HAPPY NEW YEAR -2020

Wishing all my valued colleagues and their spouses and families a very happy new year.

You would have noted my opening statement:- 

“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”.

In case readers wonder why I included the words-"always cognizant of the challenges they faced in life”, it is a recognition of the fact that in many ways, we don't really have a "free will" because, in the same situation, two people can make contrary decisions because of traumatic experiences (challenges) they faced in life which subconsciously affect their judgement. A young man brought up in an inner-city ghetto with abusive parents compared to a man brought up in a stable environment with loving parents for example. That is why we must be very careful in passing judgment on actions performed by people. Knowing the background is crucial. This type of thinking also leads to reforming a criminal rather than punishing him. I would be very interested in your feedback.

This brings me neatly to why I value our 1962 ColomboMedgrads blog and commend it to all of my Medical friends.

There are several major influencing factors in our lives.

1.  Our genes. This is probabilistic and not necessarily deterministic. If you have good genes, consider yourself lucky! Bad genes are not an excuse either!

2.    Your parents and your family and how they influenced you.

3.    Your schooling and especially your teachers

4.    The moral values you were subjected to - role models, religious precepts etc.

5.    Key Formative years, and in our case, includes our Medical undergraduate days.

The list is not exhaustive. The final factor I mentioned is of great significance to me. I changed from a wide eyed innocent boy to a mature adult. My teachers and my fellow undergraduates are and shall remain a key part of my life- not necessarily as a daily conscious thought requiring reminiscence and introspection, but certainly a key part of what makes me what I am.

I am reminded of a few worthy quotes.

(1) "True friendship comes when the silence between two people is comfortable." David Tyson Gentry

(2) "Friendship is the hardest thing in the world to explain. It's not something you learn in school. But if you haven't learned the meaning of friendship, you really haven't learned anything." Muhammad Ali“

(3) "The glory of friendship is not the outstretched hand, not the kindly smile, nor the joy of companionship; it is the spiritual inspiration that comes to one when you discover that someone else believes in you and is willing to trust you with a friendship." Ralph Waldo Emerson 

(4) "Growing apart doesn't change the fact that for a long time we grew side by side; our roots will always be tangled. I'm glad for that." Ally Condie

To all my colleagues I say, “Thank you very much and let us always be friends, however far apart we are!”

Mahendra “Speedy”  Gonsalkorale

Childhood Memories of Bogawantalawa - By Dr Nihal D Amerasekera

Much to my surprise retirement is not the beginning of the end but an opportunity to get on with what I have always wanted to do but never had the time.  Travelling, reading and writing has kept me wonderfully amused and entertained. I keep active during the day by walking and running. But it has always been my desire to emulate my grandfather who spent his retirement on an ebony “harnsi putuwa” in our family home in Nugegoda. As I breathe the noxious car fumes in London, a creaky Edwardian rocking chair is my refuge from the trials of the day.  

My soul delights in the stillness as I rest in the comfort of the chintz cushions and the gracious curves of my rocking chair. As the autumn wind and rain batter my windows, I recline in my chair at peace with myself.

When the mind is idle there is often an urge to return to the dim and distant past. It gives me a soothing warmth to rummage through the archives of my mind in an attempt to recover my earliest childhood memory.

As a teenager and even much later, I was fascinated by the past and my childhood. The transition from an infant mewling and puking in my mother’s arms to a toddler struggling to walk and talk became a catalyst for a multitude of stories which my parents took great delight in reminiscing. This gave me enormous pleasure to stitch together my disconnected recollections to an accurate and continuous narrative.

My earliest memories are of Bogawantalawa. It is a magical small town in a valley in the Central Province surrounded by mountains of tea estates. In 1869, when the pioneering British planters came across this valley and its unique climate, realised its potential and grew tea in the surrounding hills. Now it is called the Golden Valley producing some of the finest high grown teas in the country famous for their distinctive flavour and aroma.

From 1940-44 my father was a Government Servant in Bogawantalawa. Those were turbulent times with WW2 raging across Europe and the Far-East.  Somehow, my little town nestling beneath the hills remained untouched by the inhumanity and the horrors of war.  As a kid, I was bemused to see the occasional convoy of jeeps and trucks carrying military men waving rifles.

We lived in a quaint upstairs house with a small rear garden.  At the front, there was a wooden fence draped in purple Bougainvillea. Our neighbour was a friendly Tamil family. Their little girl was about my age. She came over to play with me. It seems I was more fluent in Tamil than Sinhala. I wish I had kept up my language skills. The house backed on to a hill.  The village school on the hill had a large playground where I often played with my little friend. Next to the school was Mr Cherian’s house. He was the Headmaster. Although he had a stern look, Mr Cherian was a kindly man, often seen clad in a brilliant white verti. His wife was a skinny lady with a Colgate smile. She was my mother’s closest companion.

