- Email: [email protected]
Thian Lok Tio, MD, PhD
IN MEMORIAM
Thian Lok Tio, MD, PhD Dr Thian Lok Tio died of pancreatic cancer on August 4, 2015, in Los Angeles, California. He was born in Solo, Middle Java, Indonesia on October 4, 1944. His father had come to Indonesia from China under difficult circumstances. He started with nothing and built a business empire in Indonesia at which many of Lok’s 11 siblings made their careers. Lok’s son, Ruici, said his dad once shared a story that when he was 7 years old, he observed a young boy become seriously ill, and he watched the doctor care for the boy. From that time on, he knew he wanted to become a physician. Lok’s decision to study medicine diverged from his father’s expectations, but Lok’s steadfast position won over his father and eventually paved the way for his siblings to pursue careers outside of Indonesia. The mid-1960s, the time at which Lok was preparing to go to medical school, was a tumultuous sociopolitical era in Indonesia. During a period of civil unrest in 1965 to 1966, an estimated 1 million people were killed. There were other tensions, and Indonesians of Chinese descent were barred from attending state universities. Lok completed his first few months of medical school at the University of Res Publica in Jakarta where both ethnic Chinese and others who could not attend state universities could be educated. Because of this instability and Lok’s ambition, he sought opportunities in Europe. He was accepted at the University of Muenster in Germany, where he received his medical degree. To do that, Dr Tio had to become fluent in German. During his professional career he spoke and wrote English, German, Dutch, and several dialects of Indonesian. In 1968, while Lok was in Muenster, he met Siauw Ting Soan who was studying dentistry. Soan’s uncle was one of the founders of Res Publica University where Dr Tio attended the first year of medical school. Her father, Siauw Giok Bie, was a prominent community organizer in East Java. Her father and uncle were jailed in the political upheaval in Indonesia. Soan not only gained admission to the university, but put together financial resources to attend the university and support her mother and family in Indonesia. Lok and Soan were married in 1973. After medical school, residency, and faculty positions in Germany including Vice Chief, Internal Medicine Department, St. Franziskus Hospital in Alhen, Lok moved to the Netherlands in 1983, where he worked, did research, and Copyright ª 2015 by the American Society for Gastrointestinal Endoscopy 0016-5107/$36.00 http://dx.doi.org/10.1016/j.gie.2015.09.037
completed his PhD at the Academic Medical Center (AMC) in Amsterdam. Professor Guido Tytgat became his mentor and lifelong friend. It was at this stage of his career that his life’s work with EUS began. Professor Tytgat states that Dr Tio came to Amsterdam at the suggestion of Professor Nib Soehendra, who recommended him. He had shown an interest in abdominal US in Germany, and Professor Tytgat encouraged the study of EUS. He worked with Japanese luminaries Professors Fukuda and Kawaii. The start was tedious with initial imperfections and fragility of the instruments. Due in part to Lok’s intellect and tenacity, experience with and interest in EUS increased. This culminated in a series of landmark publications and in 2 classic atlases (Endosonography and Gastroenterology in 1988 and The First Atlas TNM Cancer Staging by Endosonography in 1995). In the first atlas, Dr Tio analyzed 200 patients, comparing the presurgical EUS, the resected specimens, and the ultimate histopathology. The initial articles and atlases remain landmark works in the field. In 1991, Dr Tio began the American phase of his career. He came to Georgetown University in Washington, DC, where he worked with Dr Stan Benjamin, Dr Firas Al-Kawas, Dr Jim Lewis, Dr Cuong Nguyen, and myself. Dr Al-Kawas and Dr Nguyen both referred to him as a “pioneer” who laid the foundation for the current
www.giejournal.org
Volume 82, No. 6 : 2015 GASTROINTESTINAL ENDOSCOPY 991
In Memoriam
practice of EUS. They remarked that his contributions and spirit will live on. While at Georgetown, he also contributed to the training of advanced endoscopy fellows. Dr Nadim Haddad, the current Chair of Gastroenterology at Georgetown, recounts that he shared wonderful moments with his trainer and friend that he will cherish forever. Dr Gregory Ginsberg, a recent past President of the American Society for Gastrointestinal Endoscopy (ASGE), observed Dr Tio to be a patient teacher, and he points out that through Dr Tio’s trainees, his imaging techniques have been subsequently passed on to generations of endosonographers. While on the faculty of Georgetown, Dr Tio also served as the Director of Endoscopy at the National Institutes of Health from 1995 to 2001. In 2003, Dr Tio moved to Los Angeles, where he was Director of Endosonography at Cedars-Sinai Medical Center and Clinical Professor of Medicine at UCLA. His friend and colleague, Dr Simon Lo, noted that Lok