By Nihal D Amerasekera
Life as they rightly say is a thief of
time. How time has flown since I qualified. I now sound like a retired doctor
put out to grass. I complain about the vulgarity of contemporary life, the ‘pointlessnoise’
of modern music, fake news of social media and the irresponsible deceptions of
politics. But, thankfully, there are blissful and sober moments too when I
reflect on thelife and times now long gone.
The death of HN Wickramasinghe recently
brought back a collection of memories of those happy times we spent in
Kurunegala. Those memories swirled in my mind for days until last night I
dreamt I was back in the distant past beginning my internship. As I have lived
nearly most of my life, such a dream is predictably uplifting and alarmingly
prophetic. But there is also an overwhelming sadness that many of the players of
that memorable drama are no more.
Internship in medicine is the culmination
of five years of hard study and sleepless nights. It is the light at the end of
a long tunnel of multiple examinations, strife and psychological trauma. After
the results of the ‘finals’ there was a mass dispersal of our batch into
different hospitals. Still there was an awful lot we just didn’t know. We began
our apprenticeship working under supervision before we were released on the
public. It certainly felt like a breath of fresh air.
Thus far I was lovingly clothed, fed and
cared for by my parents. Now it was time to find my feet in a fast-moving world
and a competitive career. I do have regrets not saying a proper thank you to my
parents for their love and care.I recall with nostalgia the train journey from
home to Kurunegala, the taxi ride and the short walk to the House Officers
Quarters. I can still remember the smell of stale Arrack as I entered the
house.Everywhere I looked there was the detritus of misspent youth. So began my
step of destiny, a journey into medicine and real life.It would be remiss of me
not to mention the menace of malaria and the mosquitoes that tormented us every
night.
As I recall 1960’s was a peaceful time in
Sri Lanka. Kurunegala then called Ethugalpurawasthe capital of the Kingdom in
the 13th century.Now it is a small city with a busy General Hospital.The
majestic Elephant Rock is stillits most iconic landmark and the spiritual heart
of the town. The Medical Superintendent was Dr Bertie Wijeratne, a kindly
gentleman who had to serve the masses and balance the books. He was renowned
for his wisdom in dealing with interfering politicians and local unions who were
the bane of his life. He juggled his many impossible tasks admirably and with a
smile. The Kurunegala hospital served a large area extending from Galgamuwa and
Dambulla in the north to Anamaduwa and Nikaweratiya in the west; Alawwa and
Polgahawela in the south and Galagedera in the east. The town bordered the dry
zone where the people’s lives depended much on the rainfall. They endured a
tough life growing their food in this parched and dusty landscape. Those
wonderful people of the Wanni were poor andever so humble.They had such volcanic
tempers towards their own. This often resulted in stabbings and shootings for rather
trivial squabbles like stealing a Jak fruit.
The Kurunegala hospital occupies a
strategic location at the edge of town. Initially this has been a small cottage
hospital to treat the South Indian labourers on their way to the plantations in
the hill country. There has been a hospital in the premises since 1899.The
current administrative block was built in 1942.The hospital grew in size, stature
and importance expanding into the35 acre coconut plantation.What I saw in 1967
was a most remarkable collection of buildings with airy wards and long open
corridors.All the wards had that characteristic 1960’s smell of ether that was
ever present. There was a small private wing with posh rooms and a wide
verandah. This was separated from the rest of the ‘riff-raffs’ by a lawn and a
garden of flowers.
Three of us interns started in Paediatrics together
in July 1967. This was our entry into the real world of medicine, a significant
moment in our young lives. We were all aware of the massive gulf between the
theory and practice of medicine and its effects on real live patients. Caring
for children was tough. There was no direct history and we depended on
information from parents who were illiterate village folk. Examining kids for
clinical signs was a special art which we hadn’t mastered as yet. Taking a
sample of blood was noisy and needed skill, courage and a whole lot of patience.
On looking back I wonder how I got through the first few months of this ‘ordeal’.
