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Monday, November 30, 2015

Remembering Prof. Dayasiri Fernando

By Dr. Philip G. Veerasingham (Retired Consultant Surgeon, General Hospital, Colombo)


 I met Dayasiri for the first time at the Medical Faculty, Colombo. 

He had entered the Faculty from St.Thoma’s College, Mt. Lavinia. Remembering his school days he told me that he had played the part of Portia, in the all male school production of, Shakespeare’s ‘Merchant of Venice’. He recalled how G. L. Pieris was the ‘prompter’, waiting behind the curtain to help out the young actors, if they ‘missed a line’. G.L. Pieris became a Professor in the Law Faculty and later took up to politics.

He also recalled a night, the year before he entered Medical College when he was about to go to sleep in his bed-room. He overheard his parents discussing about any financial constraints they might have, to support Dayasiri through his years as a Medical student. They had concluded that somehow they would make it. Dayasiri told me, that this made him work hard throughout his medical career. He did his Surgical Internship with Prof. Nawaratne and became a close friend of him.

He was boarded as a medical student, with the famous Obstetrician Dr.Prince Rajaratnam. He related how Prince had told him that one must live a life, where even the undertaker would feel sorry for one’s death. This came true for Prince. After the funeral of Prince Rajaratnam, his wife got a note from Raymonds the undertakers, that there was no bill to be settled as that was the least that they could do, for this wonderful doctor.

In 1972 I met Dayasiri in Sheffield. He was working with a famous Gastro-enterologist then. He told me that at the interview where he was selected, he had produced the letter of reference from Prof Nawaratne. ‘Nawa’ was then in the editorial board of the magazine of the British Surgical Society. Prof. Hughes (if my memory is correct) had told him why he did not send Prof. Nawaratne’s letter with the application for the job. Then there would have been no need for the interview.

In 1974 he returned to Sri Lanka and was Resident Surgeon at Panadura. Subsequently he went on a scholarship to do Gastro-enterology as a speciality. He was appointed the Gastro-enterologist at Kalubowila Hospital, on his return to Sri Lanka. He resigned from his post in the Health Department and joined the Medical Faculty, Colombo, under Prof. Nawaratne.

When I was appointed Consultant Surgeon, GH, Colombo in 1991, we became colleagues and used to have operating sessions, in adjoining operating suites. I remember an incident relating to the medical students clerking with me. When examining patient’s abdomen, I would use as ‘control subject’ a medical student in the batch, doing the appointment at that time. The patient with an abdominal lump would be lying on the bed for the examination. On the adjacent bed I would make a medical student lie down and expose his abdomen. The students would examine both subjects and get a first-hand knowledge of pathological anatomy of the abdomen. Apart from occasional giggles there were no protests. I have a sneaky feeling that the boys who acted as ‘controls’ would have felt thrilled when the female colleagues, palpated their abdomen. One day a male student refused to act as a ‘control’. I told him ‘How can I teach you if you refuse to take part in this’ and sent him out. A few days later the Professor of Surgery met me in the Consultants Lounge and told me that the student was wearing torn underwear (‘banian’) and that was the reason, he refused to expose his abdomen. I told the Professor that now I understood his predicament and took him back. A few years later I heard that this student had gone to see Dayasiri. Dayasiri had listened to him and told him to go with this cooked up story to the Professor. I had a hearty laugh on hearing this. Dayasiri was very close to the Medical students who would take their troubles to him.

Dayasiri was the family surgeon for Madame Sirimavo Bandaranaike. He moved in the highest political circles of Sri Lanka.

He became Dean of the Sri Jayawardenapura Medical Faculty. His last post was as President of the Public Service Commision.

He often quoted a poem we learned at school which goes as follows:-
‘Lives of great men all remind us,
We can make our lives sublime,
And departing leave behind us,
FOOT PRINTS IN,
THE SANDS OF TIME.

He was a practicing Christian and understood the impermanence of things.


I salute him and his life
.

Sunday, November 29, 2015

Creative Spot - A poem by Mahendra (Speedy) Gonsalkorale

Oceanic balm


She was cocooned in a glass cage of emotion, 
Shattered by the shrill sounds of inner commotion
Yearned for soothing with alcohol consumption,
But wisely didn't succumb to strong compulsion
Turns to calming influence of waves of the ocean
She drifts to sleep content with what she'd chosen

Saturday, November 28, 2015

Teaching

 By Nihal D Amerasekera
“The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.”
― William Arthur Ward
We were medical students in the Golden era of medical education in Sri Lanka. Our teachers educated and inspired us to become who we are today.

Teaching is one of the most rewarding aspects of professional life. It began in 1979 when I was appointed Senior Registrar to the University College Hospital in London rotating to the Childrens’ hospital  in Great Ormand Street and the National hospital at Queens Square. I must confess lecturing to medical students was initially a shock to my system until I acquired the skills for public speaking. Then on it became a most satisfying experience to which I look back with great pride.

