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Medical negligence or medical error ?

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By Prof. Susirith Mendis

Preamble

The newspapers and social media have been full of news during the last few weeks about incidents in hospitals, which led to the death of patients. Obviously, we are aware of such incidents more now than then due to the feverish activity of social media.

The latest was the untimely and unnecessary death of Chamodi Sandeepani, a 21 year-old girl in the Teaching Hospital, Peradeniya. According to the mother of Chamodi, her daughter’s condition deteriorated and her body turned blue after the administration of two medications by a nurse. One of them had been identified as Ceftriaxone (a Cephalosporine antibiotic).

I was also truly disturbed when a very good friend of mine, a consultant anaesthesiologist – a long-time resident of UK, lost his brother, who was a card-carrying patient on his sensitivity to penicillin. He was injected with ‘Augementin’ (a combination drug of amoxicillin and clavulanic acid) in a major private hospital in Colombo and died immediately afterwards. It was alleged that the emergency tray was not readily available at the time of injection. There was hardly a ripple in the media about this incident.

Both these incidents point to anaphylactic shock. Death by anaphylactic shock occurs in all parts of the world – including the best of centres. But that does not mean that many of those were necessarily fatal. Some patients could have been revived with immediate appropriate response and emergency care. Too many incidents have been exposed in recent times about unexpected and untimely deaths of patients in hospitals. Allegations of negligence abound. These incidents must be investigated by independent investigators to ascertain the facts of each of these cases. The manner in which inquiries have been done in the past by the Ministry of Health leaves much to be desired. Most often, the end result is absolving the medical/health professionals and issues swept under the carpet. As in this case of Chamodi, where the inquiry panel is headed none other than by the DGHS – ‘a home and home affair’.

Nonetheless, as a medical professional, a medical teacher for over 40 years and a medical ethicist of some standing within and without our profession, I am most troubled by the responses and reactions I see in social media posted by doctors. There is a uniform response of criticising the victims and a myriad of excuses. There is not even a remote consideration of whether there has been negligence on the part of the medical/health professionals directly involved in the incident. There was a very recent case where a daughter who posted a bitter experience she had at the Nagoda Hospital of indifference and lack of concern and care in a facebook post. She was hounded and harassed by the police on a complaint from the hospital authorities. She was coerced by the Police to delete her post. A case of the combined effect of medical and police muscle.

A more conciliatory and introspective approach by the doctors will in the log run be more fruitful in improving the quality and standards of healthcare in the hospitals. Exuding arrogance, intimidatory self-defence and a mindset of ‘attack is the best form of defence’ is without doubt, counterproductive.My objective in this article is to look at the issues of medical negligence and medical errors in general and how they pertain to our perspective of the recent events that have taken hold of our attention during the last few weeks.

What I will not delve into in this article are the existent economic crisis that has lead to shortage of drugs, inferior drugs imported without due diligence to quality and standards, short-circuiting the due process and regulatory oversight of the National Medicines Regulatory Authority (NMRA) and the role played by the Minister of Health and the Ministry of Health. The last, but importantly, ‘clinician burnout’ due to the difficulties faced by medical and health professionals struggling to provide minimal patient care under dismal supply conditions. Collectively or singularly all of the above have directly or indirectly been responsible for these unfortunate deaths.

My comments herein, are issues related to medical negligence and medical error that are systemic as well as global.Let me start with a comment in a book that happened to catch my eye at the University of Georgetown Medical School Medical Ethics Library over 2 decades ago:

The book was “Examining your doctor: A patient’s guide to avoiding harmful medical care.” by Timothy B. McCall, MD (Carol Publishing Group, New York, 1995). This is the personal experience/confession of a doctor when he was training as a medical student in a University Hospital in te USA.

“My first experience taking care of patients as a medical student changed forever the way I viewed doctors. I was appalled. In the university hospital I was assigned, we treated one patient after another transferred from hospitals where they had received medical care that had nearly killed them. We saved some of them, though many of those we saved ended up disabled. We didn’t tell these patients or their families that they had been victims of poor medical care; we intentionally misled them. Covering up malpractice is just one example of the systematic way that doctors withhold information from their patients.”

