Memories
of internship at Kurunegala 1967/68
Dr.
Nihal D Amerasekera
Entrance to the GH Kurunegala
With
the publication of the results of the final MBBS the vast dispersal of
graduates began. The euphoria of the MBBS with all its trappings of fame and fortune
was only dampened by the stress of the internship. Interns were at the bottom
of the pile overworked and underpaid (Rs 475.00 per month). Although this was
an extension of our apprenticeship we were now to practice the trade we had
learnt for five years. After a sheltered existence so far we had to learn to be
streetwise dealing with the public. To retain ones’ good humour and common
sense was vital. Ready or not we had to start practicing medicine in the real
world.
For
those of us whose local geography has been a casualty of the permissive
sixties, Kurunegala is a sleepy town at the edge of the dry zone on the way to
Anuradhapura. Most years the monsoons deserted the town and the clouds flew passed
ignoring its parched landscape. The elephant rock stands majestically in the
middle of town. During the day the sun beats on it mercilessly and in the night
it dissipates its heat keeping the town oven hot 24 hours of the day. The
400-bed hospital is built in a coconut estate. In-patient numbers far exceeded
the number of beds.
It
was an oppressively hot day in July in 1967. I remember as if it were yesterday walking up
a narrow street by the hospital into the House Officer’s quarters. This typical
government quarters painted a drab yellow was to be my home for a year. There
were 4 shared rooms 2 in each. Armed only with a suitcase and a sagging
confidence I took up my task seriously. The caretaker was an elderly man who
had severe asthma. No one knew his real name but we called him Rhonchi
Rajapakse. His cooking left a lot to be desired and reminded me of the
chemistry book description of oxygen - tasteless, colourless and odourless. He
had a young side kick who did the washing and cleaning. We took turns to be the
“BUTH MASTER” taking charge of the finances for the month to provide delicious
food at a reasonable price.
The
hospital was managed by the Medical Superintendent Dr.Bertie Wijeratne, a
kindly gentleman who had to serve the masses and balance the books. Interfering
politicians and local unions were the bane of his life. He juggled his many
impossible tasks admirably and with a smile. The Kurunegala hospital served a
wide area extending from Galgamuwa and Dambulla in the north to Anamaduwa and
Nikaweratiya in the west; Alawwa and Polgahawela in the south and Galagedera
and Kandy in the east. The west and north being in the dry zone, the people’s
lives depended much on the rainfall. They were mostly poor and humble but had vitriolic
and volcanic tempers towards their own. This often resulted in stabbings and
shootings for mundane trivial issues. They would kill for a dispute about a jak
fruit. Those from the south and east were relatively affluent and knew their
rights but were rather placid.
GH
Kurunegala – A view from the south side
My
first appointment was in paediatrics with Dr Chandra de S Wijesundera. I
couldn’t have wished for a kinder boss. He was dignified, generous and occasionally invited us for dinner at his house. (I had
spoken with Dr Wijesundera on many occasions when he visited the UK but we never
had the good fortune to meet.) I had H.N. Wickramasinghe, lovely Priya
Guneratne and Adikaram as the co-workers. “Adi” emigrated to the UK and became
a paediatrician working in the Middle East. He sadly passed away after a battle
with myelofibrosis. H.N has always been a great comrade and colleague and is a
successful GP in Hanwella. He was tremendous company and I have had many
evenings drinking together in the privacy of the Kurunegala Rest House. Priya was
a kind person and exceptionally helpful holding fort for us when we were oncall
and drunk beyond repair. She remained in Sri Lanka to serve its people. (It was
a great pleasure to see Priya in September 2012 at the Cinnamon Grand. She
invited me for tea with “Pattas” but sadly I had a prior appointment to keep.) Sanath de Tissera joined paediatrics when I
was 3 months into my rotation. We continued our friendship which began in
Medical College. In Paediatrics in Kurunegala, diphtheria and gastro-enteritis
were the killers, both of which were so easily preventable. It is said a family
never recovers from the death of a child. I still recall the deep distress and
the wailing in the ward after a death.
Thanks
to our teachers we have had a good all round training. The art of breaking bad
news and counselling the bereaved were sadly lacking from our repertoire. We
learnt these on the job. I recall one day when a seriously ill child of 2 years
was brought to the children’s ward. I diagnosed diphtheria and gave the
appropriate treatment. Within 30 minutes the child was in great distress with
breathing difficulty. I called the surgeon who came promptly and when the child
was taken to the theatre for emergency surgery went pale and died of asphyxia.