As a Consultant Radiologist in a District General Hospital where medical students came on rotation from Cambridge and the Royal Free hospital in London the teaching was less structured and to a smaller group at a time. Teaching registrars in Radiology and coaching them for the fellowship was a most fulfilling commitment.

As we all know teaching is an art and a science. Some are born with it and other acquire it in the fullness of time. Sadly there are a few who just cannot teach and end up in important teaching positions in university, bungling their way to retirement. The ability to teach has no direct relationship to the ability to pass examinations. Nowadays after a lecture the students are encouraged to fill up a questionnaire about the performance of the lecturer and such feedback helps to eliminate “incompetence”. Help is at hand to learn the teaching skills in a Diploma Course in Education which can be done part time in 12 months. This is now an important requirement for all full time lecturers in Universities in the UK.

It is a wonderful experience to meet medical students and registrars whom I have taught, many years later at conferences and medical meetings. Fortunately I don’t recall any “Rajasuriya” moments.

Although I enjoyed teaching I was not prepared to give up my clinical commitment to embark on teaching fulltime.  Teaching patients is now a team effort. The Clinical Meetings are attended by all relevant disciplines when the diagnosis and treatment is discussed. This is far removed from the scene in the old days when the consultant clinician was the king of all he surveyed and did what he pleased. The downside of the new system is the lack of a clinical lead who is responsible for the patient from admission to discharge. But the benefits of the new method outweigh the drawbacks.

I admire enormously the decision  Sanath and Chandrasiri have taken to remain in Sri Lanka to teach medical students who will take care of the health of the people of our motherland. We applaud their commitment to medical education. 





Friday, November 27, 2015

Teaching Medical Students (continued)

Some of you may have read this already because Speedy wrote this as a comment on Sanath's  recent post under the subject "Teaching Medical Students". As I have repeatedly pointed out before, it's the comments that make a blog post more interesting.

Rather than allowing Speedy's lengthy comment to languish only as a comment, I have taken into consideration its real worth and reintroduced it as a separate post. It is done with the fervent hope that this reintroduction will generate more comments on Sanath's original post. Viewers are free to decide under which post they should comment. But let's not forget that it was Sanath who introduced the subject in the first place.

What Speedy wrote:

Lama's post deserves attention from all of us who have had the pleasure of imparting our knowledge to others. My experience has been mainly in the UK although I did teach Medical Students in SL when I was a Demonstrator in Pharmacology in 1972-3 and again both students and doctors as Neurologist in Kandy in 1978-79. My teaching audience in the UK was very wide including Medical Students, Doctors, Social workers, Nurses, Physiotherapists, Occupational therapists and most importantly, patients and carers. Each Group posed a different challenge and for me the biggest challenge was to speak to patients, carers and social workers and others with no medical background. My objective was quite simple- at the end of my talk, I wanted to be sure that my audience grasped the messages I was trying to impart and left the lecture/tall.demonstration feeling happy and enthused by what they heard. I preferred more interactive sessions as I felt it gave the opportunity for them to question me and clear their doubts. I had a few broad principles when I did these. Firstly, I didn't hide under an aura of authority. I was always friendly and pleasant ( I hope!) and never hesitated to admit that I didn't know the answer.Secondly, I never ridiculed or admonished a student who was brave enough to ask me a question, even if it was deemed "silly" by some. Thirdly, I always summarised the main points of what I was trying to impart at the end and lastly, I NEVER read from a sheet in front of me or read the PowerPoint presentation to my audience. If it was a lecture with audio-visual facilities, I would always check them out before, have a back up and spoke to the audience, not looking back at the screen. I made sure the microphone was working and tested that my voice was heard at the back of the Lecture hall. Over the years, I also learnt to speak more clearly and slowly (speaking too fast is an Asian habit and also a sign that you have not got the content right to fit the time available, trying to rush through to complete on time and forgetting that the process (talk) is good only if the outcome (imparting the messages) was achieved. I always prepared thoroughly before a presentation and how nervous I was (and I was!) depended on how well I prepared and knew the subject myself. Most of these points were an attempt on my part not to be like some of the bad teachers I had both at Royal and at Medical Faculty and to be like some of he good ones . For medical students and doctors, I tried to impart two things. Firstly the fascination of solving a problem and secondly, the need to be kind, understanding and ethical to your patients. I am happy to say (shedding modesty as Lucky advised us) that at Manchester, I was consistently rated to be among the highest Medical Teachers. I still do a bit of teaching as I love it and also because I consider it the duty of every doctor to educate.

I have touched on this before but I did my best to enthuse Medical Students and Doctors in the fascinating art of collecting evidence (History and examination) , diagnosis (collating all the evidence- both clinical and through investigations) and then the thrill of getting it right and helping the patient. This is sadly becoming a fading art, thanks to blind investigations, parrot like protocols, defensive medicine and the lure of personal and financial gain. I would like to add that I consider Dr Wickrema Wijenaike, Prof NDW Lionel and Dr Viswanthan as some of the best Teachers I ever had. My gratitude for them will always remain with me.

