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Tuesday, September 1, 2015

Prof. Kumaradasa Rajasuriya – A Life Remembered

 By Dr Nihal D Amerasekera





I have been a critic of the harsh environment of education during my years at  the Faculty of Medicine Colombo and  have every reason to stand by what I have said about those difficult times. In my discourse there was a reference to Prof. K Rajasuriya who was the ‘Czar ‘of the Department of Medicine which was less than complimentary. We saw only a small snapshot of his life as medical students and there was much more to him than was on display. This spurred me on to learn more to find out for myself what he was really like.

Kumaradasa Rajasuriya was born in 1915. His father was a Station Master and the mother brought up seven children. His parents were determined to provide the children with a good education. KR was educated both at Ananda and Nalanda Vidyalaya in Colombo. Tragedy struck at the age of 8 years when he injured his left knee severely and he was left with a stiff joint for life.  His characteristic gait became his hallmark. That ended his ability to play sports and take part in normal childhood pursuits.

Although it was his desire to study the Arts in the hope of a job in the Civil Service his uncle who was the Principal at Nalanda changed it all and made him study the sciences for entry into Medical College. At this institution there was the usual baptism of fire while joining the ‘Block’. The Law-Medical match and Body feeds had its own thrills and spills which he enjoyed. The clinicals began with the strict regime of a 7.15am start. As there were only four students in a group they received the ‘bullets’ more rapidly and frequently and life was tough. He took an active part in the pranks and the fun that was ever present during those happy years. For his indiscretions he was summoned before the Council but later was warned and discharged. This probably resulted in a cynical antipathy to authority as we saw much later. None of us could have imagined all this from the man whom we feared in Ward 41.

RK left the Medical College in 1940 with a First Class degree and the LMS. His first appointment was at Murunkan when he was confronted with a Cholera epidemic. Then he served as Prison’s doctor before proceeding to England for postgraduate studies. In 1952 he sat the MRCP examination and was successful. He speaks warmly of Dr WD Ratnavale who coached him for this difficult examination.

After the MRCP he went on to get the DCH as he had a great love for children. RK started work at the prestigious Great Ormond Street Hospital in London. In his own words “I spent some of the happiest days of my life in that institution
where hard work was appreciated. I was thrilled when the time came
to demonstrate cases during grand rounds. I demonstrated three cases, the diagnosis of which had escaped others”.

On his return to Ceylon he obtained his MD in 1954.   He worked as Physician Jaffna 1953-54 and then proceeded to Kurunegala. There were many cases of diarrhea and dysentery.  It was here RK used coconut water for IV infusions as saline was in short supply and mostly unavailable. This saved many lives. In 1955 He was appointed as Physician Colombo. That was the turning point in his life. At the young age of 43 he was appointed Co-Professor of Medicine in Colombo. Soon after this Prof PB Fernando fell ill and Dr Kumaradasa Rajasuriya was appointed Professor. He was both surprised and elated by this turn of events and in his own words “I became a member of the intellectual elite of the country”. He did much to form the Ceylon College of Physicians in 1964 and was elected its President in 1971.

His part in the 1967 malaria epidemic is worthy of mention. There were several cases of the dreaded Falciparum malaria in Matale, Minipe and Elahera. With help of the GA Kandy he established a camp at the Weragantota Rest House supervising the diagnosis and treatment of malaria and establishing there was a serious possibility of the disease spreading country wide. He coordinated troops from his own department to travel  to all parts of the country and help in diagnosis and training.

Prof KR showed great kindness towards his patients and did everything possible to make their lives comfortable. He wanted his students to develop that same empathy. He had an uncanny and enviable ability to ask simple questions from patients to help in a diagnosis. He believed strongly that a medical school should not be an ivory tower but should carry a full clinical load and serve the medical needs of the community. He worked tirelessly to provide a fine clinical service despite his teaching commitments. His junior staff treated him with great respect, not only because of his innate ability but also because his formidable memory often led him to recall a patient’s problems far better than they did. He ran a happy and enthusiastic department.

He had many publications and papers in addition to his writings on the history of medicine in Ceylon from the 5th Century. He produced valuable research on Cirrhosis of the live and chronic pancreatitis in Ceylon.

Prof KR was the Director of Health Services when the insurrection broke out in 1971. During this period he rallied the medical services to do their best in difficult circumstances. The A&E in Colombo bore the brunt in accepting and caring for the injured. Prof RK spent the nights in the A&E unit in support of the doctors. He was essentially a person who wanted to care for his patients. To be sitting at a desk at Head Office and pander to the whims of Politicians was not to his liking. He returned to clinical work again in 1972 and described his years as Director as being in the wilderness.