It is a well known complication of the condition. This tragedy has remained in
my memory ever since.
Sirima
Subesinghe (wife of our immediate senior batch Disampathy Subesinghe) was in
charge of the rota. She was firm but fair and provided great help to many young
“green” doctors who arrived in Kurunegala. (Sirima sadly passed away in Leeds
after cardiac surgery). We were on ‘call’ once every 3 days and once in 3
weekends. The calls were busy and a good night’s rest was a luxury we never
knew. The calls at night were brought to
us by a labourer on a bike. He knocked on our door saying” Sir, Call ekak” After the initial foul language we got
dressed to attend to the problem. When not on call, the evenings were spent
playing badminton with a drink before dinner. The H.O ‘s Quarters was a magnate
for the young Government Servants like the dentists, Veterinary surgeons and
Tax consultants who drifted in our direction for badminton and refreshments. We
immersed ourselves fully in the pleasures of youth.
The
Visiting Surgeons and Physicians kept their distance and rarely mixed with the
junior doctors. I believe channelling, tunnelling and funnelling private
patients kept them preoccupied. One who mixed with us regularly was Dr.Upali
Ratnayake. He sadly died of a cerebral haemorrhage in his prime at the age of
48.
The
doctors were the elite in town and were recognized and respected. The shops
gave us special discounts and the local cinema flashed our names on the screen
to say we were urgently needed in hospital ‘to save a life’. The doctors were
automatically made members of the Upper Club. It was an exclusive social club
in Kurunegala where the upper crust congregated. Every weekend was a party in
the quarters or in town and the booze flowed freely. Sing-songs were an
integral part of the fun. The general public and the local police waived off
our youthful indiscretions.
All
telephone calls to and from the hospital had to go through the hospital
exchange. Some of the guys manning the exchange were arrogant and unhelpful.
Calls to Colombo were trunk calls and we depended on the kindness and
generosity of the operators. To my recollection even for the 1960’s the
telephone service was poor.
It
seemed the flushing toilets had not reached the dry zone yet. The quarters had
bucket latrines and the daily ablutions were a tricky business. Those at the
back of the queue in the morning had to endure the worst. Sirry Cassim now a
senior Ophthalmic Surgeon in Colombo, had his own answer to the problem. He had
a generous stock of Bulgarian cigars (Bulgarian bog punt) which produced acrid
fumes to counteract the other nasty odours. The non-smokers had to make a quick
exit cyanosed and blue poisoned by the fumes and driven by the stench.
There
were many colourful characters living in the H.O’s Quarters. Pathology
Registrar Rajasekeran alias Kapoor was an honourable senior who had been there
for 6 years. He had a moustache like the
Hindi film idol of the 1950’s Raj Kapoor. He orchestrated the ‘misdemeanours’,
arbitrated the disputes and collected the funds for the daily consumption of
booze. Kapoor became a Consultant Chemical Pathologist at Bedford Hospital, UK.
I met him from time to time until he retired. He was much subdued then. Our
batchmate Rajasooriyar was our resident hermit. Being a teetotaller, he cared
for the sick and suffering doctors (from recurrent hangovers) and provided the
aspirin. Rajasooriyar qualified as an anaesthetist
and worked in the North of England where I tracked him down some years ago. He
still effuses kindness and speaks softly and deliberately, just as he did all
those years ago.
The
young Kurunegala damsels as they went past the house were greeted cordially.
After dusk the girls saw more of us. Many of the girls blushed and hurried past
but a few retaliated with some choice language. We spent many happy evenings
drinking and chatting putting the world to right. With our raging hormones many
of the topics had a sexual connotation. There was a strong and healthy
relationship with the nursing staff who were invited for our fun evenings. For
some love blossomed. For others it was just a one night stand. The house
officers quarters were a honey pot for marriage brokers who came from far and
wide on fact-finding missions. Big bucks were mentioned and “fit-ons” were
arranged. Deals were done in a backroom. Those who volunteered information (our
servants) were on our payroll and the routine was well rehearsed.
