The dangers of being an Invasive Cardiologist

Sent in by Cyril Ernest

I must confess to you that although being a Cardiologist was a prestigious assignment,
the position was fraught with many dangers that could be encountered out of the blue when you would least expect it. In my life as an invasive Cardiologist I have been fortunate to have been able to survive many ordeals and save my skin so to speak.

One of the scariest encounters I experienced was when I did a routine coronary angiogram on a young lady in her 40’s,  a heavy smoker with chest pain suggestive of angina - several years ago. Everything went off well in the early part of the test. However, when I engaged the right coronary artery, she started having PVC’s. Initially it was not considered a dangerous feature, but these occurred unrelentingly and the rhythm deteriorated into v.tach and v.fib. The patient was shocked several times without any response. Code blue was called and I decided to inject dye into the RCA to take a look at the status of the artery. To my dismay the artery had completely blocked in a vaso spastic state. I immediately gave the patient an intracoronary bolus of nitro glycerine hoping for the best. With my prayers and the intracoronary NTG, the artery opened up and the v.fib subsided and she awakened. What a relief it was. I probably died a thousand times during this encounter. She did very well subsequently and went home without any residual effects.

The next encounter I remember was of a man in his 60’s. Because of my quiet and unhurried demeanor, the new nurses who needed training were invariably assigned to me. This particular nurse with some experience made a mistake of injecting a bolus of air into the coronary artery instead of the dye by turning the stopcock of the syringe into the wrong port. Heaven helped me! The patient was in such severe pain and the ST segments went sky high on the monitor. Well , the patient was given much pain medications to no avail and we had to just wait till the coronary artery was cleared. He too made a good recovery and went home unscathed.

My next episode that I remember is that of an angry patient who attacked me - a case of me being in the wrong place at the wrong time. As always when I do rounds I visit the ICU first. On this day as I was entering the portals of the ICU there seemed to be pandemonium with a nurse being pursued by a hulk of a man at least 6ft. 2 ins tall and quite muscular. It appeared that this was a patient recovering from an overdose of opioid medication and he was angry that the nurse did not give him the medication that he demanded. He had apparently been released from the jail recently. As luck would have it, he unleashed his fury on me as I was entering the ICU. Well, I am a 2nd. Degree Black Belt in Tae Kwon Do, and I used my skills that I had learned in subduing this angry man until help in the form of Security Personnel arrived. In less than 4 seconds he was down on the ground struggling in the choke hold that I had him in. The more he struggled, the more he choked. It took a good 4 security personnel to keep him down.The nurses and other personnel who witnessed the episode were surprised that I was able to subdue this guy.

There are many other skirmishes that I have been involved in which could be discussed at a different time.

Pranks committed by me

By Cyril Ernest

From my very young days I have always been a prankster. Here are some of my exploits.

The year was 1972 and I was an intern in one of the New York Hospitals.An elderly Jamaican nurse related to me the story of how she had tricked a girl re the Fallopian tube. I remembered this incident and one night an elderly patient was admitted under my care in florid pulmonary edema. In those days one of the treatments meted out was rotating tourniquets to decrease the venous return to the heart. I immediately told one of the nurses to go get me a Fallopian tube. She was a recent grad and without questioning she went in search of a Fallopian tube. In the meantime I treated the patient and she got better. This nurse later returned to the floor with the nursing supervisor who was very angry and she admonished me saying that if I needed a Fallopian tube to go to the Ob/Gyn surgical floor. This particular nurse was so angry at me that she did not speak to me for the 5 years I was at this hospital. Late in the 80’s I saw an article mentioned about a Fallopian tube request in one of the medical journals.

There was another incident where I was working in the ICU.As I walked out of the ICU, I noticed a walking cane on the table near the Secretary. I asked the Sec. whether I could have it and she willingly gave it to me. I used this cane and I feigned injury and I walked with a limp to the elevator on the 5th. Floor. As I was walking out, the head nurse of the ICU saw me limping and she insisted on wheeling me down by wheel chair much against my protests.She wheeled me down to the 1st. Floor and through the ER where my car was parked.I told the nurse to hold on quickly left the cane on the wheel chair and ran to my car yards away. This nurse shouting obscenities at me flung the cane at me. However By this time I had made my escape.