Bogawantalawa weather was wild being served by easterly and westerly winds. The rain was never far-away. I remember the cloudy skies and the rolling mist that covered the surrounding hills. But whenever the sun shone it was closer to heaven than any place else I know. People always wore mufflers and sweaters and carried umbrellas. The raincoat was a ‘must-have’ accessory. There were many British planters rushing on their noisy motor bikes. The only shop I remember is Maskeliya Stores on the High Street. It had lots of sweets on display. This was also the biggest shop in town where the great and the good did their weekly shopping. It gives me great pleasure to see the shop has survived the ravages of time and is still open for business.

It was a daily ritual for my mother and Mrs Cherian to go for walks on the gravel road in front of our house. I often tagged along with them. The road meandered through a lonely pine forest. I recall the primaeval silence of the forest except for the chirping of the cicadas. On my way, I picked up pine cones that littered the floor. My mother spoke in fluent Tamil to her friend. The deserted winding road went up to Kehelgamu Oya. This is a fast-flowing river with a simmering rage. The views were dramatic with a deafening noise of a multitude of rapids, waterfalls and swirling currents. The charming wooden footbridge across the river stood as a lone sentinel bringing calmness and serenity to the mayhem down below. The birds that bathed and frolicked in the pools perched in tandem on the wooden railings of the bridge. The striking tranquillity of this wilderness breathed freedom and peace. One cannot get any closer to nature than this.

The nights were peaceful beyond belief. There was the occasional eerie howl of jackals that broke the silence. We had a maid to look after me. She was a kindly woman with a huge repertoire of fairy tales. In those days there was the early to bed early to rise culture for kids. Before I slept there were the nightly stories of kings and queens and wicked witches. The mornings were often dank and chilly. The dew on the grass lasted until the sun shone.

I remember with such clarity my first introduction to the concept of death when I saw a funeral procession in the High Street.  The car bearing the coffin was covered in flowers. This with the procession of wailing mourners was enough to upset a 4 year-old. Death is hard to define even for an adult. My father tried his best to explain. I found it bizarre and disorientating. I kept thinking about for the rest of the day. Now, as a septuagenarian, I understand the concept of death. It’s finality however still remains shrouded in mystery. Over many centuries religions and philosophers have tried to unravel its perplexities without much success.

When so much time has passed it is hard to find my earliest memory. A myriad of memories emerge at random but they lack date stamps.  A single vivid memory, however, stands out. It was a stormy evening. I was then about 4 years old and seated by an upstairs window fascinated by a storm that blew across the valley. Streaks of lightning lit up the darkened sky. This was followed by deafening peals of thunder that was frightening. The rain fell in bucket loads. I watched in awe as the road was turned into a river. The water went rushing and crashing into everything in its path. This is such a simple childhood memory of the magical splendour and the formidable and destructive power of nature.

Those who served the Government were moved every 4 years what was euphemistically called transfers. All our possessions were loaded into a lorry and we bade farewell to our friends. As the sunset on our lives in the valley, there was a new dawn in Kadugannawa. We never returned to Bogawantalawa again. Since I retired, with time on my hands, there are always flashbacks of times past.  Occasionally those early wistful memories still wake up bringing joy to my soul. I enjoy the hustle and bustle and the bright lights in London. Time and again there are reminders of the peaceful existence in this rural idyll that distils the true meaning of life.

I still visit Bogawantalawa in my waking hours and in my dreams. My only sojourn in real-time is through Google Maps. They are mostly detailed aerial views. The village school still exists and is now called St Mary’s School. This even features on Facebook. Our house down the hill is still standing as is the road leading up to Kehelgamu Oya. I do hope the river has retained its power and dignity. Progress has encroached on the pristine pine forest. Much of it has given way to houses and farms. The roads are crowded with people and vehicles and the High Street cluttered with shops, cafes and colourful billboards. It is such a joy to discover even after the passage of over 70 years some of the old landscape is still preserved. But the peaceful and rural Bogawantalawa of my childhood only exists in a secure corner of my mind. 

I have lived longer in Britain than in Sri Lanka but the memories of home and family and friends seem such a strong pull even after nearly half a century in exile. I have left a part of me in that beautiful island of my dreams.

My musings on Evolution

The theory of evolution is to me, a proven fact and not just a hypothesis. The evidence is overwhelming. These include fossil evidence, DNA and archaeological evidence. It is the only hypothesis that explains the diversity of Nature and its failures and successes, without the need to invoke a “designer”. One of the reasons some still have difficulty in accepting it is because they fail to appreciate the enormous time scale of life on Earth. We are talking of billions of years! There are also misconceptions such as that we arose from chimpanzees whereas the truth is that we both have a common ancestor only.

