The country’s first and foremost urogynaecologist Dr. Rajamaheshwari talks to GEETA PADMANABHAN on how her specialisation has been a trendsetter in healthcare for women

How is a super speciality surgeon born? “Guilt drove me,” says Dr. Rajamaheswari, the country’s first urogynaecologist. Accidental ureter injury she caused to a patient while performing a hysterectomy, and her dissatisfaction over the repair job by a urologist “spurred me to specialise in urology,” she writes in the International Urogynaecology Journal. “My journey as an urogynaecologist was neither expected, nor dreamt of.” A journey in which Dr. Rajamaheswari chose to do the unheard of — again and again.

With an MBBS from Thanjavur Medical College, in 1971 she moved to Chennai for her MD at the Institute of Obstetrics and Gynaecology attached to the Madras Medical College. After handling complicated referrals coming from 60-70 village hospitals, in 1982, she did the unthinkable: she returned to Thanjavur Medical College hospital. Working among rural women, “I saw countless gynaecology cases resulting in urological complications. I had to enhance my surgical skills, do a course in female urology.”

She smiles recalling her first day in a Urology department at a Chennai government hospital. The faculty had no experience training obstetricians-gynaecologists and the unit chief looked at her with scepticism, she says. “I was forced on them, they half expected me to leave soon.” She would continue, for she knew women hardly came for urological treatment; they suffered in silence. A urogynaecologist in 1985, she was appointed full-fledged head of the Urology department, Kasturba Gandhi Hospital in 1986. “In-charge at 30, I was scared,” but she learnt, innovated, standardised, till eventually, the learning curve got shorter. When she put down the keys on August 31, 2012 she had created a visible history of remarkable achievement.

In 1986, urogynaecological healthcare was unknown, suffering was not. Unattended and botched-up deliveries, tumours, caesareans, perennial pregnancies left scores of young women with pain, prolapsed uterus, urinary tract infections and that curse, incontinence. Such women became social outcasts, lost their jobs and some even contemplated suicide. “I was eager to provide the latest, advanced surgical treatment to underprivileged women suffering from urogynaec miseries,” says Dr. Rajamaheswari. She needed to tell them they were not alone, prove it’s possible for Government hospitals to offer prompt, appropriate treatment with sophisticated equipment on a par with that of corporate outfits.

It was difficult, she admitted, adding wryly. Why do you need this Urogynaecology department, she was asked. Urology/Obstetrics-gynaecology are overlapping fields but neglected, she argued. Our birth rate is high, population is high, where will care-seekers go, she demanded. “I fought till I retired, for change of curriculum,” she says.

She acknowledges Government help — Her department went from scratch (three beds, minimal facilities) to state-of-the-art, to accommodate 100 patients. She added an exclusive fistula ward. She wouldn’t allow payment, but in 2007 started a Government-approved, revenue-generating training programme and invited international experts to share experiences. She spent 80 per cent of the fee on improving facilities, and created a corpus fund. “Our aim was to bridge the gap with reference to medical care in Obstetrics-gynaecology. Women drop in at the out-patient counter, collect a ticket, come straight to the specialist.”

Will she join a private hospital now? Yes, provided “they permit me to treat poor patients with fistula free. “I operate in various hospitals. Give me an attached clinic and a free hand to continue my service.”

National, international honours have been hers, but she delights in thank-you notes. “I am blessed to have had the opportunity to serve, to have been associated with Prof. Vijaya who persuaded me to specialise in Obstetrics-gynaecology, Bhanumathi, my devoted nursing assistant, and people like Dr. Bob Shull.” Yes, she feels fulfilled, she has done her duty as a doctor, as a human being. “You make a living with what you get; you make a life with what you give,” she quotes.