Monday, March 29, 2021

Max Gonsal Detective Series 1. Episode 1

 


Introduction by Speedy: This was prompted when I read Bora’s story about the wooden rod in his comment on Nihal’s radiology post. When Srianee sent me the story below, this detective idea came to my head. I welcome all Batch friends to contribute to this series. I have a feeling that this has the potential to draw in some amazing personal experiences. There is only one condition- they have to be true and have to be anonymised (patient and others involved apart from yours).

Series 1. Episode 1 Inaugural Contributor; Dr Srianee “Bunter” Fernando Dias

A MEDICAL MYSTERY - SOLVED!

In case you think that all we pathologists do is sit in a dingy basement office all day long looking at slides, I would like to share this story with you.  Our ‘detective work’ goes way beyond that! 

It seemed like any other day. It was late in the afternoon and the last batch of specimens had been delivered to the pathology lab from the operating room, as has been done umpteen times.  Our Pathology Assistant looking pretty bored and tired was examining the specimens and processing the tissues - we call it “grossing!” As she examined one of them, she suddenly became quite animated. She noticed something unusual and excitedly called me over to take a look.  The specimen container was labelled “strangulated hernia” and was from a 70 year old female patient, but the partially dissected specimen on the cutting table looked suspiciously like a small, fibrotic testicle! She said “Dr Dias, this looks like, well, like a small testicle”.  My immediate reaction was “The O.R. did it again and mislabeled a specimen!”.  Urgent phone calls were made to the operating room. A flustered nurse who had assisted in the surgery arrived to confirm the identity and verify that the specimen was indeed from a female patient. “This is not a mistake, all proper procedures were followed. This object admittedly not usually seen in women came from the patient. I can swear to that, or my name is not Emily”. As it happened it wasn’t Emily, she was Sarah but let’s not get distracted. The surgeon was also called and informed that we had something very strange going on, but that we needed to wait until the next day for confirmation of the tissue under the microscope. The surgeon was speechless but insisted that he was not careless. 

When the slides were ready the next day, our suspicions were confirmed.  It was clearly a fibrotic testicle with identifiable atrophic seminiferous tubules.  “What was going on?” I said to myself as there was nobody with me at the time. 

I told the surgeon that this patient may have testicular feminisation syndrome. He retorted huffily “Impossible!  She is happily married and has not one but three children”. He gave me that “look”, “is she balmy?” I then appealed to her primary care physician, who also happened to be the Chief of Medicine, who was definitely more receptive. I coaxed him to do a buccal smear to look for Barr-bodies, the simplest way to confirm if the patient was indeed genetically female.  The buccal smear, however, was devoid of Barr-bodies, confirming our suspicions that the patient was genetically male. 

Where do we go from here? The mystery had to be solved. Now it was up to the Chief of Medicine to delve into the history and get the facts. He spoke to the patient privately and gently explained our findings.  He was quite moved by her response, he told me later. She broke down in tears and confessed to him that she had faked her menstrual cycles after marriage.  She had consulted a ‘specialist’ at some point in her life and had been told that she would never have children, but that was all. Her children were all adopted, and she and her husband had been happily married for over 40 years.  Apparently, two of her sisters had a similar history. 

Patients with this syndrome, called complete androgen insensitivity syndrome (testicular feminisation) are genetically male (XY) but because of abnormalities in the X chromosome are resistant to androgens, so the male genitalia do not develop normally.  They are phenotypically female, with normally developed breasts and are usually lean and attractive, and are raised as girls.  They have short vaginas, but no uteri or ovaries.  It occurs in one out of 20,000 births and can be incomplete with ambiguous external genitalia or complete as in our patient.  The testes are undescended and prone to develop malignancies.  When a diagnosis is made a bilateral orchiectomy needs to be performed.  Our patient was lucky that she did not develop any malignancy. 

I believe our patient never divulged her diagnosis to her husband (they were in their 70s at the time). I found out later that she had returned to the emergency room with a strangulation of the hernia on the other side and had successful surgery.  The surgeon and her primary care physician had both remarked on the couple’s great relationship and made me wonder about the compatibility of two XY individuals versus an XX and XY pair!

It makes one wonder, doesn’t it?! 

In retrospect, I realize that in the pursuit of answers we could have completely disrupted this patient’s relatively calm and happy life. I don’t believe anyone in the Department of Medicine explained to her why a buccal smear was being done.  If that had happened she could have declined, and we would not have been able to back up our suspicions. We may have crossed some ethical boundaries at the time, which would not be possible nowadays. 

Thankfully for all concerned the Chief of Medicine handled the problem well, and her condition remained “her secret.”

