Appreciations

Professor H.S. Keerthisinha passed away in England at the ripe old age of eighty one on October 1, 2007. Professor Keerthisinha was the second surgeon to be appointed to the Chair in Surgery at the new medical school at Peradeniya, established in 1962. There will be many more tributes to him in time to come extolling the virtues of this colourful personality. However, this tribute to him is to highlight his greatest contribution, to the teaching of surgery in this country. To me, and most of my batch mates of the so called 'Second Medical School' at Peradeniya in the early sixties, he stands as a giant who enlivened our undergraduate years. It was only long after our medical school days that we realized how he, over the clinical years, moulded us into competent and conscientious doctors. He emphasized the maximum use of the five senses we are born with, when dealing with patients. He made sure that all Peradeniya graduates possessed this virtue.

By the time we passed the second MBBS examination and were getting ready to start our clinical training in hospital, we were already familiar with the huge volumes and text books on Surgery that filled the shelves of the small library, housed at the time, in the present Medical Education Unit of the Peradeniya Faculty. We had already fingered through the pages of the enormous Bailey and Love, one of the text books of Surgery, popular at that time. The pictures of patients with grotesque tumours, mutilating trauma and numerous abnormalities shocked us. The inevitable fact that we have to deal with such situations during our surgery appointment left us with fear and uncertainty.

But things turned out to be quite different to our expectations. My group was lucky to be assigned to 'Kiththa' for our introductory surgery appointment. His clinics were fun-filled and hilarious at times, for us, to him and in many instances to the patients. We wrote 'lines', hundreds at times for simple lapses. Very little serious surgery was taught or learnt with him. But he made us masters of simple common sense and basics.The lesson he taught us on commonality and the importance of thinking of common things first when dealing with a clinical problem has made a lasting impression in my mind. He would simply interrupt a teaching session, point his finger towards the garden and ask, 'what's that bird?' We were expected to utter in unison, 'crow'. What he said was that crows were so common in the hospital premises; one will be correct 75% of the time if we answer 'crow'. But if someone says it is an ostrich or a peacock then, he would be wrong most of the time.

I have passed on this simple message to thousands of medical students who passed through me at the Peradeniya medical school, always mentioning him by name. Simple as it seems and not peculiar to surgery maybe, but what he taught us was a lesson in life that enriched our professional lives. Almost overnight he made Bailey and Love a thing of the past, at least for third and fourth year medical students.. He made surgery simple and interesting to medical students and to non-surgeon doctors by authoring the slim, novel like 'Pocket Book of Surgery', a mere midget in the company of the likes of Bailey and Love.
Every time I see a patient with a 'lump' what comes to my mind in seconds is the list-'site', 'size', 'shape', and 'movable or not'. These simple things are no doubt, found in the introductory chapters of text books but what had been ingrained in my mind is what 'Kiththa' had emphasized.

We have written 'lines' on this when the list was not followed at case presentations. He had fascinating stories about the Sri Lankan diet, narrated in his inimitable style. One of his favourites was the comparison of the traditional Sinhala diet with that of the Canadian lumberjacks. What bugged him were the hours taken to prepare our food, their quality, the sheer bulk and the time our people spent in toilets! Classes were stopped abruptly and we had to trek in pairs to various crowded places in the Kandy town to conduct 'fat man counts'. They were most enjoyable and opened our minds to the problems of obesity. Each one of us had to 'beg, borrow or steal' copies of 'Pocket Medical Dictionary, Roget's Thesaurus and the 'Third Eye' by Lobsang Rampa. These three books, purchased in the early sixties are among my most cherished and treasured possessions to this day. He was fascinated by the writing of Lobsang Rampa, the mysterious English writer who claimed to be the reincarnation of a Tibetan lama.

People of our vintage would recall the inevitable 'bottle' that all patients carried to hospital in order to bring home medicine, mostly in the form of mixtures. It was a common sight in wards to see a nurse pushing a trolley laden with mixtures of all hues. 'Kiththa' was fanatically skeptical about the efficacy of these coloured waters. The only mixture he had some confidence in was 'Mist. Pot cit', the mixture containing potassium citrate. During one of our ward classes a batchmate of mine mentioned a mixture as treatment for a particular patient. That was enough for him to call the ward nurse to bring the medicine trolley and we were made to line up in the corridor. One by one we went past the trolley receiving one fluid ounce of a mixture. Those who prescribed these mixtures should know how they tasted, was his reason. These little 'dramas' or 'plays' during ward classes made everyone happy and relaxed.

These were the fun things students expected during classes with him and we were duly rewarded every single time. There was indeed never a dull moment.

He organized discussion classes in his office in the faculty during our final year. These classes were well attended as students believed that they would pick out some 'tips' as the final examinations were on soon. I remember vividly one such discussion class. We were sitting in a circle, in his office, waiting expectantly for him to start. He looked around and immediately spotted a student who was not familiar to him. 'My friend was a football fanatic who missed classes on an almost regular basis. 'Kiththa' stood up, walked up to my friend and with great ceremony introduced himself as Mr. H.S.K. Sinha, Consultant Surgeon and the Professor of Surgery. My friend, by this time shivering and dumbstruck, managed to utter his name while extending a very shaky, cold and clammy hand in response. The professor clasped my friend's hand and smilingly stated how happy he was to make his acquaintance. Then he pulled out a box of cigars, took one out and very elegantly moved it across his nose several times like a true connoisseur. Then with much ceremony he took out a pair of small scissors, cut one end of the cigar, and said, 'Cigar Sir?' My friends had no alternative but to accept the offer.

'Kiththa' produced a lighter from his pocket and said, 'light Sir?' The whole group was in raptures enjoying every second of the drama. My friend, now with a pathetic grin accepted, without a word. What we heard next was a thundering bout of coughing and choking. The whole class erupted as the professor moved back to his seat gesturing us to calm down. The whole drama took only a minute and the ice was broken. There were no reprimands, no threats of repeating the appointment and no cheap advice. We were treated to a tremendously satisfying and intellectually stimulating discussion.

My friend registered 100% attendance at discussion classes that were to follow. There are many more happy stories and anecdotes of this remarkable gentleman. I have just penned a few that came to my mind.

Professor H.S. Keerthisinha, 'Kiththa' to all of us was one of the most colourful personalities that made the 'Second Medical School ' at Peradeniya so unique. He will be always remembered with gratitude and is assured of a treasured niche in our hearts. He certainly played a major part in what we are today. Knowing him made our lives richer. These few lines are for you Sir, with love.

He made surgery seem so easy and full of fun