When the 2026 Nobel Prize in Chemistry was announced on 7 October, I immediately thought of a scientist I have known and admired for many years—Dr. Srivari Chandrasekhar, formerly Director of the CSIR–Indian Institute of Chemical Technology, Hyderabad. The Nobel Prize went to Henri B. Kagan and Kenso Soai for their pioneering discoveries concerning how chemical reactions can favour and amplify one of two mirror-image forms of a molecule. Their work addresses one of chemistry’s most intriguing mysteries: why does life favour one of two molecular forms that are mirror images of each other, much like our left and right hands?

In February this year, I wrote an ode titled A Scientist and a Gentleman, describing my personal bond with Dr. Chandrasekhar. I recalled how, during my first visit to his director’s office, he personally fetched a bottle of water from a small refrigerator instead of summoning an assistant. That simple gesture revealed a humility I have always associated with genuinely great scientists. I also wrote about his formidable achievements in organic synthesis, particularly his work on complex natural products and pharmaceutical compounds, as well as his contributions to developing more environmentally sustainable chemical processes.

Dr. Chandrasekhar is a leading Indian exponent of chiral chemistry and asymmetric synthesis. His work includes methods for constructing the precisely arranged molecular fragments required for complex medicines such as eribulin, an anticancer drug. 

I take particular pride in having known a scientist whose work belongs to the same broad field of molecular science that this year’s Nobel Prize has brought into the global spotlight. You don’t need to land on the moon to enjoy the moonlight!

The word chirality comes from the Greek word cheir, meaning hand. To understand it, hold up your two hands with the palms facing you. Now bring them together in a Namaste, and they match perfectly. Yet, if you place one hand directly over the other, with both palms facing the same direction, they cannot be made to coincide exactly. They are mirror images but not identical objects. In the same way, two chiral molecules can have the same atoms and bonds but differ in the three-dimensional arrangement of those atoms. These two forms are called enantiomers. But why should the orientation of a few atoms matter so much? 

The answer lies in the exquisite selectivity of biological systems. Enzymes, receptors, transport proteins and many other biological structures are themselves chiral. A molecule must often fit into them with the precision of a key entering a lock. A right-handed molecular key may fit beautifully; its left-handed counterpart may fit poorly, fail to work, or engage a different biological target.

Thus, the same molecular formula can conceal two very different biological identities.

This is also how chirality can create ‘impurity’. During ordinary chemical synthesis, a reaction may produce equal amounts of both mirror-image molecules, known as a racemic mixture. If only one form provides the desired therapeutic effect, the other may be regarded as an unwanted stereochemical component. Sometimes it is relatively inactive; sometimes it has a different useful effect; and occasionally it introduces serious risks.

The pharmaceutical industry has learned this lesson through costly experience. Modern drug development increasingly depends on determining which molecular form produces the desired effect and whether the other introduces undesirable consequences. Regulatory authorities accordingly require attention to stereochemical identity, purity and biological behaviour.

This year’s Nobel Prize celebrates a deeper achievement of asymmetric synthesis: chemists need not always create both forms and painstakingly separate them afterwards. They can use appropriately designed catalysts and reaction conditions to favour the desired form from the outset. Kagan’s work demonstrated how a small initial imbalance could produce a disproportionately large preference in the final product. Soai explored an even more fascinating possibility: a reaction in which the chiral product helps generate more of its own handed form, amplifying an initially tiny asymmetry.

This brings me to a question. We know that ordinary glucose is predominantly D-glucose, one particular stereochemical form. Its mirror image, L-glucose, has the same molecular formula, C₆H₁₂O₆, and can taste sweet. But the human body’s glucose transport and metabolic systems have evolved mainly to handle D-glucose. Could L-glucose therefore offer sweetness without substantially increasing blood glucose? 

In principle, this is a scientifically interesting possibility. Because ordinary human metabolism does not use L-glucose in the same way as D-glucose, it has attracted interest as a potential low-calorie sweetening compound. But reduced metabolic utilisation does not automatically establish safety. Its intestinal absorption, tolerance, effects on the digestive system, manufacturing cost and long-term consequences would all require careful evaluation. No wonder L-glucose is not an established replacement for ordinary sugar for people managing diabetes.

Edible oils present a more interesting case. Oils are complex mixtures of triglycerides, molecules in which fatty acids are attached to a glycerol backbone. Some triglycerides are chiral, and the position of specific fatty acids on the glycerol backbone can influence digestion, absorption and physical properties. Digestive enzymes do not necessarily treat every molecular arrangement identically. Indeed, research into structured lipids has explored how modifying these arrangements might influence nutritional and technological behaviour. 

But it would be misleading to conclude that simply increasing the proportion of right-handed or left-handed molecules would make any edible oil safer. There is no universal healthy handedness. The health effects of oils depend on many factors, including their fatty-acid composition, degree of processing, oxidation, cooking conditions and quantity consumed. Chirality and stereospecific positioning provide additional possibilities for research, not a simple shortcut to healthier food.

