Lives of the fellows

Ernest Steven Monteiro

b.21 December 1904 d.2 March 1989
CBE(1957) LMS(1929) MRCP(1947) DCH(1947) MD Malaya(1949) FRCP(1956) FRCPG(1962) AM Singapore(1962) BBM(1963) PJG(1968)

Ernest Steven Monteiro was born in Singapore (Straits Settlements), then a British Colony, the youngest of an impoverished Portuguese family of ten siblings. On the untimely death of his father, the young Monteiro had to do odd jobs to help his widowed mother who worked as a cook. It was only when he was eleven years old that the family could afford to send him to primary school at St Anthony’s. He later transferred to the Raffles Institution where within six years he passed the Cambridge school leaving certificate examination. He went on to study medicine at the King Edward VII College of Medicine (later the Faculty of Medicine, University of Singapore, since renamed the National University of Singapore). He won the gold medal for the best all round performance when he graduated in 1929.

Monteiro joined the Straits Settlements Medical Service as assistant medical officer (the highest appointment at that time for the local graduates) and started work at the Tan Tock Seng Hospital. He later became house physician to R B Hawes, later Sir Richard [Munk's Roll, Vol.V, p.177], at the General Hospital, but on promotion to tutor in medicine in 1936 he was transferred to the professorial medical clinic at the Tan Tock Seng Hospital.

Monteiro’s first major discovery occurred in 1937 when he investigated cardiac (wet) beriberi among impoverished Chinese dock workers, who subsisted mainly on highly polished white rice, and which was invariably fatal. He obtained extracts of vitamin B1 from a Dutch chemist friend and injected it intravenously into his first patient - who made a quick and dramatic recovery. He treated a further nineteen cases successfully, and warned of possible shock if the injection was given too rapidly. Those of his students who had the privilege to witness the critically ill patients improve so quickly before their eyes could not fail to be impressed.

In 1939 Monteiro was promoted to the Malayan Medical Service, a branch of the Colonial Medical Service ut was a Whitehall appointment) and was appointed medical superintendent of the Tan Tock Seng Hospital. He was awarded the Queen’s Scholarship for postgraduate training in the United Kingdom but the outbreak of the second world war delayed his departure.

During the war, in 1942, Monteiro became medical superintendent of the Middleton Hospital for infectious diseases. He found that the stock of anti-diphtheria serum (antitoxin) was depleted. With considerable ingenuity, he injected filtered toxin from the bacterial cultures into the jugular veins of some goats and bled them three weeks later to obtain the serum, which he freezed and used sucessfully to combat the epidemic then spreading throughout Syonan-to (a name given to Singapore by the Japanese occupation forces).

With the defeat of the Japanese, Monteiro took up the Queen’s Scholarship and left for the United Kingdom in 1946, where he came under the influence of several eminent physicians - G A Ryle (of Ryle’s Tube fame) at the Radcliffe Infirmary, Oxford; Sir Gordon M Holmes [Munk's Roll Vol.V, p.195] and W J Adie [Munk's Roll, Vol.IV, p.596] (of Adie’s Syndrome fame) at the Institute of Neurology, Queen Square, and his former chief, Sir Richard Hawes, at the London Hospital. During his stay in the United Kingdom he successfully sat for the membership examination of the College and the diploma of child health. He also became a Fellow of the Royal Faculty of Physicians and Surgeons of Glasgow (FRFPS). In 1948 he was appointed by the InterUniversity Council of Great Britain to the chair in clinical medicine, University of Malaya (Singapore) and a separate department was specially created for him.

His next major pioneering medical achievement was his decision in 1958 to use the untested oral Sabin vaccine on a massive scale in combating the ravages of the acute anterior poliomyelitis outbreak in Singapore, in collaboration with Jimmy Hale, professor of bacteriology at the local university, and Albert Sabin, professor at the National Institute of Health, USA, in spite of strong local medical opposition. A total of 250,000 children were immunized and the epidemic was brought to an end. Since then oral Sabin immunization forms a part of the immunization programme for children in Singapore, and no case of acute anterior poliomyelitis has been reported.

In 1949 his monograph on the incidence and natural history of rheumatic heart disease m Singapore proved that the disease exists in both Malaysia and the tropics, which was contrary to the views held at that time. For this he was awarded his doctorate in medicine by the University of Malaya in Singapore. In 1956 he was elected a fellow of the College, and in 1962 was elected a foundation fellow of the Glasgow College. In the same year he was elected vice-master of the Academy of Medicine, Singapore.

From 1950 onwards he was consulting physician to the British Army, South East Asia Command, with the rank of Brigadier, and he was also consulting physician to the late Agong of Malaysia. From 1956-61 he served as dean of the faculty of medicine, University of Singapore, and was acting vice-chancellor and deputy principal of the University from 1962-63. He also served as founder-president of the Singapore National Kidney Foundation and was responsible for establishing Singapore’s first renal dialysis unit in his department. He was awarded the CBE for distinguished public service.

Monteiro retired in 1965 and was elected emeritus professor, he was also appointed pro-chancellor of the University and honorary senior consultant physician to the Singapore General Hospital, with teaching duties since 1965. He taught many generations of medical students, several of whom have gone on to occupy chairs in universities and senior consultant posts in hospitals in Singapore, Malaysia and abroad. Among his most illustrious students were Dato’ Seri Dr Mahathir Mohamed, prime minister of Malaysia, and his wife Datin Seri Dr Siti Hasmah. He played a large part in establishing the very high standard of medical practice in Singapore and was held in the highest esteem by all his students.

From 1965-68 he was Singapore’s ambassador to Cambodia and from 1968-77 ambassador to the USA and Brazil - a post he served with great distinction. In 1963 he was awarded the Republic of Singapore’s BBM (Bintang Bakti Masharakat, or Public Service Star) and the PJG (Pingat Jasa Gemilang, or Meritorious Service Medal) in 1968. In 1973 he won the coveted International Award for Distinguished Service of the US National Kidney Foundation, for his renal work and collaborative studies with American researchers during his sojourn as ambassador. On retirement from the diplomatic service he resumed private practice as a senior consultant physician.

In his youth Monteiro was junior tennis champion of the Singapore Recreational Club, but after a recurring sprained wrist he took up billiards, and was reigning champion for several years in the 1950s. It gave him great pleasure to be appointed patron of the Singapore Control Council for Snooker and Billiards. He was also an honorary member of the Rotary Club of Singapore.

Monteiro was a shy man but those who came to know him found in him a man of great kindness, empathy and humility, and one who would go out of his way to help anyone in trouble.

Like all dedicated doctors, Monteiro was married to his profession -and his marriage suffered. He was divorced from his first wife, Una Marie Lewis, in 1971. They had two sons, both doctors - Edmund is director and consultant physician in charge of the communicable diseases centre, Tan Tock Hospital, Singapore, and Gerard is a specialist physician in private practice in Winnipeg, Canada. They also had two daughters, Jeanne and Irene, both teachers. Monteiro married again and his second wife, Ling Mie Hean, was a nursing sister in his renal unit. They have a son, John, at school. He bore his last illness with commendable fortitude, considerate of others until the end.

C Kim Yong

(Volume IX, page 375)

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