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“10 Everything has already been decided. It was known long ago what each person would be. So there’s no use arguing with God about your destiny. 11 The more words you speak, the less they mean. So what good are they?”

Ecclesiastes Chapter 6, The Bible (New Living Translation)

It is in the context of these verses from the Book of Ecclesiastes that I write this biography.

I was born in Batu Pahat, a small town in Johor, Malaysia, about 150 km from Singapore. My father was an immigrant from South China who came to Singapore at the age of 20 to look for a better life in the face of the post-war famine. He left behind my mother and my 1-year-old eldest brother. From Singapore, my father moved to Batu Pahat to open a provision shop selling groceries and fruits. My mother and brother left China to join him 10 years later and 4 more boys and 1 girl, the youngest, were added to the family. I was the third son.

I attended Montfort Primary School, a Catholic school run by the Brothers of St Gabriel, and from there I completed my secondary education at the local high school. I was then offered an ASEAN Scholarship to study at Hwa Chong Junior College in Singapore and was awarded a Singapore government scholarship to study Medicine at the National University of Singapore. I met Beth, now my wife, during medical school. She was from the Philippines and had completed her training there as a dentist. She came to Singapore to consider training to be an oral surgeon. We got to know each other well during the 3 months she was in Singapore and we continued a long-distance relationship when she left to go back home.

Following medical school, I considered becoming an eye surgeon. As part of the specialty postings required to satisfy pre-training clinical experience for eye surgery, I asked to be posted to the Department of Neurosurgery at Tan Tock Seng Hospital (TTSH). During that time, in the 1980s, this was the only Neurosurgery Department in Singapore. During my posting in Neurosurgery, the then Head of the Department, Mr. Cheok Fai Tham, offered me a training position in Neurosurgery and told me that he would send me to Australia to complete my neurosurgical training, as at that time, there was no local training program [1, 2]. To become a registered neurosurgeon in Singapore in those days, one needed to either become a Fellow of one of the British surgical colleges and then spend time in a neurosurgical unit or undergo direct training in a Royal Australasian College of Surgeons (RACS)–approved neurosurgical unit and then sit for the final RACS neurosurgery examinations. The latter was a more direct route, which is now also the norm in the UK. And so, I began my neurosurgery training in Tan Tock Seng Hospital for 2 years and then went on to complete another 2 years of training in Perth, Western Australia, under Mr. (now Professor) Bryant A. R. Stokes [3].

I married Beth in 1983 and one of Mr. Tham’s requirements before he took me on as a neurosurgical trainee was that Beth had to meet up with the wife of one of the staff neurosurgeons and learn from her what the life of a neurosurgeon’s wife was like. And after hearing what it was like from her, and if she still agreed to be a neurosurgeon’s wife, then and only then would he accept me into neurosurgery training. Beth met up with Mr. Peck Leong Ong’s wife, Judy, who was a nurse, and learnt what it was like to be the wife of a neurosurgeon at that time in Singapore. This was Mr. Tham’s way of informing anyone who wanted to become a neurosurgeon about what the strains of being a neurosurgeon had on the wife and family. Mr. Tham, being the only neurosurgeon in Singapore for many years, having spent more time at work than at home, was aware of the broken marriages of many neurosurgeons he had known, although he himself was happily married with 2 girls. Mr. Ong subsequently became my boss when Mr. Tham retired a few years later [1, 4].

Perth, Western Australia, was very different from Singapore. It was open country, and very cold (by my standards, having lived only in Malaysia and Singapore where the climate is equatorial in nature—hot and humid or downpouring wet days). Mr. Stokes had arranged for us to stay in a small hospital house in a 10,000 sq ft compound (very huge by Singapore standards), which was next to Sir Charles Gairdner Hospital, where the Neurosurgery Department was located. The hospital was a short walk from the house but for someone from the tropics, it was not an easy stroll on Perth’s cold winter nights. In Perth, I honed my neurosurgery operating skills and learnt to operate independently, under Mr. Stokes, who was a kind yet firm academic neurosurgeon and gentleman [5]. I also met and befriended several neurosurgical trainees who are now well-known senior neurosurgeons in Australia. One of the highlights of my Australian training was my first exposure to “real” pediatric neurosurgery—when I went to the Registrar seminar which was held at the Royal Children’s Hospital in Melbourne, hosted by Mr. Geoffrey Klug. This was the first time I had been in a children’s hospital and saw how children were looked after, and I felt exposed to a whole new world. There was no children’s hospital in Singapore then.

