Welcome to my Blog

A warm welcome to my Blog

I shall post some news of interest to Sri lankans about life in Sri Lanka in the period 1950-1960 mainly. This will feature articles on music, general history and medicine. I am dedicated to humanism and refuse to judge people according to labels they are born with. Their actions and behaviour shall be my yardsticks, always cognizant of the challenges they faced in life.

Thursday 15 March 2018

Virtual interview- SPL Part 2

The Speedy Virtual Interview Series - Episode 5- part 2
March  2018

Professor  Sanath P Lamabadusuriya
Emeritus Professor and Consultant Paediatrician. Colombo, Sri Lanka

Speedy: Welcome again Sanath for the Final Part of the Interview.  We reached the point where you got through Part 1 of the MRCP. Was that the time when you decided to pursue a career in Paediatrics?

Sanath: No, I made my choice for a career in Paediatrics when I got the post of Lecturer in the Department of Paediatrics.

Speedy: I see. And while in that post, you were awarded a Colombo–Plan scholarship?

Sanath: That is correct, and this enabled me to proceed to the UK for post graduate studies for a period of two years.

Speedy: I see. And you told me that about this time you had a most interesting experience prior to leaving for the UK. Could you tell us about it?

Sanath: Yes Speedy, this really happened. In late 1971 (year of the first JVP uprising) I decided to have my palm read by one Dr. Kingsley Goonetilleke, who had an office at Galle Road Ratmalana. At that time I had long hair and a beard. After parking my Triumph Herald car some distance away and wearing a pair of rubber slippers and an unbuttoned shirt, I walked into his premises. After accepting a payment of 10 rupees, he daubed my right palm with India ink, got an imprint on a sheet of white paper and started reading. When he asked for my profession I replied that I am a bank clerk. Then he told me that it could not be true and unless I assisted him, he would not be able to give an accurate reading. When I replied that I was a doctor, he said that I have to be doing something more than treating patients. When I asked him what he meant, he replied that I have to be teaching, doing research or both. (He was “spot on” as I was doing all three as a lecturer).I kept quiet and he went on reading saying that I am due to proceed abroad fairly soon and after a few years that I would return single and get married to a person known to my family. At that time I had never met my future wife Buddhika, He went on to mention that I would become a professor before my 40th birthday. (It was not possible at that time because both Priyani Soysa and Herbert Aponso were due to retire in the early 90’s). After I returned at the end of 1974, I went through a marriage arranged by my parents. Buddhika’s father and my father were cousins, hailing from the same village called Pahalagoda in Tangalle.

Speedy: That is quite an amazing story Sanath! Has this influenced your views on palmistry and horoscopes?

Sanath: I do not have fixed ideas about both topics. However, my personal experience which I related just now has swayed me towards being a believer.

Speedy: Quite understandable. This shows how people approach these matters and how personal experience influence belief. Just out of interest, why did you consult this person?

Sanath: My father used to dabble in astrology as an amateur and he had dealings with Kingsley Goonetilleke. That may be the reason why I consulted him. However, the palmist did not ask for my name and he did not know my identity.

Speedy: Cultural influences do play a big role in our belief systems. I quite appreciate that.
And then you went to the UK.

Sanath: Yes, in late December 1971, I boarded a BOAC flight and arrived in London. I was allowed only GBP 2.50 as foreign exchange and spent most of it drinking Scotch whiskey on board. I followed a course in Child Health at the Institute of Child Health, University of London, which had been arranged by the British Council. I passed the DCH (London) exam without much difficulty. I was given a monthly allowance of GBP 72.00 and lived in a bed-sitter at 58, Hermiston Avenue. N8. I travelled by bus to the tube station at Finsbury Park and got off at Russell Square.

Speedy: You were just a clinical observer or were you actually doing clinical work?

Sanath: No my scholarship did not give me a clinical position and I was rather bored following this course. I contacted the British Council and informed them that as I wanted practical clinical experience before sitting for the exams, I would like to do a job in the NHS. They told me that I would have to find a job on my own and when I find one, to inform them so that they would stop my monthly allowance. I applied for a few posts and was successful in getting an SHO post in neonatal paediatrics at the Whittington Hospital in North London.

Speedy: This must have given you valuable direct clinical experience.

Sanath: Yes it did and I was also able to save some money and go to France for a short holiday. I went by train to Paris, crossing the English Channel in a hovercraft.

Speedy: I remember doing that journey with Patrick Fernando who is also sadly no more. We crossed the channel by ferry. Please tell us about your stint at Whittington Hospital

Sanath: I started work at Whittington Hospital on the 1st of April 1972 and worked for six months until the end of September 1972. I was on call every other night and when on call worked continuously from 8.00 am to 4.00 pm on the following day. I was provided with free hospital accommodation, subsidised food, free phone calls, free laundry services and free beer in the doctor’s mess! As I did not have to spend for transport I saved a lot of money from my monthly salary of GBP125.00. I purchased a Ford Anglia car for GBP 60.00. During this time I passed the MRCP (Part 11) examination at my first attempt. I also associated closely with Susiri Weerasekera, who was a SHO in orthopaedic surgery at the same hospital.

