Welcome ECC Resident Dr. Matthew Lim

Of all the animals Dr. Matthew Lim has seen come through the emergency room over the years, the one that sticks out most is a puppy named Winnie, who was in a dog fight.

“She seemed happy, just a little quiet,” says Lim, who at the time was doing an internship at the Animal Hospital at Murdoch University in Perth, Australia. “I told the resident, ‘She’s probably fine, just one puncture mark on her belly.’ He looked at me and said, ‘A dog fight wound is never just a dog fight wound.’”

An ultrasound revealed that the bite had perforated two sections of Winnie’s intestines. She underwent surgery, followed by a rough recovery, suffering from sepsis and struggling to maintain her blood pressure.

“Winnie was the first animal in my care that was really, really sick,” recalls Lim. “She ended up being fine. We saw her again last year for eating a foreign body—it was so good to see that dog come back in. But I always remember what the resident said. That was a critical lesson for me.”

Lim joined the Emergency Medicine & Critical Care (ECC) Team at Henry and Lois Foster Hospital for Small Animals (FHSA) this past July as a resident in the Department of Clinical Sciences at Cummings School of Veterinary Medicine at Tufts University.

Originally from Singapore, Lim spent two years in the Singapore Armed Forces after high school. He trained to become an officer at the Officer Cadet School and later was a forward observer in the artillery. He credits the military for exposing him to new places, including Thailand and Taiwan, and for the leadership skills he gained rising up the ranks to lieutenant.

Australia was the next stop for Lim, earning his Bachelor of Veterinary Science at the University of Queensland. He remained in Australia for his education and veterinary training until relocating to Grafton last summer.

Throughout veterinary school, Lim planned to become a surgeon. Emergency medicine and critical care came to the forefront during his internship at Perth Veterinary Specialists. He rotated through internal medicine, surgery, oncology, and the ER.

“Being able to focus on and help the really sick patients in the intensive care unit drew me in,” says Lim.

After the internship wrapped up, Lim earned his Master of Veterinary Emergency and Critical Care at Murdoch University. He worked at three different ERs during his three years in Perth, continuing on as an ER vet at the clinic, the Animal Hospital at Murdoch University, and for several months at Animal Emergency Center. He notes that Australia has a shortage of ER veterinarians, so pitched in whenever he could.

At Murdoch University, Lim found that he preferred practical, hands-on work to the didactic side of his training, and research piqued his interest for the first time. It was an intense but exciting year in the master’s program for Lim, balancing his studies, thesis, and clinical work.

Cummings School first crossed his radar when he met Dr. Claire Sharp. Previously, Sharp was on the faculty at Cummings School, where he became his mentor at Murdoch University. He worked closely with Sharp on his thesis research, analyzing a specific protein as a possible biomarker to diagnose sepsis in dogs.

Lim’s first exposure to ECC took his career down a new path, and his work with Sharp broadened that path. One of the top reasons Lim moved halfway around the world for his residency at Cummings School was the research opportunities.

The animals he treated also played a part in that decision. Similar to Winnie, another patient at the Animal Hospital who left a lasting impression on Lim was a Staffordshire Bull Terrier named Nitrox. Lim treated Nitrox during his month-long stay at the hospital for kidney disease, and since that experience with Nitrox, Lim has found that different patients have fostered an interest in learning more extensively about certain diseases and treatments, in this case, dialysis. Consequently, the spectrum of conditions he would encounter at FHSA was a huge draw as well.

“I really enjoy the caseload at Foster [Hospital for Small Animals] and the variety we see, from the not-so-sick to extremely sick. Tufts is the best place to offer me the caseload to become a good clinician,” he says, adding with a chuckle, “and maybe Dr. Sharp played a small role.”

Similarly, another benefit of working at FHSA, and new to Lim, is the sheer number of clinical departments in the hospital. Typically, veterinary hospitals in Australia consist of internal medicine, surgery, and ECC teams, with few cardiologists or neurologists.

“We have so many more different specialties here that we can approach,” says Lim. “The variety of departments is the biggest difference, there’s so much here.”

Of his first six months working in ECC at FHSA, Lim says, “I’ve loved it. What I’ve learned is that what can go wrong will go wrong. Because we get a lot of referrals that have been managed elsewhere and come to us for our expertise, we get really sick patients and see a lot of complications from diseases. Being part of the ECC Department here opened my eyes to different things I might not see elsewhere.”

Already in the early stages of a new research project, Lim is working with his mentor, Dr. Noa Berlin, assistant clinical professor of emergency and critical care in the Department of Clinical Sciences at Cummings School, to analyze the incidence of low thiamine levels in dogs with diabetic ketoacidosis, a complication of diabetes that occurs when insulin levels are too low.

Lim particularly enjoys teaching the students and interns. “As a student, I never thought I’d love teaching. Working at Murdoch forced me to, and I realized that I like it a fair bit. I try to push students to think more and explain when they see a case, to tell me what they’re going to do and why they’re going to do it. The ‘why’ part is always more important to explain than ‘what’ they want to do. I always ask students and interns why.”

Above all, seeing very sick pets in the ICU return to health and head home is Lim’s favorite part of working in ECC. “That’s the biggest driver, knowing that you can make a difference. That’s the most fulfilling part.”

Lim is acclimating well to the United States. His two cats, Marlin and Dory, made the move with him, and his partner arrives soon from Australia. She’s a veterinary nurse studying to be a veterinary technician. On moving to Grafton, he jokes that what scares him most is the winter. When the first flakes fell this past fall, he sent a photo of himself in the snow to Sharp.

“I’m really happy and excited to be here,” says Lim. “The experience has been amazing. Everyone is so nice and welcoming. I’m doing so much research as well. All in all, I couldn’t ask for anything better.”