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The inaugural Dr J B Peiris oration
Birth of the Institute of
Neurology and Iconic Existence of Neurology in Sri Lanka

On the 21st November 2009, the President (Prof. Saman Gunatilake), council and members of the Association of Sri Lankan Neurologists honoured their teacher and father figure with an oration named after him. There was a large gathering of distinguished renowned neurologists from overseas including the President of the Association of British Neurologists (chief guest). The highlight of the evening was the inaugural Dr J B Peiris oration titled "Neurology in Sri Lanka its pivotal expansion and iconic existence. It was delivered by his first trainee, Dr Ranjani Gamage, the consultant neurologist of the National, hospital, Colombo. With the help of impressive visuals, the orator went on to trace how the practice of Neurology in Sri Lanka has evolved into its present state of the art with the leadership provided by Dr J B Peiris.

At the outset, the orator said ‘Dr. J B Peiris’s role in the pivotal expansion of the Neurological services in Sri Lanka is indeed immortal. His vision for Neurology was realized during the last few decades. She recounted how Dr Peiris almost singlehandedly spearheaded the transformation of the fledgling specialty without a proper unit to an Institute of international standard that the country can be proud of’.

Dr Peiris had his education at Royal College, Colombo. His academic achievements at Royal was crowned with the award of the coveted De Soysa Science prize, the Natural history prize and the prestigious Weerasooriya memorial prize for the best performance at the university entrance. He entered the Faculty of Medicine, University of Colombo and completed his MBBS in 1963, obtaining honours in all medical examinations.

Following his success at the MD Medicine in 1967 he was awarded the Commonwealth scholarship to undergo further training in the field of "Neurosciences". He had the opportunity and privilege of undergoing training in the best and most renowned centres in London, Edinburgh and Glasgow. He was selected for the position of Registrar in Neurology at the Institute of Neurology, Queens Square, London -widely considered and accepted as the Golden Temple of Neurology where he worked with many world authorities including Lord Roger Banister - "The world’s first 4 minute miler. He was later a Nuffield research fellow in the Institute of Neurology, London with Dr Ross Russell, and an international authority on strokes.

Then the learned orator dwelt upon the history of Neurology in Sri Lanka. Sri Lanka with its rich cultural heritage and profound influences from Buddhism had much understanding with regards to illnesses of the nervous system from ancient times. Lord Buddha in the 6th century BC in the "Girimananda Suthra" enumerates all sicknesses and categorizes Nervous system disorders under three headings.

"Sheersha roga, Murcha roga and Appamaho roga" - referring to epilepsy related illnesses. King Buddhadasa in the 4th century was perhaps Sri Lanka’s, first renowned Physician-King.

The initial appointment of an official Neurologist to the General Hospital Colombo took place only in the year of 1951. Dr George Ratnavale had the distinguished honour of being the first Neurologist in the country. In 1972, young, dynamic and vibrant Dr. Peiris was appointed to the coveted post of Consultant Neurologist at the General Hospital Colombo when he was just 33 years old. Being junior in age JB discovered that most of his teachers at Medical school were his peer consultant colleagues. Dr. Peiris thus became the country’s only consultant Neurologist at that time and remained so for over 10 years. This was a decade where "Neurology was JB and JB was Neurology"!

When he commenced work, beds for neurology patients were not in a separate unit. The beds were scattered in 4 separate wards and he had to share the male ward with a physician, the female ward with the cardiologist, dermatologist and 3 other physicians. This did not deter him, he was unstoppable! He proceeded to refurbish and equip the former staff tea room into the first Neurology intensive care unit. At this time there was neither a medical intensive care unit nor a coronary care unit in existence at the General Hospital, Colombo. It is important to emphasise that there was no dedicated Neurology support services during this era. There was no physiotherapy, electrophysiology, radiology or outpatient department dedicated for neurology.

THE INSTITUTE OF NEUROLOGY

The idea of establishing an "Institute for Neurology" a task of phenomenal magnitude originally germinated as a "spark" within Dr. Peiris. Motivation and the driving force which fuelled his inspiration was his unwillingness to tolerate an unsatisfactory working environment. His vision was a well planned and fully equipped Institute of Neurology that could provide a total and comprehensive Neurological service to all patients under one roof.

This Project was estimated to cost 200 Million rupees at that time. The task obviously was Herculean and did not appear feasible. Dr. J. B. was left with no choice but to trim down the envisaged 6 storied structure to a 4 storied building. Problems did not end there. There were two other perennial issues that needed immediate addressing.

1) A Site for the Building

2) Funding - for which he depended entirely on the generosity of the public.

