There has been a well-orchestrated campaign in the media to amplify the devastating effect of the pandemic in India. While the excitement of some foreign channels to show emerging India in a bad light can be understood, why Indian channels chose to add to the mood of despair was baffling. If it was to put down the government in power, it was a pity. The nation is bigger than governments, and political parties have lost all credibility when it comes to serving people or working for the national cause. They are all in the business of powers with different optics.

Who makes the state? The civil service, the police service, medical doctors, nurses, and so on. These are made of people who are inducted through well-established selection procedures, are trained extensively, and who work as a well-knit bureaucratic system. All media houses are owned by business houses, indulge in rampant advertising for making money and use it to manipulate the power structure in the society. It is a vicious circle that the modern world is sinking into.

So, this brings up the question – are we living in a pre-set system, watching a game whose result is already “fixed,” like mere audience in a cinema theater watching a film, or, are we part of a civil society, stakeholders in the governance of the country and participants in its social development? The plight of the migrant workers in 2020, and the helpless people on the roads outside hospitals gasping for oxygen in 2021 have proved that the system as it exists has been highjacked by the powerful, and the ordinary people are fated to only struggle and endure. They are not even the viewers; they make the view, watched by the more fortunate others who feel good that it is not happening to them.

I read in the 1980s, Games People Play, a book written by Canadian American psychiatrist, Eric Berne (1910-1970), who created the theory of Transactional Analysis as a way of explaining human behavior. Everyday examples of the ways in which human beings are caught up in larger games was very insightful. People are born and die in poverty in spite of their best efforts.

As the world runs today, a young person joins an organization to become a life-time slave. All businesses are eventually owned by a few. And the elite have rigged democracy. You can never win an election if you are not supported by those holding the levers of power. The Electoral Bond scheme, by virtue of the anonymity it offers to donors, has already streamlined the financing of political parties by the big businesses.

Recently, I read, The Master Game, written by English biochemist, Robert S. de Ropp (1913-1987), a prominent author in the fields of human potentials and the search for spiritual enlightenment after his brilliant scientific career. He lamented that contemporary man, hypnotized by the glitter of his own gadgets, has little contact with his inner world.

In the 1980s, when de Ropp said so, there was no 24×7 TV, Internet, and mobile phones. In 2021, our minds are bustling at the seams under cognitive surplus and our inner worlds have indeed gone numb. An increasing number of people have slipped into a trance of indifference, and we are fast losing the collective consciousness that keeps a society functional and healthy.

Interestingly, de Ropp called the games played for wealth, fame, glory, and victory, as “low games.” He compared modern day “strivers” to pigs – getting their noses in the trough as deeply as possible, guzzling as much as possible, and elbowing the other aside as forcefully as possible. They are hungry to be known and talked about, like the proverbial cock on his dunghill, primarily to inflate the false ego and to keep it inflated. And there are leaders who would use these masses as bricks and mortar to make their citadels.

The family system is a meta-game so that people raise good children to work in the wealth-generating machines later. Religion is another meta-game. It peddles “salvation” to its followers and besides “attracting strategic investments,” an enormous amount of money is extracted from the followers for “operational expenses.” The great meta-game of science and technology is played for “knowledge”, defined to perpetuate power and profit of the corporations. What options do you have except for buying a 5G telephone, as and when it is available for sale? 

The Upanishads described the four states of human consciousness – waking, dreaming, dream-less sleep and a formless background for these three, called “Turiya.” American philosopher, William James (1842-1910) divided Turiya into Self-transcendence (self-remembering) and Objective Consciousness (cosmic consciousness). An increasing number of young people are getting attracted to alcohol and psychedelics in their desperate attempt to jump to the fourth level of Turiya, by taking a short cut. They are manipulating their minds by chemicals rather than going by the evolutionary path of struggle, pain and making the right and not popular choices.

Actually, before I find fault with younger people taking the short cut of substance abuse, I can see the grand failure of our vast religious enterprise to popularize the right techniques of introspection. Religion has become a branded business run by cults rather than being taught as a way to explore the real meaning of life. There must be some simple and practical system to help an individual to emerge out of a confused, hypnotized automaton state into dynamic, clear-minded self-realization, rather than making a puppet out of him. I found two promising methods which can be adapted to this effect.

