The Bad old days of Psychological Vandalism

By Nihal D Amerasekera 

My first introduction to the Medical Faculty was on registration day. It started with virtual ‘road blocks’ by seniors to round up the freshers. This was the beginning of the rag to usher in the new recruits and introduce them to a new brand of nastiness, a tradition that has prevailed since the very beginning of the institution. This infamous ritual has become more outrageous with time.  This kind of harassment went on for a further fortnight after we joined.  What an introduction to a supposed sanctuary of like minded scholars!!  As I look back this behavior was accepted by many of the staff in the Faculty and it was even encouraged by some of them.  It is the responsibility of the Vice Chancellor to stamp out ragging unless he too condoned it. Ragging has caused the death of students at Peradeniya University. I hope it is not a part of the faculty calendar anymore. I admire the stance taken by Buddhadasa Bhodinayake who stood up to those bullies and took no part in this pointless ritual. We should move to a system available in most British universities where there is a freshers week. During this time there is an organized period of induction by the management and the senior students help the newcomers to settle in.  

Although I loved the study of anatomy, life in the Block was a nightmare. There was this need to learn the subject in such great detail which when we look back now was totally and utterly pointless. Thankfully Dr Leicester Jayawardene was reasonable. The rest persisted in making the weekly signatures a stressful ordeal. Some tutors even enjoyed the humiliation they caused the hapless students who sat in a circle. They were  surrounded by their peers waiting to grab any pearls of wisdom or to laugh at their mistakes. There was much giggling at the  sarcastic comments by the tutors. That was indeed the circle of death. Physiology and Biochemistry were taught and administered well.  The only time I flinched was when ‘Prick’ Perera jabbed my finger for a full blood count. Prof Koch, Prof Hoover  and  Carlo Fonseka helped to bring some sanity onto an otherwise manic two years. 

As we moved on to the 3^rd and 4^th years we gained confidence.  The 3^rd year without examinations was a shelter from the turmoil and strife around me.  During our holidays Nalin Nanayakkara and I went on a motor cycle journey to the central hills on his impressive red Moto Guzzi. It was a most memorable journey that will remain with me forever. 

After the Block the  subjects we studied seem more relevant. Prof GH Cooray, Prof HVJ Fernando, Prof Kottegoda, Prof.  Chapman, Prof Abhayaratne and Prof Dissanayake were great teachers who treated the students as human beings. I admire them greatly and remember them with much affection. 

In the 3^rd year we started clinical work with the stethoscopes round our necks. Whether we needed them or not it never left our collar. My first clinical appointment was with Dr Thanabalasunderam. He was a superb teacher and one of the best. He made us work hard and taught us well. His fine approach to clinical problems and their solutions has remained with me ever since. I am ever so grateful to the Visiting Physicians of the Ragama section of the GHC for teaching me medicine. Dr Wijenaike, Dr Medonza, Dr DJ Attygalle, Dr Ernie Peiris were excellent teachers. Despite their busy schedule of ward rounds, clinics and private practice they found time to teach us clinical methods. They took great trouble to find interesting patients with multiple  clinical problems. Their efforts bore fruit as many of their students went on to be Consultants in various fields of medicine with great distinction, both at home and abroad. 

The surgeons who constantly deal with blood and guts had a macho image. Of the surgeons Dr Austin commanded and demanded respect. Once he was most annoyed I didn’t stand up when he walked passed me near the operating theatre. I really thought he would assault me as he raised me up by my shirt collar with my feet dangling in the air. Need I say more about such behaviour.  He was a good teacher. Dr Anthonis showed great kindness to his patients and taught his students well. Dr Niles had a volatile temper towards his patients but was kind to us all and was a fine tutor. His clinical classes were full of humor and always a good laugh. He had this great ability to see the funny side of day to day clinical problems. It was like being at a comedy show. Darrell Weinman, the neurosurgeon, was a superb teacher. He had a special room for his ward classes which was always full to capacity. He was a showman ‘par excellence’ and taught us the whole process from history taking to examination, diagnosis and treatment  with great aplomb. He was a kind man. I will not forget the concern he had for his patients. 

