Musings from my Rocking chair
Nihal D Amarasekera
As the winter storms batter my windows I snuggle up in my rocking chair and allow my thoughts to wander far and wide. There are times I reflect lazily on the twists and turns of my life’s fandango. It is a perfect posture to meditate, ruminate and cogitate when the days work is done. I am partial to a tot of whisky to help lubricate my thoughts just taken neat as the makers recommended.
At the faculty of medicine just like at school it was the exams and the results that carried weight. This produced a pecking order called the order of merit. There was room for expressions of individuality and pomposity but these situations were rare. Although those at the top of this list seldom made a song and dance about it there was a certain awe and respect that went with the order. This wafted and swirled amongst us in the common rooms and corridors until we left the Temple of Wisdom in 1967. Then came the endless scramble for jobs, positions and places. Among the doctors there were a few with corroding ideals with connections in high places. They benefitted in securing good jobs and better prospects with scant regard for merit, decency or friendship. We grew up in this milieu with a culture of deceit that reached every aspect of life. My ambitions being modest I’ve had no reason to be disappointed. But the deserving who were overlooked felt deserted. They had stories of hurt and these remained as raw as fresh wounds. Some of them no doubt left the country in disgust.
With the midlife crises come and gone, many of us are septuagenarians now and some even octogenarians. I hasten to add that thankfully age is not an order of exit from this wonderful world. But this is our age of wisdom accrued after years of toil and hardship being educated, learning a trade, providing a service to society and importantly bringing up our families.
On reflection those who occupied the prestigious positions in the order of merit have lived up to the expectations reaching those dizzy heights in academia and in various fields of healthcare. It is important to recognise that even those who did not show off their excellence in the faculty have done tremendously well in their careers. We left the faculty with the preconceived idea that medicine, surgery, obstetrics and gynaecology were the plum jobs and working in hospital medicine had more kudos than work in the community. We soon realised this certainly was not the situation in the real world.
There was no real career guidance and many of us fell into jobs depending on where we were sent by the government or what was more easily available. Sometimes it was our bosses that showed us the way forward. Those further up in the order of merit quite rightly had their choice and greater opportunities in jobs and better career prospects in Sri Lanka.
My memories of the health service in Sri Lanka is from 1967-74. Our entry into the Faculty of Medicine was the culmination of years of preparation and sacrifice. The university entrance examination was tough beyond compare. Let’s face it, the faculty accepted only the best. There we received a fine education for 5 long years. At the end of that long struggle many of us realised there were difficult days and sleepless nights ahead. But we all felt it was pertinent to pose the convulsive questions: Can I have a decent life style now? Will the pay reflect the struggles so far and the responsibilities of the job? Can I have a career of my own choice? As qualified doctors many of us did have visions of grandeur. They were dashed when we became just a name and a statistic with the Department of Health. Often all hope was lost with the arrival of the letters of ‘transfer’.
This difficult and unenviable task of allocating doctors to these remote and inaccessible places fell on the Department of Health. The department ruled with an iron fist and was deeply concerned with the provision of healthcare and the service commitment of doctors. The hospitals in these isolated areas in the wilderness needed medical officers. The social isolation in these inhospitable regions is complete. There was a need to learn on the job and get used to the lack of facilities and the amenities we were used to, growing up. We had the medical knowledge to save lives but had no clue how to manage a hospital with several members of staff. Politicians and local politics often became the bane of the DMO’s lives. Managing the finances, dealing with difficult members of staff and their unions were new challenges to doctors.
The movement of doctors in the Health Service was euphemistically called transfers. They were planned and executed by the department of health. I wonder how much of it was managed by the Director of Health Services. A visit to the mercurial atmosphere of the Ministry of Health is an unforgettable experience. I remember the rows of clerks glued to their chairs and busy at work. There was more than a hint of arrogance in the air as they clicked away on their typewriters. The Ministry was a magnet for doctors chasing favours, deals, promotions and scholarships. I am certain the allocation of ‘transfers’ were delegated further down the line. The process was greased by several factors beyond ‘seniority and order of merit’. The right political colour and connections to the ‘high and mighty’ did carry weight. A good word to some ‘powerful’ clerk who made up the final ‘transfer list’ may have gone a long way too. This bizarre experience in the corridors of power derailed me. Emerging from that shadowy world I realised how powerless and insignificant I was. The GMOA often tried hard to see that justice was done with some success. Interestingly the GMOA hierarchy too depended on the department for their jobs and promotions.
