Me and National hospital of Sri Lanka (NHSL), Colombo

It's 31st August 2020 ; officially leaving NHSL, Colombo. I guess I stepped in to NHSL in 2011, first to meet my personal tutor in surgery department. Then since 2012, started Clinical training, if I am not mistaken. And whatever I learnt in Medicine (ie MBBS) was learnt based there; in associated hospitals as well. God knows the number of exams I had to write in NHSL, from modules, to finals to MD selection exam.

I recall the first patient I clerked in Lalantha sir's ward very well. A fascinating story of the value of NHSL. And so many such fascinating stories, many sad and traumatizing once too. I am just blogging these to read on a time I have Alzeimers or so and may not remember these good times. Although I told it as good times, it wasn't so pleasant all the time. Conflicts and challenges were in abundance. Clinical group conflicts, prof groups conflicts etc. Reflecting back it was all very interesting. And at the end of all the training, the final MBBS; the so called great barrier. I can never forget the tolerance and the motherly love and respect shown by the patient given for my long case exam in medicine. I am sure it was her wishes that helped me perform well in the case.

And then as a demonstrator in 2017, NHSL was anyway an integral part, particularly for researches.

I was also fortunate to land on the same wards I studied as a student in my internship training as well. I have already blogged on the internship times and hence will not be repeating as I got reference material for later typed already. The 2 long years of extended internship, which had it's ups and downs. Worked under lots of bosses, over 15 consultants in 2 years career , not very bad 😌. this lot will always be remembered as the people I worked most at a stretch and those who motivated to be where I am today, every step of the way.

The particular period had so many experiences , unforgettable ones and even involved in treating bomb blast victims; which I never thought I will witness as a Sri Lankan ever, after 2009.

After the long, daunting internship, had to select so called proper RHO appointments here, with a lot of ambiguity , and hopefulness selected to work in Cardiology, preferably, an ICU. And there I met one of the best consultants I worked under, Dr. Nuwan Ranawaka, interestingly as the first MOs to the new consultant. It was a privilege to work under a consultant who recalls himself having an internship, RHO period , Registrar period and so on , prior to be a consultant. The logical teaching and the pleasant personality of sir, made Nuwan sir a great mentor. I wish I could learn more form him, but the circumstances weren't so.

Cardiology was another place to work under 10 consultants (mainly 6 lets say) in 11 months. There I met so many very helpful cardiology SRs and MOs. Particularly, seeing the cardiology SRs being able to manage so much work and retain their peace in mind was a motivation. They are virtually walking communications, and I even hated the few hours I had to attend to their phones sometimes, and these people kept doing it for minimum 3 years and I wonder how? Cheers to all cardiology SRs .

The MOs at Cardiology too helped us as much as they could, and never let the juniors exploit. Particularly with the exam times and all, the support given by all were amazing. Everyone provided us with all privileges and mutual respect.

The COVID times made the cardiology days very different and unique. I wish we never get such a time in Sri Lanka although I accept, as a healthcare professional the work load became easier though the risk of COVID infection was high.

After nearly 8 years, I will be officially going away from NHSL, Colombo to Colombo North Teaching hospital and what will happen next is in the future to see. 

Lot of things happened at NHSL, many sweet memories, some challenges and few unpleasant memories too. After all, this is what was with me as the "last supper" (for the time being) at NHSL, and ironically NHSL had a fair share of it. Will be missing it? or will I have more of it ? 😉

Magic for me

 People around me always ask me to believe in myself, particularly at times we discuss the day to matters; stressors in professional and personal lives. And often I hear, “some magic will happen, you never know”. And the same is portrayed in motivational films as well. You see very unexpected things can happen, and they change the circumstances and often leads to good, life changing moments.

 However, in my experience the magic in life has often been very confusing. It often happens to make sure the expected end result is never achieved. You plan out something for so long, and suddenly some magic happens and all the plans are jeopardized. This happens in day to day activities. You are about to leave house to meet a good friend and suddenly, a totally unexpected guest arrives and you can’t escape it. Some magic also leads to unexpected meet ups even. You think of meeting someone, but doesn't take an additional effort to do so, but you end up meeting that person in strange and memorable ways.

Magic that happens in life also comes in very threatened ways. You plan to go out for an important function; say a short case exam kind of, and then suddenly the watch is broken when getting ready and you are in a hot plate contemplating what will happen when the examiners see you taking a wrist watch from the pocket. And the magic doesn’t end there as well. It ends you getting a neurology case and ultimately the wrist watch never became important. Whether breaking the watch was magic or was the neurology short case to a candidate without a watch is magic? Or are they both magic? Or are they just incidence and I perceive them to be magic?.