I took a lot of fun in disrupting the lives of the monitor techs in the ICU/CCU.I used to go behind the curtains and shake the EKG leads on the patients to mimick V.tach and the tech would get so excited and call a code.Pandemonium would break out in the ICU/CCU immediately and I was gone by this time.

Another time, I used an alarm which a kindly nurse had given me which she had purchased at a shop which could be attached to the toilet seat and if somebody were to use it , the loudest alarm would sound. In the ICU I attached this alarm to the toilet seat and an elderly nurse, a long time employee used the bathroom. Lo and behold there was a loud alarm that sounded and this nurse came out all flustered. Later on I found out that she had heart problems. Luckily nothing happened.

Next time I admitted a patient from the ER with chest pain. He was a motor mechanic.
In passing I mentioned to one of the nurses that he was a famous Phiilosopher. Oh gosh, you should have seen the array of personnel who came visiting the ICU to see this famous person.

One other time I showed a nurse a contraption purported to be rattle snake eggs.This very gullible nurse wanted to see it. So I showed her this contraption which did make a noise when she opened the envelope. She yelled out the loudest shriek in the ICU at this disturbing the entire ICU.

Another incident was on the day after the inspection by the JCAHO. You know in days gone by, the JCAHO inspection used to be a big deal and the entire hospital would be cleaned and kept spic and span for this inspection. The inspectors had come and gone and the next day when I went to the floor it was as usual with paper towels strewn all over and the drawers pulled and half closed etc. So I went to the next floor and told the charge nurse to call the ICU and just mention three words - THEY ARE BACK. Oh, you should have seen the pandemonium that ensued, trying to clean up the mess.
Unfortunately nowadays, we cannot have such fun.

So many other incidents of similar frivolity have occurred that are too numerous to document.

A typical day at Matale Base Hospital in 1969

Dr Mahendra Gonsalkorale

It is 7.00 am and I just woke up. I don’t really want to get out of bed as I am sleepy and tired after a very busy night on call. I went to bed at 11.45 pm after doing a night round to make sure that I had attended to everything and done preventive work in anticipation to ensure as far as possible that I won’t be disturbed, such as prescribe those PRN medications and advising nursing staff on what could wait till the morning and what needed urgent action. I went all round the hospital as there was only one junior doctor on call after 5 pm till 9am the following day. Our wards included Paediatric, Obstetrics & Gynaecology, Medical and Surgical wards, spread over what appeared like miles of corridors. The hazards of night rounds included dealing with unwelcome growling dogs. But camaraderie and bonds of friendship were strong. If calls got heavy and I needed to be in several places at the same time, I had no hesitation in calling for help from my colleagues and they would willingly help.  There were no disclaimers to fill and no working hours directives.

There were no bleeps. At night you are awoken by a knock on your door with a voice saying gently, “Sir, call ekak”. After a few expletives uttered almost reflexly which the poor chap always never took personally, you open the door and read the message on the book – “Patient Piyadasa in ward 7 is having a fit, please come and advise”. By now, I am wide awake. I gather my stethoscope and getting into my trousers, hurry to ward 7. There was a time when as a mere intern house officer I slept fully clothed, ready for action, but one does mature!

Returning now to the story I began, there were many such calls and my sleep was badly interrupted but I had to be  in the Medical ward at 8.00am latest for the Ward round by Dr RanjithMunasinghe, one of the most capable, honest and caring doctors I have ever come across.

I grab a quick breakfast and reach the ward bleary eyed and partly refreshed by the strong coffee made by Letchiman, the House Do-it-all based in our residential quarters. “Good morning Sir” and Dr DRM replies “Good morning Gonsal, shall we start?”