Thursday, March 25, 2021

Speedy Dialogue series Episode 10 Chirasri Jayaweera Bandara

SPEEDY DIALOGUE SERIES- EPISODE 10. WITH CHIRASRI JAYAWEERA BANDARA  (II)



Episode 9: Chirasri  Jayaweera Bandara (nee Mallawaratchi)

“My hobbies in retirement”

Speedy: Good morning Chira. It was good to talk to you in December and we agreed to do a follow-up interview to discuss your hobbies in more detail.

Chira: Thank you Mahendra.  Yes, I told you about my hobby of cross stitching which was prompted by my daughter Anjali and also how I started painting, also helped by her.

Speedy: We discussed cross-stitching quite a bit. Shall we talk about your paintings? You must excuse some formatting errors which have crept into this post Chira.


Chira:
 Sure Mahendra.

Speedy: OK Chira. Did you have any lessons?

Chira: No, I never had any formal lessons.  I just started painting by looking at pictures on the internet. I have done more than 50 paintings on Kent A5 paper. And then I laminate them and put in an Album.

Speedy: What is Kent A5 paper Chira?

Chira: Sorry! Should have explained. It is a special paper made from pulp and is ideal for painting and drawing. A5 of course refers to the dimensions and is roughly 8.3 x 5.8 inches.

Speedy: Thank you and it is amazing to know that you have done so many and without any formal training. That really is tremendous! Would you like to show us a selection and talk through them?

Chira:.  Sure, is there anything, in particular, you want to ask me about my painting?

Speedy: Shall we talk about the type of drawings you do, the media you prefer, for example, are you fond of water colours or acrylics? Do you use oil as a medium? Do you do black and white paintings? What inspires you to start on a painting?

Chira; That is a lot of questions and I shall try and answer them and is it alright if I show you some paintings as we continue the discussion as examples?

Speedy: That would be perfect! Please go ahead.

Chira; On the medium I prefer, I started painting with water colours first and went on to acrylic later. I have never used oil paints and I have never done black and white painting. 

Speedy: You must try oils. I got into oils quite late. I first went to a weekend residential class to learn, more about the technical aspects you know, as it is very different from acrylics. There was quite a lot to learn. Oils also give you more time to make alterations, unlike acrylics which dry pretty quickly as you know. 

Chira; Maybe I should give it some thought.

Speedy: I think so, I am sure you will master it. Can I ask you what inspired you to start painting?

Chira: Well, I stopped doing cross-stitching after I did six and my daughter Anjali had been giving some thought to what else might be suitable for me as a hobby. She brought me stuff required to start painting like Kent A5 paper, water colour paints, brushes etc., and that was only about two years ago.

Speedy: What was your first painting?

Chira: The first painting I did was a rose bud and it came out well and was praised by several people. This prompted me to do more and more paintings. Funnily enough, recently I was going through my things and I found a certificate given to me for a painting I did when I was just 8 years old by The Royal Drawing Society U.K. stating “very good”.  Cheered me up!                              

Speedy: I bet it did! Can we see some of your paintings now?

Chira But of course! I am quite proud of them. The ones I chose for you are Kingfisher, Araliya, Rose, Crab claws and Flamingo.

 Speedy: They all look really great! Well done!

Chira: Thank you!

Speedy: Moving away from painting to your other hobby of what I may call creative sewing, you mentioned some frocks you did for your granddaughter.

Chira Yes, I am quite proud of them. Could I show you some frocks I have sewn for my granddaughter one year ago when she was 3 years old?  I have done 4 frocks and the last one I did smocking.

 Speedy: Not smoking? Just joking Chira! Please do.      

                      

Chira: Here they are Mahendra. I keep calling you Mahendra, I hope you don’t mind.

 Speedy: Not at all Chira. These are lovely! Any more on the sewing line you want to share?

 Sewing photo no.1 (3 frocks)

         

Sewing photo no. 4 (Baby shirt I did for my daughter and pillow case for my son with embroidery)

 

Sewing photo no.5 (frock I did for my daughter when she was 10 or 11yrs old). 

Chira: When I was expecting my son and daughter I sewed Baby shirts, Baby Pillow cases, Cot sheets, Bath sheets etc with embroidery. I still sew some of my own dresses such as sleeveless saree blouses.

I sewed many frocks for my daughter when she was small. I don’t have them now to show you but I have a Party frock I sewed for my daughter when she was about 10 or 11 years old.

Sewing photo no.3 (close up of smocked frock)

 

Speedy: That was fun! I enjoyed this session a lot. You certainly have talent and I am glad you are making use of it. Thank you so much for appearing on my interview series again. Your first interview remains the post with the largest number of comments to date on our blog (120!). Like last time I hope our colleagues will be stimulated to come up with their own experiences.