was always excited about new observations. Dr Lo describes Dr Tio as a keen observer and unique talent. Beginning with his days in Amsterdam and continuing with his professional positions in the United States, he was sought after as a lecturer. He was a Visiting Professor in 15 countries and frequently performed live demonstrations and taught numerous training courses. In the last few years of his career, he returned to Germany working as an advanced therapeutic endoscopist. In addition to previous commentaries by colleagues, several other well-known endoscopists have weighed in. Kees Huibregste, who worked with Lok at AMC, notes that Dr Tio’s accomplishments were particularly impressive, surmising that he must have been rather lonely in his early years in Amsterdam because his wife and children still lived in Germany. That meant that each weekend he traveled a long distance by car to see his wife and children. During his later years, they were able to join him in Amsterdam. He describes Lok as hardworking, dedicated, and a strong advocate for EUS. Kenjiro Yasuda, Kyoto-Second Red Cross Hospital, also a pioneer in endosonography, emphasizes that Dr Tio’s work led to important advances in cancer staging, and Lok was present at the dawn of EUS. Nib Soehendra, who was also born in Indonesia and graduated from medical school in Germany, was a friend of Lok’s for decades and makes 2 important comments. He points out that Lok was the teacher of uncountable endoscopists worldwide and that he also had a role in helping to build up EUS centers around the world as he did at the University Hospital Eppendorf in Hamburg. Rob Hawes, another past President of ASGE, admires the painstaking discipline that was required to put together the classic EUS atlases, which have served as “EUS Bibles.” He believes Dr Tio’s contributions to the development of EUS cannot be overstated. Dr Charles Lightdale, a former editor of Gastrointestinal Endoscopy and one of the early adopters of EUS in the United States, describes Dr Tio as a technical master, a passionate advocate, and a treasured friend.
Lok has a wonderful family. Soan, his wife of 42 years, is a renaissance woman. She had planned to study textile engineering in 1965 but had to leave those plans because of the turmoil in Indonesia, which led her to Germany, where she obtained a degree in dentistry. At the completion of Dr Tio’s PhD thesis, she composed, especially for this occasion, and performed impressive piano music inspired by the river of Lok’s native town in Indonesia. Later, she became a fashion designer. Their daughter, Hong Xia, is a professional photographer who spends time in New York and Los Angeles. Their son, Ruici, who has served (with input from his family) as a primary biographer for this article, works at an organization in Bangkok dedicated to human rights and social change. His respect for his father is unending, but he also appreciates the complexity of his personality and circumstances. To conclude, I would like to add some personal reflections based on interactions with Lok and the input provided by his family. First, I note that his pathway to a medical career was much more challenging than most (certainly more challenging than my own). Pursuing medicine meant defying his father, who had built a successful business. He had to apply to medical school at a time of national chaos. He had to leave his home country to pursue medicine, and he had to master a foreign language before he could study. Second, I note that he was influenced to a great extent by reading and by history. He felt an affinity for Che Guevara because of similarities in their family situations and social outlook. He was conversant with Kafka, Sartre, and other important thinkers. Lok told his son that they all shared the enormous conviction that they could achieve something that no one had done before through persistence and dedication. Third, although Dr Tio loved travel and was worldly in many regards, in some ways, he was “a man without a country.” Circumstances in Indonesia and Lok’s ambition led him to Germany, but the most important segments of his professional career were in the Netherlands and the United States. He openly discussed his frustration with the American health care system and returned to Germany during the last part of his career. He and Soan long held a desire to return to Indonesia to start a clinic to serve as a platform for Dr Tio to share his knowledge with young aspiring physicians, but that never materialized. Fourth, it is a bitter twist of fate that he died of pancreatic cancer, a disease that he studied and he helped to characterize. Finally, although he was driven to succeed, outwardly he was a gentle man with a warm smile. I was surprised to learn from his family that he was fond of rock and roll music and was an avid dancer. The legacy of Dr Thian Lok Tio will be that he was present at the “Dawn of EUS,” and his contributions laid part of the groundwork for that endoscopic subspecialty, the importance of which continues to increase.
