Saturday, August 31, 2013
Monday, August 26, 2013
Memories of Arabia
By Dr Nihal D Amerasekera
Since my childhood I had a fascination for Arabia. I was captivated by stories from the Arabian nights of Ali Baba, Sinbad the Sailor and Aladdin. As a kid I was mesmerised by this mysterious place. I often imagined travelling on a magic carpet over the roof tops to the magnificent palace of the Caliph Haroun Al Rashid and to experience its fantasies and opulence. Later in my youth it was the emotionally gripping tale of the mysterious and charismatic Lawrence of Arabia that kept my love for the area alive. As an adult I have often dreamed of trekking across the sand dunes and oases of this vast peninsular.
It was a cold wet day in London in March 1984 when I received a phone call from Jeddah, Saudi Arabia. It was from a Radiologist friend from London who was now the Director of the department at King Khalid Hospital Jeddah. After exchanging the usual pleasantries he got down to business and wanted me to accept a 4 week teaching and work assignment in that hospital. I agreed without much hesitation and pondered about the decision later. I was attracted by the short tenure, lucrative pay and the offer of an adventure. This was the beginning of a happy association with Jeddah for over 12 years.
Soon I was on a Saudi Air flight from London Heathrow travelling in 1st Class luxury to my destination. When I disembarked in the late evening what hit me was the intense heat as if I had peeped into a furnace. The terminal was packed with people. Many were pilgrims to Mecca. Some had come for employment mostly from the near and far-east. After a long wait at immigration all were tired and the tempers were fraying. Every baggage was opened and every item was scrutinized with a fine toothcomb. The books with bikini clad women were confiscated. At the Arrivals was a man from the hospital who whisked me away into his people carrier. I arrived at the hospital late at night. My accommodation which was called “The Motel”. I slumped on my easy chair ready for a cold shower and a good nights sleep.
In the Kingdom of Saudi Arabia Thursday and Friday constitute the weekend. It was a Monday and I was advised to get my ID card, the most valued document next to the passport. The bureaucracy and red tape is only second to the Indian subcontinent. Wheels of the establishment grinds slow and suffers from intitutionalised apathy. Nothing is done urgently. The byword is “Inshallah bookra “ God willing it will be done tomorrow. The tremendous weight of regulations crushes common sense. The little man seated at the desk thinks he is the centre of the universe. Perhaps he is when being the only one able to do a job for you.
King Khalid Hospital is a 500 bed facility completed in 1982. It is one of the most modern and best equipped hospitals in Saudi Arabia built on the road to Mecca. There was a multinational staff from 40 countries totalling approximately 2000. It is situated about 30 miles from Jeddah City. The hospital is surrounded by tall bare mountains parched by the sun since Biblical times. The desert was all around the hospital as far as the eye could see. In this oasis there was the hospital, the Camp for the minor staff and the Medical City for the doctors, administrators and other senior staff. Hospital had the most magnificent buildings spread over a wide area. Its tall ceilings, glittering chandeliers and marble floors took my breath away. I have no words to describe its sheer beauty. On the shiny marble walls were inscriptions from the Koran which stood out. This is the most splendid hospital I have ever seen. It was fit for Royalty.
I was taken to the Director of Radiology who showed me the ropes and the rota. The workload of the department was reasonable and the on calls were not too onerous. Many of the radiographers were British or Irish with some Filipinos. They were friendly and made wonderful company. During quiet periods the staff played card games and drank gallons of tea. Some had time even to knit while playing cards.
The foreigners working in Saudi were a diverse bunch. Many were there for the money and to soak up the sun. Others were running away from broken marriages or the taxman. Some were keen to escape from the intensity of life in the west. It is easy to be anonymous in this oasis. The feeling that one is invisible in Jeddah, so far divorced from normal life, is ubiquitous among expats. Jeddah is an exciting place providing a surreal existence, but it’s a scary one too. Learning to be alone is an acquired skill. Although I was homesick at times, the absolute silence, the solitude of the desert and the peace it provides became a meditative balm.