Magic for me also comes in forms of unexpected photos, songs, films and they suddenly change life in very unexpected ways. There are songs that you have listened to thousand times and then, on one particular day, on one particular time, the song was the background music for a wonderful experience ; (not necessarily related to the lyrics/singer/melody of the song), and the song it-self becomes a magic that ignites you/ motivates you. Same with certain films as well. For some reason you find motivation/magical power to wake you up in them and you keep watching them several times.

I am thinking, “am I overthinking these minor incidences to be magic in life – or is the small magic that happen in life make life more interesting/ challenging and motivates us to hold on to it and move forwards?"

Of all conflicting thoughts, on a conflicting night itself, I am searching for a magic to hold on to, and the best magic I can relate are looking at this photo ,

and listening to this song…

Will this magic work as I want the magic to work?

Will this pleasant feeling in these take me forwards, as far as I want?

What will be the end result of this magic? A happiness or an agony?

I wish I knew, but....

If I ever knew, it isn’t a magic any more….

So, let’s sing :  Que sara sara .. 😀

150th Anniversary of Colombo medical school; personal note

Since 2010 when I sat for A/L from Kandy and chose Colombo as the faculty of my choice, the most frequently asked question was “Why Colombo? You should have enjoyed Pera”. There often are times that I, myself wondered if I made a mistake. But life from 2011 to 2017 at Colombo and it’s memory has now convinced that I made the correct and the best choice. After passing out from 2016 and leaving the faculty in 2017 as a demonstrator, it always felt wonderful and refreshing passing by the faculty and occasionally walking in to the faculty. Walking the few corridors available in the faculty always reminded of so many memories; both good and bad of the half decade of our lives spent there. The notice boards, the benches, the quadrangle all reminded of the many hours we spent in few best years of our youth.

2020, the faculty was getting read for it’s 150^th celebration. Since we weren’t included in the faculty network much, the heat of the celebration was not much evident. Thankful to the CoMSAA membership, the email reminders kept few updates on the 150^th celebration. As a person, who is deeply attached to the places I studied, may it be college or university; I myself could not afford to miss out on this once a life time opportunity of 150^th Celebration of this beloved place.

The first event I attended in 150^th celebration was the inaugural ceremony of the Colombo medical congress, where I realized the greatness of the institute that had taught us medicine. Never in my time at medical school or later, I realized the privilege to have learnt from such a prestigious institute. More importantly, how much of its legacy has to be continued forward by the generations of medical students including ourselves who have just started our careers. The inauguration ceremony was studded with medical-stars and living medical legends were walking around. If not for the ever-welcoming Physiology teachers, I would have felt ineligible to be at the inauguration.

Then was the Colombo medical congress, which made me recall APACPH days, back in 2^nd year, post IBSS, where we volunteered in organizing a conference at BMICH.

It was one of those rare times where the academic staff and the students worked hand in hand together to achieve a common goal for the faculty or university. Mostly in medical school life is a constant battle between the students and staff, starting from punctuality in lectures, constants rejections to requests for schedule changes, limitation of faculty hours etc. How wonderful it was to witness a major conference happening in the same lecture halls where we learnt all those basic medical concepts. To see the students and the staff working in the same team was the greatest sight of all. Thanks to the never ending SLES, I was fortunate at least to present a poster at this 150^th celebration, as my only active contribution, which will be a memorable event if I make it till 175^th celebration alive.

The 150^th fiesta was not merely an academic one. The quadrangle; the car park during our times at the faculty, is now modified in to a mini open theatre by the 150^th celebration, after 4 years of execution lead by Pujitha sir. I recall the conversations at the meeting after the agony of “Pacha tree” in 2016. We expected the theatre to be functioning a bit earlier, never mind, it was made open in the ideal time in the ideal design. Recalling about the quadrangle, I remember how a small stick of Pacha tree fell on the expensive vehicle of a congress co-chair, and how he frowned at me and the fellow first year batchmates as if we threw the stick at his vehicle. 

Newly developed mini theatre added a great look to the faculty. The value of this theatre was evident at the “Paduru Party” on the 14^th. This was for me the most entertaining evening at faculty I have seen. We have witnessed and performed in few Ninnada, freshers, paduru etc but 14^th February 2020 night was epic. For this night, there were no senior professors, professors, senior lecturers, lecturers etc; it was just a bunch of past and present medical students, who are elated by the birthday celebration of their medical college. It’s was a pure joy while everyone recalled their past, lived in their own worlds for one night, under the stars at quadrangle, which I am sure, everyone would have their own share of memories; when they studied at the faculty. I have never witnessed such a staff-student collaboration during my stay at faculty and I hope, many such friendly collaborations would happen at the mini open theatre in the time to come.