Teaching Medical Students

I have received the following e-mail from Sanath. Please read it and offer comments.

While thanking all of you who have been active contributors, I wish to remind all viewers that what makes a post even more interesting is the series of comments that follows. You would have noticed that some posts have generated as much as 22 comments. It is heartening to note that at least a few are making good use of our batch blog. Keep up the good work!

Please don't forget that I do need to record here, achievements of our batch members. I have brought this up before and I do it again. Please shed your sense of modesty and do share with others what you have achieved. In fact, the "Creative Spot" feature was first conceived by Speedy and what a success it has turned out to be.

Cheers!

Lucky

PS: I have deleted Sanath's mailing list in keeping with my policy of not exposing e-mail addresses.

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

Professor Sanath P. Lamabadusuriya

10:10 (4 hours ago)
Dear Friends,

As some of you all may be aware ,I have been teaching medical students from 1st April 1969. I have taught thousands of students in three medical faculties in Sri Lanka (Colombo,Ruhuna and Rajarata) and in England and  Saudi Arabia when on sabbatical leave. All this time I have been teaching final year students.From early April I was teaching final year students at Rajarata. About 3 weeks ago I started teaching 3rd year medical students at Rajarata ..Some of these students are having their first clinical appointment. It is an entirely new experience!

The thrill of getting them to listen to a heart murmur, palpate an enlarged spleen or liver for the first time is an experience by itself indeed.

Kind regards,

Sanath


Wednesday, November 25, 2015

"Two Wheelers" of the Batch

By Lakshman Abeyagunawardene

When I read Speedy's comment under a different topic/post, I was inclined to write a separate piece on the "Two Wheelers" of the batch, may be because I was one of them.

I used a blue and white Honda 50 cc (registration Number 4 Sri 3856). During that period, I had only one accident which was not of a serious nature. On the day the Second MB exam results were announced, quite a few of the males in the batch assembled at the Mayfair restaurant at Bambalapitiya junction for a small celebration. I remember arriving there rather early and when we stopped at the traffic lights at Bambalapitiya Junction, a van belonging to EAP Edirisinghe's company knocked my bike from behind. I had my friend Sunna (SR De Silva) on my pillion and although nothing happened to me, Sunna was thrown over my head and landed in front. Miraculously, Sunna was not hurt except for some bruises and I was relieved to see him getting on to his feet soon after the accident. After using the Honda 50 for 5 years, I sold it to the late Kunasingham (Kunam) who unfortunately fell back and remained in med school (probably for one more year) after we graduated. I remember very well the day I closed the deal. Kunam was at Kittyakara Hostel on Campbell Place. When I went there by prior appointment, his father had come all the way from Jaffna (or wherever) with the cash for the transaction! The agreed amount was Rs 1450, not much by today's standards, but certainly a fair amount in 1967.

A few others owned Honda 50s as we used to call them. JC Fernando and Vishweshwara too had blue and white models like mine. Easwaran Kanapathipillai rode a red and white model and so did my bosom pal the late SR de Silva (Sunna) who came to own one a little later.

There were many who owned the more powerful Vespa and Lambretta scooters. Those who owned the newer Vespa models (the handle in particular was different) were: Sanath Lamabadusuriya (I think it had registration number 4 Sri 955), Mahendra Collure and the late LGDK Herath. Douglas Mulgirigama owned an older model Vespa. Rajan (Patas) Ratnesar was the other who used an older model of Vespa. 

Now for some digression as usual. I later found out that the bike used by Douglas Mulgirigama had been owned by my next door neighbour at Manning Town the late Dr. Bala Karalapillai when he was a medical student. In his university days, Bala was a member of the champion tennis team led by Rupert Ferdinands. Bala had graduated from the Colombo Medical Faculty in 1959 and qualified as an ENT Surgeon. After emigrating to Australia, he had married the famous Mathematics Professor C.J. Eliezer's daughter. Prof. Eliezer did some special work and became well known when a total solar eclipse occurred on June 30, 1954 which was clearly visible in Ceylon. Bala had passed away at an early age in Australia.

Getting back to our main topic, HN Wickramasinghe and Jimmy Wickramasinghe used Lambrettas. 
VA (Ananda) Hettiarachchi rode a powerful BSA motor cycle (or was it a Triumph?) during our Block days before he graduated to own an Opel Kapitan car later (registration number 4 Sri 210). Among the others who owned BSA motor cycles were Bertram Nanayakkara and A. Sachithananda.
Only a few us would remember Tilak Dayaratne riding an ?NSU motor bike (I am not too sure whether it was a Ducati). Then there were the riders of more fashionable newer motor cycles like the gleaming red Motor Guzzis owned by Nalin Nanayakkara and Ranjith Kariyawasam. Even with fading memories most of us would remember that KDPR Perera (Ranjith Dambawinne) too used a Motor Guzzi before he came to own the white Volkswagen Beetle. 
  
