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Asian Tribune is published by World Institute For Asian Studies|Powered by WIAS Vol. 12 No. 2959

Lalin’s Column: ‘In the line of Duty’ - An Autobiography and an Unofficial history

By Major General (Retd.) Lalin Fernando

Dr Gamini Goonetilleke, FRCS’s 294 page memoir ‘In the Line of Duty’ is a drama, an almost unreal adventure. It is about swift flowing, unusual and mind boggling extra ordinary medical experiences. It is fascinating, riveting and delightful with lively, subtle, impish humour, often at the author’s own expense.

It is an indispensable, revealing account of a unique and extra ordinary surgeon’s life in times in peace and war in what was once the most respected profession of all. It is both an autobiography and a captivating unofficial history of a surgeon who led a full life, enjoyed working very hard and still knew how to relax and have fun. The book should be compulsory reading for doctors, medical students, military and police officers and historians.

He writes with great skill. The book is about a passionately committed surgeon’s life from student days, qualifying as a surgeon in England at his own expense, volunteering and serving in neglected and backward Polonnaruwa, challenging war time service in Jaffna, and ‘boring’ peace time service in the Gampaha Hospital, (where ironically he had again to bring succour to victims of a of LTTE terrorist bomb near the Police station), National (General) and Sri Jayewardenepura hospitals. It includes lecturing in universities including Sri Jayewardenepura and Kotelawela Defence and in India, Pakistan, Nepal, UK, Finland, Australia and many other countries, to retirement. He is today the consultant Surgeon at the Army Hospital.

It is a compelling account of the actual if also sadly pathetic shocking conditions that prevailed in many rural government hospitals. It shows the lukewarm and stultified response of many doctors and administrators to even bother to attempt improvement.

“Only those who risk going too far can possibly find out how far one can go” (TS Eliot)

His views are rebuffed more often than accepted by those who are disturbed and envious of his out spoken views, unmatched professional experiences and commitment. This book is probably as professionally controversial as SDIG Merril Gooneratne’s and Maj Gen Kamal Gouneratne’s books ‘Cop in the Crossfire’ and ‘Road to Nandikadal’.

It is about a career long devotion to learning, practicing, improving and teaching as a surgeon. It is full of saving life if not limb of the great wretched, poor, ignorant, unwept for rural people and yet exploited without let for generations since Independence. These people were closest to his heart as were his students as testimonials also show. The brave and gallant youth, both men and women, who fought and died for the country, to defeat terrorism, came from these villages. Unfortunately almost all the country’s leaders on the other hand, except thankfully for one, wanted to live with terrorism. They preferred shaking hands with such devils and made fun of the fighting troops. They cared little for the sacrifices of the poor.

The book is superbly supported with a host of unusual photos of injured patients taken by the author before and after surgery. They have an unnerving and lasting impact on the reader. They were of inestimable value in the author’s many audio visual presentations to both medical and lay audiences in SL and abroad. There are many sketches too showing injuries in graphic detail. Readers are warned that some of the photos and illustrations could be very disturbing.

The book covers a major part of the early terrorist conflict. By incessant after action visits to the locations of the terrorists atrocities he brings an authenticity to the events and horrors that actually were. Other than protagonists possibly no one ever before had a real idea of the truth. Most were dependant on journalists some even writing from the ends of the earth. Official reports were often dismissed as exaggerated and dressed up.

He realized early that his training had not covered battle field injuries. He set about learning on the job and by reading up on visits to Colombo. He had to deal with terrible casualties from suicide bomb blasts, land and anti personnel mines in addition to bullets and shrapnel wounds. A military ward and ICU, promoted by him too, were built at the Polonnaruwa hospital. It saved many soldiers lives by rendering good care immediately instead of transferring them to Colombo, lying on the floor of an ill equipped SLAF plane, being tossed around with dead bodies too. His competency and patriotic enthusiasm grew. Very soon later he volunteered for military service and was soon at work, operating ceaselessly at the Army hospital in Pallaly (Jaffna).

