By Tissa Wijeratne, MD

Tissa Wijeratne, MD (right), with one of his mentors from his time as a student in Sri Lanka.

Born and raised in what I describe as “the jungle,” my life started in one of the remotest parts of Sri Lanka: a village called Kirioruwa-Bandarawela in the central mountainous area. Electricity, hot water, television, and telephone were all miles away from us at the time.

I fondly recall days spent reading in the shade of a tree in the rice fields that surrounded my family home — the place where sky and earth met, almost kissing each other daily. The mountains were covered with a layer of lush tea bushes. Our home sat on the top of one of these mountains.

As a young boy, I would spend hours reading my favorite magazine, the Mihira, a children’s weekly.

Fast forward several decades. I am now the director of stroke services, neuroscience research unit, director of academic affairs, and director of international affairs at a leading public health service and a leading academic institution in Melbourne, Australia. I have just been appointed to chair of the Department of Neurology at Western Health in Australia to promote better brain health through my leadership.

I have become the first Sri Lankan-born neurologist to lead an academic department of neurology in Australia.

The Journey

I was always dreaming, ravenously reading, thinking … trying to discover new things that others hadn’t, with a view to make life better for my fellow men and women.

I fell in love with the idea of medicine when I realized that the potential to change human life for the better was immeasurable.

I was accepted in to medical school at the University of Peradeniya in 1987 as a merit student. This was purely an accident. I had no idea that I could end up in medical school while I truly loved biology as a high school student. I preferred to do the biology track as I truly enjoyed learning about biology and chemistry. In the end, I did well and secured a ticket to get in to the medical school.

The day before I departed for the university, the whole village visited my parents with whatever treasure they could carry.

“We are very proud of you, son. Be a good doctor, and come back to the village. We will need you one day,” they said.

I still recall my father’s deep voice while he was walking me to the railway station to get to the University premises from Bandarawela.

“I am very proud of you. I have no doubt you will go all the way. It is very important for you to remember your roots,” he said. “Whatever you become, every time you come home, you are one of us, one of them.” (He pointed to a fellow villager who was working along a farm yard.) “You should always be very humble,” he said.

University life was a dream come true for me. There was no rice field to work; no need to offer physical labor on the farm. It was a heaven made for learning. I easily picked up high marks at the university exams.

I recall coming back to the village and sharing my experience with other boys and girls. The gates were open for them to enter universities away from the village.

Most of the boys and girls worked hard to get to the university.

Uprising

The good times did not last long. Things changed for the worse in a few months.

Suddenly, it was a tough time in Sri Lanka. I did not see this coming. It was depressing. Part-way through my first year of medical school life, a national youth uprising in 1987 resulted in several years of chaos in the country, with educational establishments closed for the period of insurgency.

Many of my batch mates were killed. They were suspected to have links with the youth-uprising group.

During what became a three-year hiatus, I tried to come to terms with the fact that I was not going to become a physician. I took solace in reading as much as I could, while helping my parents farm the surrounding rice fields and gardens in my rural village.

I really missed the university life. I missed the library the most. So, I began to convert my thoughts into words. I started to write.

I wrote poems and stories. In the end, many leading national newspapers and magazines in Sri Lanka published them one by one. In the end, I became well known in Sri Lanka, with over 3,000 written pieces. I would sit under a tree in the rice fields and write. My thoughts at that time were that if I could not be a physician, maybe I would become a journalist.

In 1990, the youth uprising was crushed, and the universities reopened. I faced a fork in the road. Should I continue with the new path and take up the post as deputy editor for a leading national science weekly in Sri Lanka, or return to my much-loved medical school and finish what I had started?

Ultimately, I chose medicine. I continued to work with media on a part-time basis, a decision that enabled me to pursue my tertiary studies without financially burdening my family. In my third year at the University of Peradeniya Medical School, I decided that the brain was the most fascinating organ in the whole body.

The Mind

The human mind always fascinated me. In fact, I was often found in the canteen, unofficially tutoring many of fellow medical students from my own class, as well as the juniors, on brain anatomy and neurological pathways. I was popular for demystifying neurosciences as a student at that time. I was quite interested in depression, anxiety, memory, and wisdom, and I often spoke on these topics on national radio at the time.

I had been learning about my own mind since I was a child, perhaps since I was about 10 or 11 years of age. A lot of people do not know their own minds. Most of us either live in the past or future, not the present, and we become daydreamers. We forget what we need to do now. We forget to live in the moment. We ruminate in the past or future. This is the root cause for suffering among us.

I graduated with high marks and secured one of the most prestigious internship appointments in Sri Lanka, at the professorial University Medical Unit and University Surgical Unit at National Hospital in Colombo, Sri Lanka.

