Sunday, January 14, 2024

A journey which commenced in 1962…Mahendra "Speedy" Gonsalkorale

A journey which commenced in 1962…

Mahendra “Speedy” Gonsalkorale

Almost sixty years ago, more than 160 fish were released to a pond to prepare for a long and hazardous journey upstream. They were all innocent, came in all shapes and sizes, both male and female but they all had one thing in common: they wanted to be conditioned and prepared for a life of caring for the sick. The pond was our faculty of Medicine and we were the fish.

The innocence was variable but real, not imagined. The innocence of youth, untarnished by experience. The final goal was also real but imagined as we hardly knew what it would be like to be doctors. The driving force was the vision of being “someone” worthy in Society, with sufficient means to maybe get married and raise a family. All human beings have a sense of identity, a sense of self or sentience as we call it. Our identity was inextricably tied up with the high regard Society had for our profession, like a glove to a hand. And, like all human beings, we wanted to be loved, to be admired and to be wanted. To be a Doctor was worth the tears, the hard work, and the effort and energy required.

The thought that we were so insignificant in a complex and massive Universe did not cross our minds. The thought that our planet Earth is just a miniscule dot in this vast Universe did not strike us. The thought that the sum total of time humans have inhabited this planet is just a blink of an eyelid in the scale that time has existed, did not strike us. These philosophical thoughts are interesting but ultimately, time, space, our place in the Universe matter to us only for the space and time we live in. Measured time could be meaningless- an F1 driver beats his rival by a “whole 12 milliseconds” which is “huge” in that time scale while a distant galaxy is “only” x light years away in a different scale.  The dog looks at the tiny mouse in front of him not knowing that a massive elephant is behind him. Our time and space might be relatively insignificant, but to us… it IS the most significant. But the realisation of the enormity of time and space and our relative insignificance should make us humble.

As we mature, we begin to ask questions such as what is reality, is there a God, we look for purpose, why we exist and whether existence ceases when we die. Why there is so much “good” as well as “evil” in this World.  But as students, we only thought of spending time equipping ourselves with the skills and knowledge required to be a good doctor. Of course, there were diversions and fun! As we matured, we realised that knowledge and skills are mandatory but of equal importance was the “human” aspect of dealing with patients such as empathy, listening skills, kindness, the subtle art of conveying bad news and so many other communication skills. We had to learn to deal with terrible things that happen to people such life-threatening illnesses, death and separation from loved ones. But we had compensations such as  the joy of healing, relieving pain and suffering, and witnessing the miracle of childbirth.

The fish continued to swim and almost all of them reached their destination. The pond was a happy place although difficult at times. Our “outer” camouflage did not matter at all, it was what was “inside” that mattered. Many lifelong relationships and friendships were formed. And finally…it was time to leave the pond, wear the outfit of the doctor  with a stethoscope proudly adorning the neck, and finally become what you strived for so hard…a doctor! The sense of achievement and reward was palpable and memorable.

Looking back over the past 60 odd years, it is salutary to reflect on the times and places we have travelled through in our journey. Who would have in their wildest dreams expected that we would be scattered around the globe? We became husbands, wives, fathers, mothers and even grander! When we were fish in the pond all those years ago, we bumped into each other all the time but as time passed and the world opened to us, fresh challenges, new friends, new relationships inevitably formed and the gossamer thread that united us became thinner, branched more and often broke off to float away. There were times when these branches ran into each other and relationships were rekindled. But everything changes; that is the Universal law and it applies equally well to the Colombomedgrads62 group.

We must not expect miracles. Just remind ourselves from time to time the brotherhood and sisterhood which united us. We were maturing souls held together by a common bond: the desire to be a doctor one day and by golly we have achieved that! We have in our midst Physicians, Surgeons, GPs, Professors, Researchers, Leaders, Followers, Innovators, Legends and most of all, we have exemplary human beings who are a credit to their parents, teachers, to their schools, to the Faculty, country and most importantly, to the much wider and important community of human beings that inhabit our precious Planet Earth.

