Though I have been a tea person all my life, coffee has always intrigued me. During my travels in the United States, it seemed to be everywhere: at breakfast tables, in offices, beside hotel reception desks and in paper cups carried through the streets. In Ethiopia, I encountered something more intimate—a tradition in which roasting, brewing and serving coffee became an expression of hospitality. My friend in Addis Ababa spoke of Ethiopian coffee with unmistakable pride. The cup held something of his country.

Both my sons are coffee drinkers. I have tried to understand why they prefer it to tea, and have come to suspect that preference belongs partly to one’s svabhava—one’s individual disposition, shaped by temperament, habit and experience. Yet chemistry offers a clue. Tea and coffee contain the same principal stimulant: caffeine, chemically called 1,3,7-trimethylxanthine, with the formula C₈H₁₀N₄O₂. The caffeine molecule is the same; what changes is the chemical company it keeps. Perhaps this is a modest lesson in individuality: even the same ingredient can participate in very different experiences.

Their differences begin in the plant. Tea comes from the leaves and buds of Camellia sinensis, usually grown as a bush under cultivation. Different processing methods produce green, black, and other teas. Coffee ‘beans’, despite their name, are seeds inside the fruit of a Coffea plant—the coffee cherry. Tea brings the leaf to our cup; coffee brings the seed.

For brewed tea and coffee, water acts as the intermediary between plant and person, extracting soluble compounds that give the drink its taste, colour and effect. What we call a familiar flavour results from many molecules coming together.

The two principal coffee species grown commercially are Arabica and Robusta. Both are evergreen shrubs or small trees, with glossy dark-green leaves and clusters of white flowers followed by red coffee cherries. And yet they are distinct species with different genetic architectures. Arabica generally has delicate, floral or fruity aromas; Robusta has more caffeine on average and a fuller, more bitter taste. Even within one species, flavour varies with variety, climate, soil, cultivation, processing and roasting. Each cup carries traces of its birthplace and the hands that shaped it.

Roasting turns the coffee bean into coffee as we know it. A dried, unroasted seed does not smell like the coffee we recognise. Heat triggers a complex chain of chemical reactions. Among them is the Maillard reaction, in which sugars in the seed react with amino compounds while heated to produce brown pigments and numerous aroma molecules.

India’s Monsooned Malabar coffee is a particularly evocative example. Under controlled conditions, dried green beans are exposed to moisture-laden monsoon air, causing them to swell and change in colour and flavour. The monsoon, which shapes so much of Indian life, also shapes this drink.

At home, most of us distinguish between filter coffee and instant coffee. We brew filter coffee from ground roasted beans. Instant coffee has already been extracted at a factory and dried into a soluble form; we add hot water to dissolve it again to make our cup.

Freshly brewed filter coffee generally offers more of the aroma and complexity enthusiasts prize. Its volatile aroma molecules are released just during and immediately after brewing. Instant coffee must pass through extraction, concentration, drying and storage. In spray-drying, the extract is dispersed into hot air, which rapidly removes its water. In freeze-drying, the extract is frozen and dried under vacuum, allowing ice to pass directly from a solid state into vapour.

One ingredient deserves particular attention in India: chicory. This is a separate plant, Cichorium intybus, whose roasted root is blended with coffee. It contributes an earthy, roasted, slightly caramel-like flavour and a fuller mouthfeel, especially with milk. It also generally costs less than coffee, making the blend more affordable.

Chicory itself is naturally caffeine-free. Familiar Indian filter-coffee blends contain around 15–20 per cent chicory, while some mainstream instant blends contain 30 per cent. When I visited Addis Ababa, my friend told me that Ethiopia had no established tradition comparable to India’s coffee–chicory blending. His pride in the coffee itself stayed with me. 

So, how might a lifelong tea drinker make a satisfying cup of coffee at home, without chicory?

A simple start is pure instant coffee with equal parts hot water and milk. The ingredient declaration should say ‘100% coffee’. Look for a pure instant-coffee product, rather than a coffee–chicory blend. For a modest 150 ml cup, use about 1.5–2 grams of instant coffee—approximately one level teaspoon. Dissolve it in 75 ml of hot water, then add 75 ml of hot milk. Taste the coffee before adding sugar. As someone who enjoys tea without sugar, I would first allow the coffee to introduce itself.

There is no universally optimal milk ratio. For a more pronounced coffee flavour, try 100 ml water and 50 ml milk. For a creamier cup, reverse those quantities. Keeping the coffee amount unchanged makes it easier to see what the milk adds.

With pure ground filter coffee, brew with water first. For a concentrated South Indian-style decoction, one part filtered decoction to two parts hot milk is a useful starting point. The right balance depends on the decoction’s strength and one’s taste. A good cup emerges through a little attention and adjustment.

