On the 9th April 2020, Dr. John Kwok, a pioneering neurosurgeon and neurointerventionalist in Hong Kong and South-East Asia, passed away peacefully at Kwong Wah Hospital at the age of 69 in the company of his family.
John was born on the 14th February 1951, the eldest of three siblings. From a young age he exhibited an inquisitive flair for invention and discovery. Long before his graduation from Hong Kong’s prestigious Saint Paul’s College, John earned a reputation for experimenting with rockets using combustible fuels to the chagrin of his parents, secondary school teachers and to the amusement of his schoolmates. He studied medicine at the National University of Ireland, Galway graduating in 1979. John continued his surgical training in Southern General Hospital, Scotland and was inspired to undertake neurosurgery after assisting Professors William Jennett, who devised the Glasgow Coma Scale, and Sam Galbraith, the brilliant neurosurgeon-turned health minister, operating on traumatic brain injury patients. In 1985 John subsequently earned Fellowships from the Royal College of Surgeons of Glasgow and Edinburgh.
Upon his return to Hong Kong in 1985, John joined the fledgling Department of Neurosurgery of Kwong Wah Hospital (KWH), Tung Wah Group of Hospitals, the oldest charitable hospital in the city committed to the treatment of impoverished Chinese patients.Working alongside his mentor Dr. Hsiang-Lai Wen, the father of Hong Kong neurosurgery, John developed Hong Kong’s first independent neurosurgical department from humble beginnings. He subsequently enhanced his skills in cerebrovascular neurosurgery, a specialty that he would dedicate his life to, by undergoing a clinical fellowship at the University of Western Ontario under the tutelage of renowned Professors Charles Drake and Sidney Peerless in 1988. Becoming increasingly aware of the benefits of endovascular therapy, John also trained under Professor Jacques Moret, the eminent neurointerventionalist, at Bicetre University Hospital, Paris. In 1989 he became the chief of neurosurgery of KWH and in the following year introduced the first digital subtraction angiographic machine devoted to neurovascular treatment. Due to his indefatigable spirit, the department’s services flourished to one of the most advanced centers in Hong Kong. Realizing the need for specialized perioperative management, John fought for funding and designed the first neurosurgical high dependency unit in the city in 1995, which to this day provides state-of-the-art neurocritical care. Following his lifelong passion, he was the first to utilize Gugliemi Detachable Coils (GDC) for the occlusion of intracranial aneurysms in South-East Asia significantly reducing the risk of intraoperative rupture compared to other devices such as balloons or nondetachable free coils .John was instrumental in introducing this technique that led to a paradigm shift in the endovascular management of such lesions in the region. In addition, he was the first in Hong Kong to report the use of flow-diverters, in particular the Pipeline Embolisation Device (PED), for the management of wide-neck internal carotid artery aneurysms highlighting their safety in what would have been difficult-to-treat lesions. As a result of his contributions to the advancement of neurosurgery, John was elected Foundation Fellow by the College of Surgeons of Hong Kong in 2000. To foster better collaboration between neuro-interventionalists of this new specialty, he founded the Hong Kong Society of Interventional and Therapeutic Neuroradiology (HKSITN) in 2006 and was treasurer of the Asian-Australian Federation of Interventional and Therapeutic Neuroradiology (AAFITN) until 2014. He was also the founding member of the Hong Kong Stroke Society, former vice president of the Hong Kong Neurosurgical Society and chairman of the Hong Kong Management Society for Healthcare Professionals. From 1991 to the year of his retirement in 2012, John performed more than 12 000 neurosurgical operations including 1645 neurointerventional procedures that accelerated the recovery of patients with neurovascular disease. Even after his retirement from frontline clinical duties, the ever-inquisitive John “The Inventor” or “Professor X” as he was lovingly called, remained active in clinical research. In the capacity as adjunct professor of the Hong Kong University of Science and Technology, John designed novel endovascular devices ranging from radiofrequency thrombectomy to a bioabsorbable endoluminal fibrinolytic patch for large vessel occlusions[4,5]. As a reflection of his ingenuity, John also developed an ex vivo human placenta model that imitated cerebral vasculature anatomy.6 The model offered an opportunity to perform authentic endovascular procedure simulations for neurointerventionalist training and to safely test novel instruments. In recent years John was also the principal investigator of an ongoing territory-wide big data study that analyzed over 14000 patients in an attempt to predict the presence of intracranial aneurysms utilizing commonly performed blood investigations.