Well, that says many things that most doctors in Sri Lanka would refuse to accept or even consider. Their arrogance ensures that they are never wrong. They can ever be wrong.

But, it is ironical that with better technology in healthcare available today, even in Sri Lanka, doctors are more likely to be found negligent. Is this because (i) medical standards have deteriorated? (ii) more doctors are now less skillful? (iii) they are now more careless? (iv) lawyers have realised that there is good money to make from ligigation against doctors? (v) patients have become more aware of their conditions (thanks to the internet) and therefore, more litigious? (vi) Insurance companies are paying good compensation? Or is it a relative permutation and combination of all of the above? I have not seen any serious scientific study done to ascertain the real situation in our country.

Let us now, look at a non-binding classification.

Medcal Negligence

It is an act of commission or omission by a healthcare provider in which care provided deviates from accepted standards of practice in the medical community and causes injury or death to the patient. To establish negligence, it is necessary to first establsih ‘duty of care’. A reasonable, foreseeable and actual loss or injury caused by or materially contributed to by a breach of duty of care will lead to an accusation of negligence.

This can be of two basic types: Criminal Negligence and Medical (or Clinical) Negligence. Criminal negligence is such that the negligence is grave enough for a police investigation and a prosecution by the Attorney General. It can lead to judicial sentencing and even imprisonment. Medical negligence, on the other hand, is a civil procedure, that could lead to damages being awarded by a Court of Law.

But prior to legal measures in a Court of Law, it is possible to pursue a lesser path of ‘pre-litigation’. This entails a departmental inquiry (Ministry of Health) which can lead from warning, transfer, punishment, reporting the the Sri Lanka Medical Council (SLMC) to even dismissal from service. A complaint to the SLMC can lead to periods of temporary suspension of registration. And in extreme instances, to complete erasure from the Medical Register.

There are even less serious avenues in instances where pateinet or their next of kin, can seek redress through a process of ‘conflict resolution’. Mediation is one of them. It has to be a voluntary process. There cannot be coercion on either parties – i.e., the doctors concerned or the patient. The parties meet privately with a neutral mediator who facilitates a negotiated agreement. This then binds the parties to that mutualyy agreed conditions of resolution of the conflict. This could be an unqualified apology to a meagre financial compensation for losses incurred. It is seen as a much more constructive and less adversarial process than conventional litigation. If agreement is not reached, the parties are free to initiate or continue with litigation.

Another non-litigious option for patients is to make a formal complaint to the Parliamentary Commissioner for Administration (better known as the Ombudsman). The present Ombudsman is a former Judge of the High Court of Sri Lanka. The former Secretary-General of Parliament, Sam Wijesinghe was the first – if my memory serves me right.

The positives of a non-litigious process is that it is (i) a non-threatening environment; (ii) it may give an increased sense of ‘fairness’ and justice for doctors; (iii) the legal and other costs are minimal and affordable to most.

The negatives are: (i) Will it give justice to the grievances of patients or their next of kin? (ii) Will the whole process be transparent and devoid of obvious bias? (iii) Will the process retain the confidence of both patients and doctors that justice has been done?

To ensure that the process is transparent and devoid of bias, there would be a need for non-medical or legal representation. Would it not be ideal, as in the Court process of ‘trial by a jury’, to have a committee of inquiry made up of competent civilians?

We, in Sri Lanka have no estimates of negligence. But, if we go by the many anecdotes of serious events of gross negligence we hear, and the number of litigation that have failed in a court f law or settled out of court, they are still a matter of very serious concern.

There are other conditions that I will not dwell at any length here. That is ‘medical misadventure’ where there is error or unexpected outcome during medical intervention leading to serious deleterious effect on patient. This happends most often in surgical and anaesthetic practice. An ‘adverse event’ is defined as an undesirable and unintentional, though not necessarily unexpected, result of medical treatment. Examples of an adverse event is discomfort in an artificial joint that continues after the expected recovery period, painful cheloids developing after open-heart surgery or a chronic headache following a spinal tap.

Medical Error

Medical error has been defined as an unintended act (either of omission or commission) or one that does not achieve its intended outcome; the failure of a planned action to be completed as intended (an error of execution); the use of a wrong plan to achieve an aim (an error of planning); or a deviation from the process of care that may or may not cause harm to the patient. Patient harm from medical error can occur at the individual or system level.