17 comments:

  1. Mahen
    Thank you for that lovely and thought provoking discourse of our journey as medics and patients of this wonderful world. Not many of us went into medicine to alleviate human suffering, at least I didn’t. I wanted a steady job which was lucrative to have a good life. There was intense parental and school pressure to choose medicine. On looking back on my life as an octogenarian I would have preferred to be a journalist, but I never knew such a profession existed. But I’m happy with the path I’ve taken. I’ve have had a good life and feel no regrets. As a journalist I would have lived in Sri Lanka. At times it has been difficult to write honestly and with conviction as an editor of a newspaper. Some have disappeared in white vans!! So I have my parents and teachers to thank .
    The 160 fish that met in the pond in 1962 did so just by chance or by the awesome force of destiny. Although many of us feel passionately for the camaraderie and closeness of the group I do understand if some feel differently.
    As doctors in SL in the mid 20th century we were the top professionals in the greatest demand and developed a certain arrogance like God’s chosen people. It was not until I started work in the UK that I was cut down to size and was made aware I was just another human being in this vast planet.
    I have learnt from people much more than I have learnt from books how to be a good citizen of this wonderful world. We learn these all the time.

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    1. Probably and idealistic view with facts, ideas, views all enmeshed to provoke thought!

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    2. Hi this is Suri
      Thank you Speedy for your visionary and poetic recap if our journey in the past 6 decades.
      I think most of us found complete satisfaction in our chosen profession whether it was a burning ambition , or forced into it by our ambitious parents , or if the path just opened before us.
      I am so glad that Communication Skills is now an accepted module in the Medical curriculum.... Our days it was either you had it or had to struggle with it !
      It's amazing how we can meet after long gaps and carry on talking non stop as if we have never been apart ! Shows how strong our initial bonding was. So grateful to you and Lucky for creating this forum and the sustained effort to keep it alive.
      Long live the Blog

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    3. Hi Suri. Thanks a lot for your comment. You have truly captured the spirit of what I tried to convey. It still amazes me when I look back at the lives of our group and see what they have been through, what they have achieved and feel humbled and honoured to be part of this wonderful group of people. Thanks again and wish you and Mahendra all the best.

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  2. RAJ GONSALKORALE. MAHENDRA'S BROTHER
    A very well written piece
    I liked the analogies you had used, the fish, and specially the dog looking at the mouse while there is an Elephant behind!
    I suppose a question doctors could ask themselves is the extent they have lived up to their initial ideals and innocence. It is a question for each individual and a self reflection they can make about themselves
    This kind of reflection is a good thing not just for doctors but for all of us, but perhaps doctors in particular as their ideals, initially at least, would have been about service to humanity
    Again very well written

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  3. Mahendra
    Congratulations ! You are great for unravelling your thoughts and aspirations your journey from a student to a doctor.
    Though it took us 5 years to study hard and achieve this goal, it was a memorable and unforgetable path.
    Making new friends and studying together made the task pleasenter and easier.
    It was a dream coming through, to walk along the hospital corridors wearing the white coat and the stethescope round the neck.
    I had no idea of specialising, but working at Eye Hospital and doing eye surgery I was advised to do so, as the senior surgeons saw my capabilities.
    The happiest day in my life was the day I passed the final FRCS Ophthalmology exam in London.
    I am so happy I became a Consultant Ophthalmologist and was able to give sight to blind patients especially by surgery.
    As Ophthalmologists we could improve vision by treating eye diseases and also prescribing glasses in addition to surgery.
    It is a rewarding profession.
    The joy an Ophthalmologist experiences when watching the reaction of a blind patient suddenly seeing is immeasurable.
    We have a forum to communicate with our batchmates, thanks to Lucky and Mahendra.
    Long live our Blog!
    I wish to thank Pram for organising reunions in Sri Lanka and in UK to keep us batchmates together.
    I am glad that I am a batchmate of 1962 Med Group.
    Chira

