[APPRECIATIONS - (27-01-2020)] | Daily News


[APPRECIATIONS - (27-01-2020)]


The Mother of Trans-Radial Angioplasty in Sri Lanka

If I was to pinpoint one reason for who I am and who I want to be, there is no competition, no guessing nor anyone close but one person - Dr. Lalani Kapuruge Kuruppuarachchi.

Dr. Kapuruge was an interventional cardiologist in my home country, Sri Lanka, but that doesn’t begin to tell the story of the person she was. It would be easy to say that her revolutionary research or numerous international awards were what inspired me the most about her. Yet what struck me hardest from the many, many strings to her bow was her perseverance, her resolute character and her overwhelming desire to achieve. And it is the word achieve that I use almost incorrectly if you call her ascension as a leading cardiologist from such humble beginnings a mere achievement.

Having grown up in the rural town of Badulla in Sri Lanka with inadequate educational facilities and little emphasis placed by parents on educating females, selection into medical school was by no means an easy feat. Adding to this, the highly competitive environment resulting from a lack of tuition free universities made this dream seemingly unattainable. Yet, as anyone who knew this incredible woman understood, no was never an option. Giving back to those who once gave to you was something that resonated strongly with her, something she always reiterated. It was the idea of someday giving back what her community had given that her fueled this overwhelming engine of perseverance.

Her attributes in revolutionising the field of cardiology in Sri Lanka continue to inspire me. Until the turn of the century, thrombolytic therapy was the sole form of acute intervention for myocardial infarction. During her post graduate training in Australia in 1997, Dr. Kapuruge was exposed to more feasible methods of acute intervention such as primary angioplasty. Understanding the benefits in terms of survival rates of this method compared to thrombolysis, she attempted to introduce this to Sri Lanka. However, this was met with opposition as a male-dominant community of health professionals was not ready for change initiated by a junior female cardiologist. Unfortunately, she was alone in her battle in raising awareness, having to face newspaper and television reporters who did not believe in her proposed novel method.

However, true to her tenacious character, she fought. Nowadays, arguably as a result of her efforts, primary angioplasty is a widely utilised form of intervention for myocardial infarction.

In 1999, whilst bearing her second child, she stayed true to her word of serving the community she grew up in and moved back to Badulla.

It was upon being back in the community that she realized the sheer magnitude of the gap in healthcare between urban and rural Sri Lanka. Novel methods such as thrombolytic therapy was unheard of in Badulla, with patients presenting with myocardial infarctions only being treated with basic measures of aspirin and heparin.

This, along with many other inadequate healthcare measures at the time, was mostly attributed to a poor understanding of health in such areas as well as the lack of equipment and trained health professionals. To combat this, Dr. Kapuruge used her meagre salary at the time to set up an ICU of 12 beds. She trained the nurses and doctors in the performance and management of thrombolytic therapy as the facilities required for primary angioplasty did not exist in Badulla.

Furthermore, she organised an ambulance service to transfer non-critical patients to Colombo who otherwise would not get appropriate treatment in Badulla primarily due to overcrowding. By the time she left Badulla a year later, the waiting list to get an appointment for a simple echo cardiogram had reduced from four years to four months.

But she wasn’t done there.

Twenty years ago in Sri Lanka, coronary angioplasty was performed through the femoral artery. This was somewhat problematic as it could result in complications such as severe bleeding and damage to the artery whilst also leading to a longer hospital stay.

In 2002, Dr. Kapuruge introduced a more feasible procedure to her home country – trans-radial artery coronary angioplasty. She initially had to perform the procedure without appropriate equipment as pharmaceutical representative companies refused to provide her with the proper equipment. Today, there is not a single cardiologist in Sri Lanka who does not use this procedure.

Sadly, as is the case for many of those who re-define the way we live, her name is mostly unknown. People are unaware of who introduced these life-saving procedures to the country. People are unaware of the battles this woman fought to do it. The people who know of her however will tell of a woman who knows no bounds or limitations, a person who creates doors to walk through walls and views barriers as something that are there to be removed. Ultimately, a person who cares so deeply for her country.

A role model, by definition, is someone whose behaviour others seek to emulate. Dr. Kapuruge is the quintessential example of this. Her divine compassion and utter selflessness brought me boundless inspiration and influenced me immeasurably in the way I think and behave – ultimately influencing the career path that I am currently on.