I returned to Singapore after I completed my FRACS Neurosurgery examinations and then started working in the Tan Tock Seng Hospital, initially as a senior registrar and then as a consultant. During those early years, Dr. Balaji Sadavisan, who was several years my senior, had also returned to Singapore after completing his neurosurgery training in Detroit under Prof Jim Ausman, and at the Boston Children’s Hospital under Prof Peter Black. Balaji was a good mentor, teaching me not only surgical management and techniques learnt in the USA but also administrative aspects like how to get grants, as well as involvement in organized Neurosurgery. At a very young age, Balaji became President of the Asian Australasian Society of Neurological Surgeons (AASNS), the continental society for neurosurgeons in Asia in 1999 [6]. Balaji was also involved in the planning of the new KK Women’s & Children’s Hospital (KKH) which was scheduled to open in 1997. However, he left government service for private practice in 1994 and asked me to look after the development of pediatric neurosurgery at KKH. Even then, he continued to help out with the early development of pediatric neurosurgery in Singapore until he went into politics and became a Minister in the Singapore Government in 2001. His death at the young age of 55 was a tragic loss to all of us.

The Children’s Hospital of the new KKH was the amalgamation of the three pediatric departments of the Singapore General Hospital, Tan Tock Seng Hospital, and Alexandra Hospital with the Neonatal Department of the KK Hospital for Women. It opened in July 1997 and was the only and largest Children’s Hospital in Singapore. I was the Head of the Pediatric Neurosurgery Service, with a staff of one, providing 24/7 services for emergencies and electives, not unlike many other pediatric neurosurgery services around the world when they first started out. I fortunately had help from the neurosurgeons from the TTSH Neurosurgery Department—Dr. Yeo Tseng Tsai, Dr. Ng Puay Yong, Dr. Ivan Ng, and Dr. Ng Wai Hoe, to name a few—as I was still a staff member, to provide emergency coverage. The Department of Neurosurgery at TTSH subsequently became part of the National Neuroscience Institute, Singapore (NNI), and continued to provide neurosurgeons to help out in KKH on a part time basis. Much later, Dr. David Low and Dr. Sharon Low became interested in pediatric neurosurgery and the Pediatric Neurosurgery Service in KKH became part of the services provided by the NNI, with 3 pediatric neurosurgeons. It also became a training center for neurosurgical residents under Singapore’s National Training Program for Neurosurgery.

In 1998, Prof. Dachling Pang was invited to Singapore as the Singapore Government’s Higher Manpower Development Program visitor for pediatric neurosurgery. His visit was crucial in building and consolidating pediatric neurosurgery practice in Singapore. Prof. Pang was an amazing teacher, and his love for teaching pediatric neurosurgery was infectious. He taught me many of the finer points of pediatric neurosurgery, especially the need to understand embryology, and operated with me (often into the night, which was then followed by supper), teaching me his then new radical resection of spinal lipomas, and many other surgical techniques. He also advised me that to be a successful pediatric neurosurgeon, one should only focus on pediatric neurosurgery. This was something I kept in my heart, and as soon as there was enough manpower to cover the adult work at the NNI, I devoted himself to doing only pediatric neurosurgery. Prof. Pang visited Singapore several times after that, each time imparting new knowledge and skills, and this continues whenever we meet at ISPN meetings and courses, encounters that I always treasure.