Asymmetric synthesis helps chemists build complex molecules with the precise three-dimensional architecture needed for biological activity. In a potent anticancer compound, an incorrectly oriented group may compromise activity or introduce an unwanted interaction. Creating the desired stereochemistry is therefore not a decorative refinement but part of constructing the intended medicine itself.

Dr. Chandrasekhar’s achievements acquire special significance in this context. His group’s research on synthesising biologically active natural products and pharmaceutical intermediates required exceptional control over molecular structure. His work on the chiral building blocks of eribulin illustrates the painstaking ingenuity involved in translating complex molecular architecture into practical chemistry. 

I have spent much of my professional life observing how advances in one field make transformative applications possible in another. In defence engineering, materials that were originally developed for demanding aerospace applications found new uses in medical devices. In chemistry, the mastery of molecular handedness can similarly move from an abstract scientific problem to the construction of medicines, specialised materials and perhaps future nutritional innovations.

The field also has a philosophical dimension that fascinates me. Living organisms display a remarkable preference for molecular handedness. Proteins are built almost entirely from L-amino acids, while the sugars essential to energy metabolism and the structure of DNA and RNA predominantly belong to the D-series. The letters L and D, derived from the Latin words laevus (left) and dexter (right), distinguish two different three-dimensional arrangements of atoms, like mirror-image forms of the same molecule. This remarkable preference for one molecular form over the other is among the defining chemical characteristics of life.

It is tempting to extend the metaphor to human life. Two individuals may have similar qualifications, opportunities and intelligence, yet their character may lead them in opposite directions. Knowledge can become an instrument of vanity or an expression of service. Authority can demand submission or encourage independence. The outward structures may look similar, but their consequences can be profoundly different.

That was precisely what impressed me about Dr. Chandrasekhar. His intellectual achievements were accompanied by a disposition towards humility and usefulness. In his office, the simple act of offering a visitor water revealed something that no citation index or scientific award could measure.

The Nobel Prize celebrates a magnificent scientific achievement. For me, it also renews my appreciation for the chemists who devote their lives to mastering matter’s hidden architecture. I feel privileged to know Dr. Srivari Chandrasekhar, a scientist whose command of complex molecular synthesis belongs to this remarkable intellectual tradition.

Chirality teaches us that two molecules can be mirror images of one another and yet behave very differently in life. The same is true of human achievement. Scientific brilliance earns admiration, but when joined with humility and compassion, it becomes something greater. That is why, long before this Nobel announcement, I had come to regard Dr. Chandrasekhar as both a scientist and a gentleman. To me, he has always been a Nobel laureate in his own right, with or without the prize.

Rivers shape civilisations, nourish their fields, connect their settlements, and enter their collective memory. The Sindhu, Ganga and Kaveri helped shape the civilisation of the Indian subcontinent– a rich tapestry of kingdoms and cultures; the Nile sustained ancient Egypt and the kingdoms of Nubia in what is now Sudan. The Yellow River was one of the cradles of Chinese civilisation, while the Irrawaddy remains Myanmar’s great river artery, formerly Burma. In the Americas, the Mississippi flows through the heart of the United States, and the Amazon through the vast equatorial landscapes of South America.

I have visited one of the Nile’s headwater sources in Rwanda, sailed a few kilometres along the Irrawaddy, and visited Shanghai, the great Chinese city on the Huangpu River near the Yangtze estuary. I have also seen the Mississippi at three places along its approximately 2,340-mile course: Minneapolis, St. Louis and Memphis. In Memphis, I stood on its eastern bank. These encounters made rivers more than lines on a map for me; they became living connections between geography, history and human endeavour.

My tryst with the Mississippi came through three friendships. 

In the early 2000s, I met Madhusudan Reddy, who came from near Tirupati in Andhra Pradesh. He had migrated to the United States in the 1980s and founded US Electronics in Minneapolis, specialising in medical displays and related imaging technology. Through him, we attempted to develop indigenous digital X-ray systems at Electronics Corporation of India Limited (ECIL). The project also brought me into contact with James Lupino, who worked with US Electronics. Although our effort did not culminate in a working system, it gave me something enduring: a friendship with James.

In 2008, when I accompanied Dr A.P.J. Abdul Kalam on his visit to the United States, James came to San Francisco to meet us. We then travelled together to Los Angeles. After Dr Kalam returned to India, James took me on a long flight to Minneapolis via Phoenix.

I stayed in Minneapolis for a few days, enjoying the cool weather and the quiet, unhurried atmosphere. Minneapolis and St. Paul, together known as the Twin Cities, both lie in Minnesota, with the Mississippi winding through them. Farther downstream, the river forms part of the boundary between Minnesota to the west and Wisconsin to the east.