While being proud of the great people produced by this faulty, it would be unfair by the present medical students, it their efforts and skills are not appreciated. Since we have passed out, it appears a set of professionals have taken up medicine at MFC. Professional level athletes, singers, musicians, dancers, organizes, announcers and what not. That Faculty is star studded even at present and it appears we were the last set of average students who studied there. While displaying the aesthetic and organizational skills, Colombo medicos never forgot to dominate their academic brilliance by clinching the global medical challenge as well.

150 year celebration is not yet over. There is the medical exhibition coming up. Another experience I personally wanted desperately during my stay; to convince a batch to get a Medex exhibition done. It still lies as a failure. However, I am anxiously waiting to see how the present medicos conduct this wonderful medical exhibition which I am sure is going to be another spectacular event.

Medical faculty, Colombo - MFC; with the 150^th celebration, I realized how privileged we are to study in you. Your legacy is unimaginable. We aren't certain if our own medical careers will succeed or fail. But we are certain, despite all failures, you would still produce those wonderful people and achievements that pioneer medicine, medical education and healthcare in this country.

“What wealth has the school given to our land? They were it’s mortal products like us all. And what treasurers have we ourselves chosen and pursued? Are these the treasures that moths and rust corrupt, or will they endure time to a realm beyond? Have we chosen wisely? This answer will necessarily be the schools own answer to our land”

Prof. Carlo Fonseka : The Colombo Medical school at 150 – Celebrating our heritage

Photoe credits to all friends who have clicked the photoes. Unable to recall the friends by each photo.

Latest proposals

                                                                      

The sudden response from vice chancellors (VC), to agree to the proposed solutions to SAITM, proves my concern of the credibility of those whom we claim to be educated. Is this because they agreed for a solution to SAITM? Obviously, the circumstance is so, but the original idea was there long time back. Firstly, why did the VCs; a group, who never even bothered of SAITM issue, suddenly agree? I was wondering if they were even worried of SAITM at all.

I expected the recent proposals to be super important and crystal clear, to be approved by Vice Chancellors of universities; a highest academic position to be hold in Sri Lanka. I expected the proposal to be flawless and doubtless to be approved by the VCs in such quick time.

I am just a new graduate, and hence have no experience in academic work or academic decision making. But I was trained in a medical faculty that maintained very high standards and logic in arriving at decisions. As a student, I have witnessed, how much detail the administration and the teachers go in to, even in simple issues like a change in a date of a short appointment. As a graduate, who was trained under such strict and logical background, I do not see a rationale of the VC or anyone for that matter suddenly agreeing to a solution which leaves us with so many unanswered questions.

To begin with, the authority under which this proposal was proposed. I recall, that the previous proposals were from responsible authorities related to this matter, The Ministry of Higher education, and Ministry of Health and later from the Presidential secretariat. But this was from the Department of Government Information. I see a huge issue of credibility of the proposals in first place.

However, as the media overwhelmingly published, SAITM is abolished now, ie, the MBBS degree awarded by SAITM is stopped, and SAITM can no longer recruit students or award MBBS here after. This is a good thing. At least prevent the other students from digging their own graves.

Also, the minimum standards, that was in the process of gazetting for months, is to be gazetted soon. However, the health minister; the responsible authority, himself promised to do so several months back, but has failed to do so yet. Hence, for me, although this is proposed, raises serious concerns in implementation, since it is in the authority of the health minister and the new proposal is issued by an authority with no credibility over this matter.

Biggest issue for me in accepting this proposal is the doubt it has left regarding this so called “new entity” to be established in “one month” to award “MBBS degrees” on a “regular basis”.

SAITM has already put Sri Lankan medical education in crisis, and disgraced the reputation of the Sri Lankan medical degree by being blacklisted in the General medical council (GMC), UK. Hence, the crisis need to be managed quickly but effectively. If you trace the history of SAITM; BOI approval, UGC approval, SLMC approval, hospital for clinical training and many more were to be completed and over the last 8 years, SAITM couldn’t fulfil them and hence attempted all the illegal and cunny attempts to get the approval. With credit to the student community and the academic and trade union community, the fraud of SAITM was exposed and hence the government is now proposing to Abolish SAITM. These approvals, and the fulfillment of the criteria must be achieved by the proposed “new entity” as well, because it is to be established to award MBBS in a REGULAR BASIS and not only as a solution to the SAITM students. On surface analysis, it is evident that no medical school can be set with all those approvals and other related developments in one month. For that matter, at least in few months. More so, as the government has not yet identified who this not for profit investor is. Hence, even though the VCs and few other parties have agreed, as a simple graduate, I have doubts in accepting this hypothetical new entity because, it can be of no difference to SAITM if it fulfills all the requirements in a few months.