Our Clinical Professors were good clinicians. They were committed to make certain we learnt our trade well before being released on the general public. Some of their teaching methods were archaic and depended on creating an aura of fear. In the process they humiliated students and at times reduced them to tears. This was totally and utterly repulsive and unacceptable.  The total of 4 months I clerked with The Professors of Medicine and Obstetrics may have reduced my life span by a good 4 years. The insults were relentless and damaging.  There are many anecdotes and sordid stories  which I will not relate as so many years have now passed and those culpable are not alive to defend themselves.  Some say they would never have studied without this strict regime – now that is what I call “Bull Shit”. Prof Navaratne, was a notable exception. He was a kind person and never showed anger to his students. We were never terrorized or intimidated by him or his department.  Didn’t we study surgery to pass the exams?? 

All through the 5 years in medical school  there was this aura of fear that pervaded the corridors, wards and lecture theatres. Such an atmosphere of terror  was created by a small minority of teaching staff. It amounts to bullying and psychological vandalism. This should not be tolerated in any institution. I am reliably informed this still goes on in the faculty in Colombo.  It is sad this  culture of bullying is not abating despite the passage of years. This is the responsibility of the Dean of the faculty to stamp out unacceptable behavior by his/her staff. Bullying was not recognized as a problem in the Faculty during my time.  Those who were bullied had no one to turn to hence  were unable to speak of their ordeal. We felt nothing would be done about it even if we complained.  There was always the distinct possibility of victimisation. In their fields, both professors were extremely clever and able doctors. But they needed to be taught how to teach and influence students. Bullying in Universities is a recognised problem worldwide and it requires the Institution to take necessary action.  Mostly it is the hierarchical nature of the environment to blame. Both the staff and the students have to be educated how to prevent and how to bring it to the attention of the authorities. 

To me personally the stress that prevailed was unbearable and took its toll. Bullying destroys morale. I was at my wits end not knowing how to cope with this constant battering on a daily basis.  I seldom spoke about my inner feelings. It wasn’t something I could discuss with my friends or even my parents. The result was  anxiety, distress and the loss of confidence in my own ability which lasted all through my years in medical school. I was reticent while presenting cases in the ward and at examinations where I performed poorly. It was when I emigrated to the UK that I regained my confidence as my bosses treated me with kindness and respect. They appreciated my hard work. Thankfully I was able to have a rewarding career in Radiology. 

The nightmare that began as I started in the Block ended the day I passed the finals in June 1967. The relief was almost palpable. I still look back on those years with trepidation but harbor no grudges. I sincerely hope things would change for the better.  

I lament that in real life, unlike fairytales, stories do not always have happy endings. Thankfully, I have not been scarred for life for those traumatic five years in medical school.  We were all in it together. Some withstood the pressures much better than others. What stood me in good stead was the camaraderie that existed and the friendships that I made during those grueling years. So much time has passed that I can now maintain an emotional distance from the turmoil of the past.

Recollections of our Teachers from Faculty days – Part 2

By Mahendra (Speedy) Gonsalkorale

In my previous instalment, I paused after Pathology. Why not parasitology and Forensic medicine?  You may ask. This series is not meant to be comprehensive and my apologies to my teachers who for whatever reason did not make as lasting an impact on me as others. However, in some cases this might be for favourable reasons and apologies may not be necessary. Moving on….

Prof Rajasuriya brings mixed emotions. He was undoubtedly a phenomenon in his own time, but I never took to him as I thought his teaching methods were archaic and based on fear. In my view, he did not treat us as adults which were so much of a contrast when compared to his Senior Lecture, Oliver Pieris who was not only an able Physician but a great teacher who treated us as mature adults. Some of my colleagues however, still thank Prof Rajasuriya with a lot of emotion and gratitude because “if not for his disciplinary methods, I would not have got through my finals”. As the saying goes, “it takes all kinds”.

