Monday, February 1, 2021

වෛද්‍යවරයෙකුගේ සිහි සටහන් - A Review by Dr. Newton Jayawardane FRCS

It is a great privilege to read Dr. Ruwan M Jayatunga’s book-වෛද්‍යවරයෙකුගේ සිහි සටහන්. It gave me enormous pleasure on reading this. There is no doubt he has been very honest in writing the facts. The simple straightforward language he used increases the appetite for reading. There is a lot to learn from this book. His school life is full of all types of boisterous and unfriendly behaviors. Some maybe not socially acceptable. During the teenage period had been an impossible character. At some stage, I was wondering how he escaped public punishment in the school chasing out of the school. He was fortunate to escape them. His teachers were tolerant. Probably they knew the psychology of teenage students and teenage problems. 

Ruwan’s life story as a student is a classic example where the so-called “Hardcore” students can be well-balanced highly qualified professionals in the latter part of their life.! Amidst everything he continued to study and had participated in sports, Scouting, Cadetting. I think these disciplines have given him the strength for his mind and the inner core. There were lots of examples where this was obvious when he went to Russia to do medicine. 

He traveled to so many different countries during their vacation. Further, his batch mates were coming from many countries. They were belonging to different ethnic, religious, social groups. As a result, he was exposed to all environments and more so he has learned to adjust, compromise, and live with them. If our all citizens just follow this we wouldn’t have all the sufferings and the bloodshed in our country.  

Dr. Ruwan M Jayatunge has elaborately described the life of an intern medical officer. How stressful or how difficult they go through this. This the period that they lay a foundation to be a good quality doctor. Having finished the internship successfully he was exposed to other disciplines of medicine. Having had good exposure he has not ignored to write down all the dirty, wrongful unethical things taking place in the medical profession. 

I am much pleased he wrote about the yeomen service done by our nurses, midwives, public health inspectors. Often their work is ignored. They are very important members of the health care team. I use to say even the sanitary worker is a part of my team and he has to be respected. I recall at some stage who greeted me first in the morning when I got down from my car was the hospital scavenger or a disabled sanitary worker who collects all garbage into a cart and taking them for disposal.  

I am much happy he selected his carrier in mental health. He has a much wider knowledge in this field of medicine whereas most of the medical personals do not have much knowledge. In fact due to this knowledge deficiency these patients are not cared for properly. During the Elam war, he was able to detect and treat and so many servicemen who had to develop multiple mental illnesses due to the war.  

During his period as SHO in Obs and Gyne, he has described the drama involved in it so as an anesthetist. He has described very nicely the stresses of these jobs similarly to how they found time to enjoy. This is common to most of doctors but not written about them. 

Nicol Nathan and Sri Lankan Students. Page 848. Here Dr. Ruwan M Jayatunge correctly describes the radical attitude of Sri Lankan university students and the possible causes for them. This is the absolute truth. Youngblood with inner energy prevents them to understand the facts. I like to say a few things here. In the remote villages for poor AL school children, some JVP UV students come and conduct tuition classes. They are free or charge a very nominal amount. If these children were to select to the university they would be handed over to the senior JVP cadres on the campuses. These innocent children do not have any option other than becoming obedient servants of the senior members. 

In the killing of the Samantha Opatha undergraduate inside the Vidyodaya University, the fellow student who led the attack was carrying two mobile phones and giving instructions. A student who was coming from a very poor family had all this wealth but backed by a political party. Analysis and comment about Major General Kamal Gunarthnes's book is a much needy thing. It was very sad to notice human attitude and treatment for the lower ranks by the higher ranks.  

Dr. Ruwan M Jayatunge has well red local and foreign all types of books. As a result, he has acquired a vast knowledge of almost everything I guess!!. This was amply shown right along with this book he quotes various books to show his point. A medical doctor having this type of knowledge is a rare phenomenon and it has to highly commended. 