Chaos at Reid Avenue
Four of the bikes - JC's Honda 50, Bertie Nana's BSA, HN's Lambretta and Rajan's (Patas) Vespa would go down in history because of a photograph that appeared in the Sunday Times newspaper soon after that infamous Law - Medical match of March 1963 (pictured here).

As two wheelers, we were constantly exposed to the elements. Come sun or rain, it was better than wasting time standing in bus queues. We always carried a rain coat, but didn't have to wear cumbersome helmets. None of us who used this mode of transport met with any serious accidents and I survived to tell this tale!

Monday, November 23, 2015

Sri Lanka Medical Council on SAITM Private Medical School

Under a different post on medical ethics authored by ND, he himself has made the following comment. Rather than replying ND's query, I have reproduced below a news item that appeared in last weekend's Sunday Times which is self explanatory.

ND's comment

Lucky
What are the reasons for the SLMC refusal to recognise the degree? There must be some valid grounds for refusal. Once those issues are sorted SAITM will be recognised. Are the reasons for refusal so serious that they cannot be put right?
ND
ReplyDelete


News item referred to:

Don’t recognise SAITM degree – SLMC

Says clinical facilities at private hospital insufficient
View(s):

The Sri Lanka Medical Council (SLMC) has urged the Health Ministry not to recognise medical degrees awarded by the South Asian Institute of Technology & Medicine (SAITM), facing accusations of a faulty approval process, saying the private medical faculty has insufficient clinical facilities.

The council in a September 4, 2015 letter to Health Minister Dr. Rajitha Senaratne, said a report by its Inspection Team concluded that clinical facilities, an essential requirement for potential doctors, are unsatisfactory at the Malabe medical faculty and thus the degrees should not be recognised. This is the very first time that the SLMC has visited the Malabe medical faculty.

“Based on the evaluation, the consensus of the council is that the number of cases students are exposed to is far from satisfactory and that the case numbers must go up by at least five times and should comprise a ‘mix of patients’ representative of all the major problems commonly encountered in practice,” said the letter and report to the Minister. It added: “The SLMC evaluated the findings of the Inspection Team and recommends to the Minister of Heath that the degree awarded by SAITM should not be recognised for the purpose of registration under the Medical Ordinance.”

In the SLMC’s first-ever inspection of the facility, the team reported that the lack of clinical facilities was being compensated by: (a) use of clinical skills lab; (b) use of role play and simulated cases; and (c) clinical rotations in other private hospitals – students being assigned to identified consultants in other private hospitals, among others. “However, none of these methods can compensate for insufficient patient turnover,” it said.

The recommendation once again blocks SAITM’s efforts to formalise its teaching and clinical programme in line with local regulatory rules. Clinical training, where medical undergraduates get real-life experiences in all forms of patient care and operations, is a pre-requisite for medical practice in State hospitals. The SLMC, by law, is the regulatory authority on medical education in Sri Lanka.

Ever since SAITM secured Board of Investment approval first as a technical college and later added a medical faculty, it has encountered problems with the authorities and the SLMC which has faulted the institute for not following a proper registration process.

A recognised one-year’s internship, after obtaining a recognised medical degree, is mandatory to register with the SLMC as a doctor. The desk-evaluation of SAITM by the SLMC was handled by a team of three professors representing pre-clinical, para-clinical and clinical disciplines and the 10-member SLMC Inspection Team comprising academics as well as clinicians visited SAITM and its Neville Fernando Teaching Hospital (NFTH) on July 13-15, 2015, at the request of SAITM Chairman Dr. Neville Fernando.

The report said the NFTH has 850 beds, of which only 200 have been commissioned, another reason why there is inadequate clinical training for students. “According to information supplied by SAITM, since admissions in 2009, the first seven batches (363 students) are undergoing clinical training in the NFTH wards. Clearly so many students having access to so few patients cannot be expected to receive adequate clinical training. This is in startling contrast to what obtains in the State medical faculties where there is a large number and variety of patients in our hospitals for students to learn the techniques of medical diagnosis and treatment,” it said.

The main deficiencies observed by the SLMC Inspection Team were — general inadequacy of clinical exposure in all areas in terms of numbers and case mix, which were of grave concern. In particular, exposure to trauma in surgery, common surgical emergencies and obstetrics and gynaecology, as well as exposure to emergencies in adult medicine and paediatric care is lacking. The faculty is making an attempt to overcome these deficiencies but it is still insufficient at present, the report said.

It added that there “is a lack of facilities for training in practical clinical Forensic Medicine e.g. to examine and report on clinical medico-legal post-mortem examinations,” in addition to a deficiency in exposure to preventive care services in the State sector e.g. MOH (Medical Officer of Health) office activities and field services.

