The importance of medical literature and humanities for medical education. A publication of the Seth G S Medical College and KEM Hospital, Mumbai

1. 2022
Literature & Medicine

2. Dr Manu VL Kothari Chair of Medical Humanities was instituted in the year 2016 as
a tribute to DR MVL Kothari's life, vision and humanitarian views. The objective of
theChairistoinculcatemoralvaluesprimarilyinthemedicalstudentsandupholda
benevolentandethicalapproachtothepracticeofmedicalscience.
Committee Members
Dr. Sangeeta Ravat, Dean
Dr. Sunil K. Pandya, Chairperson
Dr. Lopa Mehta, Advisor
Dr. Ravi Ramakantan, Advisor
Dr. Padmaja Samant, Co-ordinator
Dr. Swarupa Bhagwat, Editor, Reflections
Dr. M. Natarajan
Dr. Kanchan Kothari
Dr. Urmila Thatte
Dr. Sandhya Kamat
Dr. Santosh Salagre
Dr. Smrati Tiwari
Dr. Mridula Solanki
Dr. Varsha Kulkarni
Dr. Nandini Vallath
Ms. Gulserene Dastur

3. REFLECTIONS
On Medical Humanities

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EDITORIAL BOARD
Editor:
Dr. Swarupa Bhagwat
Jt. Editors:
Dr. Shefali Balsari - Shah
Dr. Aniruddha Malpani
Advisors:
Dr. Sunil Pandya
Dr. Lopa Mehta
Dr. Ravi Ramakantan
Cover Page Painting by:
Dr. Supriya Kamath (Front Cover)
Junior Resident III
Department of Obstetrics & Gynaecology,
Seth G.S. Medical College & K.E.M. Hospital, Mumbai
Darsita Jatakia (Back Cover)
M.B.B.S. student,
Seth G.S. Medical College & K.E.M. Hospital, Mumbai

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REFLECTIONS
On Medical Humanities
Literature and Medicine
Editor:
Dr. Swarupa Bhagwat
Annual Book Published by
Dr. Manu V. L. Kothari Chair and Division of Medical Humanities
Seth G. S. Medical College and K.E.M. Hospital, Mumbai
2022

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REFLECTIONS
On Medical Humanities
Literature and Medicine
Editor: Dr. Swarupa Bhagwat
Annual Edition: 2022
All right reserved.
No part of this publication may be reproduced, stored in retrieval
system or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise without the
prior permission of the copyright owner.
Published by :
Dr. Manu V. L. Kothari Chair and Division of Medical Humanities
Seth G. S. Medical College and K.E.M. Hospital, Mumbai.
Printed by:
Siddhivinayak Printers
Mumbai-4.
Mob.: 9323108528

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Those two complementary
components
Once upon a time, there were ‘those two’.
The ‘first one’ was wordy, talkative, lively, and expressive. It
would touch and tickle the heart of any man it happened to
meet. It would often enlighten and inspire him too! It was man’s
own creation that helped him through his good or bad times. It
was ubiquitous. It would talk about the sky and the earth, plants
and animals, war and peace, life and death, and facts and
fantasies. Sometimes it would simply recount, at other times it
would rhyme!
The ‘second one’ was mostly quiet. It solemnly dealt with the
physical and mental anguish of people. It too was man’s creation
but spoke only about the symptoms and signs of the ailment
and the quest for healing that ailment. The healer used it for
treating merely the disease and not the fellow human being
suffering from that disease. So ‘the second one’ sombrely lay
there. Though it saw successes more often than failures,
something was wrong. It was man’s formulation and he had to
find an answer.
A few wise and learned healers realized it. They fathomed
the depths of the ‘second one’ in the pursuit of learning the
reason for its dreariness... There they met ‘The first one’. Perhaps
no one had envisaged its existence there! That was a great
discovery!
The ‘first one’ called ‘Literature’ then embraced the ‘second
one’ called ‘Medicine’! How much they both had to share with
each other! They converged. As one spoke, the other
reciprocated. The healers absorbed what the sufferer narrated
and vice versa. The sufferers were understood as a whole, as

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fellow human beings! Their pain, suffering, and emotions were
now viewed with empathy and mutual trust. Medical Humanity
had enhanced itself by blending two of its many facets!
Yes. That is how I look at it. Literature and Medicine
undoubtedly complement one another. A lot has been spoken
about their relationship, their mutualism, and the importance
of literature in medical and healthcare sciences. Literature, along
with many other aspects of the humanities, facilitates the
creation of the compleat physician. (See note below)
Hence, we chose Literature and Medicine as the theme for
Reflections 2022, the annual publication of Dr. Manu V L Kothari
Chair and Division of Medical Humanities. I thank all the
contributors for their interesting and enlightening articles,
paintings, and cartoons on the theme. I express my sincere
gratitude to our Dean, Dr. Sangeeta Ravat for supporting and
encouraging the activities of the Division of Medical Humanities.
I thank Academic Dean, Dr. Harish Pathak for his support. I am
thankful to Dr. Aniruddha Malpani and Dr. Shefali Shah for
painstakingly editing the material. I am grateful to Dr. Sunil
Pandya and Dr. Lopa Mehta for their constant guidance. We
thank the Gosumec Alumni Association for administrative
support in correspondence & financial transaction of Dr. M.V.L.K.
Chair of Medical Humanities.
Note: Izaak Walton, Sir William Osler and others used the
spelling compleat to emphase - ‘to the greatest extent or degree;
total’.
Dr. Swarupa Bhagwat
Editor, ‘Reflections’
Associate Professor,
Dept of Transfusion Medicine
Seth GS Medical College and KEM Hospital, Mumbai
swarupabhagwat@kem.edu

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Physician, Heal Thyself …..
It’s an emergency, the patient is critical, the beseeching eyes
of the relatives follow you, everything seems to be going wrong,
you’re running out of time. Your heart is racing – or maybe not,
you’ve learnt to be detached. The years of study and training
kick in, you’re in autopilot mode, all consciousness concentrated
in your hands. Afterwards, you walk away.
Is it really as simple as that? What happens to you when you
witness trauma after trauma, some (hopefully most) of which
you’re able to resolve while the rest, inevitably, defeat you?
You’re conditioned to be equanimous and stoical, so you square
your shoulders and carry on. Are you even aware that you’re
likely heading towards burnout, moral distress, or even moral
injury? That a day may come when you feel that “You have lost
your wits and have gone astray; and, like an unskilled doctor,
fallen ill, you lose heart and cannot discover by which remedies
to cure your own disease” (Chorus from Shelley’s Prometheus
Unbound. Original source: Chorus from Aeschylus, Prometheus
Bound. 1926. See https://www.perseus.tufts.edu/hopper/
text?doc=Perseus%3Atext%3A1999.01.0010%3Acard%3D472)
What then?
This is when you realize that if you aspire to exercise the
power to save others, you must first be powerful enough to
save yourself. This is when you begin searching for an anchor
that can give meaning to your life and make you feel whole
again. You may try out some tested avenues like meditation,
exercise, deep breathing, counselling and therapy, and
medications. Some of these undoubtedly help. Yet often they

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treat the symptom not the disease, and function as a band-aid
when an operation may be required.
Equilibrium can only be achieved when you change from
within. You already have what’s needed – intelligence, resilience,
persistence, dedication, drive – in other words, all the qualities
that got you into this profession. But what about EI – Emotional
Intelligence? Connecting with others, actively embracing your
humanity, finding a meaning and purpose that takes you out of
yourself? All these are essential to feeling whole and functioning
purposefully and mindfully.
Some people look for a direction in faith and spirituality. I
suggest you also try literature. I won’t even attempt to list all
the benefits of reading, but this one resonates: “A reader lives
a thousand lives before he dies . . . The man who never reads
lives only one” (George R.R.Martin). Literature, the arts and
humanities, all open up a rich and soul-satisfying life – art, music,
philosophy, history, a continuum with the past that gives
meaning to the future. Don’t look upon these as value-less
escapist fantasies; rather, they humanize you, help you rise
above your troubled self, and become your entry into living.
Whatever you choose, remember the imperative: “Physician,
heal thyself.” Only then will you be able to heal others.
Dr. Shefali-Balsari-Shah
Jt.Editor, 'Reflections'
(Former) Associate Professor and Head,
Department of English,
St. Xavier’s College (Autonomous), Mumbai
shefali@fidelityorg.com

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Learning how to become a
kinder Doctor
Learning physiology, pharmacology, pathology, genetics and
immunology is easy for you because you are intelligent, and
hard working. You have become good at cramming facts
because you are experts at passing exams. However, learning
about what is happening in the heart and soul of the patient
sitting in front of you is far more difficult than interpreting what
has gone wrong with their bodies when they fall ill. This topic is
not taught in your textbooks; guides; or the lectures your
Professors deliver. And because this skill is never tested in an
exam, many extremely competent doctors come across as
uncaring, detached, cold, and clinical.
Doctors justly take pride in mastering an enormous mass
of scientific facts so they can help diagnose and treat their
patients. However, we need to remember that patients are
humans, and that being humane is far more important than
merely being scientific and technically accurate.
This is why learning humanities is so important! It allows you
to enter the inner world of your patient. It teaches you empathy,
patience, and compassion - skills that are far more important
in the practise of clinical medicine than the ability to make
sense of an arterial blood gas report. Sadly, this is often
neglected during your education, because you don't get any
marks for being kind and caring!
Remember that patients do not care how much you know
until they know how much you care!
The good news is that you are very good at reading and

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learning, so please learn to read beyond your medical textbooks.
Yes, you are busy, and there are many facts to cram and an
endless series of exams to pass, but good literature can motivate
you to become a better doctor far more than any medical
textbook can!
For example, reading Albert Schweitzer's autobiography,
Out of My Life and Thought is inspirational, because it can show
you how much difference a single dedicated doctor can do!
There is no shortage of great books to enjoy – and these classics
are all easily available online. They expand your horizons, and
remind you how privileged you are to be a doctor. The more
you read, the more there will be to read, this becomes a positive,
virtuous cycle. These books will remain a faithful companion
throughout your life, and give you hours of joy, by allowing you
to explore new horizons from the comfort of your chair.
This skill will help you master the T- shaped model of life,
where you acquire a lot of expertise in your particular area of
medical specialization – and learn to apply it to all parts of your
life, so you become a more fully rounded and responsible
citizen.
This kind of vicarious expertise and experience will help
you enjoy being a doctor, because it reminds you that you are
part of a valuable heritage of healers, who have relieved pain
and suffering through the ages. Man is a story-telling animal,
and these books will help you appreciate how blessed you are
to be a doctor.
Dr. Aniruddha Malpani ,
Jt . Editor, 'Reflections'
IVF Specialist, Malpani Infertility Clinic, Mumbai
aniruddha.malpani@gmail.com

