The sharper edge to traveling in Asia

WoWasis book review: the life of a surgeon in Sri Lanka, by Dr. Philip Veerasingam

Written By: herbrunbridge - Mar• 16•12

Dr. Philip G. Veerasingam worked in the Department of Health, Ceylon/Sri Lanka, from 1965 to 2000, and discusses his life as a surgeon in a memoir, The Cry of the Devil Bird: Incidents in the Life of a Surgeon (2010, ISBN 978-955-1723-13-2). It is essentially the story of a country doctor, working in at times arduous conditions, as he evolves his career in medicine. As we here at WoWasis found when we visited Sri Lanka, those conditions include numerous road hazards, and the author tells many a tale of fixing up the victims of automobile accidents. He also carried on the profession during  harsh monsoons, times of financial struggles, and country’s civil war. Some of his most memorable stories involve the war, including hospital incursions and casualties. Not all of the injuries were inflicted on the intended victims. Here’s one such tale, involving one such victim who picked up a tin cigarette can (cigarettes were sold in tin cans, in those days), and a creative surgical technique: 

As the heat of the JVP insurrection was cooling off, a teenage boy was admitted as a patient to the Casualty Unit, at the General Hospital, Kandy. He had been playing with a couple of his friends in the Children’s Park, at the Ampitiya end of the Kandy Lake. They had seen what looked like a wrapped up cigarette tin lying on the ground. The boy had picked it up and shaken it. He heard a rattling sound. One of his friends said that there might be a mouse inside. The patient had then held the tin tightly in his hand and struck it on a stone, with the idea of stunning the mouse. Upon impact the tin exploded, severely injuring his right hand. He came to the casualty ward. We took him to the operating theatre and inspected his shattered hand, under a general anaesthetic. His right thumb was missing and there was loss of skin in the palm. The other fingers had skin lacerations. The wound was cleaned well, and dressed. Three days later we re-examined him in the operating theatre and found the wound to be clean and free from any discharge. The small lacerations on the fingers were sutured but that still left the problem of the large ‘skin-loss’ in the palm. I fashioned what is called a ‘pocket flap on his right thigh. This is done by cutting the skin on the upper outer side of the thigh to raise a flap of skin in the shape of a trouser pocket. I stitched this skin flap to cover the raw area in his palm. The patient’s right upper limb was strapped in place in a position as though he was keeping his hand in his trouser pocket. The limb was left for four weeks to allow the flap to get an additional blood supply from the injured hand. Four weeks later when a new blood supply from the injured hand was established, we detached the flap, trimmed it and stitched it in place in the injured palm. I had ‘borrowed’ good thick skin from the thigh, to cover the area of skin loss in the palm. The wounds looked cosmetically acceptable. The skin of brown, the colour of the skin of his thigh, in pale whitish colour of the palm.  

About three years later, I was back in Kandy after my return from the UK. One day, I was walking near the Dalada Maligawa with my daughters when I approached a pavement boutique, to buy some roasted ‘Kadalai’. A young boy came out of the boutique and greeted me with clasped hands, bending low in greeting me. He asked me whether I remembered him. I could not place his face and told him so. He then put up his right hand. Only then did I recognize my handiwork of three years earlier. The flap was beautifully in position and gave him a serviceable hand but without the advantage of his thumb. The fingers were working beautifully.  

Some of the author’s most memorable essays occur toward the end of this 269 page book, with subjects including his strong advocacy for the anaesthesia profession, his poignant speech against internal racism in Sri Lanka, and his thoughts on the urban terrorism which challenged the entire nation. Travelers in Asia often find themselves in situations where they need medical treatment, and Dr. Veerasingam’s book provides an often fascinating look behind the scenes that patients rarely know about, and most of the rest of us tend to take for granted. This book is available by mail from the author, who will ship to international addresses for $15 USD postpaid. Visit the author’s blog, and scroll to the bottom for ordering instructions.

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2 Comments

  1. Hidaya says:

    Hello Dr. Veerasingham.
    This is Nursing sister A. I. Marikar
    how are you and Ramyalatha and the children remember the wonderful time we had working in Ward 12. you will always available for the patience
    . remembering the times we get ready for you early morning. you will always accessible and available. I live in the United States. would love to purchase your book and hear more about your journey thank you.
    please respond to my daughters email Soraya

  2. Sam says:

    The book can also be ordered online: http://www.ph-books.com

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