There are many ways that medical care can go wrong. Errors can occur around the administration of medications (including adverse drug events/reactions), during laboratory testing, pathology reports, hospital infections, as a result of surgery or even in documentation or data entry tasks.

Medication error are the leading cause of negligence, error and adverse events. They include; (i) prescribing errors; (ii) failure to prescribe, administer, or dispense a medication; (iii) a patient receiving a medication too late or too early; (iv) a patient receiving a drug not authorized for them; (v) improper use of a medication; (vi) wrong dose prescription or preparation; (vii) administration errors; (viii) failure to take into account a patient’s medical conditions or potential drug interactions; and (ix) not following proper dispensing/prescribing rules for a medication.

“To err is human”

An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a study of 37 million patient records. (The Health Grades Patient Safety in American Hospitals study (2000-02).

According to Dr. Lucien Leape, lead the author of a Harvard study, the number of deaths from medical errors in hospitals account for the equivalent to the death toll from three jumbo jet crashes every two days.( Public Health Reports , 1999; 114: 302-317 July/August, 1999).More people die each year in the United States from medical errors than from highway accidents, breast cancer or AIDS, a federal advisory panel has reported.

The report from the National Academy of Sciences’ Institute of Medicine cited studies showing between 44,000 and 98,000 people die each year because of mistakes by medical professionals. “That’s probably an underestimate for two reasons, one is, there are many different kinds of errors we never learn about — even in retrospective studies — because they are never written down. Second, these studies did not include other areas of care like home care, nursing homes and ambulatory care centers.” (Dr. Donald Berwick of the National Academic of Medicine, Washington DC). Medical error is the third leading cause of death in the US according to a BMJ article (BMJ 2016;353:i2139).

Here are some more statistics from the USA. The FDA receives more than 100,000 reports every year that are associated with medication errors (FDA, 2019). Forty-one percent of Americans report having been involved with a medical error either personally or secondhand (Institute for Healthcare Improvement/NORC at the University of Chicago, 2017). More than 7 million patients in the U.S. are impacted by medication errors every year (Journal of Community Hospital Internal Medicine Perspectives, 2016). Ten percent of hospital patients will be subject to a medication error (NCBI, 2019).By 2023, medication errors in the US has been tied to $40 billion in spending and up to 9000 deaths each year.

What about Sri Lanka?

To my knowledge, there are neither records of ‘medical error’ nor surveys or audits done for us to have an understanding, or even estimates, of medical negligence or errors in Sri Lanka. I am open to correction, if there are. The only record I know of is Professor Carlo Fonseka’s seminal article in the BMJ (Volume 313 21-28 December 1996) titled “To Err was Fatal”. In it he writes of five fatal errors he made that caused the death of five patient. I think it is compulsory reading for all doctors who have not yet read it. In it he makes five important and profound observations: (i) All doctors are fallible; (ii) The natural reaction of doctors to errors is to hide them or to rationalise them away; (iii) It is unscientific and unethical to refuse to face our errors; (iv) There is no cathartic ritual in our profession to expiate the sense of guilt generated by our errors; (v) Since knowledge grows mainly by error recognition, facing our errors squarely is the path to medical wisdom.

As Prof. Carlo Fonseka stated, doctors are not infallible, no matter how much patients would like them to be. While doctors’ mistakes are not usually intentional, they are often preventable and typically occur when doctors fail to exercise the proper level of care and skill. Hence, it is not difficult to accept that doctor errors occur more frequently than patients realise. The recent events are the tip of the proverbial iceberg.

Unfortunately, when doctors’ mistakes do happen, the consequences can be disastrous – even fatal. In which direction should we in Sri Lanka tread? The path traced by the West? Or go back to our own traditions and culture? Our social relations are based on the ‘Eastern Philosophical Tradition’. The Sri Lankan social milieu is predominantly based on Buddhist Philosophy – ‘The Four Noble Truths’ and ‘The Eightfold Path’ and the values of Meththa, Karuna, Muditha and Upeksha.

We are ‘serendipitously’ placed. We are a nation where all 4 major religions are practiced. Do we need to follow or abide by the Western medical ethical tradition coming down from Aesclepius and Hippocrates ?