The driving force for evolution is the quest for survival. This ensures that genetic mutations which enhance the chance of survival are favoured and a species will progressively become better suited for continued survival. Offspring which are better equipped will gradually overtake those that are not. This is natural selection. It is not a “law” that is “obeyed” but pure common sense. All living beings are constantly exposed to threats and it does not require any sort of faith to accept that those who are better equipped will survive, and in the course of billions of years, that is exactly what happened. Better adapted species emerged and the failures became extinct. In fact, 99.9% of all species that ever existed on Earth are now extinct. The more recent ones to become extinct (last 10 years) include the Tasmanian wolf, Pinta Tortoise, Baiji Dolphin, Caspian tiger and the Golden Toad. The closest known animal to Man (Homo sapiens) is the Neanderthal Man (Homo Neanderthalensis) and he became extinct around 40,000 to 42,000 years ago.

When it comes to more evolved species such as mammals and birds, other factors came in to influence evolution. This can be called cultural evolution. Reptiles and other less evolved species are solitary in nature and just care for themselves only. Mammals and birds have are more “social” because they have realised that to be successful as a species, cooperation, caring for other members and developing a “group mentality” has evolutionary advantages in propagating the species. Thus the notion of “survival of the fittest” was modified in the sense that in order to be fit for survival, the needs of other members of the species have to be taken into account. They don’t have a moral code as such, it is purely pragmatic. It is reasonable to postulate that these tendencies became genetically codified and hence transmitted to offspring.

At this stage, if we take a giant mega leap in how Man developed, we can see that behaviour traits which are now called “good” arose, and the “bad” ones were not favoured. At a much higher evolved and cultural level, these behaviours became entangled with the concept of “morality” driven by Theistic religions as well as any philosophy that believes in an after-life. There is no doubt that moral laws could help in the survival process. Discipline was found to be useful and different ways of obtaining it evolved. One of the most powerful is the emotion of fear. Fear figures prominently in many religions – fear of retribution,a painful afterlife wherever it is, and fear is the basis of law enforcement. But human beings appear to be driven to behave morally not just by these means. While it is true that many people behave well because of the fear factor, there is overwhelming evidence that humans who are atheists and humans who are not driven by fear of breaking the law and its consequence, still adopt moral attitudes and behaviour and this appears to be something that has evolved over thousands if not millions of years. This kind of moral behaviour is seen in birds and mammals. For example, rats share food with other favoured rats (their “mate”), wolves defend each other against grizzly bears, a prairie vole taken out from a cage in which he shared with another vole and is subjected to banging noises which stresses him and then is put back on the cage is greeted by his mate who grooms and licks him to calm him down, elephants are known to help injured or ill members of the herd, Chimpanzees show a sense of justice and those who deviate from the code of conduct set by the group is set upon by other members as punishment, vampire bats who successfully foraged for blood will share with those who were not successful.

For humans, and most probably for other higher species as well, I believe that two other factors (related) operate. The first is the desire to experience pleasure and the second is the desire to avoid discomfort. Indirectly, both these will enhance chances of survival. For example, the desire to avoid discomfort will lead to a safer life and thus a longer life through attention to matters of safety. The desire for pleasure will also, in general, promote a safer life although it could admittedly have the opposite effect at times. Pleasure often involves socially “survival” promoting behaviour such as helping others, sharing with others and caring for others. Like everything that occurs in Nature, deleterious effects can also occur with the pursuit of pleasure. There are no ordained laws which govern human beings and just as some mutations produce less well-equipped species, the pursuit of pleasure and avoidance of discomfort can act in more than one way but it is my contention that the nett result of this is towards a better-equipped species for survival.

THE MAX KORAL KORNER

Hello! My name is Max Koral. I am not unique. I am not perfect, but I am entertaining.  I used to be a doctor, now I need one! When you get to know me better after reading my regular posts in this column, you might even like me!

I want to start by stating that I like observing human nature and love causing consternation with the manipulation of words. Let me give you an example. I was enjoying a meal with friends at a restaurant, and I chose beef chorizo as my starter. I thought it was delicious, but as I was cutting into it with my knife, I dropped a sizeable piece on the floor near my feet.  Of course, I couldn't eat it anymore, but I was anxious not to leave it on the floor as the floor was so clean and tidy. I called the little waitress with a big smile and announced that I wanted to bring to her notice something important. She stood at the head of the table, and as I spoke, her cheery face began to display a worried expression. This, I thought, was because she was anticipating a complaint. She noticed that I was holding a fork aloft with a piece of chorizo stuck in it. I started speaking with no particular expression but with clarity, which I hoped would impress her.