Chira: Really! I didn’t know that. Thanks, Mahendra. I really enjoyed this session. Thank you for giving me this opportunity and I hope that the Blog will continue to flourish. All the best!

Speedy: It has been my pleasure and thanks again for sharing.  I shall end this with a quote from Brene Brown, who is an American professor, lecturer, author, based at the University of Houston,

“We all have gifts and talents. When we cultivate those gifts and share them with the world, we create a sense of meaning and purpose in our lives. Squandering our gifts brings distress to our lives. As it turns out, it’s not merely benign or “too bad” if we don’t use the gifts that we’ve been given; we pay for it with our emotional and physical well-being. When we don’t use our talents to cultivate meaningful work, we struggle. We feel disconnected and weighed down by feelings of emptiness, frustration, resentment, shame, disappointment, fear, and even grief.”  

Friday, March 19, 2021

My Journey into Radiology

 My journey into Radiology

Nihal D Amarasekera


 

O

nce upon a time I was an unhappy and disaffected haematology registrar in a hospital close to London. After having completed the MRCP in 1976 I would have loved to proceed to a job as a medical registrar. But I was eminently aware such posts were reserved for local graduates. Then consultancies in general medicine were an impossible dream. I just couldn’t see myself looking through a microscope for the rest of my life. 

One soggy morning I was turning the pages of the BMJ when I came across an advertisement for a trainee radiologist at King’s College Hospital London. Being young, curious and impulsive, I applied and was called for an interview. I was impressed by the charm and the elegant spread of the Victorian buildings. There were several candidates nervously pacing the corridor outside the waiting room, an ideal scene to fur up one’s coronaries. Inside the suffocating confines of an elegant room, there were half a dozen wizened old men seated round a large table. At the interview I made a dreadful start. They were not impressed I had not visited the hospital before the interview and asked me why not. I said “Kings College being a centre of excellence I assumed it would be good and there was no need to make a visit”. They were shocked and bemused by my answer but accepted it reluctantly. Perhaps they were still unsure about me when they offered me the job. I didn’t realise at the time this was a well sought-after post. The hospital indeed was a centre of excellence with a golden reputation. Its Director, John Laws, was the president of the Royal College of Radiologists. A distinguished-looking figure, he was a quiet, formal and kindly man who commanded respect and received it. From now on I was in posh company. 

After having worked in general medicine for several years, from the outset I thought I knew enough about Xray film interpretation and believed training was merely to brush up and to learn the finer points. I soon realised how wrong I was. In reality I knew nothing and had everything to learn. The return to the very basics wasn’t easy. 

The radiology training was for 5 years. The first year was for radiation physics and radiographic anatomy and all about patient positioning for Xray images. There was a lot to learn about films and developing. The subjects were so far removed from patient care this was like being in the ‘block’ in our medical faculty. The training was done in-house and also at the smart precincts of the Royal College of Radiologists in the centre of town. The coaching and discipline was intensive and tough. The harsh environment in training was no different from what we were used to in medical school. 

Many of us working in the UK did encounter racial discrimination. When things didn’t go our way we often blamed it on prejudice. This was not strictly correct nor fair. Wherever we live be it gender, colour, race or social standing, there will always be some form of unfairness or injustice. To keep my sanity I learnt to navigate my feelings and get on with the job in hand. 

There were around 20 registrars. Among the trainees a strict hierarchy existed that was protected like the crown jewels. My colleagues were a cross section of society but a brilliant bunch. The atmosphere in the department was combative, stressful and intense. Everyone was competitive trying to score points over others. On our reporting whenever an interesting film appeared, we kept this for our lunch time meetings. These meetings were toxic in the extreme. Films were shown with little clinical information for a hapless trainee to struggle to arrive at a diagnosis. There was precious little feeling for the distress it caused. Despite the 40+ years I can still picture the rookie registrars sweating on the podium trying to eek out information from difficult Xray images. 

I came to the UK just 3 years previously. After having been treated with respect in hospitals in Sri Lanka I found this particularly hard to take. Those of us from the Indian subcontinent are hyper-sensitive to adverse comments. We sulked and ached for days, reflecting and grieving over them.  I struggled my way through the first year and passed the first exam. 

In 1967 it was my decision never to do anymore examinations and even sold all my medical text-books. Now I had 4 more years of this ‘hell’ to endure. I was restless and impatient for things to happen. There were times I felt all this was far too much for me. It was now I needed some good advice. My Indian dentist Rajeev Gupta was an intelligent and enlightened person. He was a maxillo-facial surgeon who had worked at the Middlesex Hospital. I went to him for guidance if I should give up radiology and return to clinical medicine. Rajeev was an inspiration. He discussed the pros and cons and advised me not to look back but to proceed ahead.  He bitterly regretted giving up his own hospital career for short term gain. Rajeev predicted a bright future for Radiology. It was a fast-moving speciality with the advent of computerisation. I am indeed so very grateful for his wisdom and scholarly advice. 