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CONTENTS
English:
1. Medicine and Literature:
Dr. Munira Kapadia, Dr. Rajesh Parikh ......................... 3
2. Wanted: a searchlight and a scalpel:
Dr. Kavery Nambisan................................................17
3. Painting: Prasad Rajani KR........................................21
4. A brief history of times (cartoon):
Dr. Hemant Morparia ................................................22
5. The Diameter of the Bomb (Poem by Yehuda Amichai)....... 23
6. Books on my shelf...(1): Dr. Sunil Pandya .................24
7. Of Mice and Men (And a Whole Bunch of Other
Animals) : Rahul Kothari ..........................................36
8. Mother to Son (Poem by Langston Hughes) ...............38
9. Medicine & Literature: My Experience:
Dr. Anand Nadkarni .................................................39
10. Book review: Literature in Medicine:
Dr Aniruddha Malpani ..............................................42
11. Painting: Anita Rana .................................................47
12. Conspiracy theory (cartoon): Dr. Hemant Morparia ............. 48
13. The Art of Medical Practice:
Dr. Manu Kothari, Dr. Lopa Mehta ............................49
14. The Door (Poem by Miroslav Holub) .........................64
15. The Half-Known Life.... Pico Iyer:
Dr. Shefali Balsari-Shah ............................................66
16. Painting: Saumya Landge .........................................71
17. FaceApp (cartoon): Dr. Hemant Morparia ..................72
18. Books on my shelf.. (2): Dr. Sunil Pandya .................73
19. Conversation with survivor (Poem by Erich Fried,
translated by Stuart Hood) .......................................85

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20. The Lives of a Cell: Notes of a Biology Watcher:
Lewis Thomas: Jason Sequeira.................................87
21. Painting: Renuka Sutar .............................................91
22. Painting: Mansi Thorat..............................................92
23. The Unknown Citizen ( Poem by W. H. Auden)...........93
24. Breath becomes Air - a review : Dr. Ashish Mehta ......95
25. Emotional Zeal: Dr. Mahesh Abhyankar...................115
26. Cancer ward - a review: Dr. Swarupa Bhagwat .........124
27. Cancel Culture Vulture (cartoon):
Dr. Hemant Morparia ..............................................139
28. Painting: Dr. Isha Singhal .......................................140
29. Harvey Cushing: The Life of Sir William Osler:
Dr. Dattatraya Muzumdar........................................141
{hÝXr
30. ‘mZ Om ‘oao ‘Z (H Wm: lr. am‘oœa qgh H í¶n). ....................... 170
31. ‘m¡V go RZ JB© ! (H {dVm: lr AQb {~hmar dmOno¶r) ................. 174
‘amRr
32. dm°S© Z§~a nmM, Ho . B©. E‘. (Sm°. adr ~mnQ): Sm° . nÙOm gm‘§V ...... 178
33. "Sm°³Qa ZmdmMm ‘mUyg': Sm°. ¶moJoÝÐ OmdSoH a............................ 189
34. am§J (H {dVm): Sm°. ñdê nm ^mJdV ......................................... 197
35. "‘mPr g‘mOn[adV©ZmMr emoY¶mÌm': àoaUmXm¶r AmË‘M[aÌ :
Sm°. {Z‘©bm aoJo .................................................................. 199
36. Vr Am{U Vmo (H {dVm): Sm° . Anydm© Jm§Yr .................................. 205
37. EH gO©Zerb AZw^dH WZ : Sm°. Hw Umb ‘amRo .......................... 207
38. No man is an island (cartoon): Dr. Hemant Morparia ... 213
39. Painting : Sayali Neman..........................................214

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ENGLISH

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Medicine and Literature
The Power of Punctuation!
Mention ‘Doctor’s writing’ and
the preeminent image is of an
indecipherablescrawl.Itconjuresthe
storyofthephysician’sfiancérushing
to the friendly pharmacist to have
himreadouttoherhismostintimate
love letters! Move the apostrophe
and we evoke some of the finest
literature in the world.
Medicine and literature have had a mutually nurturing relationship for
centuries. Illness, suffering, endurance and triumph are significant motifs in
literature. It is impossible to comprehensively and objectively cover the rich
alluvial mix of medicine and literature in an article of limitedlength. An entire
doctoral thesis or even a large tome might be insufficient. An essay of this
kind reflects the biases of the authors. We plead guilty. Unburdened by this
disclosure, we wade through the confluence of medicine and literature,
mindful of its powerful currents, hoping not to be carried away!
Doctors’ Writings
Surprisingly, some physicians arerecognised for their writing rather than
their medical contributions. A few have sailed through literature and
medicine with equal skill, poise and pleasure.
Hippocrates (470 BC-370 BC) is arguably among the earliest physician
authors. While his works vary in length and literary calibre, they are
Photo Credit : Dr. Rajesh Parikh

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consistentlyauthenticintheirdesiretoguideandarefreeoftechnical jargon.
To generations of physicians and medical writers, his works are paragons of
clear communication. His eponymous Oath continues to be a beacon for
graduating medical students, both for its ethical principles and its clarity.
Maimonides (1138-1204), a medieval philosopher and physician, is
undoubtedlyoneofthegreatest physician-writers of all time. The 14 volume-
Commentary on the Mishnah (1168), his religious masterwork, has made
him the preeminent rabbinic expert. His philosophical classic, The Guide for
the Perplexed (1190), reconciles sacred and secular knowledge. Maimonides
produced medical treatises on several illnesses and their treatments. His
works influenced Aquinas, Joyce, Newton, Leibniz and Spinoza.
John Locke (1632–1704), amongst Europe's finest thinkers of the 17th
century, was a paediatrician. In 1666, Lord Ashley brought Locke to London
from Oxford University as his personal physician. Locke drained a large
abscess from Ashley’s liver by inserting a silver tube into the tumour. Ashley's
suffering was greatly reduced and it was probably the most meticulously
recorded operation of the 17th century. Locke’s passion for philosophy
propelledhimintoprominence asoneofthegreatestphilosophers and social
commentators. In Letter Concerning Toleration (1689), Locke advocates the
separation of Church and State. Resistance to authoritarianism is a recurring
theme in much of his writing.
Tobias Smollett (1721–1771), a Scottish writer known for his picaresque
writings, was also a surgeon. Smollett often interrupted his medical training
to pursue writing. Among his well-known works are The Adventures of
Peregrine Pickle (1751) and his epistolary novel The Expedition of Humphry
Clinker (1771), both of which chronicled the mishaps of vagabonds through
the underbelly of English society.
Oliver Goldsmith (1728–1774), an English poet and novelist, showed
an early talent for storytelling. There is ambiguity around whether he
completed his medical training. However throughout his life, he was known

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as Dr. Goldsmith. His most famous work, The Vicar of Wakefield (1766), is a
depiction of rural life told through the eyes of Dr. Primrose, whose family
faces numerous tribulations. A biting yet good-natured cynicism offsets the
novel'sidealizationofrurallife,emotionalmoralizinganddramaticsituations.
John Keats (1795–1821), the British romantic poet, began his career as
a surgeon. Despite intensive medical training, he focussed on poetry. In
poems such as Lamia (1820), he argues that scientific knowledge ruins our
sense of beauty. An Imitation of Spenser, written at the age of 19, was his
first finished composition. His poems had been in publication for under four
years when Keats tragically died of tuberculosis at 25. He achieved fame
posthumously.
OliverWendellHolmes,Sr.(1809–1894),anAmericanphysician,novelist
and poet, was a reformer and a humourist. His works include the poems
The Deacon's Masterpiece (1824) and Old Ironsides (1830). The essays in
TheAutocratoftheBreakfastTable(1857)andothervolumesintheBreakfast
Table series are dialogues between the nameless author and other boarding
house inhabitants in New England who are only identified by their
professions,placesatthetable,orothertraits.Thethemesdiscussedincluded
the advantages of becoming older, the best location for a home, and
observations on the nature of conversation. Holmes is credited with coining
the term ‘anaesthesia’ in 1846.
Sir Arthur Conan Doyle (1859–1930)is best known for creating Sherlock
Holmes. He was inspired while studying medicine and working under Dr.
Joseph Bell, famed for his acute observation. A Study in Scarlet (1887)
introducedHolmes, who featuredinthreemorebooksand56stories.Doyle's
success as a writer led him to give up his medical practice and devote himself
toliterature.Heproducedalargebodyofwork spanning history, spiritualism,
science fiction and poetry. But, much to his chagrin, Holmes eclipsed
everything. In exasperation, he killed Holmes in The Final Problem (1893).
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that he changed tack (to persist with our sailing metaphor). Doyle started
demanding more money for his Holmes novels to turn off publishers. It did
not have the intended impact and Conan Doyle became one of the richest
writers of his day!
Anton Pavlovich Chekhov (1860–1904) adroitly balanced writing and
medical practice during his brief yet productive life. In 1879, while still in
medical school, he took on financial responsibilities for his family and
published comical tales and sketches of modern Russia. By the age of 26, he
had published over 400 short stories, sketches, and vignettes! He was
awardedthePushkinPrizefortheyear'sbestliterary workin1888.Chekhov's
medical background affected his subject as well as his writing style. Ward
Number Six (1892) describes a doctor’s psychological problems both as a
paralysed idealist and as a nihilistic stoic.
Somerset Maugham (1874–1965), began his first novel as a medical
student. Later, in Liza of Lambeth (1897), he relied on his experiences as an
obstetrician. The book was well received and Maugham devoted his time to
writing. Of Human Bondage (1915), The Moon and Sixpence (1919), Cakes
and Ale (1930) and The Razor's Edge (1944) are largely responsible for his
reputation. His plays and novels are distinguished by incisive insight into
human nature. He rose to become one of his era's most well-known authors.
Maugham was nominated for the Nobel Prize on six occasions. He never
won and was even rejected for being ‘too popular and undistinguished’.
Popular, of course, but undistinguished?
William Carlos Williams (1883–1963), a paediatrician, general
practitioner and Pulitzer Prize–winning author, revolutionised American
poetry by eschewing conventional rhyme. Williams’ short stories about a
generalpractitionerinasmalltownbrilliantlydepictthedisparitiesinmedical
practice.
A. J. Cronin (1896–1971) was a Scottish doctor turned novelist. Due to
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reflected issues of his own life. His most famous work, The Citadel (1937),
followsthecareerofanidealisticScottishdoctorwhoworksinaWelshmining
community before relocating to London. Here he discovers the folly and
greed of some medical practitioners. The book exposed unlawful and unfair
practices in British medicine and is said to have inspired the National Health
Service.
Victor Frankl (1905–1997), the Austrian psychiatrist and neurologist,
hadsurvivedtheHolocaustafterspendingfouryearsinconcentrationcamps.
During this period, he authored his most renowned work, Man's Search for
Meaning (1946). The book describes how he survived the Holocaust by
finding personal relevance. He chose to publish it anonymously. He wrote
over 35 books in his lifespan but this anonymous one became his most
famous creation.
Lewis Thomas (1913–1995), an American poet-philosopher, was a
doctor, administrator and educator. He is best known for his eloquent essays.
While Thomas headed the Department of Pathology at Yale Medical School,
hisfriendDr.FranzIngelfinger,editoroftheNew EnglandJournalofMedicine,
requested him to write a monthly piece called Notes of a Biology Watcher.
Each essay would be about 1000 words. There would be no payment, but
also no editing of his work. These essays were collated in best-selling books,
including The Lives of a Cell (1974) for which he received a National Book
Award and The Medusa and the Snail(1979). His work interpreted biological
mysteries and complexities to ordinary people.
Walker Percy (1916–1990), a physician from the United States and
recipient of a National Award, is known for his philosophical stories based in
and around New Orleans. His debut novel, The Moviegoer (1961) follows a
disturbed young man as he makes the decision to become a doctor. The
narrative highlights both the internal conflicts and the more significant
societal concerns that are present in such decisions.
Nawal El Saadawi (1931–2021) was an Egyptian psychiatrist, author,

