Me and Medicine

By Dr Krishna Mohan Mishra

The book is a detailed description of his training and early years of practice and the interesting experiences of the author in this period.

• Language: English
• Publisher: AuthorHouse UK
• Release date: Aug 19, 2013
• ISBN: 9781491802823

Dr Krishna Mohan Mishra

The author is a Medical Practitioner in UK. He obtained his medical degree in India and after postgraduate training he had further training in UK and returned to India as a Senior Physician.

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2013 by Dr Krishna Mohan Mishra. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 08/15/2013

ISBN: 978-1-4918-0276-2 (sc)

ISBN: 978-1-4918-0404-9 (hc)

ISBN: 978-1-4918-0282-3 (e)

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Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

Contents

•   Foreword

•   Preface

•   Acknowledgements

•   At the Institute of Medical Sciences, Banaras Hindu University, 1964-1973

•   In The Beginning

•   My Teachers

•   Professional course and examination

•   First Professional

•   Second Professional

•   Final year of MBBS

•   My Friends and Mates

•   Final MBBS/Third Professional Examination, December 1968

•   Post Graduation at Sir Sunder Lal Hospital Banaras Hindu University 1969-1973

•   Medical Internship

•   Surgical Internship

•   Preventive and Social Medicine (including one month in Paediatrics)

•   Obstetrics and Gyanecology (O&G)

•   Senior House Officer in Medicine

•   MD (Doctor of Medicine)

•   My Thesis for MD

•   Kurji Holy Family Hospital

•   United Kingdom (U.K), 1973-1978.

•   First Visit to England

•   My First Job SHO Geriatric Medicine at Upton Hospital Slough, Berks

•   My First Return to England

•   Chadwell Heath Hospital

•   Bethnal Green Hospital, Cambridge Heath Road, London E2.

•   Locum Consultant, Chest Medicine, Chadwell Heath Hospital

•   Princess Grace Hospital, Nottingham Place, London W1

•   Reunion: Back to Banaras Hindu University, 1978-1980

•   Me as a university Reader at BHU

Foreword

When my father asked me if I would read his autobiographical account of his time in Medicine, I was under the false impression that there would be little in it to surprise me. As I started to become engrossed in his words, I was amazed by his experiences, by his sharp factual recollection and ability to bring to life events from over forty years ago. The images created were provocative to me, both as a son and as a doctor myself. To remove any names of people encountered would diminish the effectiveness of his tale, and reduce the impact of his recall of the individuals he has encountered.

My father and I have always been close. I once thought I knew everything about him. Not only do I now comprehend the significance of the 13th of February, I also realise that he was once a young man, who had confidence in his abilities, but faced uncertainties that many professionals face in their chosen careers. I began to appreciate not only the man I called Dad, but my father the doctor, my father the newly married young adult, my father the man who ventured further than any in his family before him or since, and the woman who supported him throughout his postgraduate trials and triumphs—my mother.

From a personal point of view, I have acquired a new understanding of not only my parents, but also myself. I would recommend this read to any fathers, sons, people with an interest in medicine (for whom this book provides an interesting array of diagnostic gems), and anyone who has wondered what life was like for a young doctor in India and England in the 1960s and 1970s. I feel inspired to collect my own thoughts and experiences to pass them on to my own son one day, but I suspect the wealth of knowledge I have gained will be insignificant in comparison to the wisdom shared by my father.

Amitabh Mishra (born Kshitiz Mohan Mishra)

BSc(Hons) MBBS (Lond) MRCS(Eng) MD(Lond) FRCSEng(Gen Surg)

Oxford

1st July 2013

PS As for my name change—well an explanation may have to come from Part II!

Preface

Me and Medicine is an account of my journey from my premedical test for admission to medical school, through my student and training years in India, followed by further training in England (Bilyant) to finally becoming a senior physician and teacher in the medical school where I was trained, Banaras Hindu University.

This book reflects the value of a supportive family and friends and the desire to learn and achieve with a competitive attitude. It also signifies the importance of an encouraging teacher-student relationship during the formative years of a medical student.