While physical facilities including lecture halls seem adequate, the Inspection Team report to the SLMC said that the number of non-academic staff was “surprisingly few”. “The Anatomy Department and the Biochemistry Department have a few technical officers and lab assistants but in all other departments all technical and clerical functions appear to be carried out by junior academic staff. This is not satisfactory and needs improvement,” the report said. The student-staff ratio was 7.7:1 (856 students and 110 full-time academic staff). “However, one must acknowledge and appreciate some of the rather innovative and novel teaching utilities that have been encompassed into the paediatrics training programme that tries to mitigate the shortcomings that have been present as a result of the low patient numbers,” the report said.

It said internship is not addressed in the SAITM MBBS programme and recommended that a one-year internship programme needs to be negotiated with the Ministry of Health as per order or merit status. The NFTH, it said, has no intern house officers.

Doctors’ ethics and “industrial action”

By Nihal D. Amerasekera

Hippocrates is often called the father of modern medicine. He wanted the medical practitioners to maintain ethical standards. He wrote down the ethical guidelines between the 5th and 3rd Century BC.  Although the world has changed much since the days of Hippocrates his oath has remained a beacon for doctors until the present day.

The earliest reference to certification of doctors in England goes back to 1411 but the body called the General Medical Council was born in 1858. The General Medical Council (GMC) regulates British doctors through the Medical Act. The Council comprises doctors and lay people. It registers doctors for UK practice, sets professional standards, regulates basic medical education, and manages doctors' fitness to practice.

We have the medical trade unions like the British Medical Association and the GMOA who represent the doctors when there is a conflict between the profession and the government.

Mostly, conflicts between doctors and the government arise due to pay or conditions of service or both.

The provision of healthcare in a country like the UK is a joint venture between the Government, hospital, doctor and the patient. So the responsibility for healthcare has multiple limbs. If the relations between any of the partners in this contract breaks down, the patient suffers. If the government fails to meet its contract with the doctor then it makes strike action more ethically justifiable. Society must be willing to support the doctors by paying them a proper wage. Here we assume the doctors are reasonable in their demands. As the Journal of Medical Ethics points out  “Little harm can accrue from shattering a somewhat antiquated myth of sainthood and injecting a good dose of realism”

On the other hand doctors have a duty of care to their patients. If a patient dies as a direct consequence of strike action is it morally justified? Does that amount to medical negligence when the GMC can take appropriate action? Should the striking doctors make contingency plans for medical emergencies or is that the responsibility of the hospital and the government?

If the doctors strike purely to improve patient care in their refusal to put patients lives at risk. Does it make strike action justifiable?

The doctors too have lives to lead with professional and family commitments. They have bills to pay and have a right to a decent wage and a reasonable quality of life. Their long years of study and onerous routines must be adequately remunerated.

Provision of free healthcare is an enormous burden to any government. In their attempts to economise the government will inevitably try to slash healthcare costs and doctors pay will not be exempt from the cuts. This will result in conflict and recurrent disputes.

As you see there are more questions than answers. I would ask for your opinion on this ethical dilemma that would be a recurrent problem to the medical profession worldwide.


Should doctors go on strike?

Saturday, November 21, 2015

Creative Spot - By Mahendra (Speedy) Gonsalkorale

Sanasen Nalawenna Sudo

Originally sung by Athula Adhikari, this is one of my all time favourites. In this version by Speedy, he has done a wonderful job. I am sure all of you out there will enjoy.

Lucky





Friday, November 20, 2015

SLMA Foundation Sessions 2015 - EM Wjerama Endowment Oration by Dr. Sunil Seneviratne Epa

I am pleased to publish the 2015 EM Wijerama Endowment Oration which was delivered by Dr. Sunil Seneviratne Epa at the recently held Foundation Sessions of the Sri Lanka Medical Association (SLMA) in Anuradhapura. This posting is mainly for the benefit of members of our batch who are based overseas.

Dr. Sunil Seneviratne Epa is a Consultant Physician who owns the Matara Nursing Home which is a leading private hospital in Matara in Southern Sri Lanka. Most of you may not know him as he had been a few years junior to us in the Colombo Medical Faculty. He had however served the Colombo Medical Faculty as a Lecturer before he set up his own practice in Matara. Dr. Seneviratne Epa has a special interest in this subject. He believes in the Medico Spiritual Health model which has now been accepted by the Ministry of Health in Sri Lanka. This means that doctors would now accept that religious activities such as pirith chanting will have an effect on healing. Hospitals would now recognise the spiritual needs of the patients and provide appropriate facilities. Dr. Seneviratne Epa is a Past President of the SLMA.

I have "cut and pasted" the full oration from the Sunday Times of 15 November 2015.