It would be an interesting study to see how lives and careers panned out for these doctors who were sent as DMO’s. From personal communications and ‘hear say’ some remained as DMO’s all their lives, some moved laterally becoming MOH’s, some resigned and went into general practice, a few managed to get to a teaching hospital for postgraduate training, sadly a small minority became alcoholics and perished. Many were totally disgruntled and left the country.
We owe it to the people of Sri Lanka for the free education we have received at great cost to the public purse. It gives me much satisfaction that I worked for 7 years in the Health Service in Sri Lanka. They still remain as some of the most rewarding years of my career. As for the doctors who are sent to the periphery of life, they should have a clearer path to return to civilisation and further training, if they so wish. The order of merit like seniority will remain a halo for life. Serving in the periphery must accrue points too as should the provision of an exemplary service. As we look around in our own batch there are many who developed late and have achieved excellence in a multitude of fields. They seem to be all living and working abroad.
The 1960’s and 70’s were the decades when doctors emigrated en-masse for a multitude of reasons. Political uncertainty and the economic downturn didn’t help to prevent a brain drain. Many took the advice of Horace Greely “Go West young man” being attracted by the bright city lights and lucrative pay. There was a long wait to be sent for postgraduate training by our government. Everyone I know who lives in exile is eminently aware of the effect it had on our parents and the massive loss to the country and its health service. Leaving my family, country and the life that I knew haunts me still. Serving the sick and the suffering to the best of our ability wherever we live is indeed a comforting thought. Some of these doctors who had post graduate training abroad wished to return home. They should have had a clearer path to join the health service again removing the many obstacles that were placed by the Doctors Unions and the Department which made this an impossible dream.
For those who left the sun-baked shores of home, sky was the limit. Wherever we live be it gender, colour, race or social standing, there will be some form of unfairness, injustice or bigotry. To keep our sanity we learnt to navigate our feelings. Many of us did encounter discrimination but managed to find a way into the fields of our choice more by design than destiny. We had also the opportunity to work where we wished within reason. Personally, I found the pay in the National Health Service was adequate to live a decent life. There was no need for backhanders. The private practice was built into the contract and we were able to charge a fee for our services outside of the NHS work. I personally do not see the immorality of private practice done with fairness, humanity and honesty.
I wonder how the Department of Health has evolved over the past 50 years. The institution had a difficult remit. It is easier to criticize than to understand the problems and find equitable solutions. I confess, despite its shortcomings I still have an affection for the department. To keep the doctors happy and provide healthcare in those distant days was not an easy task. Now there are many more medical schools and more doctors. The population has increased and the wilderness has shrunk. Transport and communications are better. Perhaps the DMO’s now feel less isolated. They may also have a good social life, improved facilities and better access to amenities. I hope the selection process for scholarships, lucrative posts and dream jobs is more transparent and better regulated. The long-held tradition of seniority, merit and qualifications must still hold sway but I cannot believe that political interference has gone away.
These
are memories of a time now long gone. As is said even God can’t change the
past. Life was not a bed of roses neither was it a bed of nails. We must look
back with gratitude we had the courage to change the thing we could, accept the
thing we couldn’t change and had the wisdom to know the difference, well most
of the time.
Dear Nihal,
ReplyDeleteYour article is ,as usual,thoughtful and generous for the good fortune you have had with no recriminations for the ‘slings and arrows of outrageous fortune’ we experienced at Medical school and at the hands of the pompous bureaucrats of the health dept.
Your writings remind me of some experiences,I had as DMO Kalawana.The then MP sent a man requesting a certificate recommending a toddy tappers licence;he apparently needed a daily shot for medicinal purposes!! Being young and idealistic I refused.The enraged politicians had raved “I will get that Yaka transferred in 24 hours”;I wouldn’t have minded that at all.
Of the life lessons I learnt,one important one was the need to have as many friends as possible.Once the hospital sanitary workers struck work for a trivial reason.I called the Supdt of a rubber estate and he sent his labourers post haste.The strike fizzled out in a day.
The chief of the dept at Ratnapura liked to surprise the staff and arrive unannounced for inspections.Luckily for me ,a clerk there would warn me well in advance ,and the hospital would be spick and span.
I also learnt something of rural poverty.Young pregnant women would get admitted with trivial complaints and try to stay for weeks.I was pressured by the powers that be ,to keep the inpatient numbers down and I obliged by discharging the healthy women.
The contractor who supplied the meals,then informed me that these women liked to stay because they would get three square meals a day.From that day on I didn’t discharge any mother who wanted to linger on.
