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Tuesday, February 13, 2018

ELEPHANT COMPLEX - Travels in Sri Lanka by John Gimlette – A Review.


By Srianee Fernando Dias

In January 2017, I had the privilege of hearing John Gimlette at the Galle Literary Festival speak about his book, which was published in 2016.  I made a mental note to read it, but it took another year before I got around to reading it.  It is a remarkable book and I recommend it, especially for those of us who are living outside Sri Lanka.  The subtitle is “Travels in Sri Lanka,” but it is not simply a tour guide.

The author practices law in London when he is not traveling and writing travel books, and has won many awards for his writing.  He contributes regularly to several publications, including The Times (London), The Guardian, Condè Nast Traveler, etc.

In his travels and explorations of the Island he interviews people from all walks of life; former presidents, ministers, Colombo socialites, army generals, navy commanders, soldiers, survivors of the war, former LTTE members, tuk-tuk drivers and many others.  His travels do not include stops in resorts or 5 star hotels.  He takes us through less traveled roads into remote villages and unusual places which really whetted my desire to see such places, but I think I will have to be satisfied with just reading about them. 

One such place that he describes, and one I had not heard about, is Ritigala “nestled high in the rocks,” which had been established by a community of ascetics in the seventh century.  They rejected earthly wealth and dressed only in clothes that others had thrown away or clothes salvaged from the dead.  They also rejected housing and lived in caves, connected by staircases.

Another fascinating section of the book is his attempt to find the “Great Road” which once connected Kandy to the lowlands.  It had been abandoned two centuries earlier, but had been documented by several explorers. John Gimlette undertook painstaking research to locate it, and worked backwards from Kandy to the lowlands.  His most helpful lead came from the travelogue of Dr. John Davy, brother of Sir Humphrey Davy, the inventor of the miner’s lamp.

The author writes with humor, warmth and affection about the people he meets, even when he makes certain negative observations about some of them!  He goes into depth describing some of the events of the war between the LTTE and the Sri Lankan government.  He does not pass judgment.  There may be some inaccuracies in his narrative, but I think they are forgivable, considering the extensive research that has gone into writing this book.

I found the historical accounts that have been interspersed throughout the book quite fascinating, because the historical events come alive.  I was one of those students who yawned (and probably even dozed off!) during the history class at Ladies’ College.  But, in my defense, one of the teachers simply had the students taking turns at reading the text out loud.  I don’t remember any interesting discussions.  I learned a lot of history simply by reading this book, but I also realized what a complicated and violent history we have lived through, in ancient times as well as in the recent past. 

I hope that some of the readers of this review will pick up the book and read it.  You will not regret it.  It is available in paper back on Amazon and can be ordered through  Vijitha Yapa Bookshop in Colombo.  (Each time they get a few they seem to sell out!)

Friday, February 9, 2018

An Ode to The Moon - A Video-poem by Mahendra (Speedy) Gonsalkorale

Based on the much-acclaimed poem posted by Rohini Anandaraja on 2nd February.


Castle Street Hospital - then and now - By Dr. Nalin Rodrigo

While waiting for someone to step in with a contribution so that I may publish another gem from Speedy which is in the pipeline (my policy is not to publish two from the same person successively), I thought most viewers would not have read what I am about to publish. However, I know for sure that all members of our batch would be interested in the subject. Those who have read it before, might want to re-read it. Please note that  Dr. Nalin Rodrigo passed away some years ago. I picked this up from a past issue (December 13, 2000) of The Island newspaper. If I am not mistaken, Dr. Rodrigo came to Castle Street Hospital 10 years after our graduation in 1967.

It was from this speech that I gathered that a relative of mine - Dr. (Mrs) Buddhimathi Kulatunga (nee Jayasundera) had delivered the very first baby at the CSHW when she was a Resident Obstetrician there. She too passed away some years ago when she was in her eighties. On a much more personal note, I must mention that my daughter Dilushi was born at this hospital under Dr. P. Dissanayake's care (father of Professors Manouri Senanayake - Paediatrics and Chandrika Wijeyeratne - OBGYN, the current President of the SLMA). I got my wife Mangala admitted to this state hospital on the advice of knowledgeable friends who warned me that some of the private nursing homes at that time lacked even basic facilities (and not heeding the vehement protests of the patient who was unaware of this fact and who had delivered our son Shehan at St. Michael's Nursing Home seven years before!)