As Professor of Medicine his lectures were precise and complete. He was a fine enthusiastic teacher. When I was a medical student many of us after qualifying worked in peripheral hospitals where facilities were pretty basic. Medical officers had to depend more on their clinical sense.  Good history taking, a complete clinical examination and the ability to elicit clinical signs was crucial. As a clinical teacher he felt it was his duty to teach all students who came under his tutelage to be able to provide good clinical care. When he felt we did not work hard enough he was tough and often ruthless. The relentless pressure and the sarcastic comments were at times hurtful and on looking back unnecessary. But one cannot fault his vision and determination.

Prof. KR was a devout Buddhist and had a great love for the history and the culture of the country. He remained a controversial figure with his views on nationalism and religion. Such views spilled over when he was angered in the presence of medical students. The comments were general and to my knowledge never directed to any individual. During my 2 months of the Professorial appointment I was never singled out or admonished. There are many others who were not so fortunate and were left to lick their wounds in great despair. It is said he was fair at examination whatever the race or religion. I think he was fair during the clinical appointment too. What he despised was what he called laziness or being unable to take a good history or elicit physical signs.  I am personally unaware of his views and actions outside the precincts of the GHC and the faculty.  But within those walls I have no reason whatsoever to believe he was unfair in the way he administered and carried out his duties as the Professor of Medicine. I am certain we will all have a different take on his attitude and behavior.

He died suddenly of a heart attack in 1975. The suddenness  of his demise brought great sadness to many. We lost a consummate physician, a fine teacher and a superb clinician. I will always remember him for teaching me the importance of history taking, examination and the correct way to elicit physical signs. These stood me in good stead when I went up for the MRCP examination in London. On  receiving my results the person who came to mind immediately was Prof K Rajasuriya. I said a quiet “thank you” to my guru.

He had many interests other than medicine which we would never have imagined. His hobbies were painting, writing poetry, and model trains. He was unmarried.

“It is far easier to criticize than to understand”

May he find the Ultimate Bliss of Nirvana.



22 comments:

  1. I have mixed feelings about Prof Rajasuriya. I don't doubt his ability and his dedication at all but found his attitude a bit difficult as I have pointed out before. I like to be treated as a responsible adult and didn't quite appreciate his method of "encouraging" students. But as you say ND, "it is easier to criticise than to understand". Apart from that, he was clearly a dedicated, able and sincere man.

    By the way, there is a slight inaccuracy on when he died, as it was 1975 and not 1971.

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    1. I have looked into my notes -you are correct he died in 1975. It is a typographical error. In the 21st century lecturers are expected to be trained to teach as my son has done to get a diploma in education. The Prof did his best the way he knew. Let us be generous and appreciate the good things he has done in his life. None of us are perfect.
      ND

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    3. Agree with you absolutely. It is good to emphasize what is good in people and understand that we all have failings as we are all human.

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  2. I think Speedy is correct as to when Prof. Rajasuriya died. It was after Mrs. Sirimavo Bandaranaike came to power in 1970 that Prof. Raj was appointed the Director of Health Services. I know that he continued in that post for a few years and reverted back to the post of Professor of Medicine about two years later. So, he certainly couldn't have died in 1971. According to an article written by Prof. Mahasara Gunaratne (published in the Journal of the Ceylon College of Physicians), Prof. Rajasuriya had passed away on 2 January 1975.

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    1. Thank you. It is a typographical error. Please make the correction in the article if it is possible.
      ND

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  3. By the way ,ND it's called a 'TYPO ' in the Antepodes.--- peculiar lot !!! I had put up with that LOT for 6 years. correcting their wonky English grammar, use of vowels and their recycled jokes, for a starter!!!!
    As for Prof Raj., I totally agree with Mahen. We are all ONLY HUMAN-- we all have our frailties, faults and failings. So had Pro.PK - he is no GOD. No one should have any thoughts of vengeance nor ill-willl towards ANYBODY - CERTAINLY I bear NONE of it,what ever, towards any of my fellow beings -- I have NO enemies., as yet!!!.
    May his soul REST IN PEACE & ATTAIN THE ULTIMATE NIBBANA for all he has done for us, his students, and more importantly to HUMANITY.
    Razaque


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    1. Amen! Razaque. I too have no ill feelings or animosity to anybody. The funny thing is that the person who benefits most by that attitude is yourself! Spit has a habit of landing on your own face!