Kumar
Hi,Kumar. I read your experience at Kalawana hospital and would add a few things that I had experienced in Deniyaya & Rakwana with pregnant mothers who got admitted several months before the EDD. The reasons given were their inability to get transport at the time of first stage of labour. As you know very well the public transport was not available for villages living in remove corners in places like,Deniyaya,Rakwana,Kalawana.MP for Deniyaya came to know about my discharging some mothers who were several weeks from the EDD. Messenger was sent by the MP, requesting in a descent way for me to keep those mothers who had no transport to come to hospital in the early stages of labour.I explained to the messenger that the maternity ward is getting over crowded and I had to send some mother away.I also mentioned that I would do my best to keep some mothers with difficulties to get transport to be kept until they deliver their babies. At Rakwana, there was a labourer who was the trade union rep, who used to sneak to SHS Office, whenever I sent a complaint against minor staff. There was a clerk called political Karu, who had access to those letters of complaints before SHS had a chance to read. Minor staff used to steal dry provision and share food that were meant for the patient. I had to be present in the kitchen at the time of servings, in order to stop those mean activities. One day MP for Rakwana, Mr.VTG Karunaratne, who was a junior Minister for Postal& Telecommunication visited me at the DMO bungalow. He had first hand information about my work from his stooges, employed as attendants had nothing but praise for my dedicated work.
DeleteAs for the article written by ND,I have nothing but praise for his valiant effort to expose the era, by gone. With several failures in life, I had several dreams in the past whenever I ruminated about my failure to shine at MBBS level and MRCP Part2.For some years I have peaceful nights without any dream about failures in life and enjoy learning languages, cookery etc.
Hi Sumathy
DeleteGood to get your comments and experiences of the hazards of working in the periphery. There are many who admire greatly what you have achieved in life and professional career.
HiSumathy,
DeleteIt was after 1956 that politicisation of the public service occurred.It has been going downhill since.
When I was at the Gampaha hospital,the three most powerful employees were ,the switch board operator,the gatekeeper and a medical ward attendant.We,the junior doctors were spared indignities,partly due to the fact that they needed,our services to look after their ‘relatives’;also we had a colleague,? Nalini Ratnayake,a junior who was a close relative of the local MP.I think she married Ranjith WIthana.
Was he in our year.? Both of them were really nice sorts.
Once I commented that there were cobwebs in the ward and attendants pointedly refused to accompany me on my ward rounds and started to clean the ward instead.I was SHO to Dr Nagaratnam who was a great chief.The solitary nurse would come only for his round.There was too much work for them.They sympathised with me but were helpless.Fortunately ,the affair,blew away in a few days.
Kumar, Ranjith Withana must have been in our junior batch. Name sounds a bell and I have spoken to him during Medical student days. SD Bandaranayake was the MP for Gampaha. Later he was the only MP from Bosath Bandaranayake peramuna.
DeleteSumathi, you have reminded all of us how difficult and trying it must have been to work in a peripheral unit, especially when we were fresh, young idealistic and innocent. These jobs required men with maturity but the system was such that we were just the right fodder for the job. I must confess that the furthest place I served was at Matale, hardly a peripheral unit! Those of us who worked there knew the medics at Laggala-Pallegama as they used to visit us for friendly company.
DeleteHats off to you Sumathi for the honest and hard work you did.
Kumar,
DeleteYou might remember the political interference and the attempts at bribery that went on even at Galle Hospital during our internship.
Those were the days of Channel practice when people would privately channel a consultant in the hope of securing a bed in an overcrowded ward for their relative in the public hospital. (Galle hospital had as many patients under beds as on beds at that time.)
Many were the occasions I witnessed when relatives expressed disappointment at their not securing a bed for their relative, Ana my consultant then, would pull money out of his pocket and return it to the relative explaining (in Sinhalese with his tamil accent !) that beds are given purely according to the medical needs of the patient. He would place the responsibilty of alotting beds according to medical need entirely on us and never interfered. I admired his ethical behaviour.
As for political interference - you might remember the episode where Dahanayake was harrassing one of the housemen about a death certificate and Ana came to his defense.
As Dahanayake kept insisting on having it done stat and the arguments in defense got heated, Dahanayake had said “Doctor cool down - get an ice cap on your head “ and Ana had responded “ I’ll get a bag of cement on your head “ and Dahanayake interfered no more with his junior staff .
I was not his HO then - You might remember who was, and the incident - as the HO’s quarters was agog with this story for days .
I have personally had the experience of being offered gifts by relatives of patients which I have had the good sense to decline.