I have always had a desire to learn new subjects that I can then use to improve my practice—not just in neurosurgery but also in management skills. I decided to do an MBA in Information Technology in 1996 because this would not only provide me management skills but also expose me to the IT world as the Internet was just in its infancy. I was also interested in the law, especially medico-legal matters, and obtained an LLB in 2003 and a Masters in Laws several years later. This has allowed me to teach courses on Medical Law and Medical Risk Management run by the Singapore Medical Association and Medical Protection Society as well as to introduce Clinical Incident Management and Open Disclosure programs at KKH and NNI. I was also motivated to complete a Masters in Surgical Education degree in 2015 as I felt that the knowledge gained would help me in the training of neurosurgical residents.

In 1999, I was invited by Prof. Concezio di Rocco to give a presentation at a course which he held in Assisi, Italy. This greatly inspired me to teach as well as meet and learn from other teachers and the opportunity arose when Prof. Christian St Rose, wanting to start a pediatric course in Asia that was similar to the European Society for Pediatric Neurosurgery (ESPN) course in Pediatric Neurosurgery, recruited me. I started out by presenting some cases at the Latin American Course in Iguassu, Argentina, and learnt how the course was conducted, and then started teaching at the first Asian Australasian Advanced Course in Cairns, Australia, organized by Wirginia Maixner. I have since then been teaching at the European, Latin American, and Asian Australasian courses, as well as the ISPN and AASNS courses. These courses have allowed me to give back to pediatric neurosurgery and at the same time strengthen friendships with pediatric neurosurgeons and trainees around the world, including the late Jim Goodrich, Michel Zerah, and William Harkness, who were very close to me.

I was asked to be the Secretary of The ASEAN Neurosurgical Society in 1996. As Secretary, I was able to build it into a more progressive society with its own secretariat and website. I became its President in 2015. In 2007, I was asked by Prof. Tu Yong-Kwang, who was elected president of AASNS to be its Secretary-General, to help modernize the Society. Working with an association manager, the AASNS became a legal entity and continues to this day to have the challenging task of being the continental society for Asia and Australasia, and to meet the educational needs of its members [7]. I was the Secretary-General for 12 years, serving Presidents Prof. Tu Yong-Kwang (who subsequently became President of the World Federation of Neurosurgical Societies (WFNS)), Prof. Andrew Kaye, and Prof. Basant Misra, before becoming President of AASNS myself from 2019 to 2022. These were the COVID-19 years, but were revolutionary in that Zoom Webinars became the prime media for neurosurgical education, and the AASNS was one of the pioneers in the region to do that. I became a member of the International Society for Pediatric Neurosurgery (ISPN) in 1995 and has been its Chair of By-Laws, Audit, Morals & Ethics, and Education Committee, before being elected President of ISPN at its 48th Annual Meeting when I was the Chair of the Organizing Committee. This was a highlight, not only for myself but also for being able to bring the world of pediatric neurosurgery to South-east Asia. I am also currently the By-laws Chair of the Asian Australasian Society for Pediatric Neurosurgery, the continental society for pediatric neurosurgery in Asia. I believe being involved in organized pediatric neurosurgery is crucial because organized pediatric neurosurgery unites us to improve the standard of care to our patients.

I became the Head of the Neurosurgery Department at TTSH@NNI in 2015, relinquishing the headship of the Pediatric Neurosurgery Service at KKH to Dr. David Low. As part of my administrative duties for the National Neuroscience Institute, I was Deputy Medical Director of the NNI in charge of Academic Affairs from 2015 to 2017. I stepped down as Head of the Neurosurgery Department in 2019 but remain as Chief Risk Officer and Chief Medical Informatics Officer for the NNI, continuing in my service to the NNI.

I know that whatever I have achieved so far (and the mistakes I have made)—in developing pediatric neurosurgery in Singapore and beyond, in education in organized neurosurgery—is only possible because of the people who came before me, who were with me, and some who taught and helped me, and most of all, because Jesus Christ, my Lord and God, placed me where I was at the right time and place to become the person He wanted me to be and to do the things He wanted me to do. There is much more to be done to improve pediatric neurosurgery in the world, and I know I am just a drop of water in the ocean of life. A drop nevertheless to add some salt and light to the world of pediatric neurosurgery.