Nostalgia N. Rangabashyam on a time when doctors listened to patients, the setting up of new departments in medicine and why the city drew practitioners from all over
As a few diseases were linked with certain localities — infectious diarrhoea with Royapuram, filariasis with Saidapet and tuberculosis with the slums (which started proliferating from the 1960s) — doctors at the General Hospital never failed to ask their patients where they lived. In fact, back then, doctors asked their patients a lot of questions. Since sophisticated diagnostic tools such as ultrasound, CT and MRI scans were yet to come into use, they relied on clinical examination and the patient's description of symptoms. As a result, they had to have a more humane approach to medicine. They had to be willing to listen to their patients.
Since this was before the advent of corporate hospitals, even celebrity patients queued up at the General Hospital; the ‘A' ward was full of them. Another reason was that the hospital as well as its twin institution, the Madras Medical College, had made great advances in medical science. More than anything else, doctors and professors from these institutions had a wisdom that went beyond textbooks.
In the early 1950s, Dr. Rathinavel Subramaniam discovered the effectiveness of Phyllanthus niruri (keezhanelli) in preventing liver deterioration in patients with jaundice and other liver-related ailments. When this was announced to the world, it was greeted with ridicule. Later, independent studies proved the doctor right.
Doctors had a sharp eye and were adept at spotting a student's strengths and weaknesses. Dr. C. Sadasivam, the first professor of cardio-thoracic surgery in India, with whom I had teamed up for a surgery, said I would make a good surgeon. “Your embroidery work is good. You have long fingers. And, I noticed you make 50 knots a minute,” he added.
Being associated with these institutions was a matter of pride, for pioneering efforts came out of them. Dr. Sadasivam started valve replacement surgery; simultaneously, Dr. Betz started it in Christian Medical College (CMC), Vellore. Dr. Venugopal established the urology department in MMC, in tandem with Dr. Bhat, who introduced it in CMC. Thanks to Dr. Sam G.P. Moses, MMC became the first institution in the country to get a diabetology department. Dr. K.S. Sanjivi, professor of medicine, started the Voluntary Health Services (VHS), which has set a benchmark for medical service in the country.
In every discipline, MMC and the GH showed the way to other medical establishments in the country. I can speak for gastroenterology. In 1976, the surgical gastroenterology department was introduced. Other firsts achieved during the decade were the introduction of laser to stop bleeding during surgery and the use of staplers. I vividly remember the surgery in Ward Number 10, where I introduced the Russian stapler for suturing the colon and the rectum. Following this, the use of staplers was encouraged in other applications too. In 1985, an MCH programme in gastroenterology was introduced at MMC.
Since the General Hospital had a rush of patients, it drew doctors and medical students from other countries — the huge patient population ensured they could see a range of cases. For example, you could encounter a patient with jaundice caused due to gallstones, and another with jaundice due to cancer. In February 1986, a group of 30 surgical oncologists from Britain came to the GH; they said they had never learnt so much in so short a time.
When I try to map the growth of medical science in Madras, a fascinating picture emerges. At one end, there were the General Hospitals (GH-MMC, Kilpauk and Stanley) providing the best medical treatment, free of cost. And, at the other, were private medical institutions, slowly growing in number and popularity. Thanks to famous physicians setting up their private practices on Poonamallee High Road, this stretch became a hub for medicine. For anyone looking for surgical equipment, a visit to Mount Road was a must. A row of shops that have survived to this day, sold them. These shops were set up by people from Sialkot in Pakistan who had been displaced by Partition.
In those days, ragging was innocuous. At the Madras Medical College, the seniors donned the roles of professors and the juniors were captive students. All they did was give funny interpretations of medical principles. The only thing expected of the juniors was hearty laughter and spirited clapping.
PROF. N. RANGABASHYAM Born in 1933, he is the former head of the Department of Surgical Gastroenterology and Proctology and Clinical Professor of Surgery, Madras Medical College and Government General Hospital. One of the pioneers in hepatobiliary surgery and the first to introduce staplers and laparotomy in patients with septic peritonitis in India, he has received many awards and honours, both in India and abroad. In 1987, he was elected president of the Association of Surgeons in India; in 1983, he became the president of the Indian Society of Gastroenterology; in 1995, he was elected the president of Ostomy Association of India. He has contributed chapters in the Oxford Textbook of Surgery and played a key role in getting the FRCS examination to be conducted in India. He has been honoured with the Padma Bhushan (2002), Dr. B.C. Roy National Award (1982 and 2007), the Warner Oration Award (1984) and The Royal College of Surgeons of Edinburgh Gold Medal (1995).