Sunday Times 2

Emotional and spiritual intelligence and its relevance to medicine

By Dr. Sunil Seneviratne Epa


People with spiritual intelligence are calm, peaceful and compassionate. Such people have less stress and conflict both at work and at home. They have better health and better output of work at work places
Albert Einstein said, “The intuitive mind is a sacred gift, and rational mind a faithful servant. We have created a society that honours the servant, and forgotten the gift”. My speech today is on this intuitive mind. Purpose of my lecture is to show you the vast potential of this intuitive mind and how best we can put it to good use. Emotional and Spiritual Intelligence is a function of this intuitive mind. Some people refer to this intuitive mind, as subconscious mind. According to some classifications, as much as 88 percent of our mind is subconscious. What is Intelligence? A simple way to understand this abstract term is to think of it as an ability to apply skills. We now have a definition of Intelligence which is as follows.
“Intelligence is the ability to apply appropriate skills at right time for right purpose.” We have four types of intelligence: Physical, cognitive, emotional and spiritual. If we are to place them in a pyramid, Physical intelligence is at the bottom and is the most basic level. Next is the Cognitive and above that is Emotional, and Spiritual intelligence is at the peak and is the highest form.
Traditionally, the Cognitive intelligence or Intelligence Quotient (IQ) is what we have been referring to as intelligence, at least up to few decades ago. However, this trend is now fast changing. Over the years, we have realised that after reaching a certain level of IQ, there is no direct correlation between IQ level and the actual achievements or success in life. The concept of Emotional intelligence or EQ emerged as an explanation to this observation. Emotional Intelligence basically means how skilled you are, in handling emotions, your own or other peoples’ emotions. EQ is defined as follows.

Dr. Sunil Seneviratne Epa
“Ability to make healthy choices based on the ability to recognise, understand and manage your own feelings and feelings of the others”. Daniel Goleman described EQ as a combination of four different skills under two groups. a) Ability to recognise your own emotions (Recognition) and control them (Impulse control). b) Ability to recognise other peoples’ emotions (Empathy) and ability to manage them (soft skills or social skills). One may be good at one skill but may be poor in another. So, if we are to improve our EQ we need to know in which respect we are weaker. EQ can be enhanced by training and as a result it is now a big industry in the US. Studies have shown EQ level is directly related to success in business. Being a good doctor too means having good EQ. Empathy or the ability to understand another person’s emotions is a valued trait for success in medical profession too. We are dealing with a special category of people with emotional needs. Leadership training essentially means developing good EQ. You may have heard of gut feeling. This is the feeling based on perception rather than on rational thinking. This is a function of EQ. A surgeon may use his gut feeling whether to operate or not, on a bad patient.
Conventional thinking has been, that emotions are produced by what are called emotional peptides in the brain. So it was a chemistry that we talked of. There is, however, now newer evidence that these peptides, once get attached to the cells, cause a vibration in the cell membranes, producing energy waves with different frequencies. So we are now talking of physics of emotions, producing measurable energy waves with different frequencies. This brings us to a totally new topic — Cell vibrations. In fact the body is a bundle of energy in constant vibration producing measurable energy frequencies. Nikola Tesla, who is considered to be the father of electromagnetic engineering, said: “Everything is vibration and everything is energy”. Different emotions have different vibration frequencies ranging from 20 to 700 plus Hertz. Negative emotions such as fear and anger have lower frequencies while positive emotions such as peace and joy have the highest frequency.
Empathy is the ability to perceive another person’s emotions. The secret of empathy may lie in the energy waves of emotions. So it looks, we now have a scientific basis for explaining empathy – the ability to perceive another person’s emotions. How strange? You may have heard of people who can read other peoples’ minds. This may be the secret of that, too. These emotional vibrations producing energy waves may explain the mechanism of transfer of merit or blessings on to another person by us performing spiritual activities. This is totally a new dimension connecting spirituality with science. Isn’t that strange again?
Spiritual Intelligence (SQ) is a kind of extension of EQ and is the highest form of human intelligence. We have a definition of Spiritual Intelligence too. “It is the ability or the skill to behave with compassion and wisdom while maintaining inner and outer peace regardless of circumstances”.
When people were asked to name a person with these qualities utmost, majority of them thought of their respective religious leaders. I think this is how, the term “spiritual” came to be coined with this highest form of intelligence. This inner peace component is what distinguishes SQ from EQ. In EQ we are not talking so much about inner peace. A sales man with high EQ may recognise an angry customer and may respond appropriately to calm him down and may succeed in maintaining outer peace. But he may not feel inner peace in himself during this process.
As one progresses from EQ to SQ , the person becomes skilled in maintaining inner peace too. How do you recognise people with high SQ? Essentially, they are calm, peaceful, compassionate people. Such people have less stress and conflict both at work and at home. They have better health and better output of work at work places. SQ too can be enhanced by way of training.
We can learn compassion by following the teachings of our religious leaders. Wisdom is a state of heightened inner awareness or tranquility of mind. It is something you need to develop and acquire on your own. Meditation is one way of doing that. There is now enough scientific evidence to suggest that meditation calms down the conscious brain and reduces ego. It is the ego that makes us lose our inner peace in conflict situations. Functional MRI Scan of brain during meditation has shown that activity of the conscious brain and of the limbic system is reduced during meditation. Wisdom dawns as ego becomes thinner.
The ultimate aim of any human being should be to reach the peak of intelligence pyramid or to acquire SQ before death. How do we do that? All we need to do is to change the way we think of our own minds. Let me conclude by repeating what Einstein said,
“The intuitive mind is a sacred gift and rational mind a faithful servant. We have created a society that honours the servant and forgotten the gift”.
I leave you pondering how apt it is, what Einstein said over 100 years ago, in our present context today.