Among other interludes, there are descriptions of the terrorist attacks at Anuradhapura(120 civilians at worship killed) Mannampitiya, (1985) the Good Friday massacre (Habarana-126 killed-1987), sieges of Jaffna Fort and Elephant Pass (1991) where his skills as a surgeon were tested fully. He recalls the brutality and depravity of the terrorists, the arrival of the ill disciplined, thieving, rapacious, murderous scourge of the IPKF, the near genocide of poor Sinhalese in 1988-89 and the challenge of duty in Jaffna post 1990 .He does not miss out to describe how in Giritale a notorious but dead gangster Podi Wije, was shot in the head for a senior police officer to claim a gallantry award!

While expressing his condemnation of the evils committed by the LTTE, the author does not miss out on the infringements of the Forces either. His aversion to land mines is well expressed. Only a few even among doctors have spoken about it in SL. It is and was the most evil and foul of battlefield weapons. It causes the loss of innocent lives of non combatants not only during but decades after conflict ends. It may hopefully add weight to compel SL to gain access to the Ottawa treaty banning its use. His fearless exposition of torture in peace and war is indicative of his high moral values and enduring idealism.

There is a much about his loved derelict Polonnaruwa hospital where he served the entire district for 6 years from 1982 with 3 consultants and one nurse to look after 350,000 people (Colombo city has 650 000 people (2017). Few doctors ever wanted to serve in Polonnaruwa as it was a forlorn place then with malaria and kidney disease rampant. Postings were considered punishments. Enticed by a senior colleague, he volunteered to serve there. He quickly engaged and empathized with the never ending travails of poor villagers and later when the conflict began, with the wounded soldiers in the East.

He performed with head and heart, determined to initiate, innovate and apply his skills to overcome not only the lack of organization, equipment and rudimentary facilities but even an anesthetist to help him perform surgery. In an extra ordinary if also a daring act he becomes his own anesthetist .He submits a paper on his experiences to the Medical Council (SLMC) only to be reprimanded by the President and told to stick to his job. The well researched paper was thrown out! He also did the work of pharmacist.

His humour may not be ribald and racy as the misadventures of the doctors in Richard Gordon’s ‘Doctor in the House’ series but is as excruciatingly funny. Like those British doctors he too played rugby beginning with St Joseph’s College (1965/6), then at University and also the CH & FC. In what was to be his last match he staged a sathyagraha against an incompetent referee! His school skipper was the late Rohan Jayathileke. He did not know until recently that Rohan, an Additional Solicitor General had been a Commissioned Officer in the 2nd Battalion Sri Lanka Light Infantry too.

His time in Polonnaruwa has him organizing and improving the hospital in many ways not confined only to his surgery. The whole Polonnaruwa District had only 3 specialists. He formed a Clinical Society that helped to upgrade the knowledge of the District’s non specialist medical fraternity. It also helped to bond them; developed comradeship helped by fellowship that followed and a social that was even more popular. Forming such societies became a practice where ever he was posted later. He restored wards and even put up buildings for the hospital through private donations. He organized and captained a district cricket team that had the Eastern Commander, a future Army Commander then Col Gerry (later General) de Silva and fellow Josephian as a member. The team was admitted to Division 3 of the Cricket Board tournament. All this while attending to gunshot, stab, bomb, animal attack and other injuries. Shortly after it included gruesome terrorist attack related wounds of both peasants and soldiers. He even performed surgery on a baby elephant.

When the author as a member of the Board at Sri Jayewardene General Hospital (SJGH) attended its meetings he found them ‘hilarious’ with one member often snoring. Many members, politically appointed, knew nothing about the hospital ‘beyond the 4 walls of the Boards room’. Much if not all discussions were unrelated to patient care. If it all reminds one of Ali Baba he should not be faulted. He reminded the others that the concern of the hospital should be to the patients and not about increasing perks for the staff that was their constant and real concern. Apparently the only thing the Board did for the patients was to increase their charges on an ad hoc basis to cover the losses incurred in their wasteful expenditure. In the circumstances he submitted his resignation. The vacancy was not filled for months.