Speedy: Was it all work while you were in the UK?

Sanath:  Fortunately not Speedy! In the summer of 1972, I went on a driving and camping holiday with Bertram Nanayakkara in his Volkswagen Beetle. We set off from London to Dover and crossed the English Channel to Calais. We drove to Paris and camped in a campsite in the north of Paris. These campsites had all the facilities. Then we drove to Lyon and Interlaken in Switzerland, our next camping site. We visited Geneva, Zurich and Berne and drove to Vienna where we visited two castles and then drove to Munich to see the Olympic village about two weeks before the 1972 Olympic Games. I took over the wheel and I was able to exceed 80 mph, which Bertram could not! On the autobahn, another car overtook us and one of the blacks in that car started gesticulating at us for apparently no reason. We crossed the border at Arnheim in Holland towards twilight and when we returned to the car after the immigration check, we discovered that our camping equipment had disappeared together with the roof rack! Then we realised how I was able to exceed a speed of 80 mph and why the occupants of the car that overtook us, gesticulated (they would have witnessed the roof-rack being blown away). We drove back to a police station in Germany to report our loss so that we could claim insurance. We drove to Amsterdam through Rotterdam and parked our car close to the railway station so that we could attend to our ablutions. We spent the rest of the nights in our car as our finances were exhausted. From Amsterdam, we drove to Brussels, visited the Golden Square, saw the Mannequin Pis and returned to London through Calais and Dover. During the trip Bertram was teasing me about the inexpensive Kodak Instamatic camera I was using with magicubes, in comparison to his much more expensive Canon camera. After the trip, Bertram sheepishly asked for copies of my photographs as his camera had not functioned at all during the entire trip!

Speedy: The exuberance of youth! Bet you couldn’t do that now! What followed the Whittington job? Presumably, your scholarship time was not exhausted?

Sanath: Yes, I had I had plenty of time left, as I had obtained both DCH (London) and MRCP (UK) within six months of arrival. After completing that, I had one of two choices; either I could apply for a registrar’s post in the NHS and earn more money or revert back to the scholarship allowance and pursue research.

Speedy: I know what you decided but what drove you to pursue the research option?

Sanath: As I was single I had no one close to advise me. But I chose the research option because I was already an academic and involved in a bit or research before I arrived in London. (Fortunately, I opted for the latter and this happened to be one of the most important decisions I have made in my life). My position was as a research fellow in paediatric gastroenterology at the Institute of Child Health, London. My supervisor was John Harries who was a Senior Lecturer. Others in the department were Professor Otto Wolff, June Lloyd (who later became a Baroness), Audrey Fosbrooke and David Muller.

Speedy: Could you please talk about your research experience?

Sanath: My first research project was to assess the usefulness of the Xylose Tolerance Test as a screening test for coeliac disease. My findings were different to the hitherto published work as I found it too unreliable to be used as a screening test. Subsequently, other studies proved that I was correct. Later I got on to bile salts; to find the effects of unconjugated bile salts and mixtures of bile salts and lipids on the small intestinal function and structure. The experimental model was the Wistar rat. I sacrificed well over 700 rats for my research. I had to obtain an animal licence from the Home Office to carry out the dissections. I used to present my research findings at meetings of the Paediatric Research Society, Medical Research Society and the European Society for Paediatric Gastroenterology, in different centres in England as well as in Helsinki and Verona.

Speedy: Great stuff! Did this research lead to a research Degree?

Sanath: Not unless I registered for one. In fact, after a few months my supervisor inquired from me whether I would like to register for a research degree and if so a minimum of two years was required. As I had started research on the 1st of September 1972, I needed an extension of leave as I came on two years leave which would be over at the end of 1973. I applied for an extension and with great difficulty, I was able to obtain an extension of one year.

Speedy: Was this a paid job or purely Honorary?

Sanath: This was Honorary and I had to revert back to my scholarship allowance. During this time I had reverted back to my bed-sitter at Hermiston Avenue and was stretched for finances. Fortunately, Pramilla Senanayake introduced me to the Southern Relief Service based in Crystal Palace which was a locum service for GPs on leave. I was provided with a chauffeur-driven radio car to visit patients in their homes. I was paid GBP 1.50 per hour and worked from 9.00 am to 7.00 pm, on Saturdays and Sundays. I earned GBP 30.00 per weekend to supplement my scholarship allowance. (I worked really hard, seven days of the week, without a break.)

Speedy: That must have been really tough but it must have also been a life saver! You must be very grateful to Pram.

Sanath: Indeed I was.

Speedy: Did you do more trips to Europe?

Sanath: In the summer of 1973 I went to the Scandinavian countries on another driving and camping trip with Bertram. We sailed from Harwich to Hamburg and visited Copenhagen, Malmo, Jonkoping, Stockholm, Oslo and back to Copenhagen, Hamburg and Harwich. Both these trips to the continent were really enjoyable and we used a book called “Europe on 5 dollars a day” which was quite handy.

Speedy: And back to work! How long did it take you to complete your PhD?