Quite apart from the ethics of it I was so happy I had taken this stance , when one of the patients’ relatives having accosted me in the corridor, opened a pouch of gems and on my refusal to accept , rattled off names of other doctors who had accepted gifts, in an attempt to persuade me ! Had I succumbed to temptation he could have added my name to his list as well !
Excerpts from an interesting poem which was read to me by my father during my childhood- which may have influenced me -
“ What female heart can gold despise “ ..............
“From hence, ye beauties, undeceived,
Know, one false step is ne’er retrieved,
And be with caution bold.
Not all that tempts your wandering eyes
And heedless hearts, is lawful prize;
Nor all that glisters, gold.”
My dad was very good at teaching important lessons of life through poetry .
The poem is ‘Ode to the Death of a Favourite Cat, Drowned in a Tub of Goldfishes’ by Thomas Gray. The story of how the poem got written is also interesting for those who wish to read.
Rohini
DeleteEnjoyed reading those candid stories of old written so elegantly. This was indeed the milieu in healthcare in those days.
I do have first hand information from one of Ana's patients what a kind, caring and helpful physician he was in addition to his excellent bedside manner and brilliance.
May he find eternal peace.
Thank you Nihal.
DeleteThank you Nihal
DeleteDear Kumar
ReplyDeleteGenerous comments as always. Thank you.
As you have worked as a DMO you must connect with some of my thoughts of the life and times in the wilderness. You rightly speak of the poverty that engulfed the people in those communities. I experienced it in Kurunegala of the patients who converged on the hospital from the Wanni. They were so very humble and desperate for help. There are times I feel I turned my back on them when I left SL for the bright city lights and lucrative pay.
My apologies for a long comment in two parts. Nihal as always has written this with elegance, fluency and sensitivity.
ReplyDeleteNihal has taken us back through time and expressed his opinion on several aspects of our journey. I discerned a theme of fairness/unfairness, duty/obligation, aspiration/realism, idealism/practicalities, morality/self and many others. On the whole, my own impression is that we were dealt with fairness although there were exceptions. With that great asset hindsight, we could wish that somethings could have been done differently. On the order of merit, I doubt whether anybody would question the fairness of the examination process. At least it was a measurable attribute with openness. Political interference played a part in subsequent appointments and this I am afraid was the culture then and sadly even now. I know that a few years after we qualified, the GMOA campaigned and succeeded in establishing a points system which took into account not just the order of merit but also service in peripheral units, years of service and a few others which I cannot recall. I have no idea for how long this system was used.
I doubt that anybody would contest the fact that we all owe a huge debt of gratitude to the free education we had and to wish to repay that debt is natural and not imposed. Just a statement that we have a debt is insufficient, for it is reminiscent of politicians saying “I take full responsivity” and doing nothing else. The “currency” for debt repayment need not be subsequent service alone. Service is one of the best ways to repay the debt but it is not the only way as each vessel we use to navigate the waters of life are different and there is no single method. Contributions to Postgraduate education, contributions to Charities, helping postgraduates training in other countries, helping our families financially thereby alleviating the pressure on the State, promoting the dissemination of accurate information about the Homeland and exposing inaccurate information and a host of other methods which can be elaborated.
I agree with Nihal that indulging in Private Practise is not inherently immoral. It is how it is done. Bending the rules for those who are willing to pay, corrupting the service you offer blinded by the glitter of gold, using your favoured status as a “healer” for financial gain are to me the abhorrent aspects. A person who decides to give up any kind of state medicine and embark of a life of private practice is entitled to do so. It is then open, “here is what I offer, here is what you have to pay for it”. A person who opts to work in the State Sector must guard against any temptation to be unethical and overtly or inadvertently favour those who pay them. Health is not for sale. Even in the UK, I have seen patients “go private” to get preferential access to NHS services “through the back door”. I have no qualms at all with those who do private practise TOTALLY separated from their NHS work, who never do illicit private work during their NHS hours and who make a clear unambiguous distinction betweem NHS and Private work. Even they at times find it difficult to draw the line with the expectations of those who seek their services. In an ideal world, those who choose the State Sector should be paid a decent salary so that there is no need to supplement your meagre earnings. This was the approach taken by Lee Kuan Yew when he came to power and imposed a very disciplined society in Singapore. He increased the salaries of poorly paid state employees significantly and told them “now you have no excuse to accept bribes”.
Part 2 of my long comment.