But the cup has another story, extending far beyond our kitchen.

Coffee connects an agricultural economy to a manufacturing economy and, finally, to a service economy. The grower tends the trees and harvests the cherries, paying for labour and inputs while facing pests, disease and uncertain weather. A local collector or cooperative assembles small quantities into commercial lots. The primary processor removes the fruit and protective coverings, then dries, mills and grades the beans.

Exporters, importers, and traders find buyers, finance inventories, and arrange deliveries, managing freight, storage, interest costs, exchange rates, and price fluctuations. Roasters and instant-coffee manufacturers turn green beans into consumer products. Retailers and cafés bring them to us, adding the costs of premises, staff, equipment, preparation and service. Each stage adds work and costs, but bargaining power determines how much of the reward each can claim.

Consider an illustrative café calculation. If roasted coffee costs ₹1,000 per kilogram and a drink uses 20 grams, the coffee ingredient costs ₹20. Suppose the drink sells for ₹200. The remaining ₹180 must cover milk (where used), staff, rent, equipment, utilities, wastage, taxes and profit. The ₹20 is the café’s purchase cost for roasted coffee, not the farmer’s receipt, and the ₹180 is not automatically the café’s profit.

A farmer’s share of a café cup’s price is therefore an incomplete measure of fairness. More revealing questions concern the life behind the harvest. Does farming cover its full costs? Does it provide the household with a decent living? Can the grower invest in the next crop? Who owns the café, and are its workers paid fairly? How much of the value sustains livelihoods, and how much becomes another means for ‘Big Money’ to multiply itself? The same questions apply to tea.

Coffee has the larger international commercial economy by traded value. To give a sense of scale, FAO estimated global tea production at about 7.3 million tonnes in 2025, while USDA estimated coffee in the 2025/26 marketing year at about 10.7 million tonnes of green beans. These are different reporting periods and products, so the comparison is indicative rather than exact.

The tea export business is about US$7.0 billion, compared with US$44.1 billion for coffee—roughly six times as much. India exported approximately US$804 million worth of tea and US$1,112 million worth of coffee that year.

Despite being a major producer and exporter, India imports both tea and coffee. Tea, mostly low-cost bulk black tea, comes from Kenya, Nepal and Sri Lanka. Darjeeling tea is globally cherished, but it can be grown only in a small, approximately 70-square-mile Himalayan region in West Bengal. Green coffee beans come from Uganda, Tanzania, Kenya, Vietnam, Indonesia, and Brazil. India processes much of this coffee and re-exports it.

Behind the fragrance of a cup made at home lie sacks, warehouses, grading tables, ports and ships. Farmers watch the weather; workers tend processing machines; traders study prices; someone ensures that a container remains dry through a long voyage. We rarely see this dispersed company of people, yet their work reaches our table.

The playful question, “Tea, coffee, or me?” may therefore admit a generous answer. We need the drink, but we also need the person offering it. Flavour draws us to the cup; companionship gives the occasion its meaning.

Whether you are sipping tea or coffee, you are connected to humanity and to the Earth that sustains us. In the five or ten minutes that your cup remains warm, let that connection bring comfort and a sense of wholeness. Your difficulties deserve attention, but they need not occupy the whole horizon. A world is still growing leaves and ripening cherries; someone is still willing to sit beside you; and there is still a little warmth to receive.

Since I met Dr Chinnababu Sunkavalli, the robotic surgical oncologist, in 2022 through an introduction by the Tangirala brothers, Venkat and Ravi, he has become part of my life. His enthusiasm, his commitment to connecting with people, and his extraordinary zeal to serve others have continually impressed me. When you see a younger person doing what you once wanted to do but could not, a special kind of bonding develops. There is neither envy nor regret, only the satisfaction of seeing an unfinished aspiration finding expression in another life. I wrote Live For A Legacy in 2023 about his work, and the book was warmly received, leading to a second edition earlier this year.

The evening before the Cancer Run on 11 October 2026, organised by the GRACE Cancer Foundation, which Dr. Sunkavalli co-founded, I attended a beautiful lantern-flying ceremony. The next day, the ninth edition of the Cancer Run drew more than 35,000 participants. By any standard, organising an event of this magnitude is an extraordinary achievement. Mobilising people, securing resources, coordinating with the city administration, and arranging hospitality for thousands require enormous dedication.

As I watched the lantern rise into the sky, a question came to mind. What purpose do such events really serve? How does public awareness of the agony endured by cancer patients actually reduce their suffering? Can a gathering of healthy people, however enthusiastic, make a meaningful difference to someone lying in a hospital bed, frightened by a diagnosis or exhausted by chemotherapy?

