The assertion that Prime Minister Dr Mahathir Mohamad had to opt for a bypass surgery locally because his heart attack was massive that the trip abroad would have endangered his life is factually incorrect ([#1]Patriotism has nothing to do with it[/#], April 6).

The team of specialists at the then General Hospital Kuala Lumpur would have been more than happy to refer him to one of the leading institutions in the west but he wanted to prove a point, to instil self-confidence among Malaysians. This was before the days of Malaysia Boleh!.

The prime minister's judgement was correct then, and today the beneficiaries of his courage and foresight are the thousands of Malaysians from all walks of life with various forms of heart diseases who receive quality treatment at Institut Jantung Negara every year. If only the same attention could be lavished on other branches of medicine.

But that was more than 10 years ago. Today the circumstances of former deputy prime minister Anwar Ibrahim's back ailment are vastly different. From a purely medical perspective, Dr Thomas Hoogland who, in his report after visiting the Hospital Kuala Lumpur facilities and consultations with the local team of experts comprising orthopaedic surgeons, neurosurgeons and neurologists, has recommended the minimally invasive endoscopic surgery, preferably performing it in his clinic in Germany for the best outcome.

But there is an added dimension to Anwar's case. Not an insignificant section of the Malaysian public holds the perception that he is a victim of political persecution, with the courts dragged in to give it a stamp of legality. Anwar and his family's concerns about having to undergo surgery in Malaysia is not entirely unfounded, given his near fatal beating on the night of his arrest when he should have been in the safe custody of the government.

The controversial issue of Anwar's alleged poisoning is another case in point, although this has died down without the benefit of an independent commission to shed light on the truths of the matter.

I have no doubt that the professionalism and integrity of the local team of experts are beyond reproach, but in such a high-profile case as this, a less than desirable outcome of the surgery may invite unwanted controversy. It is something that the present administration can ill-afford.