Thursday, November 19, 2015

SLMANA (Eastern Region) Dinner Dance

SLMANA (Eastern Region) had held their Dinner Dance recently in NYC. I have received these pictures from Srianee (Bunter) Fernando Dias. Thank you Srianee for sharing the photos.





Sunday, November 15, 2015

Friday, November 13, 2015

A.R.K. (Russel) Paul - An Appreciation

By Sanath P. Lamabadusuriya

Russel was the eldest in a family of four boys and two or three girls Their father was Professor R.H. Paul who was the Professor of Electrical Engineering in the University of Peradeniya and he became the Dean later. Russel entered Royal College (RC) in 1952 and was senior to me by two years, but later I caught him up and we entered the University together. His younger brother Hillary, was a good athlete at RC and he excelled in the long jump and triple jump. I think he captained the athletics team and he was one year senior to me, but I caught him up later. Unfortunately Hillary died of a malignancy prematurely. Keith was one or two years junior to me and was an excellent ruggerite and he captained the RC rugby team. Beverly the youngest of the boys, played cricket for RC

Russel excelled in the Freshers Athletics Meet when he entered the University of Colombo in 1961, by winning four events. He was an excellent student and he came second in the order of merit at the Final MBBS examination in March 1967 ( I topped the batch). I really came to know him during the internship at GHC, where we  worked together as Interns in the Professorial Medical Unit with Prof. K Rajasuriya, Dr, Oliver Peiris and Dr. David Chanmugam. We shared a room in the Main Quarters for one whole year. During our free time we played poker together with others such as Neil Fonseka, "Sodium" Karunaratna, Marius Cooray, C. Balakrishnan (who opened batting for the Ceylon Cricket Team), Michael Satchithanandan, Ajith de Silva, Sathanandan et al. He continued his internship with Dr, L.D.C. Austin at the GHC.

Later both of us went to Chest Hospital Welisara for the post-internship appointments. On 1st April 1969 I joined the Faculty of Medicine, Colombo as a Lecturer in Paediatrics. Soon after, Russel returned to GHC as a Registrar in the Professorial Medical Unit with Prof. K. Rajasuriya. In 1970 both of us spent many hours in the nights studying for the MD examination. In December 1970 we sat for the MD examination. Russel passed and I failed (the exam was only in adult medicine and there was no paediatric component). In 1971 both of us sat for the MRCP Part 1 examInation which was conducted for the first time in Sri Lanka. Both of us passed. The next morning, I managed to recollect the whole paper consisting of 60 True/False type MCQ's , five responses in each (total of 300 questions).  As there was no question bank at that time, this document turned out to be extremely valuable for future candidates. The billiards marker in the students Common Room in the Colombo Medical Faculty, cyclostyled this document, sold it and made a fortune!

Russel was romantically involved with one of our batch mates, Dawne de Silva whom he later married. In 1971, Russsel and Dawne decided to emigrate to the US. When I asked him why he was doing so, he told me that his father was a University Academic all his life and after retirement, was living in a rented flat at Duplication Road (R. A. de Mel Mawatha). Therefore, he did not want to end up like his father.  Dawne was quite affluent but Russel did not want to live off her. That was typical of Russel.

They had two children - a daughter and a son.. Unfortunately, the daughter was brain-damaged at birth and became mentally handicapped and hyperactive. Whenever they came on holiday to Sri Lanka, we used to meet up and socialise. As one of his children was an asthmatic, he used to bring all the necessary drugs, scalp vein needles and syringes which he used to leave behind for my use at Karapitiya.

In the  1970's or early 1980's one of Russel's sisters was abducted near the Eye Hospital Junction and was raped. A notorious criminal Gonawela Sunil, was convicted for the crime and sent to prison . Later, he was released on a presidential pardon given by J.R.Jayewardene. After he was released, he was gunned down by the JVP.
Russel became a specialist in Gastroenterological Oncology and settled down in Philadelphia later. I visited the US with my family in 1988 and was planning to visit Russel and his family. But I had to change my plans and we did not travel to Philadelphia. I last spoke to Russel from Indra Anandasabapathy's home in Staten Island, New York. Russel told me about the problems he was going through. Dawne had developed Ankylosing Spondylitis and was bed ridden latterly. Their daughter was a teenager by then, but was fed and washed by Russel as she was handicapped. Russel had avoided socialising with friends gradually because it was difficult for him  to manage his daughter, So, gradually Russel became isolated.

