Speedy Dialogues

THE SPEEDY VIRTUAL INTERVIEW SERIES

Speedy Dialogues

Episode 3, January-February 2019

Speedy with Appu Sumathipala

On, “Ward Classes, our Clinical teachers and anecdotes”

Speedy: Good morning Sumathi. Thanks for being my 3rd subject. Shall we start?

Sumathi: Good morning Speedy. I am ready and thanks for inviting me to join your series. I have enjoyed reading the first two.

Speedy: I am glad you did Sumathi. Let me begin the dialogue. Our clinical training included "Ward Classes" where cases were presented to the teacher by the student at the patient's  bedside and discussed. Can you recall any amusing incidents or moments of great teaching during them?

Sumathi. Let me try and answer your question.

My recollection is that most of the ward classes never ended up well, as there were pending lectures and we had to rush to attend them. Some of the histories taken were laboriously done and not relevant to the clinical problem. Eliciting of clinical signs was not very precise, and there were no proper demonstrations by the tutors.

Speedy: I myself think that there was quite a variation and while most tutors were excellent, some left much to be desired. Ward classes by Dr Wijenaike, Dr Ernie Pieris, Dr RienziePieris, Dr George Ratnavale, Dr Thanabalasunderam, just to name a few, were excellent. Can you recall teachers who stood out in your opinion?

Sumathi: Physicians with outstanding teaching qualities I recall were Drs P R Wickramanayake, K S de Silva, D J Attygalle, R S Thanabalasunderam (he was a maestro in interpreting ECG findings.) I still remember his words, left axis deviation-horizontal heart, right axis deviation-vertical heart. Prof Raj had a high regard for him. In fact, Prof. used to ask us about previous Consultants who taught us.

Speedy: What about surgeons?

Sumathi: DF de S was a soft spoken surgeon, slow and steady in contrast to Antho, who was fast and very precise.

Speedy: DF de S certainly was very soft spoken and we used to joke about his “secrets of surgery”.  Antho was the confident showman.

Sumathi: I had the privilege of having my surgical attachments with them. Last but not least, Dr Niles, who I can remember conducting a tutorial few weeks before the finals and appealing to the students to ask questions. He used the word "now or never". I am sure our Yoga did his 6 months Surgery with him. He was known to be a good theoretician but no one was sure about his surgical skills. I also remember assisting Prof Milroy Paul during my days in the Surgical Admission Unit (most probably during the final year). There was a case of acute abdomen on the day the Professorial unit was on take. The patient was taken to the theatre and I assisted Prof. He showed me the obstruction in the large bowel which he resected. The end to end anastomosis was superb. I never had a chance to follow up the case. His surgical lectures were full of sarcasm towards some of the UK Surgeons.

Speedy: Yes, the Paul brothers were quite distinguished. His brother as you know was ATS Paul, 

Cardiothoracic Surgeon. Prof Milroy had what we called the “triple”, the FRCS, MRCP and MRCOG, which was possible those days. He was the first Professor of Surgery at the Ceylon Medical College and the first Ceylonese to deliver the prestigious Hunterian Oration at the Royal College of Surgeons and he did that three times!

Sumathi: That reminds me of a story about his experience at the Royal College of Surgeons when he went to deliver his Hunterian lecture which you just mentioned. According the story, he was the first to attend and the person who came next wanted to know whether Prof was sitting for the Primary. His reply was that he had already passed. The next question was whether he was sitting for the Finals. “No, I have already passed that too” said Prof. Then to his amazement, Prof told the guest that he had come to deliver the Hunterian lecture. I am sure the guest could hardly believe that a small made chap of Asian origin had come to deliver a prestigious lecture to a very distinguished audience.

Speedy: That is a great story. I heard it slightly differently. It was the doorman who questioned him but the essence of the story is the same. How about some funny anecdotes?

Sumathi: I can think of several Speedy. When we did our attachment with Prof Rajasuriya, a question was asked about the creature that caused scabies. One bright student said that it was scabies scabiei . When it came to my turn I gave the correct answer,sarcoptes scabiei. Would you believe, that very student did well at the final? Not only that, he got his MD (Cey) and became a Consultant in General Medicine and migrated to UK, after getting early retirement from the Health Service.

Speedy: I wonder who it is, but I won’t press you. Just shows that a thorough knowledge of Parasitology is not essential!

Sumathi: You can guess! Only two from our batch passed that prestigious MD (Cey). You were one of them and the other person is pretty obvious. He and I did combined studies during the third year but missed out during the final year.

Speedy: His ears must be burning!