Castle Street Hospital - then and now

Address delivered by Dr. Nalin Rodrigo, patron of the Sri Lanka College of Obstetricians and Gynaecologists and Medical Director of Asha Central Hospital, on the occasion of the 50th anniversary of the Castle Street Hospital recently.

"I must thank you for doing me the honour of inviting me to deliver this keynote address at this meeting to celebrate the 50th Anniversary of the Castle Street Hospital. I believe I have been invited because I was one of the first House Officers at this hospital after it was made a specialist manned hospital, in the year 1953 at the beginning of career, and because later I completed my career also at Castle Street as Consultant for 12 years from 1977 till my retirement in December 1988.

This hospital was started as a Maternity Home to take over the surplus patients from the De Soysa Hospital where in 1949 there were over 13,000 deliveries and where in 1948, there had been a major outbreak of puerperal spesis. The hospital was declared open by Mr. S. W. R. D. Bandaranaike, the then Minister of Health and Local Government on the 4th of December 1950, seen here in the company of Dr. W. G. Wickremasinghe the then DM & SS. The first patient was admitted in the 11th of December 1950, and the first baby was born in the new hospital a girl named Kamala Sarojini on the 13th of December. The doctor in attendance was Dr. (Miss) B. Jayasundera, later Mrs. Kulatunga. In 1951, Dr. S. D. Ratnapala was appointed as Senior Resident Obstetrician in charge of the hospital. He was a lecturer to the midwives and nurses and it is to his credit that he wrote an excellent book about pregnancy and labour in Sinhala and included Sinhalese terms for all the technical terms in obstetrics. His two sons SR and MK are both Obstetricians now.

Statistics for the first three years of Castle Street Hospital indicate that there were 23 deliveries in 1950, 1653 in 1951 and 4765 in 1952. The staff at the start of the hospital is shown here. The hospital in its earlier years had a number of House Officers who served for fairly short periods, apart from Dr. (Miss) Jayasundera, who later became a tutor to professor Attygalle, there was Dr. Dora Weerasiri (later Dr. Munasinghe), Dr. S. B. Talwatte, now the well known Radiologist, Dr. Blaze son of the then Deputy Director of Health Services. There was also the late Dr. Wijesinghe who later became the first Plastic Surgeon. I remember later at a union meeting somebody said that Dr. Wijesinghe had never worked outside Colombo and he (said) ‘why not I have worked at Castle Street Hospital'. The hospital was at that time somewhat remote and on the outskirts of Colombo. Castle Street however was very old and very well known road and one of the most distinguished persons who lived down this road was Sir Oliver Goonetilleke who of course is the grandfather of Dr. Mrs. Hiranthi Wijemanne of the UNICEF.

In 1952 Dr. F. Noel Spittel who was the Senior Obstetrician at Kandy was transferred as the Consultant Obstetrician in charge to the Castle Street Maternity Hospital as it was then called. Dr. Noel Spittel who may be termed the father figure of the Castle Street Hospital, he was a descendent of Jan Laurence Spittel came to Ceylon from Saxony in 1760. His father was Dr. Fedrick John Spittel, Provincial surgeon. He was the brother of the famous Dr. R. L. Spittel, who was the Senior Surgeon of the General Hospital but was even better known as an authority on the jungles and the Veddha community of Ceylon. Dr. Noel Spittel was not only a strict disciplinarian but he also had a wry sense of humour. I remember one day the husband of a patient wanting some favour told Dr. Spittel 'Sir, I know your brother'. 'Then you must be a Veddha' said Dr. Spittel and moved on. Another day a man was visiting his wife outside visiting hours when Dr. Spittel was doing his ward rounds. The man tried to explain and said that he was an engine driver and said that as he was running his train at the time of the hospital visiting hours he had to come and see his wife at this time. Dr. Spittel said "I say, man if I am operating at the time your train is starting would you hold up your train until I come'. Unfortunately the engine driver could not quite understand the point and I can still remember the sense of bewilderment on his face as Dr. Spittel left the ward. Dr. Spittel was a top class Obstetrician and worked alone. He was on call, day and night every day! I remember the only time he called for a 2nd opinion was when he once called his friend Sir Nicholas to advice on a complicated case. I remember that when Sir Nicholas saw me there he said "Ah hh....this beggar is also here" and laughed loud.