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and women's rights activist. She authored several works on women in Islam,
with a focus on the practice of female genital mutilation in her culture.
I Learned Love (1957), a collection of short tales, and Memoirs of a Woman
Doctor (1958) are among her early works. Her most well-known works
include Women and Sex (1969), The Hidden Face of Eve (1980), and Women
at Point Zero (1975). El Saadawi was imprisoned in September 1981 for her
books. She used a kohl stick on rolls of toilet paper to continue writing
from prison.
Oliver Sacks (1933–2015), a renowned neurologist, presented
neurological cases to the general audience in an empathetic and insightful
manner. He wrote about the faith of patients and doctors in miraculous
recovery in Awakenings (1973). The Man Who Mistook His Wife for a Hat
(1985) and An Anthropologist on Mars (1995) are collections of essays on
patients with neurological disorders and are among his best-known works.
Robin Cook (1940-), an ophthalmologist, is best recognised for fusing
medicine with the thriller genre. From his early works, The Year of the Intern
(1972) and Coma (1977), Cook's novels have a thrilling medical edge. He has
written 35 international best-sellers that have sold hundreds of millions of
copies.These thrillers expose the public to ethical quandaries such as genetic
engineering, medical economics, in vitro fertilisation, research funding,
managed care, drug research, organ transplantation and stem-cell research.
Gieve Patel (1940-) is an Indian general practitioner, poet, author and
painter who practised in Mumbai. He retired in 2005 to be fully engaged in
writing, painting and sculpting. His poetical works include, How Do You
Withstand, Poems, Body Mirrored Mirroring and On Killing A Tree. Patel’s
poetry is preoccupied with the frailty of the human body, the social
inequalities of caste and the degradation of the environment.
Michael Crichton (1942–2008) went to the Harvard Medical School but
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producer, director, and screenwriter. While attending medical school,
Crichton began writing and publishing techno-thrillers. Jurassic Park (1990)
is among his best-known works.
Michael Palmer (1943–2013), a physician who worked as an internal
and emergency medicine practitioner for 20 years, never intended to be a
writer but was inspired by Robin Cook. Palmer wrote 19 novels, some of
which became best sellers. His books Silent Treatment (1995), The Fifth Vial
(2000) and The Society (2004) combined medicine with the genre of
suspense.
Tess Gerritsen (1953-) began writing thrillers while on maternity leave
from her position as an internist. She is most known for creating the
characters of detective Jane Rizzoli and pathologist Dr. Maura Isles, both of
whom appear in her written works and the television series Rizzoli and Isles.
Abraham Verghese (1955-), an internist specialising in infectious
diseases, attended the University of Iowa's acclaimed Iowa Writers'
Workshop. The results were spectacular! His first book, My Own Country
(1994), focuses on his years as a young physician in rural Eastern Tennessee
at the start of the AIDS epidemic. It covers his professional highs and lows,
as well as the stigma he encountered, even from those close to him. Cutting
for Stone (2009), set in Ethiopia and New York City, is dense with medical
information and human emotions.
Kalpana Swaminathan (1956-) and Ishrat Syed (1958-), both paediatric
surgeons practicing in Mumbai, write under the pen name Kalpish Ratna.
Uncertain Life and Sure Death: Medicine and Mahamaari In Maritime
Mumbai (2008) and Room 000: Narratives of The Bombay Plague (2015)
discussepidemicsintheIndianportcity.Inaddition,Swaminathanhaswritten
six detective books with the fictional detective Lalli.
Atul Gawande (1965-), surgeon and author, has four New York Times
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Manifesto (2009), and Being Mortal (2015). He emphasizes diligence and
ethics, and encourages medical professionals to never give up on a life.Being
Mortal covers the way we live and die as a result of modern medicine,
technology,andbettermedical facilities. The book poignantlyexamineswhat
matters to people in their final days.
Khaled Hosseini (1965-), an Afghan-American, quit his medical practice
of more than a decade after the success of The Kite Runner (2003). He began
writing the book in 2001 starting his day working on his novel at 4:00 am
before heading to see his patients for the day. In the book, Amir, a writer
residing in California and raised in Kabul in the 1970s, recalls his childhood
companion Hassan, a boy who was a servant. His subsequent works, A
Thousand Splendid Suns (2007) and And the Mountains Echoed (2013),
explore the connections between friends and family. The backdrop is the
change in Afghanistan’s political and social environment.
Siddhartha Mukherjee (1970-), an Indian-American oncologist, details
theevolutionofcancerdetectionandtherapyin TheEmperorofAllMaladies:
A Biography of Cancer (2010). It won the Pulitzer Prize in 2011. The Laws of
Medicine: Field Notes from an Uncertain Science (2015), focuses on the
question of whether medicine is indeed a science. The Gene: An Intimate
History (2016), a New York Times bestseller, brings together science, social
history,andpersonalexperiencetotellthestoryofoneofthemostsignificant
conceptual advances in modern times. In his most recent book, The Song of
the Cell (2022), he dives like a fantastic voyager into the intricate workings
of the basic unit of living organisms.
We conclude this section with the words of Anton Chekhov: “I have no
doubt that the study of medicine has had an important influence on my
literary work; it has considerably enlarged the sphere of my observation,
has enriched me with knowledge, the true value of which for me as a writer
can only be understood by one who is himself a doctor.”

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Doctors in Writings
Literature has often depicted doctors either as interesting characters or
biographical subjects. The representations ranging from Drs. Zhivago to
Faustus serve as inspiration and warning.
Dr. Faustus is among the most memorable characters in literature.
Christopher Marlowe (1564 - 1593) wrote the five-act play The Tragical
History of the Life and Death of Doctor Faustus in 1592 or 1593, based on a
German legend. The protagonist obtains his doctorate in theology at the
University of Wittenberg. He masters medicine, philosophy, law and logic
and yearns for limitless knowledge and power. Towards this end, he makes
aninfamouspactsignedinhisbloodwiththemagician-devilMephistopheles,
theagentofSatan,whowantsnothinglessthanFaustus’soul.Theplaycovers
the eternal battle between good and evil. The term ‘Faustian pact’ has
entered our lexicon as an agreement in which values are traded for material
gain.
Dr. Jekyllis yet another unforgettable character who, along with his alter
ego Mr. Hyde, has permeated the English language. The Strange Case of
Dr. Jekyll and Mr. Hyde (1886) by Robert Louis Stevenson (1850 - 1894)
depicts the internal battle between good and evil in humanity.
Dr. Watson is eternally eclipsed by Sherlock Holmes. Yet without him,
we would have no stories of Holmes. Their relationship is the fictional
equivalent of the one between James Boswell and Samuel Johnson in 18th
century London. Watson is colourless in contrast to the mercurial Holmes.
His first name, ‘John’ is used only four times in all the stories, one of them
being when his wife calls out to him.
Dr. Zhivago has been immortalized in the eponymous novel (1957) that
is a grand sweep of the Russian revolution and its aftermath. Yuri Zhivago is
a poet, philosopher and physician whose life is upended by the revolution
and his love for Lara, a nurse and the wife of a revolutionary. The poems at

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the end are amongst the most beautiful words in the entire novel. Boris
Pasternak (1890 - 1960) won the Nobel Prize for Literature in 1958, an award
he was sadly forced by the Soviet authorities to reject.
Dr. Zhivago has been an intrinsic part of one of our lives (RP). I first read
it tearfully as a love story on receiving it as an English Literature prize at the
age of 13. At the age of 17, I read it again, this time as a depiction of the
revolution. Later, as a medical student, I saw the epic film by David Lean
twice. This time it was a doctor’s perspective on love, cruelty, suffering and
redemption. Dr. Zhivago, like all great literature was a mirror of my
development. To this day, I continue to read the poems; my favourite is
Parting which covers Yuri’s last moments with his beloved Lara. The great
critic Lionel Trilling once described a simple test of good literature: if on the
second reading you like a book better than on the first, it is good literature.
Dr. Zhivago has repeatedly fulfilled that test for me.
Dr. Martin Arrowsmith is the hero of Sinclair Lewis' (1885 - 1951)
eponymous Pulitzer Prize winning novel published in 1925. Based on his
observations of his father and brother as well as his desire to study medicine,
Arrowsmith is an unwavering idealist. His integrity motivates him to make
theright ethical decision at each crossroad of his difficult career. Lewis covers
still-current topics such as medical education, practice, scientific research,
scientific fraud, ethics and public health.
Alexander Solzhenitsyn (1918-2008) gave the world a peep into the
repressive political fear that gripped the Soviet Union in the 1960s in Cancer
Ward (1966). Based on his experience with cancer, Solzhenitsyn recounted
his forced exile in Kazakhstan in the 1950s, when he underwent
hospitalization. Oleg Kostoglotov, the protagonist has just been liberated
from a labour camp. His hospital roommates are a microcosm of Soviet life.
The book is a fierce critique of Stalinism. Solzhenitsyn wrote other books
such as One Day In the Life of Ivan Denisovich (1962), The Gulag Archipelago
(1973), First Circle (1968) and August 1914 (1971). He was awarded the
Nobel Prize for Literature in 1970, lionized in the West and granted asylum