Russian mystic and philosopher, George Gurdjieff (1866-1877 – 1949) felt that the traditional methods of self-knowledge—those of the fakir, (acquired through pain), monk (through devotion), and yogi (through study)—were inadequate on their own and often led to various forms of stagnation and one-sidedness. He gave a “fourth method” of inner development in oneself to shift from a semi-hypnotic “waking sleep,” to higher levels of consciousness by feeling and thereby remembering memories of our eternal journey buried in our consciousness.

American mystic, Richard Rose (1917-2005), used the humble term “retreating from error” for high-sounding “spirituality.” In his approach called “Psychology of the Observer: The Path to Reality Through the Self,” Rose proposed a method of becoming an observer of your inner world and feeling all the conflicts going on by sitting alone, cut off from the outer world, every day for some time. This simple practice, over time, will convert your fears and emotions into life-energy, your doubts into substance and facts, and you can live the life of a happy and healthy person.

The COVID-19 pandemic presented a contrast in the way it rolled out in 2020 and in its second wave in 2021 in India. The rigorous lockdown in 2020 prevented large-scale spread of infection and hospitalizations, and mortality levels in India did not exceeded the global trends. However, migrant workers suffered untold miseries and peeled off the veneer off a heartless, self-centered, and transactional society.   

Then, for many months, the pandemic appeared to have receded, and people were back to their carefree ways that included large gatherings and congregations, be it rituals, festivals or election rallies. Even cricket matches were watched by people in packed stadiums. The arrival of an indigenous vaccine along with other global brands created the hubris of India as a “Vishwa-guru” that was leading the world in effectively handling the pandemic. 

 And then, the second wave struck. Even the best hospitals raised their hands in their failure to provide oxygen to needy patients. Questionable therapies like administering convalescent plasma were used to earn enormous profits by the hospitals. Beds were given to highest bidders. Unproven medicines for COVID-19 were sold in the black market. It was as if vultures were hovering everywhere. People were out in the streets not having a hospital bed. To have people not have oxygen was really tragic. 

 What might explain these staggering letdowns in a country that was discussing QUAD with the US, Japan and Australia to counter China only on March 12, 2021? Suddenly, we were receiving oxygen tankers from other countries in aid to fill the demand deficit and a section of the Western media was showing shocking pictures of long lines of dead bodies waiting for cremation. The entire system seemed to have collapsed like a pack of cards. 

In engineering parlance, there are two ways of looking at systemic failure. One focuses on how one part of the assembly failed and took down the whole system. It is a more familiar narrative: find the missing piece, the worn-out cog, the exhausted element that brought the machine to a halt, fix it and voila! Supply shortage of Oxygen in hospitals was highlighted at the center stage of the COVID-19 second wave and fixing it was seen as mission accomplishment.

However, there is a second way of looking at systemic failure. It requires widening the scope to think about the system as a whole and how it crumbled. What turned the well-tamed COVID-19 pandemic into a quick-moving and relentless public health emergency? The answer is – mass religious gatherings, cricket matches, and a general attitude of “all is well” on the one hand. On the other, huge federal budget allocations to augment hospital facilities were found unutilized by many states. Both were the hallmarks of hubris – the arrogance of doing no wrong and doing nothing. A widespread view amongst people, that they are outliers, prevailed with many living in the false belief that “I am in some way distinct from the others, and nothing will happen to me.” 

Media channels had their own hubris. One reality was shown in so many different ways based on who was reporting. Negativity and cynicism were galore. TV reporters were seen cherry-picking scenes, rather than communicating the ground situation. Thousands of lives were saved by valiant doctors, staff and volunteers bringing oxygen from factories on their two-wheelers to help people in need. The way tons of liquid oxygen is now produced by our non-medical industry after modifying their plants in few days’ time is also historic.

