Creative Spot by Mahendra (Speedy) Gonsalkorale

Instrumental version of the popular Sinhala song - "Kandula"

I have no doubt that our country will rise like the proverbial Phoenix after the devastating April 21st bomb explosions in churches and luxury hotels. A good way to resume our routine blog activities is by posting the following instrumental by none other than Mahendra (Speedy) Gonsalkorale. Here he is, performing on his Yamaha Genos.

The Prayer - With lyrics by Celine Dion and Andrea Bocelli

The  translations  of the verses sung only in Italian are as follows-

A world where pain and sorrow will be ended, 

And every heart that’s broken will be mended.

And we’ll remember we are all God’s children

         Reaching out to touch you, 

            Reaching to the sky.

          Needs to find a place,

       Guide us with your grace,

     Give us faith so we’ll be safe.

Sent in by Rohini Anandaraja

THE RECENT ATROCITY IN SRI LANKA

We were horrified, shocked and saddened beyond words when we heard the news early on Easter Sunday. All of us did our best to check with relatives and friends to make sure that none were directly affected, and fortunately the news was reassuring. But the emotional and psychological trauma that our colleagues and their families are going through must be terrible. We were heartened to see the response of ordinary people who flocked in to donate blood and help to care for the wounded. We felt proud that Sri Lankans rallied round casting aside all differences and uniting in the hour of need of their country.

                                                        

We just want you to know that our hearts are with you and we too feel the pain and sense of despair that you must feel although we can never really experience what you are going through. We fervently hope that Sri Lanka will never have to go through this kind of trauma again and will once again become the beautiful and safe Island we are all so fond of.                                                      

Mahendra (Speedy) Gonsalkorale

Nihal D Amarasekera

Appu Sumathipala

Zita Perera Subasinghe

Shanti Nalliah

Maheswary Nadarajah

THE RECENT ACRIMONY IN SRI LANKA II

By Dr Nihal D Amerasekera

The light at the end of the tunnel 

As a group of batch-mates living in the UK we felt the need to show our feelings for the friends and families of the many who have been affected by this senseless tragedy. Our country is reeling once again from this perilous situation of conflict and discord, death and destruction.

Although I live happily in England, I have left a part of me in that beautiful island of my birth and the land of my forefathers. My mind often goes back to the time of my youth growing up in post-colonial Ceylon. It was so very peaceful. How times have changed!! We now live in a world so very different. Despite the years in exile, I still share in the joys and heartaches of the people of Sri Lanka.

After the tragedy, feelings are raw and emotions run high. Investigations are in progress by the security apparatus of Sri Lanka with the help of Interpol, FBI and the Metropolitan Police. Naturally, after a cataclysm of this nature and magnitude there are boundless stories swirling around, some fact and others fiction. Perhaps, now is not the time for us to make a judgment or apportion blame until the investigations are completed.

It is imperative that we do everything possible to prevent a disaster of this nature in the future. This requires the patronage of politicians, vigilance of the security services, guidance of religious leaders and the co-operation of the various communities. We must remain strong against the corrosive elements of society who try to drive a wedge and divide us. Tolerance is the key to a peaceful Sri Lanka. Importantly, we must learn to nurture the peace when it blooms again.

As for the future of my beloved island unity of our people is paramount. It is heartening to read of the show of solidarity by the different religions and of their shared sorrow.We all grieve today. I hope the many candles that were lit will ignite the efforts to dispel bigotry and disharmony. Let the lasting legacy of this awful tragedy be a doorway to a new beginning of peace and tolerance

Minimalism for Seniors – A Personal Story

By Dr Nihal D Amerasekera

Minimalism is all about living with less. Moving to live in a smaller space is euphemistically called downsizing. It has become a trend worldwide for people to downsize after retirement. Many of my friends and family in Sri Lanka have come to realise its benefits. There is a wide choice available ranging from independent apartments to warden-controlled retirement homes and nursing homes.

Many of us will live longer than our parents. The benefits of long life are many but there is a downside which needs careful management to improve the quality of life in later years. There is the inevitable and gradual decline in health and energy as the years pass. This leads to the inability to do the things we have always done. With careful planning and some good fortune we all can minimise the inconvenience. In old age, dementia is on the increase when happiness and life gradually fade away. We have made enormous strides in postponing death and lengthening those twilight years. These are years to be enjoyed. It is true the government should create a team to look after the interests of the elderly. In the UK much has been done with free transport, healthcare, TV licence and support to cover the ever-increasing energy bills in winter. Meanwhile there are many things we can do for ourselves to make our senior years happy, healthy and manageable.

