“General Hospital”

A brief history and my memories of the General Hospital Colombo

                                     nd       By Nihal D. Amerasekera (Batch’62)

Kynsey Rd entrance from inside the GHC, 2012 copy

 

My first encounter with the General Hospital Colombo (GHC) was as a patient age 7. Having a tonsillectomy wasn’t a pleasant experience for a child.

My future experiences with the GHC were much more pleasant. Three of those years (1964-67) were as a student burning the midnight oil and a further 4 years (1970-74) as a doctor. It was much later I had the time to delve into its rich heritage, its glorious past and the colourful personalities that made the institution great.

 

As I look back I have tremendous affection for the GHC. It was my medical school, university and workshop where I learnt my trade. This note is not only a tribute to my former teachers but is also an appreciation of the efforts of the many who helped to plan and build this magnificent hospital. The General Hospital Colombo will always remain as a permanent monument to all those have worked in this institution since its early days. They all have done it proud.

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Colombo’s first modern hospital was established in 1819 in Prince Street Pettah.  The 100 bed hospital soon became overcrowded and the decision was taken to build a new hospital away from the dust and grime of the fast expanding Pettah. In 1864 Governor Henry George Ward set aside a princely sum of £3000 and acquired the land around Longden Place. This area has been a cinnamon plantation since the Dutch occupation. Soon a hospital was built on this site for the people. The government recognised the need for doctors and a Colombo Medical School was established in 1870 in a female surgical ward. This moved to its present home in 1875 helped by the philanthropy of Mudaliyar Samson Rajapakse, who owned the land. De Soysa Lying-in Home was built in 1879 by the donations of a well known philanthropist Sir Charles Henry De Soysa. Lady Havelock Hospital was started in 1885 later named Lady Ridgeway Hospital. Victoria Memorial Eye hospital opened in 1903 with the money donated by Muhandiram N.S. Fernando and the OPD started in 1910. The ‘White House’ is the magnificent building that meets the eye when one enters the GHC through the Kynsey Road entrance. That was the old administration block which was commissioned in 1904. It also housed many wards in the upper floors. The present 5- storey administration complex was built by SWRD Bandaranaike in 1958 and has several wards, operating theatres and sterilisation units. A private home in Ward place was commissioned to become the Dental Institute. The Radiology Department began in the administration block in 1925. Dr. William R. Kynsey was the Principal Civil Medical Officer from 1875 to 1897.  He contributed much towards the Ceylon Medical College in its formative years. In 1900 The long road between the Colombo Cemetery and the GHC was named after Dr Kynsey.

 

Many of the private wards were built to serve the British. William Henry Figg donated the money to build the Merchants’ Ward which was opened by Governor Manning in 1918. It  was an impressive ornate building with an elegant porch, high ceilings and manually driven lift. This and the Seamens’ ward, Planters’ Ward, Skinner- Gnanasekeram ward and Matapan ward were for private patients. In later years at the east end of the main east-west corridor was the house officers quarters in the old  ‘White House’ and at the west end was the Ragama section of medical wards. Those wards were airy and basic with rattan slats to prevent rain beating in during the monsoon storms. To the north and south of the main corridor were the surgical wards. As I haven’t visited the hospital in nearly 40 years I have used the past tense in my descriptions not knowing how much has changed.

 

When the GHC had difficulty in recruiting nurses, the government requested the services of the nuns of the order of Franciscan Missionaries of Mary.  They began work in the wards in 1886 and lived in St Peter’s House in view of the ward later managed by Professor Rajasuriya.  The nuns served in the great tradition of Florence Nightingale showing tremendous compassion for the sick and the suffering. They provided excellent care to the patients.  I recall seeing them working all hours in the hospital. Their services were discontinued in 1964. Sadly they made a hurried exit from the island being caught up in the wave of nationalism that swept the country after independence. Since the Nurses Training College was established in 1939 we had our home-grown nurses who were excellent and filled the void with great skill and expertise.

 

To all medical students of the Colombo faculty, crossing Kynsey road to start clinical work is happiness beyond belief. This brought an end to the ceaseless study of the theoretical basis of medicine, or so we thought. Now we were expected to be civilised as ladies and gentleman. This wasn’t an easy transformation for many. Armed with an Allan and Hanbury stethoscope and a knee hammer I had a spring in my step as I crossed the road to enter the hospital.  Although I hoped that traffic will stop for me to help me save a life I had no such luck!! All through my clinical years I may have covered a few hundred miles on the long corridors that crisscrossed the grounds of the hospital. Friendships were made and firmed during those ceaseless journeys. The images of the buildings, lawns and the hordes of students, doctors and nurses that thronged the corridors are still etched deep in my memory.

