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Friday, June 4, 2021

Medical School Memories

MEDICAL SCHOOL MEMORIES

Kumar Gunawardane 

THE BEGINNING

The year was nineteen sixty-two. A watershed year of my life: the year I entered the Colombo Medical College, the second oldest in South Asia. I should have been proud and brimming over with joy, for the competition to enter was fierce. First, there was the written examination. Then the practicals followed by the viva voce. But it was angst that prevailed, unfounded, but nevertheless real. Pampered at home and school, the venerable St. Thomas’s, this was a plunge into uncharted territory. It was perhaps the ‘rag’ which worried me the most. 

The happiest in the family was Mother. She was ecstatic that one son at least would be following the family tradition, her father’s family being Hela physicians for generations. Father too was overjoyed, but his bearing was subdued. The thought may have flashed through his mind of the responsibility of putting two sons through university. If so he would have dismissed it instantly, as we never lacked anything; expensive textbooks and other chattels and comforts deemed essential for the urbane undergraduate. I even had a bleached and sanitised human skeleton at home for the study of Anatomy; mother may have had reservations about this as she believed in the occult, but they were never voiced. 

The first visit to the CMC was for registration and the medical examination. We walked on Kynsey road past the stately Koch memorial clock tower, debased by an adjoining cheap milk bar and onto the portals of a three storey neo-classical building. Its interior did not live up to the exterior. A swarthy man checked the squirming boys, quickly but thoroughly. I wondered silently whether he was washing his hands between cases. Whenever a doctor visited home we had a basin of warm water on a stand and a fresh towel. There may have been a washroom nearby or he may have worn gloves. I do not remember and did not have any qualms about the result, as I was healthy and robust. It was uneventful, except for one boy giggling uncontrollably when his nether parts were touched. He was brusquely reprimanded. 

THE “BLOCK YEARS”

The next visit was the real McCoy. The seniors had warned us to wear jackets back to front ,black ties, mismatched shoes and carry red hibiscuses to propose to the girls. We  were barred from the common room and the canteen, and bypassing these stepped gingerly onto the anatomy block to the accompaniment of jeers of some seniors. The gloomy dissection room, reeking of formalin ,with cadavers laid on marble slabs, lit by single naked bulbs, was not a pleasant introduction to Medicine. It was made worse by the macabre humour of some. Cigarettes were stuck into the mouths of some cadavers, and body parts sneaked into handbags. 

However this was where we had to spend our first two years. Each cadaver was assigned to ten students. As always it was the individuals who made the difference. I was partnered by a gauche but amiable boy to dissect a lower limb. At the top were two elegant girls, formal yet friendly, dissecting the head and neck. One was petite and demure and I wished fervently some senior would coerce me to offer my hibiscus to her. One of our ‘body partners’ Chira appeared to be a masterly dissector, presaging the skilled eye surgeon she was to become. The undisputed leader of our group was Elmo S. Though small in stature, his personality was titanic. He didn’t allow any outsiders to rag us and neither did he. A renowned sportsman, he had the easy charm acquired in the playing fields of his school, St Benedict’s. There were also amongst the seniors, my school mates who called on me, during these early days ,affording more protection. All in all I escaped lightly, a far cry from what I had imagined. 

The most inconvenience was caused by having to go outside for lunch. For a few days ,I went to my father’s plush office ,a five cent trolley bus ride away .Our  lunches were sent  to him by the railway restaurant caterers and was mouth-watering. Still it was a relief to line single file for the plain fare in the noisy congested canteen, sharing a table with my old Thomian mates; Bora was the cheekiest and kept us in stitches. Sydney more mature was staid. CD was well up with all the exploits of the day and B justly dubbed him “News of the World”. Bora had an amusing tale most days. One day it was him thumbing a lift from the feared Professor of medicine, another day how a mate fleeced him for a cigarette and a cup of tea after offering him a lift on the pillion of his scooter. Again, how he and Sydney were chided by an annoyed fellow student for arriving unannounced at his home. All related with a half-smile on his lips and a twinkle in his eyes. There was never any malice. At the end of the fortnight, some juniors had to ‘perform’ in the common room the grand finale of the ‘rag’; somehow I escaped. 