Further different peoples as well as some highly prominent peoples behavior pattern he analyzed and displayed their psychological status. Consultant Umathuwa. Page 957. I am very impressed with everything he wrote in this paragraph. I must emphasize there are some Consultants who are working in Sri Lanka tirelessly with limited resources. Personally, I am aware of how difficult to get the bear minimal resources for the patients and to the hospital. There are so many red tapes. Having worked at Wathupitiwala base hospital for three months I went to the head office almost begging for the items to the operating theatre. One of the director's reply was “Ayeshe what are you talking. Your predecessor has told us this particular theatre is not suitable to do any surgery. We can not give you anything. After two weeks I returned to the same director with my major operation register and firmly I asked him to take a look at it. He was speechless. All because that dirty surgeon made this an excuse to not to operate but to engage in his private practice in Colombo. He never bothered to plan for a new operating theatre. 

Until I left Wthupitiwala I operated in the same operating theatre of course with some changes. I got a three-phase electricity supply and trip sutures and other facilities I needed. One more incident worth mentioning to show the idiotic stupid behavior of these so-called directors. Even we Sir them they do not know how to talk back with respect to a Consultant. Their language is Ayeshe, You fellow, etc. One day I was operating at the Matara Hospital. Our operating theatre sister came with a stupid director and sister said ‘sir me Colombin awilla apita adu padu monawk thiyanawada kiyala balanna’. We had a very old main headlight in the operating theatre. I have not seen a similar one in any other hospital in Sri Lanka and overseas. It consists of very powerful ordinary bulbs. not LCD or LED. The light could not focus to a point. This headlight can not have any lateral tilt-only raising and lowering was possible. It was with heavyweights balancing over it elevation and lowering of the light as possible. The Biggest problem was no heat filters and as a result, it was very warm under the light. In a few minutes' time my all the clothes got soaked with my own sweat. Surgeon sweating while operating is a real disaster as the patient is having a real danger of getting his wounds infected. Anyway I called this man I told him I request only one item and I explained A to Z about this operating theatre headlight and showed my sweat-soaked body and requested a new light. 

He asked me how long it had been in use. I forwarded the question to my operating theater sister. Her reply was “Visi theis ayruddak thisse apita mathaka kale indala thiyanawa sir. I translated it to English for him to understand better as his mother tongue was not Sinhala. Then hell broke up. This idiot told me “Ayeshe All the surgeons who were here for the last 30 years could operate under this light without any problem. You are the only one who is grumbling” I was so annoyed and told him “There is no point talking to a stupid idiot like you I am wasting my time” and went inside the theater. This man may have considered issuing a much-needed item to a hospital as a personnel favor. Further, this is the only time where they can show their importance to the professionals. 

The current day most of health administrators are consultants in their own discipline. IE Postgraduate degree holders in medical administration. This man did not have any qualifications but his name was linked to many corruptions. Further, as you very clearly pointed out most of these young consultants do not have the maturity and common sense. Some do not even get the patient to narrate his story. Having paid the money and having waited few hours for the consultant to arrive if he cannot spend little time of listening to his agony I feel it is a gross injustice to the patient. 

Some time patient will get a psychological benefit just by releasing his burning mental worries to someone else. Further patients are subjected to unnecessary investigations. Of course, they are the most favored consultants by the private nursing hospitals. They being patronized heavily by them. The consultants who do justice to the patients are not favorable consultants for them. 

 APPHAMIGE DUKA Page 977 It was very sad and heartbroken to read this chapter. I personally felt what was written here was a true story. I know some worse scenarios. GMOA will cover up any dirty game of its membership. All I can say is these culprits and their families will suffer not only during this birth but next births as well. 

Overall Dr. Ruwan M Jayatunga’s book-වෛද්‍යවරයෙකුගේ සිහි සටහන් is a  testimonial of a Sri Lankan Medical Doctor. 

Dr. Newton Jayawardane  MBBS MS FRCS(Eng) - Consultant Surgeon

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