These questions stayed with me. These days, I often find myself revisiting my experiences, much like a cow chewing its cud, reflecting on events long past and gradually drawing meanings from them that weren’t apparent when I first lived through them. During this reflection, a novel I read long ago surfaced in my memory: Irving Stone’s The Agony and the Ecstasy, published in 1961. It tells the story of the great Renaissance artist Michelangelo Buonarroti, whose life was a seemingly endless contest between physical suffering and creative fulfilment.

Stone’s Michelangelo is not the serene genius whom posterity admires, but a restless, often tormented man driven by an inner vision that exceeds the limits of his body and circumstances. He cannot always control the people and forces shaping his life, but he remains fiercely determined to control his response to them, preserving his artistic integrity and remaining faithful to his creative vision.

He quarrels with patrons, struggles with poverty, endures loneliness, and subjects himself to punishing physical labour. Yet his mind remains absorbed in what might emerge from an unremarkable block of marble. Where others see stone, he imagines a living form waiting to be released.

His work on the Sistine Chapel ceiling becomes an especially powerful expression of this struggle. For years, painting in physically demanding conditions and under pressure from Pope Julius II, Michelangelo endured the exhaustion and frustration of creating something that had never existed before. I visited the Sistine Chapel in the Vatican in May 2013, and I still remember looking up at that magnificent ceiling, overwhelmed by the scale of his imagination and the extraordinary labour behind it.

Standing beneath those frescoes, I could almost sense the agony of the man who had created them more than 500 years ago, and the ecstasy he must have felt as his extraordinary vision came alive. The experience brought home to me a profound truth: Michelangelo’s extraordinary achievement was not that he escaped suffering, but that suffering could not extinguish his purpose. The beauty he created continues to move strangers who know little of his struggles but instinctively recognise the greatness of the human spirit behind his work.

Therein lies the central insight of Stone’s novel. The human mind is not simply a passive observer of life’s circumstances. It interprets experiences, assigns meanings, creates possibilities, and sometimes discovers reasons to continue when circumstances offer little encouragement. The same event can overwhelm one person and awaken extraordinary resolve in another. A person’s inner world is as real as the external world in which they must live.

Cancer is an unwelcome biological invasion. It asks no permission, respects no ambition, and distinguishes no one as virtuous or careless. There are several well-established risk factors, including tobacco consumption, alcohol use, certain infections, environmental exposures, and inherited genetic susceptibility. Yet people who live remarkably disciplined lives, eat sensibly, exercise regularly and avoid known hazards can still develop the disease. Some cancers arise through the accumulation of cellular changes that cannot be attributed to any personal failure.

Cancer is particularly unsettling because it challenges our comforting assumption that good conduct necessarily produces good outcomes. Even someone who has taken every precaution may suddenly find life split into two periods: before diagnosis and after. Familiar routines give way to investigations, pathology reports, treatment decisions, hospital visits and the unbearable uncertainty of tomorrow.

The mind becomes a second arena of suffering, where fear of death mingles with anxieties about disfigurement, loss of independence, financial difficulties, interrupted careers, and the future of children. Some patients suffer more from the thought of becoming a burden than from the physical discomfort of treatment, while others experience profound loneliness despite being surrounded by loving relatives.

The family, too, enters a prolonged ordeal. A cancer diagnosis can reorganise an entire household, deplete savings of decades, and turn spouses into caregivers, children into anxious witnesses, and elderly parents into helpless spectators of their children’s suffering. Although modern treatments can cure or control many cancers, advanced disease may bring prolonged suffering and a slow, devastating decline, exacting an enormous emotional, physical and financial toll on the entire family.

What, then, can the mind accomplish?

Hope, emotional support, spiritual strength and a sense of purpose can certainly improve how a person experiences illness. They may help patients tolerate treatment, communicate their needs, preserve relationships and find meaning in ordinary days. But it would be scientifically misleading and morally unfair to suggest that positive thinking can cure cancer, or that patients who deteriorate have somehow failed to summon sufficient willpower.

The mind is no substitute for surgery, radiotherapy, chemotherapy, immunotherapy, or effective pain relief, but it helps a person retain their humanity rather than being reduced to a disease. This is where society must step in, going beyond celebrating medical technology to ensure early diagnosis, affordable treatment, pain relief, counselling, practical support for caregivers, and compassionate end-of-life care. It must recognise the immense unpaid labour of families and refuse to leave patients suffering in isolation.

Seen in this light, the Cancer Run becomes much more than a physical activity. Thousands running together declare that cancer is not merely a family’s private misfortune but a shared human concern. Such events can encourage screening, challenge stigma, mobilise volunteers, raise resources, and awaken compassion, provided that one morning’s enthusiasm translates into sustained support throughout the year. I now see my association with Dr. Chinnababu in this larger perspective. Beyond his surgical expertise, his remarkable ability to bring people together represents another dimension of healing: building a community around those most vulnerable. The surgeon treats the disease; the community must help protect the person.