Sanath: I obtained the PhD (London) after 2 years and 3 months of research and returned home at the end of 1974, after completing the study leave. I was the first clinician to obtain a research degree in Sri Lanka.

Speedy: The first Sri Lankan Clinician to obtain a Research Degree! I wasn’t aware of that. Congratulations!

Sanath: Thanks Speedy.

Speedy: As you said, you came back to Sri Lanka. Were you tempted to stay on in the UK?

Sanath Speedy, the country was going through difficult times; however, I was keen on returning so that I could be with my parents who were both quite old by then.

Speedy: That is a very honest and frank answer. Tell us now about what you did after returning to Sri Lanka.

Sanath: Soon after I returned, I won the George Wickramasuriya prize which was awarded for research in paediatrics and obstetrics and gynaecology; I shared the prize with Professor S.S Ratnam from Singapore. I resumed work at LRH and Colombo Medical Faculty for a monthly salary of Rs.900.00. There was no private practice but the income was sufficient to lead a comfortable life as I was single and living in Wellawatte with my parents. As it took one year for me to get a car permit, I travelled by bus to LRH and the bus fare was 25 cents. I had lunch in the Senior Common Room which cost Rs. 1.60. On two days of the week, rice was not available and we ate manioc, sweet potato or string hoppers (during Mrs Sirimavo Bandaranaike’s regime). When the sea baggage arrived, it included a bicycle and I cycled to work.

Speedy: This was a time of great political change in Sri Lanka. Can you give us the background on which new Medical Faculties sprung up?

Sanath: During this time, some opposition members of parliament made speeches in parliament saying that if and when they come to power, they would abolish standardisation at the University entrance examination. When JRJ romped to power in 1977, they had to honour their promises. When standardisation was abolished, it was found that relatively more Tamil students would be entering the two medical faculties. As this was politically not acceptable, more Sinhala students had to be admitted. Then it was found that the number of slots available in Colombo and Peradeniya were insufficient to accommodate the increased intake. In 1978 two new Faculties of Medicine were created in Ruhuna and Jaffna. When the posts were advertised I applied for Ruhuna and was selected (I was the only applicant).

Speedy: We shall discuss your family at a later point but suffice to say at this point that you married Buddhika, who is sadly no more with us, in February 1976.

Sanath; Yes, I did and we had a very happy time together till she passed away in November 2013.

Speedy: We were all saddened to learn of her illness and your loss.

Sanath: Thanks Speedy. We have to accept these inevitabilities in life and just do our best to get on with it.

Speedy: A courageous and realistic attitude. Let us get back to the next stage in your life.

Sanath:  In 1979 when Buddhika was granted her Post Graduate study leave, I took sabbatical leave and assumed duties as locum Consultant Paediatrician at Pilgrim Hospital , Boston, Lincolnshire and Buddhika joined me later. When my leave was over in November 1979, I returned home. I assumed duties at Ruhuna on the 1st of September 1980 as the Founder Professor. (Palmist KG’s second prediction was proved correct because when I assumed duties in Ruhuna, I was 37 years old).

Speedy: Sanath, you have achieved a lot in your long and illustrious career. Is it possible to single out any project which gave you the most satisfaction?  

Sanath: My most satisfying professional project is the Sri Lankan Cleft-Lip and Palate Project of which I was the co-director together with Dr Michael Mars, who was a Senior Registrar in Orthodontics at the Hospital for Sick Children, Great Ormond Street, London. When I was in Galle, in 1982, Michael contacted me and invited me to join in a research project. There was a controversy in the West about the restricted growth of the middle third of the face (maxilla) in patients who had been operated at the conventional time for a cleft palate. The dilemma was whether it was due to an intrinsic bone defect or iatrogenic, due to surgery. To resolve the issue a population of patients was required who were born with such defects and who had not received surgical treatment, at the conventional time. As such patients were not found in the West, he wished to know whether such patients are found in Sri Lanka and if so whether I would like to participate in a project to resolve the issue.. As I sent a positive reply he visited Karapitiya on a pilot trip with a maxillo-facial surgeon, David James. I collected about 30 such patients of different ages. They took plenty of photographs, dental casts and lateral X-rays of the skull using a cephalostat. They wished to come again. My reply was that they are welcome but if they come again the patients also should benefit. Michael inquired from me what facilities could be provided for surgery. As the hospital at Karapitiya was not built as yet only the one at Mahamodera was available. I told him that I could provide a theatre table, lamp, oxygen cylinders and nothing else. Later he managed to raise funds and arrived with a surgical team which comprised of plastic surgeons, anaesthetists, ENT surgeons, orthodontists, speech therapists, theatre nurses, dental nurses and a paediatrician. They were from the UK and Norway. About 30 crates of equipment were airlifted containing surgical equipment, anaesthetic equipment, drugs, IV fluids, theatre boots, gloves, gowns, dressings etc.

Speedy: This shows how determined you are when you pursue something close to your heart. How did you set about recruiting patients?

