A legacy to anyone interested in life-giving surgery
It is all about wielding the scalpel, oft not in state-of-the-art operating theatres (OTs) but in settings with minimal facilities – managing, adapting among numerous challenges, thinking on one’s feet and also not sticking to textbook lessons but acquiring new knowledge.
Amidst this veritable treasure book of surgical information, what the author of ‘The Healing Cut’, Dr. Gamini Goonetilleke picks out as his “favourites” are the stories about people whom he lifted out of hopelessness and despair who just could not swallow any food or drink.
The story of Lalitha, whose family in Handapangoda close to Ingiriya, he has helped beyond the OT like many others, is cited as an example of how his skilled fingers provided relief.
She had been among numerous patients who came to him unable to swallow, an action we all take for granted, due to their gullet (oesophagus) being destroyed.
He had reconstructed the gullets of these victims using the stomach or large bowel, in complex operations lasting 7-8 hours, with many of them just not having the wherewithal to pay for such surgery at the Sri Jayewardenepura General Hospital (SJGH).
Seeing their plight and when the President’s Fund refused to give them the money, Dr. Goonetilleke had launched ‘Gamini’s Fund’ channelling his own funds and seeking the mite of family and friends.
Skeletal and gaunt Lalitha had come to him, after ascetic acid had narrowed her gullet and this veteran surgeon explains that such patients are victims of attempting self-harm by swallowing corrosives; have drunk these acids thinking it was water; have been forced to drink them; or have been injured due to trauma.
‘The Healing Cut’ portrays a “huge” 104 “unusual” cases along with 350 colour photographs, which according to Dr. Goonetilleke cannot be found in medical journals or standard medical textbooks. The photographs are all his own, from the time of the patient being admitted either with an injury or a condition, then during and after the operation, and many years later and he recalls how initially these were clicked with a pocket camera, an Olympus Trip 35, which he still has.
Dr. Goonetilleke sets the tone for the book by referring to his very first appointment as a freshly-trained surgeon returning from abroad to the “primitive” Polonnaruwa Base Hospital back in 1982, when “one surgeon was all the hospital and the district had”.
Through the pages, thereafter, follows the blood, skill and life or limb-saving technique as he deals with trauma the “commonest” cause
of admission to hospital. “Unconventional” are the injuries treated, including from trap guns and shot guns; animal attacks such as bear, buffalo and elephant; agricultural mishaps from winnowing fan blades; knife attacks; kerosene burns; and, of course, war injuries caused by bombs, mortars, mines et al.
During the leisurely interview at his home in Colombo 5, Dr. Goonetilleke keeps stressing the urgent need for a trauma control programme in Sri Lanka, which he has also highlighted in his book.
Thereafter, ‘The Healing Cut’ looks closely and systematically at injuries or diseases in the different parts of the body. It covers the Head & neck; Chest; Oesophagus; Breast; Abdomen, pelvis & perineum; Stomach; Liver; Gall bladder & biliary tract; Pancreas; Spleen; Small intestine; Large intestine & rectum; Ovary, uterus & vagina (“when general surgery meets gynaecology”); Kidney; Scrotum & testes; and Limbs. While some of the photographs may seem graphic to the faint-hearted, there are also pictorials, sketches and human-interest pictures which keep the reader riveted.
The book reaches a highpoint with ‘Life’s unforgettable episodes within and beyond the hospital’ (the tale of Mr. Banku) and ‘From the operating room to the heart: two touching patient experiences’ (Lalitha’s story and Chatushika who had got caught in a time bomb as a child. Many moons later Dr. Goonetilleke had been the witness at Chatu’s marriage).
‘The Healing Cut’ from this surgeon who has served in Polonnaruwa, Gampaha and SJGH with a short stint at the Army Hospital, Narahenpita is not the first book to roll off the presses. In 2008, it was ‘In the Line of Duty’ and in April 2022, ‘The Extra Mile’ as he had been the first Sinhalese doctor to visit the rebel areas and also deal extensively with the treatment of the war-wounded.
Now engaging in a little practice at two private hospitals and swapping the pen for the scalpel, ‘The Healing Cut’ (those who have had a peek before the launch call it ‘The Healing Touch’), is Dr. Goonetilleke’s legacy to younger surgeons and anyone interested in intricate but life-giving surgery.