Dr. Spittel started his ward rounds at sharp 8 a.m. and all of us had to be assembled to follow him.
The ward round was a grand procession led by him, followed by the ROO, then the house officers, the matron and in every ward, the sister and all the nurses had to join the procession. When he left the ward on one side the end of the procession was entering the ward on the other side. He examined every single patient both in the anti-natal and post-natal wards as well as in the labour room. He moved from ward to ward along the bathroom corridors inspecting the condition of the bathrooms. All the time he conducted a stimulating and often hilarious conversation on various topics and telling us many stories about his past career and experiences.

At this time the hospital consisted of 6 wards, 3 ante-natal and 3 post-natal in addition to the OPD, the labour room and a pre-mature baby unit which was opened in January 1952 and work had also begun on 4 additional wards, 2 operating theatres and a labour room.

With the appointment of Dr. Noel Spittel, the hospital ceased to be a glorified Maternity Home and developed into a first class Maternity Hospital, clean, efficient and very well managed. It was at this stage with the arrival of Dr. Spittel, that two ladies and I were appointed House Officers to the hospital. Dr. Tefny Fernando who later married Mr. Denzil Fernando who became an MP and a Minister and Dr. Maimoon Lebbe were my colleagues. Dr. Lebbe who is now Mrs. Fernando was the first Muslim lady doctor who qualified in this country. In addition to the three of us, Dr. Ratnapala continued as Senior Resident Obstetrician and there was Dr. (Mrs.) Yvonne Herft who was the RO. Each of three of us, House Officers, had to look after one ante-natal and one post-natal ward. One day we were on duty from 8 O'clock in the morning to 8 O'clock in the night. The next day we worked from 8 to 5 and then came on for night duty at 8 p.m. and the following day after night we worked till 12.00 noon when we were half day off. It was very hard work, especially as the boss insisted that all episiotomies should be sutured soon after the delivery. In my case I was fortunate though a bachelor, to have one of the quarters which are now called the Married Quarters a twin house. Mrs. Herft and her family occupied the other half.

Dr. W. H. Fernando the eminent Gynaecologist who was himself RO at Castle in 1960 and 1961, tells me that he himself was delivered by Dr. Spittel. WH's father was DMO Pussellawa and Dr. Spittel drove down from Kandy at 10.00 p.m. and reaching Pussellawa 2.00 a.m. WH was born later in the morning on 1st July 1927. Dr. Spittel was presented with a gold sovereign, the ultimate present in those days!

The Matron in my time was Ms. F. M. de Silva, she like most of the senior staff was hand-picked by Dr. Spittel.

Everyone of the sisters was very efficient and were strictly supervised by the Matron. One of our nurses at that time was Miss C. M. Perera who later married Dr. Mylvaganam, and is now one of the Matrons at Asha Central Hospital where I work.

At that time there was a jam fruit tree which I had planted at the front of our quarters which has now been cut down to erect a boundary wall between the quarters. In the evenings I used to do my night rounds and after that I use to sit around and talk to the night staff. One day I remember telling a few ghost stories to the girls in the late hours of the night. Later when I was walking to my quarters I saw a ghost hanging from the lower branches of the jam fruit tree and it was slowly moving, more or less beckoning me. It was a frightening experience, I remember running back to the hospital and summoning some able-bodied labourers and finally we discovered that it was just a large distended plastic bag which was moving slowly in the wind in the moon light. This story went round all the house officers quarters and it took me a very long time to live this down. Matron Mylvaganam told me another story, that on several days at night the girls found an empty wheelchair moving rapidly down the dimly lit corridors. This created havoc among the nurses who thought that this was another ghost story. Later she tells me it was discovered that the only male House Officer, in the hospital at that time used to send this wheel chair careering down the corridor before he entered the labour room for a night call. Now that we are on the subject on this corridor I must relate another strange story which is not in the text and which took place many years later when I was a consultant. I was walking down the same corridor on to which some MOO rooms also open, followed by my retinue - Registrars SHOO and several HOO going to the clinic after the ward round. When I reached the clinic I noticed that two of my MOO were missing! The couple arrived in the clinic later. Looking a bit dishevelled to date, I don't know why.