As the days passed I got the hang of what was required. It takes diplomacy, dignity and decorum to deal with the Saudi patients and doctors. A refusal or a “NO” is taken personally and such news has to be broken gently. The work was interesting and intellectually challenging. The patients were mostly Bedouins. There were some middle class Saudis and the families of the National Guard who sought attention at the hospital. What struck me most was the many old men who had pretty young wives. They came to Radiology to investigate their wives why they cannot conceive not quite realising most of the time the man’s age was the problem - not firing on all cylinders. All the diseases of the developing world were seen in abundance. Congenital diseases and bone abnormalities were common which was partly due to consanguineous marriages. Once we had a man who had taken the female contraceptive pill himself for several months having misinterpreted the instructions. It doesn’t take much thought to figure out what the female hormones would have done to his efforts to keep his young wife happy.
Once I was greatly honoured to be asked to treat a real Saudi Princess. She came with her entourage to the Ultrasound department. Her lady-in-waiting warned me to be gentle with her and I took her advise not wanting to languish in a Saudi jail for the rest of my life. The Princess was kind and courteous and spoke fluent English. After the examination she thanked me generously and one of her aides handed me a small package containing an expensive watch. That was the closest I have come to Royalty anywhere in the world.
Most patients spoke only Arabic. I had a pretty Egyptian lady interpreter with me at all times. She just gave me a tachycardia but nil else. It was part of my duty to teach medical students. They were from affluent Saudi families, spoke good English and mighty keen to learn the trade. The students followed me at work and I got to know many of them well. They had a certain arrogance which was common to most rich Saudi’s but were mostly very able and well trained.
In hospital we worked from 8am-12 and 2-5pm. The long lunch break was wonderful. There were 3 canteens one for the minor staff, one for the senior staff and the other for the locals serving Arabic cuisine. For the minor staff who were mostly from India, Pakistan, Sri Lanka and Bangladesh the food was delicious and tasted like the curries back home. The senior staff had European food. In the main the food was exceptionally good and well presented. I have often had my meals with the Sri Lankan workers. They were a lovely bunch. Within the hospital and in the medical city the laws were liberal and the guards who kept a close eye in general overlooked some of the minor indiscretions of the Europeans.
Attached to the hospital was a Mosque and every Muslim was expected to visit and pray the recommended 5 times a day. There was a certain rigid pious atmosphere in the Kingdom which the Muslims seem to accept with much grace. Everyday I saw the faithful walk in for their prayers. I remember walking into a Mosque in Colombo. That wasn’t to receive spiritual sustenance but to satisfy my youthful curiosity. I was most impressed by its simplicity and cleanliness. My lasting memory of Jeddah is the calmness and serenity of the Muhsin’s early morning call for prayer. As it broke the peaceful silence of the desert its melodious lyrics echoed on the surrounding hills. It was magical and heavenly just like in the Arabian nights.
The sun shines every morning and there is never a cloud in the sky. As the sun rises the heat becomes unbearable. Between 11am and 3pm no one ventures into the open. The whole of the hospital, motel, camps and the apartments are air-conditioned. Evenings are very pleasant indeed. I often took a stroll along the well lit streets of the medical city after dinner. The inky night sky was often lit up by the the bright luminous milky way. The moon often lit up the desert showing off its splendour. The numerous fireflies and the constant chirping of the cicadas amplified the loneliness of this vast expanse. It often reminded me of my childhood in Sri Lanka.
In the long lunch breaks I often sat on a bench at the front corridor of the hospital and watched the world go by. There is hardly a breeze and the heat was stifling. The red and violet bougainvillea added colour to the otherwise drab landscape. They seem to thrive in this inhospitable terrain just like the prickly pears along the dusty roads. I saw the rich and the poor come into hospital. It is generally believed the Saudi women have no rights and lead a dog’s life. As I observed this is not strictly true. Some women were belligerent and assertive as anywhere else in the world.
The Medical City is a large complex of apartments, shops, sports facilities and an Olympic size swimming pool. The apartments were fully equipped with all modern facilities. The single females were segregated and no male was allowed into their apartments at anytime. There were beautifully laid out gardens and water fountains which made life bearable in the desert.