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  4. Nihal, Suri and Chira, it was a pleasure to read your comments. Life is never a straighforward path and is full of ups and downs. If we did not have "downs", we would not be able to experience the "ups"!
    The reason why we chose medicine as a career is different in every case. My idealised version is the one who wants to dedicate his/her life to caring for the sick. Such people are rare...I am certainly not one of them! I was pushed into the path leading to becoming a doctor by my mother who thought that I had the character and intelligence to be what she called "a good doctor". Financial reward was never a reason apart from the knowledge that doctors are adequately paid to lead a reasonable life.
    Nihal mentioned his reasons a (and an alternative which did not happen) and Chira spoke about how she drifted to a speciaity which she excelled in and one which gave her so much satisfaction and rewards which she didn't ask for but nevertherless came with it.

    It would be lovely to know more about the reasons why we chose medicine as a career and, later on, the speciality that we adopted.
    Apart from our careers and how we developed, my article was also meant for us to reflect on all the things, wanted and unwanted, that happened to us, and the ties that hold us together.
    If I close my eyes and sit back, images of med school, colleagues, teachers, signatures, physiology lecture theatre, ward classes, being on call for the first time, being attracted by certain batch females, the shyness, the pride, the fear, the joy of friendship and camaraderie, the other talents we developed with such a variety from music, drama, travel, sports, the lows on failing an exam, the highs on passing, the failed love affairs the successful ones, the joys of parenthood, professional success, and so on... and on...!
    Pause, ponder, wonder, wander, be thankful, be grateful, look back with pride... let us never forget. True, it is only a dot in cosmic time and space but of huge significance for us.

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  5. Dear Mahen,
    Yes! Very true ' it is only a dot in cosmic time and space but of huge significance for us'.
    Thank you very much for the very thought-provoking essay about the fish pond we all lived happily for 5 years, not realizing we were actually fish living in a pond with little chance of escaping. you rightly mentioned about the vastness of the universe, we are really a very tiny dot, but how many times have we thought about it seriously.
    I read you essay many times, every time I read realized the wisdom and the sincerity embedded deep in it. Your letter also made me look back on my own life and my life in the pond. During my school days I never thought of becoming a doctor. My parents wanted me to have a university education, they would have been happy if I had a science degree. In my first attempt at the advanced level, did not get enough credits to enter university. My Father insisted that I should try again. In my second attempt got selected for the Six-month course. I had to take Botany again. To my surprise it was my favourite subject. I got selected to do Medicine. See how destiny works. After sitting for the botany paper as a safety insurance, applied to be a science teacher and got a job as science teacher at Malsiripura Vidyalaya, Kurunegala. I was the first science teacher appointed to the school. If I did not get selected to the medical school, would have continued as a Science Teacher, instead I became a fish in a tiny pond.
    Life in the pond was pleasant and uneventful when compared to the life outside before and after. My colleague fish was a friendly lot, eager to help and understand. I am very grateful to everybody, some who was very close to me have departed for good. They have left memories of great comradeship, and unconditional care and friendship. They helped with others to make the pond a very habitable place.
    I decided to do psychiatry, that too happened by chance. I will tell you about that on another day. After going to UK for postgraduate studies and securing a consultant post in London decided to stay on. After retiring from service, have gone back to my former job. Teaching and writing from home. Have written two books, working on my next book on 'Forgetfulness and Dementia' hoping to publish it in June this year. I am writing on what I know best, and in Sinhalese as there is an acute shortage of know how and written information on Mental Health in Sinhala.
    Now looking back on the 80 odd years of life, something very powerful emerges, the passing of time and how things have disappeared form us never to come back. I know in a few years' time even I won't be there. Nothing stays the same, nothing stay's forever. Impermanence is a natural part of life. Make the best of what you have when you can.
    Mahen, you helped me to take a journey back into my life, which I found very therapeutic and helpful. We are not only tiny but also impermanent. Thank you.