Sanath: I managed to collect hundreds of patients from all over the country by advertising through the media.They were prioritised and only patients with un-operated cleft lips and/or palates were selected. Many investigations such as dental casts, speech recordings, photographs, nasendoscopies,  psychometric assessments, audiometry etc. were performed. Medical students acted as interpreters. Surgery was performed during the night as that that was the only time a theatre was available at Mahamodera. Over the years there were three surgical expeditions, each visit for two weeks and over 700 patients underwent successful surgery without a single mortality. There were several other visits for follow-up. Although the country was going through a civil war the recall rate was high from all over the country. The project resulted in many research degrees, scientific papers, lectures, orations etc. The final verdict was that the poor growth of the maxilla was due to the timing and quality of surgery. As a result of these findings, the cleft palate services in the UK were re-organised.

Speedy: Did it receive a lot of publicity?

Sanath:  There was a lot of publicity in the local media. The BBC made a film of the project titled “When to Mend Faces” and it was telecast on Channel 4 of British TV and Rupavahini. This film won an award as well. After viewing the film an anonymous person donated GBP 200,000.00 to develop speech therapy services in Sri Lanka. At that time we had only one speech therapist and she was in the private sector. As a result of this donation a diploma course for speech therapy was set up in the University of Kelaniya and currently, there are over 70 speech therapists distributed all over Sri Lanka. In recognition of my contribution to the project, Her Majesty Queen Elizabeth 11 conferred an MBE to me in 1992. Currently, I am the only Sri Lankan domiciled in Sri Lanka to receive a Royal Honour.

Speedy: A stunning achievement. Your MBE was well deserved. I am not aware of any in our Batch who figured in the Honours list although two of my classmates at Royal received Honours. One was Tissa Jayasekera who received an OBE and the other was Deepal Liyanage (known as Dai now) who received an MBE.

Sanath:  Both of them are domiciled in the UK. I remember Deepal. His brother Sunil was a boxer and a Rheumatologist. He was senior to us. Tissa Jayasekera was a Rugby colours man.

Speedy: When did you become Professor of Paediatrics in Colombo?

Sanath: After Priyani Soysa’s retirement, I assumed duties as the Professor in September 1991. (Again I was the only applicant) The Colombo Medical faculty changed its curriculum drastically getting rid of the 2nd and 3rd MBBS examinations and replacing these with modules and streams. I was appointed as the Chairman of the Clinical Stream for the new curriculum. Ten members of the academic staff, including me, visited the University of New South Wales to undergo training for this major step. I changed the evaluation process in paediatrics by giving 40% of the final mark for continuous assessment (done in a very objective manner) during the Final Year Professorial appointment and holding the clinical examination at the end of the appointment. The students were very pleased with the change.

Speedy: You became more involved with Medical Education and was elected Dean in 2002. How did this come about? Did you have some ideas which you wanted to put into practice?

Sanath: I was elected as the Dean for a three-year term of office. I was contested by Rezvie Sherriff whom I beat very comfortably. During this time I made a professional visit to Bhutan and agreed to admit about five Bhutanese students per year. Each student had to pay a course fee of USD 10,000.00 per year, which was paid by the WHO. Since then many Bhutanese students have graduated from our medical faculties. I also trained a Bhutanese paediatrician. I am very proud to say that there wasn’t a single strike by the students, academic or non-academic staff during my tenure of office.

Speedy: Keeping focused on Medical Training, how did you become involved in the Post Graduate Institute of Medicine (PGIM)?

Sanath: The predecessor to the PGIM was the Institute of Post Graduate Medicine (IPGM) whose Director was Professor KN Seneviratne. I was appointed as the Secretary to the Board of Study (BoS) in paediatrics. Later the IPGM was abolished and the PGIM replaced it. I was a member of the BoS in paediatrics from its inception until I was appointed as its Chairman in 1991 when I returned to Colombo. I was the chief examiner for both the DCH and MD examinations. I continued in that position until I retired in 2008. I brought in many reforms in the training programme and was instrumental in creating sub-specialities. I was a member of the Board of Management of the PGIM for many years in the 1980s, 1990s and until 2008.

Speedy: These were all groundbreaking initiatives. You also held many positions in various medical associations. Just to mention a few, you were the President of the Galle Medical Association in 1990- 1991 and the President of the Sri Lanka Paediatric Association in 1993 and President of the SLMA in 2011. You were a member of the Sri Lanka Medical Council for many years. You became the country representative of the South Asian Paediatric Association and culminating as the President of the Asia Pacific Paediatric Association (APPA) from 2007 to 2010. These are notable achievements.

Sanath: Thank you. Yes, I felt greatly honoured. You mentioned the APPA, and the academic sessions of APPA were held in Colombo at the BMICH in 2007, during the war. However it was very well attended. I served in the Standing Committee of the International Paediatric Association (IPA) for many years. I was honoured as “Outstanding Paediatrician of Asia” by APPA in 1997, when the sessions were held in Hong Kong. When I was President of APPA I was invited to deliver Guest Lectures in several member countries of the region. Just to complete my International profile, I was awarded many short-term WHO fellowships and was a member of several WHO committees. I was a member of the WHO Immunisation Practices Advisory Committee (IPAC), based in Geneva, for three years and currently am a member of the International Technical Advisory Group (ITAG) based in New Delhi.