Subsequent to the site clearance, the first literally ground breaking donation was pledged by Mrs Milina Sumathipala who generously provided the funds required for the ground floor in memory of her late husband. The first official donation came from Mrs Hema Premadasa on behalf of the Prime Minister Hon. Ranasinghe Premadasa.

Despite the inflow of these donations there was little or no enthusiasm or tangible momentum for the advancement of the project. At this crucial juncture, the hospital welfare service which is a branch of the ACBC headed by Ven Vipassi thero intervened.

The foundation stone for the proposed Neurology Unit was laid without much fanfare and festivity by the first donor Mrs. Sumathipala and Dr. Peiris, amidst a gathering of a few committee members.

Under the circumstances the committees’ strategy was to quantify items and request for donations.

The committee decided to accept contributions even as small as one rupee, all of which were highlighted as donations to the ‘Neuro Hospital Fund’ in the newspaper on a weekly basis.

Although the slogans were not even known, the thinking was the same as the winning US presidential candidate, Barrack Obama - namely

¥ ‘A change was needed’,

¥ ‘A change we believed in’

¥ ‘A change we can and would accomplish’

with the help of the public who were willing to help a worthy cause.

In spite of all the difficulties and many obstacles in the path, the Institute of Neurology was born. It was built exclusively by donations within a short span of three years. A monumental task, but most certainly a visionary’s dream come true.

The Institute of Neurology was thus ceremonially opened on the 8th April 1984 amidst much pomp and pageantry, with the then Prime Minister Hon. Ranasinghe Premadasa gracing the occasion as the chief guest.

The building had all the facilities required for an "all inclusive Institute" including an outpatients department, intensive care unit, physiotherapy department and a lecture hall. The first floor housed the male and female medical neurology wards and the second floor accommodated the neurosurgical wards. The top floor contained a theatre suite and a paying wing.

The Institute of Neurology was more than just a building offering services to patients, it was also a classroom where Dr. Peiris trained and moulded medical students and registrars in understanding the diseases of the brain. Widely read and up to date, he was a teacher par excellence, concise, crystal clear and systematic in his teachings, a quality that is his benchmark. He was more than a trainer to his Registrars who are now Neurologists; he was also their teacher, friend and at times a father figure.

Recognising his great services to the field of medicine and specifically Neurology, he was appointed President of the Ceylon College of Physicians in 1984 as well as in 1985. He subsequently held office as President of the SLMA in 1994. He held many positions which include, Chairman, Sri Jayawardenepura Hospital from 1996 to 1999, Director, PGIM, University of Colombo from 1996 to 2002, Patron of the ASN, Patron of the Stroke Association of Sri Lanka, Regional advisor for Royal, College of Physicians Edinburgh and Royal College of Physicians Glasgow.

"Behind every great man there is a woman"

And so it was with Dr Peiris. Dr. Peiris is married to Dr Rose, who has been a pillar of strength and support to Dr. Peiris for 40 odd years of blissful married life. They were blessed with a daughter Natasha, herself a Consultant Physician and the son, is a senior Economist with the IMF in Washington, DC.

"What we have done for ourselves alone, dies with us, what we have done for others and the world remains and are immortal"

The Institute of Neurology became a second home to Dr. Peiris and a refuge for future Neurologists. He was proud and happy to have been the driving force in its establishment as a monument for the future of Neurology in Sri Lanka and to say it in the words of the great Frank Sinatra’s ÉÉ ‘I did it my way’.

Having worked and trained under him for more than 5 years I remember with nostalgia the words of advice given to me, not only in the field of Neurology but also in my personal life.

As a researcher Dr. Peiris’s contribution was immense. Noteworthy among his contributions are the original research papers describing 4 new clinical entities. He also pioneered 3 new treatment modalities which have been adopted worldwide. The original descriptions were on Non familial juvenile distal spinal muscular atrophy of upper extremity, a delayed onset Cerebellar syndrome complicating Falciparum Malaria, Transient Emboligenic Aortoarteritis - a noteworthy entity in strokes in the young as commented by the Editor of the Archives of Neurology, July 1978.

As an accomplished writer he has two books for undergraduates and Postgraduates and a book published in UK for Neurology for the final MRCP examination of the UK Royal Colleges. He has also compiled two popular CDs for undergraduates and postgraduates.

The treatment modalities he pioneered are: Clonazepam in the treatment of choreiform activity, modified form of Plama Exchange for Guillain Barre’ syndrome in developing countries and Sodium Valproate in Trigeminal Neuralgia.

For his immense contribution to the health services of the country, he has been awarded the highest national honour of Deshamanya and for his impressive contribution to the sciences he has been awarded the national honour of Vidya Jothi - a rare combination, for any field.

Continued Next Week

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