I have also tried to highlight the mistakes I have made during those years and their effects on progressing in my chosen path.

My further journey is to continue through part two of this book, though this part is a complete read in itself.

This book should prove a valuable read for people in medicine, my friends and family members and general people interested in the practice of hospital medicine in India and the UK.

Krishna Mohan Mishra

BSc Hons MBBS MD FRCPE MRCPLond MRCP Ire

Hemel Hempstead

5th July 2012

Acknowledgements

My acknowledgements are due to my two brothers MM and LM who made a doctor of me. To my friends Ashwini, Dang, Kailash, Manvendra and Srikrishna who taught me to be an effective team player. To Prof Nagchoudhury, Drs BC Katiyar, Ranjit Sumra, Joy Edelman, Frank Goodwin and Frank Marsh who helped me to develop in to a physician and to all my patients who gave me the opportunity to be a caring doctor. Thanks to my wife, who has been at my side on this journey, and to my son, Amitabh (born Kshitiz Mohan), who did the painstaking job of editing the most arduous manuscript into its present format.

At the Institute of

Medical Sciences, Banaras Hindu University, 1964-1973

In The Beginning

My Teachers

Prof KN Udupa MS FRCS(C)

I had visited Banaras Hindu University (BHU) a couple of times and been to its medical college only once and my visit had been mainly confined to the physiology department. It had been a quick glance at things and not of much interest to me. My main reason for going had been to see the botanical garden there but it unfortunately did not impress me much. The botanical garden was just in the phase of being rebuilt at the relocated site near the Viswanath temple, closer to the Botany department of the university, whilst its original site was near the Ayurvedic medical college.

The undergraduate department of Ayurvedic Medicine was being closed and replaced by the Modern Medicine medical college. Only the postgraduate section of the Ayurvedic medicine department was to survive this development plan of the Indian government at BHU in its future. Prof KN Udupa was a graduate of Ayurvedic medicine and surgery (AVMS) who later obtained his FRCS from Canada and was appointed the first principal of the new modern Medical College which began teaching the MBBS course in 1960. The postgraduate Ayurvedic teaching continued hand in hand for the degree of Doctor of Ayurvedic Medicine (DAyvM). The two were completely separate disciplines but headed by the same principal Prof KN Udupa.

In those days, I was not keen to study medicine for various reasons. I was there mainly to prove that I could compete in the premedical test (PMT) for admission into the MBBS course and to an extent I was bullied to purse this by my older brother. To meet his challenge I reluctantly applied to the BHU PMT, while I was spending my summer vacation at DLW with my brother’s family in Varanasi. I had more or less forgotten about the PMT when a letter from university arrived at my brother’s address, informing me that my application for PMT had been rejected on the grounds that I had passed BSc part 1 of a three year degree course (equivalent to ISc, which was not accepted by BHU). This curriculum of BSc part 1 was just being introduced in various parts of India, including Bihar but not in Varanasi, UP. At that stage BHU was not up to date with that change.

In fact, I felt relieved reading that notice. I did not have to take the test and accepted the verdict that my qualification was not acceptable to BHU—my application had been rejected, end of the story. My brother Lal Mohan (or Chhote Bhai Saheb as I called him) was the main person interested in me taking the test to study medicine and he reacted completely differently and was furious with the notice. He initially expressed his views in many words about the incompetence and ignorance of the university authorities, specifically the Chief Controller of examinations. He immediately ordered me to get ready to accompany him to the university central office to meet Mr. Bhatt, the chief controller of examinations of BHU. There we met another couple of students from the south of India who were also there to see Mr. Bhatt for the same reason. Mr Bhatt initially was very upset and annoyed with the whole situation and accused Dr Udupa of creating that state of affairs and finally after making a few calls, he told us that he had passed the matter onto Prof KN Udupa for his final judgment on the matter. Without wasting any time there, Chhote Bhai Saheb, though still fumed with anger, asked me to accompany him to the medical college office, to meet Dr Udupa. The college office was then situated in the Sanskrit college on the first floor next to a small room housing the medical college library; we sat on a bench outside the office for about an hour. I was fed up and just interested in ending the matter without any interest in the result. As far as I was concerned it was all just a waste of time.