When I first started and a chest Xray was put up I often missed even the glaringly obvious abnormalities. Stress does makes fools of us so easily!! Making mistakes and getting things wrong in front of colleagues is not a pleasant feeling. This went on for a whole year. Like learning to drive a car, suddenly something clicked. The ability and confidence arrived from out of the blue. I soon began to see the wood from the trees. Before long I even began to enjoy the challenge of being shown difficult films. Regrettably, I even revelled in giving the other trainees a hard time. 

By now I had learnt about the British culture and humour and understood the subtleties of their language. This avoided the possible misunderstandings. Importantly I learnt to speak out, fight my corner and stand my ground. Quite early on in my training I was told by a Radiology Consultant that if I don’t blow my own trumpet no one else will blow it for me. In a trainee culture saturated with hubris I realised this was not a place for modesty and humility. I had to show off my knowledge and impress my bosses. My sound training at the faculty of medicine in Colombo was an invaluable help all through my apprentice years. 

Despite the tough regime I am forever grateful to Kings College hospital. They had the best structured training programme and the best examination results. There is no gain without pain was their mantra. I do not doubt they had the welfare of the trainees at heart. Above all after the training we emerged as safe and dependable radiologists. Many of my former colleagues reached those dizzy heights in the profession becoming influential names in British Radiology, examiners and office bearers of the Royal College of Radiologists. 

I was then living in north London travelling daily to the south crossing the great River Thames twice a day. This took me more than an hour each way. By then I had a young family and time at home was precious. I began to apply for Senior Registrar posts north of the river and closer to home. I finally found one at University College Hospital with a rotation to Great Ormand Street, Queens Square and the Royal National Orthopaedic hospital. It was indeed a great privilege to work in some of the prestigious hospitals in London. My only claim to fame is that I worked with those legendary icons in British radiology. It was such a privilege to have been tutored by the greats: Glyn Lloyd in ENT radiology, Simon Rees in cardiac radiology, Brian Kendal in neuroradiology and Donald Shaw in paediatric radiology.  I had the opportunity to share clinico-radiology meetings with Sir Roger Bannister and Sir Magdi Yacoub. Here I must apologise for ‘name dropping’ and for being so boastful. Perhaps, my humility was a casualty of the rough and tumble of radiology training. 

The atmosphere at UCH was more sedate and civilised. With an easier journey to work I was able to give more time to my family. Life got infinitely better for me. I became more confident and good at my job. In radiology we were trained to write reports on the images we saw. My interest in writing helped me enormously to construct precise, concise and useful reports. I made many friends at UCH who have remained friends for life. 

At the end of 5 years in radiology I passed the final examination. The FRCR(Lond) was a fearsome examination, a particularly difficult one with a meagre pass rate of 14-15%. Interestingly, most candidates did badly in plain Xrays than in cross-sectional imaging. 

Life had now come a full circle for me. The hardship and the struggles of the past have borne fruit and were at an end. I was appointed a consultant in a hospital 50 miles north of London.  I spent the rest of my professional career in the green and pleasant Hertfordshire countryside. Within 8 years of my arrival in the UK I was given their top job. I am ever so grateful to the National Health Service. Professionally I couldn’t have done better anywhere else in the world. 

Since the discovery of Xrays in 1895 by Wilhelm Roentgen, for fear of radiation, its usage has been confined to Xray departments at the basement of the old Victorian hospitals. During my lifetime radiology has been transformed. It is now a safe and invaluable tool in the early diagnosing and treatment at the forefront of clinical care. The rapid progress and the dependence of modern medicine on cross sectional imaging will always remain a source of pride and fascination for me. 

On reflection moving into radiology was one of the best things I’ve done. Looking back on my career I feel a tremendous sense of fulfilment.  After such a prolonged professional training, retirement came all too soon. Since then the years have flown by. Occasionally my mind goes back to the time when my ambition was to be a DMO. Fate had other plans for me. I then became a drifter in Colombo spending the evenings drinking at the Health Dept. Sports Club at Castle Street. I find it hard to explain how life took a change for the better. I call it the awesome force of destiny. 

(NOTE by Speedy: The image of ND is a self-portrait and I “doctored” the rest!)

Monday, March 15, 2021

Dr Sivasambu Anandaraja- An Appreciation

Here’s to your illustrious  career and innate goodness

Dr. Sivasambu Anandaraja

It’s an honour and privilege to pen this tribute to Ana.  His life was adventurous, interesting and full.