We practice Modern Western Scientific Medicine in a socio-cultural milieu seeped in ancient Eastern traditions. Can we take inspiration from those traditions and synthesise a ‘New Medical ethical tradition’ by bridging this philosophical divide?

Do we have both the creativity and the courage to do so? If we have, we can in all probability avoid the pitfalls that the practice of medicine has fallen in the West (and in particular, the USA).Let these recent unfortunate and possible unavoidable deaths open us as medical professionals to a more humane and humanistic approach to patient care in Sri Lanka.



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Viktor Orban, Benjamin Netanyahu and Donald Trump: The Terrible Threes of the 21st Century

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Orban (center) Trump and Netanyahu

In the autumn of 1956, Hungary staged the first uprising against the 20th century Soviet behemoth. Seventy years later, in the spring of 2026 Hungary has delivered the first electoral thrashing against 21st century right wing populism in Europe. The 1956 uprising was crushed after seven days. But the opposition scored a landslide victory in Hungary’s parliamentary election held on Sunday, April 12 and. Viktor Orban, Prime Minister since 2010 and the architect of what he proudly called “the illiberal state”, was resoundingly defeated. Orban who has been a pain in the neck for the European Union was a close ally of US President Donald Trump and Israeli Prime Minister Benjamin Netanyahu.

Trump even dispatched his Vice President JD Vance to Budapest to campaign for Orban. After Orban’s defeat, Trump and his MAGA followers may be having nightmares about the US midterm elections in November. Similarly, Orban’s defeat has reportedly caused “great concern in the halls of power in Jerusalem.” Netanyahu has lost his only ally in the European Union and the opposition victory in Hungary does not augur well for his own electoral prospects in the Israeli elections due in October.

Ceasefire Hopes

Trump and Netanyahu have bigger things to worry about in the Middle East and among their own political bases. Trump is going bonkers, blasphemously imitating Christ and badmouthing the Pope, launching a blockade in the Strait of Hormuz and strong arming more talks in Islamabad. Netanyahu has been forced to sit on his hands, pausing his fight against Iran while pursuing peace talks with Lebanon. The leaders and diplomats from Pakistan, Egypt and Turkey are shuttling around drumming up support for another round of talks in Islamabad and a prolonged extension of the ceasefire.

Further talks in Islamabad and potential extension of the ceasefire received a new boost by Trump’s announcement of a new 10-day ceasefire between Israel and Lebanon. The background to this development appears to be Iran’s insistence on having this secondary ceasefire, and Trump insisting on ceasefire abidance by Hezbollah in return for his ordering Netanyahu to stop his brutal ‘lawn mowing’ in Lebanon. All of this might seem to augur well for a potential extension of the primary ceasefire between the US and Iran. There are also reports of the narrowing of gap between the two parties – involving a potential moratorium on Iran’s uranium enrichment, the opening of the Strait of Hormuz, and Iran’s access to its frozen assets estimated to be $100 billion.

Meanwhile the IMF has released its latest World Economic Outlook with a grim forecast. “Once again, says the report, “the global economy is threatened with being thrown off the course – this time by the outbreak of war in the Middle East.” Before the war, the IMF was expected to upgrade its growth forecasts for the global economy. Now it is going to be weaker growth and higher inflation with oil price optimistically stabilizing around $100 a barrel in 2026 and $75 a barrel in 2027. In a worst case scenario, if the oil prices were to hit $110 in 2026 and $125 in 2027, growth everywhere will further weaken and inflation will go further up in countries big and small.

In a joint statement on the Middle East, the Finance Ministers of the United Kingdom, Australia, Japan, Sweden, Netherlands, Finland, Spain, Norway, Republic of Ireland, Poland and New Zealand have called on the IMF and World Bank “to provide a coordinated emergency support offer for countries in need, tailored to country circumstances and drawing on the full range and flexibility of their tool kits.” They have also welcomed “advice on domestic responses that are temporary, targeted, and effective, and encourage work to identify steps needed to protect long-term growth.”