Just to digress for a moment, I mentioned our House Do-it-all Letchiman. Most readers know how we managed our daily needs while being resident in Hospital accommodation, but just to refresh your memories, all our meals had to be organised by us. There were about 8-10 of us (only the MO, OPD being not resident) and each month one of us took turns to be “Buth Master”. His/her duties included managing the “Do-it-all”and his young assistant Supramanium(including their salaries) and all the shopping, cooking, devising menus etc. Each would pay an advance to the BM and at the end of the month; a true detailed account is produced by the BM and residual dues collected. This was done in the most amicable way with complete trust and worked very well. Some BMs were more enthusiastic than others. Jeff Babapulle comes to mind. He once provided each of us with a small chicken for lunch. Bacon and eggs meant much more than a rasher and an egg – there was enough bacon and egg to feed 25 people! That month, we ate exceptionally well. The bill  was as you would imagine, a bit higher but nobody minded.

Back to my ward round with Dr DRM. We came to an empty bed and DRM asked what happened to Nalliah, the patient who should have been there. The Nurse very proudly announced that although he had left against medical advice, she made sure that he signed the Bed Head Ticket (BHT) before he left- “pothaassankeruwa!” DRM asked about his medication and future care and the nurse again proudly said that as he went “pothaasankarala”, he was not given anything-“Eh minihatapissu! Kotcharakiwathahuwenaha” (he is mad; he did not listen at all to my pleas). DRM told the retinue (there was always a retinue, not as big as these days with a plethora of all types of health care workers), that in future, this is not the way to deal with those who insist on leaving against medical advice. Firstly, the doctor on call must be notified if attempts by nursing staff failed. Secondly, if he still insists on leaving after seeing the doctor, he must be issued with a few  days’ supply of medication and a handwritten note must be given with  a short history, investigations performedetc. and he must  be told that he must present this to any doctor he sees subsequently. He must also be told that if ever he changes his mind, he is most welcome to come again but always note the exact time and date of his departure in the BHT. He said that in his view, people have all sorts of reasons unknown to us why they appear to behave irrationally and we must never treat them as outcasts or punish them. This was a real eye-opener for me. DRM was the most humane and understanding “boss” I have come across and his message on why we choose to be doctors and the responsibility that we must carry, left an indelible impression on me.

Ward round over! Hurry back to Quarters for a tasty lunch cooked by Letchiman. He is there with his ever present mischievous smile with profuse apologies for not providing the Beef steak that Jeff wanted. He says “Chir, ada arak musivarai, ekanisa vegetable beef steak aduwa”.

And then the siesta on chairs (a few lucky ones on the haansiputuwas)till 2 pm for those who had clinics and 3 pm for those with ward rounds. This was one of the most welcome times of the day. It was hot; we were tired, happy after a tasty meal.It definitely wastime for that most civilised of activities, the afternoon siesta!

It is wake up time and back to the ward. Those doing Obstetrics could do anything from a breech delivery to a caesarean. The “Boss” would train you first and your first few Caesareans  are done with him supervising you, the next few with him having a fag in the doctor’s room and always available to help if needed. The same applied to surgery. We did the minor ops list and if we were that way inclined and showed interest, may even be allowed to do hernias and haemorrhoidectomies. No wonder we felt so important. When we went to Matale town, we were well known and vendors sometimes refused to take money for our purchases- “Eh mahaththuru ispiritale dostarawaru”. But none was as elevated as Senarath Panditharatne. The harmless and ineffective DMO at the timewho shall remain nameless, was over fond of the amber nectar and there were more times when he was under its influence than off it! Pandi stepped in with authority whenever required and was the real boss.

That’s it! A day’s work done and I am not on call today! Hurrah! At dinner time, it is time to catch up with all the gossip and plan that coming weekend trip to Dambulla. We will take our gas burner, eggs and bacon and have a picnic lunch at a picturesque spot complete with a stream and a pihilla. Such weekend outings were common and thoroughly enjoyed by all. Once a month or so, it was the long train and bus trek to see my parents in Nawala.