Speaking of the standards, it is proposed that “all” the credits of the current SAITM students, should be recognized by the “new entity” as it is. This itself contradicts the idea that the “new entity” would be of better standards. If they are of better standards, they would worry about accepting the credits of a degree which is rejected by Sri Lanka Medical Council and blacklisted by the General Medical council (GMC), UK. This also endangers the degrees of those who are claimed to be MBBS(SAITM) qualified. As per the proposals, SAITM is abolished. Hence, the degree awarded so far is not valid. The “new entity” cannot directly offer it’s degree for those who are MBBS(SAITM) qualified. That contradicts the idea of standards in the “new entity”. Hence it is paramount, that the outcome of SAITM assets should not be a “new entity” that will continue to award MBBS, because to set such a continuous entity it will need a lot of further discussion and planning, and a prompt decision is only going to cause more future problems. Instead, as the deans proposed, and Interim authority (IIA), only to provide solution for the current SAITM students would be more suitable to find a prompt solution for SAITM crisis, than delaying the solution with the “new entity” under discussion. Since the only objective of IIA is to find solution for the 900 students at SAITM, that may be more acceptable to solve this crisis than planning a long lasting “new entity”. If the government is planning a new medical school, that itself would need in depth discussion. For eg. The area of the new medical school. If someone has identified where the medical schools are distributed in the country, it is obvious, they are distributed all around the country improving healthcare provision. The right hospital has been identified, and later developed to a teaching hospital and then a medical school has been started. Government has stated that they have plans to start state medical faculties in Sabaragamuwa and Wayamba, making Kurunegala hospital the teaching hospital of one of them. The “new entity” will have to be planned accordingly. Just because SLIIT or any other investor has a wish to take over, “new entity” should not be established without proper planning.

World federation for medical education describes the process to follow in setting up a new medical school in the link below.

http://wfme.org/publications/new-medical-school

In a country, where there are already planned new medical schools coming, the “new entity” should be decided only after assessing the healthcare needs and the plans for the next 20 years at least. I fail to understand, undertaking the mammoth task of setting up a “new entity” would be ideal when solving a crisis as that of SAITM, and an IIA just to find solutions for those affected students would be better and could be implemented with less in depth and situation analysis as that would be needed with a “new entity” that is long lasting.

I was amused to hear the vice chancellors, suddenly declaring they agree to the proposed solutions, considering the in-depth analysis the faculty I studied would do, even before deciding a simple matter such as that of a tree, exam or a clinical appointment. Agreeing to a “new entity” with no information at all cannot be expected from the learned community. Particularly so, form a place like that I have studied, considering the level of analysis, the faculty used to do in much simpler situations. And I’d expect the faculty and the university community to stand on their grounds to make sure they would make the ideal decision after much analysis, as they would do, even when cutting down a tree in the faculty.

A few hours after the said proposals were released, the health minister himself contradicted the essence of the latest proposal, and hence as learned people, it would be much wise to trust the action of the politicians than believing the words of a notice. I am sure the same standards followed for a usual faculty decision would be considered, at least by the faculty that nurtured me, based on the past experiences and the circumstances, in deciding if the solutions are good or bad.

Reflecting 5 years

It is a little over 24 hours after it was revealed that I have completed MBBS(Sri Lanka (NOT Aluthkade)), and it is a time to reflect on five long years at the Faculty in the journey of reaching here.

Among the lot that had supported during the journey, the full credit has to be given with utmost gratitude for all the patients whom I met from the first day at clinicals in a surgical ward till the last patient who supported me at the surgery long cases in the exam. Words can never describe, how grateful I am for all these great human beings. The kindness and the selflessness to talk to us and let us examine them, while they are in pain, sometimes at the last days of their's lives, when they know that this in purely for our studies with no personal gain for them (except their self satisfaction) is unimaginable. And we are blessed that there were so many such wonderful human beings who helped us over the years to learn Medicine; which would have never been a reality with out them. ( Although the Sri Lankan trend is changing at this point of writing where clinical training has not become essential to be doctors)

It would be a wastage of words if I praise my family members and all the close relatives here, because I can never think of a life without them, and using words to praise them is just a foolish attempt. But an emphasis on the past 5 years is incomplete if not for the the mad cousins who made life interesting in the few gatherings we had over time.

Teachers we meet at medical faculty are not like those whom we meet at school. All the teachers form pre school till grade 13 nurtured us like their own children and worked for our betterment and cheered with us in our success and cried with our failures. Learning medicine was to be professionals. The teaching on professionalism was a part of the training. So, the teacher, student relationship was different. If to speak of the best role model I met among the lot of role models at Colombo, it is Dr. G.L. Punchihewa sir - Consultant Orthopaedic Surgeon. Sir was a complete doctor as I felt with the complete package of teaching, patient care, caring for students and good interactions with other healthcare staff. And there were many others too like , Prof. Saroj Jayasinghe sir, who was a role model on caring for patients , Dr. Thashi Chang sir, who was an excellent presenter and a teacher, Dr. Sanjeewa Senevirathne sir, a young teacher who made learning interesting and novel, Prof. Nandadeva Samarasekara sir, a wonderful administrator etc etc and there were many more in the list which I may not drag as the purpose of the blog is just to glance through 5 years.

