Appreciations

Prof. R.S. Thanbalasundaram, a much loved, respected and admired physician and clinical teacher died after a brief illness in Colombo on November 15, 2007 aged 85 years. He was an icon among the physicians who practised medicine for the love of humanity for over half a century with great devotion and much dedication.

Despite his illness, his interest in clinical medicine never wavered. He remained alert to the last, and his daughter lovingly recalls how his eyes shone when Dr. H.H.R. Samarasinghe who treated him during his last illness discussed an interesting clinical problem with him.

He was born to traditional Hindu parents in Kokuvil, Jaffna where he had his primary education and thereafter entered Royal College, Colombo. He had a brilliant academic record at Royal College where he won many prizes and awards including the coveted "Turner Prize" awarded for outstanding academic performance. He entered the Colombo Medical College where he continued his remarkable performance.

As a medical student he lived at the Brodie hostel during which period my late father A.D.H. Samaranayake, Sam Wijesinghe, Dr. Charlie Munasinghe, Dr. Navaratnam and Dr. H.M.P. Perera were his contemporaries. My father and Sam Wijesinghe recall "Thanaballs" (as they affectionately called him) as a brilliant and diligent student who studied each page of his medical text books thoroughly before turning over to the next page absorbing the contents fully.

In his inimitable style, he breezed through the medical faculty obtaining 1st class honours in all examinations including the final MBBS where he obtained distinctions in medicine, surgery and obstetrics and gynaecology, a rare feat indeed. Soon after he was successful in the MD (Cey.) examination and obtained the MRCP having won a government scholarship to the United Kingdom.

On his return home he was appointed Physician of his native town Jaffna following which has was appointed as Consultant Physician to the General Hospital, Colombo. It was during this period that his popularity as an eminent and caring physician reached tremendous heights and his ability as a clinical teacher made medical students throng his ward and corridors during his ward classes to hear his words of wisdom.

I had the good fortune of doing my first clinical appointment as a third year medical student under his guidance and it was from this beloved physician that I learnt the ABC of clinical and bedside medicine. He impressed upon us the value of good history taking and complete clinical examination. His Bible for clinical information was "Clinical Methods by Hutchingson and Hunter". We worked very hard indeed to please our guru during the two months of the clinical attachment.

Dr. Thanabalasundaram was one of the first clinicians to perform peritoneal dialysis on victims of snake bite who developed kidney failure. During such dialysis, two medical students of our group had to take turns alternately spending the entire night in the ward, maintaining input-output charts, changing tubes and drips, etc. throughout the night and had to return to work the next morning!

He treated all patients alike irrespective of their status. The attention and time each patient received during the ward round depended entirely on the severity of the illness or how puzzling the clinical problem was. He had a remarkable ability of just looking at a patient and making a spot diagnosis. Invariably he was dead right, much to our awe and amazement. Each morning we, medical students had to present to him the daily states of our patients including the results of urine and blood film examination. He established a well equipped laboratory alongside his ward and we medical students made full use of this laboratory to help us in our clinical work.

Dr. Thanabalasundaram was an astute teacher. His definition of bronchial breathing, which I learnt from him in 1971, is better defined than in any text book, and still echoes in my ears. It is the clinical information that I gathered from teachers like him that I have attempted to convey to medical students who have come under my guidance at the Colombo North Teaching Hospital, in Ragama, and Sri Jayewardenepura General Hospital. He was held in much esteem by the students of the North Colombo Medical College who considered him their "father of medicine."

At the end of our two month clinical appointment our group which comprised David Seevaratnam, Diyanath Samarasinghe, Asoka Samarasena, Sathyaseelan, Rathnaswaran, Premila Sabapathy, Damayanthi Sabaratnam and I entertained him and his gracious wife to dinner at the "Akasa Kade". It cost each of us only Rs. 50! This was a small measure of showing our deep gratitude to our beloved teacher for all that we learnt during our first clinical appointment.

Many years later when I was a Physician at the Colombo North Teaching Hospital in Ragama it was with much awe that I sat with my former guru as a fellow examiner assessing students at the clinical examination in medicine at the final MBBS examination. He was overjoyed that his grandson was selected to do medicine in the United States and I had the pleasure of showing him clinical problems at the Sri Jayawardenepura General Hospital. When I visited him in hospital during his last sickness I recalled many events of the past with nostalgia. Despite his illness, he enjoyed reminiscing these events.

He faced death fearlessly as he was a man who lived his life to the fullest. He fulfilled all his family obligations with ease, and devoted the prime of his life and his sunset years to the service of the sick and needy. Dear Sir, long after you are gone, you will live on in the memory of all your students and doctors who had the privilege of training under you. We will remember you with much love and gratitude for your commitment to clinical teaching, caring of the sick, your warmth, simplicity and humane qualities and above all, your devotion to the cause of medicine.

A teacher and doctor of commitment and compassion