In children, diphtheria and
gastro-enteritis were the killers, both of which were so easily preventable. It
is said a family never recovers from the death of a child. I still recall the
deep distress and the wailing in the ward after a death.Those sad images haunted
me for days. We were fortunate to have Dr Chandra De S Wijesundera as our boss.
He was a quietly spoken,unassuming andintelligent clinician. “Uncle“ as he was
affectionately calledwas inspirational and showed great kindness to the staff
and the doctors. C De S had tremendous
empathy for the children under his care and for their parents.
In this strange new environment it was a
great relief to see aknown face. H.N Wickramasinghe and K Adikaram were my
colleagues for those memorable 6 months.Sanath de Tissera and Priya Gunaratna
joined us in October that year. HN, Sanath and Priya, I had known from the
Colombo faculty.Adikaram was from Peradeniya.With his mop of distinguished curly
hair, self-assuredness and zest for life, HN soon charmed us all and became our
leader and spokesperson. His immense loyalty to his friends was his hallmark. I
recall with much nostalgia our time together in Kurunegala. The evenings were
hot and so peaceful. After work we went on long walks ending up in the Rest
House to cool off with a beer. We talked a lot about our lives thus far and our
aspirations for the future. It is a matter of such great regret I saw HN only
once in the past 50 years.
We were fortunate to have Priya with us. Her
sincerity and obliging presence held a unique place in the hearts of all those
who came to know her. With her school-girlish air of mischief she was a
glamorous girl who broughtcharm and elegance to the medical community.Shewas
indeed our girl next door who had a calming influence on us all. Priya was ever
willing to cover our busy on-calls. She had the natural ability to deal with
kids and we learnt to appreciate her presence as a blessing.
Sanath and I were close right through
medical school.It was such a great pleasure to have him with us. He had
tremendous confidence and the ability to remain unruffled in the mostdifficult of
situations.Sanath had a sound sense of right and wrong and was never a
push-over.I write this as a compliment that he was never afraid to criticize or
disagree. Sanathqualified as a psychiatrist in the UK. I have fond memories of
our meetings in London when he arrived in his posh sporty Ford Capri.He later
emigrated to Perth, Western Australia. His courteous manner concealed a
sharpness and grasp that took him rapidly to the top of his profession.On my
travels,some years ago, I was a welcome guest in his house in Perth.
Adikaram was anexceptionally talented
medic, a wonderful friend and a caring doctor. He was full to the brim with his
own brand of dry humour. His amusing narratives of daily life delivered with
habitual flair was a crowd puller. “Adi” became a great friend of the nursing
staff.We were never short of thosedelightful cakes that were so lovingly baked
in the Nurses Quarters.
It brings me great sadness to think that of
those interns only Sanath and I are alive today. HN had a successful career as
a GP in Hanwella. He passed away in November 2019from cardiac failure. Priya married
an engineer and had a family. Whenever there was a batch reunion she never
failed to inform and entice me to join in. She lived and worked in Colombo and
died in October 2014.Adikaramemigrated to the UK and worked in paediatrics in Wales.
“Adi”died in the 1990’s from the complications ofmyelofibrosis.
My second 6 months was in Surgery with Dr
Rasiah. He was even-tempered with an easy-going attitude to life. This was a
far easier appointment than paediatrics. My colleague was Tudor Wickremaratchi
with whom I shared the work. With a stentorian voice, at times he was an angry
young man. But he had a softer kinder side to him too. Those were days when the
cigarette was a fashion accessory. It was hard to see him without a fag. Tudor had
a natural rapport with people from all walks of life which was his hallmark. He
had a prodigious capacity for drink and was the life and soul of any party.
Those were a tremendously happy time. After internship he had a spell as DMO
Dambulla. When I visited him he seemed happy and well settled. But I was
surprised to hear he too had emigrated to the UK. In England there was an enormous
transformation in the Tudor we knew, becoming a much-subdued family man. He
worked as a forensic pathologist in Bristol. Tudordied unexpectedlyon a Golf
course in November 2005, aged 66.