 

After the University of Ceylon was established in 1942 the GHC became its teaching hospital in 1946. We honour its original teaching staff, Professors Milroy Paul, PB Fernando and GAW Wickremasuriya in Surgery, Medicine and Obstetrics and Gynaecology respectively. We owe them a great debt of gratitude.

 

The 1960’s was the golden era of medical education in Sri Lanka. The visiting physicians and surgeons who served the hospital were clinically some of the best in the world. The orthopaedic surgeon Francis Silva was a Hunterian lecturer, a prestigious award conferred by the Royal College of Surgeons of England. Professor K. Rajasuriya was a Registrar at the Great Ormond Street Hospital in London when very few foreign doctors were allowed in its precincts. The physicians and surgeons took on the task of tutoring students seriously and gave of their best. We benefitted enormously from their clinical skills and teaching. Despite their busy schedule of ward rounds, clinics and private practice they found time to teach us clinical methods. They took great trouble to find interesting patients with multiple clinical problems.  I was mesmerised by their formidable powers of analysis, mastery of detail and ability to penetrate to the core of a complex problem.

 

Every medical student maintained a little yellow book of the lectures and appointments they had to complete. There were several 2 month medical and surgical appointments and numerous ward classes where we were taught clinical medical and surgical skills. They were committed to make certain we learnt our trade well before being released on the general public. Many of the clinical visiting staff gave us the impression they were invincible and wielded great power. Their wards were their kingdom which they ruled with an iron fist. It seemed to us they never got on well with each other perhaps due to professional rivalry or their enormous ego. Many never believed in 2nd opinions or took kindly to their diagnoses being questioned. Some of their teaching methods depended on creating an aura of fear. In the process they humiliated students and at times reduced them to tears. Having said all that It would not be fair to judge our former teachers with the attitudes and values of the 21st century. I still have a deep sense of gratitude to all of them.

 

Darrel Weinman, the neurosurgeon, was a superb teacher. He had a special room for his ward classes which was always full to capacity. He was a showman ‘par excellence’ and taught us the whole process from history taking to examination, diagnosis and treatment  with great aplomb. He was a kind man. It was a sad loss to Sri Lanka and to medical education to see him give up neurosurgery to become a GP in Australia. In the same breath I recall the teaching of George Ratnavale. His teaching and tutorials were master-classes in clinical neurology. The surgeons who constantly deal with blood and guts had a macho image. Prof Navaratne, was a notable exception. He was a kind person and never showed anger to his students. We were never terrorized or intimidated by him. Dr Austin commanded and demanded respect as if it was his divine right. He took great trouble to teach us well. Dr Anthonis showed kindness to his patients and was such a fine teacher. He was well known for his interesting anecdotes supposedly from real life.  Dr Niles had a volatile temper towards his patients but was kind to us all and was a fine tutor. His clinical classes were full of humour. He had this great ability to see the funny side of day to day clinical problems. Dr K.G Jayasekera had a fearsome exterior but taught us well. Dr DF De S Gunawardene was a kind man who spoke softly and was a great teacher. I am ever so grateful to the Visiting Physicians of the Ragama section of the GHC for teaching me medicine. Dr Wijenaike, Dr O.R Medonza, Dr D.J Attygalle, Dr Ernie Peiris  and Professors K Rajasuriya and R.P Jayawardene were excellent teachers. Dr Peiris had a subtle and sophisticated sense of humour. Once a pretty girl from my batch presented an interesting clinical case in a rather soft tone and people standing at the rear could hardly hear. Dr Peiris named her whispering pectoriloquy. Many of the clinicians called the students out for  dinner with drinks at the end of the appointments. Those were wonderful and memorable occasions. My first clinical appointment as a medical student was with Dr Thanabalasundrum. In that firmament of shining stars Dr. T  was the one that shone the brightest. In the De Soysa maternity hospital Professor Ranasinghe was a great teacher but had a quick temper. Dr Viswanathan was greatly loved by the students for his friendly manner and excellent tutorials. In the Lady Ridgeway Hospital Professors CC De Silva and Priyani Soysa were excellent teachers as was Dr Stella De Silva. I remember Dr W.J Gomes who took great care to teach us the basics of paediatrics.

