Reflections on my retirement

By Dr Nihal D Amerasekera

I recall most vividly the euphoria on being a doctor in 1967. I was completely overawed by the occasion. For my family this prestigious position was a dream come true. The excitement lasted several months until the rigours of a professional life of sleepless nights and busy days wore me down. I saw the long and tortuous road ahead of more examinations and the unrealistic expectations of a room at the top. Having reached there, now, my retirement looms large. The bell has rung for the final lap of my marathon of 40 years in medicine. I look forward to this well earned rest with the same excitement and euphoria as at the beginning of my career. The long years of toil has taken its toll.  Hopefully I have emerged more philosophical with an ability to live what’s left of my life without the driving ambition, greed and avarice of my youth.

I have delved deep into the archives of my mind to recall why and when I had chosen a career in medicine.  Those recollections were hidden at the bottom of a mass of countless memories. Only a small fraction of that thought process could be salvaged despite my valiant efforts. I was then fourteen and full of the joys of life. I just wanted a career with a stable job and a regular income. In those days this was synonymous with government service. I wish there was a more noble reason for my choice. Helping the suffering humanity and relieving pain was the inevitable fallout from my choice of career.

The first public hurdle was the GCE O- Levels and the requirement was 5 credits. Then came the University Entrance examination which was a game of chance. Just 300 were chosen from several thousand able candidates. My journey into the profession began in Medical College. I still feel deeply nostalgic for the bohemian lifestyle and pranks of my days as a medical student. There I was introduced for the first time to the drink of the Gods, a habit which was to last a lifetime. We seemed to have everything to live for despite the hard grind. During those gruelling years what impressed me most was the dedication and commitment of the Physicians and Surgeons of the General Hospital, Colombo. They taught us their craft unstintingly. Our apprenticeship was worth its weight in gold. We emerged confident and with a sound practical knowledge to face an uncertain future in a country in turmoil. Many couldn’t accept the status quo and left the island. I stayed on in the hope that good times would return.

My internship in Kurunegala gave me an insight into life away from the big city. The power cuts and the water shortages were a regular feature. I learnt to accept this with good grace knowing how much more the villagers suffered. I still feel deeply for the simple rural folk of the “Wanni” who had such implicit faith in my powers of healing. They often thought I had influence over life and death.  When I think of the individual patients and recall their anguish I wish that was true. The gods, nature weather, politics and disease were all heaped against these simple folk. Sadly  their only release from this enormous burden was death. Little has changed since the graphic description of  the hardship of village life by Leonard Woolfe in his “Village in the jungle” at the turn of the last century. This grim reality was accepted as the norm by politicians who could have done much more to improve their life. In Kurunegala, my life and career was at a standstill. I applied for a transfer to Colombo. After much heartache my wish was granted.

In 1970 our economy was in serious distress. The country was seething with unrest . The tide of discontent reached its peak with the insurgency of 1971. After it was promptly and brutally crushed the dust settled slowly. The government imposed strict import restrictions. All foreign goods became too expensive. Only politicians and the very rich could afford such luxuries. There were restrictions on leaving the country like in the Soviet Republic. The intelligentsia made use of their political connections to go abroad which was then euphemistically called the brain drain. I was frustrated by the erosion of our freedom and was overwhelmed by a feeling of oppression. The country seemed to be heading into an abyss.

After the house jobs my career prospects became a part of the Health Department lottery. For seven years I had drifted from one job to another. In sheer desperation, finally, I decided to pack my bags to seek my fortune abroad.  The decision to leave my family, friends and country was not taken lightly. I still recall the sleepless nights  the agony and the anguish. This at times tore me apart. I wanted a different life from what I saw around me and was attracted to the bright lights and the sophistication of a life in London.  The day of my departure came too soon. I left for London in  June 1974.

In London  I struggled with the cold and looked for jobs. My Sri Lankan friends helped me overcome homesickness and maintain my sanity.  In those distant days racial discrimination was rife both in day to day life and also in the National Health Service. I learnt to accept these vagaries. I had to be twice as good as a local candidate to get a job and often even this wasn’t good enough. There were times when people curiously preferred to stand in the bus than sit next to me. Despite these setbacks I passed my examinations without delay and was fortunate enough to work in two of the most prestigious teaching hospitals in London for a period of five years. This is however more than what I could have ever achieved in my own country. As my finances improved. I developed expensive habits. Although guilt ridden, I ventured to buy myself a small car. After the manic driving in Sri Lanka I re-learnt to drive sensibly in England.