Then come the friends who can either make life at university wonderful or a suffering. I am glad to have been  blessed with a wonderful set of school friends who can either be my teacher, counselor,  friend, idler and whatever the role the situation demands.

A complete 5 years of medicine is obviously boring with out changes to life. Complete different exposures are an essential part of life I guess. To serve this purpose I am blessed to have a set of friends, who will be "My Set" for ever in life. The fellow scouts of the troop committee are almost like my own brothers with all the conflicts, resolutions, fights, arguments in abundance. Organizing Centennial ROCKS with this lot while doing medicine was something I truly enjoyed.

Well, this doesn't mean it was 5 years with school friends. There were a lot of other great friends I met at the Colombo medical faculty too. Reflecting back I am fortunate that all 200 batch mates have helped me at least once at some point during the long journey. But as with anyone else, I too had a set of Extraordinary friends who made the 5 years special. All of them played different roles during the 5 years of stay, sometimes pleasant memories, sometimes life lessons, sometimes unbelievable experiences but everything to look back and smile about. 

This was the batch father in year one and was one of the best friends I met during the 5 years time, and the friendship had it's ups and downs , but the memories will never be forgotten

This guy unfortunately had to help me out with all trouble I get myself into, may be conference, hosting Japanese delegates, doing repeat campaigns, training swimming, etc etc and for some reason, still works with me at times of need(like finding old photoes for this blog)

This guy is the guide and the ever ready man who is the first contact at any sort of an issue and more importantly was freely available at any time (then)

This was my treasurer as a rep and since then for some unfortunate reason for him had to be a good friend of mine till this day, obviously with so many arguments and disagreements starting from hair and beard

This union president had to bear most of my direct criticism , but still keept laughing for a reason unknown to all. This person makes the properties of associations, faculty etc public which help sometimes, but not all the time.

This genius, who has climbed and excelled in all possible subjects, had always been a pillar with valuable inputs for a successful 5 years at the faculty, and had been the final destination when a decision regarding a subject matter is needed.

The union guy since year one.  Had so many plans, so many fights, disagreements , but was continuously supportive, particularly in the early years of need and led Anti SAITM campaign from our batch.

This is the Drama friend, who lit bulbs throughout 5 years and been motivating at times things were getting pretty bad with no solutions.

And then there were a lot of others who had always been a wonderful support over the years,  Carbo - The constant admirer, Sasangi - The constant supporter and particularly her family; where their house became a public property of 2010. There were so many other friends who contributed for a great life at faculty.

Somewhere down the line, I happened to end up being a batch rep and if not for Lakshika (the repi) and her patience, her way of working and her leadership, that particular year would have been a much worse one for the 200 in batch of 2010. I am truly grateful to her for the wonderful support given.

In this long reflection I can never forget the lot that had to bear me for 3 years at least every morning in different wards. There were issues more often than not, but if not for this lot the dream of MBBS would never have been a reality.

And then there are groups with different names, body group, community group, family attachment group, research group, elective group, prof groups, study group, cases group etc etc where I had to be a member sometimes with greatest enthusiasm and sometimes with greatest reluctance, but somehow ended up being a nice memory or an unforgettable experience( good and bad).

Also there were different committees namely Disaster Management, Sports Association etc which I had to be a part and contributing in different scales. They provided me the greatest opportunity to work with wonderful/not so wonderful students from senior/my/junior batches.

Not not to forget the long list of roommates I had - Lape, Sithasiha aia, Dasun, Randika, Yeshan and Diluksha ; the long list explaining how troublesome I must have been to the people who lived around.

Slowly but steadily we had to enter the so called ''Prof" year , the final lapse. It must not have been what it was if not for Praveen aia, Aindrani akka, Chapa akka - some i have met and some I haven't and only a Colombo medical graduate will know their value. And how can I ever forget , the dedicated seniors who were sometimes more enthusiastic than us to get good results for the faculty they studied. The Genius Mythili akka, Yasith aia, Kasun aia, Arjuna aia, Tharunya akka guided us with all that they gathered over their lives in medicine, and sometimes to the extent we couldn't even believe their commitment for a junior batch that had troubled them so much. If not for Praveen aia in particular, some Prof. appointments would never have ended with what the final results have displayed.

