In its early stages, progressive supra-nuclear palsy is similar to Parkinson’s disease.
Symptoms include slow physical movements, impaired vision and balance, resulting in a tendency to fall.
Following this, there is a risk of choking, aspiration, pneumonia, and even death as a result of difficulty swallowing.
"Further progression of the disease will lead to dementia with prominent behavioural changes such as disinhibition and impulsivity,"
It would be nice if this entire episode turns out to be a nightmare and that I will wake up. But it is getting increasingly real and inescapable every day. My movements are slow and hesitant and I have difficulty getting up from my futon,
Having been born into a middle-class family, my parents were sensible enough not to want to raise their children as rich and privileged. As my father was Singapore’s Prime Minister, we could have stayed in a huge bungalow on the grounds of the Istana. However, he didn’t want us to grow up with the wrong idea of our importance and entitlement. He disliked the idea that a butler would run after a ball we threw. As a result, we lived in Oxley Road, our old pre-war home.
As equals, we played with the butler’s children and watched their little television set in their sitting room. Even now, if we happen to cross paths, we greet each other as childhood friends and on a first-name basis. Over the years, I’ve seen Flora and Stella when their children have been admitted to the hospital, usually because of asthma attacks. I haven’t seen John and Aloysius for a long time.
School was both academically and socially enjoyable for me. I even represented Raffles Institution in swimming and athletics. My ‘A’ level exams earned me a President’s scholarship and admission to medical school. My academic performance was excellent once again, and I topped my cohort.
MRCP (Membership of the Royal Colleges of Physicians) was my first taste of failure. Almost all Singapore doctors knew I failed the test a day after the results were announced, and they cheered. I learned a valuable lesson about resilience from that experience. It was the second time I took the exam and this time I passed.
My parents dissuaded me from studying veterinary medicine, so I chose paediatrics.
Veterinary medicine and paediatrics face similar challenges. Doctors deal with patients who cannot clearly communicate their problems, and patients may be uncooperative without being malicious.
Then I chose to sub-specialise in pediatric neurology and was awarded a Health Ministry scholarship to train at Massachusetts General Hospital, a famous Boston hospital.
Since epilepsy was the only neurological condition that could be treated at that time, I focused on paediatric epilepsy, which has a wider range of manifestations than adult epilepsy. Therefore, I became competent both as a paediatric and an adult epileptologist.
Overall, I enjoyed my years working as a neurologist and epileptologist.
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