If one can afford it, moving to an apartment with easy access is more than a luxury.

It is often said moving house is as traumatic as a divorce. I wouldn’t disagree. This is doubly so if one is 70+. We moved into our present house 33 years ago from busy London. As I recall the day with such great clarity, this seems just like yesterday. It was a warm sunny autumn afternoon with hardly a breeze. A couple of chirping robin redbreasts perched in a window sill welcomed us to our new home.

The year 1982 was a momentous one. Ronald Reagan was the president of the USA and Margaret Thatcher, the British Prime Minister. The Falklands war was raging in the South Atlantic. On a lighter note Italy won the Football World Cup. I had started work as a Radiologist in a hospital 50 miles north of London. The hard grind of training and exams were over. With a stable job and a happy family it seemed like the beginning of paradise.

We moved into a brand-new house and were its first occupants. I created a little "Walawwa" in a leafy suburb in rural Hertfordshire, far from the madding crowd as I could manage. We converted the backyard from a muddy patch of overgrown weeds into a wonderful garden with a fine lawn and elegant flowerbeds that were in bloom all year round. I have spent many long summer evenings seated in the garden sipping wine and allowing my thoughts to wander into those happy times of my childhood.

My professional career and the children’s education took precedence. My wife gave up her career to care for the kids. Ferrying them to school and back and for the myriad of their activities usurped our time and energy. Their success was our joy which we recall with great delight.

Wherever we went on holiday it was our ritual to bring back a memento. A collection of those adorned the mantelpiece and the windowsills. Reading has been my joy since I was a kid, a habit which has been passed on to my offspring. The resultant collection was a fine library. Computers have been my hobby and Apple Macs whirred away deep into the night. Their detritus and wires filled every corner of my study.

A "Walawwa", however magical it may sound is not the place for an ageing couple in their retirement. Keeping such a place in good shape even with help is tiring and time consuming. We took the hard decision to move to a small flat just enough for the two of us.

As I look back what amazes me most is how rapidly time has gone. The children have now flown the nest leaving empty rooms, empty chairs and a void that cannot be filled. The once noisy music room became engulfed by silence. The laughter that was ever present seems to have deserted us. Every corner of every room brought back a store of memories of times past. The house had lost its life and sparkle.

Downsizing is a heart-rending business. Losing personal possessions specially those attached to important events in our lives is not easy. Throughout our lives we took photos which are a priceless reminder of times past. They were real paper photos that need space and care. It is impossible to retain them all. Discarding them broke our hearts. Much of the books, clothing and furniture have been given away to charity.

Downsizing helps to concentrate one’s mind to what is important in life. We come into this world with nothing and we leave with nothing. What happens in between is a journey and its memory evaporates into thin air as it ends. After all the next move will be our final rest.

Each of us, my wife and I, owned a car to give us independence. We loved our cars so much we became very attached to them. In London, a car is a liability and parking is a nightmare. There is a congestion charge for all cars for creating pollution. With the passage of years driving at night had become difficult. My reflexes weren’t as quick as before. Unwittingly I had become a reluctant driver. The transport in London by bus, train and underground was excellent. It was free for senior citizens. We both felt it was best to give up our cars. Initially it was like losing our right arm. But soon we began to appreciate the wisdom of our decision.

Although I was moving just 50 miles down south I realised it will be harder to keep friendships with my close pals and former colleagues of 33 years.  Friendships are one of life’s rich gifts. As adults we grew up together and have so much in common. I recall with much nostalgia the many parties we have enjoyed deep into the night. Meeting them now will need planning and effort. The all important ingredient and social lubricant called alcohol will not be there at the table. They have to drive back.

Buying and selling a house is fraught with problems. Estate Agents are in a cutthroat business as are the solicitors who like scavengers live on our misery. The buyer gets bullied by the seller, Solicitors, Estate Agents and the Removal firms. In the UK it is a nightmare. And it astounds me why the government hasn’t come up with an easier path for buying and selling property.

I remember well the day we left our home in Letchworth. The house was completely empty of furniture. As I wandered in silence from room to room, many images of the past flashed across my mind. They were 33 years of bewitching memories, mostly of the children growing up. Leaving these behind was a heartbreak. Life is a huge compromise!!