She made me realize how incredibly privileged I am and instilled within me the importance of helping those who are more disadvantaged. I have learnt that the satisfaction gained from serving for the greater good is more rewarding than any gained from serving yourself.

Dr. Kapuruge is the reason why I am the person I am today. Her ability to make such an influential contribution to society while simultaneously raising two children allows me to put my problems into perspective. The words “thank you” don’t seem to do justice to appreciate the lessons I have been taught, the places I have been and the person I have become. It would be remiss for me to not say that I owe everything I am and everything I will be to this wonderful person and I am tremendously proud to call her my mother. However, I suppose the brightest stars do burn the quickest. Although she is unfairly no longer with us, in my heart she will always be with me. ‘We all die- the goal isn’t to live forever, the goal is to create something that will.’ Gumshi, you will always live on in the heart of everyone you touched. It was a privilege being your daughter.”

- Chamasha Kapuruge



He had a reputation for unerring professionalism

“God, give us men!

A time like this demands strong minds, great hearts, true faith and ready hands;

Men whom the lust of office does not kill; Men whom the spoils of office cannot buy; Men who possess opinions and a will: Men who have honour: Men who will not lie: Men who can stand before a demagogue and damn his treacherous flatteries without winking!

Tall men, sun-crowned, who live above the fog, in public duty, and in private thinking; For while the rabble, with their thumb-worn creeds, their large professions and their little deeds, mingle in selfish strife, lo! Freedom weeps, Wrong rules the land and waiting justice sleeps.”

- Josiah Gilbert Holland

The sudden passing of Prasanna Jayawardena, Justice of the Supreme Court, is a sad reminder of the impermanence of all things, however giftedor high, no person can escape the human condition.

I first met Prasanna when we started the Colombo (host) Leo Club in the mid-1970s. The club was launched ceremonially at the Jaycees Secretariat down Wijerama Mawatha, in those days a prestigious venue for such functions.

Prasanna was its inaugural President, and I was the editor of the club newsletter. His parents, Stanley and Sujatha were well known social workers and active in the Colombo (host) Lions Club. I was introduced to the Leo club by Mrs. Marion Abeysuriya, my English teacher.

Stanley and Sujatha Jayawardena were an impressive couple; well read, urbane, and imposing. Busy as they were, in them, the fledgling Leo Club had a ready source of help and guidance, graciously given, and even volunteered. One time, when I had no way of typing out the club newsletter (before sending it through the Roneo machine) Mrs Jayawardena referred me to a friend, who kindly spent an entire morning typing (and editing!) what I had scrawled on scrap paper. Later, I learnt that she was a very senior officer at the Inland Revenue Department.

Among the Leo projects I recall was an undertaking to clean a ward at the Deaf and Blind school in Ratmalana. I think Prasanna had visited the school earlier and agreed on the “scope of work”. Mid-morning, at the Bambalapitiya bus stand, we all trooped into a crowded CTB bus (the only transport available in those days) with our “gear” of scrubs, cleaning material, paint and brushes.

The Leos “worked” till late afternoon and then caught a bus back to Bambalapitiya where we proceeded to a repast of thosai, warm gravy and hot sambols at the irresistible Greenland’s Café situated on the green and leafy “Shrubbery Gardens”.

If I remember right, Prasanna entered the Law Faculty about that time. Although such judgement was beyond our young minds then, now recalling our earnest but adolescent ventures into social service, I think the qualities that shone right through Prasanna’s brilliant professional life showed even then. He was intelligent, responsible and mature in all his undertakings.

Those adolescent years are only fleeting, and soon we drifted into our own career paths. Then on, I met Prasanna only occasionally.

After, completing his law studies, Prasanna did not follow the typical career path of a lawyer, opting instead to join an international banking corporation, where he worked for many years. Then, perhaps tiring of the routine of banking minutiae, Prasanna answered the call of law. Before long, he was in the leading ranks of the legal profession, with a reputation for unerring professionalism, strong integrity and abidingd ecency. It was the general opinion that the all-important matter of “fees”, with him, was only a secondary issue, the satisfaction he derived in the practice of the law, was paramount.