Onto the veranda where we were sitting, walked a medium-height, almost-fully-bald man, with a very fair complexion and an impressive personality. I vividly remember he was wearing a greenish plain shade bush shirt and a pair of cream colour trousers. He walked briskly into his office. When we greeted him and I had started to tell him my story, he began pointing at me and said, Boy from Bhagalpur? I have already ordered Mr. Bhatt to issue you with the admission card to sit in the PMT. Go and collect it from his office. I collected my admission card that day. My first impression about Dr Udupa was that he was an inspiring person who could make decisions very quickly about important matters. That remained my everlasting impression of Dr Udupa, even after knowing him over all those years.

We did not meet again until December 1966. First and second year medical students were at the Medical National Cadet Corps Camp outside Varanasi, when he came to address us on the last day of the camp. Afterwards, he joined us for the dinner. By then, I had heard a lot about his dynamism, quick decision-making, kindness, effectiveness but also that he was quick tempered but liked by most colleagues and staff but also not liked by a few. I got a very brief chance to talk to him and topics covered included our food habits and he told me he was a vegetarian but agreed that non-vegetarian food offered a lot more choice in general. He seemed to be very comfortable in meeting and talking to people, another of his unique qualities.

My next meeting with him outside the classroom and tutorials was when I went to invite him to attend our hostel annual day function. It used to be a big day, full of activities from midday until after dinner, followed by a variety entertainment programme running into the early hours of the morning. It was a very important day for me; I was the president of the Boys’ hostel that year. He used to be very encouraging and attended all functions related to the institute unless he was away from Varanasi. Dr Vitalingham, Professor of Cardiology from the Christian Medical College, Vellore was the Chief Guest for the occasion that year.

On that second meeting, I had just come out of the student ward, where I had been an inpatient for a few days for observation of my high blood pressure. I went to his office in the college and formally requested him to come to the function and handed over the proper invitation card. While reading through the card, light heartedly with a small laugh he asked if the hostel day celebration was causing my high blood pressure, how I would manage the big role I was due to play later, and this time he laughed very loudly. He told me he would be there on time. It was his usual style to say that he approved of what was happening and more so of saying he was pleased with your action in general. When he was cross he would be red-faced with his eyes popping out, nostrils wide open and he would say only a few words, but loudly, making one very uncomfortable and inclined to leave him his office as quickly as possible. The function went very well, as did my speech, although I can’t remember what I said any more.

My next meeting with Dr Udupa was not very pleasant. One of my professors had been assaulted by a mad man in the outpatient department, when I was working as a house officer. Students and teachers were very upset and some of us were on our way to see Dr Udupa in his office and when we met him half way, he was walking back from the Outpatients department of the Sir Sunder Lal hospital towards his office in the operation theatre block. We surrounded him and everyone including me verbally blamed him and his lenient manner in dealing with hooligans and thugs harassing the doctors and medical staff time to time. He was irritated, as was displayed by his body language, but was able to maintain his calm and tried to quiet everybody down. He kept saying he was going to deal with the matter strongly, effectively and without delay. Later on that evening when things calmed down, normality returned and I had time to think over the whole incident. Good sense won over me, and I went to see him in his office in the new medical college (which was now the Institute of Medical Sciences), and I apologised to him for my behaviour. Surprisingly, he did not show any unhappiness over that morning’s event. In fact, he immediately said it was ok and he gave me a piece of advice. KM Mishra. Mishra do not do like Dang and Vaish, as they come from very different backgrounds and they are students’ leaders. You are not destined to be a politician, your priorities are different. You want to complete your education here as soon as possible and want to help to your family, so get on with your aim. I returned to my hostel with a very positive message to develop my personal plan and not to dwindle away from my aim.

Whenever I met him for a personal reason, I always returned in a positive frame of mind which helped me to plan my future each time. On that day, I reaffirmed my own decision to have nothing to do with politics in my life. But now I disagree with that decision—one should not ignore politics but politicians, as politics shape society and life.