The daily routine appeared to have been set in stone. Every day lectures began at eight am in the physiology theatre. I had to leave early to catch two buses, the second a London Transport double decker from Dehiwala to the Lipton circus junction. The bus journey was leisurely as it stopped at every halt. The same crowd would board the bus on-the-way, usually onto the upper deck and with passage of time we developed friendships with most boys. The girls would smile but fuse with their own group. The landmark at our destination was the red and yellow Victoria Eye hospital. Its Indo-Saracenic architecture did not appeal to me but was acclaimed by many. Another landmark less prominent, but more popular was Bake House an eatery, more upmarket than a ‘Buth Kade- the poor man’s restaurant’. 

The first lecture was physiology and delivered by the avuncular professor A.C.E.Koch. He was a pleasure to listen to, the accent was  polished and the words carefully chosen. Clearly he loved his role ,for in his first lecture as professor ,he had quoted Rabbi Akiba from the Talmud “ my son ,-more than the calf wishes to suck, does the cow yearn to suckle”. The talks had been prepared in advance and ,even the jokes were said to be integrated into them. The uninhibited laughter of the students and the loud stamping of their feet on the wooden floor was music to his ears. He had studied physiology at Oxford and had been a contemporary of Roger Bannister, the first athlete to run the mile under four minutes. RB was then twenty five years old. Prof had a faded slide of RB which he would project year after year. He was witty and had a good sense of humour, gentle and inoffensive and also an eye for beauty. Manil H, who was two seats away, tells of the time she arrived late for his lecture; as she was about to take her seat, Prof K, remarked “it is the privilege of a Bella Donna to come late”. It was appropriate in another sense too as he was talking of atropine. 

 We were to encounter another distinguished teacher ‘‘Bull’ Seneviratne only at the end of the second year. The duo was affectionately called ‘‘Cock and Bull’. However we did have early, another outstanding teacher, Carlo Fonseka. He made neuro-physiology, that most complex of subjects comprehensible even to dullards. I followed some of his techniques when I started teaching medical students myself. He would state the principle first and then adduce the evidence.I preserved these notes and used them for my postgraduate studies. 

Stamping of feet at lectures was likely a European tradition and signified applause, while shuffling of feet conveyed displeasure. Reflecting our own culture, we never shuffled our feet even if we were bored to distraction. An hour long biochemistry lecture, which followed physiology may have justified some shuffling,; we then tramped to the canteen for a ‘tea-punt -a cup of insipid milk tea and a cigarette’’. I was following the herd as I really didn’t enjoy smoking. Luckily, I had to stop owing to a bad cough ,not caused by smoking but by tropical pulmonary eosinophilia; this is an allergic response to filariasis prevalent in the Dehiwala-Mount Lavinia region. It was easily treated with a freely available drug. ‘Diethylcarbamazine’. I never smoked cigarettes again. 

The rest of the day was in the dissection room, interrupted by an occasional anatomy lecture or the dreaded ‘signature’ the fortnightly oral test. Some examiners, we had “cold feet” with, were the junior lecturers. Others we looked forward to, like Professor Chanmugam. He addressed the questions to the whole group and anybody could answer. At the end he signed all our books. Prof C was eccentric and some boys parodied his pronunciation of ‘tissue and issue” The girls were more refined and did not resort to crudities. Another favourite was a pretty young woman teacher. Boys named her “Sweetie” ;the name fitted her to a T. 

The Anatomy Block was the oldest building in the campus. The lecture room was a steep amphitheatre with creaky wooden floors, uncomfortable wooden benches and a musty smell, befitting its age as the oldest building in the campus. The Professor stood at the podium; the only thing I remember now is, him using an aerosol for his wheeze; he was a kindly examiner and helped many to get over the line. The retired professor’s talks evinced mirth on account of bizarre pronunciation of certain words. 

The physiology lecture theatre was modern, spacious and cozy. The seats were numbered to facilitate roll call and assigned in alphabetical order. The tiered floor was wooden ,and stamping produced a deafening din. The stamping was sometimes, in genuine appreciation of a good joke, but sometimes a good ploy to let off steam even if the joke was tepid. Girls who arrived late also got the ‘treatment’; we got the impression, perhaps unkindly, that some of the latecomers were using it as a catwalk. Bora reminds me of our friend Tilak D arriving for a lecture five minutes before the end. His thinking had been that he was five minutes early. The uproarious laughter and the wave of stamping was endless.