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    2. Razaque
      Thank you for your comment. Typographical errors are more common with age. I hope Atul Gawande has a magic portion for this common malady which he has not included in his fine book. My treatment is to read the text more carefully before sending it for publication but this task too has to be remembered.
      It is always good to hear from you Razaque from the inseparable Wattala Mafia of the 1960's
      God Bless
      ND

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    3. Thank you, ND & Mahen.
      The "Wattala Mafia of 1960's" -- as I could recall it was in excess of at least 11, including Seniors and Juniours -can name them,---- , may be more.!!!
      Mahen you are right. One should be careful to 'Spit' even in the prone or supine positions as well--- certainly NOT into the storm or the wind --- (wind not the ones you are used to passing)!!!!!
      Razaque.

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  4. I've read ND's well researched article and the comments by Lucky, Speedy and Razaque. My contact with Prof R was minimal, because I think he was out of the country when I did the rotation in his ward. The senior female medicos scared me into donning a sari with a long sleeved blouse , instead of my more comfortable dress when I was assigned to that rotation. Somehow, I also missed him at the final exam in Medicine! I think his tyrannical reputation may have been mostly legendary. I remember that his lectures were very good. I've never forgotten the correct way to palpate a spleen! He was a good teacher. Srianee

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  5. Srianee
    Thank you for the comments. Your return to our fold has added a fourth dimension to our Blog. Do please stay with us.
    ND

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    1. No ND, ---- its the 8th Dimension -- that's about - of us, that seem to seem to have any 'response' in this Blog of OUR BATCH. -------------ITS'S A SHAME!!!!!.
      Razaque

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    2. Raz
      Very true. Got to get the Wattala Mafia on the job and get batchmates to communicate in this digital world. A few clicks of the rodent and you are in.
      ND

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  6. As I have outlined earlier, my encounter with Prof.KP in the clinical arena as a student was mot a very 'happy / pleasant' one when I was doing my Professorial Appointment!!
    However years later I had another encounter with him when I was DMO Siyabalanduwa. He, as the DHS then, was visiting the Monaragala District and there was a Lunch organised by the GA, at the Monaragala Rest House. Putting our differences behind I attended it along with the DMO, Monaragala,- Dr Milrory Nanayakkra de Silva-- by the way he married the Actress Punya Heendeniya --what a FINE & FRIENDLY person Punya was.!!.
    Before LUNCH we all had 'drinks'- I with the AMBER COCONUT WATER! & Prof. had -- a Fruit drink, but it was not 'THE BARLEY WATER'!!!. We had a chat & when I mentioned my Designation,& to this he said "You must be having a good PRACTICE" rather sarcastically meaning PP !! I replied "No, Sir, I shunned a lucrative PP partnership to work here in the 'Wann[-- the 'out back. I do not indulge in BAD PRACTICES"-- rather annoyingly.
    To my surprise he apologised profusely and said " I am glad you are helping those poor people and thank you"!!!! I thought that he might remember me and I could 'influence and be 'lenient' to me if and when I did the 'MD'!!!
    Then I related the incident where a patient's husband 'presented' me a hind quarter of a wild boar- "wal uru mas"!! He could not contain his laughter & he spilt his 'drink' all over his coat!!!!
    "NEVER THE TWAIN" ever met up again.
    I suppose I made up to him -- ALLS WELL THAT ENDS WELL.

    Razaque

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  7. Raz
    Amber nectar and Wal-uru-mus what a combination. I wish I was there!! Reminds me of a trip to Rattota when RADW Bernard was DMO. We sang until the 'wee' hours of the morning. Now I have turned a new leaf and keep to the 24 Units of Alcohol/week but my quota finishes too early and have to borrow from the next week. I maintain a healthy overdraft of units.
    ND

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  8. ND had said somewhere that he is interested in knowing more about the private life of Prof. Rajasuriya. I have heard from third parties that his private life was totally different. As students, we saw only one facet.

    Some years ago, I heard an interesting story about him. When he was DHS, he had gone on circuit to Moneragala where the DMO was Dr. Milroy (MB) de Silva who was two years senior to us. As most Sri Lankans do, Milroy had invited Prof. Raj to stay overnight in his bungalow as Milroy himself was a bachelor at that time. Since there was only one bed, both of them had slept in the same bed. According to Milroy, Prof. had been relating yarns and also sang a few sinhala songs late into the night.

    I have not been able to verify this with Milroy, but Razaque's comment about Prof's visit to Siyambalanduwa corroborates it. Milroy later married film actress Punya Heendeniya and migrated to Zambia.

