The first and last lesson
Psychologist Martin Seligman once did a study where people were asked to write a letter of gratitude to a person who has never been thanked properly for his or her kindness. Afterwards, these persons experienced an immediate increase in their level of happiness which lasted several months. I thought I will do the same and write a gratitude letter to my teacher Professor Carlo Fonseka. He is no more and would laugh at the suggestion that he might read it from somewhere in the supernatural realm. But this is for my benefit, and those who read it, to appreciate how deeply teachers can influence their students.
Dear Sir
On February 16, 1981, I started my career in medicine. Unlike today there were no induction courses or introductory lectures. The honour of delivering the first lecture to medical undergraduates of the Faculty of Medicine Colombo was given to Carlo Fonseka. We nervously gathered in the panelled and tiered lecture hall of the Department of Physiology. Precisely at 8 a.m., you walked in, a small-made man in a dapper safari suit. You spoke in a soft but clear voice in precise and clipped English. What a memorable first lecture it was. Even after 38 years I can still remember parts of it.
You told us that there were four prime duties of a doctor. Never to do harm, often to relieve, sometimes to cure and always to reassure and comfort. Researching for this article, I found the true origin, a quotation by the great 16th-century French surgeon Ambroise Paré- “The task of medicine is to cure sometimes, relieve always, and to comfort always.” The first part, “Never to do harm” is attributed to Hippocrates though not directly mentioned in his famous oath for doctors.
You told us another important thing in that first lecture. You said, “A doctor must have a sense of history.” I can’t remember your elaboration of that statement. I think you meant that the knowledge acquired in our field of medicine did not fall from the skies but was the result of hard work by generations of doctors and scientists. For a doctor to know his place in the grand scheme of things and to truly appreciate the knowledge found in books we must know the history of medicine. Later when I wandered into our medical school library, I found several rows of books on the subject, covered in dust and started reading them. I had plenty of time. I could renew them endlessly. Others were not interested in reading them. Thus, was born my interest in the history of medicine.
Later in another lecture, you laid down for us the foundations of physiology from which follow the foundations of medicine. You introduced us to Claude Bernard, the great French physiologist, the father of modern physiology. You quoted, in original French, his famous principle of homeostasis – “La fixite du milieu interieur est la condition de la vie libre, independante” (The constancy of the internal environment is a precondition for free and independent life). What a profound statement. When the body is in balance, we are well, when the body is in imbalance it becomes ill. The same is true for our minds as well. After all these years this is the only French I can remember. What a great teacher you were.
Over the years you used to call me, usually on a Sunday, to ask about some article or the other related to mental illness. Though I answered your queries each time, you always taught me something as well. Your last call was three months before your death. I can’t remember what you asked me but in the course of the conversation I told you, “… and the reason is because…….” A few moments later you gently told me, Raveen your English is good but it is better to say the reason is or because but not both. For those of you interested in grammar it is a tautology – a statement that says the same thing twice in different ways. Other examples of tautology are, a short summary, dilapidated ruins, dry desert and sad misfortune. I think you get the idea. That was your final lesson for me.
How fortunate I have been. What a grand sweep of learning, from the duties of a doctor, medical history, foundations of physiology, medicine, to English grammar. As I write this, I feel a sense of sadness that I will not hear your voice anymore or be able to learn from you. Also, I feel a sense of waste that your erudite brain or mind is now stilled forever. At this moment in time we do not have the technology to record the memories of a great mind and store them forever. But in a sense great teachers will pass on their knowledge and thoughts to their students who might then write them down for posterity. But yet thoughts are not the person and I shall miss you the person. There is no way around that reality but acceptance.
You would have been amused by some who knew you wishing you a blessed nirvana. I know that though born a Catholic, you later became a rationalist. You will, I am sure, agree with Carl Sagan, another rationalist who, dying of myelodysplasia wrote, “I would love to believe that when I die, I will live again, that some thinking, feeling, remembering part of me will continue. But as much as I want to believe that, and despite the ancient and worldwide cultural traditions that assert an afterlife, I know of nothing to suggest that it is more than wishful thinking.”
Around four years ago you wrote in an article,‘Having strutted and fretted my time on earth, I am ready to embark on the journey to “The undiscover’d country, from whose bourn/No traveller returns”. When I kick the bucket one of these days…you can if you care to, sum up my lengthy earthly existence in Shakes-peare’s words: “Nothing in his life became him like the leaving it.”’ Now sir, I do not agree with your choice. The quote from Malcolm reporting to Duncan in Macbeth is about a person regretting his treachery prior to his execution. It was your life and teaching that became you not the leaving it. I would rather offer this quote, again from Shakespeare, as a more suitable alternative. This is Hamlet paying tribute to his father.
He was a man, take him for all in all,
I shall not look upon his like again.