My dear girl, I said. What is perching at the end of my fork is a piece of chorizo which came from a much larger one you were kind enough to place before me on this small white plate you can observe on the table. You probably noted that the plate is now empty and I can state without any ambiguity that the reason for this emptiness is because I ate the contents on it apart from this piece I am now showing you on my fork. You may well ask why I have not consumed the piece I am showing you. Why has this piece of chorizo not been sent to its rightful place which is to my stomach? Is there some deficiency which prevented this small piece of rather sorry looking cooked chorizo not been given its rightful place in the World, which is my stomach? Was it not cooked properly? Did it offend me in some way? Have I developed a sudden unexplained aversion for chorizo? Am I planning to take it home and eat it later? Am I saving it for a loved one at home who has a particular liking for chorizo? The answer dear girl is none of these you will be pleased to hear.

The facts are as follows to the best of my recollection. As only a little time has passed, I can assure you that the facts I now recall are correct and an accurate description of what transpired. As I was cutting this chorizo, which I expected to be as delicious as the fellow chorizos I consumed only a minute ago, this piece which I am holding in my fork, fell to the ground and stood close to my feet on the clean carpet. It was a sorry sight, and if a piece of chorizo could speak, it would have said something like "Why have you discarded me?" If chorizo could comprehend speech, I would have said "Of course not dear chorizo. It was just an accident. You can call me clumsy if you like".  I may not be the brightest but I know for sure that chorizo cannot hear and I did not say anything at all, apart from something like “oh dear”. The question now arises. What do I do now? Pretend it never happened? Push it away under the next table? Pick it up and eat it and risk food poisoning? None of these appealed to me because although I am not perfect as stated at the beginning of this discourse, I am honest and entertaining. I, therefore, plucked up courage and decided to make a clean breast of it and face the consequences. Dear girl, will it offend you if I do not eat this and merely place it on this clean plate now that you know that my not eating it does not in any way indicate that the chorizo was not cooked properly or cooked inadequately. No offence meant and no need to inform the chef that a customer did not appreciate the chorizo.

The girl looked somewhat puzzled and merely said "What?"

I mean to say, so much for honesty and appreciation of food!

Professor Sanath P Lamabadusuriya.50 years of Academic Service to Sri Lanka

A truly illustrious career. We are all proud of our Batchmate. I just read a post about a felicitation ceremony for Lama for completing 50 years of academic paediatrics (on the 1st of April, 2019), held on the 6th of June 2019, by the Faculty of Medicine, Sabaragamuwa University. The felicitation address was delivered by Professor Deepthi Samarage.

She ends her speech thus:-"As a practising paediatrician, he strode the world of paediatrics in our country to greater heights. His academic brilliance, attention to detail, splendid diagnostic skills and unwavering commitment to excellence are indeed legendary.

I fervently hope that I have managed to do the justice to the profile of this spectacular academic
Thank you Prof Lamabadusuriya. I wish you good health and many more years of life to continue your invaluable services for another generation of medical students and little kids".

Please click on the link below to view a Power Point Presentation at the event.

Tribute to Prof. Sanath P Lamabadusuriya

IS THERE LIFE AFTER DEATH?

IS THERE LIFE AFTER DESTH?

If human beings have only one life, I.e., there is no existence after death, the only concern as far as being happy is to find a way to be in that state for as long as possible either continuously or in long bursts till they die as death is inevitable. Even an unhappy life has to be endured only till such time as death intervenes to provide release. In other words, even the worst journey is time limited. If this is accepted, it has many repercussions that follow.

1. It provides a different perspective on end of life decisions.
2. It should enable persons to not worry about death ( apart from concern about how it would affect others who are left behind, possibly fears about the process of dying itself).
3. It would make life activities more urgent and focus the mind on making best use of our lives before it ends.
4. It could potentially lead, at least in some, for a reduction in moral behavior in those who lead moral lives only for fear of repercussions in the next life.

If there is life after death, why is it not obvious? For such a significant truth about lives, why is it so “hidden”? One would reasonably expect a large number  of well documented and well authenticated accounts of previous lives. While there are some such accounts in the literature, they are of questionable accuracy.

But, our recollection of past events even in this life are incomplete and does not stretch back far. Is it then reasonable to expect memories of past lives to persist. 

Even if there was a past existence, if we have no recollection of it at all, is there any point in being concerned with the possibility of a previous life?

If life does continue after death, there are major questions to be answered as to its mechanism. This leads concepts such as existence of “body” and “mind” (or soul), for example, and greater understanding of consciousness, self awareness, self image. 

Basing morality on the basis of rewards or punishments, or the need to please or satisfy supernatural forces who are able to shape our future, is common.

If life persists in some form, is it restricted to the human form or could it be in lesser animals or even in beings which are outside our realm?

If death is followed by passing onto another form of existence, is it a permanent state (good - heaven) or (bad - hell)?

What makes that state desirable or undesirable?