Then fate intervened. I met a girl, who later became my wife. Born in Sri Lanka, she had moved to Australia as a young student in medicine and, as a fellow medical graduate, was taking an elective at a Sri Lankan hospital when she and I met.

At the completion of my internship, I was handpicked to be the youngest junior lecturer at the University of Peradeniya, being trained in neurology and stroke medicine under the mentorship of Prof. Nimal Senayanake. This was a highly competitive position. Prof. Senayanake is well known to the World Federation of Neurology thanks to his significant contributions in neurotoxicology in the past.

Family

At the time, I was observing the brain drain happening around me as my peers left for the U.K., Australia, and America. I hated them. I strongly felt that they had a duty to serve in the less green parts of the world.

Because of my marriage, I had to leave Sri Lanka in the end. The guilt I felt at leaving my beloved homeland in 1998 cut deep. It was some months before I could make progress in establishing a new life in Australia with my wife.

In 1999, my wife and I moved to New Zealand as part of her training in psychiatry. I then had the good fortune of working with a remarkable young infectious diseases physician, Dr. Richard Everts, who pushed me to complete physician training in Australasia while I was contemplating a neurobiology PhD at the time.

For the first time in my life, I could practice what I read in textbooks. I couldn’t do that in Sri Lanka.

After completing my basic physician training in New Zealand and having our first child in North Island, we moved south, to Christchurch, where I undertook my advanced training in neurology with Prof. Tim Anderson and colleagues. Here, I developed my skills in movement disorders, stroke medicine, and headache medicine. I was on call for the EPITHET trial as an investigator 24/7 for nearly three years.

We then moved back to Australia, and I took up a post at the Royal Adelaide Hospital, where our second child was born. I underwent further training in stroke and movement disorders under the leadership of Prof. Philip Thompson, then president of the Movement Disorders Society.

In 2006, Prof. Robert Helme invited me to set up a stroke program, neuroscience research program, and movement disorders program at Western Health, where resources were limited.

I went on to develop the fastest-growing stroke service in Australia at Western Health. A number of PhD students completed their higher degrees through the Western Health neuroscience research program. Our collaborations generated 10 to 15 high-quality publications in high-impact factor journals annually.

Prof. Helme is a remarkable person. We owe him a lot. He inspired a department, helped me establish a research program at Western Health, and encouraged my interest in stroke medicine. He is still my mentor. We meet every six weeks or so over a coffee, and even though he criticizes me for not doing more, he always smiles at my achievements.

I go back to Sri Lanka with surprising frequency, to promote better brain health in Sri Lanka. I have conducted more than 150 master classes in stroke medicine, headache medicine, and movement disorders throughout Sri Lanka since 2007. I have trained a young neurologist/physician from Sri Lanka at Western Health almost every year since 2008. At present, another Sri Lankan neurologist from Kandy is training with me in Melbourne, Australia.

I spend almost 70 percent of my annual leave returning to Sri Lanka. To my knowledge, I am the only permanent visiting professor of neurology to be officially appointed to a Sri Lankan University.

Australia has one of the best health care systems in the world, and I am proud to be a part of it. We deliver state-of-the-art care for our patients regardless of how much is in their pocket.

I don’t believe in complaining or whining about what we don’t have. Not so long ago, I did not have any office space or a personal assistant at Western Health while I was leading one the biggest stroke services in Australia. I was using a dustbin along the corridor to lean on and sign paperwork. The stroke service head from Colombo National Hospital and two other physicians who visited me noticed this in 2009. Just because I am in Melbourne does not mean I have a silver spoon.

I believe I am a link between the developing world and the developed world. If someone turned back the clock to 1998, and I was given the option of staying in Sri Lanka or coming to Australia, I would still come. I always wanted to do something great for the world and fellow human beings, and the Australian health system has given me the opportunities I never would have had in Sri Lanka.

Last year, I was very sick. I almost lost my life. At one point, I was told that I was not going to live more than two months. I recall the sleepless nights I had earlier in the illness.

“Did I get it wrong? I could have done more private practice and paid off the mortgage. Why did I spend time traveling back and forth to Sri Lanka rather than building my wealth and CV?”

I knew the answer right away. This is the best way to live my life. There is nothing that makes us happier than giving and expecting nothing in return.

I enjoy perfect health at the moment. I will continue to do my very best to dedicate my life to making life better for my fellow human beings. I have no boundaries for this purpose.

There is much more to do in this world. There is much more to do in the Asia-Pacific region. The World Federation of Neurology is our platform to do this work and to get the job done.

Make sure you sign up for the advocacy workshop at the upcoming world congress in Kyoto.

I look forward to seeing you all in Kyoto. Let’s get together and promote better brain health.

Let us bring our very best to get the best possible care for our patients, irrespective of the resources we have.