The lesson of The Agony and the Ecstasy is that agony and ecstasy are inseparable dimensions of human existence. We are all mortals, and death comes in myriad ways, cancer being only one of them. What ultimately matters is not how long we live or how we die, but what we make of the days given to us. Michelangelo left behind masterpieces in marble and fresco, but a life lived with kindness is no less of a creation. A burden shared, a helping hand extended in times of distress, or a gentle word remembered long after we are gone can be equally enduring masterpieces of the human spirit. We may never have our names engraved in stone, but we can leave the goodness of our hearts in the lives we touch. May Dr. Chinnababu’s tribe increase.

Dr. Prithvi Raj Jampana is a distinguished radiation oncologist with extensive experience in radiotherapy and systemic treatments for a wide range of cancers. He trained in clinical oncology at Oxford University Hospitals and worked in the UK for over two decades before returning to India. He is now Consultant and Head of Radiation Oncology at Sindhu Hospitals in Hyderabad, a cancer-focused, not-for-profit institution inaugurated by Prime Minister Narendra Modi in May 2026. The hospital combines state-of-the-art technology with multidisciplinary cancer care—a fitting environment for a physician whose professional life has bridged two very different healthcare cultures. 

I first met Dr. Prithvi Raj in 2015 at CARE Hospitals, after his long professional innings in the United Kingdom and the National Health Service (NHS). During the following year, we jointly delivered a weekly lecture series on Healthcare Service Science. Conducting fifty-two lectures together proved to be an education for me. I came to appreciate not only his expertise in oncology but also his deep understanding of the human body, physiological processes and the relationship between scientific knowledge and clinical judgement.

Healthcare Service Science looks beyond individual treatments and asks how the entire system serves a patient. It examines the pathways through which people enter healthcare, how decisions are made, how resources are allocated and how the work of doctors, nurses, laboratories, pharmacies, administrators and families comes together. A treatment may be technically excellent, yet the patient’s overall experience may still be poor because of delay, fragmentation, financial anxiety or inadequate communication. Conversely, even a resource-constrained system can produce remarkable outcomes when its people coordinate intelligently and act with compassion. 

When I met Dr. Prithvi Raj again recently, after a long interval, our conversation naturally returned to healthcare. I asked him how he viewed the differences between the Indian and British systems, having worked extensively in both.

He responded with his characteristic equanimity and perspicacity. No healthcare system is perfect, he said, and searching for one wastes time. Every system continually evolves in response to its economic conditions, political choices, demographic pressures, available technologies, and public expectations. What appears unsatisfactory to one stakeholder may be necessary to preserve the system’s functioning. A system must therefore be judged not against an imaginary ideal but against the realities within which it operates.

This is a deceptively simple observation. Healthcare debates often run to extremes. The British National Health Service is either celebrated as the finest expression of social solidarity or condemned for its delays and bureaucracy. Indian healthcare is either praised for speed, clinical skill and affordability or criticised for inequality, commercialisation and high personal expenditure. Both descriptions contain elements of truth, but neither captures the whole picture.  

The NHS rests upon a powerful ethical principle: access to essential healthcare should depend on clinical need and eligibility rather than personal wealth. It offers universal coverage for NHS services, strong financial protection and, in England, a structured path beginning with the general practitioner. The general practitioner is the first point of contact, maintains continuity, and refers patients to specialists when needed. This arrangement can help reduce unnecessary specialist consultations and investigations while allowing scarce resources to be distributed according to clinical priority. 

Its great strength is social assurance. Illness does not ordinarily confront a person using NHS services with the immediate fear ofastronomical hospital bills. Consequently, the United Kingdom records comparatively low levels of out-of-pocket spending relative to total health expenditure. In 2024, direct out-of-pocket payments accounted for 14.6 per cent of total UK healthcare spending, including dental care, medical goods, and long-term care.   

But the NHS’s strengths also create its characteristic pressures. Because access is publicly funded and resources are finite, the system must regulate demand through referral pathways, clinical thresholds and waiting lists. A patient may wait for a specialist consultation, diagnostic procedure or non-emergency operation. Workforce shortages, an ageing population and the growing burden of chronic disease further strain the system. Standardisation protects patients and promotes fairness, but it can also create bureaucracy and sometimes limit an individual clinician’s or patient’s freedom to act quickly. 