My first posting as an intern was in the medical unit of the institute, and the next 3 months was a surgical posting of which I was posted with Prof Udupa for the first month. I had discussed my career ambition with the senior registrar and requested he exempt me from theatre duties, so he did and I spent one hundred percent of my time looking after patients on the surgical wards. I took full responsibility for admitting the patients, their preoperative and postoperative management and discharging them from the wards. I attended all the ward rounds with him and his team. He was the king or emperor. He always saw all of his patients, however briefly, talked to them and advised his juniors on their management. He would come every day to do the ward round unless he was away, but there was never a definite time of his ward round. It caused serious frustration amongst the junior doctors as they had to wait sometimes until 9pm to start his ward round, and he expected them all to be present at his round. He would notice and ask about anyone who was absent from the round, and he would definitely display his annoyance towards the absentee on the next round. He cared for his patients and he liked the loyalty of his junior doctors, especially if they were planning to become surgeons. I did not see much of him performing operations, but it was very well known he was the best during my time at the IMS.

I remember two other occasions. He was honoured with a Padmashree—a national honour awarded to only a few by the President of India. He was invited by teachers and students to celebrate the occasion. He attended and thanked everyone for helping him to develop the IMS, BHU, although I personally feel he was the single force behind developing the medical college. This started with the first student registration onto the MBBS course in 1960 and its transformation into an Institute of Medical Sciences in 1968 with well developed postgraduate departments in Medicine, Surgery, Community Medicine, Eye, ENT, Obstetrics/Gynaecology, Radiotherapy and all preclinical and paraclinical disciplines of the medical faculty. He hardly said anything about himself, even on this occasion. It was not that he did not like to be praised for anything for which he was worthy, he was not one to blow his own trumpet. One thing he certainly did not like was someone undermining his authority—I suppose it is possible he found that obstructive to his mission of developing the Institute further, which he actively pursued for all of his life.

The second other occasion worth mentioning was when I was a final year medical student and the national medical conference was organized at IMS BHU that year (1968). Most of the eminent physicians from India were in attendance and being the chief host, Dr Udupa went to most of the meetings, and was there until the last day of the conference, which lasted a whole week. Only after the conference finished did he leave for his native town of Udupee in Karnataka, to attend the remaining ceremony of the last rites for his mother, who had died. He had received news of her death two days before the conclusion of the conference, but had kept it secret. Amongst Hindus, the cremation of the dead body is performed on the day of death and it is the duty of the sons to be present at the time of the cremation, though the ceremonial activities of last rites go on for a few more days and even up to twelve days in certain parts of India. I am not in a position to comment whether his action was right or wrong, and I leave it to the readers to have their own opinion.

I had left the institute by the time I heard the following things through the grapevine. After his first wife died, he remarried at a very mature age, either nearing or after his retirement, to a theatre nurse who was a widow with a young child. This caused a serious breakdown of his relationship with his own small family—his only offspring, a daughter, was so unhappy with this action that she moved out of Varanasi with her husband and daughter down to the south of India and never saw him again. He died of colonic cancer at the age of 84 years.

We all knew of his very fulfilling and successful professional life but his relationship with his first wife was very unhappy, even though it was a love marriage. I was also told that his relationship with his daughter was also strained. This information came from one of his very close students, an eminent surgeon.

Prof J Nagchoudhury B Sc (Hons) MBBS PhD (London)

In 1962, when I visited BHU as a tourist, the only department in the medical college I went to was the department of physiology, though mainly from the outside. When I joined the college in August 1964, I attended a few lectures in physiology and anatomy, and while the latter did not seem that bad, physiology (especially biophysics) appeared very boring. I had proved my point that I could compete in the PMT for admission at all India level and decided to quit. I went to return the laboratory manual of physiology, bought from the department office. I went to chief technician Mr Labh and handed over the manual to him and asked for a refund to his utter surprise, as this had never happened before. He asked me to wait as he had to ask sir, what to do. He returned and asked me to follow him as Sir wanted to see me. I had no option but to follow him. I had seen Sir (in the physiology department they all used to call Prof Nagchoudhury, Sir.) when attending his lectures. He was a dark oval faced, very Bengali-looking man, with a frightful face. He was slightly obese, around forty in age, but with a very distinguished look on the whole. He was sat in his chair with a large desk in front of him. Something I worked out much later was that every morning at around 9am he came in to the department and spent a couple of hours on his desk reading medical journals, mainly on physiology topics before doing anything else. This was his ritual and it kept him very up to date in his subject.