His schooling was at Royal College, Colombo where he was a prefect, managed the Senior Literary Association and was a proud participant in the debating team.

At age 17 he was one of seven Boy Scouts who represented Ceylon at the first World Scout Jamboree in Moisson near Paris. He had vivid memories of this event and the invitation to a garden party at Buckingham Palace that followed, where the scouts had formed a guard of honour for King George the Sixth.

Though born a Hindu, he had no religious affiliations and called himself a free thinker. He was concerned about the downtrodden from a young age and was an elected and active member of the Trotskyite movement in Colombo while a senior in school.

A distinguished alumnus of the Ceylon Medical College, he qualified in 1958. The Ceylon Medical College, founded in 1870 was the second oldest medical school in Asia and entry was by a competitive examination followed by a stiff viva voce. The latter was to assess the appearance, personality and fluency of candidates in English. Ana sailed through it all with ease.

On graduation and completion of internship he accepted an appointment as lecturer in Anatomy at the Colombo Medical Faculty. He soon realized this was not his preferred career path, and armed with a brilliant reference from his consultant during internship Prof. Milroy Paul, who was well acclaimed amongst the medical fraternity in Britain having delivered three Hunterian Orations at the Royal College of Surgeons, left for the UK to obtain an MRCP.  He felt immense gratitude to Prof.Paul for his reference, as he felt it secured him appointments in prestigious hospitals in the UK.

During Ana’s long career as a consultant he kept this in mind whenever he wrote a reference for a junior doctor, and did them in such a manner as to give young doctors the best chance for future success.

In Britain, he worked in the Worthing and Whipps Cross hospitals. He soon acquired membership of the Royal Colleges of Physicians of Edinburgh (1962) and London (1963) and was made a Fellow of the London College subsequently.  He returned to Ceylon in his Peugeot 403; an epic journey overland with two other friends who also became eminent in their respective spheres, Professor K.N. (Bull) Seneviratne, a renowned physiologist, and Dr. Kirthi De Silva (Kira), physician, who too later migrated to New Zealand.  The slides of this journey shown to us fresh medical students shortly after our entrance to the Medical College by Prof.Seneviratne kept us spellbound and excited our wanderlust.

On his return to Ceylon, Ana initially served as a consultant physician in the Jaffna General hospital (1963~67) and the then Galle General Hospital (1967~68).

We, the medical interns of the year 1967 first met Ana at Galle. We may have been naïve and idealistic but we could sift the grain from the chaff. Ana was the grain. An outstanding physician, who was not only erudite but caring, independent and unbowing.  A common theme that runs through all the tributes paid to him, is that he had a passion for education and was warm, helpful, refined and dignified. His kindness and excellent bedside manner did not discriminate between the poor public and affluent private patients.

He could be formidable. The story goes that when the local Member of Parliament of Galle who was also a powerful Cabinet Minister, once attempted to influence him unduly, Ana stood his ethical ground and refused to oblige. During the heated conversation that ensued, the Minister had said “Doctor cool down, place an ice bag on your head,” and Ana had retorted, “You need a cement bag on your head!”

Being a young man then, Ana developed a close rapport with us junior doctors. We all vied to be in his team owing to his clinical excellence and passion for teaching. In Galle it was that he met his future wife Rohini, “the love of my life” as he wrote of her in later years.

Ana was generous and would be the first to shout a round of drinks, usually the most expensive available. He had carried this tradition wherever he was and his ‘end of rotation’ parties were renowned for good food and the most costly Glenfiddich. Dissatisfied by the prevailing conditions in the land of his birth, he returned to England where he was offered a consultancy, but opted for Aotearoa, ‘the land of the long white cloud’ where he spent the rest of his days. It became his haven and Taranaki his niche.

In the Taranaki District Hospital he was the head of the Department of Medicine and director of the Intensive Care Unit. His fame as a clinician and teacher made him a sought after lecturer at postgraduate local and international seminars. We often met each other at Australian meetings. He would ask pertinent and penetrating questions that illuminated the topic on hand. Colleagues have remarked how he practised state of the art cardiology at Taranaki even before Auckland centres had adopted them.  In spite of his brilliance as a clinician, he was warm, approachable and kind, going out of his way to help the many who sought his assistance.

Retirement was mandatory then at age 65 in New Zealand and he came over to Queensland where he was Director of Medicine at the Gladstone District Hospital from 1998 to 2004, during which time he was also a participant examiner for the FRACP clinical examinations. Once New Zealand rescinded the law on compulsory retirement at 65, Ana returned to New Zealand as a consultant at the Auckland City Hospital and cardiologist at Waitemata Cardiology.