In the House Officers Quarters we had the
luxury of electricity and running water butthe toilets were squalid. There was
a cook and a helper. The cook was an asthmatic.We called him Ronchi Rajapakse. We
all had our turn to be the ‘buthmaster’ who was in-charge of the finances for
our food for the week. This was our introduction to domestic finance. Every
week there was a budget deficit which never amounted to much.We put it down toRonchi
Rajapakse’s cigarettes and betel. The weekly verbal reprimand was just water
off a duck’s back. We forgave his misdemeanours for his unwavering loyalty and being
such a fantastic cook. Our laundry was done by “Lensuwa”. I could still picture
him, a pleasant young man with a broad smile. The laundry was delivered to us
spotless and creaseless.
There was much friendship, a common bond
and a deep-seated loyalty amongst the interns. In my House Officers Quarters
there were 2 others from our batch, M.H.SCassim and W. Rajasooriyar. While the rest of us floated on a tide of
alcohol, MHS and WRwere the only teetotallers for miles around. They were the
only guys without the unpleasant dystonia, dysarthria and dyspepsia in the
morning!! MHScompleted his internship in Obs and Gynae and Medicine. After
completing his FRCShebecame a respected Eye Surgeon in Colombo. W.Rajasooriar
had his internship in Medicine and Surgery. His greatest attribute was an
infinite willingness to put in the hours to his hospital work. WRcompleted his
Fellowship in Anaesthesia and went on to become a Consultant in SL. He later
emigrated to the UK with his family. After retirement he developed pulmonary
fibrosis and sadly passed away in January 2015 of a heart attack.
The House Officers’ Quarters had become a
social hub for the bachelor government servants working in town. We played
badminton in the evening until dusk. Our badminton court next to the Quarters
was ideally located with the elephant rock as the backdrop. Two Assistant Commissioners
of Income Tax,Sabapathy and LasathPerera, Veterinary Surgeon Siri Abeyratne and
dental surgeon AponsoWickramasuriya joined us in the badminton and in the
banter.We enjoyed the evenings immensely and often proceeded to a few cans of
beer and a chatin our quarters. Kapoor Rajasekeran(Registrar in Pathology) and
DisampathySubesinghe(MO/OPD) joined us in the badminton and the fun later. N.K
Gunatilleke (Nihal) from our batch was a regular visitor staying on at the
quarters as he had relatives in the town. Later he became Relief M.O and spent
more time with us.
The Visiting Surgeons and Physicians kept their
distance and rarely mixed with the junior doctors.They were rich and lead
privileged lives. Kurunegala was a hotbed of private practice with a wealthy
clientele.The word spread that the consultants resorted to unscrupulous
practiceat the expense of the non-paying patients. Many of us juniors were deeply
troubled and disgusted by this behaviour.News of the rift became a hot-topic in
the confined space of the hospital bubble. I still remember the hysteria that it
generated. Misinformation and gossip spread like wild-fire and the conflict
turned tribal.Eventually an iron curtain fell between the consultants and the
junior doctors. The Juniors carried out a campaign of attrition against those ‘shameful’consultants.A
most unpleasant and a tense atmosphereprevailed in hospital. Compromise seemed
dead and civility with it.
In retrospect, it was the junior doctors’over-zealous
and misguided youthful idealism that was part of the problem. This was made
worse bythe arrogance of the egocentric Consultants. The disharmony between the
seniors and juniors caused more harm to patient care than the private practice.Thinking
back in the cold light of day, there was only one particular consultant whose
behaviour was questionable. All this was just a storm in a tea cup!!It has been
my life-long belief that healthcare just like education should be free to every
citizen.Knowing its financial implications,for most countries, this is an
impossible dream. Should doctors in government service be allowed private
practice? Thisis a difficult question to answer without prolonged debate and
discussion.If the doctors are adequately remunerated why should they be treated
differently from other government servants? That was merely a question and not
and answer. Living abroad it would not be wise for me to proclaim judgment on
this issue. Returning to the troubles of long ago - I wish those consultants
were alive today to read my take on the all-consuming conflict of 50 years ago.
As for the juniors, our main crime was being young, callow and starry eyed.
The GP’s in Kurunegala were a wealthy bunch.
