It’s a little past 1pm and the Prestige team has arrived at Neurosurgery Partners for our interview appointment with its co-founder, Associate Professor Ivan Ng. Greeting us at the door in his blue scrubs and surgical cap, we can’t help but notice that he has a handful of mixed nuts in his left hand. “Oh this? It’s my lunch,” he says with a laugh. “I’ve become accustomed to not having a full meal at this hour.”
And yet, Ng is bursting with energy as he shows us around his clinic on the 10th level of Mount Elizabeth Novena Specialist Centre. His consultation room is drenched in sunlight and its window sill is lined with plaques — a testament to his illustrious 20-year career. A couple are from the National Neuroscience Institute at Tan Tock Seng Hospital (TTSH) and Singapore General Hospital (SGH), where Ng previously headed the departments of neurosurgery; three from institutions in Laos and Vietnam, where he has spearheaded training programmes; and a crystal modelled after the Burj Al Arab, a thank-you gift from a patient in Dubai.
While proud of his achievements and the recognition accorded to him, Ng, who turns 50 this month, says that it is the interaction with his patients that he appreciates most. This is the single driving factor that convinced the senior consultant to take the leap of faith to start his own private practice in 2012.
And he could not be happier.
“Private practice removes me from an administrative role that required me to be at specialist and medical board meetings as well as departmental meetings. While important, I’ve always felt that they take me away from my first love of patient care. It was a management role that took a lot of my time,” says Ng, who earned his medical degree from the National University of Singapore and completed his fellowship at the renowned Addenbrooke’s Hospital in Cambridge University, where he was chief resident from 1999-2000.
Epiphany hit when he realised that it was patient contact and the surgical aspects of his job that would drive him to the day he retires. “Being able to sit down and talk to patients without being rushed off your feet was important and appealed to me. And so, here I am.”
Where he is, is not too bad a place to be. Despite running his own practice, the Norman Dott medal recipient remains a visiting neurosurgeon at both public hospitals and typically performs procedures at least once a week at either one — an arrangement that has worked well for him. “I’m still able to help a certain segment of patients who usually wouldn’t get the chance to see me. I see that as a way of giving back,” Ng, a fellow of the Royal College of Surgeons, Edinburgh, explains.
An active educator, he has lectured at the Duke-NUS Medical School since 2007, where he was co-director of the Brain and Behaviour programme till 2011. Till today, he continues teaching its first-year students. He also mentors neurosurgical trainees at TTSH and SGH where, among many things, he guides them in operating techniques, discusses surgical viewpoints and, of course, provides moral support.
“The trainees know that they can just call me should they need anything. After all, I’m just a short walk away,” Ng says, pointing to TTSH through his clinic window. Being able to inspire and instil confidence in his mentees is something Ng relishes.
He tells us the story of one of them who chose the specialty after being exposed to Ng’s work about a decade ago. “This boy, now in his 30s, met me when he was a young medical student. He had been accompanying his younger brother, who had a bleed in his brain, for his appointments. I operated on his brother a total of four times. Because of this [personal experience], he chose to do neurosurgery. It is heart-warming to know that I, in a little way, inspired that choice,” he says.
Ng’s efforts to educate and train neurosurgeons also extends beyond our shores. Together with the World Federation of Neurosurgical Societies, Asian Congress of Neurological Surgery, AO Foundation and Aesculap Academy, the associate professor runs international training programmes for neurosurgeons in countries such as Australia, Japan, Germany, India, Kazakhstan and Vietnam. This is yet another way to contribute back to society, he says.
Judging from his passion for the profession, some may it find hard to believe that neurosurgery was not always the obvious choice for Ng. It was only when as a houseman, he found himself at a talk by the late neurosurgeon and politician, Dr Balaji Sadasivan, that he began to consider the speciality seriously. A subsequent one-on-one chat made an indelible impression on him. “He was very encouraging when he heard I was considering neurosurgery at a time where very few were attracted to the field, because of its long hours and commitment required,” Ng recalls.