As far as I was concerned, I managed quite well during these strenuous duty shifts because the Health Department Sports Club was just next door and I use to walk there and the call book was brought there.

In those days in the early 50s, when I was a house officer at Castle, the practice of Obstetrics was different from now. For many reasons, Caesarean section was not performed very often. Deliveries were performed mostly vaginally and forceps mid cavity and even high forceps were performed. Kiellands forceps was used frequently and we became fair experts in the use of these instruments, especially the Kiellands, in fact I even bought a Kiellands forceps for my own use. Internal versions, decapitation and craniotomies were often performed. These are not procedures we would dare to do now I dread to think of this now, but they were common place at that time. I remember many cases of decapitation for prolapsed arm. This was a common procedure in those days especially as we got transferred cases coming in after many hours with a prolapsed arm, infection, and a tonic uterus. Most of the procedures were performed by Dr. Spittel under chloroform. Even, now it is sometimes difficult to get an anaesthetist, in those days it was almost impossible. I remember that one of those we managed to get to anaesthetize at that time was the late Dr. Leo Fernando who later founded the Philip Memorial Hospital in Kalutara. Chloroform was administered by us HOO. In time I became an expert in chloroform and other Anaesthesia. In fact, I remember a ceasarean section performed by Dr. Spittel with myself holding the chloroform mask.

Age tells and memory fades but I can remember that those days at Castle Street, though extremely strenuous and hazardous, was very rewarding in the big run. I have always told my House Officers and I have had about 140 through the years, that if they work very hard during their internship they will continue to work hard for the rest of their career but that if they slack during their internship, they will be lazy and shirkers for the rest of their career. Gynaecology was started in 1955 and Dr. Spittel retired in 1956 and Dr. S. W. Jayaratnam succeeded him as Obstetrician in charge. In September 1954 I myself was transferred as Resident Obstetrician. Kandy Hospital under Dr. P. de S. Wijesekera had tremendous experience and was a master of Obstetric vaginal examination and manipulations. It was rumoured that he had examined so many women that even when he walked he had the 2nd and 3rd fingers of his right hand stretched out ready for action! Kandy was an extremely heavy station as there were no specialist units in Anuradhapura, Polonnaruwa, Matale, Kegalle, Gampola and Nawalapitiya and all the complicated cases from these areas were transferred to Kandy. Several people protested saying that I was too junior to be appointed to this job and would not be able to manage the arduous duties as RO Kandy. However, due to the excellent training that I had under Dr. Spittel I managed. In later years Dr. Wijesekera went to the extent of asking me to look after the confinement of his own daughter who is married to my friend Dr. Atukorala, the eminent Dermatologist.

It was 23 years later in 1977, that I returned again to Castle Street Hospital for Women as it is now called, this time as Consultant in charge of Wards 3 & 4. The existing rule of grade seniority alone for Colombo was changed to a point system and at last the golden day dawned and I was able to get to Colombo on the 1st of January 1977, after 19 long years as a specialist in the outstations, 19 years as a Consultant in the outstations was then and I believe even now, a record.

When I returned to Castle Street in 1977, things were quite different. Not only had the practice of Obstetrics changed, the buildings and equipment in the hospital were also much more developed than when I was a House Officer in the early 50s, the historical landmarks up to this period are summarized here. There were now 10 wards with 5 consultants, where there was earlier, only 6 wards and one consultant, a new set of theatres, an excellent pre-mature baby unit, a large House Officers Quarters and a nurses quarters there was a blood bank and there was a pathologist, Dr. Meththananda de Silva, whose son is now a medical specialist at Sri Jayawardenapura Hospital.
My colleagues during my earlier years were the late Dr. Ashley Dassanayake who was the leading figure in Obstetrics at that time with an extensive practice who in his own words worked "round the clock". There was my old friend P. Dissanayake, who went to England with me and passed the membership with me, Dr. J. B. Gnanapragasam and the late Dr. W. S. C. Fernando. We got on extremely well and I cannot remember any problems between us. Gradually, one by one all my colleagues retired and were replaced by other senior consultants from the outstations. I must mention the name of Dr. Ashmore Atapattu who worked for 5 years and in addition to being a consultant, he also did the administration of the hospital. I must of course, mention Dr. Lakshman Fernando who is out of the island who started his Obstetric career with me in Negombo and was with me in Castle as Consultant for the last five years of my career.