Saudi Arabia is well known for its ban on alcohol. Lord Bacchus is too cunning and saw to it that those who persevered got their way. I spent a Christmas in Jeddah. There was no shortage of drinks of any kind. It was a most memorable Christmas in a country where December 25th is just another working day. I personally preferred the non-alcoholic lager which was freely available. We worked as usual and no decorations or fireworks were allowed. I am pretty certain the guards knew what went on but turned a blind eye. Every weekend there was a party in the medical city and life was good. The booze flowed freely as did the seminal fluid. These events ended with much gossip and innuendo.
There was a large Sri Lankan contingent of minor staff. They lived in the camp just a short walk away from my accommodation. They were a closely united bunch who looked after each other and shared their joys and sorrows. I cannot speak highly enough of my countrymen who behaved impeccably in this often harsh and unforgiving environment. In the evenings I frequently saw them at their camp. A single large room was shared by upto 4 people. They had their own recreational facilities. Nimal Fernando from Moratuwa was one of their leaders. I got to know many of them over several years and knew of their families, problems and aspirations. We had mutual respect and during each of my several visits became their mentor and physician. Often they cooked a Sri Lankan meal in the evening which we all shared. In Ceylon I grew up with old Sinhala songs of the 1950’s from films and radio. They played these for me on their audio sets bringing back happy memories of my childhood. We talked and reminisced about our lives back at home.
My Sri Lankan friends in Jeddah were gardeners, telephone operators, security guards, shop assistants and clerks. Others worked within the hospital in sterilisation units and did office work. We had a Lankan barber who did my hair listening to his vast collection of old Sinhala music from the films. It certainly brought back memories of my youth. He was a repository of gossip of those in the medical city and was well loved. Shantha and Neville were brothers from Matara and were swimming pool attendants and life savers. They saved lives and were popular with the girls. Many of the work force had families back in Sri Lanka and have lived in Saudi Arabia for 5 to 10 years. They had missed their children growing up and also their important milestones. They earned ‘good money’ and bought land, built houses, educated their children and spent for their weddings. This in itself is a marvellous achievement. The sacrifice has been worthwhile. They had broken the cycle of poverty.
The Sri Lankans working in the hospital received free treatment of the highest quality including coronary bypass grafts free of charge. Food and lodging too were free and all their wages went straight back to their accounts at home. As I write I can see their smiling faces and their willingness to help me and each other in every which way they can.
In the evenings and weekends I took the hospital bus to Jeddah City. The bus goes past the wealth of the affluent Saudis and the squalor of the destitute. The houses were painted a brilliant white and had flat roofs. Every house has a large roof top water tank .
Jeddah is the gateway to the two Holy Mosques Mecca and Medina. It is the commercial and industrial centre. Being one of the oldest cities in the Arabian Peninsula it has a beguiling history. Jeddah began about 2,500 years ago as a tiny fishing settlement. Situated in the middle of the eastern coast of the Red Sea it has expanded on a colossal scale in the past 20 years growing from a population of about 30,000 in 1947 to one and a half million in 2002. The population of Jeddah has doubled between the boom years of 1974 and 1980. It is now the Kingdom's principal seaport. Jeddah remained under Ottoman influence and was released from Turkish rule in 1915. The buildings of old Jeddah are tall and graceful, constructed of coral limestone and decorated with intricately beautiful wooden facades typical of Turkish architecture of that era.
The souks or markets are the heartbeat of old Jeddah. It is still an exciting and picturesque part of today's scene. The splendid gold souk with its gold chains elegantly displayed and hanging boldly from the ceiling is a sight never to be missed. There is a Filipino souk selling everything from T-shirts to screw drivers. The carpet souk is run by the Afghans and Persians. I have often wandered through the narrow cobbled streets buying stuff from the vendors drinking the strong Arabic coffee. They sold those delicious Shawarma – roast lamb, shredded tomatoes and onions wrapped in a thin roti. The place was always packed with people. Everyone felt safe despite the milling crowds. The markets are a haven for pirated software, games and music CD’s. New shopping centres, office building and apartment blocks were springing up everywhere. Stretches of former desert have now become part of an expanding, concrete city. Jeddah has successfully managed to combine the dignity and traditions of the past with the dynamism of the modern business world.