Prof Navaratne’s lectures stand out in my memory. He would stand near a window peering outside while lecturing to us in his monotonous, heavy didactic style. What emerged from his oral orifice were gems which had to be carefully collected in the form of written notes and kept in safe keeping for later digestion. In the post- lunch lecture, it was not unusual to see some of my colleagues in the front row catching up with their sleep but thankfully, nobody snored and Nava didn’t seem to mind. Nava was yet another with thick black rimmed specs, the favoured style of the time. He was a striking figure as he was small, slightly hunched, narrow and furrowed frontal area with bushy eyebrows and most of his face gently moving forwards towards the apex of his facial contour, his nose. He often wore a “bush shirt” with a sort of built-in belt made of the same material as the garment.

Prof Ranasinghe of Obs &Gynae fame was an anachronism even in his time. Not for him to stimulate his students to enquire and research the subject. All that was required was to commit all his notes to memory to be regurgitated at the exams. Futhermore, the regurgitation had to be in the right order. “There are 5 causes of post partum haemorrhage, and they are a) xx, b)yy c)zz…” and so on and when a student is asked for the causes of post partum haemorrhage the answer had to be the 5 he gave us, and you know whether you got them in the right order because his fingers would fold in the right order, for example, if the student gave “z” as the first cause, and “z” is the third in HIS list, his middle finger would fold. If the student gives 4 causes (say the first 4), he would point his little finger at him and ask “what is this” – and the answer is NOT “Sir, that is your little finger”. But he was always smartly dressed and his enunciation was clear. Scoring high marks was eminently possible. As to his clinical skills, well, that was a mystery.

Senior Lecturer Dr Viswanathan (later Prof) was a total contrast. In the time allotted to him he would ask us not to take down any notes but just listen to him and at the end of the class, you are free to make notes. He said that useful information can get through the skull, be understood and stored in the brain during an attention span of not more than 20 mins. He always summarised the key points in his lecture at the end. We did not realised it at the time, but he had clearly studied not just Obs & Gynae, but teaching and learning theory. His lectures were clear and succinct – a good teacher.

In Paediatrics, I vaguely recall Prof CC d Silva. His presence was noted mostly by his absence. He seemed to be away most of the time and was typical of some Academics who are “rarely seen or heard in their own territories”. When he spoke, we wondered whether he was an European, such was his accent. He also had this habit which some have of tailing away his voice towards the end of a sentence. He would for example say, “When you consider diarrhoea in infants, we must never forget important cause such as  Aaaaa…………”. As the last words were almost whispered and gobbled, we were left in the dark. We were also very aware of his reputation and International stature.

Having said all this, I am sure all of you agree with me that on the whole, we were well served by our Teachers and that we owe them a deep debt of gratitude.

I shall return in due course with my recollections of our Clinical Teachers.

Visit to an Old Friend

We arrived in New York on 2 July for a brief holiday in the US. My old friend Indra (Anandasabapathy) met us at JFK and we spent three most enjoyable days at his beautiful home in Staten Island. Indra's wife Rani as usual, spared no pains to graciously host us. Our daughter Dilushi too drove up from Virginia to join us there. We left for Virginia Beach, VA on 5 July and are now enjoying our stay with Dilushi.

We will be returning to Sri Lanka on 31 July after visits to Greenville and Columbia in South Carolina (to see old friends) and to Columbus, Georgia where Mangala's sister is residing.

These two pictures were taken by Rani who is an accomplished photographer apart from her numerous other talents.

 

 

NICU in New York named after Sri Lankan physician

NEW YORK – At an official ceremony last week, Richmond University Medical Center (RUMC) dedicated the hospital’s Neonatal Intensive Care Unit (NICU) in honour of the late Dr. Anantham Harin, a Sri Lankan physician, who directed the unit at the time of his death in 2010 at age 65.