The gossip turned toward me and I was asked whether I still wake up and peer out of the window in quarters at 7.00am to catch a glimpse of one of the nurses I  found very attractive leaving the next door nurses quarters for work. Yes, I did! Sadly, I never plucked up enough courage to do anything constructive about it. My only physical contact was when she assisted me at the Minor Ops list and those brief touches spread as an erotic tingle enveloping my entire body. It was a case of being grateful for small mercies!

This was Matale in the late 1960s, a time I shall always treasure.  The friendships I made still linger, the lessons I learnt still shape me, and my memories of that important period in my life will continue to make me happy and say “After all, life is not that bad- I am truly grateful”

Get-together of Staten Island Hospital doctors

Sent in by Indra Anandasabapathy.

Today some of the ‘ survivors ‘ met at a local Italian restaurant  on Staten island, New York to break bread.This is a group of physicians who were on the staff at Staten island university hospital for years ( the 5th largest in NY ) who are all retired. There are two of Sri Lankan origin  in these pictures. The second one besides yours truly is Dr. Fawzie Saleem, an internist , wearing glasses seated on the right. We had two other Sri Lankan physicians  on staff , both of them anesthesiologists (one still active, other deceased ) on staff.

Little Hearts Project of Lady Ridgeway Hospital

Photo: Lakshman Abeyagunawardene

Photo: Lakshman Abeyagunawardene

"Little drops of water

Little grains of sand

Make the mighty ocean 

and the pleasant land"

It is quite well known now, that I have never used the Batch Blog for fund raising, propaganda, politics etc. In fact, I have had occasion to politely turn down a couple of contributions from members of our batch on such grounds. It is to their credit that they accepted my decision in good spirit without any form of misunderstanding. So, let me reiterate that the sole purpose of this post is to highlight the efforts of our colleague Sanath Lamabadusuriya. I have also steered clear of copyright issues. Not wanting to take a chance by downloading photos from the Internet, I drove to Galle Face on Sunday evening when the roads are almost deserted, to combine my evening walk with a "photo shoot" with my modest  camera. I selected two from my own shots of the mighty ocean and the fast changing Colombo skyline to be used as visuals for this post.

As you can see from the following string of e-mail correspondence with a circle of his friends, Sanath is doing his bit to raise funds for the Little Hearts Project of the Lady Ridgeway Hospital. His friendship with Dr. T. L. Chambers, the eminent Consultant Paediatrician of UK dates back to the time in the late 1980s when both of them were Co - examiners at the MD examination held in Sri Lanka. Later, Dr. Chambers had come several times to Sri Lanka for the same examination and for the Annual Sessions of the College of Paediatricians. On one occasion, Sanath had examined with Dr. Chambers in Portsmouth at the MRCP UK clinical exam as well. Both happen to be ardent cricket fans!

The Sri Lanka College of Paediatricians is closely involved with this project. Sanath is the current Chairman of the Board of Trustees.

In keeping with my policy of not exposing e-mail addresses wherever possible to keep away phishers, I have deleted all e-mail addresses.

*****************************************************************************************************************************

Professor Sanath P. Lamabadusuriya	09:53 (45 minutes ago)
to bcc: me

i---------- Forwarded message ----------
From: Professor Sanath P. Lamabadusuriya
Date: 22 September 2017 at 09:50
Subject: Re: Little Hearts Project - Lady Ridgeway Hospital Colombo
To: "Dr. T. L. Chambers"

Dear Tim,

Thank you very much for supporting the Little Hearts project. Your generous contribution is greatly appreciated by all of us. It is indeed a pity that Kumar decided to retire from international cricket and deprive us from witnessing his exploits on the cricket  field.

Kind regards,

Sanath

On 21 September 2017 at 17:19, Dr. T. L. Chambers wrote:

Sanath,

I have sent a modest donation to mark the many kindnesses I have received in Sri Lanka. (Also to mark the wonderful batting of Kumar Sangakkara I witnessed yesterday at the OvalGG.

Kind regards,

Tim

---

From: Professor Sanath P. Lamabadusuriya
Sent: 13 September 2017 07:05:25
To: XXXXXXXX
Subject: Little Hearts Project - Lady Ridgeway Hospital Colombo

Dear friends,

When I was working at LRH,I carried out an audit regarding causes of death in my unit. Infections was the leading cause closely followed by congenital heart disease ( CHD). CHD accounted for 25% to 35% of deaths every year. Majority of these deaths could have been prevented if facilities were available.