Speedy: And in 1989 you were awarded a prize for Social Paediatrics jointly by the WHO and International Paediatric Association (IPA). What was the nature of this award?

Sanath: This was a travelling fellowship worth USD 10,000.00 and I spent two months in the Chinese University of Hong Kong and one month in the Chulalonkorn University in Bangkok, Thailand.

Speedy: Sanath, there is one more thing which brought you a lot of Media attention. I am referring to the Professor Priyani Soysa Medical Malpractice case. If you don’t want to discuss that please let it go.

Sanath: Speedy, I am quite happy to discuss it. Let me outline the case. In May 1992 I was contacted by my former RC classmate Shibly Aziz, to take over the care of the daughter of a colleague of his, Rienzie Arsecularatne, both of whom were State Counsel in the AG’s department. Suhani Arsecularatne was warded at Nawaloka Hospital, under the care of Prof. PS. She was being treated for rheumatic chorea for over a month by PS. I disagreed with the diagnosis as I detected that Suhani had very brisk knee jerks in addition to the choreiform movements. As I suspected a brain tumour, I requested for a CT scan of the brain, which revealed a brain stem glioma, which proved to be inoperable. After Suhani passed away a few months later, Rienzie filed a case against Priyani and was found guilty in the District Court but was acquitted in the Appeals Court on a technical issue. This was a landmark case in the annals of legal history in Sri Lanka and received very wide publicity in the media. I gathered that this case is quoted very often during lectures for law students, both in the Law Faculty as well as at Law College.

Speedy: Sanath, we know a lot about you now but as I indicated earlier, would you mind telling us something about your own family, about your wife and your children?

Sanath: I am happy to do so. Of course, I am proud of my professional achievements but I am even more proud of my own family. As I already indicated, I married my wife Buddhika, in February 1976 at the Holiday Inn Hotel in Colombo. Our batch-mate Janaka Wijetunga was the best man. Buddhika was a Peradeniya graduate. At that time only 75 guests could be invited and only a wedding cake and a soft drink could be served. However, at the home-coming held at my home in Wellawatte plenty of friends and relations were invited and plenty of food and drinks were served. Buddhika returned home after obtaining the MRCP (UK) and was appointed as OPD physician at Karapitiya. Later she assumed duties as Visiting Physician, Homagama Hospital and retired as OPD physician, National Hospital. She was a very kind hearted individual who helped many relatives who were less well off. She was also very spiritual minded and attended dhamma talks and participated in many meditation retreats. She accompanied me on my numerous trips abroad. Unfortunately, she was diagnosed to have ovarian cancer in November 2011 and survived only for two more years.

Speedy: Yes, when we learnt about it, we felt a lot of sadness.

Sanath: Thank you Speedy. I had a lot of support from family and friends for which I will always be grateful. We had three lovely children who are all doing well I am happy to say.

Speedy: What is your spiritual side Sanath? Are you religious? What makes you tick?

Sanath: I am not the temple-going type and I don’t believe in rituals. I feel that by doing an honest job of work very diligently, one acquires merit.

Speedy: Thank you very much. I hope it wasn’t an intrusion! Do tell us about your children

Sanath: Not at all. Regarding my children, our elder son Shamin was born in November 1976. He attended Richmond College, Galle and later Ananda College, Colombo where he represented the school in chess and badminton. He later entered the Colombo Medical Faculty and captained the University chess team and was awarded colours. After graduation, he specialized in rheumatology and is currently working at the National Hospital. He is also very spiritually minded and attends dhamma talks frequently.

Speedy: Taken after the mother!

Sanath: Indeed. Our second son Harshan was born in January 1979. He attended Richmond College, St, Thomas’ (Mt. Lavinia) and Royal College. He did not like the way he was taught and we had doubts whether he would enter a university. We purchased a coconut estate in Weerapokuna so that one day he would be able to live off the land. However, there was a dramatic change in his career when I went to England with my family on sabbatical leave in March 1996. He used to play scrabble in school and represented Royal College at scrabble as well as the country. In England, he participated in numerous tournaments and won many awards. He was invited to appear on the popular Channel 4 TV programme, Countdown and became the runner-up. Later he won the British National Scrabble title and represented his adopted country as well. He attended Stenning Grammar School and obtained five A’s at the London A level examination. Later he entered Cambridge University and moved to Oxford for the clinical studies. Currently, he is working as a consultant paediatrician in Swindon Hospital. He married Michelle Gunasekera in 2011 and became a father last November. Last year he became runner-up at both the World Scrabble championship and British national championship after resuming playing scrabble after an absence of many years. Michelle is a registrar in nephrology in Oxford.

Speedy: I recall Harshan’s Scrabble achievement and in fact, there is a post on our Blog about it from Lucky on 27th August 2017. I find it fascinating to listen to how your son changed over the years.