The library, spacious, cool and peaceful was a haven in times of stress .The comfortable individual chairs and polished timber tables, shielding one from users across, induced slumber which was difficult at times  to resist. It was used more often in subsequent years. 

CALAMITY

The nadir or more precisely, the calamity of our block years was the behaviour of some of our colleagues during the “Law-Medical” cricket encounter. In a frenzy, fueled by alcohol and perhaps testosterone, they invaded a girl’s school and to put it mildly, behaved inappropriately. They were duly reported to the authorities and faced expulsion if identified. The inquiry was conducted by the Dean, himself; a Pickwickian figure he could strike an imperious posture when the occasion demanded. In actual fact he was kindly and fatherly. His daughter was in our year but in that era, conflict of interests may not have mattered.

There were moments of inadvertent humour too. The Dean warned that he had photographs of the culprits and would scrutinise them under an electron microscope. The guilty parties who knew next to nothing of this weird and wonderful contraption, were cowed into submission. Another boy when questioned claimed that the truck he was gallivanting in was only halfway in the school compound and he was in the half that was outside. But to the everlasting glory of our colleagues, the boys decided to accept culpability as a group. This was a collective and unanimous decision. We were fined ten rupees each and suspended from lectures for two weeks. he silver lining of this black cloud was the bonding of the boys and the loyalty of the girls. They volunteered to transcribe the lectures meticulously, and loan the notes to us. 

My abiding memory of this disastrous day is being sloshed to the brim on toddy straight out of a barrel and cheap arrack. My faithful friend Bora somehow shepherded me from the wilds of Wanathamulla to his apartment in Bambalapitiya. He put me on his bed; I’m not sure where he slept. I was too inebriated to call my parents. The next day, sober, spruced up and repentant I gingerly made my way home, prepared for the dressing down that I richly deserved. Mother quietly whispered in my ear “puthe (son) your father hasn’t slept a wink. He paced up and down the verandah all night”. Father discreetly kept out of my way. It was an enduring and salutary lesson to me of their love, concern and anguish for my safety. There was never a repetition. 

We were punished by some of our immediate seniors with a second rag, more vicious than the first.It was an expression  more of sadism than righteousness.

The glory of youth is its beauty and vitality; but its resilience and tenacity are equally or more important. Soon we rolled back nonchalantly into our dull routine of lectures and dissections with interludes in the canteen and the common room. The Law-Medical match was a bad dream, a nightmare. 

ROMANCE

I was quiet and diffident by nature then, as always, but unlike at school, I found it difficult to make new friends amongst either boys or girls. My interests in the opposite sex, few and far between were known only to me and a couple of close friends. They were only platonic friendships at the most, and that too ,if the girl was aware of my existence. Our inhibitions and morals were Victorian and we were aeons away from the permissive society. 

There were exceptions of audacity, though .A good friend was enamoured of a girl, an Audrey Hepburn lookalike. As I was a relative he twisted my arm to accompany him to her home. We arrived ,on a weekend ,uninvited ,but heralded by the rumbling of his large motorcycle. She and her mother were unfazed and charmed us with their hospitality. The romance was probably short lived as there were no more visits. 

Our introduction to clinical work was in the final term of the second year. For the first time we could sport that age old insignia of the physicians, the stethoscope. Some dangled it on their necks, others including me, concealed it bashfully, amid our books. However, on the way back home that day, it was deflating that an ill-mannered youth blared to all and sundry “Oi ,there’s a doctor in the bus”. 

There were compensations too. I made the acquaintance of a pretty Burgher girl, on account of the peeping stethoscope. She, a fellow bus traveler, an office worker was as tall as me ,slim ,with the complexion of her Eurasian forbears and an engaging smile. The next day I accompanied her to the railway station to catch a train instead of my usual, the red double decker. The trysts had to end soon, however as there were hostile glances from many, who I surely knew would report this to my mother. 