Every year 3000 children are born with CHD..Eight out of every 1000 children are lost before their first birthday.

Little Hearts project is a dream with the vision of securing the ability to treat 10,000 babies born with CHD every year and prevent 1500 unnecessary deaths..Once the facility is established  it would  provide 100% free of charge medical services to children from all parts of Sri Lanka. It is a project approved by the Ministry of Health. Total amount of funds required is Rs. 2 billion . So far Rs. 175 million has been raised. My daughter Dilusha, who is residing in Norwich, UK ran a Sri Lankan food festival recently and raised over Rs, 500,000.00 for the project. My appeal to you is to contribute in whatever way for the project so as to save precious little lives .Majority of parents of these poor children do not have lobbying power and therefore it is our duty to do it on their behalf. 

I have attached some relevant documents as well.

Kind regards,

Sanath

Blog Administrator's note: The documents referred to are not posted. Viewers who wish to see them may contact Sanath directly.

My years as a "vampire" in the Central Blood Bank, Colombo.

By Dr. Nihal (ND) Amerasekera

The year was 1970. It was an ominous year. President Nixon protracted the hugely unpopular Vietnam war. The teenage heart throbs and ever popular Beatles disbanded. The charismatic Egyptian leader Gamal Abdel Nasser passed away. Our country was in economic decline and our coffers were empty. Political unrest loomed in the horizon. This caused great anguish and brought the middle classes and the rural folk to their knees. On a personal level, my professional and private life was in turmoil and 1970 became my annus horribilis.

I remember as if it were yesterday walking into the Central Blood Bank (CBB) in Colombo to accept my job as Medical Officer. It looked so pristine painted in brilliant white. National Blood Transfusion Service was moved to this site in 1960. Its newly refurbished façade hid the remains of a charming old house which stood there since the creation of the General Hospital, Colombo (GHC)  in 1864 by the Governor, Henry George Ward.

Dr. Nandrani De  Zoysa welcomed me warmly  and showed me the ropes and the rota. It wasn’t an onerous regime. After a month's training and fine tuning, I was to be a part of a happy band of doctors serving a huge mass of patients in the vast expanse of the GHC.

The Superintendent of the National Blood Transfusion Service, Dr Percy Goonewardene, had his office in the Central Blood Bank. He managed the service with remarkable efficiency. His planning, organisation and attention to detail made complications of blood transfusion a rarity. He ran the service with an iron fist but stood by the doctors under him. He never interfered with the day to day running of the unit and only stepped in to sort out problems. Dr Zoysa was the Senior Medical Officer, the matriarch. She remained our spokesperson and conduit to take our woes and worries to the boss.  Dr. Z represented us well with friendly kindness. I am also grateful for her help, understanding and courtesy shown to me during a difficult time in my life.

There were several from my batch at the CBB and in the transfusion service. Vedavanam who was a bachelor then was my constant companion. He had the time to join me in the evenings. I cannot think of a more helpful and considerate colleague. Asoka Wijeyekoon was great company and we often went on official travels together. One that I will always remember is staying at the Nikaweratiya Rest House by the ancient Tank and having a drink together in the evening putting the world to right. From a nearby hut we heard a song being sung “Oya thamai bamba ketu ekkana”. After the arrack, it sounded like a choir of angels. Bernice De Silva, Sydney Seneviratne and Razaque Ahamath were with us briefly. I am still in contact with MGS Karunanayake who was our senior. 

The Central Blood Bank then became the centre of my universe.  I accepted its quirks, idiosyncrasies and oddities as a part of working life. We were in the main, a fiercely united bunch of doctors. Although these posts were generally accepted as dead end jobs, its attraction was the luxury of being in Colombo. Since schooldays, I’ve been a city slicker and this fitted in well with my psyche. I free wheeled endlessly enjoying the company of friends, visiting the cinema and being a pillar of the Health Department Sports Club. The Club was a magnet for health workers who loved a drink and a chat in the evenings and I was never short of company.