On entering the room I greeted him, he looked at me with his very prominent, piercing eyes and asked me why I wanted to leave the college. I told him I was finding physiology, particularly Biophysics very difficult to grasp, and he asked me what I was going to do after leaving Medicine. I told him that I planned to pursue my studies further by joining the MSc course in Botany. He asked me a few other questions about my family, and finally summed up something which was the turning point in my medical life.

He asked me not to leave the college for at least 4 more weeks, at which point he would review the situation with me. He also told me that I need not worry about Physiology, I would do fine and told me further, You will not only pass the MBBS examination but you will be one of my shining students. I agreed to the a trial of four weeks, and when I returned to my hostel, I bumped in to one of my classmates, Prem Kumar Srivastava, who asked me what was happening, was I really leaving the medical college and going back home. I narrated my encounter with Sir to him, and by that evening it was the hot topic in the medical college campus. A few students I met praised my courage and boldness (which I felt was not visualized in the right perspective by them). But later their comments made sense when I realised that the two professors people in our college were most afraid of Prof Sumer Singh of Anatomy who reportedly was responsible for forcing people out of medical college by failing them in their anatomy examination four times in their first two years (a rule then existed in BHU), and the second was Prof Nagchoudhury. He would not force anybody out of the college but definitely made them feel very inadequate by asking very simple questions which were difficult to answer when doing Physiology practical work in the laboratory, where he would usually walk in practically every day near the end of the experiment, wearing white trousers, a white shirt, neck tie and a very long white doctor’s apron, which made him look even more scary. He would ask a simple question, starting with a student at one end of the laboratory and follow asking that same question to each student in turn until it was answered correctly or until the question reached the last student in the laboratory. Then he would say something like, Leave the college, go back home and help your family, why are you wasting your father’s money? I still remember the day I first met him in his office after which I went to the practical class, where he came later at the end of the period. I certainly don’t remember the question he asked but vividly remember him starting from one end and after a few silent students my number came up and I gave him the correct answer, to which he remarked, See, I told you, you will be alright. After this, I rescued my group from embarrassment many times, but perhaps once or on a maximum two occasions I could not answer his question, and he just walked away without saying any word, but displaying his annoyance. Out of the many questions he asked me, I still remember even today two of the questions. 1) What are the causes of low eosinophil count? 2) Which structure involves the upper motor neuron?

I gradually settled in and soon found that physiology was rather easy and natural to learn; more baffling was anatomy which was very onerous to learn. This was reflected clearly in my day-to-day performance. Soon it was time for a formal examination, my first since entrance to the medical college, (apart from everyday anatomy dissection vivas, surprise anatomy tests and physiology rounds with Prof Nagchoudhury which I have already described). I scored 47/100 (the pass mark was 50) and it remained around that mark until the pre-final examination in the 2nd year, despite my all efforts to do better. I just could not help it and I was always afraid that I could easily be a casualty in the final Anatomy examination. The story was different in physiology. In the first formal examination, the theory section went well—one of the questions was to discuss the physiology of breast and similar other questions. I had never used the model question answers before or on this occasion, and in fact didn’t start to until very late. I think the first time I used model question answers for any examination was for obstetrics and gynaecology—the Bhattacahrya series and I can tell you the outcome was good but I would not recommend anyone use these books until the few days before the final as they limit your basic understanding of the subject. My basic strength was attending all classes without fail and listening very carefully to the lectures and reading the textbooks. This was the main reason I could always answer Prof Nagchoudhury’s viva questions with confidence and correctly. In this very first examination I faced Prof Nagchoudhury and Prof DP Burma (head of Biochemistry). A few very basic questions went well, and Prof Nagchoudhury asked me about thyroid function and various tests related to it and I could answer them all. I was then asked to leave without any comment. I had one funny habit. Whatever happened in the examination, I always felt well after it and I felt the same euphoria after the first examination. After a few days the marks were put out on the notice board but I did not see the board. Arvind Gaur, son of the reputed Prof KN Gaur MBBS FRCP Edin DCH Dublin PDI, our professor of medicine, came in to the class and told me that both he and I had scored the highest equal marks in physiology. I do not remember scoring the highest mark in physiology again, but I always did well.

