Obituary: Dr Waryam Singh

EYEBROWS WERE raised in certain quarters of polite Edinburgh society when in 1991, a somewhat obscure Sikh ear, nose and throat surgeon from one of their suburbs was nominated for the Annual Great Scot of the Year Award for medicine. It's not every year that Scotland can boast a Nobel prizewinner in Medicine or Science, so Waryam Singh was not surprisingly pipped at the post by Sir James Black, though it was Singh's nomination that caught the public imagination and, having met at the Downing Street reception, he and Black became fast friends. The Nobel laureate hinted darkly on more than one occasion that he regarded Singh as a far more ingenious man than himself.

One reason perhaps was Singh's remarkable skills in technical innovation. His speech valve for instance, now widely used around the world, was designed to provide "hands free" speech for patients who had undergone laryngectomy for cancer and in consequence now face life with permanent tracheostomy. Other speech valves required the patient to "stop-up" the device with a fingertip and for many, the Singh Speech System, patented in 1987, provided a solution to a troublesome and often embarrassing drawback in communication.

In addition, for many years, he was very much in the forefront of analytical voice research, pioneering computer-programming techniques for measurement of laryngeal pressures and speech profiles. Equally, as a practical man, he was amongst the first to recognise the crucial importance of psychosocial rehabilitation for laryngectomy patients, founding a local laryngectomy club in 1983, well before such concerns had become widespread.

At the time of his death, he was working in close collaboration with Keele University (to which he had just been appointed Professor though, alas, was fated never to take up the post) on further laboratory techniques for assessment and improvement of non-laryngeal speech - a key initiative since the continued prevalence of cigarette smoking throughout the world will doubtless ensure a continuing high volume of laryngeal cancer patients, many of whom will require radical surgery for cure.

Waryam Singh was born in the Punjab and educated at Patiala Medical College, qualifying in 1962 and almost immediately entering the speciality of ENT surgery and arriving in the UK for postgraduate studies in 1968. After early posts at the Whittington and Central Middlesex Hospitals he travelled north to Aberdeen, rapidly becoming enraptured with Scotland and the Scots, and remaining there (apart from a brief period as a locum at St Thomas's Hospital in London) for the remainder of his career.

He was appointed in 1980 as a consultant in ENT surgery and, despite being single-handed and in relative isolation in the military huts of the District Hospital (Bangour General in West Lothian), he was determined to develop a voice research laboratory in the region. Aided by an award from the Scottish Home and Health Department, and due entirely to his unceasing efforts, this took shape shortly after the opening of the St John's Hospital, Livingstone, just outside Edinburgh, in 1989.

The voice laboratory is now a focus for observers and collaborating scientists from all over the world. Health officials, colleagues, junior staff alike - we all found that a potent and charismatic mixture of charm, tenacity, and single-mindedness made him a most difficult man to say "no" to. His lack of pomposity was reflected in his preference always to be known as "Dr" rather than "Mr" - the normal appellation for surgical specialists.

His local fame (or was it notoriety?) was assured when he fitted a Singh speech prosthesis to the throat of the post-laryngectomy vicar who could now deliver lengthy sermons. Even more importantly, Singh rapidly developed a wider international reputation for academic and practical excellence both in the fields of head and neck sur- gery, and also voice production and restoration.

Among many papers, essays and books, his book Functional Surgery of the Larynx and Pharynx (written with David Soutar, 1992) has proved very popular and influential. He hosted and organised the first ever International Voice Symposium in Edinburgh in 1987, and brought together 300 delegates from 40 countries.

Active in the fields both of surgical research and medical politics - each so consuming as to be generally exclusive of each other - he became the first ever British doctor to be invited to take the Presidency of the European Association of Phoniatrics as well as holding the posts of Chairman of the Overseas Doctors Association of Scotland and President of the Lothian Section of the BMA for five years (1990-95).

In 1993, as President of the British Association of Head and Neck Oncologists, he stamped his exuberant personality on this multimodal inter-disciplinary group by rapidly expanding the membership during his two years of office and by bringing off the most successful of all its 25 annual meetings despite the misgivings of many consultants that a conference outside London would surely prove disastrous. In this he was greatly supported as ever by his wife, Maya, who herself gladly gave up a promising career in ophthalmology to support his many activities.

Universities around the world clamoured for his expertise and wisdom. He was the first British surgeon to receive the French Comite d'Honneur Association de Reeducateurs des Mutiles de la Voix for work on reconstructive surgery of the larynx. He took visiting professorships at Mayo Clinic, Berlin, Prague, and Kyoto and was awarded honorary diplomas or degrees from universities in France, Russia, Hungary and Portugal (including, in 1994, the medal of Distinction of the Portuguese Society of Otorhinolaryngology and Head and Neck Surgery).

He was at the Universite Ziekenhuisen in Leuven, Belgium, as visiting professor, when he suffered his final devastating heart attack.

Waryam Singh Brara, ear, nose and throat and head-and-neck surgeon: born Punjab, India 1 June 1933; married 1980 Dr Maya Sudha (one son, one daughter); died Leuven, Belgium 30 May 1998.