The Blood Transfusion Service was a huge organisation. The Nurses, Public Health Inspectors, Medical Laboratory Technicians, Attendants, drivers and Labourers propped up the service with tremendous loyalty and efficiency. Travelling the length and breadth of the country collecting blood, was a task and a responsibility we all had to accept. Some were reluctant travellers, but I loved it. I owned a rugged and reliable 1954 VW Beetle, a masterpiece of German engineering. It never let me down as I crisscrossed the length and breadth of the country for the Blood Bank. This official travel gave me the opportunity get away from my personal travails and see the country at government expense. The travelling team included a medical officer who carried the money for the donors and supervised the programme, a Public Health Inspector to speak to the people and appeal to their conscience to donate blood and several attendants and labourers to assist in the collection of blood. Two vans accompanied us. One was the refrigerator van and the other carried the staff and equipment. We travelled to all the festivals including Kataragama, Dondra, Anuradhapura, Mihintale and Polonnaruwa. We were in Nuwara Eliya, Bandarawela and Diyatalawa at the height of the holiday season. Temples, churches and schools became our blood donation centres. I often stayed in Rest Houses. In the evenings, the team often got together for a chat and a drink by a lake or a river or the beach. The attendants and labourers had a tremendous sense of humour and often had me in stitches. Among them there were comedians, storytellers, actors and singers. We drank and laughed so much. They sang songs from the Sinhala films using tin pots for their tabla. I have such vivid and fond memories of those happy times singing in the stillness of a moonlit night on the banks of the Minneriya Tank. There was a time when I got dead drunk at one of these events with several thousand rupees of donors’ money in my pockets. The team looked after and cared for me and not a cent was lost. I value immensely their loyalty and friendship and remember each one of them with much affection. Despite the passage of years, as I write these memories, I can see their smiling faces and feel the warmth of their goodwill.

The location of the Central Blood Bank was priceless. We had a wonderful view of all those who entered or left through the Kynsey road gate of the GHC. There was an endless stream of nurses, lady medical students and visitors passing through the gates of the hospital. We were often mesmerised by the glitz and the glamour that paraded before us. The proximity to the Medical Faculty with all its facilities was a great blessing. The tea never tasted better than in the smoke filled room of the Faculty canteen.

We worked in shifts, morning evening and night. The doctor on night duty slept in the old block at the rear. Although there were many intriguing stories of apparitions and ghosts I never saw or heard anything in all the four years. The morning shift was busy doing the cross-matching prepared for us by the technicians. Until the racks of test tubes were ready for microscopy, there was an hour or so of friendly banter and bonding with an exchange of racy hospital gossip.

I must pay tribute to the blood donors without whom there will not be a blood bank. Many donate out of the goodness of their heart. Some donate as the blood bank insist they donate if they wish to receive blood for their kith and kin. Others give blood for the money they receive. I presume the situation hasn’t changed since my time, except no money is paid. They all received a little red book as a token of our appreciation.

Much of those memories are lost in the fog of time. It may have been in 1971 when it was announced that the MRCP Part I will be held for the first time in Colombo the following year. I was one of the few male doctors in my medical school year who never wanted to go abroad. Since my childhood, I was always aware of the limitations of chasing money.  My ambition was to be a DMO in some distant town, far from the madding crowd. My dreams were dashed when the  Department of Health, in its wisdom, decided to send me to the CBB. This strange quirk of fate in retrospect was indeed a Godsend. Hence my firm and unwavering belief in the awesome force of destiny. Time passed relentlessly as I enjoyed the excesses of the “la dolce vita”. At least for the moment, this heady bohemian lifestyle suited me well. Living with my parents, I was never short of good advice. I saw my friends’ climbing the ladder and progress in the profession. This gave me great inspiration.  I was also getting disenchanted and weary of the indolent and lazy life I lead. After much deliberation, the decision was taken to prepare for the MRCP. I realised this was a huge commitment. At first giving up the easy life was painful and challenging. The Medical Faculty library was a great help as were my doctor friends who were attempting the same. After my reckless existence, I needed more encouragement than most.