Sanath: Yes, it was a great relief when he became more keen on his studies. My daughter Dilusha was born in January 1983 and studied at Ladies College and Visakha Vidyalaya. She graduated from the Colombo Medical Faculty, topping the batch with a first-class scoring 4 out of 5 distinctions at the final MBBS examination and winning eleven gold medals. She easily outshone her father who also topped his batch but obtained only 2 out of 3 distinctions and a second class at the final examination.

Speedy: Wow! That is an amazing record. You must take some credit for it Sanath, I am sure genes had something to do with it!

Sanath: I don’t know about that!  She married Upul Wickramarachchi and is currently in Norwich on postgraduate study leave. Upul is a research fellow in cardiology in Norwich. Dilusha delivered a son (my first grandchild) in June last year.

Speedy: Sanath, what have you done since retirement from your post? 

Sanath: My children have advised me to enjoy life by travelling. I embarked on an Alaskan cruise in August 2016 and a Baltic cruise in August 2017, both of which I enjoyed very much. As the Rajarata Medical Faculty is short of staff, I volunteered to teach there and was appointed as a Visiting Professor in April 2015. I visit Anuradhapura, Monday to Friday alternate weeks. The students are very appreciative of my decision as they are aware that I turned down three invitations from SAITM, to join it. (Logistically and financially,I would have been better off at SAITM) Last year the Vice-Chancellor of the Sabaragamuwa University, Professor Sunil Shantha, invited me to be the consultant for the establishment of a Medical Faculty in Sabaragamuwa. This faculty would be located in Ratnapura and 75 students would be admitted this year. Currently, I am the Chairman of the Meththa Rehabilitation Foundation which was founded by Dr B. Panagamuwa. I am also the Chairman of the Board of Trustees of the Children’s Convalescent Home in Thalagolla, which was founded by Professor C.C. de Silva in the early 1950s.

Speedy: Sanath, you mentioned the Meththa Foundation. You are probably aware of the fact that the SLMDA (Sri Lankan Medical and Dental Association in the UK), of which I am an active member, strongly support Meththa and we have raised considerable sums of money for it. Dr Bandara Panagamuwa who leads Meththa is a member of the SLMDA.

Sanath:  Yes, I am aware of that and welcome your support wholeheartedly.

Speedy: With your long and distinguished career which is by no means over, have you got any advice for young doctors who are just embarking on a career?

Sanath:  I always advise the students to spend more time in the wards rather than in the library, so as to acquire clinical skills, which I did as a student. As I am totally against strikes, at every opportunity, I advise them against strikes as it is the poor people who suffer during GMOA strikes.

Speedy: That is very good advice. Well, Sanath, we have travelled far together in our two interviews and now I like to conclude this virtual interview. Your story is also one that covers a period common to all of us who graduated about the same time and rekindled so many pleasant memories. What you have achieved is something we are all very proud of. It has been an immense pleasure to journey through your life and I wish to thank you for agreeing to feature in the Speedy Interview and wish you all the best for the rest of your journey.


Sanath: Thank You. It has been a pleasure and privilege.

Thought for the Day

I am mostly a Buddhist but I say mostly because I still have problems accepting it fully.

About "fairness", I wonder whether this is something intrinsic in us, sort of biologically, as there is no real reason why a physical Universe of which we are part of, should have any moral (Good vs Bad) Laws operating within it apart from the evolutionary perspective of survival, and survival of a species certainly depends on "moral" behaviours such as cooperation, sharing and caring for each other. These operate on a more macroscopic level but when it comes to explaining individual misfortunes, I struggle to see the connection, unless you either believe in a Supreme Force (very manipulative if there is one!) or in Karma. I can see the law of Karma or cause and effect, operating in the Universe, but not necessarily in a "moral" way. For example, a man who fiddles his Tax return or grows assets in off-shore investments, breaking the Law, could get rich and then reap the "effects" of his "actions" by having a nice house, holidays, ability to donate large sums of money to Charities, educate his children, support his less well-off relatives and so on. Morally what he did was wrong as accepted by Society as he could have been jailed and punished for it, and provided this did not happen till he died, he only had gains rather than losses. Buddhists may say that he will reap the consequences in his next birth, but he may say "who cares, it is not "me" as far as I am concerned". That actions have reactions is thus quite acceptable to me but how it operates morally in a physical Universe is beyond me. Having said that, just because it is beyond me, it does not mean it is not there! Which brings me to this fascinating concept of fairness. Fairness means different things to different people. The  thief might say that "it is not fair that I was caught because of all the precautions I took and it was quite by chance, nobody could have guessed, that the power would cut off at a critical moment", "it just ain't fair!",he says.