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in the U.S. Then he started criticizing the West for its insatiable materialism
and ‘awful music’. He was now no longer a profound intellectual but an
ungrateful crank!
Sir William Osler (1848–1919), the father of modern medicine,
emphasizedthevalueofliteratureforhealthcarepractitioners.Therenowned
neurosurgeon, Harvey Cushing (1869 – 1939) wrote The Life of Sir William
Osler (1925), a two-volume masterpiece that won the Pulitzer Prize. It
captures his journey from an unruly Canadian childhood to Regius Professor
at Oxford and at The Johns Hopkins Hospital. He was wise, kind, and funny
(once submitting a case report of ‘penis captivus’ under an alias, asserting
that a passionate couple could not disengage. He was astonished that the
article was published!).
Drs. Manu Kothari and Lopa Mehta urged medical students to read
Aequanimitas (1904) and graciously loaned it to freshers like one of us (RP).
I read it frequently and years later was thrilled to find an early leatherbound
edition in an old bookshop in Baltimore. The book is a collection of essays in
which, among other sage advice, Osler urges us to develop equanimity as
physicians. The book stayed by my bedside for years, only to be loaned and
lost. With equanimity, I seek solace in persuadingmyself that it resides within
me. However, it is a struggle to find it when I lose it!
Henry Marsh (1950-) in Do No Harm: Stories of Life, Death and Brain
Surgery (2014) shares insights into what it's like to hold another person's
life in one's palm. He discusses agonizing decisions made during extreme
urgency and uncertainty.
Quanta Ahmed (1969-) In the Land of Invisible Women (2008) chronicles
her life as a western-educated woman and Muslim doctor in Saudi Arabia.
Her experiences with anti-Semitism, sexism, and anti-Western views provide
insight into women’s lives in Saudi Arabia.
Paul Kalanithi (1977–2015), a neurosurgeon, poignantly details his dying
days in When Breath Becomes Air (2016). The author blends literature and

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medicine in describing his life as a doctor and as a dying patient. On the cusp
of finishing ten years of study to become a neurosurgeon at 36, Paul Kalanithi
received a stage IV lung cancer diagnosis. He was a doctor treating the dying
one day and a patient fighting for his life the next. He died before his book
could be published. It became a New York Times bestseller, staying on the
list for 68 weeks, and was a finalist for the Pulitzer Prize.
William Shakespeare (1564–1616): Diligent readers would have noticed
the glaring omission. We just saved him for the last. There are medical
references occurring in nearly every one of his plays, while especially
abounding in Hamlet (1599-1601), King Lear (1605-1606), Coriolanus (1605-
1608) and Timon of Athens (1605-1608) .
Shakespeare’s knowledge of medicine is so extensive and occasionally
aheadofhistimethatithasbeenusedasanargumenttodenyhimauthorship
of the plays. One argument runs that it would be impossible for someone
who had just completed school and spent his time as an actor to acquire
such sophisticated knowledge of medicine. Hence, the scholarly Edward de
Vere, the Earl of Oxford, becomes a contender for authorship.
Shakespeare’s description of pia matter, tumours, ulcers, clots, malaria,
epilepsy, plague and of the circulation of blood ahead of William Harvey
defy explanation. Indeed, there are several books devoted to Shakespeare’s
medical writings. Of these, most notable are John Bucknill’s The Medical
Knowledge of Shakespeare(1860) and Medicine and Kindred Arts in the Plays
of Shakespeare (1896) by John Moves, a physician.
Doctors and Writing
A languid Saturday afternoon in July 1975, one of us (RP) is sitting in the
office sharedby Drs. Manu Kothari and Lopa Mehta. Manubhai (as we fondly
called him) is engrossed in a journal. I am doodling and sketching something.
We sit silently as the monsoon knocks politely before entering gingerly
through a partially open window. We let it in and silently continue with our
preoccupations. Suddenly he exclaims. “Not one student had borrowed it!”

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I look at him quizzically. Manubhai is recollecting a famed physician’s
last day at a famous hospital. Speeches with heaps of praise were made
over lunch. He heard them with equanimity and took a last round of his
favourite haunts making his way to the library. He picked up his favourite
bookAequanimitas withnostalgia,andwept.‘Notonestudenthadborrowed
it;' the famed physician said painfully.
I try to console him, pointing out the hospital was not a medical college.
“There are hundreds of doctors; not one” Manubhai continues. I try to
rationalise that the staff may have read it in the library and that some of
them may have bought the book. He is inconsolable. By the time there are
tears, I show him something I have sketched and with that we drop the
unpardonable literary crimes of the hospital staff!
So, why read anything other than our medical books? First, for the sheer
pleasure of enjoying great writing. Good literature trains us to listen
empathetically to our patients. To paraphrase John Donne, "Every patient is
a novel in himself". Reading thoughtfully helps in developing observation,
analysis, and reflection skills. Literature also prepares us for the unexpected
narrative twists and turns which we encounter in medical practice. We learn
to treat these with fascination rather than frustration.
Osler repeatedly urges us to understand the type of patient who has an
illness rather than the type of ailment harboured by the patient. One of
Galen's books has the heading ‘That the Best Physician is also a Philosopher.’
In the 1980s, Drs. Manu Kothari and Lopa Mehta held Saturday lunches
followed by a line-by-line reading and discussion of Shakespeare’s plays. The
group was led by Prof. Mahendra Pandya, a retired professor of English
Literature and former principal of a city college. Those discussions are
amongst my most vivid memories. Sadly, they were interrupted for me as I
went abroad for further training. Occasionally, I pepper lectures with
Shakespeare thanks to those discussions, and am told it helps make my talks
less boring!

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The distinction between humanism and science is a Cartesian duality
originating in the Enlightenment, initially promoting a discourse it may now
well obstruct. Too often, these days, humanities and medicine are presented
asdisparateapproachesratherthanascomplementarypathstothesametruth.
These days, students in their early teens are compelled to choose a
humanist or a scientific path, hindering their ability to gain a holistic
perspective. Just as in the metaphorical union of body and soul, we need to
move towards a synthesis of literature and medicine for our own good and
that of those who entrust their lives to us.
Dr. Munira Kapadia
Clinical Psychologist & Medical Researcher
Jaslok Hospital & Research Centre. Mumbai
munira.kapadia@hotmail.com
Dr. Rajesh M. Parikh
Director Medical Research & Hon. Neuropsychiatrist
Jaslok Hospital & Research Centre. Mumbai,
Author of three national best sellers : Kashmir : Hameent Ast (2005)
The Coronavirus : What You Need to Know About the Global Pandemic
(2020), The Vaccine Book (2021)
dr.rmparikh@gmail.com
The authors thank Ms. Maherra Desai and Dr. Shilpa Saralaya
for their inputs on syntax and content.
Shakespeare Club
Photo Credit : Dr. Rajesh Parikh

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Wanted: a searchlight and a scalpel
Surgery and literature appear to be unlikeeach other,butthere aresome
fundamental similarities. Surgery grapples with life and death; and if you
take a journey into the heart of all writing, you will see that literature too
engages with the same topics , but in a different way. Where does the breath
of life come from? When we die, where does it go?
We have not come anywhere near the answers but in the attempt, the
doctor and the writer take different routes. Doctors bring babies safely into
the world. We look after their well-being through life and if a serious illness
strikes, we do our utmost to preserve life. There is no avoiding death but as
doctors , we attempttodelay it foras long as possible. Literature too explores
thecomplexities of lifeby daring to go intothemindsandthoughtsofpeople.
It portrays life in all its beauty and terror; it depicts death, the fear of death,
the agony of not knowing what happens beyond that exit door. Literature
shows the oddities of human nature, so we better understand each other. It
makes us weep,laugh,shudder, pause and ponder. Literature makes usthink.
Surgery(indeed,allofMedicine)requireslearning, hardwork, dedication
and a genuine concern for every patient. Literature too demands integrity
and fearlessness. It is easy enough to say these words but to practice them
is quite another thing. I have at times doubted my ability to be truthful and
brave, whether it is at the patient’s bedside, in the operating theatre, in my
own personal life, or when I sit down to write.
Society provides a soft and accommodating blanket that enfolds us as
long as we follow certain rules of behavior. Impressions such as, “She’s a
fine person.” “He’s a great guy” are superficial, based purely on cordial
relations with like-minded people. This is good, but it is not enough. It is not
mere cordiality we need, but confluence - the ability and desire to mingle

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with all kinds of people. It can be difficult.
Literature has a responsibility towards the world in which it exists and
so do we the writers, readers, teachers, and lovers of good writing. The word
is a potent weapon, more potent than anything else that humankind has
created in its entire history of existence. It is more powerful than any
technology, gadgetry, or weapon.
Because words have so much power, they are vulnerable to corruption.
Writers must be vigilant and avoid the misuse and abuse of words. Misuse is
commonly due to a lazy choice of words. It is also a habitual offense of the
business and the advertising class – the use of flowery, clichéd language in
exaggerated praise of their goods; the use of dense, obfuscatory words, with
the purpose of keeping you ever so slightly confused. For if you understood
everything, their cold-blooded profiteering intentions will become too clear.
There is the other class of people who misuse and abuse words all the time
with a clear intention to deceive. They are at the top of the power structure
ofeverycountry.Theywillusedeceitful,flatteringwords,sloganeeringwords,
bullying words, offensive words, sweet words, self-congratulatory words –
so as to serve falsehood as truth and to take away that one thing which is
your fundamental right - freedom, all the while trying to tell you how much
they care for your freedom.
In the ordinary humdrum of my life, I see the might of courage every
day. I see it in the tribal laborer who cares for his four children and also two
others who are parentless. I see it in the couple who live in a thatched home
of two narrow, dark rooms not far from our home. I pick up my bottle of
milk – still fresh and warm – milked from their cow. I have been friends with
that couple for over four years. They give me beans and cucumbers they
grow behind their home and I give them medical help when they need it. I
asked them recently why they did not raise the price of milk like all the
others who sell milk in nearby areas, especially since the milk they provide
is excellent. The man replied, with his toothless smile – “We are grateful we

