Moderation in your diet is key to weight loss if that’s what you are after. Sometimes resistance is futile and if you cannot stop yourself reaching out for that one slice of chocolate cake, it is ok. But stop at that one piece. Keep your house as free as possible of junk food. Cut down on carbohydrates though not completely and cut down as much as possible on red meat.
As a part of my series about the women in wellness, I had the pleasure of interviewing Dr Manju Chandran.
Dr Chandran is a Senior Consultant from the Department of Endocrinology at Singapore General Hospital. Senior Consultant and Director of the Osteoporosis and Bone Metabolism Unit which she set up in 2008. She completed her Fellowship in Endocrinology and Metabolism from University of California San Diego School of Treatment , USA. Dr Chandran is Chairperson of the Singapore Ministry of Health’s Appropriate Care Guidelines for Osteoporosis Working Group, and, was recently elected to the Board of the International Osteoporosis Foundation (IOF).
Thank you so much for doing this with us! Our readers would love to “get to know you” better. Can you share your “backstory” with us?
I grew up having a very sheltered and I must admit a cossetted life in Kerala, the tiny little state in India dubbed God’s own country for its incredible natural beauty. My Dad is a Neurologist — (he still practices) who retired as the President of the Indian Academy of Neurology and my mom is a stay at home though highly educated (she was a Physics and Math Lecturer before giving her job up to raise us) lady. Though I briefly entertained thoughts of becoming a cat-walk model or strangely enough an air hostess –(I have no idea why I wanted to become one) while I was growing up, I knew deep down that my true calling was to be a doctor. My early medical education was at the State’s oldest Medical College- the Trivandrum Medical College which in those days one could get admission into only after a grueling entrance examination. Medical School was a shocker to most of us youngsters- most of us were only 161/2–17 years old when we started the first year! The oldest amongst my group of friends in the first year of medical school was all of 19 or 20 and we looked upon him as a respected elder statesman!! Looking back, I often wonder if I (or any one of my contemporaries) knew what we were going to be in for. But it was fun, and I graduated from Medical School at the ripe old age of 22! Destiny took me to the US to the sunny state of California, right after I finished my Medical School and the next few years were spent clearing the numerous exams that Foreign Medical Graduates or FMGs as they were called then had to take to get into a Residency program. I completed my residency in Internal Treatment at Maricopa Medical Centre in Phoenix. Those 3 years at ‘the County” as it was fondly known were an eye-opener. As interns and residents, we had to rotate through the Scottsdale Mayo Clinic also, as Maricopa Medical Centre was affiliated to it. At the Mayo Clinic, even the interns and residents were expected to dress in formal attire every day and its fancy and posh clientele though also extremely nice, could not be more different from the County which was set in one of the more dangerous areas of downtown Phoenix, with our regulars being people with pistol-shot wounds and other colorful and checkered histories. We regularly had patients from across the Mexican border show up at our doorstep — and I with my “exotic” looks and woeful but “adequate to take a medical history” Spanish was often mistaken for being from Spain and was often the confidante of those lovely, voluble people some of whom had such incredibly sad stories to relate. Training at the County gave you a badge as being equipped to handle anything. After my residency in Internal Treatment in Phoenix, I moved back to California, and because I was very “gung -ho” about doing procedures, I worked as a Hospitalist — which was a budding new specialty in those days at the nation’s largest managed care hospital for a year and a half before switching to doing purely outpatient work for another year or so following the birth of my first born. I always knew that life as a purely primary care physician was not going to be the one for me and when my son was two, my family and I moved to the southern city of San Diego where I got into a fellowship program in Endocrinology, Diabetes and Metabolism at UCSD literally by the skin of my teeth when a vacancy opened up. The program at USCD in those days was heavily focused on Diabetes but surprisingly enough, that was where I fell in love with the field of Bone Metabolism. Right after completing my fellowship, my globe-trotting instincts kicked in again and we were on a plane to Singapore — a place that I only knew from its world famous airport where we used to stop off in transit on our trips back every year to see my family in India. What was supposed to be a “let’s go check it out for a year” has turned out to be 17 years and counting, and now I consider this little island nation with all its quirks and foibles my permanent home. My younger son was born here, and after a very brief 1 and ½ year stint at the quaint old Alexandra Hospital, I was asked to come over to Singapore General Hospital by the then Head of Endocrinology at the hospital, to set up the Osteoporosis and Bone Metabolism Unit and here I have been since then.
Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?
As a doctor, I am privileged to see and listen to so many people — I am a firm believer in the adage that everyone has a story to tell. Countless stories pop into my mind, most of them sad, but there are also uplifting ones. The time that I was doing my residency at Maricopa in the late 1990s was also the time of the most troubling crisis in health care with people dying by the scores due to AIDS -and I remember being incredibly touched by the self- less devotion of a couple of our physicians at the county hospital who doggedly ran an AIDS clinic against all odds. This was around the time when the stigma around AIDS was deep and profound. As I mentioned earlier, we also used to have patients many of them illegal, come to the hospital from across the Mexican border — this was before the wall came up. One patient that stands out in my memory is this young fully pregnant woman who had been brought in by some rangers who had found her collapsed in the desert. She had trudged through the deserts barefoot after being separated from her husband and older son while attempting to cross the border.
Another incident which made a deep mark on me was once right here in Singapore when we had a lady in her late 30’s who was admitted for severe Graves’s disease- a condition that causes overactivity of the thyroid gland and she was absolutely insisting that she did not want to be in the hospital and she only wanted to go home. She was the sole caretaker of her mentally disabled young son who had to be left at home to fend for himself when she had to be rushed to the hospital. It was heartbreaking to see her worry about her child. The aftermath of the story was that she discharged herself out of the hospital against medical advice. That incident shook me to the core not only because it pointed out the gaps in even the best of health care and social systems but also again showed me how insignificant one’s own worries are compared to what a lot of people go through. I often find myself going in to my work at the hospital fretting over some small problem and as soon as I get there, I get caught up in the incredibly demanding yet fulfilling work of seeing patients, my research and teaching, and I completely forget about them.
Can you share a story about the biggest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
I think the biggest mistake that I used to make was letting myself being pushed over by vociferous people. Though I have always tried to stand up for the underdog and for people who I feel were unfairly treated, when it came to my own self, I used to be very hesitant . I am direct in my approach but dislike aggression and competitiveness and personally will go all out to avoid confrontation. Many a time I have rued that I did not protest when I was treated with lack of respect or just simply treated unfairly. That changed a bit when early in my career as a young “Osteoporotian”, when smarting under the unfair treatment of a chairperson at a talk I had just given, I had retreated to a corner of the lecture theatre sulkily mulling over life’s injustices when a very senior professor came up to me. He as well as everybody in the theatre had been upset at the way I had been treated. He gave me the very sage advice that if I ever have an objection to something and felt disrespected, I should not be afraid to voice my concern immediately and If I did not do it then, then I should just completely put it aside and not think and sulk about it afterwards. I have tried to take that little piece of advice to heart and though many a time I still cannot find the words to come up with smart rejoinders, I will try to speak up for myself and for others even if my voice shakes while I am doing it.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
I often joke that it is “in spite” of certain people that I have reached where I am today. But on the other hand, there are many persons who have helped me in my path. From my dad’s friend and colleague in the US who arranged for this wet behind the years young doctor from India that I was then to have an “observership” at a hospital in California, to the consultant attendings at Maricopa County who instilled a passion for treating the needy and the underdogs, to the Professor in the Bone Metabolism section at my University in California who instilled in me the love for the field and who was responsible for me catching the “publishing bug” as he used to call it, the international colleagues in organizations such as the International Osteoporosis Foundation who seeing my passion for this exciting, challenging and often neglected field have encouraged me to play an active role in the regional and international arena, to the dear friend in this field who is infinitely wiser and more level-headed than I am and who I call my “Yoda”– all of them have been my mentors and staunch supporters at various stages in my life. And of course, I cannot thank my parents enough — they never discouraged me from pursuing my dreams and never discriminated against me for my gender. But then Kerala where I am from is famous for its gender equality in the work area. Lastly but most importantly, I owe a lot to my two boys — who keep me grounded, have accommodated to their mother’s crazy schedule, and have grown up to be two fine and independent young men.
When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?
