PAST & PRESENT
The good doctor
THE HINDU PHOTO LIBRARY
SOME years ago, I was in the National Library of Scotland, digging into the papers of the great scientist and polymath J.B.S. Haldane. I came across a diary written by Haldane's scarcely less talented sister, Naomi Mitchison, the novelist, travel writer, educator, and champion of African independence. This dealt with a visit to India in the late 1970s. The Emergency had just ended, and stories were still circulating about its excesses. Mitchison contrasted the methods of Sanjay Gandhi with the work of a band of devoted doctors working in Tamil Nadu. Thus "village health in the area round Madras has improved enormously thanks to the work of Dr. S. and his teams, mostly of young (doctors), dedicated, as he is, to the poor people. Their family planning has been acceptable, as also their inoculation and insistence on decent sanitation ... " Amidst all the degradation and the poverty in rural India, this was an example of "change for the better".
The "Dr. S." of Naomi Mitchison's account was K.S. Sanjivi. Born 100 years ago (on December 27, 1903), Sanjivi was the youngest of three brothers. The elder two obtained scholarships to study abroad, but since Sanjivi was reckoned to be duller than them he was told that he was "fit only to study in the Medical College".
Sanjivi duly took a doctor's degree, and then a M.D. in General Medicine. Now commenced a long and distinguished career as teacher and physician. His diagnostic skills were legendary. He was also a greatly respected mentor; at one time, most of the top specialists in Madras had been taught or trained by him.
But Sanjivi was more than an exemplary professional. At an early age he imbibed the idealism and spirit of service of the national movement. As he writes in his memoirs, "although Mahatma Gandhi was not a forceful orator, his simple manner appealed directly to one's heart. I regularly bought Young India and read every line of it. We considered Gandhi and Nehru more as spiritual forces than political leaders. Although I did not leave school and join politics, I believed in social service and started a night school in a slum at the sea front, and ran it for several years. After graduating I started a free dispensary for the poor. We all felt that one should serve the poor in some capacity or other, however well placed in life one may be".
Colleagues have written feelingly of how, in 30 years in government service, Sanjivi always refused to put status above need. In his clinic, no minister, or secretary could jump the queue. This quality, along with the accident of birth in a high-caste household, ensured that Sanjivi was passed over for the job of Director of the State Medical Services, despite being the best as well as the senior-most candidate.
Nowadays, an official who is unfairly superseded is prone to go to the press or the courts. Sanjivi, however, resigned without a fuss and chose to serve the poor more directly. The vehicle for this was the Voluntary Health Service (VHS), which was started in 1958. The idea was wholly Sanjivi's although in its execution, he was helped by a quartet of public-spirited friends. These were the lawyer T.R. Venkatarama Sastriar, the Congressman M. Bhaktavatsalam, the industrialist M.A. Chidambaram (who in his capacity as president of the Madras Turf Club persuaded it to donate a portion of its earnings to the new endeavour), and Kasturi Srinivasan of The Hindu (who was also the first president of the VHS).
The VHS emphasised prevention, identified the family as a unit of medical care, and sought community participation. It encouraged families to enrol as subscribers, by paying an annual fee for free or subsidised treatment. Those who could afford to pay the full cost of treatment were asked to do so. Besides, the VHS successfully persuaded wealthy patrons to divert money from temple hundis into medical relief.
Others might identify the VHS with Sanjivi. He himself never made that mistake. Unlike other Indians who build institutions, he ensured a smooth succession. Thus in 1967, he gave up the VHS's Secretaryship to a younger colleague, V.S. Subramanian, who, in turn, passed on the baton to N.S. Murali. With Sanjivi around to guide them, these talented and motivated men nurtured a hospital that remains singular in the world of modern medicine.
Eminent Indians tend to grow cynical as they grow old, but not this one. Naomi Mitchison provides a vivid portrait of Sanjivi at 75: "his hair and eye-brows glistening white, his vigour and courage undiminished, his step light, his interest in others still delightful". When he died in October 1994, an obituarist wrote that the "medical world, and more so the moral world of Madras" had been diminished by his passing. Writing in the National Medical Journal of India, a former student, the nephrologist M.K. Mani, called him "the best of teachers and the best of men", adding that he was both "a true patriot" and a "true Gandhian".
Sanjivi was all of this, and more. Like Gandhi (but unlike most Gandhians) he also had a sense of humour. Once, his brother, the distinguished chemist K. Venkataraman, was advised to have his appendix removed: trusting no one but Sanjivi, he sent him the x-rays and reports and asked what he should do. Sanjivi advised him against the operation, in these words: "The time will shortly come for you to shuffle off your mortal coil. Why do it piecemeal?"
Sanjivi was venerated by his peers, his students, his patients indeed, by anyone who had the good luck to come into contact with him. As a grand-nephew I freely shared in this adoration myself. As a little boy, I warmed to the elder who treated me as an adult. As a young man I marvelled at the public figure who would not raise his voice nor pass judgment on others.
Sanjivi was not incapable of veneration himself. Among the institutions he most admired were his eldest brother, K. Swaminathan (chief editor of the Collected Works of Mahatma Gandhi), and this newspaper. When I last met him, he lay critically ill in a bed in his own hospital, the VHS. He was sightless, but his mind was still crystal-clear. He expressed regret that he could not read a book I had just published. But then he added, "Chamanna says The Hindu gave it a good review."
I was naturally pleased with what I took to be a triple endorsement. Did not George Orwell once describe authors as the most egoistical of human beings? They are, for the most part, but when confronted with a doctor at work they know how utterly useless their own craft is in comparison. A book is an act of vanity that helps no one but the author himself.
The healing of humans, by contrast, is among the noblest of all callings. The older I get, the more I have come to respect doctors who are skilled and yet not greedy. I have been fortunate to know a few such; of these the first, and most remarkable was K.S. Sanjivi. He was that altogether rare phenomenon, a great man who was also a good man.
Ramachandra Guha is a historian and writer based in Bangalore. E-mail him at email@example.com
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