The Smile Effect: how positive feedback fuels Mohan
By day, Mohan Shanmugam is a consultant anaesthetist at Manchester University Hospital. He says he chose to volunteer with Operation Smile because he wanted to find a charity whose values align with his own principles.
Since working with Operation Smile, Mohan has helped change the lives of patients all over the world, attending surgical programmes in a multitude of countries including Morocco, Paraguay and Honduras. Here Mohan shares his experiences and describes the ‘positive feedback loop’ that keeps him coming back for more.
Q: What do you enjoy most about being an Operation Smile volunteer?
A: We meet so many vulnerable children facing different difficulties and challenges. And the parents trust us, complete strangers, to look after them, they have that trust and confidence in us. So being able to repay that trust and confidence and make a difference to the children’s and families lives it’s huge. I’m very proud to be able to do that consistently, over and over, everywhere we go.
Q: How does it feel being there at the surgical programme and meeting families when they arrive?
A: A lot of people turn up on screening day and we have to check to see which children are suitable for that particular programme. It’s not just about delivering a set number of patients, it’s about getting them through the surgeries safely as well. If they have other health conditions, this can have an impact on the outcome. One example could be a child who has a heart condition which would be difficult to look after on a short-term surgical programme, but it’s certainly hard when we have to turn a child away. It’s not an easy decision to make, so that’s why we have a set process to go through on screening day and policies to govern us. But not everything can be written down in black and white, and we consider each child on an individual basis. If we decide that it is not suitable for a child to have surgery on this particular programme, then we always consider the alternatives, for example, can they come along to the next programme? If it’s not possible, we try to find a referral centre nearby for them. The local patient coordinator helps us identify the right thing to do for each patient; we will even write a letter to the referring hospital and help the parents to understand what is happening and why.
Q: Is there a particular patient whose story really stays with you?
A: There are so many. A lot of patients stay in my mind. It’s scary for a child in the beginning, I’m the one taking them away from their parents on the day of surgery. They’re trying to keep a distance from you as the scary person with a stethoscope. So I try to get some interactions with them and try to get to know them on the screening day so that they feel at ease. I always introduce myself to their parents in their language with a translator saying ‘OK, this is me. I’m going to be looking after your child. I’ll bring your child back safely.’
When we bring them back from surgery and follow up with them on the evening or the next day, we see how much different they are. Often the child doesn’t recognise the difference in themselves, but they see the reaction of their parents and that makes them happier. The parents are so happy, so ecstatic. It’s rewarding to see that the feedback from a parent and their child is so positive. It’s happened so many times now. It’s a positive feedback loop which keeps all of us volunteers coming back. I’m like, ‘Yeah, let’s look for the next one!’
Q: What made you choose a career in medicine?
A: It’s pretty cliched but I wanted to make a difference, and see the difference first hand, almost instantly. And that’s how I chose anaesthesia. It’s one of those specialties that makes a difference instantly, as I am in charge of a patient’s life for the duration of their anaesthesia. And in at that moment the difference I make for that particular patient has a positive impact that you can see throughout their care: the surgery, the anaesthetic, the perioperative care. In my day job here in Manchester, that’s what I do, I look after patients who need liver cancer surgeries and transplant surgeries. The difference we make on that day is critical for the rest of their life, and I can see how rewarding that is. I give everything I can to each patient and that responsibility is addictive. I will do everything I can to keep that patient safe.
Q: How and why would you encourage other people to get involved with Operation Smile?
A: I’ve done quite a few presentations about Operation Smile where I work. I was surprised a hospital this size didn’t have many Operation Smile volunteers. So I make it a point to tell these stories to a lot of people. I encourage trainees to learn more about volunteering and talk to them about the benefits. Yes, of course it’s for the benefit of the child, but at the end of the day it does benefit the medical provider too. It’s the feedback loop I was telling you about that makes you feel better about being able to do something life-changing for somebody who needs your help. And if you are able to go away once and work with Operation Smile and see how it makes a difference to you, and to the patients and families you meet, you’ll do it again. And I have seen it happen often, time and again.
Sincere thanks to Mohan for taking the time out of his busy schedule to talk to us. We have no doubt that he will continue to have a positive, life-changing impact on the children and families he meets around the world.