When I was working as Obstetrician in Negombo we had a badminton team which played against many local teams. I was the captain, not because I was the best player but because I was the only Consultant on the side. I only played in the doubles and Dr. Lakshman Fernando who was MO, OPD was my partner. He covered the baseline and did a lot at running while I stood at net and did no running. At this time the post of RO, Negombo fell vacant and the Head Office asked me to nominate someone to act as RO. Although Lakshman had done no Obstetrics at the time, in order to safeguard my place in the badminton team, I recommended him and he got the job. There was no stopping him after that, later he became an assistant to Prof. Ranasinghe and had no difficulty with the membership examination.

Before us, many eminent consultants served at Castle Street. Among others those were Dr. S. H. P. Nanayakkara who set the pace especially in major gynaecological surgery for us to follow, there was Dr. S. Rajanayagam, Dr. A. G. Muthuthamby, Dr. E. W. Jayaratnam and Dr. S. Panchalingam.
I succeeded Dr. Miss Panchalingam who herself was a strict disciplinarian. Once her SHO Dr. T. Siriwardena now a busy Consultant was coming late for work. He had to pass her to get to the hospital before her and he ducked under his steering wheel of his car as his car went past her car. I am told that Ms. Panchalingam saw a driverless car passing her and was terribly distressed and had even wanted to inform the police and complained. Dr. Siriwardena himself who had told her that these areas being close to the cemetery were haunted and after this I am told she always came with a servant in her car.

I remember when I took over wards 3 and 4, out of about 20 lavatories only 3 were working and this was terrible for the patients. I told the PWD overseer several times but he did not do anything, saying that various items were out of stock, etc. At the end, I told him that I knew Mr. Premadasa very well and could speak to him and get whatever was needed. Mr. Premadasa was Minister in charge at that time, and I knew that he got things done! Although I told him that I knew Mr. Premadasa and could get the required parts — actually I did not know Mr. Premadasa at all at that time but within 3 days of my telling this to the overseer the bathrooms had all been repaired. Later the wife of Mr. Ratnasiri Rajapakse, who was later Mayor of Colombo delivered in our ward I told him this story, that merely mentioning the name of Mr. Premadasa had bought spectacular results. He had repeated this story to Mr. Premadasa thinking he would be pleased about it but Mr. Premadasa sent word to me asking for the name of the overseer and saying that if he could have repaired it after his name was mentioned why he did not do it before, etc. I avoided this subject when Mr. Premadasa visited the hospital later and luckily he did not press on asking for the name of the Overseer.

I visited Castle Street hospital very recently in order to write this report and I was amazed at the progress that had been made after my retirement at the end of 1988. There is now a library, a new auditorium to seat 250 with a tutorial room and a mid level staff library. A powerful generator has been installed which can supply electricity to the entire hospital starting in 15 seconds. An Intensive Care Unit is in operation. An excellent Paediatric ICU is functioning. A new waiting hall is nearing completion and all over, there is activity. Even the road is being carpeted and what was a crying need in my time, a casualty operation theatre for emergency caesarian operations will shortly be commissioned. A model system of waste disposal has been put into place and administrators from all over the island come to study this.

This slide shows the bathrooms and the toilets in Dr. Sirisena's ward. The Past Patients Association collected funds and completely renovated these toilets at a cost of 1 million rupees and now a cleaning service is paid Rs. 12,500 a month to clean the toilets. This I would imagine is the only public toilet where hot water showers are available. Incidentally I am glad to mention that Dr. Sirisena was also one of my past Registrars. Arrangements have also been made to notify the local midwife when a patient is discharged after delivery so that she can to be followed up. It is also noteworthy that at Castle Street Hospital, all national events such as Wesak, Deepawali, Christmas and Ramazan are celebrated at the hospital and this includes religious observations.
There is also a praiseworthy system of counselling of all the patients entering and leaving the hospital regarding their special needs and problems as shown here. This slide shows the neat verandah of Dr. Almeida's ward - these flower pots and chairs were all brought in by him.
It must be mentioned here that the first AIDS positive mother was delivered at Castle Street Hospital in 1990. It is praiseworthy that Dr. Marlene Abeywardena, who was the qualified RO, readily and willingly handled this case at this time.