ReplyDeleteI have mixed feelings on the amount of time and to the extent we should reminisce. There are undoubted benefits but there is also the risk of drifting into the land of “what might have been” and “what should have been” and “if only”. As a way of formulating strategies for the future and doing your best to learn from past mistakes, it is to be commended. As a way of recognising and acting on “things” and people who contributed to make your own life a better one, again there are merits, so long we never forget that nobody can press the rewind button and we should not let regrets, errors or judgments and the fact of chance occurrences in this stream or road of life we travel affect our current wellbeing and happiness. (Nihal said, and I completely agree with him, that “As is said even God can’t change the past. Life was not a bed of roses neither was it a bed of nails. We must look back with gratitude we had the courage to change the thing we could, accept the thing we couldn’t change and had the wisdom to know the difference, well most of the time”).
As Abraham Lincoln famously said, “The best way to predict the future is to create it”. I am as Nihal knows well, not a subscriber to the theory of “the awesome force of destiny”!
Thanks Nihal for this provocative and nostalgic missive of which I hope I don’t come across as dismissive!
Mahen
ReplyDeleteThank you for your comments which as usual done after careful reading. You have given thought to some of the important issues that I have raised. I appreciate the honesty with which it is written including some aspects of your personal philosophy of life.
For many of the important issues and problems of life there is no easy answer. There are many things I would do differently if given a second chance.
As for our gratitude to our country of birth and helping Sri Lanka there are many who wish to speak about their efforts to generate awareness and also requesting further support. I applaud their altruism. There are many others I know give enormous help and provide generous donations without any fanfare and remain anonymous. This is an emotive subject and they all play their part and needs recognition.
DeleteNihal, as always you have written an elegant, thought provoking article with equally evocative follow up comments by Sumathi, Kumar and Mahen. I am picturing you on your rocking chair on a cold winter day and imagining that you are practicing 'Hygge' as they do in Denmark!
ReplyDeleteSpeaking for myself, I try not to reminisce too much and dwell on the 'What ifs' of my past. None of us could have lived our lives according to a structured pre-set plan; rather we got wafted like a leaf in the wind!
The health care system we left behind in Sri Lanka was not perfect, and I really don't believe that the corruption and political interference is any better now in government service. Still, we should be proud of the fact that in Sri Lanka even the poorest person can get excellent medical care when they need it. Regardless of the system, there will always be people who will exploit it. My experience at the Karawenella Hospital opened my eyes to this. The corrupt DMO who was in charge, had spotless wards, where some of the patients were admitted with 'chits.' (The walls in these wards were regularly painted with paint donated by nearby planter friends of the DMO.) The four Medical Officers who worked at the hospital, including me, had unwritten instructions that we were not to admit any 'floor patients' to his wards from the OPD, but only the number that could be accommodated on the beds. A couple of months after our arrival we found out that the patients in his wards had all consulted the DMO at his 'home office' and paid him a fee prior to presenting themselves at the OPD. The two new appointees (both with the last name Dias!) decided this was not right, and began flouting the unwritten rule and admitting 'floor patients' to the DMO's ward in rotation with the rest. That was when the plot to oust us began!
Aside from him, the experience of living in a village was a pleasant one. Our house, which was not official government quarters, had electricity but no running water. The toilet was an outhouse with a pit-latrine, and water had to be drawn from a deep well. Luckily, we had a 'Man Friday' who did this for us keeping two large tubs filled up. Baths had to be taken outdoors (with clothes on!) by pouring water over our heads. Privacy was afforded by flimsy cadjan walls near the well! When we observed villagers walking to the river past our back fence for their evening baths, we decided to start doing the same thing. After a while, we realized that we were the only bathers at the river. We had scared away the villagers! And so very reluctantly we gave up the luxury of the evening river baths.
Srianee
DeleteAs always a thoughtful comment. Thank you. I must read about Hygge!! I love to reminisce and always have not with recrimination or regrets but to step back in time and appreciate what life was like and think of the people and events of long ago. It takes some self-control and discipline not to dwell on sadness and things we could have done better.
I never got the opportunity to work in a peripheral hospital although that was my dream as I have said in my last post on Health Department Sports Club. Your brilliant description of your experiences gives us a pretty good idea. As for the river baths it reminds me of that famous song we sang in the Men's Common room " Tika venna nala konde kadagena yanawada surathaliye"
Ah! the ubiquitous Man Friday of the hospital quarters up and down the country. We couldn't have managed without them.
Srianee, that was an eye-opener! But having heard similar stories before, what amazes me is the acceptance by a large section of the Public that it is okay for the chit system to operate, after all , it is good value for money. The "Loku dostera" had a problem managing resources and he has found a way around it. Then we come to "degrees of acceptability". Does the chit operate for beds only and the care and treatment provided is the same? Does the chit still compromise the doctor as he is under obligation? Would the chit be acceptable if the proceeds went to Charity? and so it goes on!
