How a Malaysian made it to International Recognition

(The Listener, New Zealand) The way I learnt English was to read the newspaper from page one to the last page every day. But if you want to go somewhere, that’s what you’ve got to do. You can feel sorry for yourself and do nothing or get up and do something useful – and look beyond what you’ve got.

From the article: Introducing Cells to Suicide

A breakthrough strawberry-birthmark treatment discovered by a New Zealand surgeon and his team points the way to treatments for other tumours.

Swee Tan is a master of the rhetorical question. Outlining how his research into strawberry birthmarks could lead to a new way of treating cancer, he asks: “Would that be a good thing?” Suggest he could be making big money in cosmetic surgery overseas, and he asks, ‘Would I be a happy man?”

Hutt Hospital’s director of surgery should be happy enough – because what began as his research into disfiguring strawberry birthmarks has just won his four-strong research team a major international science prize. The implications for cancer treatment and regenerative medicine are so valuable that news of the award has been under wraps for a couple of months while the intellectual property involved has been registered internationally.

But the prize Professor Tan really has his eye on is a national research institute he plans at Hutt Hospital, being named after the two great pioneers of plastic surgery, New Zealanders Sir Harold Gillies and Sir Archibald McIndoe. That Tan and his team have done their breakthrough research without such facilities and with little funding is testimony to their dedication – and their willingness to spend huge amounts of time working for free.

Strawberry birthmarks grow from nothing into tumours that often cover much of the face within a year – and then shrink over about a decade. The usual strategy then, in the absence of an easy, effective treatment, was “just sit and wait”.

In one in 10 cases doctors had to intervene as a birthmark moved to cover an eye or obstruct the windpipe, threatening death by asphyxiation. High-dose steroids were the first line of attack. “This is a terrible thing to do to young children,” Tan says. “It’s like using a machine gun – and it doesn’t necessarily work. In 30% of cases the birthmark shrinks dramatically, and in 40% it stops growing – but in 30% it just keeps growing. When we got desperate, we used to use daily injections of interferon – with the side effect, in one in four children, of spastic in the legs. Because of that, people moved to chemotherapy. Treating a birthmark with chemotherapy – you have to be pretty desperate.”

That moment in April when Tan’s team won the John Mulliken Prize for the best science paper at the conference of the International Society for the study of vascular anomalies amazed their international colleagues. But Tan must be getting used to being considered amazing. Vicki Lee, the CEO of Cure Kids (formerly the Child Health Research Foundation), calls him “a cross between a genius and a saint”. The Museum of Wellington has made him a Living Treasure. Nicholas, a patient who blogged about his operation and recovery declared, “Swee Tan is part Chinese, part New Zealand and part Jedi.”

Tan has a gentle charisma. But within the velvet glove of charm, the iron fist of determination is clearly evident. His wife, Sanchia, says people once told him he could never be a surgeon with his hands, roughened by hard physical work as a child.

One of 14, he was born in a little village in Malaysia. “As children, we worked in the plantations – coconut, coffee, palm oil. Life was always a struggle, but I wanted to rise above that and have a professional life, and being a doctor was my dream.”

His father had only primary-school education, his mother none. They sent Tan to a Chinese school – “which means you can’t go anywhere, not even to the local university. It was madness, but they believed they should keep the heritage. In order to go to a Western country, I had to learn English. So after high school, I went to a college run by Australians in Kuala Lumpur for nine months. The way I learnt English was to read the newspaper from page one to the last page every day. But if you want to go somewhere, that’s what you’ve got to do. You can feel sorry for yourself and do nothing or get up and do something useful – and look beyond what you’ve got.”

Australia was offering free tuition to a limited number of students from developing countries, and having gained a place Tan started at the University of Melbourne’s Medical School in 1980. He got up at 5.00am three times a week to clean a supermarket. “In my final year the surgical registrar took me aside and said, ‘I don’t think it’s good for you to be half an hour late every morning’, and I had to tell him. He said, ‘Why don’t you take out a loan, and I’ll be the guarantor.’ He took that risk with me and gave me a hand. This is something I never forget and I do for the next generation – because it is the right thing to do.”

By then he had already experienced life across the Tasman. In their fifth year students could do an elective anywhere in the world, “so I came to New Zealand – and fell in love with this country. People here are so friendly, just so accepting, interested in you, not pretentious – and they are colour-blind.”

In 1987, having worked for a year in Melbourne Hospital, where he met Sanchia, then training as a nurse, he had to leave Australia under the terms of his scholarship. He took a job at Waikato Hospital, and Sanchia joined him after graduating.

“My first run was plastic surgery, which I knew nothing about. I was fascinated by the life-transforming nature of plastic surgery – and the creativity. You had a problem and you had to work out a solution. There’s no doubt people who want to do plastic surgery are naturally quite creative people, but no doubt that plastic surgery gives people the opportunity to be creative. It’s kind of a mutual attraction. Why did it attract me? It was the fascination when you see something happen – ‘Wow, I’d like to do that. It is an adventure.’”

There were only four positions in plastic surgery for training every three years. “It was almost laughable – mad! So, give it a go – and again people gave me a hand,” says Tan.

After two years at Burwood Hospital, he arrived at Hutt, where he qualified as a plastic surgeon and Sanchia had the first of their three children, now aged 17, 15 and 11. He won a fellowship to Oxford to do further training in craniofacial surgery – “you cut out eye sockets and move them, basically” – and to Harvard Medical School to do research. It was his boss there – John Mulliken, the man for whom the prize is named – who got him interested in strawberry birthmarks, or haemangioma.

“Life unfolds as you go along, not as you expect, and quite often much better than we expect. I believe in that. You have to take every opportunity and cherish everything that comes along. People often don’t realise opportunities at their doorsteps. It’s a matter of recognising them, because opportunities will keep coming and going – and they can just bypass you.”

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