Among all senior inputs , I need to remind this character , 

whom for his fortune/unfortunate had us behind him during the Prof. year (his intern year). The ward tricks, BSS breaking bad news, Pearls of being a Good & Efficient intern were lessons taught by this man with example. Maheshi akka too had her inputs, particularly during Surgery appointment.

What is in word here are just bits and pieces from here and there that ran through mind when reflecting on the last 5 years at a glance. The Dances, visits, trips, dramas, decorations, sports and many more keep rushing in to mind which I would purposefully omit for the benefit few readers who will ever read this blog.

At the end of it, the papers Dean madam sent us through air, has unfortunately divided the batch to two broad groups on the day after our "Going Down", as those who passed and those who were not so lucky in the 1st attempt. However, I personally am proud that a batch mate of ours has set a legacy that would motivate thousands of students who come to Colombo to enjoy and excel in medicine with a balanced faculty life. If there's a will, there's a way is a famous saying I have listened to and this time it was proven in reality. 

It had been interesting (sometimes there were issues too like with anybody else) to work with Praveen since year one at various levels Med fest, Law Med, Freshers'welcome (Induwara). His prep talks, the unbelievable leadership skills , the entertainment has always been a great asset to Dahaya, until  he proved yesterday that he is unstoppable, by setting an example of balancing everything and finally reaching the target one needs to achieve. Among all good things he did for the batch , he has set the exact motivation for the  batch mates who needs to attempt again in May, "It is never about what you got in the past, it is about what you want to achieve in future, and getting the right advice, doing the right thing to get to the position you want" - Congratulations Praveen! And Thanks for making 2010 batch and Faculty of Medicine, Colombo Proud! 

and All the very best for the friends who will be attempting again! :) After all this is not MBBS(Aluthkade), and it has to be earned in the correct way which is hard ; not by money, court orders or corrupted politicians! 

The Strike Times

When I walk to the ward everyday, with utmost difficulty by 7.30am, as the register was marked around that time, I see her doing the ward round and over half of it already completed. Well, she is obviously not one to be missed with her big belly with a foetus on ,over 24 weeks. I remember the complaints my relations had when they were pregnant. Difficult to walk, morning sickness, leg pains etc etc and here is a lady perhaps with all those difficulties still managing to come to the ward and do the rounds before any of us come to the ward. It was not only her, the junior doctor who was presenting patients to her was also with a belly of over 28 weeks perhaps. Some days, the nurse following the ward round too was pregnant. It was a ward treating sub-fertility and as expected, a ward with good success rates in that regard perhaps.

I see that senior doctor doing the ward round there, takes something for breakfast and returns to consultant's ward round wiping her mouth; perhaps half eaten. Then she follows the consultant, under goes the mind storming the consultant expects of her. Then are the scans which she has to complete. Sometimes it is the operation day, she is to visit the theater early, guide her juniors, make everything ready and wait for her boss to come and make the incision. She does the surgeries, not second to any. Then there are issues like the belly coming between the bed and her, making the approach much difficult. But somehow she is to complete the theater with in the time limits allocated.

Ward and theater are better, then comes the clinics. Many patients coming from all around the country. She is a doctor taking care of the patients, a student under her consultant, a tutor for the lazy medical students around and is the one who has to make all decisions the SHO is unable to. To add on to this, there are days we hear the consultant saying things like, there is some session and ask her to make a presentation for him to present. Or asking her to visit some place where there is session for her to attend to.

Well, she must have run through the 3 wards she has to take care when she is on call; which comes every other day as there are just two registrars working; and complete her night ward round around pm. And then complete all the scans by about 9.30 pm. Then comes her teaching episode. She visits to the class of medical students, who by this time are blaming her for being late as she has requested the students to come by 8 pm, and one and half hours of their precious time is wasted. Somehow she comes and do the teaching for the medical students for about 30 minutes, which is a bit quicker teaching than usual speed medicos will get. The usual worry of the medicos at the end of session is, 'why the hell did I come to class today? It was too fast. I better would have slept at that time. With all these untold comments on her teaching, I see her leaving, to somewhere a HO has requested her opinion on a bad patient, about 11 pm on the clock and still with the same dress I saw her at 7 am

Then it was one night, I was chatting in fb around 12am mid night as it was my rotation that day, there was a bad patient in labour. The new HO's who are clueless of most what is happening around anyway, are supposed to call registrar's opinion. The nurses, and all were busy stabilizing the patient, and here comes her, with tiresome eyes, swollen face, and her child in the womb. What ever she had felt, how much she would have wanted to sleep after the heavy work of the day, she had no option. That is what she decided her job must be.