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have this cow which helps us to live. I don’t want to take undue advantage….“
I merely want to point out that greatness is quite often unspectacular..
As a writer and surgeon, I have twin responsibilities. A surgeon’s duties
are clear-cut and they are focused on giving relief to my patients. There are
a few essentials that writers must possess. A keen participation in the events
of our times; an understanding of history, and of how society functions; and
the desire to be a part of it. We have the choice to be stagnant with our lives
and collect dead debris; or to be supple, free, and flowing.
An attitude of unchanging stubbornness with our views and beliefs can
lead to ignorance. This is dangerous. A writer must evolve constantly. My
job as a writer, then, is to set out with a searchlight and find out what is real.
I use a metaphorical scalpel to tease open my own flaws and reconstruct
what is true.
I am a troubled writer. The scalpel and the word have been vital to my
existence. Words can be as sharp or sharper than the scalpel; they can
penetrate deeply and incisively; they can draw blood or tears or laughter.
Along with art, music and theatre, literature is a treasure that is precious
tohumanity.Historyhasshowntimeandagainthatcivilizationsthatabandon
these gems of creation have eventually perished. The best example I can
give is that of the Roman Empire which preceded the Common or Christian
era. The rulers became corrupt, greedy and cruel; any form of dissent was
swiftly put down; the poor became poorer. And poorer. To prevent any form
of unrest or rebellion, they kept them engaged with spectator sports,
festivitiesandcarnivals–accompaniedbydrinkinganddebauchery.Spectator
sports became more and more bloody and cruel. The people, deprived of
the salutary effects of the arts, reveled in watching and participating blood
sports. The entire civilization fell apart and perished. It was after this total
decline that Christianity came to Rome.
These are disturbing, corrosive moments that we live in. The tendency

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at such times is to g-e-n-e-r-a-l-i-s-e; to use sweeping statements and
platitudes, which are used to deceive ourselves and others.
Margaret Mead, the historian was once asked, what the first sign of
civilization was: she said, “A healed thigh bone.” The thigh bone is the
strongest bone and when it breaks, there is a lot of blood loss, besides
damage to muscles and nerves. Finding a thigh bone that clearly showed
the line of healing of a fracture is evidence that the person was being cared
for after the injury for months and months while it healed. Someone had to
bring him food, look after his other needs and protect him from the danger
posedbywildanimals.Itisamarvelousthing.Caringforothersorcompassion
for another suffering being is a true sign of progress. I believe that every cell
in a human being is tuned towards mutual caring. It is an instinct we are
gifted with, just like that other characteristic of humans: the ability to hate.
Literature is nothing if it is not imbued with caring, while resisting hate.
Hatred is linked to fear. Ray Bradbury, the American novelist wrote a novel
titled, “Fahrenheit 451”. It is about a fictional city in America where those in
authority decide that because fresh perspectives and new ideas come from
books, they should all be burned. They engage the firemen of the city, who
are supposed to put out fires , to instead start big bonfires into which all
books are thrown. A new thought or idea meant trouble. Oppressive regimes
are always afraid of the word because it might expose their motive which is
only to hold on to power.
Let us then keep clean our routes of communication, our weapon sharp
and true so the words, flow with the essence of truth. Let us learn also to
tread lightly, to laugh at ourselves as writers or we may be in danger of
being pompous, patronizing and smug.
Dr. Kavery Nambisan
A surgeon and writer. Her surgical work has been mainly in rural areas.
Her writing includes several novels and a medical memoir.
kavery.nambisan@gmail.com

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Prasad Rajani KR
Undergraduate student,
Occupational therapy,
K.E.M. Hospital, Mumbai
prasadrajani1005@gmail.com

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Dr. Hemant Morparia
Consultant Radiologist,
Breach Candy Hospital, St. Elizabeth Hospital, Mumbai
morparia@gmail.com

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The Diameter of the Bomb …..
The diameter of the bomb was thirty centimeters
and the diameter of its effective range about seven meters,
with four dead and eleven wounded.
And around these, in a larger circle
of pain and time, two hospitals are scattered
and one graveyard. But the young woman
who was buried in the city she came from,
at a distance of more than a hundred kilometers,
enlarges the circle considerably,
and the solitary man mourning her death
at the distant shores of a country far across the sea
includes the entire world in the circle.
And I won’t even mention the crying of orphans
that reaches up to the throne of God and
beyond, making a circle with no end and no God.
Yehuda Amichai
Yehuda Amichai (1924–2000) was an Israeli poet. He was one of the first
to write in colloquial Hebrew in modern times. Amichai was awarded several
national and international poetry prizes and was nominated for the Nobel
Prize in Literature.

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Books on my shelf… (1)
1. The autobiography of Williams Carlos Williams. New York: New
Directions 1967.
2. The doctor stories. William Carlos Williams. CompiledbyRobert Coles.
New York: New Directions 1984
The autobiography was originally published in 1948. The copy under
review is a paperback edition.
If a hall full of doctors was asked about Dr. Williams (1883-1963), the
vast majority would be ignorant of his life and work. An occasional
pediatrician may recall his work in Rutherford, U.S.A. in the first half of the
20th century. A similar hall full of poets may, however, have encountered
some of his poems, especially his great work Paterson. He was awarded the
Pulitzer award posthumously. And yet, his work with patients is at least as
important as his literary output.
Dr. Williams starts his foreword with a caveat. ‘Nine-tenths of our life is
well forgotten in the living. Of the part that is remembered, the most had
better not be told… A thin thread of narrative remains – a few hundred
pages…’
Intriguingly, he cautions us, I do not intend to tell the particulars of the
women I have been to bed with… Do not look for it…’ (‘Famously Williams
confessed the affairs to his wife when he thought he was dying, only to live
for many more years – years in which his wife was doomed to take care of
his failing body.’ Harriet Staff 2011)
He summarises the purpose for writing this book: ‘All that I have wanted
to do was to tell of my life as I went along practicing medicine … As a writer

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I have been a physician and as a physician, a writer; and as both writer and
physician I have served sixty-eight years of a more or less uneventful
existence, not more than half a mile from where I happen to have been
born.’
The urge to write was always strong in him, at times, overpowering.
‘Time meant nothing to me. I might be in the middle of some flu epidemic,
the phone ringing day and night, madly, not a moment free. That made no
difference. If the fit was on me … burning inside me, having bred there
overnight demanding outlet … that demand had to be met. Five minutes,
ten minutes can always be found… Finally, after eleven at night, when the
last patient had been put to bed, I would always find the time to bang out
ten or twelve pages (on the typewriter). In fact, I couldn’t rest until I had
freed my mind from the obsessions that had been tormenting me all day.’
Several family vignettes are included here. The paragraph on page 9
describing the interaction between his mother, who lived to be 92 and her
mother-in-law, who lived to be 83 is hilarious. Williams concluded this
account by wishing that he took after his female ancestors.
He recalls his first romance as a child ‘with a girl up the road who was
said to have heart disease. I was so sorry for her. She was a quiet little girl
but very attractive to me; it was her sorrowful isolation, I suppose, that
foundmeanally.’Atthisage,healsoremembered‘oneofGrandma’snaughty
stories. If a lady was just about to take a bath and a man came suddenly into
the room, where should she put her hands? Over his eyes, of course.’
Whilst his grandmother and father were from England, his mother was
from Puerto Rico. Spanish and French were spoken as often as English at
home. His mother was reputed as a psychic medium. Williams’ surprise at
the first evidence of her being tuned in to the spirit of another makes
interesting reading (pages 15-17).
His father introduced him to the poems of Paul Laurence Dunbar (1872-

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1906) and the works of Shakespeare (1564-1616). He offered his son a dollar
apiece if he would read Darwin’s The origin of species and The descent of
man. ‘I took him up. It was well-earned cash.’
His childhood was also full of adventures in the wilderness of nature
amongst trees, grasses, flowers, spiders and insects. ‘Of course, we were
brats: lied, stole fruit and bits of lumber from new constructions…’
His first encounter with a schizophrenic relative terrified him. (pages
23-24).
He tried an interesting experiment. ‘It is impossible to recall whether it
was in late childhood or early adolescence that I determined to be perfect…
The fascination of it still affected me: Never to commit evil in any form,
never especially to lie, to falsify, to deceive, but to tell the truth always,
come what might of it. The elevation of spirit that accompanies that resolve
is a blissful one. It didn’t last long…’
In 1897 he and his brother accompanied their mother to France and
then to Switzerland, where they went to school. There he had a friend –
Leon Pont, from Rajputana, India. He describes the stabbing of the Empress
Elisabeth of Austria on Saturday 10 September 1898, by Luigi Lucini,
witnessed by him and others.
Some of his adventures in Paris are interesting, especially the episode
wherehewascoaxedto wearhismother’sclothesandvisitTanteAlice(pages
36-37). His description of Joseph Pujol performing as Le Pétomane is brief
but captivating. Pujol would get air pumped into his rectum and then expel
it as desired, producing a variety of sounds. The grand finale involved the
release of all the remaining air with a bang!
TheyreturnedtoAmericain1899.WhilststudyingwithUncleBillyAbbott
(who inculcated in him the love for old classics such as The Ancient Mariner,
Lycidas and Comus) and Miss Butler (who introduced him to Greek, Roman