Take the case of the son of a very distinguished colleague of mine (A Professor and Knighted). The whole family had gathered in the Prof's House the day before the wedding and in the evening, his son went out for a walk with his fiancee. They passed a wooded area and suddenly, a man leapt at them and stabbed the son to death and ran away. He was caught, He was a Mentally unsound person on "community care" under supervision in a hostel. As a result, the whole family was turned upside down, You can imagine the grief and despair they must have felt. Being good Christians,  they went to church and thanked God as He must have had a good reason for allowing this to happen and the son must be happy up there in the arms of the everloving One. This experience will only strengthen them and help make them better persons, so they believe. If they were Buddhists, they would probably console themselves saying it is not only his Karma but that of all of us for this to happen. So what really happened? Was it just chance? He happened to be in the wrong place at the wrong time? Was it retribution? The bare fact is that he is dead, he is no more, he is an ex-son (as John Cleese would have said!). How to come to terms with it? Both the Christian approach and the Buddhist approach would undoubtedly help the victims, whether it is true or not. It does not matter whether or not there is a Helicopter hovering above you ready to descend and help you if you need as you trek the Sahara (Samsara), what matters, in the end, is your belief that it is there which will calm you down and give you confidence.

Fairness is I think intrinsic. We believe that there is or there should be some kind of justice in this World. Even an Atheist will say that good people deserve to lead a good life. An Atheist would not go beyond saying that chance can operate in this World, leading to all sorts of disasters ("I happened to be in that plane that crashed" Period. It was not God's will or Karma). Or, take another instance, I helped that man in every possible way when he needed me and it just isn't fair that he cheated me after all that I did to him.

Returning to whether it is "fair" or reasonable for the current "me" to suffer the consequences of a previous "me" (rebirth), the problem arises because we cannot see a continuum of previous "me" to current "me". If I see the continuum, I can see how it happens and it has happened, fair or not! The example I often quote is the child who through carelessness, lost most of his hand in an unfortunate factory accident. This child is now an adult - without one hand. Is it fair that what he did as an innocent, and may be an ignorant child, should "punish" him now? Fair or not, it was action leading to consequence.

Sunday 4 March 2018

A Letter to a Friend

By Mahendra, March 2nd 2018.

Introduction: First of all, let me say that I have a close friend with whom I exchange philosophical ideas. What I have discovered about my communications with her is her absolute honesty and sincerity. She trusts me and appreciate that good friends can be frank with each other, have differing views but still have respect for each other. I regard that as a tremendous compliment and find it deeply touching. With each other, we needn’t worry about political correctness and the question of hurting each other’s feelings do not arise as our discussions are at an intellectual level and although critical at times, always open and devoid of malice, scorn or other such negative connotations.


“I have often wondered why I think on matters such as what is the meaning of life, is there a God, does  Rebirth really happen, what is morality, why should we be moral, does it matter to know the answers, can we ever know the answers, does any human being have the capacity to know the answers, does  the acquisition of knowledge by reading books and other sources of information provide the answers, can we “understand” by deep introspection by just “thinking” and finally does it matter to know the answers, if that was possible?

I cannot provide one consistent answer but I can share my thoughts with you.

Firstly, I am a curious person and have always been so. My beloved mother used to say “Mahendra, why do you keep asking me why? Why? Why this, why that!” in frustration! The fundamental appeal of science to me is that. I can still picture my Chemistry teacher at Royal Mr Arulanandan, addressing the class and saying “Always asks the question why, never accept without questioning”.

It therefore seems that asking questions and asking “why” is something which is part of me and in some ways, almost an end in itself. But with ageing and maturity, my attitudes towards knowledge and beliefs have also changed. I am much more aware of our limitations and of the wide literature, both in Science and Philosophy on these subjects.

I know that there are no simple answers to many of the philosophical questions I ask. Furthermore, I have abandoned the quite naïve belief that if you are intelligent, you will apply the scientific method and you will get the answer. Long long ago, I thought that anybody who believes in a God, especially an all-loving merciful God is daft! I am pleased to say that I don’t hold that view now. Intelligence and belief in God or not linearly related!

I know that what we believe and accept is driven by a whole host of factors, some conscious and others not. The conclusions we come to are made within a Physical brain and a “hard to understand or conceptualise consciousness, or mind”, which operates by churning a whole host of available information, feelings, concepts, beliefs, knowledge acquired now and before, being influenced by cultural factors, family influences, past personal experiences and many more. Because of this, each one of us is unique, as our past and present are unique. If I listen to a classical piano piece and enjoy it, I will also recollect things connected to it such as a memory of where I heard it, with whom  I was with, the events which preceded it and succeeded it and all this will condition the way I feel during the moment I hear the music. The same music will be associated with very different memory associations for another person and although we are listening to the same music, the experience for that person at the same time could be totally different. Every sensory input causes arousal of a host of past experiences and responses, some conscious and others unconscious and determines the manner in which we perceive and interpret the sensory input. In this way perceptions produced by the same stimulus are unique to that person.

I think the same applies to phenomena which are yet to be fully explained by Science. I don’t think many will doubt the existence of the Moon and the mechanism of an eclipse as the evidence is irrefutable but when we ask a question such as, “Is there a God?”, we cannot expect a straight consistent answer from every person that question is asked because in the absence of proof, the acceptability of such a notion would be influenced by that person's background (all the factors I have referred to above). Furthermore,  there are different concepts of God. (a very common error when people “argue”, is that very few define what they are debating before they start!). There is God and there is God! An all-powerful super-being who created everything and loves everybody unconditionally (the humanistic more New Testament type), or an all-powerful super-being who created everything and picks and chooses people to favour and “better keep on his good side as he is quite capable of being nasty, really nasty, but if you accept him and have faith in him, he is absolutely fantastic!” (The Old Testament type, the Islamic type).