She might have been someone who wanted to be a doctor from her early childhood, like about 50% of child population in Sri Lanka. ( Perhaps figures might have changed these days as majority would like to be some sort of a star) She might have chosen Bio stream in A/L's; perhaps as she really wanted to be a doctor. May be because her best friends did the same. May be because she was not good in writing essays with numbers in Maths, ( I have seen my friends doing A/L maths, the question was so long. As a person who usually messed my +,- signs in my O/L maths days, i was clueless how these guys would not mess the so many letters, signs, numbers in the questions), or hated her own Sinhala handwriting ( like in my case, end of O/L Sinhala day for me gave a great satisfaction as i thought that would be the end of my Sinhala essay writing- which partly was true, I hated my hand writing), or not much in to business ( in commerce if you do it, you would need a lot of experience and do CIMA,AAT etc etc extra exams to get a good job). Her only option would have been to do Biology. Then for some strange reason she might have passed A/L s with flying colours. And since that day her friends, relations etc everyone would have called her 'doctor'; though she never wondered the courses she would have applied with her results. She might not have known herself, what she likes, what she doesn't like when she applied. Obviously she might not have expected the life she is spending now. Somehow she must have entered to the Medical faculty, and since day 1, she might have had thousands of lectures, dissections, practicals, tutorials, visual learning exercises etc etc And at the end of the teaching, she would be given the vacation of one or two weeks, which at the end will be proceeded with an examination. The term of 'vacation' redefined by 'study leave'. Not to miss the number of family gatherings, college functions and friends' gatherings she would have missed, not merely because she was busy with studies, but she had to be marked present to avoid repeating the appointment , which she will have to repeat during a rare free week that she may get. These are just the study issues, what about her other girl issues?? The fashions, the relationships etc.. All issues that an ordinary girl in this age would have will surely be common to her if she was doing medicine or not.

Well, non of these should be an excuse to her. She chose the field of medicine with the great social respect associated with the profession. Surely like most of the medicos, she would never have expected to go through this journey to get there. But nothing should be an excuse. All the sacrifices, hardships, they all come in the same plate which all privileges a doctor is entitled to. I have often seen people complaining of jobs, the A/C in the office is not working, heavy work load with about 100 reports for a day, need to work in the dark, the office issues are too much etc. Well imagine a life where your office is a place of crying people, people coming with pain, bleeding, vaginal discharges , menstrual irregularities etc.. It is a life which you will never imaging. A mother will know the pain she under goes during a labour. But to be with mothers undergoing that pain everyday, bear through the screaming daily, and console her with pain relief daily is never an enjoying task. Well the only place you will feel a bit comfortable would be a Paediatric ward. It is like a pre school. Children playing and hiding. There too children cry, but crying is something children do. So, a paed ward would be a bit nicer place. But there are children with serious conditions; where the atmosphere completely changes.

But you admit it or not, she must be really satisfied with the work she does. The job satisfaction she gets by relieving pain, giving a new born to the mother's arm, are only in this sacred position. She is extremely lucky in that regard.

One day I heard a junior doctor was speaking to her saying, one day a security officer has asked who she was while passing through the gate. She has responded saying She was a doctor. The security has replied, "if you were a doctor, why don't you come in a car?". The junior doctor was furious, she has blamed the security officer. Well, I know the majority would say the doctor is rude, she must be clam and explain the reasons, or crack a joke at the security officer. If you were an intern, with a salary just enough to manage yourself, has completed a long day, going for dinner around 11.30 pm , and if some one comments like the security officer, you will understand. But again, nothing is an excuse, it was her who selected the profession, she has to take all the good and bad that comes with it.

All in all, what I see here is that, great majority has a dream of being doctors, yet they don't realize what it is like to be one. When they do realize, some times there is no way out. True, being a doctor comes with a lot of privileges, and so does the dedication and commitment. None of the doctors can say their life is hard, because that is what comes with the profession. It was them who chose it and no one asked them to. But the other aspect must also be remembered. As much as they are responsible for the difficult life they agreed to, they must get the benefits the profession is getting. If the privileges are lost, it is their right to fight. People can say thousands of things, but if you take off some privileges of those who blame others for striking, those guys will be the first to get in to streets. Of the people who shared most posts against doctors recently,  the ones who called if I could help them take medicine early with out being in a cue, or asked who the best consultant in a particular field was, or asked if I could give them an extra car pass were the great patriotic activists.

How much She- the character I described; has to under go in her life these days, I must admit that She is doing one of the greatest and sacred jobs in the world, which the satisfaction can never be compared. She must have done some great great merits to get it in this life. Sometimes, the sinners too get in, may be by mistake. But that is rare, the majority are the lucky ones. Otherwise our health will not be in the standard it is there now.