During prayer times all the shops close and this occurs 5 times a day. All the women wear their head scarfs (tarhar), The long black dress the abaya and the face mask the burqa. Those who don’t follow this experience the wrath of the Muthawas – the religious police. Women are not allowed to drive vehicles or travel alone as a passenger except with her husband. If stopped by the police they may have to prove they are married showing the marriage certificate. These are the laws of the land. All Saudis adhere to the laws and it is the duty of all foreigners to abide by them too.
Once I remember a Norwegian Radiologist who worked in the hospital. He was in his mid sixties and lived alone in an apartment in the medical city. His family lived in Norway. We became good friends and in the evenings he took me in his car to Jeddah City and to the various other places of interest. He was fine company and knew the history of the area well. He particularly loved the desert and spent weekends there all on his own. It was my in-built caution, the fear of the unknown, that prevented me from joining him. About a year after my return to England I had a phone call from my Norwegian friend. He wanted me to work at King Khalid Hospital again. He made it a point to tell me I have to join him on a weekend trip to a far away desert. I agreed reluctantly. When I went to King Khalid Hospital the staff in the department were in a sombre mood. They finally broke the news that the Norwegian radiologist had gone into the desert the previous weekend and has not returned. Helicopters and search parties looked for him for over a week. They finally found his body in the desert beside his jeep. Apparently a wheel had got stuck in the sand and he had got a heart attack whilst clearing the sand with a spade. It was a sad goodbye to a warm hearted and sincere friend.
The hospital is 40 km from Mecca which is the holiest city in Islam. The city is revered from being the first place created on earth, as well as the place where Ibrahim together with his son Ismail, built the Ka'ba. The Ka'ba, the centre of Islam, is a rectangular building made of bricks. Around the Ka'ba is the great mosque. Around the mosque, in between the mountains, are the houses that make up Mecca. On numerous occasions I have seen on Television the mass of pilgrims walking round the Ka’ba – a splendid awe inspiring sight. Every year some 2 million pilgrims attend the hajj. Some come to Mecca for the umra. There is a regular free bus service from the hospital to Mecca every day of the year. During Ramazan work in Saudi Arabia virtually comes to a standstill. The Moslem hospital workers are allowed to start work at 10am and also leave earlier as they are fasting. This is the time of the year when the number of road traffic accidents increase keeping the Accident departments on full alert.
The Kingdom must be one of the safest countries in the world due to its harsh punishments for crime. Women can go about their duties unmolested and robberies are rare. The punishment for rape is death and for robbery -amputation of the hand. The Sharia law certainly is a deterrent and I have the greatest respect for the Muslim religion and their strict code of conduct.
Despite its parched terrain and the forbidding landscape the desert has its own beauty. This is most evident during the rainy season in December when it comes alive. The soil does not soak up the water which remains on the surface making lakes and fast flowing streams within just a few hours. It rains incessantly for days and suddenly stops and the sun shines again. Within these few days the mountains and valleys become a carpet of green and purple with grass and many coloured flowers. This is a very pretty sight indeed. As I had imagined the desert is not all sand. There are many rocks and pebbles of all sizes. Despite the heat and the dry atmosphere the desert is full of life with lizards, scorpions, insects and small snakes. The ubiquitous beige terrain and the scorched earth supports life and has done so from the beginning of time.
The oasis of the hospital is a haven for numerous colourful birds. Many have migrated to escape the harsh winters in Southern Africa and Scandinavia. I have driven on the highway towards Mecca with my uncle Neville Weerasekera who was an Engineer in the petroleum industry. The desert roads are long, straight and seem to go on forever. Looking at the road ahead one can see mirages and the haze rising from the heat of the road. The desert appears rather featureless except for a few Bedouin tents and camel trains. The Bedouins are the true people of the desert and are known for their hospitality. They regard it as a tribal duty to welcome strangers. Non Muslims are not allowed into Mecca and we took the “Christian bypass”. The desert although very hot during the day it does become rather cold at night.
Sandstorms are another scourge of the desert. I experienced one in the month of July. One mid afternoon when the sun should be at its brightest, suddenly, darkness descended on the whole area, It was like a fog and visibility was reduced to a few yards. We were advised to stay indoors and it was many hours before it cleared and the sun reappeared. Sand particles get everywhere covering the cars buildings and even the trees. No one ventures out in a sandstorm.