Personally, my own sense of logic does not allow me to accept and be comfortable with either of the two types of God referred to but I do know that if I was brought up as a Christian and a particular model was drilled into me, it is quite possible that I would have accepted one or the other model of God, - which brings me to rebirth, as that is the model in which I was brought up as a Buddhist.

The only reason why I am somewhat agnostic about rebirth is that I read widely on case histories where reputable, serious sceptical investigators investigated cases of recollection of past births and found the details given about that alleged past life correct in every detail, beyond chance and with no evidence of fraud. Western experts call it “unexplained persistence of memories of a past existence” with the statement that “rebirth or reincarnation is offered by some Asian religions” as a possible explanation.

When I put my Science hat on, rebirth seems utterly impossible and borders on the ridiculous. There is no biological explanation and furthermore, it appears to go against the theory of Evolution, which Scientists (and most humans) accept as a fact and no longer a theory. If the Buddhist concept is true, a human can regress and be born as an animal, which is against Evolution.

You can see my problem. Logical thinking and science tell me it can’t happen but I am still left with some doubts for the reasons I gave (the cases of recollection of past births).

This brings me to what I think is a logical thought process. Just because if some observed phenomenon has no current scientific explanation, it should not be discarded only for that reason. The correct approach would be to first investigate it thoroughly and make sure it is not a hoax or fake. If all the evidence points to indisputable data, then the conclusion is that this phenomenon has happened but we have currently no explanation for how it happens. Taking the example of recollection of a past life, quite a significant number turned out to be publicity seeking engineered falsehoods but there were instances which passed the test for a genuine observation. What I find unscientific is the attitude adopted by some scientists who investigated and found that the stories were genuine but nevertheless dismiss them by saying “it just can’t be true” or “they have somehow doctored this as it just can’t be true”. The proper conclusion should be that "A person recalled accurately details of the life of a person who has died, with no way of having obtained knowledge about that person, and we found the details to be correct. At present we have no scientific explanation for it”. That’s it, it is not “proof of rebirth but something which needs to be explained and not just dismissed, which, is the easy way out.

In many instances when a belief is tested, it boils down to this. What does your reasoning power indicate to you and what does any “inner consciousness or voice tell you” after critically analysing the problem? They may say the same or possibly the "inner voice" may suggest that your reasoning is faulty. Whenever that happens I would suggest that a sensible approach would be, whatever it tells you, to ask "is it compatible with what I believe is the proper way to live on this Planet to achieve happiness and Peace of mind?" If it is, it is unlikely to have harmful effects. If the answer is, "no, it would not", then that belief should be discarded.  For example, If your inner voice says “he is a heathen, kill him”, I am not advocating that you should go ahead and kill him! On the other hand, if the voice says "there is a God who loves me and all living beings", surely no harm can result.

It is my belief that morality is an evolved characteristic. Animals who roamed the Planet on their own without caring for other animals had a greater chance of not surviving. Or conversely, those who grouped together and supported each other increased their chance of survival. Cooperation, supportive behaviour, sharing and such beneficial characteristics enabled species to survive. Survival of the fittest as stated in the Theory of Evolution is one of the most misunderstood, misstated theories. Those who misunderstand say that it promotes selfishness. I say it is quite the contrary. Based on this ongoing beneficial behaviour pattern, Man has succeeded but as you would expect, not every individual man will display it but as a group, as a tribe, this moral behaviour has made us advance. It is still survival of the fittest, and the best way to survive is through cooperation.

My dear friend, what matters, in the end, is the comfort in your mind (and Body). Live a healthy lifestyle, do believe in God if it helps you and knowing you, if you do believe, your model will be one of unbound Love and Care for ALL and not just for those who believe in Him and accept him. If you truly believe in such a Power, you will do no harm and you will also not worry about Evangelism, or whether there is Rebirth or not, because His love is unbounded. A  lovely Christian friend I had (she is sadly no more), one of the best human beings I have known and who is sadly no more, told this to me when I asked her “Do you worry about the fact that your good friend Mahendra does not believe in God?”. “Mahendra dear, I know you extremely well and the kind of person you are and God will look after you whether or not you believe in Him”. If this is the way with all good God believers, the World will be a better place.

I wish I could believe in such a Force but I just cannot for the reason that for me, it does not fit with my own experience and understanding.

The very last point is if you do believe in some sort of life after death, then you may lean towards not just accepting just a “way of living well” now, in this life, but also taking steps to gain further insight and salvation through various practices such  as Meditation, prayers etc.in preparation for what follows death. The extreme position of this could be choosing a monastic life.

Well, that was a long rigmarole and thank you for your patience, if you read this far. Shall end by wishing you all the best and it is indeed a privilege to have you as my friend. In the end, after our basic needs for food, shelter, safety and good health are met, what matters most are not material possessions or power, but good friends and family living in a Society where people care for each other”.


Mahendra