The endless struggle with long days and late nights finally paid off.  To my great surprise, I was successful in the examination. This gave me a glimpse of a possible future career. By 1974 my personal troubles had ended and I was ready to leave the country. I recall most vividly the long hours and the agonising discussions I’ve had with friends of the rights and wrongs of leaving my homeland. The thought of leaving behind my aging parents and family was painful in the extreme and left me in a wilderness of confusion. By now I had done 7 years of service for the Department of Health and was free to leave. In the end I decided to  move to London to complete the MRCP. Arranging flights wasn’t an easy task then. The heartache and the sleepless nights that followed haunts me still.

Blood transfusion work and haematology were never my passion. I couldn’t see myself looking through a microscope for the rest of my life. After the examination, I started to search for my calling and niche in life. My well honed antennae drew me into a career in Radiology which was rapidly expanding with the advent of computer technology. This required another 5 years of training and further examinations. To borrow the cliché, I was in the right place at the right time.

On my many visits to Sri Lanka, I always went to see the old Central Blood Bank. The ravages of time took its toll on the bricks and mortar and the wonderful people who worked there. Many retired and others moved on. Dr Percy Goonewardene died in 1975 which was a sad loss for the National Blood Transfusion Service. I have often wiped a tear hearing of the demise of the staff who enriched my life all those years ago. It breaks my heart to know that of the PHI’s, attendants, labourers and drivers, none of them are alive today. I have fond memories and a tremendous affection for the CBB. It brought happiness to my life when none existed. I made friendship that lasted a lifetime. Those 4 years changed my life for the better, as I look back with so much affection. The CBB has lost its name and has moved to Narahenpita and none of the old staff work on that site anymore. In my mind's eye, it will always remain where it was. Voices and laughter must still echo in the ether of what remains of that grand edifice which once was the CBB. The enchantment of those years in that great institution will remain with me forever. May the Blood Transfusion Centre in its new surroundings be a great success.

General Hospital, Ratnapura - House Officers 1968

Sent by Indra Anandasabapathy. Try to identify those in the group. I am making the first guess (see comments).

A Tribute to the Lady Ridgeway Children's Hospital

An appreciative parent writes about the services provided by the Lady Ridgeway Children's Hospital when her son was warded there with Dengue Fever.

The writer's husband Johann Bandaranayake (a nephew of Sriani Basnayake) further says that the family was touched by the medical and personal care provided by the hospital and staff. They had thought of showing their appreciation through this article.

WAY TO GO Lady Ridgeway Hospital!!!

The first thing most parents of middle income families want to do when a child falls sick is to ensure that their child has the best of care, and with this noble intention will not think twice before scraping up their meagre savings to have their child admitted to a name recognised private hospital with all its creature comforts than consider the “much in the news” (for the wrong reasons) government hospital assuming that the former is better. 

In many ways their perception seems justified, there are no strict visiting hours so you can be with your child at any time, your sure of a bed not only for the child but also for yourself, you can demand certain amount of service, have access to state of the art medical facilities (the cost of which may send you to the grave sooner than expected) you may even be able to have the doctor changed if you feel so inclined, after all you are paying for it.  In contrast the perceptions of the state medical facilities are that you will never know when they are on strike, your child may not have a bed or even worse may have to share one with a child of a ‘less desirable’, the service is poor, long lines and waiting times, the place is smelly and not maintained, bathrooms – well that’s another story, no medicine, nurses and attendants couldn’t care less and doctors are marking time only to run off for their private practice.

But perceptions remain perceptions until you face reality.  However repulsive the initial thought might have been, when our son was diagnosed with dengue, there was no question in our minds on where we wanted to have him admitted.  It was going to be the Lady Ridgeway Hospital (LRH).  The reason was simple enough; they were the best and most experienced to efficiently manage the disease.  In fact, when things go wrong in other hospitals, children are transferred here, not only for better management but for better remedial management as well.