It was not ‘all work and no play’, for Ana was a lover of the arts, eastern and western classical music, enjoyed horse riding and having obtained his pilot’s licence delighted in taking to the skies in a Cessna 172 with his friends and family. The sky was not the limit to his zest for life; colleagues have recalled the days he drove himself to work at the Taranaki District Hospital in his beloved two-toned beige and gold Rolls Royce, to deliver to his patients his Rolls Royce care.

Ana and Rohini have two children, Romesh and Natasha (Anushri) of whom he was exceedingly proud. He was a loving husband and father, and touched the lives of many with his kindness, empathy, generosity and readiness to help, a man we could proudly call our own.

Ana, we salute not only your illustrious career, but also your innate goodness. “To live in the hearts of those we love is never to die.”

May you rest in peace.

Dr. Kumar Gunawardene

Tuesday, March 9, 2021

The Weligama Matriach- Kumar Gunawardane

 The Welgama Matriarch

 Dr Kumar Gunawardane. Published 28th Feb 2021 in the Island on line

( 05/01/1928 ~06/02/2021)- published in the Island (http://island.lk/the-welgama-matriarch/  )

A son-in-law remembers “Our beloved Amma, Beatrice, is no more”.

The rock around which the family’s hopes and fears flapped, sometimes swirled and raged is no more. In Khalil Gibran’s deathless verse,

“The most beautiful word on the lips of mankind,

Is the word ‘‘Mother’……..

The mother is everything,

She is our consolation in sorrow,

Our Hope in misery,

And our strength in weakness,

She is the source of love,

Mercy, sympathy and forgiveness.” 

I remember the first day we met. She and her husband had come to see my parents and me as a prospective son-in law-for their second daughter, Kanthi. Beatrice was one of the most beautiful Sinhala women I had seen. Secretly I was delighted. Surely her daughter must be equally or more beautiful. In fact, Mrs. Welgama was more captivating than all her daughters.

Kanthi’s father was moved by my ‘simplicity.’ A self-made man from the hinterland of the Kalutara district, he was warmed by my unpretentious attire – a sarong and shirt.

The bonds forged on that propitious day would last a lifetime. They both treated me like one of their own, more so after my own parents passed away.

Amma was born in a sylvan hamlet in the Kandyan hills and the grandeur of the mountains and the beauty of the valleys seemed etched in her. She was betrothed as a beautiful teenager to a mature but equally good looking and imposing husband. At first she may have been overawed by him, an entrepreneur who went onto build one of the largest trucking companies of the land; but soon became an equal partner.

Her first and highest priority after her spouse was the family; the children, children’s children and us children by marriage. When I was dealt an injustice by the department of health, she who was welcome in the highest circles of the land endured agonizing waits and arrogance of the then health minister. She was as disappointed as I that I was not able to accept a training position in a major American centre due to the intransigence of bureaucrats. Being a woman, the minister should have been more sympathetic to a mother’s anguish. In some ways I was glad that her efforts didn’t bear fruit;I ended up in Australia rather than USA.

Again when part of Kanthi’s property, in a fashionable suburb of Colombo, was annexed, it was she who toiled and laboured to get us some compensation. Similarly, when a large extent of land that belonged to her husband was seized by the State it was she who obtained some recompense which, though meagre in comparison to its value, enabled her to build a hospital in memory of her much loved husband. This had been his cherished ambition.

His own mother had died at childbirth and his aspiration for the impoverished women of his village was an easily accessible, well equipped and staffed maternity health centre. She worked like a Trojan coaxing and cajoling suppliers, contractors and craftsmen and even attending to even the most minor details. The day that the hospital was declared open by the then President would have been one of the happiest days of her life. She may well have echoed the poet’s words “My task on earth is done, by thy grace, the victory’s won”.

She would be the first to rush to the sides of her daughters having their babies and to other afflicted relatives. When I had major surgery, she travelled alone across two continents to be with me and Kanthi the next day. Arriving directly from the airport to the intensive care unit, her mere presence hastened my recovery. Staying on for a month, leaving her husband and rest of the family at home, the counselling and support she gave Kanthi and me was immeasurable.

When my father was hospitalised for the first and last time in his long life it was Amma who visited him every day. He was widowed and both sons were unable to come quickly. On his last day he told her, “Sister, for what you are doing to me you will be born an Imperial Princess in your next birth.”

Her hospitality was legendary. We would look forward eagerly to the weekly lunch on a Sunday. The repasts were magnificent, fit for royalty; an excellent cook herself every delicious dish was checked and augmented by her. Our favourites were the pork curry and biscuit pudding. The family gathering was convivial and full of fun and we retired for the conventional siesta only hours later.

