Many of them have been tried and tested and been pushed to the edge, for they have been the front-liners facing the onslaught of the pandemic. They have battled hard to save all those gasping in agony, sometimes even at great danger not only to themselves but also to their families. They have watched in [...]


Being a ‘good’ doctor: Steering CCP into 2022 with simple but important message

Prof. Arosha Dissanayake inducted as 46th President of the Ceylon College of Physicians (CCP)

Many of them have been tried and tested and been pushed to the edge, for they have been the front-liners facing the onslaught of the pandemic.

They have battled hard to save all those gasping in agony, sometimes even at great danger not only to themselves but also to their families. They have watched in anguish as, whatever their efforts, death has come and seen grieving loved ones unable to hold a hand and send their relatives on their final journey.

The distinguished gathering not only of doctors but also other professionals. Pix by Eshan Fernando

For, these are unprecedented times and on Tuesday, while saluting them, came a strong spur to strive harder still to be a “good” doctor.

As Prof. Arosha Dissanayake stood before a distinguished gathering not only of doctors but also other professionals when he was inducted as the 46th President of the Ceylon College of Physicians (CCP), his earnest plea obviously came from diverse experiences not only as a medical practitioner but also as a journalist at the Sunday Times and a home where language and literature held sway.

It was a different kind of ceremony too at the Waters’ Edge Hotel – the august procession walking in to the music of Beethoven’s Ode to Joy from the 9th Symphony and the lighting of the lamp taking place to the violin rendition of Jayamangala Gaatha.

It had been back in 1967 that 12 eminent physicians met at the then Colombo General Hospital (now National Hospital of Sri Lanka) to form this premier academic professional organisation for physicians in the country.

Today the CCP has general internal medicine specialists; physicians from all finer specialties and also other specialists such as psychiatrists, pathologists and paediatricians with representation in the council. It also has associate members who have passed the entry examination in MD medicine and are trainees at Registrar and Senior Registrar levels.

This is why, Prof. Dissanayake reiterates that “deriving strength from both the academic and professional eminence of its fellows and members”, the CCP is “uniquely” placed to guide patient care and act, as the “thought leader” in defining the future direction of healthcare in Sri Lanka. He promises that he and his council would “do it differently” by adopting a “bottoms up” approach, without following the usual practice of thinking of a theme and setting up programmes to meet it.

Turning the spotlight on the current situation, he said that “we are all cautiously optimistic about the year ahead. Though virus variants appear on a frequent basis ever expanding our knowledge on the Greek alphabet, with wide vaccination coverage, we may be able to resume greater personal interaction whilst retaining the wonders we claimed through online gathering. While retaining our new gains, we set out to recapture past glories of the CCP”.

Prof. Arosha Dissanayake delivering his address after being inducted as the 46th President of the Ceylon College of Physicians on Tuesday

And so Prof. Dissanayake’s vision for the CCP for 2022 on the theme ‘Crossing Divides & Bridging Gaps’ goes hand-in-hand with his personal simple mission in medicine – to become a “good” doctor, for which none of the lectures he attended or books he read could give a clear, precise answer.

“There are many good doctors around, but how to get there I believe, one has to discover one’s own truth. I have spent hours observing the good doctors, trying to learn. The doctors whom the patients would say, just seeing the doctor made them feel well. What is the quality that the good doctor has which can make these miracles happen,” he asks, laying down three essential attributes and how CCP will support this cause:

n Technical prowess – the possession of up-to-date knowledge about illnesses and treatment, bedside medical examination skills and the ability to perform relevant diagnostic and therapeutic procedures. The CCP is to continue to strengthen the current academic activities in this regard.

n Analytical thinking – the ability to understand and solve complex problems by analyzing them to arrive at a comprehensive differential diagnosis, determine the most suitable tests and instituting patient-centred care. The CCP is to facilitate learning from peers their successes and mistakes; from international experts in the ‘Cutting Edge’ series, from senior colleagues who have seen it all, in the ‘Pearls of Wisdom’ programme; and from colleagues who work away from the centre in limited resource settings under the ‘Peripheries to the Fore’.

n Communication skills – the ability to understand the ‘told’ and ‘untold’ stories of patients. Doctors need to communicate with patients, families, colleagues and other staff in the medical setting. Our successes and failures depend on how well we communicate. An often made mistake in communication is to limit it to imparting information.

Communication includes how we look at patients, how we smile and put them at ease, how we listen to their stories and not merely take histories, being empathetic, being able to understand how patients think and feel, being a friend to them whom they can approach to discuss their innermost worries and making them feel that the doctor has their best interests at heart.

He quotes the poignant and celebrated ‘Gaudeamus igitur’ (‘So let us rejoice’) from contemporary poet and cardiologist John Stone to propel forward his message: “For you may need to strain to hear the voice of the patient in the thin reed of his crying, for you will learn to see most acutely out of the corner of your eye, to hear best with your inner ear.”

The CCP is to facilitate greater engagement with the humanities to give doctors happiness and reduce exhaustion and burnout; to understand patient narratives better; develop the skill to observe similar circumstances from different perspectives or lateral thinking and help build an all-round story through a series of ‘Beyond Medicine’ programmes.

Harking back to the challenges doctors have faced due to the pandemic, Prof. Dissanayake recognizes the existence of a fourth attribute or a fourth dimension – resilience.

He stresses: “Resilience is the capacity to see through difficult times and recover quickly. The physicians who handled the pandemic better had greater resilience. As Epictetus, the Greek slave turned philosopher wrote in ‘Enchiridion’, the most important thing is our ability to understand that external events are not under our control but we control how we respond to them.

“We could always look to survive a crisis, battled and bruised. But resilience means not just survival, but coming out of the tragedy with a greater set of skills and a greater ability to face up to similar situations in the future……….to become better than we were, before the pandemic. As Marcus Aurelius, the great Roman emperor and philosopher wrote, in ‘Meditations’, impediment to action advances action, what stands in the way, becomes the way.”

Therefore, he assures that the CCP will take on this challenge of building greater resilience among doctors by contributing to personal development of individual physicians while also reaching out to a wider segment of both medical and non-medical professional partners.

Prof. Dissanayake concludes with perhaps the “greatest” song ever sung, the ‘Song of Buchenwald’. It had been written, set to music and sung by the starved, ill, shivering-with-cold inmates facing imminent death at this notorious Nazi concentration camp, to keep themselves from despair. They implore us not to lament or complain but to have courage and hope and say: “Yes to Life.”

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