Subversion from the Right

The two men, Trump and Netanyahu, who started the war and precipitated the current crisis are not being held accountable by anyone and they are still free to do what they want and as they please. The third man, Victor Orban, who did not have anything to do with the war but extended wholehearted ideological and political support as a faithful apprentice to the two older sorcerers, has been democratically defeated. Together, they formed the terrible threes of the 21st century, spearheading a subversion from the right of the emerging liberal status quo of the post Cold War world. Orban’s defeat is a significant setback to the illiberal right, but it is not the end of it.

The three emerged in the specific historical contexts of their own polities that are both vastly different and yet share powerful ingredients that have proved to be politically potent. The broader context has been the end of the Cold War and the removal of the perceived external threat which opened up the domestic political space in the US, for locking horns over primarily cultural standpoints and climate politics. This era began with the Clinton presidency in 1992 and the election of Barack Obama 16 years later, in 2008, created the illusion of a post-racial America.

In reality, the right was able to push back – first with the younger Bush presidency (2000-2008) pursuing compassionate conservatism, and later with the foray of Trump (2016-2020) threatening to end what he called the “American Carnage.” Of the 32 years since the election of Bill Clinton, Democrats have controlled the White House for 20 years over five presidential terms (Clinton – two, Obama – two, and Biden -one), while the Republicans won three terms (Bush – two, Trump – one) spanning 12 years.

Trump has since won a second term for another four years, but already in his five+ years in office he has issued executive orders to roll back almost all of the liberal advancements in the realms of civil rights, equality, diversity and inclusion. All that the celebrated acronym DEI (Diversity, Equality and Inclusion) stands for has been executively ordered to be banished from the state, its agencies and its programs.

In Europe, the European Union became the champion and bulwark of liberalism and subsidiarity, which in turn provoked the rise of right wing populism in every member country. Brexit was the loudest manifestation against what was considered to be EU’s overreach, but after Britain’s bitter Brexit experience the populists in the European countries gave up on demanding their own exit and limited themselves to fighting the EU from their national bases.

Viktor Orban became the face and voice of anti-EU nationalists. But he and his political party, the Christian Nationalist Fidesz – Hungarian Civic Alliance, are not the only one. Nigel Farage’s Reform UK in Britain and Marine Le Pen’s National Rally Party in France are becoming real electoral contenders, while right wing presidents have been elected in Argentina and Chile.

The rise and fall of Viktor Orban

Of the three terribles, Orban is the youngest but with the longest involvement in politics. Born in 1963, Viktor Orban became a political activist as a 15-year old high schooler, becoming secretary of a Young Communist League local. He continued his activism while studying law in Budapest, visiting Poland and writing his thesis on the Polish Solidarity movement, giving lectures in West Germany and the US as a potential future Hungarian leader, and undertaking research on European civil society at Pembroke College, Oxford.

At the age of 26, Orban gained national prominence with a speech he delivered on June 16, 1989 in Budapest’s Heroes’ Square to mark the reburial of Imre Nagy and other Hungarians killed in the 1956 uprising. Imre Nagy was the leader of the 1956 Hungarian uprising against the puppet Soviet Union outpost in Budapest.

To digress and make a local connection – the pages of Sri Lanka’s parliamentary Hansard of 1956, contain an impressive record of the political debate in Sri Lanka over the events in Hungary. The LSSP’s Colvin R de Silva eloquently led the Trotskyite prosecution of the Soviet invasion of Hungary and the suppression of its freedoms. Pieter Keuneman of the Communist Party used his wit and debating skills to defend the indefensible. GG Ponnambalam, the unrepentant anti-communist, used the opportunity to take swipes on both sides. Finally, for the government, Prime Minister SWRD Bandaranaike deployed his own oratorical skills to empathize with the uprising without condemning the USSR. The four men were Sri Lanka’s foremost verbal gladiators and they used the occasion to put on quite a display of their talents.

Back to Hungary, where Orban began his political vocation identifying himself with Imre Nagy and demanding the withdrawal of the Soviet army from Hungary and calling for free elections in that country to elect a new government. That same year in 1989, Fidesz was recognized as a political party; Orban became its leader four years later in 1993 and led the party and its allies to their first victory and formed a new government in 1998. At age 35 Orban became the second youngest Prime Minister in Hungary’s history.