In 1990 or 1991, when I was working at the Ruhuna Medical Faculty, I was shocked to read about the murder/suicide of Russel's family in the front page of the "Daily News". Russel had apparently injected some drug IV to his family members and committed suicide by injecting himself. I am sure that it was a joint decision taken by Russel together with Dawne.The coroner did not disclose details of the drug used as others may have followed.
Knowing Russel, he would have calculated the individual doses to a decimal point, taking the body weights into account. I think it came to a breaking point when he could not manage his family by himself. I am sure  this tragic event would not have happened if Russel and his family lived in Sri Lanka because of the extended family support found here.

Thus ended the life of a wonderful human being and a close friend.

Thursday, November 12, 2015

Untold Stories

This was posted as a comment by Sanath Lamabadusuriya under the Appreciation on Prof. Rajasuriya written some time ago by ND (Nihal) Amerasekera. I decided to publish it as a separate post because of two reasons. Firstly, it is quite some time now since ND's Appreciation on KR was posted and it is unlikely that the majority of viewers would go back to read comments under old posts. Secondly and more importantly, it is much more than a mere comment and in my opinion, an interesting story yet unheard by many. I for one, had not heard it before. So, I have posted it as an "Untold Story" on this blog.

Sanath writes....

I did my internship in the Medical Professorial Unit at the General Hospital, Colombo (GHC) from May to November 1967. My co-house officer was Russel Paul, who was my room mate as well, at the Main Quarters for one whole year. In the post internship year, Russel and I were together again at Chest Hospital, Welisara. I joined the University as a Lecturer in Paediatrics on 1st April 1969 and Russel came back to GHC as a Registrar in the Professorial Medical Unit. We used to do joint studies until he emigrated to the US some time later. As you can appreciate, we were indeed very close to each other.

Dr Oliver Peiris was a Senior Lecturer in the Prof unit and David Chanmugam was in the female ward. The Registrars were, H.B. Karunaratne,  P.H. Billimoria and Soma de Silva. Mr. L.H. Mettananda (former Principal of Ananda College) was a patient during this time and he was terminally ill with cirrhosis of the liver. One day, KR. asked me who was on call for the next weekend and when I replied that I was on call, KR was happy. It was probably because Russel was a Catholic and I was a Buddhist. He told me that if Mettananda dies, not to mention cirrhosis of the liver as the cause of death in the death certificate. So I mentioned "Liver Failure" as the cause of death.

Towards the end of the internship, KR called me to a side and showed me a letter. He said that PH  Billimoria had applied for a Commonwealth Scholarship and had requested for a reference. He had mentioned in the reference "PHB came to work with me on such and such a date as a Reader and he worked with me until such and such a date". I told KR that it was  grossly unfair by PHB because he was the hardest working registrar out of the three. Nevertheless, PHB proceeded to UK to be trained in Neurology. He returned about 2 years later after over staying for about a week. When he reported for work at the Ministry of Health, the Director of Health Services happened to be KR.  PHB was served with a vacation of post notice. Although PHB protested, it was not withdrawn and PHB continued his journey "Down Under" where he is still domiciled. Dr George Ratnavale  retired or resigned soon after and J.B. Peiris who returned at about that time was appointed as Neurologist GHC.

My second half of the internship was with Dr. P. R. Anthonis, Senior Surgeon, GHC. Both KR and PRA were excellent clinicians and what I learned from  both of them during my internship, helped me to mould my future.
I returned to Sri Lanka after post graduate study leave on the 1st of January 1975 and reported for work on the 2nd of January. When I visited the Colombo Medical Faculty, I was happy to see KR's silver coloured Borgwaard Issabella car parked in the quadrangle at the  usual place close to the canteen. I proceeded upstairs and met the Dean, Prof  S, R. Kottegoda and when I told him that I was going to meet KR, he told me that KR had collapsed that morning in the MD examination hall, and had been admitted to GHC. KR died the same day  and I regretted very much that I did not meet  him after being  away for 3  years. Later, I heard that KR was eager to see me when he had come to know that I was returning to the country because not many were returning home during those difficult days.

Wednesday, November 11, 2015

Exclusive with Prof. Nancy Olivieri & Prof. Sanath Lamabadusuriya

Sanath Lamabadusuriya was interviewed on MTV on Tuesday 10th November over a full half hour program on the subject of thallasaemia. This is not to be confused with the brief 3 minute interview on "Secret of Success" that was aired earlier.

The full interview can be viewed by clicking on the arrow.






Saturday, November 7, 2015

Indra and Speedy

Indra Anandasabapathy, Mahendra (Speedy) Gonsalkorale and Suren Iyer were in town recently. Mangala and I hosted a dinner at our Battaramulla home to meet and greet them. Suren could not make it but the others were there. JC (Sura is enjoying her second grand child in Australia), Sanath Lama and Pram joined us.

We were able to watch Sanath on TV when the program "Secret of Success" was aired on MTV that evening. See pictures below.