With the postgraduate exams completed I found my room at the top in a town 50 miles north of London. It is a leafy suburb created after the war to accommodate the spill over from the East end of London. The prevalent Cockney accent was a source of amusement having being brought up on the high-brow BBC pronunciation in Colonial Ceylon. They were a friendly bunch although rather stoic and rough, at times. I found a house in a peaceful village by a golf course which has been my home ever since. Here I have seen the summers come and go whilst serving the local community.

Working in the UK is a pleasure. Their work ethic is exemplary and I learnt enormously from their attitude to work and patients. They plan well for a crisis before it arises. Their dedication to duty and their commitment to patient care cannot be faulted. On my retirement it grieves me to leave an institution with such a fine work force. The hospital has grown in size and stature to become one of the best in the country. We have the most modern equipment and experts to provide good healthcare. It has been a privilege to be a part of this team.

In 1974 I joined the best Health Service in the world which was free at the point of use. Over the years the patient demands became greater. They wanted the best service in the world - free and were not willing to accept the inevitable medical errors. They were quick to resort to litigation for minor issues. The legal bills and the cost of such a service became too great for the government to finance. Then the cutbacks began to erode into patient care. At present the National Health Service is in crisis providing a substandard service. The doctors are disillusioned and leaving the country in their thousands. A brain drain yet again as I saw in my youth in Sri Lanka. The politicians are not prepared to inform the public they cannot afford a free health service. This they reckon would be political suicide. So the blame for this multifaceted problem lies on the Politicians for their lack of honesty and guts and the patients for expecting too much from a ‘free’ service.

I have now reached the end of a long journey. My most abiding memories are of patients who also became my friends. I would never forget the tremendous courage of those who had only a few days to live. Many showed remarkable bravery in this most difficult situation. Some had a strange premonition of when the end would come. These deep and conflicting emotions of my professional life has been both challenging and rewarding.

I leave the medical profession with a heavy heart but also happy to be free again. Now I can get on with my life without the time tables and onerous routines of a hospital doctor. Would I study medicine again if given a chance? – yes, indeed. Diagnosis and treatment are a  difficult but fascinating challenge. The physical, mental and emotional demands of the profession although exhausting has its rewards. Its camaraderie and team work makes the work attractive and motivating. People ask me how I would spend the rest of my life. This would indeed depend on maintaining good health and having sufficient funds. I wish to travel when I can carry my own luggage. China, Australasia and South America have been on my list for many years. Cricket has been my passion since childhood and now I would be free to watch it live at Lords or the Oval and also on television.  Listening to music, reading and going to the theatre would fill my days with pleasure. I would not work again for money. I have paid my dues to society!! The driving desire to earn money has left me now. We leave this world as we came – with nothing.

I have missed my family in Sri Lanka enormously and have paid a heavy price for my desire to live and work abroad. I wasn’t present for the births, weddings and deaths of those most dear to me. I am now a stranger to the new generation born during my absence. I feel a foreigner in the country of my birth as Sri Lanka has moved forward in leaps and bounds despite the destructive forces of a long ethnic conflict. Although I live happily in England I have left my heart in that beautiful island of my birth and the land of my fore-fathers.

I have lived a passionate and impetuous life. These are attributes that could lead to serious grief and there was. When I look back what stands out is the awesome force of destiny. There are countless examples of this unusual and unexpected phenomena in my eventful life.  I was one of the few in my batch at Medical College who did not want to leave Sri Lanka. Extraordinary circumstances in my life paved the way for this change of heart. Then I always wanted to be a physician but by a strange turn of events I was directed towards Radiology. This was a godsend and I have never looked back. I am appreciative of the luck and the privilege. Thankfully destiny has smiled on me and good fortune has been on my side most of the way.

This closes the chapter on my professional life. Hopefully the new phase would be sedate and a peaceful. As always destiny would have the last word.

I must pay tribute to my parents. They have been my inspiration always. I compliment most warmly my dear wife who had to endure and share the pain  and hardship of my demanding  professional life.

May God Bless them all.