DeleteWe are always assured of a treat when Nihal sits on his rocking chair !
ReplyDeleteIt was good reading this well balanced account of what went well and what didnt , and what was fair and unfair with our Health Department at that time, which seriously impacted the lives of so many trusting young doctors.
Nihal’s level-headed understanding of the issues from different perspectives, and the way he has written of them with sensitivity and elegance I admire.
Equally to be admired is Mahen’s excellent comment .
Thank you both.
Dear Rohini
ReplyDeleteHow lovely to see you on the blog and thank you for the generous comment. Whenever I see your name on the blog I'm transported to Tamaki Drive with views of Mission Bay.
It was my Friday Night - music night last night. Perhaps my fingers slipped and I poured myself a too generous amount of the amber nectar. I did enjoy the music last night more than usual but am paying for it this morning for my indiscretion.
My rocking chair is made in England and is older than me as told by the elderly friend who gave it 20 years ago. The coiled spring that controls the rocking reminds me of the underside of an ancient railway carriage.
As I write I hear Scheherazade on my radio which transports me to the time I read the Arabian Nights and the many tales of the wind swept desert, skulduggery, intrigue and also the magic and tenderness of love.
The doctors of my era had a love hate relationship with the Dept of Health. We couldn't bite the hand that fed us.
Take care and stay safe.
To all my learned friends
ReplyDeleteI have written about the Dept of Health with empathy and much feeling as the hand that fed us and the employer that controlled us. We are yet to hear from the many who worked their entire lives for the dept for their experiences, pain and pleasure. Now they are retired there is no question of looking back over their shoulder at the big brother to avoid recrimination. I say this only because I love to hear how things have moved on as medical school numbers and the numbers of doctors have expanded.
The points of view expressed on the value or otherwise of reminiscing show what complex lives we lead and a reminder again that generalisations are dangerous. Language is the greatest achievement of Humankind but it is still symbolic and does not always succeed in connecting the brain of the one who receives with that of the one who projects. Life often comes to occupying time in the most enjoyable and stress-free manner. Some read, others watch, many just think, a lot of enjoy a good meal or a drink, busy working people with young families have far less time to for mere indulgence in the pursuit of pleasure. Reminiscing is always available, what you tune0in to is your choice, no need for wi-fi or technology (a rocking chair is an useful accessory!) and it does not harm anybody! Provided it does not lead to sadness and negative thought, what a lovely way of spending time!
ReplyDeleteMahen
DeleteThank you. I do agree with your thoughts on reminiscing. I seem to have a head full of them and the majority are simple memories. Once when I was around 7 or 8 years old and was awake at night I heard the sounds of a buggy cart winding its way. The nights were so quiet in those days. My father told me they were several carts carrying sand from Mutwal to some building works in Kohuwela. To me personally this is a wonderful memory of my father and of Nugegoda in the late 1940's. These are recollections of a time now long gone. My father is no more and so is the peaceful Nugegoda I knew and of course the buggy carts. Recalling these brings me great joy.
I agree with all of you that reminiscences should not result in regrets and self recriminations. Instead they should comfort you like a warm blanket on a cold winter evening!
DeleteNihal, my maternal grandmother had one of those buggy carts drawn by a bull. My uncle maintained it and even retained a 'carter' who took care of the bull and the cart. The brass fixtures were always polished to perfection. I remember riding in it just before entering Medical College. Those carts were not an uncommon sight in Moratuwa during those laid back days, when traffic jams did not exist.
Nihal,Sumathi,Kumar,Srianee,Mahen and Rohini, I really enjoyed reading your experiences in different parts of Ceylon.
ReplyDeleteAfter my interneship at the GHC,I spent nine months at the Chest Hospital,Welisara. Russell Paul was also there with me. On the first day when I wanted to do a ward round, the nurse informed me that it is not required. Few BHTs were brought to my office and I had to deal with those. Most requests were for short leave. I had to cover about four wards, but I used to finish my work by about 10.00 am.Then I spent time with the radiologist Dr. Warakaulle. He was an unforgettable character. He owned three cars but at any given time, two of the engines had been disassembled. Although he was an excellent radiologist he was more interested in motor mechanism. He used to come for work with both hands stained with grease and the lips painted with betel juice!In thw evenings we played soft ball cricket and badminton together with the para-medics.The Vespa scooter was very useful because I used to visit the Health Department Sports Club when I was not on call.I started giving lectures in Sinhala to the student nurses as there was a NTS at Welisara.It was a very enjoyable nine months that I spent at the CH Welisara.From Welisara I moved to the LRH on the 1st of April 1969.