Up to 1972 the babies were all kept in a special baby room. Then after a severe diarrhoea epidemic it was Dr. Lakshman Fernando who was instrumental in organizing the present system where babies are kept with their mothers after delivery.

Mention must be made of what happened in the hospital in March 10th this year. After the bombing at the Aurvedic Hospital junction, some of the terrorists ran along Castle Street Hospital shooting at random. They fired five shots into the hospital injuring 8 visitors and an RPG fell in the space between Dr. Senanayake's and Dr. Almeida's ward. Fortunately these two worthy gentlemen were not injured! One of the visitors was badly injured in the abdomen. He was the only male ever admitted to Castle Street Hospital and was operated by a team of young registrars and house officers led by Dr. Abeysinghe. This patient was saved due to the excellent service by the hospital and its young doctors (a window damaged by a gun shot as shown here.)

Dr. K. K. W. Karandagoda, the present Director is a very able man and a man with vision and it is noteworthy that the Castle Street Hospital in spite of financial and other constraints is moving forward under his able guidance.

Above all the hospital is now staffed, by an able and dedicated team of Obstetricians namely, Dr. L. A. W. Sirisena, Dr. Lakshman Senanayake, Dr. Ranjith Almeida, Dr. K. D. S. Ranasinghe and Dr. Desmond Warnakulasuriya who was recently appointed.

To end on a personal note, at this stage of my life and career when I have practically retired from active obstetric practice, I was extremely happy to have been given the opportunity to make this address. Dr. Senanayake told me not to make this a mere recital of facts but rather to make it contain more reminiscences and stories and this I have tried to do. It is extremely gratifying to me to find that most of our consultants in Obstetrics and Gynaecology now, have crossed my path, some time or other as medical students, HO, Registars, or colleagues.

Those doctors who worked in my own unit at Castle Street Hospital and are now distinguished Consultants include, Dr. Ranjith Pathiraja, Dr. Deepal Weerasekera, Dr. Rohana Haththotuwa, Dr. Hemantha Perera, Dr. Darshan Weerasena and to mention last but far from least, Dr. Kapila Gunawardena. Incidentally Prof. Malik Gunawardane, present here also worked here and Maud, his wife conceived and had her babies here. Professor Chamberlain, then President of the Royal College of Obstetricians and Gynaecologists who toured the island a few years ago when he was given a farewell dinner at Kandy and spoke after I did said, jokingly amidst laughter that he seemed to be the only Obstetrician in the country who had not worked with Dr. Rodrigo.

In preparing this paper, my thanks are due to the Director Dr. Karandagoda, to Dr. Lakshman Senanayake for his considerable help and specially to Lakshman's son Asela, the medical student who did the photography, to other Lakshman Fernando from whose paper the "Tale of two hospitals" I have quoted, and Sampath our Secretary, who typed this and had a tough job with my handwriting".

BA's note: Dr. Nalin Rodrigo is a former Chairman of the Sri Jayewardenepura Hospital.

Friday, February 2, 2018

Creative Spot by Rohini Anandaraja


 “Reverie”.

As I gaze at the sky on a starry night,
Once the sun has relinquished its power and might-
A gentle light from the eastern sky
Catches my eye to my great delight.

With light so pure - a ‘maiden’ chaste
Glides across the sky in grace.
I cannot help but hold my gaze
At the beauty of her radiant face.

The stars dim out as homage they pay
To this celestial beauty as she makes her way
To smile on earthlings, though far away
From her distant home in the Milky Way.

Joy she brings wherever she roams
And turns into silver all she beholds.
Through wisps of cloud she peeps to glow
Ripples of silver on the sea and the shore .

Her silver beams make lilies bloom,
As lovers swoon and minstrels croon.
Enraptures all with ‘Clair de lune’,
And sublime  ‘Sail along Silvery Moon’.

An artist’s dream, a poet’s delight,
Her mystic charm can’t be analyzed-
Nor words describe her elegant style,
She reigns supreme - the queen of the night.

Rohini adds: 

"This is dedicated to Nihal Amerasekera my friend whose fine literary flair I have long enjoyed, and at whose insistence I have written this poem to submit to the blog"


Saturday, January 27, 2018

Sri Lankan cardiologist honoured in Australia

From today's The Island newspaper


 

article_image
Dr Kumar Gunawardane (right) and Mrs. Gunawardane after the award.