992 GASTROINTESTINAL ENDOSCOPY Volume 82, No. 6 : 2015
www.giejournal.org
David Fleischer, MD Mayo Clinic Arizona Scottsdale, Arizona, USA
Thian Lok Tio, MD, PhD Dr Thian Lok Tio died of pancreatic cancer on August 4, 2015, in Los Angeles, California. He was born in Solo, Middle Java, Indonesia on October 4, 1944. His father had come to Indonesia from China under difficult circumstances. He started with nothing and built a business empire in Indonesia at which many of Lok’s 11 siblings made their careers. Lok’s son, Ruici, said his dad once shared a story that when he was 7 years old, he observed a young boy become seriously ill, and he watched the doctor care for the boy. From that time on, he knew he wanted to become a physician. Lok’s decision to study medicine diverged from his father’s expectations, but Lok’s steadfast position won over his father and eventually paved the way for his siblings to pursue careers outside of Indonesia. The mid-1960s, the time at which Lok was preparing to go to medical school, was a tumultuous sociopolitical era in Indonesia. During a period of civil unrest in 1965 to 1966, an estimated 1 million people were killed. There were other tensions, and Indonesians of Chinese descent were barred from attending state universities. Lok completed his first few months of medical school at the University of Res Publica in Jakarta where both ethnic Chinese and others who could not attend state universities could be educated. Because of this instability and Lok’s ambition, he sought opportunities in Europe. He was accepted at the University of Muenster in Germany, where he received his medical degree. To do that, Dr Tio had to become fluent in German. During his professional career he spoke and wrote English, German, Dutch, and several dialects of Indonesian. In 1968, while Lok was in Muenster, he met Siauw Ting Soan who was studying dentistry. Soan’s uncle was one of the founders of Res Publica University where Dr Tio attended the first year of medical school. Her father, Siauw Giok Bie, was a prominent community organizer in East Java. Her father and uncle were jailed in the political upheaval in Indonesia. Soan not only gained admission to the university, but put together financial resources to attend the university and support her mother and family in Indonesia. Lok and Soan were married in 1973. After medical school, residency, and faculty positions in Germany including Vice Chief, Internal Medicine Department, St. Franziskus Hospital in Alhen, Lok moved to the Netherlands in 1983, where he worked, did research, and Copyright ª 2015 by the American Society for Gastrointestinal Endoscopy 0016-5107/$36.00 http://dx.doi.org/10.1016/j.gie.2015.09.037
completed his PhD at the Academic Medical Center (AMC) in Amsterdam. Professor Guido Tytgat became his mentor and lifelong friend. It was at this stage of his career that his life’s work with EUS began. Professor Tytgat states that Dr Tio came to Amsterdam at the suggestion of Professor Nib Soehendra, who recommended him. He had shown an interest in abdominal US in Germany, and Professor Tytgat encouraged the study of EUS. He worked with Japanese luminaries Professors Fukuda and Kawaii. The start was tedious with initial imperfections and fragility of the instruments. Due in part to Lok’s intellect and tenacity, experience with and interest in EUS increased. This culminated in a series of landmark publications and in 2 classic atlases (Endosonography and Gastroenterology in 1988 and The First Atlas TNM Cancer Staging by Endosonography in 1995). In the first atlas, Dr Tio analyzed 200 patients, comparing the presurgical EUS, the resected specimens, and the ultimate histopathology. The initial articles and atlases remain landmark works in the field. In 1991, Dr Tio began the American phase of his career. He came to Georgetown University in Washington, DC, where he worked with Dr Stan Benjamin, Dr Firas Al-Kawas, Dr Jim Lewis, Dr Cuong Nguyen, and myself. Dr Al-Kawas and Dr Nguyen both referred to him as a “pioneer” who laid the foundation for the current
www.giejournal.org
Volume 82, No. 6 : 2015 GASTROINTESTINAL ENDOSCOPY 991
In Memoriam
practice of EUS. They remarked that his contributions and spirit will live on. While at Georgetown, he also contributed to the training of advanced endoscopy fellows. Dr Nadim Haddad, the current Chair of Gastroenterology at Georgetown, recounts that he shared wonderful moments with his trainer and friend that he will cherish forever. Dr Gregory Ginsberg, a recent past President of the American Society for Gastrointestinal Endoscopy (ASGE), observed Dr Tio to be a patient teacher, and he points out that through Dr Tio’s trainees, his imaging techniques have been subsequently passed on to generations of endosonographers. While on the faculty of Georgetown, Dr Tio also served as the Director of Endoscopy at the National Institutes of Health from 1995 to 2001. In 2003, Dr Tio moved to Los Angeles, where he was Director of Endosonography at Cedars-Sinai Medical Center and Clinical Professor of Medicine at UCLA. His friend and colleague, Dr Simon Lo, noted that Lok was always excited about new