Even now, when my imagination wanders, it sometimes returns to those riverbanks. I find myself wishing that I might live there—if not in this life, perhaps in another. My belief in reincarnation leaves room for such a quiet hope. A river disappears around a bend without ending its journey; perhaps life, too, continues beyond memory. And perhaps, in some future birth, I shall find myself beside the Mississippi, feeling at home without knowing why. 

I visited St. Louis with Hamish Shahani, son of Chandru Shahani and Managing Director and CEO of Klenzaids Contamination Controls Pvt. Ltd. The enterprise his father founded in Mumbai began in the early 1970s, producing its first HEPA filter in 1971. From that modest beginning, Klenzaids helped build India’s cleanroom technology and biological containment capabilities. Its work included laboratories where carefully controlled airflow and filtration help prevent potentially harmful microorganisms from escaping into the surrounding environment. As India’s pharmaceutical and biotechnology industries expanded, such indigenous expertise helped reduce dependence on imported equipment and facilities, conserving valuable foreign exchange.  

What astonished me most in St. Louis was the Gateway Arch, rising 630 feet above the western bank of the Mississippi. Its gleaming stainless-steel exterior gives this immense structure an almost weightless grace—a single, assured curve drawn against the sky. Within its legs, a specially designed tram carries visitors to the observation deck at the summit. Its reinforced-concrete foundations extend 60 feet underground. The Arch was built between 1963 and 1965, although the larger memorial project began three decades earlier. To an engineer, it is a remarkable marriage of structural discipline and artistic imagination: every hidden calculation serves the simplicity of the visible form. Nearby, the historic Eads Bridge, completed in 1874, spans the Mississippi with three graceful steel arches—an earlier expression of the engineering imagination that would later create the Arch.

In the underground theatre, we watched a beautifully made film about America’s westward expansion. The historical turning point in 1803 was the Louisiana Purchase, which doubled the country’s territory; the Lewis and Clark expedition followed in 1804. St. Louis became celebrated as the “Gateway to the West,” and the Arch gives that name a monumental form. Beside the Mississippi, I felt how a river could be both a geographical boundary and an invitation to cross it—carrying people towards possibilities they could scarcely foresee. 

My visit to Memphis, in the southern state of Tennessee, gave me an opportunity to visit Professor Ramareddy Guntaka, whom I had known well before the journey through his Hyderabad connections. An eminent molecular biologist, he had made important contributions to research on collagen gene regulation and fibrosis. His work also extended to cloning and genetically characterising Indian strains of the hepatitis C virus. My friend, radiologist Dr Naiyer Imam, hosted me on that trip and accompanied me to see him. 

Dr Imam drove from his home in Roanoke, Virginia, to Charlotte, North Carolina, where he left his car at the airport before we flew to Memphis. What may seem commonplace today struck me then as a small cultural revelation: a long drive, an airport parking space and an onward flight fitted together with remarkable ease. Distances that appeared formidable on a map had become ordinary arrangements in everyday life.

At Memphis airport, the rows of FedEx aircraft were an astonishing sight. I was told that every night there were some 400–500 aircraft arrivals and departures. I had understood global commerce through companies, contracts and markets; here, its physical scale stood before me. Memphis houses the FedEx World Hub, where shipments converge, are sorted and depart again through a vast network of connecting flights. Behind each aircraft lay an intricate coordination of people, machines, information and time. Some things must be seen before their meaning can be fully grasped. That airport gave the phrase “global business” a tangible form.

Memphis also brought me back to the Mississippi, this time on its eastern bank. The river had long made the city a centre of transport and trade; the aircraft were a newer expression of that enduring role. The connection fascinated me. Barges followed the river’s course, while aircraft crossed the sky, both carrying goods across distances and linking one community’s needs with another’s work. The ancient waterway and the modern air network belonged to different ages, yet served the same impulse to connect.

America’s ‘Father of Waters’ carries more than its own stream. Through its many tributaries, the Mississippi gathers water from a vast drainage basin encompassing all or parts of thirty-one American states and two Canadian provinces. As it flows, distant landscapes become part of a common journey. Standing beside it, I could understand why this river has been one of the great forces shaping the United States. Its waters have nourished fields, sustained settlements and carried trade, drawing the life of an immense interior towards the sea.

After Minneapolis and St. Louis, Memphis revealed another face of the Mississippi to me. The visit brought together the warmth of an old acquaintance, the hospitality of a friend and a glimpse of the vast machinery of world commerce. Amid it all, the river continued its unhurried passage. Modern business measured its promises in hours; the Mississippi seemed to keep a longer account of human endeavour.

I shall not be going to the United States again, and these journeys now seem almost like dreams. Yet each encounter played its quiet part in expanding my inner frontiers, leaving me with more than I had taken there. James, Professor Guntaka, Dr Imam and Hamish all live within me, their presence still glowing with warmth. The journeys are over, but something of their life continues in mine.

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?