A few weeks before the first professional final examination, students went on strike, to support the national movement of Angrajee Hatao (remove English from Curriculum) and bring in Hindi to replace it in teaching and as the official language, which caused a bit of chaos, as the date for this final exam was postponed by a few weeks just seven days before the examination. I had been fully prepared by that stage, and I could not get back into the rhythm of the examination again, and so I did alright but could have done a lot better if the examination had taken place as originally scheduled.

Some of my classmates went to meet Prof Nagchoudhury to ask what they should prepare for the examination. I do not understand how they thought he would tell them anything at all, as he was a real rigid disciplinarian, without any chance of flexibility from the rule. During their meeting, he told them that those that had worked throughout the year need not worry and they were shown a list of few students who had performed well throughout the year in all the examinations. They told me that my name was amongst them on that list. They also told me that Prof Nagchoudhury told them that the students on the list would pass their final examination, even if they submitted blank answer books in the examination. It did not surprise me at all.

But my worry was the Anatomy examination, and as a result I completely ignored physiology and put all my efforts into revising Anatomy. The pre-final examination went well, and on the first time I passed both the theory paper and Anatomy Viva, scoring more than 70% marks in both subjects. Later on the final examination went well and I passed both Anatomy and Physiology but without any honours, whereas four students got honours in Physiology. They were K Bharathan, JN Nayak, KN Bhatt and Vibha Shukla. I knew I had not done well enough to deserve honours because I spoilt my theory paper and also could not talk about Gastrointestinal hormones in my viva as I had probably never realized the importance of them—this subject had been taught when I was thinking of leaving the college, but I recognise its real importance now when gastric acid blockers and incretin-like drugs are being used clinically. In fact I got 2% more in Anatomy than in Physiology. A year after passing my first professional I saw Prof Nagchoudhury who said, You were one of the prospective candidates for honours but you did not do well in the examination and did not get the honours, and I fully agreed to that, and told him that I knew I had not performed to honours standard.

Most students did not like his lectures, as they were facts delivered without any dramatization, without any variation in pace, speed, tone or volume in the entire lecture. Some of my classmates and friends in other classes told me that they could not help but sleep in his lectures. My view was that his lectures needed full attention and concentration. They were full of scientific facts and knowledge; if one lacked concentration during any part of the lecture you lost the whole lecture.

After passing my first professional I did not get a chance to meet him at all for about a year or so, but always heard about him. Various aspects of his life always remained focal points of discussion amongst the students, like his strict sense of justice, fairness, exceptionally intellectual pedigree, his out of the way living, a bachelor, life devoted to his mother, his famous father, a retired Principal of the Arts college at BHU, an ex Professor of English with a doctorate from London, and his brilliant brothers. I only met his father once when a few of us in the second year went to his house during Dushhera, with Vijya greetings. The meeting was too brief for me to comment on his father. A servant brought some Rosogulah for us, so we asked his father to share. He said, You will not ask me to share Rosogulah with you. I am a diabetic. Prof Nagchoudhury was not present during our visit. His father Dr Upendra Nag died circa 1967. I always heard these discussions with interest but never contributed anything. I did not know much about his personal or even professional life apart from being one of his students.