India presents almost the reverse picture. Its healthcare system is plural, decentralised and highly heterogeneous. Government hospitals, private institutions, charitable hospitals, small clinics and individual practitioners operate side by side. In major cities, a patient who can afford care may consult a specialist directly, obtain investigations promptly and receive surgery or advanced treatment within days. Indian hospitals have shown remarkable agility in adopting technologies, building high-volume clinical programmes and delivering sophisticated procedures, often at substantially lower costs than those in many Western countries.

Indian medicine also benefits from adaptability. Doctors routinely manage enormous patient loads and make decisions when complete information or ideal resources may not be available. This produces a kind of clinical resourcefulness that textbooks cannot easily teach. India has created internationally respected centres in cardiac care, oncology, transplantation, ophthalmology and other specialities, while its pharmaceutical and vaccine industries contribute far beyond its borders.

Yet speed for some coexists with delayed or inadequate care for many. India lacks a uniformly accessible and strong primary-care and family–medicine system that serves as a trusted first point of contact. Patients often go directly to specialists and hospitals, sometimes undergoing fragmented consultations and repeated tests and procedures without continuous guidance. Rural and underserved regions face shortages of trained personnel and facilities. Quality varies widely, and families still bear a substantial share of healthcare costs.

India’s out-of-pocket health expenditure fell from 64.2 per cent in 2013–14 to 43.4 per cent in 2022–23, but it remains far above the UK’s 13.8 per cent. The tax-funded NHS provides most care without payment at the point of use, protecting patients from catastrophic bills, though often at the cost of longer waits. India’s mixed and fragmented system may offer faster access, particularly in the private sector, but medicines, tests and treatment can still drive vulnerable families into debt.

The contrast, therefore, is not between a good system and a bad one. It is between different trade-offs. Britain provides universality, continuity and financial protection, but often at the price of waiting and restricted choice. India offers speed, flexibility and rapid access to specialists for those who can pay, but at the price of inequality, fragmentation and financial exposure. Each system can potentially draw lessons from the other. The NHS can learn from India’s operational agility and capacity for cost-conscious innovation. India can learn from the NHS’s commitment to primary care, continuity, standardised pathways and protection from catastrophic expenditure.

The best future may not lie in copying either system. India needs to build its own synthesis: strong primary care combined with the energy of its private and charitable sectors; universal financial protection without stifling innovation; digital continuity without compromising privacy; and advanced hospitals connected to community-level prevention, screening, rehabilitation and palliative care. Sindhu Hospitals’ emphasis on modern technology and comprehensive cancer treatment represents one such opportunity, provided technological excellence remains joined to accessibility and humane care.

As our meeting drew to a close, I asked Dr. Prithvi Raj what single quality had contributed most to his medical career and to life in general. He answered spontaneously: resilience.

I then asked where that resilience had been formed. His memory travelled back to The Hyderabad Public School, where he studied from Class I to Class XI, between 1978 and 1989. A native of Kakinada, he spent those formative years as a boarder. There, he developed a passion for basketball. He and his teammates played for nearly three hours every day, continuing until the warden compelled them to stop.

Sport is indeed a royal road to resilience. Resilience is not a motivational slogan or a heroic claim that difficulties do not hurt. It is the cultivated capacity to absorb pressure, recover from disappointment, adapt to changing conditions and return to purposeful action. On the basketball court, one misses a shot, loses possession, falls behind and grows exhausted—but the game continues. There is no time for prolonged self-pity. One must regain position, support the team and prepare for the next play.

Medicine requires precisely this quality. A doctor encounters uncertainty, suffering and outcomes that knowledge alone cannot always control. Oncology demands it especially. Treatment may be prolonged, technology may change, and even the most carefully designed plan may need revision. The resilient physician neither becomes indifferent nor collapses under every setback. He remains sensitive without becoming paralysed, realistic without becoming cynical, and hopeful without misleading the patient.

Resilience is also the quality that healthcare systems need most. No system reaches a final, perfect form. Disease patterns change, populations age, costs rise, and new technologies alter both possibilities and expectations. A good system is not one that never experiences strain. It learns, adapts, and protects its moral purpose as it changes.

Dr. Prithvi Raj’s journey—from the basketball court at The Hyderabad Public School to oncology in Oxford, and from the NHS in the UK to Sindhu Hospitals in Hyderabad—shows that resilience is built long before it is publicly tested. It is formed through discipline, teamwork, setbacks and repeated return to the task. Whether in an individual life or a national healthcare system, resilience means accepting that perfection is unattainable without ever abandoning the pursuit of improvement.

I have been reading an English translation of the Kathasaritsagara—The Ocean of the Streams of Stories—composed in Sanskrit by Somadeva, a Kashmiri writer of the eleventh century. Organised into eighteen books, it is less a conventional book than an immense reservoir of narratives. Stories arise from within other stories, branch into still more stories and then disappear back into the larger current from which they emerged. The celebrated twenty-five tales of Vikram and Vetala are embedded within this extraordinary ocean. 