After the Gulf war there was a palpable change in the ethos at the hospital. Working conditions of all foreign staff suffered due to reduced funding. The pay did not keep pace with worldwide inflation and appeared less attractive. There was a natural progression to greater Saudi-isation which perhaps came too quickly. There was a drop in the standard of healthcare. Many felt the various strictures of life in the country was not worth the sacrifice. Meanwhile pay and conditions had improved elsewhere. My last visit to Jeddah was in 1996. I enjoyed my time there enormously. I do miss the wonderful staff, the sunny days, the arid landscape and the ultimate bliss of solitude. Even now when I eat a Shawarma it reminds me of the buzz in the souks in the warm night air. Most of all I miss the Sri Lankans in the camp. They brought sunshine into my life in a foreign land.
On my last visit to Jeddah the Hospital coach had forgotten to pick me up from the airport. I didn’t have any Saudi Riyals but had some Pounds Sterling. I went across to the official airport information desk and explained my plight. He just waived his hand and asked me to get lost. I asked several security guards in the airport premises who understood me but were unwilling to help. I saw several telephone boxes which needed Saudi coins to operate. There were many shops in the arrivals area and I asked all of them to exchange some money to make a call. To my surprise none of them were willing to help.
I felt now that I was in real trouble being in a foreign country without any local currency, without a friend in sight and unable to get to my destination. In this world it’s assumed that we can all find a comforting hand of friendship somewhere. In Arabia that just isn’t so. I was angry and disappointed at the lack of compassion shown to me by so many people who could have quite easily helped. Jeddah is a scary place for a foreigner who cannot speak Arabic and is alone. Getting into a taxi not knowing the local lingo is not for the faint-hearted. I spoke about my plight to almost every one without a positive response.
When I was relating my story to a bystander a well dressed gentleman overheard our conversation introduced himself as a Sri Lankan and offered to help me. He took me by the hand and spoke to a Taxi driver in Arabic giving instructions to take me to my destination. He paid for the taxi. Before leaving he handed me his business card. The next day I phoned to thank him. He refused to accept any money. This was indeed an extra ordinary experience which could have ended in disaster. Sadly I lost the business card of this Sri Lankan Muslim whose kindness I cannot ever forget. As the years have passed I consider this as yet another life’s experience. I do not hold it against all Saudis.
The romance of my time in Arabia is now a distant memory. I dedicate these memoirs to the enigmatic helpful stranger in the airport hoping “Inshallah” we will have the good fortune to meet again.
Friday, August 23, 2013
As part of the build up towards the upcoming 2nd International Scientific Congress and Reunion on Sunday 8th September 2013 at the Blue Water, Wadduwa, the Executive Committee of CoMSAA met on 14th August to discuss arrangements among other matters.
Picture shows from left to right - Prof. A.H. Sheriffdeen, Dr. Chandra Jayasuriya, Prof. Lalitha Mendis, Dr. Champa Nelson, Dr Shiro Gunawardene, Dr G Shanthilal de Silva, Dr Lakshman Abeyagunawardene, Dr. M. Sarath Gamini de Silva, Dr Dennis Aloysius, Prof Saman Gunathilake, Dr. J.B. Peiris (President), Dr. Piyusha Atapattu (partly covered), Dr Nanda Amarasekara, Dr. Romain Perera, Dr Deepa Wimalasena (partly covered), Prof. Jennifer Perera (partly covered), Dr. Philip Veerasingam, Prof. Athula Kaluarachchi, Prof Ravindra Fernando (not seen).
Absent: Dr. B.J.C. Perera, Dr. Saroja Siriwardene and Dr. K. Rajendra
Please confirm your participation before 15th
Absent: Dr. B.J.C. Perera, Dr. Saroja Siriwardene and Dr. K. Rajendra
Colombo Medical School Alumni Association
2nd International Scientific Congress
Sunday 08th September 2013, 8 am - 5 pm
The Blue Water, Wadduwa
Inviting CoMSAA members, their families & friends to enjoy a day filled with fellowship, music, dancing, fun, games and academic exposition
Tickets - Rs 2000.00 (Adults)
- Rs 1000.00 (Children below 12 years)
Special Deluxe Room Rates on 7th September 2013 for Alumni who wish to stay overnight
Single - B & B Rs 7000 .00 - HB Rs 9000.00
Double - B & B Rs 9000.00 - HB Rs 13000.00
Dr Piyusha Atapattu - 0779501610 <email@example.com>
Dr Nalika Gunawardene - 0776975402 <firstname.lastname@example.org>
Dr Deepa Wimalasena - 0777236845 <email@example.com>
** New members can enrol at the registration desk **
Indra Anandasabapathy's daughter Sharmila is the Editor of a newly published book more suitable for Post Graduate students in Gastroenterology. As requested by Indra, I have coordinated the donation of a copy of this book to the Sri Lanka Medical Library. Please see picture below and the cover letter that accompanied the donation.