Dr. Anantham Harin

“This is a simple honour for a man who earned the recognition and admiration not just of his colleagues here at Richmond University Medical Center, but served as a leader and role model in the Sri Lankan community on Staten Island,” said President and CEO, Dr. Daniel J. Messina, who delivered remarks during the dedication. “It is truly fitting that his memory be honoured in our Neonatal Intensive Care Unit, among the vulnerable babies he dedicated his life to.”

During his 30-year professional career at the NICU, more than 15,000 infants passed through him recording one of the lowest mortality rates in the State of New York. Described as a brilliant physician and a warm hearted humanitarian, Dr Harin was regularly featured in the New York media for his work with premature babies and was repeatedly listed among New York magazine’s list of Best Doctors.

While a resident of Staten Island, New York, Dr. Harin emerged as a leading figure in the borough’s Sri Lankan community, which at over 5,000 estimated residents is one of the largest outside of Sri Lanka itself. His career was described as an American success story.

Dr. Harin graduated from the University of Colombo Medical School in 1970 and migrated to the United States in 1973 to begin a residency at what is now SUNY Downstate Medical Center in Brooklyn, and an internship in pediatrics at Kings County Hospital Center.

After completing a fellowship in neonatology at North Shore University Hospital in Long Island, Dr. Harin worked as an attending physician in neonatology at Bellevue Hospital Center and NYU Medical Center in Manhattan. Having relocated to Staten Island in 1979, Dr. Harin began working at the former St. Vincent’s Hospital (now RUMC) in the early 1980s where he worked until his passing.

Last week’s dedication ceremony was held at the University hospital auditorium in the presence of doctors, nurses, medical staff, his wife Nirupa and his friends in the Sri Lankan expatriate community.

The official unveiling of the plaque at the NICU preceded a memorial lecture.

 

This news item was sent by Indra Anandasabapathy who is also a resident of Staten Island, NY.  Dr. Harin was our colleague Satchie's brother.

Creative Spot - A Poem by Mahendra (Speedy) Gonsalkorale

Tropical downpour

 

A darkness creeps over the town

as angry black clouds gather in force

sweeping aside soft white ones with disdain.

The calm and gentle breeze is cast aside

as the howling wind gets stronger and stronger

causing trees to sway to and fro helplessly.

Leaves blown everywhere,

ladies holding on to their hats.

An old man digs his stick to the ground

as he defies the wind that pushes him.

Frantic umbrellas being unfolded

only to turn inside out, defeated.

People running for shelter

Swarms of frightened birds flying to their nests

A flash of lightening illuminates the sky,

the haughty rumble of thunder follows.

Sheets of rain pour unrestrained

the torrential downpour pelts the ground,

raising little flowers of water at impact on the ground.

Rivers of water lead to pools by the roadside.

Happy children run laughing and screaming.

Some huddle under trees for respite,

soon their clothes soaked to the skin

The rain continues unabated.

The horizon is a blur in the watery shroud.

More flashes of lightening,

loud claps of thunder strike and rumble on.

The wrath of the wind mercilessly swaying hapless trees.

Pieces of paper and plastic bags flying in gay abandon.

The busy road now deserted. 

Mud pools everywhere.

Gushing muddy water flows into drains.

Then as suddenly as it started

the rain ceases and the World brightens.

A fresh crispness is in the air.

Little by little life reappears on the roads.

First a few and more and more resume

As people carry on with their lives.

This was but a passing distraction. 

Cuba Libre

By Nihal D. Amerasekera 

Cuba Libre to a tourist is a glass of Rum and Coke with a slice of lime. To the Cubans it is freedom from tyranny and oppression. This came about after a bloody revolution that ended in 1959 but at a price – lack of personal freedom.