When the Japanese gifted the 1001 bed SJGH hospital they had said it should be non fee levying. This clause was violated with SL’s famous ‘impunity’ by all governments from the very beginning to date. The last thing the other board members would do after reading his book is to commit hara kiri

Dr Goonethilleke relates many adventures in surgery where he was tested to the limits of his knowledge and skills. While he illustrates the horrendous injuries from trap guns and wild animals, readers are introduced probably for the first time to those caused by primitive winnowing fans that among other injuries cause dislodged fan blades to be embedded in the victims face. He has to improvise, face threats of arrogant people and politicians and in one instance even from the Army Commandos. He defies calls by his union to stop work and more dangerously refused to bow down to JVP threats (1989) to close the hospital. He overcomes them all by showing his unyielding nature and professional competence. When the local MP and his aide Upali were injured by a bomb explosion he unerringly attends to the aide as Upali, not the MP, was seriously injured. There is a sketch of the MP’s wife worshipping him as he prepares for surgery. He is in his underwear!

His most daring adventure and probably the high light of the book is a conflict time related experience that few would have heard of. It is a professional visit to LTTE held Jaffna. It is scarcely believable. It passes only because of the doctor’s credibility. It is unsure if any of the war winning Generals or their subordinates had ever heard of it before.

Asked by his friend MG (Dr M Ganesaratnam) the sole surgeon of the Jaffna hospital in1994 when the terrorists were ruling Jaffna, (thanks mainly to late President Premadasa’s unopposed follies), to be the external examiner in the final MMBS exam of students in the Jaffna Faculty, he accepts without much ado.

He goes to ‘Tiger land’ as it was called, in an ICRC ship. He is taken off at Point Pedro, received and taken care and given the freedom to travel as he pleases on a guarantee by the LTTE. After examining the students and attending many receptions to felicitate him he finds himself as the only Sinhalese at a Mahaveera celebration. When asked before his return what he would like to take back with him, he asks for the release of 2 wounded Sinhalese fishermen, prisoners of war. He had observed them in the Jaffna hospital. This is granted magnanimously. He then takes them in a boat virtually skipping over the waves to a merchant ship carrying rations to the troops off Point Pedro jetty as arranged by the ICRC. He, not having been a combat soldier, has to climb a dangling rope ladder in rough swirling seas at night to board the ship. He does it in great fear, even as the boat skillfully avoids crashing into the ship. He is followed by the 2 fishermen who climb easily. They were taken to Kankasanthurai harbour and returned to Colombo by SLAF plane. His description of Jaffna under Tiger rule is educative and priceless. He describes the grave yard of the dead terrorists as a ‘master piece’. Many military men who saw it after the liberation of Jaffna in 1996 called it that too.

The book takes one through the Doctor’s schooling at St Joseph’s College, Colombo where his character was moulded by the strict discipline of the Jesuit fathers especially Fr Peter Pillai. The author chose one day to cut the Principal’s religious class to concentrate on his University entrance exams. He was found out and given a final warning. He says his knowledge of Catholicism ‘was poor’ and it so it remained. He may not have been a Bible puncher but his Catholic beliefs and values have guided him constantly to act far beyond the ‘Call of Duty’. A Buddhist priest who had been observing his ward rounds through a window in the Polonnaruwa hospital came inside and said “Doctor are you a Catholic?”. The priest later said he knew the doctor was a Catholic by his actions! The intrepid chief monk at Dimbulagala Hermitage who was killed by the LTTE was both his patient and a special dear friend. With no politicians getting involved, communal amity prevailed in Polonnaruwa.

The author comes out as a decent, attractive man with grace, humour and inborn if not learned and trained leadership. The book is a testimony to initiative, courage, persistence and tolerance if not always forgiveness. It is also about moral standards, emotive, compelling and uplifting. It is clear in meaning as it is eloquent. He is a man refreshingly and steadfastly imbued with the values of the Hippocratic Oath even as it’s modern version and even the Buddhist oath Vejjaratapada appears to be forgotten if not discarded by many SL doctors.

The book is about the invincible nature of human hope. It has a dignity and style that is typical of the author. Each incident has dramatic finishes. It is meticulously honest and has the genesis of greatness. It is a revelation of human understanding, written with a gift of vivid description. It may be the best SL surgeon’s book.

Dr Goonethileke is a true SL Lion of a doctor who carries a scalpel instead of a sword.SL should be thankful for his memoires.

- Asian Tribune -

Lalin’s Column: ‘In the line of Duty’ - An Autobiography and an Unofficial history
Lalin’s Column: ‘In the line of Duty’ - An Autobiography and an Unofficial history
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