The choice was clear, now it was to brace ourselves for the typical state run delays, lethargy, disorder, abruptness and inefficiency on all counts.  At admission, though, we were pleasantly surprised to find that our son was attended to immediately by a doctor and subsequently by another doctor who took down every conceivable, relevant piece of information in the most pleasant and courteous manner.  This was a refreshing change from most privately channelled doctors, who are generally in a great hurry to dismiss you with very little interest in what the patient has to say.  

During the admission process there was another child being discharged.  With all the formalities being concluded for the discharge, something unthinkable happened, the doctor asked the little child for a kiss and the child responded enthusiastically.  It was so nice to see such bonding and love by a doctor (whom you would normally consider to be stoic and aloof) attending on the children in her care, what was striking about this incident was that it wasn’t an isolated event, it was true for most doctors attending to children in this ward, they spoke kindly and immediately built up a rapport with the kids.

During our son’s stay in Ward 1 at the LRH (perhaps the foremost ward in paediatrics in the country), we found not only the doctors but even the nurses to be ably attentive to the children’s needs.  Every child is constantly monitored; doctors check on the children at regular intervals.  If you are assertive enough to question, they care enough to explain. It was always obvious; the foremost concern was the child, his symptoms, his prognosis, his well-being.

The discipline maintained in the Ward in other aspects was also commendable.  Rules and regulations were adhered to in order to keep the place clean and free of food smells and litter.  The wards and even the toilets were constantly swept and mopped.  Toilet facilities though basic were clean and void of noxious smells putting to rest many an anxious hallucination of having to face the unthinkable after literally bottling up for as long as it was physically possible without exploding.  What a relief.  The entire ward was well organised even with the limited resources available.  It was heartening to note that people from all strata of society automatically adhered to what was expected of them.  

Our son’s platelet count gradually dropped.  However, it was comforting that the staff didn’t panic, nor did they take anything for granted.  As one of the Professor’s themselves said, “in 24 hours many things could happen with dengue”, so they simply took all precautions and strictly monitored the child. Our son was then transferred to the High Dependency Unit (HDU) for even closer monitoring.  The HDU is on par with any ICU found in the best of the private hospitals, thanks to the philanthropy of Messer’s Arthur Senanayake and Hemaka Amarasuriya, who had it built and equipped in memory of the sons they lost to dengue.  Today so many children benefit from this generous donation underlined with love and concern for others.  Every hour our child was monitored by a doctor, from blood pressure to fever, with PCV counts taken every four hours, and platelet counts twice a day.

Whilst my son and I were at the HDU, a very sick boy was admitted late at night.  A nurse tried her level best to explain to a less literate mother the process of monitoring liquid intake and urine output, which appeared to be futile.  The nurse in exasperation finally volunteered to help out in the process. It was amazing to see the nurse willing to take on this added responsibility, on top of everything else that she had to do.  As if this wasn’t enough of a display of compassion, the nurse then went a step further to ask if the mother had had anything to eat that night and having found out that she hadn’t, went out of her way to find some food, despite it being way past hospital food distribution time.  I was both astounded and touched at not only this kind concern but wondering if I would ever witness such in a private hospital.

Seeing the many acts of care, concern and compassion in a state hospital was not only heart-warming, but also reassuring, that the state medical sector has so much to offer despite the political bungling of such services. One might argue that this was one ward, but the fact remains that if this one ward in one state hospital can serve people in this remarkable manner then why can’t all the others follow suit?  It is not impossible.  The example is already set.  The path is paved.

We also wish to encourage those who would not consider places such as LRH for their child’s well-being that this is perhaps the best place in the country to address your child’s needs (emphasis being the child), especially in the case of dengue.  Our heartfelt gratitude to all of you who work so hard with nothing more than a passion to serve the children in your care with no other expectation apart from experiencing the joy of seeing your patients healed and well.  Bravo and kudos to you!

Prasi Bandaranayake

Lalantha in High Company

Lalantha Amarasinghe in high company at the ceremonial opening of the new Army Hospital in Narahenpita.