 

Photo- A typical street view of Havana

The travel guides and the travelogues never describe Cuba accurately.  I arrived in Havana with preconceptions and prejudices but it is far better than what I was lead to believe. When the opportunity arose to tour Cuba I was prepared to leave behind the June sunshine and the cricket, back in England. I first came to know about Cuba when Castro’s revolution toppled Batista’s despotic regime. I was then an idealistic teenager with a jaundiced vision of a fast changing world. The history of the revolution 1953-59 is a gripping tale of selfless courage. Subsequently with the failed Bay of Pigs invasion and the Cuban missile crisis, Cuba remained a thorn in the side of the Unites States for decades. Many rich Cubans fled the country to settle in Miami. 

Fidel Castro, a qualified lawyer, brought in wide ranging reforms including equal rights for Blacks and women. Significantly reduced corruption and unemployment. They eliminated illiteracy and brought in land reforms. Great improvements were made in hygiene and sanitation. Supposedly the country has the best free health care in the world. They make their own vaccines and medicines and even export doctors to other Spanish speaking countries in South America. Education is free to all. The man on the street is well informed and civil. Many seemed happy with their lot.  Those Cubans we met were kind and generous. No one was allowed to travel abroad until recently when restrictions have been removed. There is a possibility that the American embargo will be lifted. The Cubans have mixed feelings about this. They fear the arrival of drugs, mafia, casinos and the return to capitalism, the very climate that brought on the revolution. Fidel Castro in a speech whilst on trial during the Batista regime said “History will absolve me”. The world can decide!! 

As I set foot on Cuba the warm breeze and palm trees brought back memories of my beloved homeland. The airport is small and seemed very basic. On the way to our hotel the narrow roads and the tired looking old buildings with plaster peeling off reminded me of Ceylon of the 1950’s. There are no skyscrapers. The popular Russian Lada  and old American Dodge, Buicks, Pontiacs and Plymouths plied the streets of Cuba. Import restrictions have made all foreign goods expensive and beyond the reach of the people. They call Miami the 2^nd capital of Cuba as many Cuban émigré live there sending money to their relatives in their homeland. Cuba depends on tourism, Sugar cane, Cigars and money sent by émigré to balance their budget.  Cuba received considerable economic support from the Soviet Union. The American embargo since 1959 and the dissolution of the USSR in 1991 , have had a crippling effect on the Cuban economy but it has survived the worst. They have 2 types of currencies. One for the tourists called CUC and that for the rest it is the  CUP. 

The hurricane season runs from June to November. Cuba is very well organised, disciplined and prepared for such events and there are excellent evacuation procedures. This is in stark contrast to other Caribbean countries like Haiti.

 

Photo – Vinales Valley

All businesses are owned by the state. People can rent a property to farm or to open a shop but have to give the state a percentage of their income. Although theoretically all the houses are owned by the government there are some houses owned by individuals and I was unable to get to the bottom of this issue as much of this information is shrouded in secrecy.  The Cubans have ration books to obtain essential items of food at below cost. If more is needed they got to pay. Towards the end of my stay I asked our guide, most discreetly, if their was a secret service in Cuba like the CIA and KGB. After a short but distinct pause she said, yes, and went on to illustrate the point that such an organization is needed to safeguard the country and its leader Castro. There has been 600 attempts on his life since 1961 and far too many bids to destabilize the country. 

The Castros and the political hierarchy maintain a low profile. I saw so very few inscriptions or statues of the leaders although they have been ruling the country since 1959. There is a mausoleum and a museum for Che Guevara in Santa Clara. He is considered a martyr for the cause and is remembered with great awe and affection. I read his memoirs in my youth and saw a film about his “Motorcycle Diaries”. As a young man he travelled widely in Central and South America and witnessed the poverty and oppression due to dictatorships and authoritarian regimes. With his Marxist ideology Che felt the only solution was armed revolution. He gave up a comfortable life as a doctor in Argentina to fight for the people. The rest is history. I wore my Che Guevara T-shirt with pride to visit his mausoleum and pay homage to a man who had the courage to give his life to make it better for others.  He died at the age of 39 and left a wife and 4 children. Personally, I have no strong political affiliations, convictions or ideologies. My revolution will remain against disease and the resultant suffering. 

