Insights from a medical career spanning over two decades.
By Aiden Jewelle Gonzales
I always liked a good challenge,” Dr. Rekha Hanvesakul, an internal medicine physician at BNH Hospital for the last 20 years, and Head of both the Departments of Internal Medicine and Travel Medicine, tells me with a smile. “It’s why I chose to pursue medicine despite realising how many years of study and experience it would take.”
Part of embracing this challenge was gaining her educational and professional experience all over the world, and embracing the cultures and lessons she’s learnt along the way. Born in Jaipur, the pink city of India, Rekha came to Thailand when she was one, and finished secondary school at Ruamrudee International School (RIS) before pursuing the rest of her education in the USA. “I did my undergraduate degree from Northern Arizona University, after which I did two years of post- graduate work in neurophysiology, before attending medical school at St. George’s University, which has a two-year programme in the Caribbean, and a two-year programme in the USA. I finished residency training in Internal Medicine at the New York Hospital Medical Center of Queens, which was the Cornell University programme. After that, I came to Thailand, did the licensing exam here, in Thai, and after that I was very fortunate to join BNH Hospital, where I’ve been for 20 years,” she recounts.
When asked what these multinational experiences have given her, Rekha is passionate about its role in allowing her to become the problem solver that she is today. “Coming from Thailand and with Indian parents who do everything for you, being on your own in New York is a very different kind of culture shock,” she explains. “But having come from an international community here helped me adjust and adapt better with the international communities in both my medical school and residency programmes. I learned to do a lot of things on my own, and it gave me a broader view on how to look at problems and solve them.”
This love for problem solving has served her well as an internist, which she explains is “a medical field where you use medicine and diagnostics to deal with more severe diseases in adults. This can vary anywhere from a small cold, to hypertension, to diabetes to heart problems. On top of that you can also be proactive and talk of prevention, which is very important in this day and age.” This diversity, she enthuses, specifically appealed to her. “I can’t walk into a room and do the same thing every single day. Because there’s so much diversity in this specialisation, it keeps me interested. It’s like an investigation using the tools you have in front of you – blood tests, labs, X-Rays, etc. You keep learning new things and growing.”
Part of this growth, Rekha emphasises, comes from learning from her patients themselves. “There’s a lot of readily-available information out there, and patients these days want to be informed. Before they come into the office, they already know what Google says. They’ll come to you with all these different questions, and as physicians we need to be open-minded and understand where are our patients are coming from,” she says. “It’s ok to not know something, and to tell the patient, ‘I’m really not sure, let me go read about it and get back to you.’ You need to be willing to discuss things because that’s the only way you can clear any misconceptions. You need to build a system of trust with your patient and through that, we can learn from them as well. Medicine is not about the doctor knowing everything, it’s an ever-changing world, as COVID has recently proven. We learn from our patients, and we help one another.”
Rekha speaks to Masala further about how her passion for the medical field is intertwined with her passion for people, her predictions for the future of medicine, and advice she’d like to give to those wishing to enter the field.
You’re also a family practitioner – what has your experience been like, treating generations in a family?
I’m not a paediatrician, so I only treat adults, but yes, there are a few families that I take care of. Often, when you meet one family member, they trust you so they bring their families to you, and you become their family practitioner. When you develop that connection with a patient, and you pass that line of, “only tell me what I want to know, don’t step across the line and give me information beyond what I need,” that’s when you can build trust and give advice. It’s very simple but it means a lot to them.
As you start to learn about their families, you start to understand a lot of behaviour, based on genetics, or certain issues stemming from their family history. Once you’ve built that trust, you can overcome a lot of obstacles both for you and for them.
Over the last year and a half, telemedicine has become more important than ever. What has your personal experience been with the advantages and disadvantages of telemedicine, and the resources provided at BNH?
We’ve been doing a lot in the past year since COVID has come along, because patients don’t want to come into hospitals, and physicians need to stay safe too. If it’s our own patients, it’s very easy to give them advice because you already know them and their problems. If need be, you can send medication back home to them.
In terms of new patients, of course there are limitations because you can’t physically examine a patient. But by talking to them and asking them the right questions, you get a lot of information. We do a lot of counselling; a lot of patients are very stressed during COVID and just by talking to them about their symptoms, it releases a lot of their stress.
Telemedicine has helped a lot of our patients, especially those with COVID who have gone to the hospitels or are doing home isolation. We contact them every single day, and at least it lets them know that there’s someone looking out for them.
Do you believe telemedicine will be a big part of the future of the medical industry?
I think so. If it’s not critical and it can be done online, a lot of patients would prefer that. And they’re developing different ways to deal with certain issues associated with telemedicine, such as equipment that you can send to patients beforehand, so the patient can place it on their heart and you can listen to their heartbeat. There are many interesting developments coming along, and we physicians have to be willing to adapt to these changes.
That’s not to say that there’s no future in having doctors or physical consultations. AI and technology may be important, but I don’t think it can replace everything. In many aspects, you do need the patient- physician contact; you need to be examined physically, and you need that doctor-patient bond.
What do you enjoy most about your career?
Aside from loving the challenge of my career, and connecting with people, I enjoy talking to people from different cultures. BNH is an international hospital, and I’m very lucky to be here because I have patients from all over the world, and my previous experiences have enabled me to relate to them. Because of the differences in culture, people approach problems differently. To be able to talk to them and understand them is key to treating them in the long term.
I am also a travel medicine specialist and I give advice regarding travel. I truly enjoy travel medicine. I have interesting discussions with my patients about the places they plan to visit and the type of travel they’re planning, and we talk about the diseases prevalent at their travel destination, and vaccinations and medications they need. I find this part of my job very interesting as I too enjoy travelling and experiencing different cultures, which we can hopefully enjoy again once the pandemic improves. I truly believe in this quote by Gustave Flaubert: “travel makes one modest. You see what a tiny place you occupy in the world.”
What is the biggest challenge you’ve faced as a healthcare professional, and how have you overcome it?
When your patient reaches a point where you know they won’t make it. It’s especially tough when you approach the family, and more than explaining the situation to them, it’s helping them reach acceptance. It’s also a big challenge for oneself emotionally, because you need to be able to pull yourself back and be professional, which is why I’m a big believer in practicing what you preach as a doctor and maintaining that balance of mental and physical health.
On another aspect, the biggest challenge for all of us has been COVID. It’s something new that changed the whole world, and we’ve had to learn to adapt our lifestyle, and everything we know. My biggest learning from this pandemic so far has been that nothing is permanent, you have to be willing to learn and adapt every day. And we need to appreciate what we have.
What are some common healthcare misconceptions that you’d like to address, especially for those wishing to enter the medical field?
A lot of youngsters may be wary of the long hours, and while there will be long hours when you’re in medical school and residency training, once you start working, you can set your own hours.
Some may avoid going into medicine because they’re scared of blood, or they don’t want to treat patients. I think in the healthcare aspect, there are many different things you can do if you don’t enjoy patient- physician contact. In today’s generation, there’s more to healthcare – there’s research, teaching, insurance, there’s so much out there. And I think all this is very exciting.