 

The 2-month clinical appointments were invaluable tutorials. In those days the pathological investigations and radiology were pretty basic and much depended on the history taking, clinical observations and examination. Those basic clinical methods we learnt from our teachers. It makes me shudder when I see the 2 line histories on patient’s notes nowadays. Now so much depends on the scans and other investigations when they can get to the diagnosis faster without breaking into a sweat.

 

Interns, SHO’s and Registrars ran the hospital with the expert advice and supervision of the Visiting clinical staff. Doctors worked from 8am to 12 and 3pm to 5. Interns life was never easy clerking patients and doing the onerous on-call duties. The SHO’s supervised the interns and were 2nd on-call. The registrars were occasionally called in but the Visiting physicians and surgeons were never called after 5pm except perhaps in surgery. The registrars oversaw the work of the juniors and presented the patients to the Visiting physicians and surgeons on ward rounds. All this seemed to proceed seamlessly and like clockwork. The junior doctors lived in the hospital quarters within the GHC or in Violet Cottage or Regent House. It was such great fun living together and being an integral part of the GHC community. Life then was good despite the hard grind. We played cricket in the back garden. There was never a shortage of alcohol and chit chat in the evening and at weekends.

 

The GHC in those distant days had 3000 beds and at least 500 patients sleeping on corridors on mats and at the far end of the wards. As students we scoured the wards day after day in our endless search for ‘good case’ until we completed the final examination. Whenever there was a ‘good case’ that patient was questioned and prodded endlessly until they got weary and grumpy. The Patients too were a cross section of Sri Lankan society. Some understood our plight and complied. Others were annoyed and refused to take part in the ritual. The majority submitted without question. A few even saw the benefit of a thorough examination done by several would be ‘doctors’.

 

It is only when one works in the hospital one becomes aware of its soft underbelly. Most of its patients were poor and many were from far away villages. To them hospitals were unknown places synonymous with hopelessness, heartache and suffering. They were fearful of doctors and operations. There were unscrupulous and deceitful people who preyed on these gullible and vulnerable patients and their relatives promising accommodation, better treatment or even help to become private patients to get privileged care. Many were duped into parting with their cash. The undertakers too had their henchmen like vultures riding the thermals and descending on the terminally ill and the bereaved touting for business.

 

My final fling with the GHC was in 1973/74 when I was a Registrar to Dr U.S Jayawickreme. He took over the ward from Dr W Wijenaike. Dr USJ was a fine clinician and a dignified gentleman. Always immaculately dressed he showed tremendous kindness to his patients and to the staff. In turn he received great loyalty and enormous respect. He showed us how to conduct ourselves calmly and with dignity in the ward. His patients adored him. His work ethic and bedside manner had a tremendous impact on me. That was a fine finale for my clinical years at the GHC.

 

The General Hospital Colombo became the National Hospital of Sri Lanka in 1995. It now serves the people from cradle to grave. With a compassionate and caring staff and its fascinating history it will always remain at the forefront of healthcare in Sri Lanka and close to my heart for evermore.

 

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

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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.

Medical Relief

SLMA Relief Fund

The Sri Lanka Medical Association (SLMA), a responsible and leading doctors’ association in Sri Lanka, has opened a fund – SLMA RELIEF FUND – to help the health sector overcome the shortage of essential medicines and equipment. The official launch was planned for the 10th of May but had to be cancelled because of what happened on the 9th and the ensuing curfew.  Citizens and expatriate friends have already started donating to the fund.

If my batch mates would like to contribute towards this worthy cause, to help save patients’ lives, please visit the website of the SLMA Relief Fund for more information: https://slma.lk/slma-relief-fund/

Thank you very much.

Anoja

Dear Anoja,

Thank you for that information.
Will do the needful. 
The only practical and immediate thing we can do from abroad.
I am sure the batch of 64 will rise to the occasion.
With best wishes,
CJ

Another Proud Moment

Sri lankan Conrad de silva sings on the voice television show in Australia at 80 years of age

 

Popular Sri Lankan Australian singer Conrad de Silva made history when at 80 years of age, he performed on “The Voice” show in Australia. “The Voice” is a BIG HIT show and it is very difficult to get on it unless you are very talented. Conrad introduced his wife of fifty years and presented her with a ring. The judges included country and western star Keith Urban, who is married to Nicole Kidman. All the judges were in tears!
Congratulations to this wonderful product of Ceylon, who still wows audiences at 80!

Enjoy!

Shared by Mahilal

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