Dr. Manohari Seneviratne
Dr. L.N.D. Abeyagunawardene 60/9, 8th Lane MBBS (Cey), MPH (California), MD (Col), FCCPSL Kandawatte Road
23 August 2013
Sri Lanka Medical Library,
6, Wijerama Mawatha,
Dear Dr. Seneviratne
Further to the telephone conversation I had with you and Librarian Sriyani Gomes today, I am pleased to hand over the following publication to the Sri Lanka Medical Library. It is a donation from Dr. Indra Anandasabapathy of Staten Island, New York. As the title indicates, the book would be mainly utilized by post graduate students in Gastroenterology.
Please note that I am only acting on behalf of my friend and fellow member of my batch that entered the Colombo Medical Faculty in June 1962. We are both Founder Members of the Colombo Medical School Alumni Association (CoMSAA).
Title: Advanced Imaging in Gastroenterology
Clinical Review Articles
Gastrointestinal Endoscopy Clinics of North America
Editor: Sharmila Anandasabapathy
Consulting Editor: Charles J. Lightdale
Date of Publication: July 2013
I would appreciate very much if you would please send an official acknowledgement to Dr. Anandasabapathy directly.
Dr. Lakshman Abeyagunawardene
Monday, August 19, 2013
My childhood tryst with destiny
By Dr. Nihal D. Amerasekera
Childhood is a risk we all take - David Hughes
The year was 1949 and my country was then called Ceylon. We had just gained independence from British rule. A certain sense of euphoria pervaded the length and breadth of the island. It was then that patriotism spilled over into xenophobia to spoil the calm serenity of this tropical paradise.
At the age of seven my life of privilege as an only child was marred by an intermittent fever that baffled the best doctors in the land. Twice a day everyday a glass-mercury thermometer was thrust under my tongue. It was the start of a cruel illness that consumed and changed my young life. I could see my hopes and dreams ebb away. Many said it was tonsillitis. For others it was some elusive form of Malaria. I chewed the Cinchona bark and drank gallons of Quinine until I was deaf. The fever clung to me like glue. Smelly lotions and bitter potions of Ayurvedic medicine filled my days with despair. Oils were thrust through my every orifice. They even sought divine help but to no avail. Strangely, the spiritual assistance cost much more than the doctors wisdom. Dr. MVP Peiris, LMS (1925), FRCS (Eng) 1929, was in charge of the Surgical Department General Hospital Colombo. The great man decided it was Tonsillitis and suggested the only solution was to operate. His gently probing style and disarming courtesy won us over. In those days there was an unassailable belief the doctor was always right. He finally persuaded my parents to take the plunge.
Operations in those days were not without peril. Surgeons believed in the old adage "when in doubt cut it out". The survival after anaesthesia was a lottery. Then there were very few antibiotics around. Hence infections post surgery was a killer. The wit of George Bernard Shaw comes to mind: All professions are conspiracies against the laity. I trust the rationale for surgery was fully discussed with my parents. They were made aware the result of failure was death, a hard pill to swallow for any parent.
The Ceylonese love giving advice. Some relatives begged of my parents never to allow me near the surgeon’s scalpel. They related gory tales of blood and death. To the general public what happens in a hospital is a permanent source of intrigue and fancy. As for the surgeons they have confidence that all will be fine on the day. For my parents it was a hard choice. They remained in a wilderness of confusion baffled and bewildered by these swirling fearful thoughts.