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    1. Thank you Douglas for your comment "from the heart". There is nothing for me to add to what you have stated. I think we are a great bunch to have kept in touch over so many years although it is unreasonable to expect all to have done so. The starting pond and all that brought with it is not enough to maintain contact unless other common threads were also developed. I hope you will maintain your interest in the blog and do not hesitate to send me anythng which you would like to share.

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  6. Sometimes I just like to ramble my thoughts as they arise. There is no better place than the blog to express one’s feelings, instantly. To the rapidly diminishing audience and readership it may not be thought provoking or even interesting but I’ve got it off my chest.
    I mentioned earlier about the friendships and the camaraderie that was endemic both in med school and beyond. They were strong bonds despite my calling it a ‘chance meeting in med school’ and AFD. When I look back those bonds have lasted a lifetime. My closest pal was Bernard Randeniya and not a week passes without recalling our time together. Sivakumar Vedavanam, HN Wicks, Zita and Razaque had a certain sincerity that reached deep within me. I miss them dearly and pine so much for that Christian prophesy that we will one day meet again.

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  7. My pal, Nihal, long may you continue to "ramble"! We revel in your rambles too! You named some of your closest friends in the Batch and it is wonderful to know that they were so special and that you still recall the with fondness and affecttion.

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  8. I have found the journeys of Michael Palin fascinating and his commentary superbly woven. It is indeed an armchair travelogue. Recently watched his Around the world in 80 days in the wake of that famous Jules Verne epic. What sticks in my mind is his journey from Dubai to Mumbai in a small boat with no electricity or modern conveniences and navigated using an old sextant. No proper toilets either. The crew hardly spoke his language and communication too was basic. There was no cabin and no bed. The camaraderie that ensued is a tribute to Michael Palin. After the 6 day voyage the goodbyes speaks volumes for his deep affection for the crew.
    Then I continued to watch the followup travelogue which he did after 20 years when he longed to meet the old crew who were then living in Gujarat in India. The boat had sunk and some of the older crew had passed on but there were some whom he met and enjoyed watching the clips of the old journey with much laughter and some tears. I would recommend this very highly. All this is available on BBC iPlayer.
    This reminded me of my time as a doctor in Kurunegala treating the simple rural folk of the Wanni. They were so kind, generous and so very helpful although they had so little to give away. I still remember some of their smiling faces, wonderful dialogue in their cadjan huts where i've enjoyed such tasty food.

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  9. Dear Mahen, you have done it again! You have written a thought provoking article which makes us look back and appreciate the journey that we have taken. We may have been swept away by the currents into still water ponds, or raging white water rapids, but most of us have managed to stay afloat! There is no question that this blog has facilitated and deepened friendships, and expanded our circles, because honestly while we were in Medical College we didn't have a whole lot of time to socialize.
    I read the comments by Nihal, Chira, Suri, Douglas and your brother Raj with great interest. It is great, as Suri said, that even though we may not see each other for many years, we reconnect without missing a beat when we meet again.
    My choice to do medicine was my own. I think I was influenced by the books I read about doctors (AJ Cronin is an author I remember) and also by the kind doctors who were our neighbors on 5th Lane. (Dr.and Mrs. L. O. Abeyratne). The decision to do pathology was a default because in NYC when I began my residency, there was no way that both of us as young parents, could have been on call at the hospital. Path residents were allowed to take calls from home. However, I do not regret it at all, because It is a really fascinating speciality. The "internist" in me continues to give free advice to my friends even after retirement!
    Nihal, I am glad you did not become a journalist. I'm afraid you may have disappeared in a white van!
    Mahen, thank you for your valiant efforts in keeping the blog going!

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    1. Thanks again Srianee. Although I offer these blog thoughts via the Forum that Lucky began and I maintain, I do so with the fond hope that a lot of colleagues still access it and gain pleasure from it. Comments are a rewarding form of feedback of course and I thank those who post and forgive those who don't!

