Saving lives and limbs– no-holds barred account

In the Line of Duty. Life and Times of a Surgeon in War and Peace, by Gamini Goonetilleke. Published and printed by Unigraphics (Pte) Ltd.

In the Line of Duty is a book about contemporary Sri Lanka, about wartime and hardships and facing challenges head on… by a man who did it his way.

A surgeon’s memoir, Dr. Gamini Goonetilleke’s attitude not just to his work but his life comes out strongly in this frank, no-holds barred account. His has been a career as colourful as it is eminent and whether writing about his experiences in Tiger territory, battling officialdom or in a rural hospital, he gets straight to the heart of the matter, drawing the reader in from the first page.

Polonnaruwa was a posting Dr. Goonetilleke volunteered for in his early days as a surgeon, shortly after his return from the UK and this was viewed with some scepticism by his friends, who thought he was being sent on punishment transfer to this malaria- infested backwoods. The conditions at the District Hospital were basic but for Dr. Goonetilleke, the six years he spent there were a life-changing experience.

When he took over the surgical ward, there were no anaesthetists and Dr. Goonetilleke had the option of either transferring all patients needing surgery to other hospitals or caring for them in the absence of an anaesthetist. Never one to duck a challenge, he studied anaesthesia, learnt from his friends in the profession and proceeded with operations. But he writes that when he prepared a paper titled ‘The role of a surgeon as an anaesthetist’ for the annual sessions of the College of Anaesthetists, it was turned down, as the President of the college did not accept that a surgeon could double up as an anaesthetist. But as he puts it, work had to go on and he says proudly that there were no deaths related to anaesthesia during this period.

In time the WHO sent Burmese volunteer doctors to Polonnaruwa and though that brought further complications of language difficulties, they got along fine, he writes, recalling with much humour a particular Burmese Dr’s fondness for snake flesh.Polonnaruwa was also significant for his interaction with the people, the majority of his patients being impoverished farmers. The Dimbulagala monk was one with whom he forged a bond as he did with the Catholic priest Rev. Ranjith De Mel and he also worked, in his free time to expand the two Catholic churches in Polonnaruwa.

“Many were the situations that I found myself in which I had never dreamed of facing as a doctor……Such experiences came to me in the most unexpected of circumstances. They were not learnt in the great halls of learning but in the remote parts of the island, serving especially the poor, the marginalized and the helpless,” he writes.

It was also in Polonnaruwa that he came across many cases of trap gun injuries, burn injuries all with terrible wounds that he as a surgeon had to deal with. Kidney stones were also common, due to the hardness of the water. He recalls with humility the gratitude and trust of his humble patients who often unable to pay him in cash would bring ‘sargeon mahattaya’ gifts of honey, rice and eggs and sometimes even wild boar meat.

Post- 1983, as the war intensified, there were more military casualties to treat and so too those injured in landmines and bomb blasts. Then came the Military Ward in 1986 at the Polonnaruwa Hospital which has saved the lives of many military personnel. Treating war victims takes up a large portion of the book and here he speaks with the authority of one who has been in the midst of it all.

The incidents that led to Black July and its immediate aftermath saw a flood of casualties to the Polonnaruwa Hospital, a situation that placed the medical staff under tremendous pressure. “We grew up and learnt medicine and surgery during peaceful times….The initial exposure to these gruesome circumstances was dreadful and horrendous.” It was a case of saving life first and limb afterwards, he says, recalling how he referred books and journals to try and understand these types of injuries.
Despite having treated many injuries he writes with feeling of the desperate pleas of soldiers not to amputate their limbs. The shock from the exploding mine can destroy blood vessels located much higher that the site of the primary wound, compelling surgeons to amputate a larger section of the limb than the injury may show, he says, and it is this concern for the permanent disability that the injury causes in most cases that has led him to campaign for a ban on anti-personnel mines, even suggesting that Sri Lanka lead such a campaign in the world. An estimated 1-1.5 million anti-personnel mines have been laid in the North and East, he points out. “For a country engaged in or recovering from war, the presence of thousands of people disabled by mines is a heavy economic and social burden, for the family and the community. For the victims, themselves, it is an unending tragedy,” he writes with deep compassion.

There is much more in the book of his experiences as a surgeon in wartime; his trips to Jaffna in the height of the war after volunteering his services to the Army, the siege of the Jaffna Fort, the numerous operations and major battles, all described in detail.

The book also allows the reader a glimpse of his personal life. He writes of his happy childhood and Medical College days, prowess on the rugger field (he captained the Medical Faculty, Colombo and the Combined Universities’ team) his marriage to Shelendra, a supportive and caring partner, the early days while seeking to specialize in London, the birth of their children, all in the same easy style affording the reader an understanding of his religious ethos and dedication to serve, however difficult the circumstances. There is too a section at the end, of tributes from his students.

The book is illustrated and here a word of caution is included that some of the pictures are graphic and may be disturbing.

“The readiness to be available for service when required, especially to relieve human suffering in the war-torn areas, is truly a test of the human spirit,” he says and this in a sense sums up this remarkable real-life story.

By Renuka Sadanandan

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