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Friday May 23, 2014 MYT 12:00:00 AM
Sunday June 1, 2014 MYT 6:44:10 PM
by mangai balasegaram
Datuk Dr Manickavasagar Balasegaram, 1929-2014
The world revered Datuk Dr Manickavasagar Balasegaram for his dedication to medicine, but to his daughter he was most of all a remarkable and principled man.
SOME may say only fate decides when we go, but for M. Balasegaram, a pioneer and father of liver surgery, he fought fate all the way. He determined his life at every step, never giving up on a goal, no matter how outlandish. His final goal was to live till 85 years, which went against all odds with his diagnosis at 57 of kidney failure. Yet on April 15 this year, he turned 85. Three weeks later, he passed away peacefully.
Datuk Dr Manickavasagar Balasegaram was one of Malaysia’s most distinguished doctors, with an array of international awards for research that expanded the frontiers of surgery.
He won acclaim for designing surgical instruments – namely the “Balasegaram clamp” – to control bleeding of the liver. A “vascular sponge” prone to bleeding and infection, the liver was relatively unexplored then.
He never sought royalties for the instruments he designed (manufactured by a surgical firm in London) as he wanted them to be affordable.
Bala, as he was known to colleagues, confronted challenges to save lives. In his efforts to improve patient care at the Seremban general hospital, he built the first modern intensive care unit in South-East Asia. Local organisations, such as the Rotary Club, provided support as he could not get government funds.
He had a relentless quest for good medicine. He instilled his “creed” of good bedside manners and patient care in the hundreds of doctors he trained.
“In my ward, no-one is higher than the patient in front of you,” he would say. He ran a tight ship as the head surgeon of the General Hospital, Kuala Lumpur. He had zero tolerance for dereliction of duty.
As a child, this powerful, strong, authoritarian figure seemed almost omnipotent. Growing up, I realised that my father was a mere mortal.
Later as an adult, I realised that my father was indeed remarkable. He was a tall order to live up to. He had a dogged determination to succeed. He conquered adversity after adversity that life dealt him with his unbending will. Opportunity never knocked twice on his door.
My father was responsible to a fault. The eldest of 10, he supported many siblings and relatives. He was also extremely hard working. He once shouldered the on-call duties of another doctor for weeks, virtually living in a hospital restroom. As a child, I remember him going to the hospital every day, even Sundays, to check on his patients.
His greatest quality was his unwavering commitment to something beyond himself, which was surgery. The greatest among men are those who stand for a cause beyond themselves.
My father’s life was also extraordinary because he lived in extraordinary times. Born at the start of the Great Depression, he endured an Occupation and a World War in his teens. Later, he dealt with the carnage of the May 13 riots up close. Like many from his war-weathered generation, he was driven and hard. He didn’t suffer fools.
I felt the generation gap growing up. It was not until I wrote my father’s biography From Small Town Boy To World Class Surgeon, that I really understood him. I saw him as an uncut diamond, rough around the edges, but priceless.
His dream to be a doctor was outrageously ambitious. He had little money or influence, as the son of a supervisor in an oil palm estate, and at that time, few Asians became doctors. Education was then a privilege not a right, and he moved from place to place to go to school, even teaching himself at one time. He overcame more obstacles to finally get into Singapore medical school. But a year later, his sponsor died. He then won a state scholarship.
As a young surgeon in Seremban, he was inundated with road accident victims. Many had liver injuries, as without seatbelts, they hit steering wheels. He studied the liver, injecting coloured latex into cadaveric livers to unravel dense blood vessel networks.
When he travelled around the United States in 1967, many surgeons knew of his published work and his clamp but few knew of Malaysia. They were stunned to discover his research was done in a small hospital in a small town.
My father’s longest night was the nation’s darkest – May 13, 1969. Fate conspired for him to be in the right place at the right time. He led the team that operated on dozens of injured patients – many with liver injuries.
Interest in his research led to lecture tours in medical institutions in 25 countries. In South Africa, he was invited as an “honorary white”.
He broke other racial barriers. He was the first Asian to be honoured by the Royal College of Surgeons in England’s Hunterian Professorship award (1969) and the first Asian to win the coveted Jacksonian prize, the highest prize in surgery (1971). He also won honours from the Irish College of Surgeons and the Royal College of Surgeons in Edinburgh – respectively the Abraham Colles Lecture and the Chienne Memorial lecture.
A tough taskmaster with rigorous standards, he groomed many top surgeons. He didn’t just impart skill and knowledge, but stood for his principles. He “walked the talk”.
At home, he also set high standards, stressing discipline and learning. Books were almost sacred and his library reflected his love of history. He never groomed his five girls just for marriage and motherhood, unlike some from his era. Today, all six of his children hold masters degrees. My brother has followed my father’s footsteps fighting for good medicine as a director with Medicins Sans Frontières (Doctors Without Borders).
After retirement in 1983 from government service, he continued a tiring routine in private practice. Liberal use of painkillers for raging headaches led to kidney failure. By 1989, he was on regular haemodialysis. Many dialysis patients do not live long; some only a few years. But my father took dialysis as another battle in his life. He became probably the longest-surviving dialysis patient in the country. His nephrologist described him as an “exemplary patient” who saw dialysis as “an adjustment to lifestyle”.
After my father died, hundreds of people visited our home to pay their respects. Their stories made me realise that there was so much I didn’t know about my father, because of course, I only knew him as a father.
I met one young surgeon who had only met my father once for a few hours. His mentor had been mentored by my father and the impact of my father’s mentoring had been so powerful that it passed on a generation.
My father was resolute and unwavering in the principles he stood for. That certainly wasn’t always easy to live with but it was always the right thing to do. He was old school, a man of integrity.
I realise that with his passing, I have lost a pillar in my life, an embodiment of values I uphold, a beacon in these times where corruption prevails and principles decline.
This Father’s Day is my first without my father, and ironically, the first that I have something to say. I never told him how proud I was of him, not just for the man he was, but for the way he lived his life and the principles he stood by.
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Lifestyle, M. Balasegaram, Memoriam
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