Sumathi: There was another interesting Surgical tutorial,where a question was asked about the clinical diagnosis of fracture of neck of femur, whether it is intracapsular or extracapsular. I was ready with the answer as I had read Hamilton Bailey. The Consultant was a Sri Lankan Muslim and I have forgotten his name. He also mentioned that cases with hip diseases were presented at the Final FRCS. Anyway, the Consultant was very impressed with my knowledge of Orthopaedics. During the Orthopaedic attachment we had a few cases of missing arms and limbs from birth. I used to tease Virginia, who was in my group as she was clueless about the Medical terms for those conditions. Remember terms Amelia and Phocomelia?

Speedy: I can’t remember whether at that stage I would know those terms. I would have thought that Amelia was a girl! I sympathise with Virginia.

Sumathi: I know you are teasing me! There were a few “colonial types” that I remember. When we did our attachments with Dr Austin, we had to wear ties and he was a terror.

Speedy: I remember Dr Austin very well as I had ward classes with him; quite an imposing character. Can you remember the eye surgeon, I think he was Dr Weerakone who  insisted that we wore ties for his ward classes?There is a story about him and Geri Jayasekera. Geri forgot his tie and borrowed a theatre nurse’s green cloth belt and put it round his neck like a tie. Dr W lined us up as usual and gazed at everybody one by one and when he came to Geri, he paused for just a moment and carried on the inspection and Geri escaped!

Sumathi: I can well imagine Geri doing that. He had such a great sense of humour. You know of course that he was good singer too. Remember his song with his brother Perrin, called Maluwelenda?

Speedy: Of course! The famous Jay Brothers. Any more juicy stories?

Sumathi: I can recall some hilarious encounters during Antho's teaching rounds.

I was in a group which included Patas, HN, Virginia and some others. Antho asked Patas to do a PR examination on a male patient. Patas was dumbfounded and after waiting for a couple of minutes, told Antho that he had never done it before. Antho wasted no time and told Patas “Mr Ratnesar, if your father told your Mum that he had never done it before, you would not be here".

Speedy: Ha! Ha! That is priceless!

Sumathi: HN was asked to examine a man's scrotum and he was wondering how to get on with it. Antho told him,"Look Mr Wickramasinghe, when you have to give something hot, you don't waste time”. I am sure  you get the meaning Speedy!

Speedy: I can imagine! There are a few things that come to my mind, one of which involved Punsiri Fernando. During a ward class with Dr Burhan, Dr B asked whether anyone knew the main constituent of anti gasgangrene vaccine. We were all quiet till Punsiri put his hand up timidly. Burhan said, "at least one of you donkeys know. Yes?” he said, looking at Punsiri. Punsiri said, completely deadpan, "Sir, it is 90% water". We all laughed but Burhan chased him out of the class!

Sumathi: Punsiri, great guy, sadly no more. He rose to great heights in Sri Lanka and was Head of the Anti-Malaria Campaign.

Speedy: I met him a few times on my visits to Sri Lanka and I used to bring him stamps as he was an avid stamp collector. Few more stories Sumathi?

Sumathi: Well I could go on and on Speedy! I recall some stories connected with Prof Ranasinghe, or Ranaya as we “reverently” called him! At the time we did the appointment, the Registrars to Ranaya were, Mahasara Gunaratne, P C Induruwa and Ashmore Attapattu. The trio were boring and never taught the nitty gritty stuff in examination terms. Ranaya did a couple of Utero-vaginal prolapses via vaginal route and allowed his registrars to do the rest.

Speedy: I am afraid I wasn’t a great fan of the trio who treated us like errant schoolboys. Ranaya was an imposing figure and a very didactic teacher. Good for evening Academy type but not at University level in my opinion. I recall him saying, “There are 5 causes of post-menopausal bleeding and they are No 1 (flexes his thumb), No 2 (flexes his index finger), carrying on till all fingers are flexed and when a student regurgitates this at the viva Ranaya’s fingers would flex in the order he has given and if the student gave 4 causes and missed the 3^rd, he would ask the student “what is this, what is this?” showing his middle finger! Viswa on the other hand was an excellent teacher. He would not allow us to take notes while he was lecturing but gave us 15 minutes at the end to write what we had heard and understood.

Well Sumathi, all good things have to come to an end. Thanks a lot for agreeing to take part and I wish you all the best.

Sumathi: Speedy, I enjoyed looking back and reviving old memories. I am happy I was able to contribute to our most valuable Blog. I hope our batch mates enjoy reading this Dialogue and post comments of their own recollections.