Lady Havelock Hospital for Women and Children was opened in 1896. It was inaugurated by Dr Kynsey (Principal Civil Medical Officer), a name we will all remember. ‘Situated in spacious environs in the Colombo suburb of Borella, the hospital’s architecture was of typical British colonial-style with red terracotta walls, ornate windows, and imposing colonnades…’ (Robert Boyle). In 1909 a separate block was built for Children. This new addition was named after Lady Lina Ridgeway, wife of Governor His Excellency Sir West Ridgeway, who was an energetic patron and fund raiser for the project. The first qualified Paediatrician appointed to the hospital was Dr L. O Abeyratne, in 1937, who also became the Medical officer in Charge. When the Castle Street Hospital for Women opened in 1954 the Lady Havelock Hospital ceased to exist. Then the LRH expanded to become the premiere Childrens’ hospital in the country. Dr C C De Silva was appointed Professor of Paediatrics in 1949 . (I say it with great pride that one of my own batchmates, Sanath Lamabadusuriya, became the Professor of Paediatrics at the LRH in 1991.) In 1949 Paediatric surgery was performed at the General Hospital Colombo. It was in the 1950’s that Drs Milroy Paul, MVP Peiris and FA Sandrasagra carried out surgery at the LRH.
As I continued to suffer ill health a place was booked for me at the Childrens Ward at the General Hospital Colombo. It was a small ward of 20 beds in the first floor of the surgical section of the hospital. Those were days when the medical profession was less sophisticated and less specialised. The surgeons and physicians did everything that came their way. The wind of change was blowing across the profession for greater specialisation.
The ward was clean and neat. Colourful paintings adorned its walls. There was a playroom too with some toys and games like Ludo and Snakes and Ladders. Wherever there are children whatever the circumstances mischief fun and laughter are never faraway. We played from dawn to dusk. The ward had a wonderful view of the long corridors that criss-crossed the hospital. I have watched hordes of doctors and nurses come to work in the morning and leave at night. A large flamboyant tree with spreading branches full of orange flowers filled the quadrangle between the blocks. None of the children in the ward seemed seriously ill. There was a boy with a boil behind the ear, probably a mastoid abscess which had broken through the skin. He didn’t smell too good but we played together a lot. Initially treatment was fairly aggressively chemical. Then came the scalpel.
Adjacent to the main ward was the ‘Injection Room’. It had an aura of fear. The steaming stainless steel sterilisation units, glass syringes with needles and the many bottles and jars gave it an eerie feel. In the morning and evening we were taken there, one by one, for the penicillin injections. This was a ritual we learnt to accept. Children are remarkably resilient. Within a week I became amazingly comfortable in the ward. There were some lighter moments too. We devised a game to be played with the silver tops of penicillin bottles similar to draughts. There was one lad who became my best friend. He was utterly self confident. He sang and danced to entertain and was the nurses’ favourite. I learnt many Tamil songs some of which I remember to this day. As the days passed we became bolder and walked in to the next ward and to the corridors beyond.. The nurses knew us and greeted us warmly. I distinctly recall a very ill man who was in a coma after a fall from a tree fitted with a saline drip. The din of the wailing relatives upset us deeply. Death was not a concept I could comprehend then. I remember the next day they pulled the screens around him and he was gone.
A children’s ward just next door to the seriously ill grown up men and the deafening chaos wasn’t a good idea. After all that was the middle of the 20th century. Every day one of us went to the operating theatre and returned moribund which scared us no end. But with time they recovered and after a few days went home. We all seemed to understand the warmth of this refuge. My lasting memory of the ward is its unmistakable strong smell of ether which pervaded every room and every corridor of the hospital. It was a odour synonymous with disease and suffering. I remembered this smell well into my medical student days.
We looked forward to the evening when our parents came with oranges and grapes which we all shared later on. The nurses too were most kind and often brought us sweets and some even had the time to play with us and relate stories. I clearly remember a pretty young nurse, a paradigm of beauty to my young eyes, who played and sang with us. I had no true concept of time and seemed happy. When my temperature has settled Dr. MVP Peiris asked the nurse to prepare me for operation the next day.