On the inaugural day we walked briskly, along the lengthy corridors of the Colombo General Hospital to the holy of holies the main surgical ward and waited with trepidation for the arrival of Dr Noel Bartholomeuz, the senior surgeon. He arrived in a style worthy of medical royalty, followed by his chief nurse and house officers. They welcomed him in the carpark and accompanied him to the ward. Immaculately clad in a white suit with an orchid in his buttonhole, this Burgher patrician had a commanding personality. A nurse gently removed his jacket and robed him in a long white coat. And then began the process of the bedside walk from patient to patient with us respectfully bringing up the rear. It was perhaps, at this moment, that the idea of becoming a hospital consultant took root. 

FINALE

In the penultimate month of our Block years John F Kennedy the 35th President of USA was assassinated by a sniper. The date was November 22 1963, the day Friday. Like the rest of the world ,I remember what I was doing at the exact moment the sepulchral tones of the announcer came through our ageing HMV radio. I was “cramming” for the 2nd MBBS examination which was just a few weeks ahead and pacing the long corridor of our house, lecture notes in hand. Overcome by anguish I couldn’t study the rest of the day. 

He was a celestial figure to all of us in our formative years. For this young man, so handsome, brave, inspiring and eloquent, and the husband of a beautiful wife and father of two adorable children to be snatched at his peak was more than we could bear. Woefully, we had to get back to books soon, however, as the terror of  the examination outweighed the grief. 

The exam itself was a maze of written papers, interviews and laboratory practicals. Not only did I survive, but triumphed, much to my relief. 

Examinations produced their own brand of humour. A repeat student in Anatomy did unexpectedly well with the left femur. The indulgent professor said “you can now choose any other bone and you will pass if you do well”. He picked the right femur! Fortunately, the examiner had a sense of humour. 

The celebrations were low key, one bottle of gin shared with three other friends in salubrious surroundings.

20 comments:

  1. I meant to post this wonderful post by Kumar G in instalments but decided against it as I could be accused of intended and cruel harassment of my colleagues! So here is The Full Monty!

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  2. Dear Kumar,

    I want to make this short and sweet. I am posting it as a comment on the blog, but it is not what I would have done under normal circumstances. It would have been much longer. All this bla, bla because I have been advised not to spend too much time at the computer.

    I am sending this to you as a personal e-mail as well because I really wanted you to know that it made very interesting reading and had me in fits of laughter. My congratulations!                                                             
    You have mentioned the visit to Audrey Hepburn look alike. I think you related to me this story while having a personal chat. But I relived those moments. There is so much to write. But you do understand my predicament, don't you?

    Regards,

    Lucky

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  3. COMMENT BY KUMAR
    Dear Mahen,
    Thank you on many counts. Firstly for publishing the article in full. ( word count 2946).
    Then, for editing with correct punctuation and spacing. I will abide by your advice on these matters.
    You are doing a magnificent job in Lucky’s enforced absence, keeping us informed and amused.
    The Remembrance Week was one of the best ever.
    ������
    Kumar

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  4. COMMENT BY KUMAR
    Dear Lucky,
    Thank you. A sense of humour, is essential in these troubled times.
    You have bestowed on us a legacy which we all must treasure and enrich.
    I do understand your predicament. We are fortunate, that Mahen has stepped so adroitly into your role.
    I have two more articles on our medical school days. One completed, the other in gestation.
    Best Wishes to you and Mangala from Kanthi and me.

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  5. Kumar, I really enjoyed reading your post. As you have mentioned,our's is the second oldest Medical School in the region, which was established in 1870. I was a lecturer when the Centenary Celebrations were held in 1970. There were academic sessions in which distinguished medical personalities from overseas participated. During the medical exhibition Carlo Fonseka performed fire walking. Last year the 150th anniversary was celebrated, in which some of you all participated.
    Inidentally the oldest medical school in the region is the Bengal Medical College in Calcutta, which was established in 1839.Some Ceylonese students studied there. It has folded up since then.
    However the oldest Medical School in Sri Lanka, is the Green Medical School and Hospital in Manipay in the Jaffna peninsula.It was founded by an American missionary, Samuel Fisk Green(1822-1884).He translated and published over 4000 pages of medical literature from English to Tamil as part of his efforts to train doctors in their native language. Later the students were sent to South India for their clinical studies.
    During that infamous "Law-Medical" match, few of us invaded the field at the Royal-Trinity cricket match,at Reid Avenue. During the Dean's interrogation, few of us owned up. When the Dean inquired from me why I invaded the field, I replied that I wished to check the score from the umpire! The Dean replied "so, you are the inquisitive type"! When Asoka Wijeyekoon was asked the same question, he said that he wanted to convince the umpire that Royal should win the match! I cannot remember the answer given by Chanaka Wijesekere.
    During our Final Year trip, we spent a night in Kurunegala and there was a concert held at the Free Masons Hall, In one of the items Asoka Wijeyekoon appeared as Dr Argyle Robertson and my role was to be his pupil. We also broke journey in Badulla and during the party held at the HO's quaters in the Badulla Hospital, I performed a strp-tease dance!

