Lives of the fellows

Mohamed Ajwad Macan Markar

b.23 April 1923 d.? 1998
MB BS Ceylon(1948) MB BS Lond(1950) MD Lond(1952) MRCP(1952) FRCP(1973)

Ajwad Macan Markar was a pioneer of medical education in Sri Lanka and the first professor of medicine at the University of Peradeniya. He was born into a wealthy business family in Sri Lanka. His father, Sir Mohamed Macan Markar, who was minister of state in the government of the then British colony of Ceylon, was knighted for his philanthropic and political work on the island.

Under the guidance of his father, Ajwad was educated at Royal College in Colombo, the premier institution for the secondary education of boys. In addition to excelling academically, he also represented his school at cricket. He maintained his interest in the game during his medical school days and represented the University of Ceylon as a medical student. His career in medical school was exemplary and he qualified with honours and a distinction in medicine and was awarded the gold medal in obstetrics and gynaecology.

I was fortunate to be an intern in his unit in 1955, the time when he had just returned to Sri Lanka from the UK after passing the membership examination in London. 'Clinical sense' was the main anchor for the diagnosis and treatment of diseases in Sri Lanka half a century ago, at which time preventable tropical infectious diseases filled the medical wards. Macan Markar had an abundance of clinical sense which he imbued into his juniors. Impeccably dressed in his white tweed suit and sporting the College tie, his ward rounds spawned insights not documented in the traditional text books of medicine which had been authored in the developed countries. His rounds always left his patients reassured.

Our paths crossed again a decade later when he held the chair in medicine at the medical faculty of the University of Peradeniya in Sri Lanka and I was a senior lecturer. Those were the days prior to the current fashion of 'evidence based medicine' and when conservative approaches to the treatment of diseases held sway. The then rare disease of myocardial infarction was treated with six weeks of absolute bed rest. Macan Markar was one of the first to question the validity of this regime of prolonged bed rest and went on to document the ill-effects of such long periods of immobility. This is one example of his many innovative approaches at a time when the zeitgeist in medicine was 'the lesser the interference the better for the patient'. His philosophy was rooted in the belief that good clinical sense tempered with empiricism should be the basis for the management of disease.

His interest in medical education drove him to implement changes in the medical school curriculum. These changes were based on what was required for managing diseases prevailing in a developing tropical country. Objective questions such as multiple choice questions were introduced in to the final MB BS examination during his tenure as professor. He was one of the first examiners for the MD examination of the University of Ceylon.

The medical school at Peradeniya is located within a residential campus with many other faculties in close proximity. His influence on the rest of the University was recognized through his membership of the University Senate and University Council. 'Higher education' he used to say should be above the traditionally accepted narrow academic disciplines. He demonstrated this by attempting to get the engineering faculty interested in the topic of human engineering, especially in the workings of the cardiovascular system. The local development of a pace-maker for managing complete heart block was on his agenda but unfortunately he could not see it to fruition for reasons beyond his control.

Towards the end of his career at the Peradeniya Medical School Macan Markar, an academic empiricist, paradoxically turned to spiritualism. He became a Sufi, a member of a spiritual movement within the Islamic religion, and travelled frequently to the Sufi center in Philadelphia in the United States.

T Varagunam

(Volume XI, page 354)

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