Medical Journal

Published by

Faculty of Medical Sciences,
University of Sri Jayewardenepura,
Sri Lanka.

Original Articles

It’s not the scalpel but the heart - A Book Review

Sheriffu A A1

 1Second-year medical undergraduate, Faculty of Medical Sciences, University of Sri Jayewardenepura

About the book

Title – Knife Pill and Words to Help – An anthology of Medical short stories.

Authors – Ramith Fonseka and Sadini Upeka under the guidance of Dr. Mohamed Rishard

Publication – Electives Committee, Faculty of Medicine, University of Colombo. (Copyright © 2022, Ramith Fonseka, Sadini Upeka)

Review of the book

The stethoscope, the knee hammer, tons of books and millions of information are typical findings in any medical student or a practitioner’s luggage. Apart from these findings, it’s more of the kind words, the warm gentle smile and the tender heart that moulds one to become ‘THE DOCTOR’ a patient needs during times of distress. This is exactly what Ramith and Sadini achieve from the very first word of the anthology to its last – Compassion overtakes Knowledge.

Throughout the book, Ramith and Sadini, 4th year medical undergraduates from the University of Colombo take the reader on a wonderful rollercoaster ride where we meet nine different patients who happened to have crossed the lives of nine profound consultants, telling nine different stories and opening nine different avenues upon which the reader ponders on.

Each clinical aspect of the book is wound around settings scattered around state hospitals in Sri Lanka but the essence of each story is universal and can be applied to any corner of the world.  (Note that all names of patients used are concealed to protect their identity but in the event of relatability to such names is purely coincidental).

‘I’m very sorry, Nalini. It’s what the law says. I need you to understand that I must report this crime. Perhaps, I think, a little kindness is in order, everywhere. A little understanding, a little openness…’ (Ramith and Sadini, 2022, pg. 8 and 10).

With this story narrated by Professor. Sameera Gunawardena, the book brings us to the first problem any medical professional will undergo. Do I go by the textbook or do I go by feelings towards the patients? This dilemma of conflict of interest where the decision the doctor took as a JMO reporting Nalini’s illegal abortion took a U-turn resulting in the same JMO having to perform Nalini’s suicide autopsy. In life we as humans, particularly as practitioners need to take that knife edge decision to do it or not and this universal phenomenon is wonderfully portrayed by this scenario. The readers are left out to make a crucial decision. A question that I too personally tend to fumble upon.

‘The first thing I heard was the blip-blip of the heart rate monitor interrupted by a loud bep-BOP-bep that repeated over and over as the lights on top flashed orange-red.’ ‘I was a medical student again, craning my neck to listen to the doctors discussing my patients’ case in a ward round.’ (Ramith and Sadini, 2022, pg. 13 and 21)

Panic solves nothing – an absolute pinch of truth put forward by Dr Vihara Dassanayake and Dr Ravindra Samaranayake is something that is of absolute importance to any medical student or practitioner. You and I may have all the knowledge but at the end of the day it’s the quick reflexes and quick thinking that eventually saves a soul tasting death. In the story, trouble on the table, Ramith clearly puts out how Dr. Dassanayake had to face a patient who had gone into severe anaphylaxis due to morphine allergy in the middle of a colon cancer surgery. It was the blink of the brain and the flutter of the arm of the anaesthesiologist that bought the rough seas to calmer shores. Dr Samaranayake also tells that we  can always reach the pinnacle of any career but at the end of every mountain there is always a downward cliff. The doctor himself was at the pinnacle of his medical career when he had to lay down in bed as a patient and with the utmost difficulty try to pick up bits and pieces of his case just as he did as a medical student. Even if you dance high up on a 50m pole, you have to come to the bottom to collect money is a Tamil saying which I believe wonderfully suits this. All success and all the joys we have in life are only short-lived because after all we never know when we have to say adieu to this very soil. Ramith and Sadini seem to constantly reiterate this truth by putting two narratives one after the other.

As the book progresses, it is quite notable that the authors try to carefully orientate day-to-day issues we may have in the most subtle of manners. They go on to say

“I had brought my money for safekeeping … and this gown doesn’t have any pockets you see…”

(Ramith and Sadini, 2022, pg. 33) Although many of us may seem to consider ourselves to be sensible in our actions, once a disease conquers you, you are unable to figure out head or tail. Swallowing money just because the scrub didn’t have pockets shows the level of maturity and understanding one possess during times of distress.

The next one on line has a major drawback as I see it, since it is more focused on a Sri Lankan context and not on a universal scale. However, for a typical resident of Colombo, this was one of the most horrifying nightmares that one can face. The stories that follow also portray as to how both broken love and abusive love will eventually end one’s life.

All in all, the book ends with a universal message

“Changing lives is, indeed, what we do.”

It’s not the scalpel of the doctor that matters but the tender heart he possesses!


  1. Fonseka and Ueki’s. (2022). Knife Pill and Words to Help – An anthology of Medical short stories. Electives Committee, Faculty of Medicine, University of Colombo. (Copyright © 2022, Ramith Fonseka, Sadini Upeka)