In the morning of the operation I was dressed in a white gown and had my head covered with a white cloth. I felt rather sleepy and may have been given a sedative. As I lay on the trolley in the ward corridor my parents stood beside me, distress written all over their faces. They kept stroking my head and holding my hand. I recall working hard to keep awake but my eyes kept closing. As I shut my eyes the world went silent and all I could hear was my heart beat. I recall my father asking me to open my eyes that all is well. There is a vague recollection of the trolley going through swinging double doors which now I know must be that of the operating theatre. I can’t remember the details of what happened to me next but remember waking up back in the ward.
I saw the sun on the wall and it seemed like evening and my parents were by my bed. I had great difficulty in opening my eyes. It was impossible to move my body or limbs which baffled and frightened me. Perhaps that was the effects of the muscle relaxant. I was confused and couldn’t think straight. I slept and woke up briefly several times that night. As the sun peeped through the windows in the morning my mind seemed much clearer and I was able to open my eyes fully. The nursing sister and the wonderful staff seemed greatly relieved to see me alive. They gave me sips of ice water as I felt so thirsty. I tried to speak but could only whisper and no one could understand me. I was terrified.. My parents came everyday and hung around stroking my head trying to comfort me. That was indeed an ordeal for a 7-year-old. It took me to the outer edges of human tolerance. Throughout all this, I never doubted my parents’ love for me..
The ritual of penicillin injections continued everyday until I got better. Then I was back playing with the kids again. Finally the day came for me to leave hospital. My parents had arrived to collect my few possessions. They took a photo of myself with the pretty nurse which is still in one of our photo albums. My fellow patients looked on as I said goodbye and parted.
I can only vaguely remember Dr MVP Peiris but recall working with his daughter at King’s College, London, in 1977 where she trained to be a Dermatologist. The surgeon died many years ago.
I worked in Sri Lanka for 7 years before leaving its shores which even in a small measure helped to repay my debt to my country. My internship began in the Childrens ward at GH Kurunegala. At any age being a patient in hospital is an ordeal that is never forgotten. For kids being incarcerated in hospital is a blistering experience. For me it was a lesson for the future. I often had a great deal of sympathy towards the kids and parents who took refuge in our wards. The people of the ‘Vanni’ lived desperately poor lives that depended totally on the monsoon rains. Infant mortality was high, diphtheria and diarrhoea being the worst killers although so very preventable. Sadly, they brought their sick children when they were at death’s door. I was immensely privileged to work with the paediatrician late Dr. Chandra de S. Wijesundera (he was married to Manel Ratnavibhushana our erstwhile batchmate) and my colleagues Dr. HN Wickramasinghe and Dr. Priya Guneratne. They had boundless energy, courage and empathy to provide a wonderful service to every child and parent who walked into our ward. They are very special people indeed. I was so pleased to see HN on many occasions and Priya on my last visit to Sri Lanka in September 2013.
Trials in life can be a great privilege. This ordeal may have shifted my focus towards a career in medicine. It will always remain as the best decision of my life. I am much better off now without my tonsils. As a medical student in Colombo in the 1960’s I have visited the old Childrens’ Ward at the GHC. It was now a General Surgical Ward . I looked through every window to recreate a bit of the old magic but alas nothing ever remains the same. Looking through the fog of time I have wondered what became of my fellow patients and the nurses who created a home away from home. The sickly scent of penicillin in the injection room did haunt me for many years later. But the memory of the kindness and affection of the staff will remain with me until the end of my days. My thanks to Dr.MVP posthumously and to all his team for a job well done. Thankfully my fever never returned.
Destiny was on my side. I survived !!!
(Blog Administrator's note: This article in original form was first published in the Sunday Island of 21 December 2003. It has since been updated by the author himself for publication in this blog)
Tuesday, August 13, 2013
We were on a brief visit to London in July/August on our way to do the Cosmos European tour that covered six countries. I had time to visit two members of our batch who were my schoolmates at Ananda. I met Suren Iyer after 43 years! The last time I met him was when I attended his homecoming in 1970. I also visited Sunil Abeysuriya at his West Hendon home. I have known Sunil since 1949 when we lived in the same neighbourhood in Manning Town. Much as I would have liked to, I simply didn't have time to meet any others. In fact, most of our friends in the UK would not have known about our visit to London.
Clicking glasses with Sunil. Looking on is my friend Lakhi Liyanage whom I have known as a classmate at Ananda.
With Suren and Swini in their backyard.