A Sri Lanka-born cardiologist, Dr Kumar Gunawardane, has been bestowed the most prestigious award - CONSULTANT EMERITUS by The TOWNSVILLE HOSPITAL AND HEALTH SERVICE BOARD.

The presentation was made by the Minister for Health, Queensland, Dr. Steven Miles at a glittering staff excellence award ceremony. This was attended by many local dignitaries including the state and federal parliamentarians and the Mayor of Townsville Cr Jenny Hill.

Dr Steven Miles also presented a floral bouquet to Mrs Shirani Gunawardane honouring her selfless contribution to her husband’s career.

Dr Gunawardane’s initial cardiology training was with Dr Ivor Obeysekare and Dr N. Walloopillai at the General Hospital, Colombo. Subsequently, he worked as Registrar in the Newcastle-Upon-Tyne Regional Cardiac Service UK and the Prince Charles Hospital in Brisbane, the leading cardiothoracic institution in Queensland.

He assumed duties as Director of Medicine at the Townsville General Hospital in 1982. This is the premier public tertiary care facility in North Queensland and also the main teaching hospital for the James Cook University Medical School which is on site. He is an Adjunct Associate Professor of the JCU.

The citation was by Dr Ryan Schrale a young Interventional Cardiologist colleague.

Dr Gunawardane had a highly distinguished 33-year service to the Townsville Hospital and Health Service as a Consultant Physcian and Cardiologist. He demonstrated the highest levels of leadership and professionalism throughout his medical career including an 11-year tenure as Director of the Department of Medicine (1982-1993) and also four years as the Director of Cardiology (2002 -2006). He was also the Chair of Cardiac Services for part of this time. For many years he was a member of the Statewide Cardiac Advisory Committee.

Dr Gunawardane’s career has spanned decades of major advancement in the understanding of and treatment of cardiac disease; throughout this time he spearheaded introduction of modern cardiology at the Hospital. He staffed the Coronary Care Unit single-handedly for 12 years - probably a unique record for Australia. He established local treatment protocols in conformity with national and international guidelines.

He also single-handedly established Echocardiography in North Queensland. For the first eight years, he performed and interpreted all echocardiograms personally without the assistance of sonographers or cardiac scientists. Dr Gunawardane, through a commitment to continuing professional development and improvement of services, undertook a sabbatical training year in USA. (1988/89).

He worked with another distinguished Sri Lankan Cardiologist, Professor P. A. N. Chandraratne, who was the Deputy Chief of Cardiology at the University of Southern California Medical School in Los Angeles. This allowed Dr Gunawardane to establish advanced echocardiography techniques to North Queensland including trans-oesophageal and stress echocardiography.

Dr Gunawardane demonstrated outstanding leadership during the establishment of the Cardiac Unit. The establishment of the unit faced stiff competition from competing centres Cairns Base Hospital and a proposal from the Princess Alexandra Hospital Brisbane. He made a compelling and effective application to the selection committee headed by Dr Graeme Sloman, Director of Cardiology at the Royal Melbourne Hospital. He carried the day and was the sole cardiologist in the planning Northern Regional Health Authority Committee reporting to the Director General of Health.

Throughout his career Dr Gunawardane has had an abiding commitment to teaching. From 1982 onwards he was a Senior Lecturer of the University of Queensland and subsequently was Senior Lecturer and Associate Professor of Medicine at the JCU. He taught medical students, junior medical staff both basic and advanced trainees, allied medical staff and also medical practitioners in Townsville and outreach areas. Some of these trainees have gone on to become outstanding Consultants including two current Professors of Medicine.

Owing to the national recognition of the Townsville CCU, Dr Gunawardane participated in ground breaking international cardiovascular trials, the results of which still shape our current practice. The most notable were ISIS2 (International Study of Infarct Survival -2), the first trial which conclusively proved the effectiveness of thrombolysis and aspirin in the treatment of heart attack.

LIPID (Long term intervention with Pravastatin in Ischaemic Disease Trial), proving statins reduce heart attacks and vascular events. CURE (Clopidogrel in Unstable Angina to prevent Recurrent Ischaemic Events)

Dr Gunawardane also participated in JCU, QUEENSLAND and NATIONAL major collaborative studies some of which were presented internationally. He has published many manuscripts in peer reviewed journals.