The author and journalist Ernest Hemingway loved Cuba and its people. He bought a house and named it  “Finca Vigia” in the outskirts of Havana where he spent time writing his books. Two of his best books ‘For whom the bell tolls’ and ‘The old man and the sea’ were written while in Havana. Hemingway loved fishing for Marlin in the waters around Havana.  He held lavish parties for his Hollywood friends at Finca Vigia and the lovely Ava Gardner was a regular visitor. The house is well maintained as it was during his day and is a monument to this Nobel prize winning writer. 

I have left the descriptions of hotels, scenery and landscapes to the last as it is no different from the rest of the world. The internet is painfully slow  and the Wifi virtually non-existent. With its Caribbean sub-tropical climate the fauna and flora are very similar to Sri Lanka. The many different and colorful plants reminded me of the taxonomy in Pulimood and Joshua. Delonix regia are in plenty and were in full bloom as if the trees were on fire. Ipomoea biloba, Antigonon leptopus, Magnolia, Thunbergia grandiflora, Nerium oleander were all in flower in June. There is manioc and bread fruit in plenty. Although they have many snakes non of them are poisonous.  

The capital Havana looks tired and old and needs a lick of paint. The people are discouraged from demolishing old buildings.  When painting they have got to use its original colour. Cubans are very musical and their favourite instrument is the guitar. Whenever we had a meal in a restaurant there was a group to serenade us playing the old favourites – Guantanamera and Cielito lindo.  I visited the famous Buena Vista Social Club. It played  the perennial favourites of the  1950’s.  Buena Vista Social Club’s popularity was revived by Ry Cooder in 1998 with a famous album and a film of that name. Cubans are born with the natural rhythm to dance. Their evocative hip gyrations and rhythmic movements have given rise to the ever popular Cha cha, mambo and the Salsa. It is indeed a great pleasure to see the dances performed in their native environment. 

Vinales Valley is a UNESCO World heritage site. It is encircled by green mountains and is a pretty sight. They use traditional techniques for agriculture using cattle. Much of the best tobacco is grown in this region. Their staple food includes rice which is cultivated here. 

We moved on to Cienfuegos where they grow sugar cane. This again is a World Heritage site. Its buildings and architecture show their French and Spanish past. 

Varadero has beautiful beaches and many plush hotels. This is a city which shows life is changing fast in Cuba. Do visit the country before it loses its old world charm and values.

 

Photo – The Beach in Varadero

It is indeed a beautiful country. Cuba is just beginning to open up to the outside world. I hope I have succeeded in giving you a birds eye view of Cuba and an overview of its tormented past and its less troubled present.  

Perhaps the present regime in Cuba has done their best.  They need to tweak their dogma to improve the quality of life of the people.  In a democracy the people decide but in Castro’s Cuba it is much harder to change. The Cubans deserve peace and freedom like us all without returning to the problems of the past. I wonder for how long they will continue to chant “Viva la Revolucion” Long live the revolution?

Creative Spot by Mahendra Gonsalkorale and Zita Perera Subasinghe

A combined effort between Zita and Speedy. Zita played this beautifully on her Yamaha Clavinova and Speedy  accompanied her rendering his superb voice. The result is the "Whispering Hope" YouTube video.

A bit of history on the song itself, sent in by Speedy.

There is very little information regarding the circumstances of the writing of "Whispering Hope" other than the  fact that the song was written in 1868.  But one thing is certain, the song was written by prolific songwriter Septimus Winner who released much of his work under the pseudonym, Alice Hawthorne.  The text of this  song appears to be based on the scripture from Hebrews 6:19 which refers to the anchor that keeps the soul steadfast.  That anchor is also the "Whispering Hope" of the Christian.

Septimus Winner was an American songwriter of the 19th century. He used his own name, and also the pseudonyms Alice Hawthorne, Percy Guyer, Mark Mason, Apsley Street, and Paul Stenton. He was also a teacher, performer, and music publisher.

Click on:

https://www.youtube.com/watch?v=MUnyjXT2URM