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  9. Much has been written about the ordeal medical students of our era went through with some of our Professors. As Srianee had pointed out, I too may have been in a group that missed the Professorial appointment with Raj, probably for the same reason that Prof. Raj was out of the country. I can't recollect doing that dreaded professorial appointment.

    Speaking (or writing) entirely on my behalf, I must say that Prof. Raj was extremely nice to me during the few encounters I have had with the great man. I don't know whether he looked into each student's background just prior to such encounters!

    Who knows? He may have found out that I am a Sinhala Buddhist who attended Ananda College! Believe me, he never knew who I was. My parents were ordinary folks who didn't try to be familiar with my teachers.

    At the final examination, I don't think I ever stepped out of line. I remember answering the Medicine theory paper well. The long case was a breeze. He may have been impressed.

    After graduation, in the year 1972 when he was DHS, WHO Fellowships for the year were advertised. I applied although I was only 18 months into Public Health (the ad stipulated that applicants should have a minimum of 24 months experience in PH). I made out a case that the period I served in the Anti VD Campaign in 1968 be counted as PH. I was called for the interview. The Interview Board was headed by DHS himself. I remember Prof. Priyani Soysa being there. To cut a long story short, I was selected although I was the junior most applicant among the lot. That's how I ended up in Berkeley, California just 5 years after graduation - a 24 month Fellowship, an MPH degree and a chance to go abroad so early at no cost to me!

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  10. Hi Lucky, my good friend,
    Its nice note your comments about Prof. Raj's visit to Moneasgala. I was DMO at Siyabalanduwa iin '69//'70, (& DMO Ittapana in '71 during the Che Gueara Uprising!!)-- Prof's visit was in 1970. I distinctly remember the dates as I was taken to Moneragala Hospital by ambulance following a bad attack of Malaria and severe Cellulitis of my right leg. Milroy treated me in a 'special' room in the Hospital and my food was provided by his wife, Punya!!! A GP there, Dr Parmajothy - a good friend, regularly visited me and kept my "mood" up. I also do remember that Milroy and Punya had a baby girl - the name of whom escapes my memory just now-- 'naki wayasa' and not "NAKI VISAY"!!!!! My sister, a very good seamstress had hand-sewn a beautiful dress for the new born as a gift to the child. It was during this period that Prof.Raj visited the area .During my stint in the area I moved very closely with Milroy and Paramajothy. as there was nobody else to keep my sanity intact!!!
    I have not heard the story that you relate and I am not in a position to give any credence nor refute it?? All the evidence indicate it is 'Hear say.' In fact the Monaragala DMO's Bungalow is fairly large & nice place next to a 'running' stream and I have visited it several times before Raj's visit, unlike mine -- a two bed roomed "shack" just about habitable and just as well I was not married at the time!!!. In fact one of my Uncles, Dr Nizam Ismail, was DMO, Monaragala in the early '50's. You may have heard of him as he was MOH, Kandy in the early '70's at the time of my marriage.
    I hope I have shed more light to Raj's visit to Monaragala as DHS. and given some insight.
    Yes, Now I remember - delayed memory response!, the little girl of Punya and Milroy was named....... wait for it...... ANUPAMA.
    Also the last I heard was that Milroy was a GP in North London and one of his sons is also a doctor!!!!
    Our fondest regards to You, Mangala & family.
    Razaque


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  11. I have tried hard to make a case that Prof KR was a good man and that we saw only a snapshot of his life in the Faculty and Ward 41. But there are some who feel differently and have good reason to be that way. We were all fellow travellers together in that long and tortuous journey once just for a short while. I hope with the passage of time and becoming wiser we all can forget the past and wish him well.
    ND

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  12. I think it is far to say that all of us are a complex mass of feelings, experiences, views and perceptions. What we are at any moment are coloured by where we are, with whom we are and the challenges and opportunities we face at that moment. This whole complex "being" is constantly changing, readjusting for survival and makes judgements on whatever is around us based on past and present experiences. The only sensible thing to do is to recognise this and always try and focus on what is good and what is commendable in people. Prof Raj may have "areas of difficulty" and disagreement but as ND says, let us remember him for the good things he did, of which there are many, but at the same time not turn a complete blind eye to some of his regrettable views and actions. To hold no grudge and be forgiving and understanding is the quality we must strive for and the good news is that this then becomes a "win-win" situation for all. - Speedy

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  13. Thanks Mahen. No one can put it better. Let us remember the good and forget the rest. Our lives will be so much the better for it.
    The disdain and the antipathy I have for politicians will however remain for a lot longer !! They have the unenviable task of pleasing everyone but end up pleasing no one but themselves.
    ND

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