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and English history) he found his literary horizons widening. He confessed
that mathematics was not his forte. The anecdote featuring Mr. Bickford is
heartwarming (page 45). It was around then that he developed his interest
in the poem. You will find his first poem and his own criticism of it on page
47. His realization that he could not earn a living by writing led him to join
the medical school in the University of Pennsylvania. There, he developed a
fascinationforneurologyastaughtbyProfessorWilliamGibsonSpiller(Spiller
had worked with Oppenheim, Edinger, Dejerine and Gowers. When, in his
later years, Spiller was asked to write a textbook on neurology, he replied,
‘When I can write a better book than Oppenheim I’ll do so.’ Walter Freeman
– famed for his lobotomies – was Spiller’s pupil. Spiller’s lectures were always
crowded, and he was famous for the quotations from Shakespeare that
punctuatedhissolutionsofneurologicalmysteries–allproducedinhisrather
soft voice.) Williams’ description of the man is interesting: ‘I loved the man
with his big roundhead and the prominenttemporal arteries like twin snakes
upon his temples. Had I myself felt stable enough, nothing would have
pleased me more than to have gone in … for neurology.’
It was then that he met Ezra Pound and developed a friendship that was
lifelong. Chapter 12 is devoted to Pound and there are numerous other
references to him throughout the rest of the book. Ezra’s plan to make a
million from 606 – the anti-syphilitic arsenical newly discovered by Ehrlich –
in north Africa is worth reading (page 92).
Williams started writing poetry in a series of ten-cent copybooks.
Describing his friends at the time, he said: ‘Flossie, my wife, who is the
rock on which I have built. But as far as my wish is concerned, I could not be
satisfied by five hundred women… Men have given the direction to my life
and women have always supplied the energy.’
His early medical experiences included the offer to marry the widow of
a prominent doctor. She was ten years his senior and was reputed to have a

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million dollars. Not surprisingly, Williams turned down this offer. Another
incident provoked the wrath of Krumwiede, an outstanding pathologist.
Krumwiede had asked for a dozen slides with blood smeared on them to be
sent to the laboratory for study the next morning. When he tried to study
them the next morning, he found no trace of blood. The cockroaches had
eaten the slides clean!
Williams was appointed as a pediatric resident to Nursery and Child's
Hospital. Whilst he admired some of his mentors, there were significant
failings in it. On one occasion he demonstrated a multitude of bedbugs that
were the cause of a child’s nocturnal cries. The management was riddled
with corruption. Eventually, he resigned his residency because of a run-in
with the administration over ethics. Despite the coaxing of senior doctors
and his mentor Dr. Kerley’s dangling a lucrative job in his office, which would
assure a well-oiled career as a New York specialist, Williams refused to sign
papers that falsified the hospital's monthly report to the state government
on admissions, discharges, births, and deaths. (As a result, Albany withheld
financial aid calculatedby these data.) Williams’ discovery that the Chairman
oftheBoardofTrustees hadbeenconductingafurtive affairwith the hospital
administrator, Miss Malzacher, and that the tainted money went to her, did
not sway his decision. When none of the senior doctors backed him up, he
quit and returned to his parents’ home in Rutherford to mull over his future
in medicine.
‘It was during the next few months of spring weather that I first observed
Flossie… and my whole life came to a head.’
He went on a trip through Germany, France and Spain. On his return, he
started general practice and recalled that his first patient sought treatment
for dandruff. He attributed his small practice to the location of his office and
his own lack of confidence in himself. By now he had already published his
first volume of poems.

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Leibowitz, in his biography of Williams, offers another explanation for
his poor practice. Williams hated pharmaceutical companies and supported
socialized medicine. He ministered to poor immigrant Italian and Polish
families who lived and worked around Rutherford. He faced poverty, illness
and death often and so developed a sympathetic worldview.
After three years of close companionship, Flossie married him. The
jeweler, to whom Flossie took the ring to be engraved couldn’t help
exclaiming at the date of the wedding: 12-12-12. When Flossie became
pregnant, they moved to their own home, purchased with a loan given by
her father, Mr. Herman. ‘We paid off the interest on the loan regularly but
just as regularly, Pa Herman gave if back to Floss as a Christmas present.’
In addition to poems he was also writing plays. He had narrowed down
his work to pediatrics but also gave birth to nearly every baby born on those
streetsabovetheoldcoppermines.Attimes,helearntfromhisagedpatients.
‘I had an oldish woman with a retarded placenta. I had the undelivered
placenta in my hands but could not … withdraw it.’ An older woman gave an
empty bottle to the patient and jabbered to her in Italian. The woman in the
bed pulled in her breath and putting the neck of the empty bottle to her
mouth gave a mighty heave. ‘My hand holding the placenta was expelled
forthwith.’ As in most such poor communities, they respected the doctor
who did so much for them. At times, though, this was counterproductive.
‘One night, whilst I was sleeping across three chairs (during a prolonged
labour), they put clean sheets down for me and gave me a fresh pillowcase.
When I awakened during one the woman’s noisier moments, the bedbugs
were all over that whiteness.’
He had titled his third book Kora in hell. As he described its writing, he
told of ‘the stupidity, the calculated viciousness of a money-grubbing society
such as I knew and violently wrote against; everything I wanted to see live
and thrivewas being deliberately murdered in the name of church and state.’

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He describes the influenza epidemic of 1918 and how it hit his patients.
And there were the problems of poverty. ‘I’ve seen some terrible cases: a
woman with six children living over a tobacco shop, who died following a
criminal abortion; a case of placenta previa with every joint in her body
infected (I drained them one after the other over a period of at least three
months whilst she lay there)…an untreated case of diphtheria strangling on
the floor because of an excess of religious fervor on the part of the parents…’
Two anecdotes featuring Ernest Hemingway might be in place here. On
a visit to Paris in 1924, ‘met Hemingway on the street, a young man with a
boil on his seat, just back from a cycle ride in Spain’. Whilst in Spain, during
a halt in the train ride, the passengers found a dead dog beside the track, his
belly swollen, the skin iridescent with decay. His colleague wished to move
away but not Hemingway. He got out his notebook and to the disgust of
others, took minute notes describing the carcass. Williams could not help
murmuring, ‘I thoroughly approve.’
During their visit to the Louvre Floss and he found a gap in the space
occupied by the Mona Lisa. It had been cut from its frame and stolen just a
week earlier.
Williams was committed to pediatrics by then. He had two offices, one
in Passaic and the other in Rutherford. Besides he attended a hospital for
sick children. Evenso, he wascalled in to manage some patients with difficult
labour. The account on pages 247-249 is especially delightful.
Chapter 38 is devoted to Gertrude Stein. Her icy demeanor and acerbic
comments are encountered here as can be expected. On page 291 you will
find more on her and her studies at Johns Hopkins as she believed that you
must know medicine to be a good writer.
Chapter 40 should be of general interest as it deals with medicine and
poetry. Williams was put off by surgery and surgeons. ‘What is there to cut
off or out that will cure us? And to stand there for a lifetime sawing away!

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You’d better be a chef or a butcher.’ He tells us how his mind worked when
he saw a patient – ‘to treat him as material for a work of art made him
somehow come alive for me.’ There are further ruminations on physicians
in the next chapter. He issues a cautionary note to every reader: ‘The worst
doctors know how to make themselves attractive. They are usually popular.’
He concludes: ‘Today the hospital is part of the fairgrounds for the
commercial racket carried on by the big pharmaceutical houses.’
He provides his own credo in the third paragraph on page 291. You can
get further insights into Williams as a medical practitioner and how closely
intertwines medicine and writing were in chapter 54 – The Practice. It is of
interest that he listened to the histories of his patients so keenly that ‘for
the moment at least, I actually became them, whoever they should be, so
that when I detached myself from them at the end of a half-hour of intense
concentration over some illness which was affecting them, it was as though
I were reawakening from a sleep.’ I strongly recommend this chapter for
close scrutiny.
____________
Fortunately for those of us who are not enthused by poetry but would
like to learn more about Dr. Williams – the pediatrician – we have The doctor
stories. These describe – as do some of his poems – his experiences as a
physician with men, women and children of northern New Jersey. Robert
Coles, in his introduction, notes, ‘I remember the doctor describing his work,
telling stories that were real events, wondering in retrospect how he did it,
kept going at such a pace, hauled himself so many miles a day, got himself
up so many stairs, persisted so long and hard with families who had trouble,
often enough, using English, never mind paying their bills. And as he knew,
and sometimes had to say out loud, even mention in his writing, it wasn't as
if he was loaded with money, or a writer who took in big royalties.’ During
the Depression, the parents of many of his patients – ‘obscure, down and
out, even illiterate’ – could pay nothing. And yet, Dr. Williams continued

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with his work amongst them. Even when tired and overworked, he found
his work with patients sustaining, healing, inspiring.
Williams, himself, explained these stories thus: ‘I lived among these
people. I know them and saw the essential qualities (not stereotype), the
courage, the humor (an accident), the deformity, the basic tragedy of their
lives--and the importance of it.'
‘Youcan't writeaboutsomethingunimportantto yourself.Iwasinvolved.
That wasn't all. I saw how they were maligned by their institutions of church
and state--and "betters". I saw how all that was acceptable to the ear about
them maligned them. I saw how stereotype falsified them.'
‘Nobody was writing about them, anywhere, as they ought to be written
about. There was no chance of writing anything acceptable, certainly not
salable, about them.'
‘It was my duty to raise the level of consciousness, not to say discussion,
of them to a higher level, a higher plane. Really to tell.
‘Why the short story? Not for a sales article but as I had conceived them.
Thebriefnessoftheirchronicles,itsbrokennessandheterogeneity--isolation,
color. A novel was unthinkable.’
As Coles points out, ‘These are brief talks, or accounts meant to register
disappointment, frustration, confusion, perplexity; or, of course,
enchantment, pleasure, excitement, strange or surprising or simple and not
at all surprising satisfaction. These are stories that tell of mistakes, of errors
of judgment; and as well, of one modest breakthrough, then another—not
in research efforts of major clinical projects, but in that most important of
all situations, the would-be healer face-to-face with the sufferer who half
desires, half dreads the stranger's medical help….’
He confessed to a sense of guilt when he used these medical experiences
in his poems and stories. ‘I would learn so much on my rounds, or making

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home visits. At times I felt like a thief because I heard words, lines, saw
people and places—and used it all in my writing.’
The book contains six poems and fourteen tales. (Of the latter, The
practice is reproduced from his autobiography.)
Let me deal with the poems to start with. I found Le Médecin malgré lui
especially interesting as it is based on the farcical play by Molière (1667). In
the same spirit, Williams imagines the various tasks he should be doing as
he sits in his office, awaiting patients – but will never do! How then is he to
be a credit to his Lady Happiness?
Whilst The birth is the low-key triumphal announcement of a difficult
delivery, Dead baby describes exactly that – the manner in which the father
and mother cope with the death of their child. A cold front might represent
the feelings of many Indian women today. Exhausted by looking after seven
foster children with a new baby of her own now added to the brood, the
mother‘likeacatonalimbtootiredtogohigher’asksforpillsforanabortion.
And Williams, the doctor, realizes ‘in cases like this I know quick action is the
main thing.’
I will leave you to read the poems in full but cannot help stating that
they vividly bring out his experiences as he dealt with his poorest and most
helpless patients.
Of the essays and stories let me deal with but two of them to give you
their flavor.
Old Doc Rivers is the archetypal narrative of the physician practicing in
the American backwoods in the horse-and-buggy days. Indeed, the story
starts ‘Horses. These, definitely should be taken into consideration in
estimating Rivers’ position…’ Later, Dr. Williams was to recall, ‘The account
of Old Doc Rivers was a detailed setting down…of the life of an older fellow
practitioner of medicine and surgery in the same town which I inhabit.’