“Dr Balaji said to me: You only have one shot at being a neurosurgeon because of the number of years required to study it, but many shots at building a social life. When you choose it, it becomes a moral responsibility for you to become a good one. There is no value if you are mediocre at it, as you won’t be able to save anyone. I will always remember that.”
The fact that it is the brain that shapes a person’s identity also helped push him towards neuroscience. “The brain fascinated me as it is what defines us as humans. Every area of the brain has a specific purpose for which any loss would affect a bodily function. It is also a speciality that combines numerous surgical techniques and I was attracted to the opportunity to learn them,” he says.
At that time, little did he know that the lessons he would learn as a neurosurgeon would extend far beyond medical science. Over the course of his career, Ng has time and again learnt about the strength of the human spirit. He cites the case of patient-turned-friend, Czeslaw Szarycz, a banker who was half-paralysed when he came in for a consultation in August 2013.
Despite meeting under tense conditions — Szarycz had a tumour on the parietal lobe, the area of the brain that affects movement — the pair got along famously, due to their shared passion for sports. At Ng’s clinic, Szarycz had spotted a row of Ironman medals hanging above the doctor’s desk. “We chatted about our training routines for a few minutes and then we got into the business of dealing with my brain tumour. Unlike other neurosurgeons I talked to, who created an atmosphere of a pupil-headmaster, Ivan was open to a two-way communication in engineering a solution to my problem,” says the banker who now resides in Australia.
About a day after undergoing an awake craniotomy, Szarycz felt well enough to challenge the good doctor to running with him in a marathon that was to take place just three-and-a-half months later. “Well, I agreed, even though I knew that a patient would typically take much more time than that to heal,” Ng recalls. But Szarycz proved him wrong. The 55-year-old patient was up on his feet in five days. Four weeks later, he was exercising on an elliptical machine and together, they completed the Standard Chartered Marathon Singapore in December 2013. “He was indomitable in spirit and is living proof that when you put your mind to something, you can achieve it,” says Ng.
But not all cases conclude on such a positive note, Ng adds. “It would be a lie to say that you are not affected by such an outcome. I draw reference from this book, titled Do No Harm, by British neurosurgeon Henry Marsh. In it, he says that all neurosurgeons have their own little cemetery in their minds, a cemetery of regrets of what could have been. Me included.”
“But you cannot dwell on it too long as it will cripple your ability to help other patients that come after. You need to give your all and be able to tell yourself honestly, that you did your very best given the circumstances and with the best of intentions. This is the one thing I always tell my trainees,” he adds.
To help clear his mind, he runs twice every weekday, early in the morning and again, after work. It’s a habit he developed from his early days in neurosurgery as a way to wind down from the vigorous mental and physical challenges of the job. To “save his knees” he has also started swimming and cycling and participates in triathlons. He has completed the full Ironman race in Australia (2011) and Germany (2012), and several Ironman 70.3 (half distance) races around the world.
“Running takes me through a different mental terrain,” Ng, whose longest surgery lasted 26 hours straight, says. “When you run, you look at things differently and your mind is free to roam. It also builds stamina, which, to me, is a valuable physical trait as a surgeon,” he says.
Most of Ng’s Ironman adventures coincide with the school holidays so that he and his wife — obstetrician and gynaecologist, Dr Choo Wan Ling — are also able to go on a break with their two daughters Abigail, 17, and Kirsten, 11. Choo, who runs her own private practice, also juggles a tight schedule, so such vacations are very precious to the family.
“I admit, I don’t have much of a social life,” Ng admits. “Both Wan Ling and I can be summoned to the hospital at any moment, so we prefer to keep it simple and spend our time at home with our kids, two cats and a dog…on a typical day, we have dinner with the kids and watch movies on the weekends. I also drop the kids off at school in the mornings — a time I treasure as they give me insight into their lives.”
Have these morning talks ever evolved into grand plans of them following in their parents’ footsteps to become doctors?
“Not at all. They’ve sworn not to be like us and have admitted to being frightened of our long working hours,” Ng says with a chuckle. “It doesn’t matter to me what they go on to do, as long as they grow up to be happy.”