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Monday, August 19, 2013

My Childhood Tryst with Destiny



My childhood tryst with destiny

By Dr. Nihal D. Amerasekera


Childhood is a risk we all take - David Hughes

The year was 1949 and my country was then called Ceylon. We had just gained independence from British rule. A certain sense of euphoria pervaded the length and breadth of the island. It was then that patriotism spilled over into xenophobia to spoil the calm serenity of this tropical paradise.

At the age of seven my life of privilege as an only child was marred by an intermittent fever that baffled the best doctors in the land. Twice a day everyday a glass-mercury thermometer was thrust under my tongue. It was the start of a cruel illness that consumed and changed my young life. I could see my hopes and dreams ebb away. Many said it was tonsillitis. For others it was some elusive form of Malaria. I chewed the Cinchona bark and drank gallons of Quinine until I was deaf.  The fever clung to me like glue. Smelly lotions and bitter potions of Ayurvedic medicine filled my days with despair. Oils were thrust through my every orifice.  They even sought divine help but to no avail. Strangely, the spiritual assistance cost much more than the doctors wisdom. Dr. MVP Peiris, LMS (1925), FRCS (Eng) 1929, was in charge of the Surgical Department General Hospital Colombo. The great man decided it was Tonsillitis and suggested the only solution was to operate. His gently probing style and disarming courtesy won us over. In those days there was an unassailable belief the doctor was always right. He finally persuaded my parents to take the plunge.

Operations in those days were not without peril. Surgeons believed in the old adage "when in doubt cut it out". The survival after anaesthesia was a lottery. Then there were very few antibiotics around. Hence infections post surgery was a killer. The wit of George Bernard Shaw comes to mind: All professions are conspiracies against the laity. I trust the rationale for surgery was fully discussed with my parents. They were made aware the result of failure was death, a hard pill to swallow for any parent.

The Ceylonese love giving advice. Some relatives begged of my parents never to allow me near the surgeons scalpel. They related gory tales of blood and death. To the general public what happens in a hospital is a permanent source of intrigue and fancy. As for the surgeons they have confidence that all will be fine on the day. For my parents it was a hard choice. They remained in a wilderness of confusion  baffled and bewildered by these swirling fearful thoughts.

Lady Havelock Hospital for Women and Children was opened in 1896. It was inaugurated by Dr Kynsey (Principal Civil Medical Officer), a name we will all remember. ‘Situated in spacious environs in the Colombo suburb of Borella, the hospital’s architecture was of typical British colonial-style with red terracotta walls, ornate windows, and imposing colonnades…’ (Robert Boyle). In 1909 a separate block was built for Children. This new addition was named after Lady Lina Ridgeway, wife of Governor His  Excellency Sir West Ridgeway,  who was an energetic patron and fund raiser for the project.  The first qualified Paediatrician appointed to the hospital was Dr L. O Abeyratne, in 1937,  who also became the Medical officer in Charge. When the Castle Street Hospital for Women opened in 1954 the Lady Havelock Hospital ceased to exist. Then the LRH expanded to become the premiere Childrens’ hospital in the country.  Dr C C De Silva was appointed Professor of Paediatrics in 1949 .  (I say it with great pride that one of my own batchmates, Sanath Lamabadusuriya, became the Professor of Paediatrics at the LRH in 1991.)  In 1949 Paediatric surgery was performed at the General Hospital Colombo.  It was in the 1950’s that Drs Milroy Paul, MVP Peiris and FA Sandrasagra carried out surgery at the LRH.

As I continued to suffer ill health a place was booked for me at the Childrens Ward at the General Hospital Colombo. It was a small ward of 20 beds in the first floor of the surgical section of the hospital. Those were days when the medical profession was less sophisticated and less specialised. The surgeons and physicians did everything that came their way. The wind of change was blowing across the profession for greater specialisation.

The ward was clean and neat. Colourful paintings adorned its walls.  There was a playroom too with some toys and games like Ludo and Snakes and Ladders. Wherever there are children whatever the circumstances mischief fun and laughter are never faraway. We played from dawn to dusk.  The ward had a wonderful view of the long corridors that criss-crossed the hospital. I have watched hordes of doctors and nurses come to work in the morning and leave at night. A large flamboyant tree with spreading branches full of orange flowers filled the quadrangle between the blocks. None of the children in the ward seemed seriously ill. There was a boy with a boil behind the ear, probably a mastoid abscess which had broken through the skin. He didnt smell too good but we played together a lot. Initially treatment was fairly aggressively chemical. Then came the scalpel.

Adjacent to the main ward was the ‘Injection Room’. It had an aura of fear. The steaming stainless steel sterilisation units, glass syringes with needles and the many bottles and jars gave it an eerie feel. In the morning and evening we were taken there, one by one, for the penicillin injections. This was a ritual we learnt to accept. Children are remarkably resilient. Within a week I became amazingly comfortable in the ward. There were some lighter moments too.  We devised a game to be played with the silver tops of penicillin bottles similar to draughts. There was one lad who became my best friend. He was utterly self confident. He sang and danced to entertain and was the nurses’ favourite.  I learnt many Tamil songs some of which I remember to this day. As the days passed we became bolder and walked in to the next ward and to the corridors beyond.. The nurses knew us and greeted us warmly. I distinctly recall a very ill man who was in a coma after a fall from a tree fitted with a saline drip. The din of the wailing relatives upset us deeply. Death was not a concept I could comprehend then. I remember the next day they pulled the screens around him and he was gone.