It was more through luck than judgment I found my nest for life. Living in a flat requires a different mind-set. The block is a community, although not a close one. Everyone is busy with their own lives. We hardly know our neighbours. There are house rules - some written and others implied. There are also civic and social responsibilities. We must respect others’ privacy while sharing the space. Looking through the window at night, I see the geometrically arranged lights of the surrounding blocks. This creates its own beauty. Each light represents people with their own lives, joys and sorrows - we are all a part of the rich tapestry of life.

Moving house is not the end of life but the beginning of a new phase in my life’s journey. I look forward to the peaks and dread the troughs, as I have always done. London is a place of fun, which we can still enjoy. The museums, galleries, concerts and the theatre will fill our time with joy. It is the culinary capital of the world and a gourmets’ paradise. It is said if you are tired of London you are tired of life - how very true. There is so much on offer. I will drink a toast in anticipation - no more moving house again, as long as there is any breath left in my body.

(From the Sunday Island of 21 April 2019)

Classical Quotes for Critical Care

Suriyakanthi Amarasekara had recently been invited as the Chief Guest to make a presentation to the Clinical Society of Sri Jayawardenepura Hospital. What follows is a gist of her talk. 

When I received the gracious invitation to be the chief guest at the Scientific Sessions of the Clinical Society, I had to choose a topic of my address. After much thought I decided that rather than talk to you on a ponderous scientific theme, I would share with you some of my collection of quotes concerning life and critical care. I may add that from my early teens I got into the habit of jotting down anything that touched my heart so what is presented to you in the next few minutes is picked from a collection that has taken me almost a half century to compile.

All of us present here are engaged in working. So I would like to start with a quote by Khaleel Gibran from his masterpiece “The Prophet”

“A plough man said speak to us of work.

And he answered saying

You work that you may keep pace with the earth and the soul of the earth

For to be idle is to become a stranger unto the seasons,

And to step out of life’s procession that marches in majesty and proud submission towards the infinite

When you work you are a flute through whose heart the whispering of the hours turn to music.

Which of you would be a reed dumb and silent, when all else sings together in unison ?

You have been told that life is darkness.

And in your weariness you echo what was said by the lonely.

And I say that life is indeed darkness save when there is an urge,

And all urge is blind save when there is knowledge,

And all knowledge is vain save when there is work,

And all work is empty save when there is love.

And when you work with love, you bind yourself to yourself,

And to one another and to God

I firmly believe that no one working in critical care of for that matter caring for the sick in any location can be truly successful and happy unless he has a special care and concern for the welfare of his patients. We need to treat or patients with compassion and we need to work with love.

I think that St Paul’s epistle to the Corinthians captures the type of love we should have when he wrote:

“though I speak with the tongues of men and angels, and have not love, I am becoming as a resounding gong, or a clanging cymbal.

And though I bestow all my goods to feed the poor, and though I give my body to be burned, and have no love I am nothing.

Love is patient, love is kind.

Love does not envy and does not boast

Love is not proud, it is not rude it is not self seeking

Love is not easily angered, it keeps no records wrong

Love does not delight in evil but rejoices with the truth

Love always protects, always trusts, always hopes and always preserves

Love never fails”

I remember being told many years ago, to replace the word love with “I” .

So to paraphrase

I am patient,  I am kind.

I do not envy and do not boast

I am not proud, I am not rude I am not self seeking

I am not easily angered, I keep no records wrong

I do not delight in evil but rejoice with the truth

This shows us how far short we fall from the expected ideal

Every patient is important, and every encounter with that patient and his family is important. Things that we may sometimes consider trivial, and therefore overlook, may have tremendous significance, especially in view of the complexity of multiple medical problems that we are faced with.

As John Donne said,

“No man is an island entire of itself,

Every man is a piece of the continent, a part of the main…..

Any man’s death diminishes me because I am involved with mankind

and therefore never send to know for whom the bell tolls,

it tolls for thee”.

Very few people work harder than ICU personnel, but not infrequently, it does not really seem to change things. All our skill, wisdom and efforts may seem to be of no avail, not only with patient care, but also academically.

“I returned and saw under the sun

That the race is not to the swift

Nor the battle to the strong

Neither yet bread to the wise

Nor yet riches to men of understanding

Nor yet favour to men of skill

But time and chance happens to them all”

Ecclesiastics 9 : 11 – 12

Sometimes we feel so let down and disappointed by the circumstances we are faced with, that we wish we could transform the situation and remake the world

“Ah love could you and I with fate conspire

To grasp this story scheme of things entire

Would we not shatter it to bits and then

Remold it nearer the Hearts Desire”.