Sanath
DeleteGreat to hear your experiences in transit to all the honour and glory in later years. There is a Dr Warakaulla who is a radiologist in the UK no doubt a relative of the betel chewing great man whom I haven't met.
I wonder if you could enlighten me on the current situation in the Health Service. With so many medical schools and so many doctors is there still a difficulty in filling posts in far flung places? Are the medical services in the so called wilderness improved with hospitals managed by more than one doctor? Are apothecaries still present? Are DMO's allowed to do private practice?
How does the order of merit work with so many medical schools? Are some medical schools given preference over others?
I would love to hear your views on the health service now compared to when we were HO's.
Sanath, I too had a great time at Welisera after I Left Matale, I think in 1971. All the doctors there were a close group of friends who got on really well. Just as you, work was over around 10.30 am or 11,00 am. Then to quarters, good lunch, nap, quick round and back to quarters for soft ball cricket, cards, scrabble and stories. I was in Welisera when the JVP insurrection broke out in April and we were confined to quarters. It was games and chat the whole day with helicopters flying over frequently.
ReplyDeleteAnd Waraks, he is easily one of the most interesting characters I have ever met. As you say, grease stained hands, betel juice red mouth, spiky greying hair cut short with a prominent "bush" at the front and dirty white shirt and often dirty khaki trousers. He couldn't have looked more remote as possible as a Radiologist. As a Radiologist he was one of the best, and a wonderful teacher too. I wonder what happened to him.
One other thing worth recalling. Dr Terry Waas (brother of Prof Anatomy) decided to contest for GMOA President. As a bit of a joke, my mates proposed me for Vice President. Waas lost but I won! I still remember my first meeting as VP. I was shi***ng in my pants surveying all the Senior Doctors sitting glaring at me from the front row. I somehow managed to survive with Anton Fernando as President.
Mahen
ReplyDeleteAlthough I worked with CT, MRI, Ultrasound and Nuclear medicine (also called unclear medicine) all my professional life in Radiology I still consider plain film radiology a greater challenge. Plain chest xrays can be pretty tough to interpret. I remember an ENT registrar who came to me for a Xray for a chronic cough. The only abnormality to find was a thickened horizontal fissure. As he was smoker I proceeded to a CT chest which showed 4cm mass behind the hilum. Dr Warakaulla being a plain film radiologist must have been excellent as you and Sanath have said.
Nihal, you posed some great questions in your response to Sanath. I hope he will oblige and answer some of them. I would love to hear what he has to say. It was fun to read about 'Dr. Waraks' in the comments from Sanath and Mahen. He sounds like a happy man messing around with cars in his spare time! We should share some other anecdotes of the interesting characters we have met along the way during our careers. Just a suggestion...
ReplyDeleteNihal, Mahendra and Srianee, I am very glad that all of you enjoyed what I mentioned about Warakaulle. One day he was very drunk and insisted on going to his residence in Gampaha. As he was not fit to drive any of his vehicles, Russell and I took him by train to Gampaha. He bought his Jeep from an Army auction and it was towed to Welisara by a bullock cart!I am not quite sure whether Warakaulle drove the bullock cart!!.I know his nephew Nissanka Warakulle who was a former registrar of the University of Colombo. Later both of us were members of the Council of the University of Kelaniya. Nissanka W. is aregular contributor to the local press. Recently he wrote an article about the Burghers of Ceylon, many of whom were from the Light Blue and Dark Blue school(WC).
ReplyDeleteThere are about one thousand doctors graduating from the State Medical Schools, annually. Another one thousand doctors return home after graduating abroad. However there is a maldistribution of doctors, with an excess in the Colombo district. Nihal,the right of private practice was given to grade Medical Officers in the late 1980s.Most MO/OPDs run private clinics. Few of them mention MO/OPD,LRH after their qualification/s,so as to attract patients.In the OPDs of LRH and NHSL, although the roster for a session is for ten, only three of them work;the others are busy running their private clinics.I used to meet many young doctors working in the Northern Province, who had graduated abroad, in the train when returning from Anuradhapura.
I wonder whether you all are aware that the first batch who graduated from Peradeniya were not offered jobs by the MoH, after graduation. Instead they were given an allowance of a few hundred rupees and requested to attach themselves to GPS so as to be trained in private practice. That was the catalyst for the brain drain in the late 1960s and early 1970s.