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Doc Rivers could berate his patients without fear as they knew he meant
well. Once upon a time he was a good and competent physician. Gradually,
he had gained the confidence of those he treated. He knew them and they
knew that he would do his best for them. Now, he is rundownanddependent
merely on his vast experience. He had a store of practical wisdom and knew
what needed to be done under the circumstances his poor patients existed.
Most folkhecateredtoknewofhisfailings–alcoholanddrugs–butcontinue
to seek his help, in part because they could not afford anyone else. The
consequences of his failings were, at times, tragic. And yet, many still clung
more tightly to Rivers the more he went down as they believed he alone
could cure them. The story holds your attention even as you witness his
decay.
The use of force is an excellent narrative of doctor versus sick child. The
understanding parents are on the doctor’s side in their eagerness to learn
the cause of the child’s fever. Suspecting diphtheria, the doctor needs to
see the child’s throat. The child resisted all attempts by the doctor. Williams’
efforts eventually amount to storming the throat. After one such bout where
the obstinate child splinters the wooden spatula, the normally gentle doctor
was saying to himself: ‘The damned little brat must be protected against
her own idiocy.’ I am sure you will sympathise with the doctor, especially at
the end of the tale.
As a finale, we have a bonus granted to us.
Afterword: my father, the Doctor is an essay on Williams by his son
William Eric Williams, also a pediatrician and is well worth study. ‘…My father
sounds like anything but a struggling young physician, three years married,
father of one, still being judged by the established physicians of the town…’
He tries to explain the pursuit of literature even as he struggles to establish
a practice. It includes a poem which says:

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‘If I did not have
verse
I would have died
or been a thief.’
It is an essay that could have complemented the elder Williams’
autobiography but has been placed here.
Dr.WilliamEricWilliamspublishedWilliamCarlosWilliams:anAmerican
dad in 2005. This should help all of us wanting to know more about the
illustrious father.
Reference
Harriet Staff "His infidelities gave Williams a bad case of the jitters”
2011 https://www.poetryfoundation.org/harriet/2011/11/his-
infidelities-gave-williams-a-bad-case-of-the-jitters
Dr. Sunil Pandya
Former Professor and Head,
Dept of Neurosurgery,
Seth GS Medical College and KEM Hospital, Mumbai
shunil3@gmail.com

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Of Mice and Men
(And A Whole Bunch Of Other Animals)
While we people-treating doctors and medical students get away with
knowing the anatomy, pathology and therapeutics of just one species in the
course of our profession, veterinarians must be proficient in dealing with,
sometimes quite literally, an entire menagerie’s worth to treat their patients.
They must make their diagnoses without much of the detailed clinical
histories we find so essential, and administer to frightened, uncooperative,
and mute patients well equipped to bite, scratch, kick and gore. It would,
therefore, appear as though the two fields are only distant cousins in
resemblance. And yet, if you follow James Herriot’s delightful narration
through the farms and hills of 1930s Darrowby in his book All Creatures
Great And Small, you’ll find many surprising similarities between the two
occupations.
The most obvious is the routine of clinical examination. Although the
setting changes from the OPDs and wards which we’re familiar with to lush
fields,openpasturesandgloomybarns,thediagnosticproceduresperformed
are extremely familiar. The palpating of suspicious masses and auscultation
of troublesome chests are described, albeit in Mr Herriot’s uniquely
humourous fashion, as though straight out of Hutchison’s Clinical Methods.
So, of course, is the quest to identify a puzzling illness which baffles
diagnosis. Indeed, the writing is engaging enough for the author’s vexation
toseepoffthepage and investthereader. You mayeven find yourself racking
yourbrainstoplacethesymptomsandassociatethemwithfamiliardiseases.
And when the diagnosis is finally made, you share in the author’s exultation.
But, just as in our own human medicine, that is just the beginning.

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Treatment is yet another uphill task, especially in those days before the
advent of penicillin and sulphonamides, when recognisably modern medical
practices were just beginning to show quaint practices the door. You will
encounterseveral formulationswithexoticnamesandfascinatingproperties,
rubbing shoulders with several homemade farmer’s remedies of dubious
efficacy.(Perhaps you will relate to the author’s exasperation with the latter).
You will also witness dramatic surgical procedures and cheer on miraculous
recoveries.
But James Herriot’s stories are not primarily about noteworthy cases.
They are, instead, character sketches of the two legged and four legged
personalities he’s met during his career - some flamboyant, some unpleasant
and some endearing. Most of these stories are amusing, and more than
capable of making you chuckle out loud. A few, however, have less than
happy endings, and it is hard not to feel a twinge of sadness when they
conclude. All of them will linger in your memory.
In spite of the animals being the stars of the show, or perhaps because
of it, this bittersweet short story collection reminds you of the roller coaster
of emotions behind every clinical case. And this, although the years have
left Herriot’s Darrowby almost a century behind, is a valuable lesson even
today.
Rahul Kothari
MBBS student,
Seth GS Medical College and KEM Hospital, Mumbai
skotharirahul@gmail.com

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Mother to Son …..
Well, son, I’ll tell you:
Life for me ain’t been no crystal stair.
It’s had tacks in it,
And splinters,
And boards torn up,
And places with no carpet on the floor—
Bare.
But all the time
I’se been a-climbin’ on,
And reachin’ landin’s,
And turnin’ corners,
And sometimes goin’ in the dark
Where there ain’t been no light.
So boy, don’t you turn back.
Don’t you set down on the steps
’Cause you finds it’s kinder hard.
Don’t you fall now—
For I’se still goin’, honey,
I’se still climbin’,
And life for me ain’t been no crystal stair.
Langston Hughes
James Mercer Langston Hughes (1901– 1967) was an American poet,
novelist and playwright and social activist .He was a leader of the Harlem
Renaissance. The poem ‘Mother to son’ was first published in ‘The Crisis’ , a
magazine.ItwasthencollectedinHughes’sfirstbookTheWearyBlues (1926).
The poem in the form of a monologue describes the troubles faced by black
people in a racially prejudiced society

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Medicine & Literature : My Experience
“Medicine is my legal spouse and literature, my mistress. Whenever I
get tired of one, I go to the other” - Dr.Anton Chekov.
I had written this sentence by the great Russian fiction writer and
playwright, who was also a practicing doctor, on the first page of my diary
where I planned to collect verses from poetry, and quotes and motivational
sayings from famous people. It was 1976, and I had just entered the historic
premises of Seth G.S.Medical College and KEM Hospital. Although Chekov’s
words headed my diary, I had hardly any exposure to English literature. In
Marathi, my mother tongue, literature had been a constant companion ever
since I started recognizing the written word. In fact, that had occurred quite
early in my developmental journey, as my parents noticed. Now, as I tried
to cope with my new environment, my deficiency in spoken English seemed
glaring to my own eyes and made me restless as well as reflective.
I had studied English as a language in the academic curriculum, but not
as a rich source of literature. Hence, I decided to start reading the classics,
but gave up pretty fast as there was a vast disparity between ingestion
(reading) and digestion (understanding). The book vendors on the footpath
near Flora Fountain (Hutatma Chowk) became my saviours. Cheap second-
hand books in English priced around eight annas (fifty paise) were both
affordable and interesting. I started with the legal cases of Perry Mason
and the thrillers of James Hadley Chase. This increased my speed and
familiarity with reading, and the language now seemed friendlier. Soon I
graduated to reading many doctors who had made their mark as writers.
The list had famous names such as Arthur Conan Doyle (creative father of
Sherlock Holmes), A.J.Cronin (The Citadel still remains one of my favourites),
and Anton Chekov himself. Around this time, I came across Ivan Illich and
his famous work Medical Nemesis. This book changed the trajectory of my
life, both personal and professional. It inspired my first book in Marathi, on

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the theme of Medicalization of Life in the context of the Indian subcontinent.
Meanwhile, my experiments in Marathi creative writing were bearing
fruit. I venturedinto different genres such as short stories, reportage, literary
essays and personality sketches. I triedmy pen at one –act plays with themes
related to medicine. One of them, on the psychosocial realities of people
sufferingfromHansen’sdisease(leprosy),wonmanyawardsatintercollegiate
and state level competitions. I was able to address themes like gender
dysphoria (homosexuality), rehabilitation of a schizophrenia patient, and
even the ill effects of wars, through these one- act plays. My musical script
on alcoholism and recovery was staged by recovered alcoholics themselves.
These experiences showed me that literature was a medium where my
creative drive and the desire to sensitize society on health-related issues
could get integrated. When I entered the field of Mental Health as a young
postgraduate student more than four decades back, l startedbecoming more
and more sensitive to scripts that all of us write and live at the same time.
My patients became my source and inspiration in many ways, and I
experimented with different literary forms.
Itriedtograpplewiththestigmaregardingmentalhealth. WhenIstudied
Rational Emotive Behaviour Therapy (REBT) propagated by Dr.Albert Ellis,
there was an innate urge to bring these ideas into Marathi literature. Thus
started a series of books in Marathi. I didn’t know then that five of them
would go into double digit editions and would get translated in different
languages.
A similar fate was in store for my plays. Understanding caregivers of
schizophrenia patients, recovering from addictions, coping with marital
disharmony, these were some themes I explored. My plays were successfully
staged on the commercial Marathi stage and received wide and favourable
audience response. I also contributed creatively to national award-winning
films like Devrai and Kasav. This journey led all of us at our institute IPH