A childrens ward just next door to the seriously ill grown up men and the deafening chaos wasnt a good idea. After all that was the middle of the 20th century. Every day one of us went to the operating theatre and returned moribund which scared us no end. But with time they recovered and after a few days went home. We all seemed to understand the warmth of this refuge. My lasting memory of the ward is its unmistakable strong smell of ether which pervaded every room and every corridor of the hospital. It was a odour synonymous with disease and suffering.  I remembered this smell well into my medical student days.

We looked forward to the evening when our parents came with oranges and grapes which we all shared later on. The nurses too were most kind and often brought us sweets and some even had the time to play with us and relate stories. I clearly remember a pretty young nurse, a paradigm of beauty to my young eyes, who played and sang with us. I had no true concept of time and seemed happy. When my temperature has settled Dr. MVP Peiris asked the nurse to prepare me for operation the next day.

In the morning of the operation I was dressed in a white gown and had my head covered with a white cloth. I felt rather sleepy and may have been given a sedative. As I lay on the trolley in the ward corridor my parents stood beside me, distress written all over their faces. They kept stroking my head and holding my hand. I recall working hard to keep awake but my eyes kept closing. As I shut my eyes the world went silent and all I could hear was my heart beat. I recall my father asking me to open my eyes that all is well. There is a vague recollection of the trolley going through swinging double doors which now I know must be that of the operating theatre. I can’t remember the details of what happened to me next but remember waking up back in the ward.

I saw the sun on the wall and it seemed like evening and my parents were by my bed. I had great difficulty in opening my eyes. It was impossible to move my body or limbs which baffled and frightened me. Perhaps that was the effects of the muscle relaxant. I was confused and couldnt think straight. I slept and woke up briefly several times that night. As the sun peeped through the windows in the morning my mind seemed much clearer and I was able to open my eyes fully. The nursing sister and the wonderful staff seemed greatly relieved to see me alive. They gave me sips of ice water as I felt so thirsty. I tried to speak but could only whisper and no one could understand me. I was terrified.. My parents came everyday and hung around stroking my head trying to comfort me. That was indeed an ordeal for a 7-year-old.  It took me to the outer edges of human tolerance. Throughout all this, I never doubted my parents’ love for me..

The ritual of penicillin injections continued everyday until I got better. Then I was back playing with the kids again. Finally the day came for me to leave hospital. My parents had arrived to collect my few possessions. They took a photo of myself with the pretty nurse which is still in one of our photo albums. My fellow patients looked on as I said goodbye and parted.

I can only vaguely remember Dr MVP Peiris but recall working with his daughter at Kings College, London, in 1977 where she trained to be a Dermatologist. The surgeon died many years ago.

I worked in Sri Lanka for 7 years before leaving its shores which even in a small measure helped to  repay my debt to my country.  My internship began in the Childrens ward at GH Kurunegala.  At any age being a patient in hospital is an ordeal that is never forgotten. For kids being incarcerated in hospital is a blistering experience. For me it was a lesson for the future. I often had a great deal of sympathy towards the kids and parents who took refuge in our wards. The people of the ‘Vanni’ lived desperately poor lives that depended totally on the monsoon rains. Infant mortality was high, diphtheria and diarrhoea being the worst killers although so very preventable. Sadly, they brought their sick children when they were at death’s door. I was immensely privileged to work with the paediatrician late Dr. Chandra de S. Wijesundera (he was married to  Manel Ratnavibhushana our erstwhile batchmate) and my colleagues Dr. HN Wickramasinghe and Dr. Priya Guneratne. They had boundless energy, courage and empathy to provide a wonderful service to every child and parent who walked into our ward. They are very special people indeed. I was so pleased to see HN on many occasions and Priya on my last visit to Sri Lanka in September 2013.

Trials in life can be a great privilege.  This ordeal may have shifted my focus towards a career in medicine.  It will always remain as the best decision of my life. I am much better off now without my tonsils. As a medical student in Colombo in the 1960s I have visited the old Childrens’ Ward at the GHC. It was now a General Surgical Ward . I looked through every window to recreate a bit of the old magic but alas nothing ever remains the same. Looking through the fog of time I have wondered what became of my fellow patients and the nurses who created a home away from home. The sickly scent of penicillin in the injection room did haunt me for many years later. But the memory of  the kindness and affection of the staff will remain with me  until the end of my days. My thanks to Dr.MVP posthumously and to all his team for a job well done. Thankfully my fever never returned.

Destiny was on my side. I survived !!!

(Blog Administrator's note: This article in original form was first published in the Sunday Island of 21 December 2003. It has since been updated by the author himself for publication in this blog)

 

7 comments:

  1. ND, you should most definitely write a book! Your relaxed style and ability to "paint pictures with words" is a talent you possess. I enjoyed reading your article. I never worked at the LRH myself apart from being there off and on as a medical student. Prof CC of course made a huge impression on me. I first thought he was a Brit, the way he spoke! I also recall his literary work "out steps the don" which I think was written after a visit to Russia. I am sure all of our generation also recall that peculiar and indelible memory of ether that pervaded the wards those days. Thanks again for a wonderful piece. - Speedy -

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  2. Thank you Speedy. It is just a true short story. So glad it is well received. I remember Prof CC and his relaxed style of teaching in an era when Medicine was full of egocentric Consultants. They instilled fear and provided a harsh environment. Despite this adverse comment it must be said we were fortunate to have such great teachers who despite their private commitments considered teaching as a duty to be taken seriously. I recall those years with much fondness and nostalgia.
    ND

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    1. I have been telling ND the same thing, but in different words. It's never too late to start. I should know! Very few doctors write their Memoirs. For that matter, very few write anything at all.

      As the Administrator of this blog, I keep a tab on the number of "hits" (viewers). As of today, we have had 25712 visitors. During the last 24 hours alone, 77 had visited the blog. That's quite a number. My guess is that all of them would have read this story about ND's brush with death.

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