 In Greek mythology, hubris is punished by the goddess Nemesis. Overconfidence in our specialness led to lack of preparedness, prevented collaboration with others, and limited the opportunities of learning from the experience of other countries. Deficiencies in administration and greed of the people emerged as punishment by Nemesis for the hubris of “world-power India.” Two lessons are apparent:

1. Panic mongering for profiteering – Most Covid positive patients may recover on their own. The things needed for them to do so are oxygen level monitoring to maintain a level of 93 and above, Paracetamol for fever and body ache, and home isolation to make sure that they do not pass on the virus to others. Large numbers of hospitals beds were occupied by the “affluent anxious,” denying them to those who actually needed them. People were seen squatting on beds for their “Masters,” should they need it. 
2. Highjacking of science – In any infectious disease, the virus mutates while jumping from one host to another. The science is that every mutation adds to transmissibility and virility is lowered. Mutations happen in clusters along the genome. In the SARS-CoV-2 virus of the 30,000-letter long genome, hundreds of mutations have happened and will continue to happen. A hype was created about “double mutations” and the “Indian mutation.” When intellectual garbage was overflowing like an open drain in social media, most of our scientists stayed away from making public rebuttal. 

Except the availability of a vaccine, and cognitive surplus on rampant media, there is no difference between the 1918 Flu pandemic and COVID-19. COVID-19 will run its full course over about 3 to 4 years and stop after herd immunity is achieved, making the virus incapable of causing any mortality. Till such time we need to be humble – moderation in living, and the self-discipline of wearing masks and maintaining social distancing. A very large number of people are just not doing this. 

Nature is as brutal as it is benevolent. Post globalization, in the late 1990s, a pandemic was imminent. It happened in 2002 as the SARS-CoV, in 2009 as H1N1, and then in 2012 as MERS. Luckily, it remained confined to a few countries. Finally, SARS-CoV-2 became a pandemic as a large number of infected tourists carried it across the globe while holidaying for the Chinese New Year in 2020. There were signs of trouble, but they were ignored to prevent losses by the airline and hotel industries. And we had the COVID-19 pandemic! 

A recurring theme in mythology is that of a man or woman who loses sight of human limitations and acts arrogantly and with violence, as if an immortal, and pays a terrible price for it. So, what is the lesson? 

Don’t get carried away and suffer despair. Be humble, live with humility, and like a reed, bend before the storm, waiting for it to pass by, which eventually it will, as it has to. Know your limitation of being a mortal and plan your life a little more meaningfully. 

I studied mechanical engineering and became a missile scientist as a fairly good accomplishment of a career, which got me an opportunity to develop India’s first titanium airbottles, used in missiles to power the control system. The airbottles were successfully tested at Aerospatiale factory in Bordeaux, France, in 1985, in my presence. I was floating on Cloud Nine as they say.

Then, two things happened. I had a severe bout of tachycardia and was admitted to Nizam’s Institute of Medical Sciences, Hyderabad, under emergency. My heart rate was 240 beats/ minute and ECG waves were not even getting plotted. I was given electric shocks that broke the spell. But then, I did not respond to any of the available arrythmia drugs and had several other episodes while in ICCU. 

There, on February 8, 1987, Dr APJ Abdul Kalam, Director Defence Research & Development Laboratory (DRDL), where I was working, visited me and right at that moment, I was in   tachycardia. He nervously asked Cardiologist Dr B Soma Raju, who was attending to me, if he could do anything. Dr Soma Raju asked him to procure Amiodarone HCL, a new anti-arrythmia drug recently introduced in Europe but yet to arrive in India. And Dr Kalam got the drug for me pulling it off in a way that only he knew how. 

Amiodarone acted on me like a “Sanjeevani.” Arrythmia disappeared like a bad dream and I joined my work in two weeks’ time as if nothing had happened. Realizing the ephemeral nature of life at a rather young age, I grew up in that one month as if by a few years. I gave my best to the Akash missile airframe and developed it almost single-handedly, winning in the process, Dr Kalam’s heart. He started calling me “Buddy.”