      I understand the logic behind "live in the present" and whole heartedly endorse that but I always add a cautionary note to think that reminiscing on the past and reflecting on the future are therefore futile. In my view this is totally wrong and I doubt whether the great philsophers and religious leaders meant that at all. On the contary, the best way to make use of the present moment is to show that you know how to learn from the past and how best to prepare for the future. There are 3 intertwined circles, with the big one in the middle being the present moment (available) and two small ones, one behind (past) and the other ahead (future), just overlapping the Big One! Just to drive home the point, only an absolute idiot would undertake a journey without researching the past and examining the future: to put it metaphorically, I google the journey details, take precautions to drive safely taking into account possible demands such as fitness of the car, petrol tank fill, state of tyres (tires for Srianee and USA kids!) and then only sit and start driving! Human beings (and a lot of animals) have memories but only human beings, I think. can imagine the future almost with cinematic detail! That is one reason why we are a cut above the rest in the animal kingdom (many other reasons of course incuiding that vital component, language).

      I was interested to know that Medicine was your choice Srianee - in a way it was mine too because I made the ultimate decision to accept my mother's recommendation as I considered engineering too.

      Whatever reasons we had, the secret was to enjoy it and if at first you didn't, learn to enjoy it as there is nothing worse than a life of drudgery in your working life. One reason why people fail to do so is because they ponder on the impossible dream of "what if..and if only." which is soul destroying and futile. This stops them from feeding on the positives of the job rather than being saddned by the negatives. You did just that Nihal, you enjoyed your life as a Radiogist although you could have been a journalist and in a way, you achieved success ib both. I was at first dejected and saddened to change from Neurology to Geriatric Medicine but I am a pragmatic person and I genuinley found my work as a Geriatrician fullfilling and enjoyable and I found a way of making use of my expertise in Neurology by specialising in Parkinson's disease and other Movement Disorders in the Elderly.

      My mantram is "Learn from your mistakes... do not dwell on them as it is gone forever and nothiing can change it... anticipate the future from time to time wisely but do not waste hours on everything that is possible and do not waste the only certain and precious time you have by inaction because of wasteful reminscing and forecasting. Make your reminiscing and forecasting as fruitful as possible... "Life is always a balance...make it a thoughful and effortful balance which can never be perfect but aim to manage it be sensibly"

      My apologies for making this sound like a Sermon!

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    2. Mahen, you do give good sermons! (Just kidding) I did have a back up plan when I did my A levels. I was going to try a couple of times, and if I didn't make it to the medical faculty, I was going to apply to the school of architecture! If you remember, at that time in Sri Lanka it was not a university degree. (At least that's how I remember it.) Now I just appreciate good art and architecture whenever the opportunities arise. Your reference to tires vs. tyres reminded me of my early days as a pathology trainee. I would correct the spelling on my dictated reports from esophagus to oesophagus, and from hematology to haematology, until the Chief of Pathology pulled me aside and said "Srianee, you have to stop doing that, because you are driving the transcriptionists crazy!" I had no choice and quickly switched to the American spelling.

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    3. Srianee and Mahendra
      I look back often but don’t wallow in regrets. I look forward, not too often and not too far. The present is important to manage the day.
      I came to the UK to qualify in haematology. After the membership I was a registrar in haematology and was not happy looking through a microscope all day. I wanted a change and wanted it now. On a Friday morning looking through the BMJ found a job advert for a trainee radiologist at Kings College hospital. I applied and did nothing after that until I was called for an interview. At the interview there were many wizened old men looking at me over their glasses. One asked me why didn’t you come to see the department prior to the interview. I said I know nothing about radiology to know if a department is good or bad. Being a teaching hospital with a good reputation I assumed it will be a fine department. They smiled politely. After the interview I got the job and the boss showed me around the department. He happened to be the President of the Royal College of Radiology. The rest as they say is history. Be it good fortune or the awesome force of destiny, I had a successful career which I enjoyed enormously. Journalism is just a talking point on which I do not dwell very long.

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    4. Nihal, you said "I look back often but don’t wallow in regrets. I look forward, not too often and not too far. The present is important to manage the day.". I couldn't agree with you more;spot on as they say! In my case, my present actions do get influenced by a brief glimpse at potential future scenarios.

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