The Rubaiyat of Omar Khayyam Stanza 99

Often our efforts seem futile and there seems to be nothing we can do about what is happening around us

“the moving finger writes and having writ

Moves on: not all your piety or wit

Shall lure it back to cancel half a line

Nor all your tears wash out a word of it”

The Rubaiyat of Omar Khayyam Stanza 71

But we should not be discouraged. In life, in medicine there are few “quick fix” situations. But eventually the impact of our efforts begin to show.

‘The smallest effort is not lost

Each wavelet on the ocean tossed

Aids in the ebb tide or the flow

Each raindrop makes some flower glow

Each struggle lessens human woe’      Charles Mac Kay

For an ICU or that matter any Unit or Ward to function optimally, everyone on the team has to do his job well no matter how menial or small the task is.

“We can’t all be captains, we’ve got to be crew

There’s something for all of us here

There’s big work to do, and there’s lesser to do,

And the task you must do is near

If you can’t be a pine on the top of a hill

Be a scrub in the valley – but be

Be the neat little scrub by the side of the rill

Be a bush if you can’ t be a tree

If you can’t be a highway then just be a trail

If you can’t be the sun be a star

It isn’t by the size that you win or fail

Be the best of whatever you are!”

Douglas Malloch

We must also recognize that we can never stop trying to learn. Acquiring medical knowledge is like rowing up stream against a strong current. You have to work very hard to make any headway at all, but if you slacken your efforts you are rapidly swept down stream. I recall that I never felt confident about my medical knowledge as I did when I was a 3^rd year Medical Student

“A little learning is a dangerous thing

Drink deep, or taste not the Pierian spring

There shallow draughts intoxicated the brain

And drinking largely sobers us again”

And

Be not the first by whom the new are tried

Nor yet the last to lay old aside

An essay on Criticism Alexander Pope

A sense of humour is something that we need to cultivate if we are to keep our sanity in this stressful world of ours.

If you see the funny side, you’ll stroll along the sunny side

While other folks are walking in the shade

Things will never harass you, embitter or embarrass you

A sense of humour is the finest aid

To wisdom and philosophy, in trouble and adversity

It brings you smiling through the stress and strife

So cultivate the power to see, the little touch of comedy

Behind the trials and tragedies of life

We often do not appreciate the role played by the nurses in the care of critically ill patients. The 3^rd stanza of William Wordsworth’s poem “She was a phantom of delight” captures the description of a perfect ICU nurse

“Endurance, foresight, strength and skill

A perfect woman, nobly planned

To warm to comfort and command

And yet a spirit still and bright

With something of angelic light”

And again

Oh woman in our hour of ease,

Uncertain, coy and hard to please

Uncertain as the shade

By the quivering aspen made

But when pain and anguish wring the brow,

A ministering angel thou”

I recall an incident when I was about 14 years old, I was running a very high temperature and having a blistering headache. My mother gently placed a cloth soaked in iced Eu de cologne on my forehead. It felt so soothing that I caught her hand and quote the above poem to her. My mother’s response was to pop a thermometer in my mouth – she thought I was delirious!

Eventually no matter how hard we work we need to go to a very special place we call home. At home at the end of the day we may finally be able to relax with some peace and quiet

Longfellow captures a sense of that relaxation that might come at the end of the day in his poem The day is done

“The day is done and the darkness

Falls from the wings of night

As a feather is wafted downward

From an eagle in his flight

And the night shall be filled with music

And the cares that infest the day

Shall fold their tents like Arabs

And as silently steal away”

As we are just  a little over 2 weeks away from the dawn of the New Year, some of you may be thinking of making new year resolutions. So I thought I would share with you a poem I wrote for the SLMA Newsletter in January 2006:

FOR THIS NEW YEAR

This I would like to be, braver and bolder, just a bit wiser, because I am older

Just a bit kinder to those I may meet, just a bit braver taking defeat

This for the New Year, my wish and my plea,

May this New Year make a good doctor of me

This I would like to be, just a bit finer, more of a smiler and less of a whiner

Just a bit quicker to stretch out my hand, helping another, who’s struggling to stand

This is my wish for the New Year to be

May this New Year make a good doctor of me

This I would like to be, just a bit truer, less of a wisher and more of the doer

Caring, compassionate, more willing to give, living and helping me patients to live

This for the New Year, my wish and my plea,

May this New Year make a good doctor of me

Finally I would like to end with the words of Henry Wadsworth Longfellow from A Psalm of Life

“Lives of great men all remind us

We can make our lives sublime

And departing leave behind us

Footprints on the sands of time

Footprint that perhaps another

Sailing o’er life’s solemn main

A forlorn and a shipwrecked brother

Seeing, shall take heart again

Let us then be up and doing

With a heart for any fate

Still achieving, still pursuing

Learn to labour and to wait”

Ladies and Gentleman I thank you for your attention.