Sanath, the Peradeniya grads were not the only ones. When I finished my internship at the end of August 1968 I had to wait about 4 months before my appointment as M.O. OPD at Karawanella. (Poor planning on the part of the government, no surprise!) I believe people like Sunna also suffered the same fate.
DeleteMy batch was also told that employment was not assured after house jobs and as Srianee said, it acted as the impetus for the brain drain, which might have happened anyway later.
DeleteSanath, Mahendra and Srianee
ReplyDeleteYour description of the Warakaulla antics is from our early professional years, a mythical time in medicine. Before the advent of the internet the laymen knew nothing about human afflictions and the treatment. They all thought doctors had the knowledge and also the power to cure or kill. This resulted in the profession to be regarded as a certain cult and the doctors went along with it. The hospitals were places of secrecy and mystery. From this milieu emerged eccentrics like Warakaulla with spirit, personality and humour described so beautifully in the doctor series of books by Richard Gordon. They brought life and laughter to the profession and much else. The internet has robbed this mystique from hospitals and the profession, I hasten to add, with enormous benefits all round. But we have lost those special personalities in the profession. Surgeon Niles is the name that comes easily to mind for his brilliant humour. Nowadays doctors are busy, social media and the internet snoop on them and comment on their work. The big brother is watching riding on our backs all the time.
I recall an incident that took place when we were in the BLOCK. A person from our batch brought a person who was not a medical student to show him the dead bodies and the dissecting room. When Dr S.S Panditharatne came to know about this he was absolutely livid. He said by bringing outsiders we took away the mystery that surrounded the place, amidst the other issues.
As you mentioned double blue are the Wesley College colours. During my time we had a Burgher Principal Mr. C.J Oorloff, an old Royalist. This resulted in a huge influx of Burghers to Wesley College. I have always felt the Burghers brought a 4th dimension to life in Ceylon with their own culture. Many of them were vibrant personalities and loved to dance, sing, play sports and enjoy life when the “natives” went for tuition to serve their inflated ambitions. When they emigrated en-masse we lost our friends and a culture that enriched us all.
Nihal, I totally agree with you regarding the contribution made by the Burghers to our culture, sports, entertainment etcAs I grew up in Wellawatte, I came across very beautiful damsels. Do you remember Maureen Hingert who was a runner up in the Miss World contest in the 1950’s? She lived down Lorenze Road Bambalapitiya
ReplyDeleteSWRD’s Sinhala only policy drove them away. Our loss was Australia’s gain!
Maureen Hingert - wow what a pretty sight. She was runner up at Miss World and emigrated to California. Many of the Burghers worked for the CGR and lived in the Mount Mary estate next door to Wesley. The girls were friendly and never shy to speak to us. For some love did blossom.
DeleteMore on the Warakaulle story from comments is Sumathi's post about Bloem recollections.
ReplyDeleteI said "This is from an article in Ceylon-Ananda.com on 20th Feb 2020 by by HM Nissanka Warakaulle,Former Registrar, University of Colombo.Reminiscences of Faculty of Medicine, University of Colombo.
Kumar said "Nissanka Warakaulle has other medical connections.
His elder son Dinuke W is a radiologist in UK. His brother Anuke W was a resident in our Cardiac unit and is now a GP in Brisbane.
I was pleasantly surprised to learn that Upali Wijeratne aka Cunningham lives in QLD."
I said "These are his credentials. M. B. WARAKAULLE
M.B.B.S., T.D.D., D.M.R.D. He was a bachelor and was always chewing betel and messing about with cars. He had an old Land Rover. He just wore a white short sleeved open shirt and khaki trousers. He was superb on chest x-rays especially and x-rays in general. New hospital employees who have never seen him before would question him on why he is walking in the corridor in working hours. He has a great sense of humour too"
Lama said "When Russel and I worked at the Chest Hospital Welisara, I came to know Dr. Warakaulle quite well. He was an excellent radiologist but he was more interested in cars. He had three vehicles and at any given time, two of the engines were dismantled. He came for work with greased hands, teeth stained with betel juice and smelling of alcohol.
Nissanka Warakaulle was a nephew of his and I came to know him when he was the Registrar of the University of Colombo. Until recently both of us served in the Council of the University of Kelaniya.
Anuke W. was a student of mine in Colombo.
ReplyDeleteNihal, there are no RMPs being trained in Sri Lanka at present any more. Earlier they were called apothecaries. In Sri Lanka, wherever you live,there is a health facility(inclusive of ayurvedhic physicians) within a four kilometre radius.