Whenever Kanthi and I arrived from Australia she was at the airport even if the hour was ungodly. The journey to her house in Wellawatte was long in the pre-highway days. Mother and daughter in the back seat would catch up on news and gossip while I snatched forty winks. The house was sparkling clean and brightly lit and the dining table loaded with ripe bananas and sweetmeats. We would quickly adjourn to the bedroom, air-conditioned to dispel the heat and humidity. The bed and linen were luxurious and we would sleep soundly until the houseboy Gamini’s deferential knock the next morning woke us for bed tea.

Afterwards I would go for a walk on the beach, only a quarter-mile away, with Gamini and the faithful hound, Jimmy. To quote my own words “the bracing cool of the morning, the fresh air, the soft breezes and the music of the waves, crashing on the shore was the perfect start for a new day. Gamini and Jimmy squatted on a rock, watching me walk barefoot on the sand, with the warm salt water wetting my feet only now and then. They did not need the workout.”

Every meal was a delight. She got the choicest fruit, vegetables and fish in season from the Kollupitiya market. Her favourite vendor Sanath whom she had helped gave her only the best.

The car and chauffeur were at our disposal for shopping -books and music for me, clothes, gifts and souvenirs for Kanthi. There were of course innumerable parties and the occasional visit to a coastal resort down south and sometimes a hill country resort.

These holidays with Amma are an indelible memory; although we have had vacations in many exotic parts of the world, we will always treasure these grand times with her.

With five daughters of marriageable age, wedding planning and dressing brides became her metier long before it became a lucrative business. She dressed six brides at home, the sixth being our Australian sister-in-law; she dressed countless other brides too as her fame had spread far and wide.

Months before the event, she would go on shopping sprees to Chennai and Mumbai for sarees, jewellery and other paraphernalia deemed essential for brides from affluent families. Her husband gave her free rein, but being prudent she would get the best only at the right price. There were a thousand and one other matters and people to be dealt with. She did them all, maybe with some fuss, but well nevertheless.

The weddings themselves were spectacular events graced by the esteemed, the chic and friends and relatives. One of our attesting witnesses, J.R.Jayewardene and a guest, R.Premadasa, went on to become Presidents. The other attesting witness Maithripala Senanayake, the then deputy prime minister, was a rarity even then – an honest gentlemanly politician.

Our nuptials were at the Mount Lavinia Hotel overlooking the azure waters of the Indian Ocean and my alma mater, S. Thomas, the famed school by the sea. The pomp and splendour of the ceremony overawed me. I remember an aunt whispering to me ‘ smile putha ,smile’. Very few of the guests may have known the immense efforts that Amma put in to stage this breath-taking event.

She was fearless in the mould of our national hero, Madduma Bandara or even Lord Horatio Nelson of whom she would have learnt at school. It could have been inborn or acquired from her husband whose forefathers were soldiers in the service of the Sinhala kings. Perhaps, many pregnancies and childbirths would have made her immune to pain and fear.

On the first day of the disturbances of July 1983, returning from Ratnapura, we were stopped many times by goons wielding clubs, knives and swords, enquiring about our ethnicity. Our driver was timid and so was I. But Amma who was in the backseat with Kanthi ordered them loudly to let us proceed. And they did.

When we reached Wellawatte the street was ablaze with household goods set on fire. The house itself was packed with Tamil neighbours, numbering more than 50. Without batting an eyelid and unmindful of her own safety and that of the family she set about looking after them till they moved to a refugee camp the next day. Nearly 40 years later, I can scarcely believe how she managed such a feat.

Travel was a passion and It gave us much satisfaction to indulge her. Their first vacation in the West was in Britain in 1975. They were blessed with a golden summer. We were then living in Shotley Bridge, a picturesque town halfway between Newcastle upon Tyne and Durham. From there they visited the Lake District, Edinburgh and other famed tourist spots.

In London their gracious and caring hosts were our good friends, Lalitha and Gemunu; they were taken around to many vibrant tourist attractions and Amma was able to shop for her daughters in Oxford street and the bustling markets. She had been given long lists of items to buy.

Kanthi and I then accompanied them to Freiburg in the Black Forest district where a son, Mahinda, was a University student. He spoke German like a local, knew all the important sights and had many good friends, young and old. One of them, Frau Laufer welcomed us to her opulent mansion where we stayed. I remember specifically the cellar as large as the house where she stored homemade wines, jams and pickled fruit.

Two unforgettable visits were to the Mercedes Benz factory in Stuttgart and the other, a day trip to Switzerland. Father, a Mercedes enthusiast was enthralled with the automated production of cars. They were enchanted with all the places they visited and language barriers didn’t hold them back from socialising with the locals. As Germany and Switzerland were very different from Britain, their holiday was as varied and fascinating as they could have wished.

