trained as doctors,” said Prof. Tseng.
A video introducing Tzu Chi University’s silent mentor programme was also shown to the audience. Starting from the home visits before the start of the Anatomy course to the suturing of the bodies (at the end of the course), to encoffinment, funeral, cremation, and to the final memorial service, great care was taken to show deep respect and gratitude to the body donors and their families.
On 22 April 2009, The Wall Street Journal published a report on Tzu Chi University’s silent mentor programme titled, “Poems and Tears for 'Silent Mentors' Spark a Surge of Cadavers in Taiwan”. The article caught the attention of readers worldwide. A reader commented that it was the most moving article he had ever read in the newspaper and another said he hoped all medical students in the world could read it.
A Source of Motivation and Guidance
“My wish will be fulfilled when the day comes for medical students to make incisions on my body.” Prof. Tseng shared these moving words spoken by one of the early body donors in Taiwan. All body donors have the same compassionate wish ─ they hope to give what they can to benefit others even when they have reached the end of their life. Not only is their selfless spirit exemplary to medical students, but it also helps to motivate and guide the latter on their path of learning. Such a humanistic aspect of education is rarely seen in conventional medical training.
Conference attendee Hee Li Heng graduated from the NUS medical school two years ago and is currently in National Service. He said that Gross Anatomy is a compulsory subject in the first year of medical school. When he was at NUS, the silent mentor programme had not been introduced yet, and, as the medical school was short of cadavers, he only had the chance to learn about the human body on prosected cadavers.
Hee revealed that he first heard of the term “silent mentor” from his former classmate, Ho Xin Qin, who had participated in a cadaveric surgical simulation session at Tzu Chi University in Taiwan. “The silent mentor programme is definitely very helpful to students’ learning. It is especially important for those training to be surgeons,” he commented. After hearing that body donors would rather medical students practice on their bodies than make a mistake on a living patient, he was very touched and was further reminded to stay true to his vocation and serve his patients well.
Promoting Body Donation in Singapore
Following Prof. Tseng’s talk, Assoc. Prof. Ng Yee Kong from the Anatomy Department of NUS medical school spoke about the body donation programme in Singapore. Inspired and moved by Tzu Chi University medical school’s silent mentor programme, he has introduced and incorporated its humane practices into the Anatomy course. With determination, the NUS professor has selflessly been working to promote body donation in Singapore. He hopes to bring about a positive change in public opinion on the issue.
Assoc. Prof. Ng said that most of the cadavers used for medical education at NUS used to be unclaimed bodies. After 2001, the number of unclaimed bodies gradually dwindled and medical students could only study Anatomy on anatomical models. Before 2012, there were hardly any efforts to promote body donation in Singapore.
While participating in the 2008 TIMA Convention in Taiwan, Assoc. Prof. Ng was deeply impressed and moved by the culture of humanistic care in Tzu Chi hospitals, and the great respect and gratitude shown to body donors. After returning to Singapore, he began thinking about how to promote such a noble and caring culture in NUS medical school.
In March 2009, Assoc. Prof. Ng invited the head and deputy head of NUS medical school’s Anatomy Department to join him on a visit to Tzu Chi University, where they observed a surgical simulation class and gained a deeper understanding of its silent mentor programme. They felt even more inspired and reassured after the visit and were very motivated to implement such a programme in Singapore.
In April of the same year, NUS medical school held its very first memorial service where students and teaching staff expressed gratitude and respect to their “silent mentors”, many of which were unclaimed bodies. Though busy preparing for their upcoming exams, the medical students made time to organise artistic performances for the service, which surprised and touched their lecturers and teachers. From then on, the silent mentor programme became a part of the NUS medical school.
“Some in Singapore still harbour doubts about body donation. We hope to change their perception through the silent mentor programme,” said Assoc. Prof. Ng. He also actively contributed to the signing of a Memorandum of Understanding and Cooperation between NUS and Tzu Chi University medical schools, thus enabling the continued participation of Singapore medical students in the latter’s simulated surgery course.
With the efforts and support of many, the body donation programme has gained increasing recognition and acceptance in Singapore. According to the National Organ Transplant Unit (NOTU), from 2012 to February 2015, some 1500 people have signed up to donate their bodies after death. Prior to 2012, there were only 300 body donors.
My Father Is a Silent Mentor
After Assoc. Prof. Ng’s talk, second-year medical student Benjamin Tan went on stage to give a sharing on the life of his father, Dr. Tan Chee Beng, a body donor.
Formerly the CEO of SingHealth Polyclinics, Dr. Tan had actively worked to improve the quality of family medicine in Singapore and to promote further training for family doctors. He died of prostate cancer in 2013, and was the first doctor in Singapore to donate his body for medical education and research. It was his son, Benjamin Tan, who first mentioned to him about the body donation programme after attending Assoc. Prof. Ng’s Anatomy class. Upon learning of the programme, Dr. Tan expressed his wish to become a body donor but doubted whether he would qualify due to the advanced stage of his cancer.
In a moving speech which touched many hearts in the audience, Benjamin Tan shared some valuable words of guidance that his father had given him: “There are only two things you must do in this lifetime: be of service to others as much as possible, and polish your inner being to its fullest radiance.”
“I feel that being a body donor is a very noble thing to do,” remarked conference attendee Tung Saw Meng, a nurse at the intensive care unit of Gleneagles Hospital. She was surprised to learn about how donated bodies are treated with great respect and care in the silent mentor programme. She commented that if medical students could be so respectful towards a lifeless body, they would be even more willing to give selflessly of themselves to patients and their families. In the past, Tung could not summon up the courage to sign up as a body donor, but through the talks on the silent mentor programme, she had come to understand how meaningful it is to donate one’s body for medical education. She is now willing to do so.
The ICU nurse had always thought that Tzu Chi is just a charitable organization and was unaware of its many contributions to the medical field. She was also very impressed by Tzu Chi volunteers’ warm hospitality, which made her feel very welcome from the moment she stepped into the conference venue.
The TIMA Conference focused on the humanitarian and humanistic aspects of medical care, and such an event is relatively rare in the Singapore medical field. The talks left a deep, indelible impression on Tung, and she said that she would definitely share what she had learned with all her colleagues in the hospital. She also expressed a keen interest to join TIMA members in serving the sick and underprivileged in society.
Inspired and moved by Tzu Chi University medical school’s silent mentor programme, Assoc. Prof. Ng Yee Kong has been incorporating its humane practices into the Anatomy course of the NUS medical school, as well as working to promote body donation in Singapore. (Photo by Lai Tong Heng)
Benjamin Tan, son of body donor Dr Tan Chee Beng, delivered a moving speech on his father’s life, which touched the hearts of many in the audience. (Photo by Lai Tong Heng)
TIMA Singapore members present the song “A Bodhisattva Indeed” in sign language to share with the audience the selfless bodhisattva spirit of the silent mentors. (Photo by Wong Twee Hee)
Touched by the altruistic spirit of body donors, medical graduate Hee Li Heng (centre) reminded himself to stay true to his calling and to serve his patients well. (Photo by Lai Tong Heng)
Gleneagles Hospital nurse Tung Saw Meng (left) was inspired by the humanistic medical culture she learned at the conference and hoped to join the ranks of TIMA members in the near future. (Photo by Wong Twee Hee)
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