In recognition of his services and achievements Dr Gunawardane was awarded a Fellowship of the Royal Australian College of Physicians (FRACP), Fellowship of the American College of Cardiology (FACC), Fellowship of the Royal College of Physicians Edinburgh (FRCPE) and the Fellowship of the Cardiac Society of Australia and New Zealand (FCSANZ).

Sunset – Nature’s art with a message and more technical details

 The subject of Sunsets has evoked so much interest and generated many comments from the "regulars", that I thought of publishing an article by ND followed by a useful link sent in by Rohini Ana.

At the end of ND's article, I have given the link that Rohini had sent.


Sunset – Nature’s art with a message
By Nihal Amerasekera

I have often wondered why sunsets being a natural phenomenon which occurs everyday evoke such intense passion and emotion amongst us. Is it the crimson glow that mesmerise us ?  But we don’t pine for the day that’s gone!! The combination of the sun, the clouds and their reflection on the water gives the sunset a magical status.  I am reminded of Rabindranath Tagore’s poem “Stray Birds”

Clouds come floating into my life,
no longer to carry rain or usher storm,
but to add colour to my sunset sky.”

Something to remember when we behold those enchanting sunsets.

The sunset is transient . Although unfailingly regular its never the same in appearance even at the same venue. So much like our own lives changing from day to day and from year to year, sometimes the clouds hiding the beauty within.

Sunset ushers in the end of the day and the end of our toil. It brings on the silence of the night and the peace that comes with it.  During my sojourn in Arabia I found the Muhsin’s  evening call for prayer hypnotic, as the sunset across the ever changing sand dunes. I grew up living opposite a church in Nugegoda. Every evening at 6 pm the church bell rang rhythmically and gave us kids a clue it is time to get ready to find refuge in our homes. This reminds me of Gray’s Ellegy written in a country Church Yard (1751).

The curfew tolls the knell of parting day,
The lowing herd wind slowly o’er the lea,
The ploughman homeward plods his weary way,
And leaves the world to darkness and to me.

In the tropics, sunset also energisers hordes of mosquitoes to torment us in waves!! But worldwide it is a busy time for thieves and burglars to earn their living. Despite its beauty Sunset has its drawbacks.

I am born a dreamer. Once it nearly cost me my life. I was living at the Jeewaka hostel in 1966. After a long afternoon study, I walked to the Colpetty beach with Sanath de Tissera, to sit on a rock and watch the sunset. We often talked about things spiritual to relax and unwind. As darkness fell we started to walk back, deep in thought. When I was about to cross the railway line, my friend pulled me back with great force - and I saw the train go whizzing past me. I could feel the warmth of the steam and coal and was just inches away from certain death.

It must be the diurnal variations caused by our hormones which make us more serene and emotional past sunset and a lot more amorous and sensual too. With all its beauty, sunset ushers in a seedy aspect to life and none more graphic than the wartime music of Marlene Dietrich which was a popular when WWII was raging. The song ‘Lili Marlene’ conjures up images of a young lady waiting under a gas street lamp for her Army lover to return.

Underneath the lantern
By the barrack gate
Darling I remember
The way you used to wait
'Twas there that you whispered tenderly
That you loved me
You'd always be ………
My Lili of the lamplight
My own Lili Marlene

Everything that has a beginning also has an end. For the light of the day, sunset is its end. Sunset is a reminder for us all of our own mortality and also a memory of all who have gone before us. It enlightens us to use our time wisely and to keep our thoughts calm and peaceful. These are our sunset years. The simple thought that we leave this earth as we came, with nothing, appeals to our generosity and altruism.

I recall with much nostalgia the sunset at Angkor Wat and its thousand year old temple now being restored by the Cambodian government. Gordon’s Bay sheltered by the Helderberg mountains in Capetown provides a wonderful vantage point to watch the sunset knowing well there is no land beyond its horizon before the South Pole. South America is like no other place on earth for its climate, mood and landscape. Sunsets across the breath-taking landscape of the Atacama desert and that across the Magellan straits in Punta Arenas in Chile will remain with me forever. I have kept the best for the last. The sad story of the Taj Mahal has resonated through history and its magical beauty fails to hide its grief and torment. The sunset beyond the Yamuna river with the Taj Mahal as a back drop is a sight fit for the Gods.

The link that Rohini had sent.