About four years ago, in another surprise move, Prasanna decided to accept an offer of a judgeship on our Supreme Court. As described by the country’s constitution “the judicial power of the people shall be exercised by parliament through courts…”.

It is said that the law is a jealous mistress, with varied allurements. Having argued the law from the Counsel’s table, Prasanna would now exercise the “peoples’ judicial power” as a judge of the apex court. He was to the manner born;suave, liberal, intelligent, an ornament to the institution. Unlike the many who only draw glory from a chance association with a school, a batch or aposition, he gave lustre to whatever he touched.

I haven’t had the occasion to read any of his judgements, but undoubtedly they were well considered, reasoned and just.

We cannot choose the times, nor the circumstances of our lives. In a society, impoverished not only in a material sense: beholding institutions politicized and corrupted to the point of no return: confronting men ‘with thumb-worn creeds, large professions and little deeds’: one can be forgiven for giving up on the absolutes, to tread the path of the lesser evil.

Inevitably, in the minds of most citizens, the name of Justice Prasanna Jayawardena would be associated with the three-member Presidential Commission that inquired into the issuance of Treasury Bonds in the period February 2015 to March 2016. Naturally, Justice Jayawardena who was a member of the commission, played an important role in the proceedings.

Going by the widely publicized details, it was apparent that the processes of the issuance of Bonds were deeply corrupted. Despite the several hearings and their findings, the matter yet remains unresolved, the multiplicity of inquiries only exhibiting the defects of our investigative/judicial processes, than their merits.

Was this a simple question of a conflict of interest, or, was there a deeper conspiracy, a cunningly thought out orchestration of matters, both before and after the fact, to facilitate what amounted to a naked crime against the country?

Like so many other recent crimes, there is no closure to the matter, the “people’s judicial power” is yet to speak.

The greatest homage we can pay to the memory of a good judge is to conclude a process of justice to which he gave much.

- Ravi Perera



She always greeted you with a smile

I knew Saro as a very sweet girl from our junior batch at Medical College. All having surnames beginning with ‘P’, BJC naturally saw Saro often, and the attraction for this lovely girl, who suited him in every way, was very strong. Their love story is best related by BJC himself. BJC probably considered Saro as a gift from heaven. Like Maria von Trapp from the Sound of Music, he may have mused ‘somewhere in my youth or childhood, I must have done something good’. Besides, he married into a lovely family too, a family that always supported and encouraged him, just like Saro did.

Sarojini, in addition to her work in the Ministry of Health, managed the home front superbly, giving BJC adequate time for his clinical and academic work as well as all his research projects, not to mention the tennis, which he was quite passionate about. They both showered a lot of affection on their daughter Maneesha and after Maneesha got married and had her children, the same love and affection were showered on the grandchildren too, who are now growing up to be nice kids. Little misunderstandings were all ironed out by Saro who was a person high in emotional intelligence.

One remembers Saro as a charming lady who always greeted you with a smile, the smile she wore even up to the grave. A quiet but cheerful person; a role model par excellence. Thinking of Sarojini always reminded me of that verse ‘The Perfect Woman’ by Patience Strong which I take this opportunity to pen. It is as follows :-

She is good, she is kind,
She is gracious and refined.
She is gentle, loyal and calm,
She is vivacious and gay.
In a quiet sort of way,
She has dignity, wisdom and charm.
Self-possessed, yet not vain,
Though she may be quite plain.
She has something no words can convey,
Sympathetic and polite.
Free from malice and spite,
She despises all vulgar display.
She is true, she is real,
The eternal ideal,
She is the woman all women can be.

Yes, I can truly say Saro fitted that description perfectly and Saro wasn’t plain, she was quite pretty too.

How BJC must be missing his ideal companion and Maneesha and the children their most helpful and understanding mother and Nana I can truly understand. Future Sri Lanka Medical Association Doctors’ Concerts will be without the singing duo – Saro and BJC.

Saro at the end of her life was full of thanks to BJC for a beautiful marriage and for providing her with everything she wanted in life. It was just a few days before she died that she said that after such a happy life, she was quite ready to leave this world.

We all miss you so much Saro. You, with your sweet smiling face, a genuine friend you were.

May be some day, somewhere in another realm, we might meet you again.

- Dr. Vinitha Perera, Consultant Physician

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