My opinion on her is that, I have seen her dedication, I have gone just a small distance she went, So, don't bother of what the 'unknown' is shouting, do your job THE BEST way you can, so you may get the satisfaction to the maximum. In the meantime, if there are any issues with the privileges you get, it is only you that needs to fight for it. No one will care of You  in time to come. But at all time, remember, " It is a highly satisfying occupation you got, and at all times keep it's respect. If you are uncertain of your ability, or your suitability for the occupation, or if you are hoping to be a millionaire, just plan some other future that suits you and make life much easier! "

Same warmth, Different routes!

Today, in neonatal resuscitation trolley at labour room were two babies, kept for warmth to prevent hypothermia. They were sharing the same warmth, kicking at each other and were having a good time. They belonged to the two mothers who just delivered them in adjacent beds, who are completely unknown to each other. The two babies, who were born on the same day, perhaps a few minutes apart , are having a good time. I was wondering around, (as usual) and the view of the two neonates just made me think “Will they ever meet again in life? And if they did, will they ever remember that they shared the same warmth on the day they were born ? What would the “time” would have done for their lives by the time they meet? “.This thought reminded me of my own experience.

As for the Free education system in the country, Grade 5 scholarship was (rather still is) an important obstacle for us who studied at the peripheries. We had after school classes; done by our class teacher, 4 days per week, (unlike today, it was free of charge, a social service of the class teacher ; who is the mastermind which guided our lives for our academic achievements up to date ). There were many friends, whom we used to play cricket until class starts and one of them , for the purpose of this story will be Nimal. It was a wonderful childhood we had though scholarship was a competitive exam. We passed the exams, Me, Nimal and many more included. Well by tradition, at my school, the students who passed the scholarship exam used to give a treat for the staff of the school ; one reason for this being that most who would pass will go for so called better schools around and else where. One of the passed students, will have to deliver the welcome speech for the teachers , and the class teacher offered me the opportunity, as I was the highest scorer, but She told me that, “ if you can’t just let me know, because Nimal would even do a better speech than you, but this is offered to you as you are the highest scorer “ . Well as a kid, I did not want to miss opportunities ; something which is practiced still I suppose. So the speech was delivered, within a few days I left the School and travelled Kandy for better education. I did not meet Nimal since then till date.

Let’s say Sunil; was another student among those who passed the exam with me. He decided to stay at the same school. Up on subsequent visits for my home place I would have met him once or twice, chatted sometimes. Last time when I met him before the story which I am about to describe, he was a Security Officer. But it was last year(2014), as a 3^rd year medical student, when I was walking around, some minor staff person called me. I was not sure what the message the minor staff member wanted to deliver to a medical student, and up on turning I met Sunil, after many years, being a minor staff member : partly explained by the fact one of the previous minister of Health ( Before November 2014) was from the peripheral area where I studied). He was busy carrying some samples, so we only could have a little chat. It was not the Grade 5 discussion we had. Perhaps because he was busy for his work and I was running the marathon from hostel to ward to be at the ward a second before the consultant comes. Subsequently, I met Sunil a few times around the hospital. We had short chats here and there, what the duties are, how the staying conditions , the wards they work, the salaries etc etc etc.. Still I meet him once in a while and each time – both of us running in different directions , in a hurry, just like after scholarship exam.

Last April, I visited my home place for the new year, and I was not feeling quite well. I visited a doctor there and he prescribed some medicine ;( all of which I would have prescribed by myself and so is my mother or any one who had a fever and cough before) I went to the counter and gave the prescription. The lady inside was staring at me; which is a rare occurrence, and after sometime she asked if I was Leonard. Well I was a bit surprised, but given the fact it was my home place I though she would have been someone who would have known me. But she introduced her as; Let’s say Nayanaa ( The Grade 2 Sinhala book),who was another classmate of the Grade 5 class, And I was much surprised and happy to meet her after a long period.  Like Sunil, She is also in the field of medicine, which I would be attached to in the due time, Hopefully.

Well this is the fate of lives the time has taken us over the time. You would have waited to see what happened to Nimal at the beginning. But I don’t really know. Hope he is having a great and a enjoyable life. Sunil is in the same hospital I am training, but he is serving the people & earning and I am studying. Nayanaa, as I heard has married recently, and she is also in the medical profession. There were many who were in the class with me. I do not know that happened to most. I remember one friend was killed by LTTE at a Paddy field during war times. All of us shared the same warmth of the Grade 5 class, had the same freedom and happiness at that time. Just like the two babies in the labour room now. But now we do not know what happed to most of our friends. But, once in a while we might meet some of those classmate. But when we do meet ; our lives are never the same again – THE TIME will tear us a long distance part.

So dear babies , you might probably meet again ; but you will never recall that you shared the same warmth on the day you were born and even if by accident you recall that you were together on your birth day, time will take you a long distance apart.