What fascinates me is not merely their antiquity. It is their survival. I can vouch that when I read them now in my seventies, I loved them. I could enter the tales almost effortlessly—as easily as one gets wet while walking in the rain. Something in them traverses geography and time. Or perhaps they resonate with something already present deep in the human psyche.

 Increasingly, I have come to believe that we do not merely tell stories. We live through them.

When we watch a movie or read a novel, we willingly enter a deliberately streamlined version of life. Irrelevant moments have been removed. Characters have motivations. Events lead somewhere. Cause and effect become visible. A good screenplay rarely says, “This happened, then this happened, and then this happened.” Its deeper grammar is closer to: this happened, therefore that happened; however, something intervened, therefore events took another turn. 

Real life is far messier. Yet when we remember it, we instinctively impose some of the same order upon it. 

We remember the song played when we had dinner with a friend, but often forget the food. We remember why we left a job, why a friendship ended, why somebody betrayed us, why a particular decision changed everything. Years later, the ‘event’ may feel perfectly coherent not because our memory retains the whole event, but because it retains the meaning we constructed from it—and perhaps the emotion we felt. The mind loses details while preserving much of the interpretation.

During the past two decades, neuroscience has begun to illuminate parts of this narrative machinery. Researchers studying people watching films and listening to stories have found that the brain naturally segments continuous experience into meaningful events. It also draws upon familiar ‘schemas’—mental structures representing situations such as entering a restaurant or passing through an airport—to understand new experiences. Higher-order cortical regions appear capable of representing an event’sunderlying structure even when its surface details differ.

In other words, we possess mental scaffolds for the kinds of stories life repeatedly presents to us. 

One famous experiment made this dramatically visible. In 2004, neuroscientist Uri Hasson, now a professor at Princeton University, and his colleagues placed five people in brain scanners while they independently watched half an hour of Sergio Leone’s film The Good, the Bad and the Ugly. Their brain activity showed striking synchronisation across viewers—not merely in elementary visual and auditory regions but across substantial areas of the cortex.

 Five separate brains, watching the same unfolding film, showedsignificant correlated patterns of activity in several respects. A film made decades earlier produced synchronised patterns of activity in their brains as they watched it. 

The brain, of course, is not a film studio, but the analogy is hard to resist. It selects scenes, identifies characters, predicts intentions, recognises familiar situations, marks transitions, and stores some experiences while letting countless others vanish.

And more than that, the brain does naturally what the storyteller does deliberately: it searches for patterns.

Perhaps this is why humanity’s oldest stories remain recognisable. The Mahabharata, the Iliad, the Odyssey, the Epic of Gilgamesh and countless oral traditions across civilisations repeatedly return to a surprisingly persistent repertoire—love and jealousy, loyalty and betrayal, courage and fear, ambition and sacrifice, justice and revenge, wisdom and folly, mortality and the desire to transcend it.

The familiar saying, “there is nothing new under the sun,” from Ecclesiastes, one of the wisdom books of the Hebrew Bible, resonates because of precisely this recognition: circumstances change enormously, while certain human patterns keep returning.  

This is also why stories are powerful—and dangerous. 

For a story to persuade, it must resonate with structures already present in the listener. Every culture therefore develops master narratives about success, duty, family, nation, honour, gender, wealth, heroism, failure and happiness. We inherit many of these long before we can examine them.

Then something subtle happens.

We keep living stories, fitting our experiences into parts of the template. Storytelling is therefore not merely entertainment. It is one of the mechanisms through which cultures reproduce themselves—and occasionally transform themselves. 

And now enters artificial intelligence.

When I decided to attempt ‘my’ retelling of Vikram and Vetala, I gradually began to see that AI could become a new-age Vetala.

The ancient Vetala never lets King Vikram walk peacefully towards his destination. Hanging over his shoulder, from inside the corpse, Vetala tells Vikram a story, presents a dilemma and compels him to answer. If Vikram remains silent, despite knowing the answer, he will die; so he responds, and Vetala escapes back to the tree.. Vikram must return, lift the corpse once more and begin again. 

It is a magnificent recursive structure. 

So, I decided to call my retelling Out of the Box. The ‘box’ is not simply conventional thinking. It is the invisible architecture of assumptions through which we organise reality.

Here AI becomes interesting.

Used lazily, AI can strengthen the box we are already in. Ofcourse, AI itself has boxes of its own, shaped by the information, patterns and assumptions embedded in its training and design, as well as by the information supplied in a particular interaction. It can tell us what we already believe, reinforce our prejudices, generate comfortable explanations and surround us with endless variations of familiar ideas. Recommendation algorithms can go further, repeatedly serving material similar to what has engaged us before. A machine that can predict our preferences can easily become an extraordinarily efficient manufacturer of intellectual comfort.