When I was a final year medical student, I was president of the boy’s hostel and in those days girls were not allowed to visit the boys’ rooms and vice versa—it was an unwritten rule. A unique incident happened. A girl was visiting one of the boys’ rooms in Dhanwantari hostel and was noticed by some of the boys. In those days it was not customary for the people to visit hostels of the other sex, unless they were relatives or accompanied by others adults. The boys made a big deal out of that. Once the girl walked out of the hostel, they beat up the boy who was visited, whether that was due to their high moral values or a cultural issue, or just suspicion of involvement of the intimate nature or sheer jealousy always remained a puzzle. The incident was reported to the director of the institute Prof Udupa who was away from Varanasi, so the report went to Prof Nagchoudhury, the acting director for action. He called in all the boys involved in the incident and after interviewing them, told them, KM Mishra is the president of Dhanwantari Hostel. I shall pass the matter on to him to decide on, and the appropriate action to be taken. His decision to pass this on to me was agreeable to both parties, because they were all on friendly terms with me and could not have contemplated me to punishing them. After all, they were my senior students; some were already fully qualified doctors. I was summoned to his office to see him.

I saw him in his office, and he asked if I was aware of what had happened. I told him I had heard about it from other boys and also from the servants. From him the ultimate question was, What punishment would you give them? I expressed my difficulty and inability in deciding their punishment; they were all senior to me. He told me, You have to make such decisions all your life and this is the time to start doing it. Finally I decided that as it was their first offence, and they should all be reprimanded and expected not to repeat such an act in future. Fortunately they all felt relieved with this decision, as did I. The boy who was beaten is at present is a General Practitioner in a suburb in London. Amongst the offenders, one became a Professor of Medicine and another, a famous Professor of Surgery. It was completely out of character for them to do anything like that, and I never understood what made them act like that on that occasion.

In my final year of MBBS, one of my seniors and a good friend of mine, called Sheikh Mahboob Alam, already a doctor asked me if I would like to go with him to Professor’s house in the evening. I asked why. He said it was a social visit, but at the same time he could check Maa’s (Dr Nagchoudhury mother’s) blood pressure. I remember his mother, an elderly lady with all grey hair, who spoke English and Bengali very well, did not speak any Hindi, was always dressed in a white sari, always chewed pan without ever spilling it in the pandaan when anybody was around. She had a very typical Bengali appearance, especially the way she used to dress up in her sari. One could easily make out the marked resemblance between her face and the Prof’s; more than any of his siblings.

After that day I accompanied Alam a few more times to his place and realised that before Alam, Dr GN Trivedi (Gajanand) used to look after Maa. Alam took over when Gajanand moved away to AIIMS, New Delhi, pursuing his research in Diabetes. At some time after I become an intern, and then a house officer in medicine I gradually also took over Maa’s care from Alam without realising it was happening. The visits were not very frequent, perhaps once every six to eight weeks, mainly to check her BP and if needed and to adjust the dose of her antihypertensive medications, which she had been on for a long time. Very occasionally Prof PN Somani would visit her, to reassure that things were alright. During these visits Maa would tell me lots of things about her past. They came from Maiman Singh District in East Bengal (now Bangladesh). She used to describe how Malviya ji, founder of BHU, asked Prof Nag and most of the elite teachers to join the university with very little pay on offer and they accepted with a sense of belonging to the university. She also told me about the early years of her children and their growing up, what sort of transport they had (Bagghi—a horse driven hooded cart, used by rich people those days), games children played in their large garden around the big house in which they were still living. Prof Nagchoudhury was allocated that house by the university on the retirement of his father Prof Nag. Many a time she expressed her regret for not allowing their oldest son Dr BD Nagchoudhury to marry the girl of his choice but she did not elaborate on that. I always saw remorse on her face when talking about it and so I never probed in to that further. Or was she trying to tell me more about it by bringing up the topic again and again? Something stopped her; perhaps she needed little encouragement.

She also talked about her annual trip to Calcutta in the early years and her decision not to go out of the house after the death of her husband. She was very particular that a garland over Prof Nag’s portrait was changed every day, fresh flowers laid, essence sticks ignited, diya was lighted and a water filled small pot was changed every evening. She would usually do these tasks herself, but later when she physically was not capable, a servant or maid would as she watched. My visits to her continued until I left BHU after obtaining my MD in June 1973, and I gradually introduced and handed over my responsibility to Vijai Bathla, a couple of years junior to me and a good friend of mine.