On
weekends we made trips to Kandy, Anuradhapura, Sigiriya, Dambulla and Puttalam
which were a striking distance away. Once we went to Sigiriya and Sirry took his
gun with him and shot a wild duck. Rhonchi Rajapakse cooked it for us. We still
may have lead shots lodged in our appendices to remind us of those happy times
of our internship.
The
Law-Medical cricket match was the highlight of the year held in the Kurunegala Town
Hall. It was similar to what we had in Medical College Colombo, a fun filled
programme with a concert ending with a dinner and dance. The funds for the
event were collected from the hospital Consultants and the Private
Practitioners who, to our eyes, had tremendous wealth. The drinking began at
midday and some of us forgot the lines being completely ‘stoned’ during the
show. Those acting as angels could hardly stand. Few could remember how it all started
but none could recall its end. Many had total amnesia for the whole event start
to finish.
The
second appointment was surgery with Dr. N. Rasiah. He had a certain a magnetism and charm and
took life and his work easy. (He is now living in retirement in Australia).
Dynamic and mercurial Tudor Wickramaratchie
was my colleague. Tudor loved the good life and held his drinks well. His sense
of humour and his interesting and provocative ideas made him a joy to work
with. Tudor emigrated to the UK and became a Pathologist in Bristol. He passed
away in the Golf Course playing the game he loved. The Surgical training was a
strenuous six months with many knife injuries. During this period I had to deal
with 4 murder cases which were committed to trial in the Supreme Court. Once a
woman was brought with a vaginal prolapse bitten by a dog, while she was
asleep. The husband had more sympathy for the dog than his dear wife.
Mist
Sodi Sal and Carminative formed the bedrock of our treatment. Aspirin tablets
were given out like Smarties. Once whilst returning for lunch there was an
almighty commotion by the gynae ward. A man in national dress was shaking his
fist unable to contain his anger and one of my doctor colleagues was calmly
explaining to no avail. It transpired the man was accusing the houseman of stitching
the episiotomy too tight. The doctor finally asked the man to mind his own
business, which left him rather speechless.
Time
moved on swiftly and relentlessly. The colleagues who shared our house had
become a close knit family. Despite the hard toil it is the good times that often
come to mind. At the end of internship I distinctly remember the sadness I felt
saying goodbye, many of whom I never saw again.
Some
of us took the advice of Rudyard Kipling “Go West young man”. As Sri Lankan
politics was in turmoil and our coffers were empty life for the middle classes
became intolerable. There was a mass exodus of doctors to the USA and UK in
1968. I was to remain in Sri Lanka for a further 7 years. My future was decided
by politicians in head office and depended on whom I knew and not on my
ability. My career development was at a standstill when I decided to join the
rest of the herd for greener pastures abroad. Although I had agonised about it
I never realised the enormity of that decision. My youthful exuberance
protected me from the fear of reality.
I
dedicate these memoirs firstly to the many doctors who have walked the long
corridors of the General Hospital Kurunegala. Secondly to the simple, kind and
generous rural folk of the Vanni who had implicit faith in our powers of
healing. Thirdly to the nurses who taught us practical medicine and provided
warmth and comfort during those difficult times. I must thank our teachers at
Medical College and the Consultants at GHC who taught us the basics so well.
I
remember with deep affection all those who shared our lives together and are no
more. May they find Eternal Peace.
Senior Hospital Staff - 1967/68
SHS – Dr Kulasiri/Dr
Oliver Fernando MS- Dr Bertie Wijeratne MO in Charge OPD – Dr Sabapathy
Blood Bank M.O – Dr
Aloysius De Silva
Physicians- Dr Parakrama
Weerasekera and Dr Miloo Visuvaratnam
Surgeons: Dr Arumugam and Dr N Rasiah
Anaesthetists:
Dr Dharmarajah and Dr Dexter ……
Obstericians: Dr
Andrew Perera and Dr Upali Ratnayake
ENT Surgeon: Dr Ana de Soysa Eye Surgeon Dr Miss Muthukumarana
Paediatrician: Dr C
de S Wijesundera
Radiologist : Dr
‘Poosa’ Jayawardene
Medical Officer in Charge of TB
Services:
Dr John Douglas Seneviratne
I am now living far away from my beloved country and
Kurunegala. All that is left is a storehouse of wonderful memories of times
gone. Yet in an odd twist of homesickness, what I miss mostly are the people
and places I knew in my youth.
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