During his first term, Orban started well on the economy, reducing inflation and the budget deficit, was welcomed to the White House by President George W. Bush, and led Hungary to join NATO overruling Russian objections. But the slide into authoritarianism and corruption was just as quick, including the attempt to replace the two-thirds parliamentary majority requirement by a simple majority. By the end of the term the ruling coalition disintegrated and Orban lost the 2002 election and became the leader of the opposition over the next two terms till 2010.

Orban returned to power with a two-thirds majority in 2010 and immediately introduced a new constitution that set the stage for ushering in the illiberal state. What had been previously a communist state now became a Christian state where ‘traditional values’ of gender rights, sexuality, and exclusive nationalism were constitutionally enshrined. The electoral system was changed reducing the number parliamentarians from 386 to 199 – with 103 of them directly elected and 93 assigned proportionately. Orban went on to win three more elections over 16 years – in 2014, 2018 and 2022 – each with a two-thirds majority, and used the time and power to transform Hungary into a conservative fortress in Europe.

The new constitution and its frequent amendments were used to centralize legislative and executive power, curb civil liberties, restrict freedom of speech and the media, and to weaken the constitutional court and judiciary. It was his opposition to non-white immigration that made him “the talisman of Europe’s mainstream right”. He described immigration as the West’s answer to its declining population and flatly rejected it as a solution for Hungary. Instead, he told his compatriots, “we need Hungarian children.” His ‘Orbanomics’ policies restricted abortion and encouraged family formation – forgiving student debt for female students having or adopting children, life-long tax holiday for women with four or more children, and sponsoring fixed-rate mortgages for married couples.

Orban wanted to make Hungary an “ideological center for … an international conservative movement”. Orban heaped praise on Jair Bolsonaro for making Brazil the best example of a “modern Christian democracy.” He endorsed Trump in every one of Trump’s three presidential elections, the only European leader to do so. In return, Orban has been described by US MAGA ideologue Steve Bannon as “Trump before Trump.” Orban’s attack on universities for being the citadels of liberalism have found their echoes in Trump’s America and Modi’s India.

For all his efforts in making Hungary a conservative ideological centre, Viktor Orban’s undoing came about because of Hungary’s growing economic crises and the depth of corruption and systemic nepotism that engulfed the government. The economy has tanked over the last three years with rising prices and the national debt reaching 75% of the GDP – the highest among East European countries. Orban’s critics have exposed and the people have experienced systemic corruption that enabled the siphoning of public wealth into private accounts, the creation of a ‘neo-feudal capitalist class’, and the enrichment of family and friends. Orban’s corruption became the central plank of the opposition platform that Peter Magyar and his Tisza Party presented to the voters and caused his ouster after 16 years.

The Prime Minister elect is not a dyed in the wool liberal, but a member of a conservative Budapest family, and a politician cut from the old Orban cloth. Magyar (literally meaning “Hungarian”) was once a “powerful insider” in the Fidesz government – notably active in foreign affairs, while his ex-wife was once the Minister of Justice in Orban’s cabinet. Mr. Magyar may not fully roll back all of Orban’s illiberalism, but he has committed himself to eliminating corruption, increasing social welfare spending, limiting the prime ministerial tenure to two terms, and being more pro-European, EU and NATO.

EU and European leaders have openly welcomed the change in Hungary, and may be looking for the new government to change Orban’s vetoing of a number of EU initiatives, especially those involving assistance to Ukraine. In return, the new government in Hungary will be expecting the unfreezing of as much as $33 billion funds that the EU extraordinarily chose to freeze as punishment for Orban’s illiberal initiatives in Hungary. For Trump and Netanyahu, the defeat of Viktor Orban removes their only ally and supporter in all of Europe.

by Rajan Philips

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ICONS:A Dialogue Across Centuries

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Sky Gallery of the Fareed Uduman Art Forum is dedicated to bringing audiences, cultures, and time periods together through meaningful and accessible art experiences to create the closest possible encounters with the world’s greatest paintings. Previous exhibitions include, Gustav Klimt, Frida Kahlo, Paul Gauguin, Vincent Van Gogh, Salvador Dali.