When in 1992, he moved to Delhi to head DRDO, Dr Kalam transferred me out of the missile program and assigned me, what he called the “superior” task of developing civilian spinoffs of defence technology. He observed that most of the medical devices and consumables were imported and that only the rich could use them. Life-saving medicine must be affordable and for everyone, he believed. 

We created a Cardiovascular Technology Institute with World Bank’s financial assistance routed through the Industrial Credit and Investment Corporation of India (ICICI), which later became ICICI Bank. I successfully developed India’s first coronary stent with Dr A Venugopal Reddy at the Defence Metallurgical Laboratory (DMRL), making the very special steel. This work fetched me the 1997 DRDO award.

In 1999, legendary Prof Kakarla Subbarao, Founder Director, Nizam’s Institute of Medical Sciences gave me Harrison’s Principles of Internal Medicine. It was such an intellectual feast. I have never read that quality of English writing – no jargon and the most complex ideas expressed in plain words and phrases of dew-like clarity. 

Dr B Soma Raju gave me Aequanimitas of William Osler that tackles head-on a timeless question: What makes a good doctor? “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head,” writes Osler.

In 2001, as if ripened to receive him, I met Maestro cardiologist Dr P Krishnam Raju. The only son of former Executive Engineer with the Andhra Pradesh Government and a landlord, Dr Krishnam Raju never allowed his wealth and privileges to act as deterrents to hard work. He won eight gold medals, every year topping his class, that included the first ever cardiology gold medal from the All India Institute of Medical Sciences (AIIMS) in the year 1978. Dr Krishnam Raju had been Head of the Department of Cardiology in Osmania Medical College, Hyderabad, till superannuated.

In 2005, we went to Myanmar together during Dr Kalam’s Presidency to help introduce super-specialty medicine there. Many people in Yangon spoke to Dr Krishnam Raju in Telugu. We learnt that their ancestors had sailed to Burma (earlier name of Myanmar) as it was part of British India and Rangoon (earlier name of Yangon) was the “happening city” as Mumbai and Dubai are now. 

When we were walking through the campus of Rangoon Medical College, Dr Krishnam Raju noticed that it was an exact replica of the Andhra Medical College at Vishakhapatnam (called Waltair by the British). He correctly predicted various buildings in the campus. The same engineering team would have constructed both the hospitals. The first Indian woman cardiologist Dr Padmavati (1917-2020) studied here. Her photo was placed in the conference hall. 

Sitting through the long sessions with Dr Kyaw Myint, the learned Health Minister of Myanmar, who had three FRCPs in Medicine (London, Glasgow, and Edinburg), General Tin Maung Aye, the Chief Cardiologist at the Military College of Medicine, and other doctors, I learnt that medicine had been more of an art and only very recently with the advent of interventional technology, was becoming a science. 

Any medicine is essentially a poison and what dose was good for a patient had emerged over years of scientifically collated “practice” of thousands of doctors across the world. Also, any new procedure that was not possible earlier is pregnant with long-term consequences, which must be anticipated for and taken care of through rigorous clinical trials. 

I have seen first-hand, how after the advent of computers, medicine was turned into a process-driven process with clinical guidelines, evidence-based treatment, and the diagnosis-related group (DRG) system, which turned hospitals into an industrial enterprise. Later, terms like “packages” started being used and finally medicine became a business enterprise driven by insurance companies ensuring that you get only this much treatment, and hospital owners ensuring that you are provided “all the possible services” that you can be billed for. 

So, what does a doctor do now? Is he destined to be a mere cog in the wheel of this money-making machine? The two biggest threats to medicine are doctors who buy their medical seats at a high price and then “recover the investment” lifelong from their patients; and private hospitals owned by faceless investors, mostly foreigners. These two are indeed a curse on the Indian healthcare system. 

Dr Krishnam Raju feels that the doctor-patient relationship is sacrosanct. As a doctor, if you lose the trust of your patient, you are finished. He feels that though things are not very good at present, India has not yet become as bad as other countries in this regard. Indian doctors indeed put patients’ care first, before profit. As we can see during the current pandemic, they are also putting their lives at great risk to save ours.