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  6. Kumar, you write so well and your vocabulary (even after removing medical terms which expand that of our profession) is enormous.
    The Rag is something I would like to forget as for me it is uncivilised behaviour allowing sadists to enjoy themselves humiliating others. But one funny thing I recall is "playing" table tennis without racquets or balls - it was good fun looking back but at the time it was a harrowing experience. I am still amused at colleagues who justify the Rag as "character-building"!

    All the things you said about the Anatomy and Physiology lecture theatres are so true and so well portrayed.

    I remember Patchaya walking in to the Anatomy lab, standing with his legs apart, hands tucked behind him and completely ignoring a swaying lamp from a very long lead from the ceiling. The lamp was attached by a string to the penis of an unfortunate cadaver and the motion obeyed the law of physics in a simple harmonic motion, sadly rising and falling.

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  7. Dear Kumar
    I am so pleased Mahen has published the whole drama as this is not a story that can be told in halves. This reminds me of the ‘Doctor’ series of books by Richard Gordon.

    What a wonderful account of those glorious years in the faculty told with such elegance, warts and all. It is like watching a movie in Cinemascope and full and vivid Technicolor. For at least some of us, including myself, it is a ‘rags to riches’ story. In the fading light of our twilight years it all seems like a dream now. You indeed have a remarkable memory for detail which you have used with wisdom and brilliance ,relating those stories without upsetting the players in your drama, not compromising the facts but retaining the unintended humour.

    The faculty of medicine was to the public the playground of the island’s intelligentsia. In the marriage market the men were ‘up for grabs’ to the highest bidder. The skull and crossbones became part of our insignia. We loved to flash our stethoscopes and knee hammers as instruments of our ability to save lives. I hasten to add this is just a part of the story. Med school was a hard grind for 5 years and fear of our teachers was ever present. Although rich in public glory it wasn’t a bed of roses nor a bed of nails.

    As you had described so lavishly the administrative building of the faculty occupies a large part of my memories too. I worked in the Central Blood Bank for a further 4 years, just across Kynsey Road from the faculty. I continued to visit the canteen and the library like an extension of my student days. The elegant sweep of that magnificent building will remain in my memory forever.

    Mention of those faculty romances sounds exciting. The benefits of that permissive society hadn’t reached our little island yet. Cupid would have had a field day if we were bold enough. Mixing of the sexes was in its “infancy”. We had separate Common Rooms for men and women. In the faculty we were neither lounge lizards nor lotharios, just greenhorns schooled neither in Mills and Boon nor Barbara Cartland. Many of the romances were doomed before they started as the chivalrous men were just too bashful to express their affections. The girls too did what was expected of them and played hard to get. Ah! I have mixed emotions which rekindles many memories for me, some happy and some less so.

    Our drama came to an end with the fall of the curtain in 1967.

    Our blog is a repository of information 1962-67. When in future years the history of the Faculty of Medicine will be written the material including the teachers, students and events of our years will be in our blog. I can think of no better persons to collate that information than our batch scribe Kumar and our technocrat, Mahen with our very own Sanath Lamabadusuriya’s scholarly presence to grease the process.

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  8. Kumar,Nihal and Mahendra, Many things have changed in the "Block"since the 1960s. Malkanthi Chandrasekera, Professor of Anatomy at Peradeniya, initiated a programme termed"Giving thanks to the Silent Mentors",coupled with the chanting of pirith by Buddhist priests, prior to starting the dissections. The idea was to gve due respect to the cadavers. Sometimes, few relatives are also invited for the event. At Sabaragamuwa we are perpuating it. I gathered that similar events are conducted in other medical schools abroad as well. So, we have come a long way since our student days, when we gave no respect at all. Body parts were put in girls' hand bags and also thrown at others!
    Do you all rember Somarama's (SWRDB's assassin) cadaver been dissected by some of us? After he was hanged, his body was not claimed by the relatives and it was brought to the Faculty. We readily identified it as there was only one testicle!(He was shot in the groin by one of the body guards at the Tintagel down Rosmead Place and an orchidectomy was performed).