ICONS is conceived as “a dialogue across centuries” bringing together over a dozen artistic geniuses whose works span the Renaissance to the modern era. These works at their original scales of creation changes the conversation. You can finally stand in front of a life-size Vermeer or a monumental Monet and feel the dialogue between artists who never met but shaped each other across time. Each exhibit is meticulously presented on canvas, hand-framed, and finished at the exact dimensions of the original masterpieces, preserving the integrity of composition, texture, brushwork, color and scale.

At the heart of the exhibition is Jan van Eyck’s ‘Arnolfini Portrait’, a work that epitomizes the detail, symbolism, and human intimacy that have inspired generations of artists. Alongside it, visitors will encounter paintings that shaped the renaissance, impressionism, modernism, and the evolution of visual storytelling by Munch, Matisse, Monet, Degas, Da Vinci, Renoir, Vermeer, Rembrandt, Cézanne, Caravaggio, and more. The exhibition invites audiences to experience a rare conversation across centuries of artistic brilliance.

By bringing together works that are geographically and historically dispersed, ICONS creates a compelling space for comparison, reflection, and discovery. Visitors are invited to move beyond passive viewing into a more engaged encounter—tracing artistic influence, identifying stylistic shifts, and uncovering unexpected connections between artists who never shared the same physical space, yet remain deeply interconnected across time.

Designed and curated for both seasoned art enthusiasts and first-time visitors, ICONS offers an experience that is at once educational, immersive, and accessible—removing many of the traditional barriers associated with global museum-going.

Exhibition Details:

Dates: April 24 – May 3
Time: 10:00 AM – 5:00 PM (Monday – Sunday)
Venue: Sky Gallery Colombo 5

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Our Teardrop

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BOOK REVIEW

Ranoukh Wijesinha (2026)

Published by Jam Fruit Tree Publications.
82 pages. Softcover. ISBN 978-624-6633-81-3

The author is a graduate teacher at St. Thomas’ College, Mount Lavinia; his alma mater. On leaving school he read for a Bachelor of Arts Degree in English Language and English Literature at the University of Nottingham (Malaysia). On graduating, in 2024, he went back to his old school to teach these same disciplines. There seems to be a historic logic to this as his grandfather, a notable Thomian of his day, also started his working career as a teacher at the College before moving on to the world of publishing; as a newspaper journalist and sub-editor.

On his maternal side, Wijesinha’s grandfather was an accomplished journalist, thespian and playwright of his day, and his mother is also a much sought after teacher of English and English Literature and, as acknowledged by him, his first, and foremost, English teacher.

Ranoukh Wijesinha and friends at STC

Though there are some well-written, almost lyrical, pieces of prose in this publication, it is the poetry that dominates. Written with a sensitivity to people and events he has either observed himself, or as described to him by those who did, it also encompasses all genres of poetic verse, from the classical to the modern, including sonnets, acrostics, haiku to free and blank verse, the latter more in vogue today. All in all, it presents as a celebration of English poetry and its ability to, sometimes, express depth of thought and feeling far better than prose.

Dedicated to his mentor at St. Thomas’, his Drama and Singing Master had been a great influence on Wijesinha His sudden, premature, death understandably came as a shock to the still developing student under his tutelage. The poems “The Man who Made Me” and “The Curtain Called” best demonstrate this. In addition, it is apparent that Wijesinha has endured much mental trauma in his young life. Spending much time on his own, the questions these moments have raised are expressed in “When No One is Listening”, “There was a Time”, “Midnight Walks” and the prose “A Ramble through Colombo”.

However, the majority of the poems concern ‘Our Teardrop’, Sri Lanka, for whom the writer has a great love. He explores its history, its natural wonders, its people, its tragedies, its corruption and the hope that things will get better for all its people. “Bala’ and “Dicky” address a time of violence from days gone by when there were few glories, just victims. “Easter Sunday” brings this almost to the present time.

There also is humour. “Ado, Machang, Bro, Dude” celebrates his friends and friendships in a way that will reverberate with all the present and previous generations of those who are, or were once, in their late teens and early twenties.

There is little to criticise in this first of the writer’s forays into published works except, as referred to previously, to re-state that the prose quails in the face of the power of the poetry. It is all well written, filled with passion and compassion, and gives comfort that there still are young Sri Lankan writers who can be this brave, and write so powerfully, and profoundly, in English. It is hoped that this is just the first of many from the pen of this young writer.

L S M Pillai

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