About the biggest health issue of our times, Dr Krishnam Raju quotes Mother Teresa, “The greatest disease … today is not TB or leprosy; it is being unwanted, unloved, and uncared for.” He feels that children are not caring enough for their parents and perhaps it is a backlash of the neglect of the ambitious people who chased their careers over their children when they needed them. There is hurt everywhere, like an overcast sky, and it is time to give priority to healing, loving and caring starting with our own selves and our families, friends, neighbors, colleagues at the workplace, acquaintances, strangers, humanity as a whole and extending to every creature living on the planet. 

When tall, handsome and perspicacious, Prof. RC Paliwal taught me Thermodynamics at the College of Technology, GB Pant University in 1972, it was amongst the first courses that acted like a moat that must be crossed to enter into the citadel of engineering. I started learning how tangible things like steam and ice are “made” by moving heat energy in and out of water. It was in those days that I learnt a mysterious term called “Entropy.” 

 Prof. Paliwal called “Entropy” the ultimate reality of the engineering world, while teaching the second law of Thermodynamics. In an isolated system, that is not plugged into the environment, entropy keeps increasing as the system inexorably becomes less structured, less organized, less able to accomplish the outcome for which it was designed and eventually slides into an equilibrium that is gray, tepid, monotonous and eventually dead. Everything that comes together, falls apart.

Later, when I read, through translations of the words of the 13th-century Persian poet Rumi, 

“I died as a mineral and became a plant, 

I died as a plant and rose to an animal, 

… As a human, I will die once more, 

Reborn, I will with the angels soar…” 

another aspect of entropy became clear. Nothing is lost. . . everything is transformed. When clever people are trying to organize things, entropy is shaking its fist at their effort. English philosopher-scientist Sir Arthur Eddington (1882-1944) cutely declared entropy as “time’s arrow.”

Our bodies grow and function following genetic material from our parents. The DNA & RNA inherited by us makes codons, which make amino acids, which make proteins. And from the proteins our body is built and draws energy from food, air and water. As time passes, the body ages and finally dies. So, is entropy the Maya? Not an effect but the original cause!

A 2003 paper proclaimed that the Second Law of Thermodynamics is the First Law of Psychology. It was written by John Tooby, Leda Cosmides, and H. Clark Barrett at the University of California. They called evolution, a story of ceaseless repetition and endless reincarnation of consciousness trapped into physicality. Whenever one sees functional order, one is seeing the downstream contrivances of natural selection. If we make a human being a closed system – free from society – the second law of thermodynamics tells us that every individual would start out and end up a horrifying monstrosity.

It is a well-established fact now that gene activity can be turned off and on by environmental or extracellular factors such as sensory experience, social context, hormones, temperature, diet, and photoperiod. These factors make gene action dynamic, contingent, and bidirectional. Continuous exposure to light, especially blue light emitted by the black screens of TVs, computers and mobile phone screens is changing the present young generations and the future generations through them. The bad news is that an increasing number of young people are opting for living single lives.  

Chasing and fleeing are not just sequences of muscle contractions – they are goal directed. A life without a goal is indeed an organic waste. When you are surfing the Internet – is it goal directed? If it is not, some faceless program soon sucks you into the entropy of “wanting” unnecessary things, which are mass produced for profit. How stupid is “liking” or “disliking” someone whom you have never met and would never meet! 

Similarly, poverty of the masses is the entropy of wealth generation by the few. It is the default state of mankind and therefore, widespread. Generation of wealth is a goal directed organized activity. Matter does not arrange itself into “things”; we need “engineering” to make products. Products do not get sold on their own. We need “businesses” to make them reach the needy and “collect” from them the “price” to plough back into making more and better products. Of course, money wealth thus generated, at times turns into entropy of gold and diamonds hoarded by the rich. 

So, make no mistake about the truth that human survival depends on how it controls natural evolution to its own advantage. When the coronavirus pandemic started, we could control it by the discipline of lockdown. Even a vaccine has been made in less than a year’s time. But then, we allowed entropy to enter into reckless behavior and a second wave of pandemic hit those areas where people allowed their pleasures and conveniences override caution.

