Suresh Gnasegarah's letter delivers coherent arguments against Anwar's insistence on overseas treatment for his spinal condition.

There is one point that needs clarification.

Spinal endoscopy as practised by Malaysian spinal surgeons is in its infancy. The 'failure' rate (i.e. conversion to open operation) is still high and I think that the handful of practitioners locally who have tried to engage with this technique are still pretty much on the low end of their learning curve.

So for all intents and purposes, the operation of spinal endoscopy is not yet available at an acceptable level of safety and expertise in Malaysia.

Doctors here who profess to be able to offer this to Anwar should be prepared to demonstrate peer reviewed results of their experience with the technique.