But that is the least interesting use of AI.

Its greater possibility is precisely the opposite.

 We can ask it: What am I missing? What assumption have I made? Argue against me. Interpret this event from another person’s position. Show me evidence that would overturn my conclusion. What would a historian see here? A scientist? A child? An adversary? What if the person I regard as the villain were telling the story?

Suddenly the machine becomes Vetala.

It pokes. It prods. It contradicts. It asks another question just when we think the matter is settled.

The greatest challenge in life is to free oneself from conditioning—to overcome fears, doubts, habits, compulsions and prejudices. Friedrich Nietzsche made ‘self-overcoming’ central to his philosophy: human beings must continually confront and transcend inherited limits rather than merely inhabit them. If human life is understood as an expansion of embodied consciousness, this becomes especially significant. Growth requires not merely acquiring more information, but seeing through the conditioning that shapes how information is received, interpreted and acted upon. True freedom begins when we can observe the forces shaping us without automatically obeying them.

For most of human history, such interrogation depended upon finding an exceptional teacher, philosopher, wise friend—or a story.  

Today, we can enter sustained dialogue with an artificial intelligence that has access to an extraordinary range of human knowledge and perspectives.

So, what next? Where do we go from here?

Perhaps towards a new kind of literacy.

The essential skill of the AI age may not be learning how to obtain answers from machines. It may be learning how to use machines to question the stories through which we ourselves operate.

 We must learn to recognise the narrative we have constructed, separate event from interpretation, distinguish memory from reality, invite alternative explanations and remain willing to revise the script.

 Let AI be Vetala, not Vikram. Use it to question and provoke; let itchallenge you. 

But we must remain Vikram—the one who walks, listens, decides and bears responsibility for the answer. For perhaps the purpose of every great story is ultimately not to tell us what happened to somebody else.

Is not the purpose of all learning, experience, travel and meditation ultimately to make us discover the story from which we ourselves need to escape?

One teaching of Dr. A.P.J. Abdul Kalam that I have always tried to follow is to ‘stay in circulation’, as he put it. By this, he did not merely mean travelling, attending meetings or remaining publicly visible. He meant keeping the mind in motion—meeting people, visiting institutions, listening to new ideas and allowing one’s own convictions to be questioned and renewed. Circulation prevents intellectual stagnation. It keeps experience connected with emerging realities.

Now that my health does not permit me to travel widely, I consider myself fortunate to live in Hyderabad, a city endowed with many fine institutions. I make it a point to visit some of them whenever possible and exchange ideas with people who have accomplished meaningful work in their chosen fields. Such visits are not formal obligations for me. They are opportunities to remain a student of life.

One such visit recently took me to the Banjara Hills campus of the Administrative Staff College of India (ASCI), where Dr. Subodh Kandamuthan, Professor and Director of the Dr. Kakarla Subba Rao Centre for Health Care Management, invited me to deliver an inaugural lecture to the new Batch 21 students of the PGDM (Hospital Management) programme.

It turned out to be one of those excellent visits that immediately occupy the ‘front seat’ of memory. The ASCI campus stands at perhaps one of the highest elevations in Banjara Hills. From there, one gets a panoramic view of KBR National Park, the precious green expanse that remains a vital lung for our fast-growing metropolis. The setting itself seemed to offer a lesson. As towers, roads and commercial establishments steadily encircle this surviving forest, one is reminded that progress must be measured not only by what we build, but also by what we choose to preserve.

The audience was pan-Indian: bright young students who had arrived at ASCI after walking meritorious academic paths in different parts of the country. Their presence represented India not merely as a geographical entity but as a confluence of diverse aspirations. They chose healthcare and hospital management at a moment when India’s health system is expanding rapidly but also confronting serious questions about affordability, access, ethics, and purpose.

What stayed with me most, however, was my tête-à-tête with Dr. Kandamuthan, a health economist. A native of Kerala with an MPhil from the Centre for Development Studies, Thiruvananthapuram, affiliated to Jawaharlal Nehru University, New Delhi, and a PhD in Health Economics from the Institute of Social and Economic Change, Bengaluru, his academic rigour is enriched by a perceptive grasp of India’s social complexities. In him, one can see the enduring social conscience of Indian society—a conviction that human welfare cannot be left entirely to the seasonal tides of capitalism.

Markets are powerful instruments. They can mobilise resources, encourage innovation and improve efficiency. But they cannot, by themselves, decide what a society ought to value. If profitability alone becomes the organising principle of healthcare, illness begins to acquire greater economic value than wellness. More tests, procedures, hospital admissions and interventions generate more visible revenue than fewer illnesses. The system may then grow financially while society becomes progressively less healthy.