Amazingly enough there was nothing in the house affiliated to any religion or God, not even a portrait of any saint or prophet. I never heard any member of that family discussing anything religious in a sense of belonging to any religion though I had met them all apart from son of the oldest son (who was studying abroad in those years). I had met all her six sons, their wives and children, as they all visited her at least once a year, while I was at the university.

During my last couple of years at the university, I became almost like a part of that family. At least once a week I had to dine with them, whether Prof was there or not. The cook and the servant were instructed to make sure that I had dinner with Maa at least once a week. If for any reason I could not make it, Maa would keep asking the servant and the maid, why I had not been there. When Professor was away from Varanasi, I might stay the night, and sometimes Alam and I would stay there together to give company to each other. As it was a big house with many rooms, accommodation was not a problem, and in the morning bed tea and breakfast would be served before we left. The house was less than a 10 minute walk from Dhanwantri hostel, where Alam and I both resided. I remember, when I was on the call neurology registrar, the team knew where they would find me and contact me using their sense of discretion and at around 4am, a call came for me to perform an emergency carotid angiogram on an a patient with a stroke.

The patient’s son had brought his father in the night from a place called Ghazipur which was 30 miles away. He came to take me to the hospital in a transit van with a driver. While I was walking to the van to go to the hospital, the son took out a bundle of currency notes from his pocket and put them in the top pocket of my shirt with a big thank you. I immediately took the bundle out from my pocket and gave it back to the son, explaining, that it was prohibited and also immoral for me to accept any money from a patient, that I was forbidden from private practice as a doctor employed and paid by the university to look after my patients. He was very reluctant but with no other option, he took the money back.

The next morning I mentioned this incident to my Consultant, Dr Bimal Chandra Katiyar (Kaka), and he asked me, Why did not you keep it? He could see my bemused expression and gave a cryptic smile which reassured me; I realised it was a joke. I was relieved; I knew he was honest both in his conduct and code of practice.

Later on I had several character building conversations with Professor Nagchoudhury. I found out he cared for the under privileged as well as he liked well-to-do people—he was never condemnatory to anybody. I never had the courage to ask him whether he had any religious beliefs or if was he an atheist, or if he had any political bias. Although I heard people saying he was leftist in ideology, I never saw anything to support that view.

Over the years I found he was a very well read man and one could discuss with him the latest research in medicine as well world politics, literature and music in depth. Once I asked him his view on marriage, though obviously not his marriage. He started his answer saying That was a funny question! Being asked for an opinion from a man who was not married himself we then discussed various aspects of marriage and concluded it was right thing to be married. However I missed the opportunity to ask him if it was the right thing to get married why he had never got married himself. It was funny how he could be quite non serious. Once one of his relatives asked him to suggest names of any male doctor with a view to marriage negotiation, and he told them he had no knowledge of that type of thing and everybody laughed when he said that, for the matter that he was himself not married.

My other teachers were Dr Ratan Mala Gupta, Dr Saroj Gupta, Dr B Dubey of the department of Pathology, Dr AK Sanyal, Dr PK Das, department of Pharmacology, Dr AK Sanyal department of Anatomy, Prof Mehra of Ophthalmology, Prof MK Basumalik, Dr D Sharma of Obstetrics and Gynaecology, Dr SP Ganguli of Radiology, Prof SK Dixit of Paediatrics and most of the staff of the departments of medicine including Drs SK Bhttacharya, RS Sumra, KP Dubey, Abhai Narayan Rai, Prof PN Somani, Prof SK Vaish and above all Prof BC Katiyar (then a reader) and Dr BNS Bhatnagar, department of surgery. In England Dr Harry Caplan, Dr Joy Edelman, Dr Frank Goodwin and Dr Frank Marsh played positive roles in shaping my medical career. Dr AK Verma of Preventive and Social Medicine (PSM), Prof SK Vaish of Medicine and in England Dr David Adler,