Our biggest armory as humans is our cognitive, emotional, and moral faculties. These are provided to us by education, the family system and religion. We see that these three systems are infested with bugs unleashed by global corporations with long-term agendas and politicians out to grab levers of power.

Consequently, education is now seen as a gateway to get a job, a family has turned into a zero-sum give and take system and religion has regressed into rituals and cults. But worse still, our minds are getting polarized around our egos. Most of our emotions revolve around the pleasures and domination of others. Most of the educated, highly placed, affluent people of today are indeed highly insecure bundles of doubts. 

There is a trend to think as a stereotype, and act by projecting our own wishes upon others. Our leaders are marshalling evidence that confirms their convictions while dismissing evidence that contradicts them. “The Nation wants to know,” is the new cliché. These are all engines of entropy. Unless these are checked, mankind is going to be buried under cognitive wreckage and the garbage of consumerism. 

Swiss psychologist and philosopher, Carl Jung, famously said, “Until you make the unconscious conscious, it will direct your life and you will call it fate.” Entropy is our fate but not our destiny. Billionaires, Nobel laureates, sportspersons, professionals and artists do not emerge out of entropy. They are products of discipline, sacrifice, training and sustained efforts toward definite goals.  

When it is said that “the dust goes to dust,” it is not some random phenomenon. Cognitive evolution is the ultimate purpose of human life. So, live a conscious life. Know your place in the existential system. Control its processes, sense your internal milieu and interact with the outside environment, including people and institutions around you. Take only what is needed and dispose of what is not necessary. Even a little lowering of your guard, a little complacency, and you are “rushed and gushed” into the suction of the fiery mouth of consumerism, following the law of entropy.

A center of excellence is the best thing that can be created in this world. The reason is that it involves several decades of dedicated work, generations of people, and a great purpose that is relentlessly pursued without wavering. And above all, it changes destinies of countless people across generations. Unfortunately, India lacks such centers. There is no Indian university in the top 100 universities of the world and most of our national laboratories are not counted in the global comity of science.

I have been connected with the LV Prasad Eye Institute, Hyderabad, more as an admirer and know Dr G. Nageswara Rao, its founder, and Dr Tara Prasad Das, the second-in-command, as friends. In 1996, when Dr APJ Abdul Kalam started having difficulty in reading, I took him to the Institute. Dr Das checked his eyes, assisted by optometrist Ghanshyam, and he was prescribed glasses. He never had any problem with his eyes thereafter, but that visit created a lifetime bond between him and the Institute. 

When Dr Kalam became the President of India, Dr Das sought Dr Kalam’s help to start an eye hospital in Bhubaneshwar, to where he belonged. A word from Dr Kalam to Chief Minister Naveen Patnaikji made things move fast. I accompanied him on the inauguration day on July 3, 2006. At the time, Dr Kalam said, “This hospital has the great challenge of providing eye care support to Orissa (now Odisha) state where nearly 2 percent of their population is visually challenged as against the national average of 1.4 percent.” Sacrificing his retina research work wherein he is world-renowned, Dr Das stayed there for six years to ensure that systems and people were in place. And today, LVPEI, Bhubaneshwar is a center of excellence in its own right.

Months before he departed, in February 2015, Dr Kalam visited Rajgangpur in Odisha’s Sundargarh district to inaugurate a unit of the LVPEI there. True to its name, this beautiful district has half its area under forest cover and numerous colorful tribes dotting its landscape. But for someone who lacks the gift of vision, of what use is all this? The hospital soon became a hub for needy patients in Raigarh and Jashpur districts of Chhattisgarh, Simdega and West Singhbhum districts of Jharkhand, and the Keonjhar district of Odisha. There was no good eye hospital even in cities like Jharsuguda, Sambalpur, Deogarh and Angul in this region. 

While returning to Delhi, at Bhubaneshwar airport, Dr Kalam hugged Dr Das and said, “I am proud of you.” Who knew it was the last time they would meet! Today, similar to Rajgangpur – LVPEI has established hospitals at Rayagada, Berhampur and Keonjhar; the fifth one in Odisha is being built at Balasore, not very far from the Wheeler Island, now called APJ Abdul Kalam Island. 