Emblematic of his interests in computer science and appreciating the importance of data-driven healthcare, John led the taskforce responsible for the introduction of the award-winning electronic patient record (ePR) system in 2000 to the Hospital Authority (HA), the largest statutory public health service provider in Hong Kong. The arduous task of transforming paper-based patient records into digital format changed the face of healthcare delivery in Hong Kong where its services are considered one of the most efficient in the world. Currently the ePR system is one of the largest existing in-house designed medical informatics systems handling 2.1 million transactions per day with a data storage capacity of 4.2 terabytes. In recognition of his exceptional contributions to public healthcare, John received the acclaimed Hong Kong Ten Outstanding Young Person award in 1991, the Hong Kong Information Technology Achiever award in 1993 and the Outstanding HA Staff award in 2000.
Aside from his clinical duties, John was tirelessly committed to fundraising for the Tung Wah Group of Hospitals, the oldest and largest charitable group in Hong Kong. As an accomplished guitarist and pianist, he performed regularly as a rock bandleader at televised events. His talent also extended to oil painting where his portraiture pieces of friends and family were well known within his social circles. The innumerable detailed surgical sketches that accompanied his operation records undoubtedly sharpened his artistic skills.
John’s attentiveness to teaching has inspired generations of neurosurgeons, neuro-interventionalists, radiologists and nurses to follow his lead. He dedicated his whole professional life to enhancing Hong Kong’s public healthcare and neurosurgical development, earning deep respect for his operative skills, humility and stature. Many a late night, one would find him quietly reassuring inpatients and their family members instilling them hope for recovery. John was a giant in the Hong Kong neurosurgical field and we were fortunate to be associated with him. Although he will be sorely missed, his faith and legacy will forever inspire us.
John is survived by his wife, Grace Au, whom he married in 1993, and their two children, Valerie and Johnathan.
1. Tan TC. Father of neurosurgery in Hong Kong. Neurosurgery. 2004;54(4):984-990; discussion 990-981.
2. Tan LT, Kwok CK, Lam HS. Early experience with surgically inaccessible wide-necked intracranial aneurysm embolised with Guglielmi Electrically Detachable coils and electrothrombosis. Singapore Med J. 1996;37(5):549-552.
3. Chan TT, Chan KY, Pang PK, Kwok JC. Pipeline embolisation device for wide-necked internal carotid artery aneurysms in a hospital in Hong Kong: preliminary experience. Hong Kong Med J. 2011;17(5):398-404.
4. Qin Z, Ciucci F, Chon CH, Kwok JCK, Lam DCC. Model development and comparison of low hemorrhage-risk endoluminal patch thrombolytic treatment for ischemic stroke. Med Eng Phys. 2018;61:32-40.
5. Chon CH, Qin Z, Kwok JC, Lam DC. Mechanical behavior of rf-treated thrombus in mechanical thrombectomy. Med Eng Phys. 2017;47:184-189.
6. Kwok JC, Huang W, Leung WC, Chan SK, Chan KY, Leung KM, et al. Human placenta as an ex vivo vascular model for neurointerventional research. J Neurointerv Surg. 2014;6(5):394-399.
7. Cheung NT, Fung V, Kong JH. The Hong Kong Hospital Authority's information architecture. Stud Health Technol Inform. 2004;107(Pt 2):1183-1186.
8. Miller LJ, Lu W. These Are the Economies With the Most (and Least) Efficient Health Care. 2018; https://www.bloomberg.com/news/articles/2018-09-19/u-s-near-bottom-of-health-index-hong-kong-and-singapore-at-top. Accessed 23 September, 2020.
9. Sek AC, Cheung NT, Choy KM, Wong WN, Tong AY, Fung VH, et al. A territory-wide electronic health record--from concept to practicality: the Hong Kong experience. Stud Health Technol Inform. 2007;129(Pt 1):293-296.