The two names that come easily to mind are Drs Riley Fernando and Bernard
Weerakoon. They were ever ready for a good time. The young DMO’s in the
surrounding hospitals joined us too. DMO Gokarella- W.S.L de Zoysa, DMO
Galagedera- Dr UpaliPerera were regulars to our many functions. We all liked to
escape the pressures of doctoring by partying. The Law-Medical cricket match
was the highlight of the year.Thisbegan with cricket and ended in a concert and
a dance in the Town Hall. PerrinJayasekera was a popular colleague who had
completed his internship in Kurunegala and was DMO at Galgamuwa. He was already
well known for being part of the famous singing duo, Jay brothers, with his equally
illustrious brother Geri. The highlights of the concert were the humorous
sketches and the elegant ballet dancing of Perrin. It was like a re-run of what
we had at the Medical Faculty. He was such a talented comedian, singer and
dancer.Perrin was a force of nature and a phenomenon. Performing to an audience
came naturally to him. Hecontributed his many talents to society with modesty,
intensity anda great deal of humour.So sad he died so youngduring coronary
by-pass surgery in New Haven, Connecticut, USA.Dr Riley Fernando passed away in
Colombo in 2003 aged 75. Dr Bernard
Weerakoon died in York Hospital, UK in 2013 age 80.
There were two social clubs in town. The
upper club was frequented by the upper echelons of society and the lower club
by the so-called working classes.The Bolsheviks in townbelieved the lower club
was for the proletariat and the upper club for the bourgeoisie. This class distinction
was an unwanted relic of more than a century of British rule. In my naivetyI thought
the upper club was given that name as it was built on a hill.The ethos of the clubswere
different too. The doctors went to both clubs and enjoyed the best of both
worlds.The dances in the clubs were well subscribed. Music of the Beatles were
popular.EngelbertHumperdink and Tom Jones were on the cusps of their success.‘The
green green grass of home’was the popular belter at these events and sounded
heavenly after the amber nectar. Those were chivalrous times when we were
gallant young men and the ladies were modest and genteel.Despite our youthful
exuberance, honest! there was no hanky-panky.
There was also high intensity work to be
done in hospital. Having been trained at the Temple of Wisdom in Kynsey Road, we
were no strangers to hardship and hardwork. Doctors worked from 8am to 12 noon
and 3 to 5pm. Kurunegala was hot as a furnace between 12 and 3 and we all had a
nap. We were on ‘call’ once every 3 days and once in 3 weekends. The calls were
busy and a good night’s rest while on call was a luxury we never knew. Without
the bleeps in those days the dreaded emergencies were notified by a man on a
bike who knocked on the door “Sir, call ekak”. This often resulted in loud cursing
and a barrage of unparliamentary language.
As we didn’t own cars to get about and
there was no Television our free time was mostly spent partying in the House
Officers Quarters.This included lots of hard drinking and loud singing. CT
Fernando songs were popular and we knew the words of them all. We remember how
the parties started but very few remember their end.Until we completed our
university education many of us were used to an orderly life. What we had now
was completely the opposite and we were simply intoxicated by it.
When not on duty the weekends were peaceful
beyond belief. It was so blissful waking up late into the warm sunshine. I
befriended Siri Abeyratne who owned a rugged and reliable 1950’s VW Beetle.We
often planned trips to appreciate the beauty of the countryside. Our favourite
destination was the Batalagoda Tank by the rustic village of Ibbagamuwa. It wason
the road to Dambulla. BatalagodaWewa as it was called is around 2000 years old
and has the most remarkable and distinguished history as told by the British irrigation
engineer and historian Henry Parker(Ancient Ceylon – 1909) and also recorded
in our own epic chronicle, the Mahawamsa. Its locationistranquil and idyllic.
The lake is one of the most picturesque I know backed by the tall peaks of the
Matale hills.There were no tourists, no holiday chalets and no motor-boats. It
was just the two of us. There was the occasional man on a catamaran casting his
net on the still blue waters. There were several untouched villages off the
beaten track to explore. We parked our car and walked for miles along the water’s
edge.Minimalism wasn’t even invented then, but all we had for lunch was a
home-made sandwich and shared a Lanka Lime. We often spent the whole day in
that pristine wilderness to return home in the late evening with our batteries
recharged and our minds refreshed. Siri rose up to become an Assistant Director
of Agriculture in Kandy.In his retirement he followed his children to Florida,
USA. We speak occasionally to reminisce and relive those wonderful years in
Kurunegala.
