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Monday, April 2, 2012

The Gentle Giant in the Grey Suit - Dr. W. Wijenaike

It was on April 3rd, 2001 that our revered teacher Dr. Wickrama Wijenaike passed away. To commemmorate his 11th death anniversary, Mahendra (Speedy) Gonsalkorala has sent in this appreciation which I am pleased to post on our blog.

The Gentle Giant in the Grey Suit- Dr W.Wijenaike
By Mahendra Gonsalkorala
Whenever doctors in the UK of a certain vintage who graduated from Sri Lanka meet, they recall with gratitude the excellent training they were so privileged to have received as medical students. Views on training doctors have changed a lot and will continue to change, as it indeed should. There are many aspects to the excellent education and training our batch received but I want to dwell briefly on the clinical training we received while being "attached" to Consultants and from attending "Ward Classes". The range of clinical medicine we saw was nothing short of amazing. I remember scouring the wards of General Hospital for "interesting cases" and in one day we would listen to all the possible cardiac murmurs, palpate a handful of spleens and livers, listen to crackles, crepitations and rhonchi of all kinds and see neurological patients from Parkinsons' to paraplegia. Clinicians in that era needed sharp clinical skills as we did not have the range of specialised  investigations  which is common place now. The sheer volume of patients made it also necessary to be skillful in rapidly assessing patients with a high degree of heuristic analysis.

There are many Consultant Physicians I can think of and names like Drs Wickrema Wijenaike, Ernie Pieris, RS Thanabalasunderam, DJ Attygalle, GS Ratnavale spring to mind. In this article, I want to focus on Dr Wickrema Wijenaike, instantly recognisable as a tall figure in his characteristic grey suit and tinted glasses. I had the pleasure of learning from him during my 3 month medical attachment and from attending his Ward Classes and finally, the ultimate honour of working as his HO with the delightful, vivacious and beautiful Srimathie Fernando as my co-HO. The bespectacled and benign Dr Harold Perera was our most helpful and supportive SHO.

Dr WW had amazing listening skills and the ability to arrive at a diagnosis with a few pointed questions after listening to the history presented by the HO (without looking at the notes), followed by skillful clinical examination. He taught me many good clinical practices which I never forgot and did my best to pass on to junior doctors working with me after I became a Consultant. These are too numerous to mention but I will just refer to a set of guidelines he gave us to follow after "clerking" a patient and formulating a management plan. "Do not order any investigations unless you can explain exactly why you asked for them and show me how the results would help". "You are not allowed to prescribe a medicine unless you can explain clearly the indication and show me  that you are aware of the common side effects. The dose need not be known by memory as you can always refer to the Formulary". How relevant these words are in these days of ordering "shot gun" tests with the hope that the results may throw some light, with resultant waste of valuable resources and dulling of analytical skills.

He was a gentle man, extremely kind to patients and relatives and never had a harsh word for anybody.  He was very honest and never gave any special privileges to patients who had consulted him privately. I recall a ward round when he found a patient occupying a bed when there were far more needy ones on the "floor". He was told by the nurse that he was one of his private patients and Dr Wijenaike immediately asked him to be shown the floor and requested a very ill floor patient to take his place. This impressed me so much that I remember it to date. It accorded with my personal view that unfair financial gain should be an anathema to good medical practice. Sadly, he is no more but  I am sure that all those who were privileged to have known him in any capacity, will recall him with fondness and admiration.

1 comment:

  1. I didn't say anything about Dr WW's wicked sense of humour. I remember him posing the question of how you surface mark the position of the apex beat during a ward class. A bright person volunteered and proudly announced that it is 1/2 and inch internal to the position of the nipple and DrWW took him to a bed occupied by an old lady and said "According o you, this lady's heart will be on the side of her bed!"