Till recently, the field of Metabolic Bone Diseases and disorders such as Osteoporosis were given scant attention especially in the Asia Pacific region. I think that my very small legacy would be that I think that I have been able to instill a passion for the field in at least a few young doctors in Singapore and in the Asia Pacific region who are now coming forward to specialize in this area. My involvement in the International Osteoporosis Foundation (IOF), the largest not-for -profit Musculoskeletal Health Organization in the world as board member, member of the Council of Scientific Advisors and as Deputy Chair of the Asia-Pacific South Africa Regional Advisory Council is incredibly fulfilling and has helped even if in a small way to represent the voice of the Asia Pacific musculoskeletal community in the international arena. The focus of the IOF which is to improve the bone health of the global population is something that I passionately believe in. Osteoporosis is a global public health burden, that affects more than 200 million people worldwide and initiatives by the IOF such as the first of its kind Capture the Fracture Initiative will go a long way to reduce this huge burden. This initiative is a partnership between multiple bodies and will very well likely change the landscape of fragility fracture management internationally. My work as Chairperson of the Asia Pacific Consortium on Osteoporosis (APCO), a non-partisan and apolitical organization comprised of individual osteoporosis experts from multiple countries across the Asia Pacific region and beyond is also extremely fulfilling. We have taken it upon ourselves to attempt to find solutions to the vexing problems facing the delivery of osteoporosis care in the Asia Pacific. The Asia Pacific region is the world’s most populous region and is going to face the brunt of the huge health economic burden that osteoporosis carries if steps to prevent this calamity are not taken immediately.
Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing? Please give an example for each.
- Don’t believe in fad diets. They may work in the short-term, but they are hard to sustain
- Moderation in your diet is key to weight loss if that’s what you are after. Sometimes resistance is futile and if you cannot stop yourself reaching out for that one slice of chocolate cake, it is ok. But stop at that one piece. Keep your house as free as possible of junk food. Cut down on carbohydrates though not completely and cut down as much as possible on red meat.
- Don’t let people tell you that meditation must involve sitting cross-legged on a mat and trying to tune out the world or that you must have a spiritual guru to guide you. I tell people that meditation can mean anything that focuses your mind on a particular task. I consider my research work as my meditative space. Nothing calms me more than when I am concentrating on writing up a research paper. To another person, it might be yoga or painting , to another it might be some extreme sport, or hiking in the wilderness or the mountains.
- Moderation in exercise is also important. Just because taking part in marathons or doing yogic stances might be the in thing, if you don’t get anything out of it and you are just doing it to fit in with your peers, don’t do it. If all you can do after a long day of work is walk around the block briskly -just do that.
- Lastly, be kind to yourself — Don’t beat yourself up if you miss out on one day of exercise or have “cheated” on your diet a few days.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
It would be to come up with a program that could weed out Fake Medical News. Especially now with the current COVID-19 pandemic and the sprouting of 1000s of self-styled medical experts.
What are your “5 Things I Wish Someone Told Me Before I Started” and why?
- What other people think of you is none of your business. But others’ opinions are also important- and if somebody’s opinion helps you to become a better person, heed it.
- Time heals almost everything- give time, time.
- When it comes to going after what you are passionate about and believe in, don’t take no for an answer.
- Don’t get cowed down by people who act superior to you- stand up for what you believe is right. Often, they are just blustering their way out of their own ignorance.
- Don’t underestimate the power of being well dressed and putting your best face forward.
Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?
Mental health especially in adolescents and young adults. I have seen the amazing difference that non -stigmatizing and most importantly non-patronizing psychological help can make in a person’s life. The stigma around mental health problems must be removed. Mental health should be considered as important as physical health and teaching about mental health should be considered as an integral part of curricula in schools.
What is the best way our readers can follow you on social media?
Unfortunately, I do not have much time to spare to be active on social media and my social media accounts are for very close friends and family only. However, here are the websites and social media accounts of the 2 professional organizations that I am active in — the International Osteoporosis Foundation (www.iofbonehealth.org, international-osteoporosis-foundation, and the Asia Pacific Consortium on Osteoporosis ( apcobonehealth.org, asia-pacific-consortium-on-osteoporosis) .