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(Institute for Psychological Health) to form a complete audiovisual setup of
our own, including a You Tube channel (AVAHANIPH) that has over 1,35,000
subscribers as of now.
ForourcareerconferenceVEDH,Istarted writing,composingandsinging
songs as per the theme of the year. This event, which is now spread over ten
cities of the state, prompted me to come up with over fifty songs expressing
‘positive psychology’. The Covid epidemic stirred the poet within me to
post poems on social media, and eventually to come up with two books of
poetry. A third book of poetry was generated during the study of Buddha’s
teaching and how it can be used in day to day life. Reflections on Vedanta
philosophy, neurosciences, and cognitive philosophy resulted in another
book,alongwitha21-part seriesonYou Tubeonthe same subject. A popular
novel for children, imparting emotional education, emerged when a physical
illness forced me to stay at home. And here I am, with not one, but twenty-
five publications in a variety of literary forms ranging from songs and poetry
to plays, novels and serious psycho-educational writings.
When I look back atthisrelationshipbetweenMedicine (health sciences)
and Literature, I feel very humble and excited in the same breath. Literature
has enabled me to take my goals in mental health forward, and the human
stories have given me deep insights into the literature that each one of us
carries within. I have lost that distinction of ‘Spouse’ and ‘Mistress’ along
the way; now I am in constant love, and awed by this integrated Beloved
that I am graced with…. Lucky fellow, I often call myself….
Dr. Anand Nadkarni
Consultant Psychiatrist,
Institute for Psychological Health,
Thane, Pune, Nasik
anandiph@gmail.com

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Book Review : Literature in Medicine
I was a junior doctor many moons ago, but I still remember how hard
life was. Many residents get burned out during their training which is a trial
by fire. There is so much new content to master: the patient workload seems
never-ending in our teaching hospitals, and there are endless exams to pass.
Most residents are sleep-deprived and dog-tired, and the clinical
responsibilities they have to shoulder make their lives even more difficult.
The challenge of getting into the postgraduate course they want, and then
of finding a job so they can earn enough to support their family, adds to
their woes; many end up graduating as cynical and jaded doctors because
of the grind we make them go through.
Reading anything outside their medical textbooks is a luxury few can
afford, which is why I have chosen these two books with great care. Here
are real-life accounts of Indian medical heroes – doctors who have gone
beyond the call of duty and serve as a source of inspiration for everyone in
the medical profession. They remind us why we became doctors in the first
place: to serve patients selflessly. This can be hard to remember when life is
so competitive and grueling. These real-life accounts can remind you that
being a doctor is a huge privilege, and that you have worked hard to get
your medical degree so you can make a real difference to patients, and not
just to earn money.
Infinite Vision: How Aravind Became the World's Greatest
Business Case for Compassion
By Pavithra K. Mehta and Suchitra Shenoy
In 1958, when Dr. Govindappa Venkataswamy (Dr V) reached the
mandatory retirement age of 58 in his government post as an
ophthalmologist, he retired to Madurai, and instead of sitting back and doing

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nothing, which is what most retirees do, he founded an 11-bed eye hospital
which he named Aravind after Sri Aurobindo, one of 20th century's most
powerful spiritual leaders, Sri Aurobindo's progressive teachings had a
profound influence on Dr. V's life and vision. Inspired by his spiritual values,
he enlisted his family members (virtually all of them ophthalmologists like
him) to help him found this small, nonprofit hospital to provide cataract
surgery to all who needed it, regardless of their ability to pay.
They implemented a staggered fee schedule, charging market rates to
those with the ability to pay; a heavily subsidized rate to those with limited
means; and free of charge to those who could pay nothing — thus allowing
every patient to choose his or her own level of payment. Surprisingly, this
approach of "putting patients first" allowed Aravind to earn a profit from its
earliest days – and it continues doing so until the present. Today, it is the
world’s largest provider of high-quality eye care. It does not depend on
donations or grants, and is sustainable and scalable. Aravind’s success is so
remarkable that it has been the subject of a popular Harvard Business School
case study, but most Indian medical students and doctors are still completely
unaware of this jewel in our midst.
This book explores Aravind’s history and the distinctive philosophies and
practices that are the keys to its success. This unique model of profits with
purposeintegratesinnovationwithempathy,servicewithbusinessprinciples,
and inner change with outer transformation. It proves that choices thatseem
utopian and unworkable can, when executed with compassion and integrity,
yield powerful results – results that literally light the eyes of millions.
You can also watch a video about Aravind free at https://
www.youtube.com/watch?v=_mXVmGr2TCw (in Hindi)
and https://www.youtube.com/watch?v=MA5Dzlf7JEE (in English).
The quality of Aravind’s eye care services exceeds the standards of any
hospital in the world. What’s remarkable is that it provides this at a fraction

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of the cost of what corporate 5-star hospitals charge. They are so good at
what they do because of their huge clinical workload, and their willingness
to treat everyone who needs their help.
They train about a hundred young women from villages each year, who
become highly trained paramedics to assist each doctor, thus optimizing the
use of the surgeon’s time. Each Aravind surgeon does about 2000 surgeries
every year, which is why they are so highly skilled.
The following maxims are what have made them so successful:
Service to the poor is the primary goal
Maximize service instead of profit
Do the work first and the money will eventually follow
Apply the McDonald's service model to attain consistency, reliability,
low costs, and clear standards
Aravind’s business model is unique in many ways. It’s a nonprofit that
consistently turns a profit. It subjects all its processes to strict statistical
analysis — everything from the manner in which the floors are cleaned to
the number of sutures its surgeons employ, which is why it has attained a
level of efficiency that would impress even a manager at Toyota. It openly
shares its management secrets with all comers, with a willingness to train
even competitors that is simply extraordinary. Instead of waiting for poor
patients to come to them, they go to their patients by doing screening camps
in villages and transporting those who need surgery (along with their
caregivers) to the hospital, free of charge.
It’s amazing that Aravind thrives in this age of cutthroat competition
among hospitals and doctors. This beautiful true story will make you want
to reach for the stars. Their model is the bible of compassionate capitalism,
and gives me hope that the medical profession can reinvent itself by realizing
that it’s not necessary to sacrifice ethics to become successful.
There’s no need to go to the Mayo Clinic or Mass General if you want to
seehow world-class carecanbedeliveredwithloveandcompassion.Reading

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this book will make you proud that Indian doctors can create something so
original, innovative, and of such high quality. It should inspire you to strive
to do better all the time and for all the right, humane reasons.
Aravind Eye Care was started a few decades ago, and many doctors may
feel their story has no relevance to modern times.
An equally inspiring story is that of Dr Taru Jindal, a junior doctor who
refused to join the rat race of becoming a highly-paid super-specialist by
joining a corporate hospital or starting a private practice, choosing instead
to go to Bihar, to serve the poor and needy. This book is a must-read for
every passionate doctor in India!
A Doctor's Experiments in Bihar
By Dr. Taru Jindal
This book proves that it’s possible for an individual doctor to change the
functioning of even a moribund public hospital in a BIMARU state! For most
of us, Community Medicine is a subject we are forced to endure during our
medical education, because it seems to be so disconnected from the clinical
care we take pride in mastering. This is because public health in India,
especially maternal and child healthcare, has suffered from a long history of
neglect and mismanagement. This book is a testament to how a single
committed individual can bring about significant change through sheer
perseverance and compassion. What’s even more remarkable is that she
did so in spite of numerous personal challenges and even though everyone
attempted to dissuade her from doing something so unusual and different
from the choices which her peers selected.
While it’s true that you can earn tons more money by practicing as a
super-specialist in a metropolis, or by migrating to greener pastures abroad,
you need to ask yourself why you chose to become a doctor in the first
place. If you just want to become rich, there are many easier ways of doing
this,insteadofpracticingmedicine.However,ifyouwanttocreateanimpact,
and be proud of the life you lead, you should be willing to explore the path
lesstravelled.Thisbookshowshowanordinarydoctorcanchangethesystem
by pouring her heart and soul into her work. And how when one doctor

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leads the way, others are happy to follow! All change starts with one person;
doctors are blessed because society looks up to us, and we command a lot
of goodwill. Sadly, we have frittered this away in the chase for material
possessions, as a result of which we are treated as businessmen, rather than
as respected and trusted professionals who put their patients first. I truly
believe that most of us want to do good, but we tend to wait until we are
financially well-off or have retired.
You can watch Taru Jindal speak about her transformational personal
story at
https://www.youtube.com/watch?v=98lwgElhM28 and
https://www.youtube.com/watch?v=ZlPiAj698Vg
This book will help you ask yourself the question. " Now that I have
been trained as a doctor, what am I going to do with the rest of my life?"
I hope reading these books will inspire you to make the most of the
privilege which being a doctor grants you , so you can serve many more
people . Creating an impact makes life fulfilling and meaningful , so please
make the most of your medical education by doing as much good as you can
to as many people as you can !
Dr Aniruddha Malpani
IVF Specialist, Malpani Infertility Clinic, Mumbai
aniruddha.malpani@gmail.com

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Anita A. Rana
Sister Tutor,
School of Nursing,
K.E.M. Hospital, Mumbai

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Dr. Hemant Morparia
Consultant Radiologist,
Breach Candy Hospital, St. Elizabeth Hospital, Mumbai
morparia@gmail.com

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The Art of Medical Practice
By all standards, medical practice has to be a lot of Art and a little of
Science. In recent times, this has been most emphasized by the modern
Hippocrates, Sir William Osler. The reason for such an approach is simple:
the material handled – namely, the human body – is the most complex
machine in the universe about which humanity knows naught.
Such ordinary phenomena as health, disease, illness, sickness, blood
pressure, cancer, coronary artery disease, stroke, infection, inflammation
and so on have remained undefined. Normality and its obverse abnormality,
as terms and concepts, are routine and extensively used, without the bother
of defining them. A million dollar query is: How do you refine what you have
failed to define!
The other major bugbear is medicine’s Basic Binary Blindness: Animal
body comprises of the binary code of 0 and 1, 0 representing the cell, and 1
the fibre. Nuclear-swaps have dethroned nucleus from its prime position
making modern cytology redundant and useless, in so far as it thrived on
nucleism. The fibre - collagen fibre - with its array of 1052 amino acids is the
mostcomplexmoleculewellbeyondthestrongestnoseinthefieldofbiology,
microscopy and medical science.
Medical sciences’ claims to know the human/animal body reminds one
of a bishop from Vatican visiting another city, and dashing off a letter to
Vatican, and then come down to the hotel’s exit to ask a boy where the
postbox nearby was. The boy reverentially took the letter, posted it, and
then was back to his play. The Holy Father, effusively thankful, offered the
boy a free pass for his oration the next day on “How to go to Heaven.” The
uncontrollable peals of the boy’s laughter nonplussed the Father who asked