I had my cataract surgery done at the LV Prasad Eye Institute, Hyderabad, on May 13, 2015, in the left eye and recently, on March 3, 2021, in the right eye. Dr Das received me at the hospital as a brother would. Both procedures were conducted by Dr Pravin V. Krishna, Chief of Cornea Division at the Institute. Dr Pravin’s father is a Radar scientist who worked for the Electronics Research & Development Establishment (LRDE), Bengaluru. In Defence parlance, ‘E’ is used for explosive and the second letter ‘L’ is used as abbreviation for electronics. Dr Pravin did his medical graduation at Bangalore Medical College and ophthalmology at Guntur Medical College. Living in Hyderabad for the last 19 years, he sees LVPEI as his sanctuary. 

Keep doing your work like a precision machine, in a sterile environment, serving people whom you don’t even know, is how I understand “Tapas,” as mentioned in the Bhagavad Gita, and what we can call “ardor,” in the modern world. People like Dr Nageswara Rao, Dr Tara Prasad Das, and Dr Pravin Krishna are indeed blessed souls who have been sent in this world to relieve pain. Ordinary people and those in the medical profession who opted for making money and collecting toys like big cars, diamond studded watches and gold tipped pens, would never taste the bliss these people feel.

How is a center of excellence created? And more importantly, how does it sustain itself?

For the sincere seekers of answers to these two questions, LVPEI is indeed gold-standard. First comes the land. It must be owned by the hospital. The Hyderabad campus of LVPEI is built over the land donated by LV Prasad Film Studio after their Telugu film Maro Charitra (1978) and its Hindi version Ek Duje Ke Liye (1981) proved blockbusters. Except giving his name to the institute, LV Prasad forbade his successors from interfering in it in any manner. Dr Nageswara Rao approached his non-resident Indian friends for donations in order to create the institution, like Buddha did to create the Sangha. Almost every room bears the name of the donor who helped create it. Later, Dr K. Anji Reddy, founder of Dr Reddy’s Laboratories donated a part of his fortune made in pharmaceutical industry to modernize the building. 

Next come the human resources. You need people for whom serving a patient is a “calling” and not a job. And they must be continuously trained by the best in the world and on the best of the machines. When Dr Rao was elected Chair of the Board and CEO of the International Agency for the Prevention of Blindness (IAPB), he refused to relocate to London and in an unprecedented gesture, IAPB shifted its headquarters to Hyderabad for his entire term in office. Everyone arrives at the Institute at 7 a.m. and attends one hour of learning before reaching their workstations at 8 a.m. Every month, employees are acknowledged for their good work through a peer review system. 

Good medicine rests on Research. What a patient needs must be sensed right by the doctor and delivered right by adapting global technology to the local conditions. Renowned scientist, Dr D. Balasubramanian, chose to work at LVPEI after his retirement from the Centre for Cellular and Molecular Biology as Director. He told me that it was here that he carried out the best of his work on stem cell biology and its use in restoring lost vision. Seeing him working in his eighties is like meeting a Rishi.  

Finally and of utmost importance is the working capital that is needed to provide world-class treatment and services on a day-to-day basis. The general solution is high tariffs that have given our best hospitals the tag of “five stars.” LVPEI has solved this problem by starting a “Sight Saver” system. Here, people voluntarily pay high tariffs, just as we buy a business class ticket while travelling by air. A part of this tariff is used to subsidize the treatment of poor people, who pay low tariffs and even nothing, in many cases. Like in the aircraft that ensures safe travel for everyone, there is no difference in the quality of the treatment. However, “sight savers” are given other facilities, like the use of a good lounge or parking area near the entrance and other making-you-feel-special mannerisms. 

Why are there not many other hospitals like LVPEI? May be goodness has to always be in limited supply! Not many doctors make it their life’s mission to create institutions that outlive their lives, keeping their families away from ownership, and living and dying while doing their work and serving others. I know many people who are in the Institute since its inception. It is not that they get the highest salaries here, but they feel rich on being a part of this Institute and put this bliss at a premium.