A year passed at the blink of an eye. By
then theinternshad formed a warm and supportive community. Soon it was time to
move on. Despite the hard toil, mostly the good times come to mind. I clearly
remember the sadness I felt saying goodbye to my friends, some of whom I never saw
again.Although I felt “the show must go on”, it never did as marriage and
family got in the way. On looking back It was such a privilege those friends were
in my life. I continued to work in Kurunegala OPD for a further two years. During
this periodwe were deeply saddened by the demise of Ronchi Rajapakseafter a
brief illness. He was so much a part of the Quarters scene. The doctors were his next of kin.We gave him atraditional
Catholic funeralin the General Cemetery Kurunegala. He will be remembered for
his fine culinary skills, toothless smile and his wheezy banter. May his Soul
Rest in Peace. As I stepped out of the hospital for the last time the sun broke
out of the rain as if to wish me goodbye. After leaving in 1970, I never
returned to the town or the hospital ever again.
Many of us followed the slogan of the American
author and newspaper editor Horace Greely “Go West young man”. There was
a mass exodus of doctors to the USA and UK in 1968. I was to remain in Sri
Lanka for a further 7 years. I had learnt from my father to believe in the
value of working for the government. I believed and still do, it was a
respectable and honourable thing to serve the people of my country.Being cripplingly
naïve, my life took many twists and turns. The turmoil in my life made it
impossible to live and work in Sri Lanka. Both my personal and professional
life became darkened by uncertainty. But I never lost hope. It was only then,
though with great reluctance I decided to leave my country.I too joined the
rest of the herd into greener pastures.Everything has a price!! I hadstepped on
the treadmill in the competitive world of hospital medicine, a seismic shock to
the system. It was more study, several more examinations
and innumerable job interviews. Thankfully, the work ethic and the discipline
instilled by my parents and my old school kicked in.
The time flew. Socially and politically it
was a period of bewildering change. I continued to serve humanity although in a
different continent. My workwas still dominated by an ethic of public service. After
retirement, here I am in London, where the grass is greener and the concrete is
warmer. London is a convenient place to meet those living in the UK. I met with
Kapoor Rajasekeran, S.Balakrishnan and DisampathySubesinghein the summer of
2018 at a Chinese restaurant near to the Victoria Station. Despite a few
infirmities we have all weathered well. Our conversation oftenreturned to our
roots, to those shared memories and to the magic of those years in Kurunegala. Amidst
thehappiness and laughterthere was some sadness too of lost friends.
I am now happily writing of my dreams of
the life and friends I’ve left behind. I do have regrets and wish I had kept in
closer contact with those who shared my youthful years. I will add this to my long
list of regrets. Not having seen some of them grow old I do remember them as I
saw them last, young, energetic and smiling. But I am sure I will treasure and
revisit those memories which I have garnered inKurunegalaall those years ago.
These were the remarkable and enduring
events that defined my internship. I dedicate this narrative to all the doctors
who came into my life during those years in Kurunegala and have now departed
this world. They enriched my life beyond measure.May they find the ultimate bliss
of eternal peace.Despite the passage of years the fun and the laughter will
swirl in the ether of that simple but memorable house, for many decades to
come.
The past is another world we cannot enter but
only reminisce. Although the mind has kept a record of it all, much of it has
melted away.We have to be meticulous as an archaeologist to resurrect them. I
remember with fondness and friendship each and everyone in our batch who have
been on this journey of life. We have spent too long fretting over our careers,
children and grandchildren. In this year New Year it is the present that
matters more than the past. It is so importantwe take care for ourselves. May you continue to appreciate the goodness
of people and the beauty of this world. Let the 3rd decade of this
century be the best you’ve had so far. May you all have good health and
happiness now and forevermore.