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  9. I posted a comment regarding Somasunderam just now. Please read it.

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  10. Dear Kumar
    The block was a baptism of fire starting with the rag. I never understood Koch’s physiology and Samson Wright wasn’t a help either. I tried to copy the lecture word to word. When the Prof said “Adrenaline” I copied it down. When he said “Nor Adrenaline” I thought he said No Adrenaline and I crossed off the adrenaline. The detailed anatomy was anathema to me. Bell Davidson and Scarborough was best as a door stopper. Come the 2nd MB exam it all seemed to fall into place. What helped me was the combined work done at St Anthony’s School in Wattala when Claude Bernard, Razaque and I sat together at weekends with lots of cutlets, patties and Lanka Lime. After we finished the eats and drinks Razaque often sloped off with a catalogue of excuses. I can now say it loud and clear that the 2nd MB course wasn’t great for me. The only good thing that came from it was the detailed anatomy that I learnt – which was an enormous help in Diagnostic Imaging with MRI and CT showing the most minute details.
    To me the real work began after the 2nd MB. The work was more relevant and beautifully taught. Including our clinical teaching this was indeed the Golden era of medical education. I have nothing but praise for my teachers in medical school. They were egotistic and difficult at times but they taught us beyond the call of duty. I cannot praise them enough.

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    Replies
    1. Thank you Nihal. This will be brief, as getting into comments, is very much hit and miss for me.Agree totally that clinical teachers were excellent,particularly at ward classes. Drs Wijenayake,Ernie Peris,Darrel Weiman, George Ratnavel
      and P.R.Wickremanayake were simply brilliant. I too enjoyed clinical teaching very much, and the lateral thinking of the modern student, and perhaps learnt as much as I taught.
      Kumar

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  11. Kumar
    Heartiest Congratulations for that interesting, well written account of your medical memories. I admire your Memory Power !
    It made my memory to go back to those college days with so much enthusiasm.
    Till you mentioned recently I had forgotten that we were body partners.
    Thank you Kumar for sharing your Medical Memories with a sense of humour which I enjoyed. Chira

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    1. Thank you Chira.Irwin and I looked in wonder at your dissection ,while we butchered our way through.I cannot remember your dissection partner. We can look back at those Dayasiri with amusement now, but wasn’t very pleasant then.
      Kumar

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  12. Kumar
    Very well written as usual.A balanced article which described friendship,humour,mischief,history and tradition.Brought back many memories.

    .I remember somebody,may be Lareef, being asked to bowl an over using his shoe.He stopped after six and he was told to complete an Australian over which as you know consisted of eight balls.The eighth ball and the subsequent ones were called no balls and the poor bowler went on and on.
    Like Nihal,during Prof Koch's lecture,i crossed off Adrenaline soon as he mentioned Nor Adrenaline.
    Thanks for taking us back to the good old days,

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    1. Thank you Bora.Brilliant story , related in your inimitable style.With your permission, I will include it in any future versions.
      Keeping this short , as not sure whether this will vaporised.
      Kumar

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  13. Kumar
    Glad you liked the story,please go ahead.

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  14. Kumar, I was sick and tired of listening to the boring lectures, most of the time. I felt a sleep during the third, fourth and final year lectures that were held on the top floor of the administrative block. Heavy lunch and humidity played a part. I was aware that my neighbours were coping notes religiously.

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  15. COMMENT FROM KUMAR WHO IS UNABLE TO POST FROM HIS IPAD
    Dear All,
    My sincere apologies, to everyone for not commenting or acknowledging on the blog, all the contributions and comments on articles of mine and others.
    I can read but not able to get through using my iPad .
    Will have to wait till I can use my android laptop when I get back to Australia.
    Kindest Regards
    Kumar

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  16. Kumar,
    A superb account of our early years in med. school so well written in your inimitable style .
    Enjoyed it very much. Look forward to the later years .
    Hope you are safely back in Oz. Love to Kanthi and you.

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