Creative Spot Quiz

By Indra Anandasabapathy 

Guess what's going on inside the building. The clues are there for the viewer to figure out

Prof. Lamabadusuriya marks 50 years as a medical academic

From The Island newspaper of Sunday 7 April, 2019.

April 6, 2019, 6:43 pm

S.P. Lamabadusuriya

Prof. Sanath. P. Lamabadusuriya who joined the Faculty of Medicine Colombo as a lecturer in Paediatrics on April 1, 1969, this month marked his 50th year as a medical academic. He has worked in this field both here and abroad and in 1992 was conferred an MBE by Queen Elizabeth.

Afetr taking his MBBS degree, he went abroad in 1972 on a Colombo Plan scholarship for post graduate training and returned three years later with a Ph.D. (London), MRCP (UK) and DCH (London). He was trained at the Hospital for Sick Children Great Ormond Street, London and at the Institute of Child Health, London.

Prof. Lamabadusuriya I was the first Sri Lankan clinician to obtain a research degree which he achieved after two years and three months of research. Later he worked at the Faculty of Medicine of the Colombo University as a Senior Lecturer until he went to the Faculty of Medicine Ruhuna as the Foundation Professor of Paediatrics.

In 1980 he returned to Colombo when the Chair in Paediatrics fell vacant in 1991. He retired in 2008 and now serves as an Emeritus Professor of the Colombo University.

He was the Dean of the Colombo Medical Faculty from 2002 to 2005 and since April 2015, been working as a Visiting Senior Professor in the Faculty of Medicine in the University of Rajarata.

Over a year ago he was invited to be the consultant to establish a Medical Faculty in the Sabaragamuwa University to which 70 students were admitted in January this year. This faculty is based in Ratnapura.

During sabbatical leave, he worked as a Locum Consultant in Paediatrics at the Pilgrims Hospital in Boston, Lincolnshire, England in 1979. From 1987 to 1988, he worked as a Professor in Paediatric Gastroenterology at the King Faisal University in  Dammam,,Saudi Arabia. From 1996 to 1998 he worked as a locum Consultant Paediatrician in Worthing, West Sussex. England.

He was awarded an MBE in 1992 by Queen Elizabeth in recognition for his contribution to the Sri Lanka Cleft Lip and Palate project – probably the first Lankan domiciled here to be so honored..

This project was instrumental in setting up a diploma course for the training of Speech Therapists in the University of Kelaniya, with a donation of 200,000 pounds sterling. Prior to that there was only one speech therapist in Sri Lanka and she was in the private sector. At present there are over 80 speech therapists working in Sri Lanka.

Creative Spot - INNOVATION and LIFE IN THE UNITED STATES

Sent by Indra Anandasabapathy

The following series of mail box photographs shows this work which has a humorous side. This series excludes
pictures 1& 2 , which are the old fashioned boxes. The rest are creations of a company whose work is 
gathering momentum in this town. 

 Among them  - a lady with a surf board in a beach town

                       - a flamingo

                       -  mail box in front of a cafe

                       

Picture 1

Picture 2

In front of a physician's office (viewers can guess the speciality!)

News from Sanath Lamabadusuriya

Sanath has just returned from his recent tour of Panama where he attended the International Congress of Paediatrics. He made use of the opportunity to tour Cuba, a country about which we have heard so much.

An interesting observation he made on this tour was that Panama City is like any other western capital with many skyscrapers but that Havana in Cuba does not have a single skyscraper. He goes on to say that Havana is full of American classic cars, Buicks, Cadillacs, Dodges, Chryslers, Chevrolets, Plymouths, Oldsmobiles, Fords etc which were manufactured in the 1950s.

Soon after his arrival in Sri Lanka, he lost no time in proceeding to Anuradhapura where he is teaching the Rajarata medical students. He had been pleasantly surprised when the students hosted a party to felicitate Sanath's 50th year in academic Paediatrics.