Life Remembered

Hi Sam
How are you doing? It seems a long time since were at Jeewaka but those memories are still very fresh. Then we met again in Kurunegala. I wonder if you would publish this in your wonderful Blog

Professor of Medicine, Kumaradasa Rajasuriya – Life remembered

Dr. Nihal D Amerasekera

It is 44 years since the demise of a great clinical teacher and a dedicated and skilful professional.

I have been a critic of the harsh environment of education during my years, 1962-67, at the Faculty of Medicine Colombo. Many would agree Prof Rajasuriya was a tough taskmaster. As medical students we saw just a small snapshot of his life. There was far more to him than what was on display. This spurred me on to learn more about the Professor.

Kumaradasa Rajasuriya was born in 1915. His father was a Station Master and the mother brought up seven children. His parents were determined to provide the children with a good education. He was educated both at Ananda and Nalanda Vidyalaya in Colombo. Tragedy struck at the age of 8 years when he injured his left knee severely and was left with a stiff joint for life. His characteristic gait became his hallmark. That ended his ability to play sports and take part in normal childhood pursuits.

It was his desire to study the Arts in the hope of a job in the Civil Service. His uncle the Principal at Nalanda made him study the sciences for entry into Medical College. At this institution there was the usual baptism of fire while joining the ‘Block’. The Law-Medical match and Body feeds had its own thrills and spills which he endured and perhaps enjoyed. The clinicals began with the strict regime of a 7.15am start. As there were only four students in a group they received closer scrutiny and life was tough. He took an active part in the pranks and the fun that was ever present during those happy years. For his indiscretions he was summoned before the Council but later was warned and discharged. This probably resulted in a cynical antipathy to authority as we saw much later. None of us could have imagined all this from the man whom we feared in Ward 41 at the General Hospital Colombo.

Kumaradasa Rajasuriya left the Medical College in 1940 with a First Class degree and the LMS. His first appointment was at Murunkan when he was confronted with a Cholera epidemic. Then he served as Prison’s doctor before proceeding to England for postgraduate studies. In 1952 he sat the MRCP examination and was successful. He speaks warmly of Dr W.D Ratnavale who coached him for this difficult examination.

After the MRCP he went on to get the DCH as he had a great love for children. Dr. Rajasuriya started work at the prestigious Great Ormond Street Hospital in London. In his own words “I spent some of the happiest days of my life in that institution where hard work was appreciated. I was thrilled when the time came to demonstrate cases during grand rounds. I demonstrated three cases, the diagnosis of which had escaped others”.

On his return to Ceylon he obtained his MD in 1954. He worked as Physician Jaffna 1953-54 and then proceeded to Kurunegala. There were many cases of diarrhoea and dysentery. It was here Dr Rajasuriya used coconut water for IV infusions as saline was in short supply and mostly unavailable. This saved many lives. In 1955 He was appointed as Physician Colombo. That was the turning point in his life. At the young age of 43 he was appointed Co-Professor of Medicine in Colombo. Soon after this Prof P.B Fernando fell ill and Dr Kumaradasa Rajasuriya was appointed Professor. He was both surprised and elated by this turn of events and in his own words “I became a member of the intellectual elite of the country”. He did much to form the Ceylon College of Physicians in 1964 and was elected its President in 1971.

His part in the 1967 malaria epidemic is worthy of mention. There were several cases of the dreaded Falciparum malaria in Matale, Minipe and Elahera. With help of the GA Kandy he established a camp at the Weragantota Rest House supervising the diagnosis and treatment of malaria and establishing there was a serious possibility of the disease spreading country wide. He coordinated troops from his own department to travel to all parts of the country and help in diagnosis and training.

Prof KR showed great kindness towards his patients and did everything possible to make their lives comfortable. He wanted his students to develop that same empathy. He had an uncanny and enviable ability to ask simple questions from patients to help in a diagnosis. He believed strongly that a medical school should not an ivory tower but should carry a full clinical load and serve the medical needs of the community. He worked tirelessly to provide a fine clinical service despite his teaching commitments. His junior staff treated him with great respect. This was partly because of his innate skill but also because his formidable memory. Often he could recall a patient’s problems far better than they did. He ran a happy and enthusiastic department.

The Professor had a sophisticated sense of humour. We were on our two month clinical appointment. The students gathered round the professor as he carried on his afternoon ward round. Only the male students were present when he quipped “where have all the flowers gone” (from the Pete Seeger song of 1956 concerning the horrors of the Vietnam war.) During our lectures on medicine Professor was teaching us the clinical features of Cholera. He said the patients pass a lot of flatus before the diarrhoea “the wind before the rain”.

He had many publications and papers in addition to his writings on the history of medicine in Ceylon from the 5th Century. He produced valuable research on Cirrhosis of the liver and chronic pancreatitis in Ceylon.

As Professor of Medicine his lectures were precise and complete. He was a fine enthusiastic teacher. When I was a medical student many of us after qualifying worked in peripheral hospitals where facilities were pretty basic. Medical officers had to depend more on their clinical sense. Good history taking, a complete clinical examination and the ability to elicit clinical signs was crucial. As a clinical teacher he felt it was his duty to teach all students who came under his tutelage to be able to provide good clinical care. When he felt we did not work hard enough he was tough and often ruthless. The relentless pressure and the sarcastic comments were at times hurtful and on looking back unnecessary. But one cannot fault his vision and determination.

Prof Rajasuriya was the Director of Health Services when the insurrection broke out in 1971. During this period he rallied the medical services to do their best in difficult circumstances. The A&E in Colombo bore the brunt in accepting and caring for the injured. Prof RK spent the nights in the A&E unit in support of the doctors. He was essentially a person who wanted to care for his patients. To be sitting at a desk at Head Office and pander to the whims of Politicians was not to his liking. He returned to clinical work again in 1972 and described his years as Director as being in the wilderness.

Prof. Rajasuriya was a devout Buddhist and had a great love for the history and the culture of the country. He remained a controversial figure with his views on nationalism and religion. Such views spilled over when he was angered in the presence of medical students. The comments were general and to my knowledge never directed to any individual. During my 2 months of the Professorial appointment I was never singled out or admonished. There are many others who were not so fortunate and were left to lick their wounds in great despair. It is said he was fair at examination whatever the race or religion. I think he was fair during the clinical appointment too. What he despised was what he called laziness or being unable to take a good history or elicit physical signs. I am personally unaware of his views and actions outside the precincts of the GHC and the faculty. But within those walls I have no reason whatsoever to believe he was unfair in the way he administered and carried out his duties as the Professor of Medicine. I am certain we will all have a different take on his attitude and behavior.

He died suddenly of a heart attack in 1975. The suddenness of his demise brought great sadness to many. We lost a consummate physician, a fine teacher and a superb clinician. I will always remember him for teaching me the importance of history taking, examination and the correct way to elicit physical signs. These stood me in good stead when I went up for the MRCP examination in London. On receiving my results the person who came to mind immediately was Prof K Rajasuriya. I said a quiet “thank you” to my guru.

He had many interests other than medicine which we would never have imagined. His hobbies were painting, writing poetry, and model trains. He was unmarried.

May he find the Ultimate Bliss of Nirvana.