Their last vacation together was to Hawaii and Disneyland and as I was working in Los Angeles able to guide them around Anaheim.

After the passing away of Father we were able to take her with us on two European tours, a couple of USA vacations and a Scandinavian tour which she much enjoyed. Born to a Catholic family, the tour of the Holy Land enchanted her the most. We also visited Egypt afterwards. A good traveller, she revelled in fresh experiences and cuisines and enjoyed meeting people of all ages.

The childlike astonishment at her first sight of snow in Vancouver alone made that journey worthwhile. The following day was sunny with blue skies and the Grouse mountain covered in a white blanket was a sight to behold. Walking and riding in a snow cart on the mountaintop thrilled her.

Now, there is only a void that can never be filled. Yet we rejoice in a life lived to the full, mostly in the service of others.

 “A mother is she,

Who can take the place of all others,

But whose place, no one can take”

Cardinal Mermillod

May her journey in Samsara be short and may she attain the supreme bliss of Nibbana.

Kumar Gunawardane

Emeritus Consultant Cardiologist

Friday, March 5, 2021

A mother's advice- Srianee Dias

 A MOTHER’S ADVICE

Srianee (Bunter) Fernando Dias

Several years before she died peacefully at age 91, my mother wrote several ‘farewell letters’ to her children.  She wrote individual letters to each of us which were personal and private, but she also wrote one letter addressed to all five of her children.  We were unaware of these letters, because she had given them for safe keeping to my cousin’s wife with instructions that they be given to us after her departure.  This letter was ‘good advice’ and we all agreed that it needed to be read at her Memorial Service, so that her wise words could be shared with her nieces, nephews and grandchildren, as well as other relatives and friends.

When I happened to mention this letter to Mahen during a phone conversation, he asked me if I would consider sharing it with our friends on the blog as well. I think that I should tell you a little bit about my mother before you read her letter. (Some of you got to know her during our years in Medical College.) 

My mother, Merlyn Fonseka, grew up in Moratuwa, the third of six siblings.  She excelled in her studies at Princess of Wales College, and represented PWC in tennis.  I have in my possession a prize book that she received for mathematics in Form VI in 1930!  It is a copy of “The Abbot” by Sir Walter Scott.  She told me once that she had wanted to study medicine but thought that studying for five years was too long!  Instead she entered the Teachers Training College, and after completing her training she returned to Princess of Wales College to teach. Prof. Priyani Soysa was one of her students.  Prof Priyani often addressed me as “my teacher’s daughter” whenever I appeared at one of her ward classes. My mother’s final teaching appointment before retirement was at St. Thomas’ College, Mt Lavinia, where she taught for many years in the Lower School.  I think she really enjoyed her years at STC Mt Lavinia.  Judging from the tributes we received from her students, I think they enjoyed her too.  

In June 1962 she suffered the sudden and devastating loss of my father.  In addition to the emotional strain, she also had to cope with the financial stress, because my father had been the main breadwinner in the family.  She decided to take on students for private tuition at our home, which she did after a long day of teaching at school.  When one well-meaning relative suggested to her that I should quit Medical College after the ‘2nd MB’ and “get a job” to supplement the family income, she politely told him to “mind his own business” or something to that effect!  Even though the years following my father’s death were difficult, she was determined to have her children complete their education. Later in life she enjoyed several trips to the U.S. The fact that two of her sons were Captains on Sri Lankan Airlines gave her the privilege of discounted tickets on some of her flights.  In spite of the distance she managed to have a close relationship with my two daughters as well as her other grandchildren.  On her last trip to the U.S. she celebrated her 84th birthday in Connecticut with us! 

Her letter is short, simple and wise, a reflection of who she was.  It is my pleasure to share it with my friends.  Here it is:
 

To All my Darling Children

First of all, many thanks for all you’ve been to me and all you’ve done for me.   I can with a clear conscience say I did my best for you.  If not for your love and support I would have followed your darling Thaththa soon.  Your love and support, together with God’s guidance and His blessings, helped me to live this long.  Whenever I had a problem - and I had many - I took it to the Lord in prayer.  He always answered me.

Now that I am no longer with you the most important thing I ask of you is that you will always remain a united family.  You have your differences.  No two people are alike.  Always look for the good in others and live peacefully.  Help one another when help is necessary.  Go on Holiday trips together, whenever possible.  Bring up your children in the way God wants you to.  More than anything else teach them to respect elders and show love and concern for the less fortunate.

Your darling Thaththa and I will send you blessings.

Farewell and God bless.

Fondest love and kisses,

Your darling Amma.”