K.V. Thiruvengadam on childhood in Royapuram, the practice of medicine in the last century and the unique doctor-patient bond

In North Madras where I was born, the only recreation we had at hand was the Royapuram beach, where we would watch ships drop anchor and set sail again; coming in less than a mile out, close enough for us to read their names. This continued till the 1950s, when the Port Trust took over the area.

Clive Battery, the magnificent fort at the sea-end of the Black Town wall still stood then, with gun emplacements for cannons to be trained on advancing enemies; later, it was pulled down to make way for the flyover connecting Royapuram and Rajaji Salai.

On a rainy full moon night in 1942, a lone Japanese bomber began to approach the Sivaswamy Bridge, skilfully making it past the barrage of bullets from the anti-aircraft guns. The lights had gone off all over the city, but the bomber could be seen, diving straight for the harbour. It dropped the bomb, but missed its target.

The schools in the North were modest, though the standard of English taught there was usually very high. I studied at the Muthialpet High School; I remember how beautifully our English teachers would read out the texts, so much so that we would get intensely involved in the stories. In fact, the reading of A Tale of Two Cities moved more than a few of us to tears.

A 'clinical sense'

The practice of medicine in the early part of the last century was largely in the hands of LMPs — a title you acquired after a modest course, nowhere nearly as thorough or rigorous as a degree in medicine. But, most of their sign boards proclaimed ‘Physicians', or ‘Surgeons'.

There were no facilities for sophisticated investigations to diagnose illnesses; so it was to the smell, sight and behaviour of disease that we turned. Essentially, we used what could be termed a ‘clinical sense'.

Physicians prescribed medication based on their experience, and not merely the evidence. There were only two places you could get an X-ray taken — one on Poonamallee High Road, and the other on Edward Elliots Road. But, it could be said that we managed pretty well with such limited resources.

There are a few practitioners of medicine I remember with reverence. The first is the great Dr. Rangachari, who could transform a room in the patient's house into a place for major surgeries such as hysterectomies. This, at a time when sterilisation and anaesthetic techniques were but basic, was remarkable.

There were few telephones in the city then, and one of them was in his house. He levied robust payments from his wealthy patients, so that he could treat the poor free of charge. And he cocked a snook at his British colleagues by buying not one, but two Rolls Royces — and then capped it all by buying an aircraft! And, on that plane, he would travel to remote parts of the country to treat the ailing, landing on make-shift runways that would be hurriedly put together by people.

Most doctors burned their candles at both ends trying to attend to as many patients as humanly possible. Work was hard, and we had no buffers — there were no real hospitals, no intensive care units, nothing to ease the burden. Emergencies had to be treated at home, which meant extensive travelling. The wear and tear in a doctor's life was very high — many of them died very young. In fact, Dr. Rangachari died at 52, succumbing to typhoid that he had contracted from one of his patients.

Teaching medicine, at a time with no audio-visual aids, was also very different from what it is now. Some of our professors would actually enact the symptoms of various diseases before us — the tremors, the gait, the deformities, everything. A significant initiative that was taken to integrate various schools of medicine and therapy, to bring them together and study them holistically, was the Kilpauk College of Integrated Medicine. It was a radical new way of looking at medicine. The college made way for the Kilpauk Medical College in 1960.

The entry of antibiotics

It was somewhat late into the Second World War that antibiotics such as penicillin first reached Madras. Around 1949, I remember the professor of medicine at Stanley cautiously bring out a minuscule vial of chloromycetin, the drug for typhoid, handling it with something approaching reverence.

Some of the most significant lessons in medicine for a doctor came from the general wards of Government hospitals. The patients there had no recommendation letters or gifts, only their sacred trust in your abilities. Most of the time, once they were discharged, they would have no money to return to their villages. So, a few of us would collect money to send them home. We didn't have to go looking to treat the poor in slums; the slums came to us.

Every single day spent in the practice of medicine, was a remembrance, a reiteration that its function is not merely to treat, to heal, but also to comfort and console.

(As told to CHITHIRA VIJAYAKUMAR)