observations. Dr Lo describes Dr Tio as a keen observer and unique talent. Beginning with his days in Amsterdam and continuing with his professional positions in the United States, he was sought after as a lecturer. He was a Visiting Professor in 15 countries and frequently performed live demonstrations and taught numerous training courses. In the last few years of his career, he returned to Germany working as an advanced therapeutic endoscopist. In addition to previous commentaries by colleagues, several other well-known endoscopists have weighed in. Kees Huibregste, who worked with Lok at AMC, notes that Dr Tio’s accomplishments were particularly impressive, surmising that he must have been rather lonely in his early years in Amsterdam because his wife and children still lived in Germany. That meant that each weekend he traveled a long distance by car to see his wife and children. During his later years, they were able to join him in Amsterdam. He describes Lok as hardworking, dedicated, and a strong advocate for EUS. Kenjiro Yasuda, Kyoto-Second Red Cross Hospital, also a pioneer in endosonography, emphasizes that Dr Tio’s work led to important advances in cancer staging, and Lok was present at the dawn of EUS. Nib Soehendra, who was also born in Indonesia and graduated from medical school in Germany, was a friend of Lok’s for decades and makes 2 important comments. He points out that Lok was the teacher of uncountable endoscopists worldwide and that he also had a role in helping to build up EUS centers around the world as he did at the University Hospital Eppendorf in Hamburg. Rob Hawes, another past President of ASGE, admires the painstaking discipline that was required to put together the classic EUS atlases, which have served as “EUS Bibles.” He believes Dr Tio’s contributions to the development of EUS cannot be overstated. Dr Charles Lightdale, a former editor of Gastrointestinal Endoscopy and one of the early adopters of EUS in the United States, describes Dr Tio as a technical master, a passionate advocate, and a treasured friend.
Lok has a wonderful family. Soan, his wife of 42 years, is a renaissance woman. She had planned to study textile engineering in 1965 but had to leave those plans because of the turmoil in Indonesia, which led her to Germany, where she obtained a degree in dentistry. At the completion of Dr Tio’s PhD thesis, she composed, especially for this occasion, and performed impressive piano music inspired by the river of Lok’s native town in Indonesia. Later, she became a fashion designer. Their daughter, Hong Xia, is a professional photographer who spends time in New York and Los Angeles. Their son, Ruici, who has served (with input from his family) as a primary biographer for this article, works at an organization in Bangkok dedicated to human rights and social change. His respect for his father is unending, but he also appreciates the complexity of his personality and circumstances. To conclude, I would like to add some personal reflections based on interactions with Lok and the input provided by his family. First, I note that his pathway to a medical career was much more challenging than most (certainly more challenging than my own). Pursuing medicine meant defying his father, who had built a successful business. He had to apply to medical school at a time of national chaos. He had to leave his home country to pursue medicine, and he had to master a foreign language before he could study. Second, I note that he was influenced to a great extent by reading and by history. He felt an affinity for Che Guevara because of similarities in their family situations and social outlook. He was conversant with Kafka, Sartre, and other important thinkers. Lok told his son that they all shared the enormous conviction that they could achieve something that no one had done before through persistence and dedication. Third, although Dr Tio loved travel and was worldly in many regards, in some ways, he was “a man without a country.” Circumstances in Indonesia and Lok’s ambition led him to Germany, but the most important segments of his professional career were in the Netherlands and the United States. He openly discussed his frustration with the American health care system and returned to Germany during the last part of his career. He and Soan long held a desire to return to Indonesia to start a clinic to serve as a platform for Dr Tio to share his knowledge with young aspiring physicians, but that never materialized. Fourth, it is a bitter twist of fate that he died of pancreatic cancer, a disease that he studied and he helped to characterize. Finally, although he was driven to succeed, outwardly he was a gentle man with a warm smile. I was surprised to learn from his family that he was fond of rock and roll music and was an avid dancer. The legacy of Dr Thian Lok Tio will be that he was present at the “Dawn of EUS,” and his contributions laid part of the groundwork for that endoscopic subspecialty, the importance of which continues to increase.
992 GASTROINTESTINAL ENDOSCOPY Volume 82, No. 6 : 2015
www.giejournal.org
David Fleischer, MD Mayo Clinic Arizona Scottsdale, Arizona, USA