From the stimulating and sagacious company of Dr. Kandamuthan, I could distil the need for a decisive paradigm shift: from an illness-based healthcare ‘industry’ to health economics rooted in wellness.

He drew attention to the wrong scorecard by which healthcare success is commonly measured. We count hospital beds, surgeries, diagnostic procedures, intensive-care facilities and insurance claims. These indicators are necessary, but they mainly tell us how much illness we are managing. They do not tell us how much illness we have prevented.

A hospital may perform thousands of cardiac procedures and be celebrated as a great success. But if many of those patients could have avoided severe disease through early screening, nutritional guidance, exercise, tobacco control, stress management and timely primary care, the larger health system has not truly succeeded. It has intervened efficiently at the end of a chain of failures.

Is not the cheapest hospitalisation the one that never happens?

This question brings us to the idea of the ‘Wellness Dividend’. In simple terms, a wellness dividend is the value created when individuals and communities remain healthy for longer. That value is not abstract. It is reflected in fewer hospital admissions, lower expenditure on medicines, reduced absenteeism, greater workplace productivity, longer working lives and less emotional and financial distress for families. It also frees public resources for education, sanitation, nutrition, housing and the treatment of illnesses that cannot be prevented.

Consider a person at risk of diabetes who receives timely advice, regular monitoring and sustained support to change diet and physical activity. If the onset of diabetes is delayed by ten years—or prevented altogether—the gain is much greater than the price of a few consultations and tests. The individual gains years of healthier life. The family avoids expenditure and anxiety. The employer benefits from greater productivity. Insurers face fewer claims. Hospitals retain capacity for those who genuinely need advanced care. The nation gains from the continued participation of a healthy citizen.

That combined value is the wellness dividend.

Yet our economic system often fails to recognise the wellness dividend because those who fund prevention may not receive its eventual savings. The benefits are dispersed across individuals, employers, insurers and governments—and may appear only years later. We readily calculate the cost of vaccination, screening or nutrition, but rarely the value of the illness prevented.

Realising the wellness dividend therefore requires incentives that give prevention measurable economic value. Healthy behaviour could earn lower insurance premiums, tax benefits or credits in a Personal Health Account. Employers could be rewarded for healthier workplaces, and primary-care providers for keeping communities well—not merely for treating them.

A Personal Health Account, linked securely with the Ayushman Bharat Health Account (ABHA), could serve as a lifelong health ledger supporting screening, vaccination, nutrition, mental wellbeing and chronic risk management, while safeguarding privacy and consent. It could also recognise citizens economically for remaining healthy, rather than paying only after serious illness occurs.

Hospitals and advanced care remain indispensable, but they must rest upon a vibrant primary-care system—the economic and moral foundation of modern healthcare. Without it, patients reach specialist care too late, illnesses become costlier to treat, and expenditure rises without proportionate improvement in public health. Family physicians, nurses, community health workers, nutritionists and local diagnostic centres may prevent more suffering than sophisticated hospitals can later repair; their contribution must therefore be recognised, measured and rewarded.

The movement from the economics of illness to the economics of wellness is ultimately a change in what we choose to celebrate. Do we celebrate only the dramatic rescue in the intensive-care unit, or also the quiet work that prevented a thousand people from entering it? Do we reward only the procedure, or also the years of healthy living that made the procedure unnecessary? Do we regard health expenditure as money spent after disease appears, or as an investment in human capability?

These are not merely philosophical questions. Nor are the Personal Health Account and the Wellness Dividend utopian ideals. They are practical concepts articulated by an astute economist whose thinking remains grounded in the realities of his country and its people.

India needs many more such conversations. It must also cherish institutions such as ASCI—places where administrators, economists, healthcare professionals and young managers can meet beyond their disciplinary boundaries and reconsider the assumptions governing public systems. Institutions acquire greatness not through buildings alone, but by creating spaces where experience encounters inquiry and ideas become instruments of service.

We must equally celebrate people such as Dr. Subodh Kandamuthan: true sons of the soil whose education has taken them across institutions and disciplines, but whose hearts continue to beat with their people. Their scholarship does not distance them from society; it returns them to it with greater responsibility. In their work, knowledge remains accountable to the ordinary citizen.

As I left the high-ground ASCI College Park campus, with KBR Park spread below and a new generation of healthcare managers beginning its journey, I felt renewed by Dr. Kalam’s counsel to stay in circulation. Sometimes circulation is not about travelling far. It is about reaching the right place, meeting a thoughtful person and returning home with an idea capable of changing how we see the future.