On the eve of my cardiac bypass surgery on 6 February, 2004, at the Care Hospital, Hyderabad, my friend, Madhu Reddy, the Chief of University Press, who published Wings of Fire came to see me. He gifted me, Glass Palace, a book written by, perhaps the best of contemporary authors, Amitav Ghosh (b. 1956). I read the entire 552-page novel while still in hospital, recovering from the surgery. When President Dr APJ Abdul Kalam came to see me, he saw the book and asked me to brief him on it. 

Later, when I visited him at Rashtrapati Bhavan in May 2004, I stayed there for about a week and had the opportunity of telling him the story of King Thibaw Min (1859-1916), the last king of Burma, and the central character in the novel, during our daily walks in the Mughal Gardens. With the story of how Burma lost its freedom to the British as its backdrop, the novel brought out the involvement of Indian-origin people in Burmese society, the complicated business of timber and rubber plantations, the moral dilemmas faced by soldiers in the British Indian Army, when Japan conquered Burma, who eventually formed the Azad Hind Fauj and finally, their exit as victims of rioting when Burma regained independence in January 1948. 

While the entire coastal Burma was under British rule, the kingdom of Ava in Upper Burma was still sovereign, with Thibaw as king, living in the sprawling and magnificent Glass Palace in Mandalay. When it fell to the British in 1885, the king was captured with his family and taken away to India. He briefly stayed in Madras and was later shifted to the rather remote town of Ratnagiri on the Konkan coast practically under house arrest. A 30-room house was built for him, that exists even today. The king died in 1916 and after that, his family was sent back to Burma.  

President Kalam arranged my meeting with General U Kyi Thein, Ambassador of Myanmar (as Burma is now called) in New Delhi. He facilitated my visit to Myanmar along with cardiologist, Dr P Krishnam Raju. This visit helped revitalize “old but cold” India-Myanmar relations. Soon after, Myanmar President Senior General Than Shwe visited India in October 2004 and President Kalam visited Myanmar in March 2006. I was involved in both visits. In Yangon, we visited the mausoleum of Bahadur Shah’s Zafar, who was exiled here in 1857 after the sack of Delhi by the British. When Dr Kalam was signing the visitor’s book, we noticed the signature of General Muhammad Zia-Ul-Haq (1924-1988), President of Pakistan, who had been there in May 1985. 

Mandalay, located on the east bank of the mighty Irrawaddy River, 716 km north of Yangon, was pristine. Atop the 800 feet high Mandalay Hill, is the Sutaungpyei (literally wish-fulfilling) Pagoda. When we were standing there, our host pointed to a jail complex on the western side, where Lokmanya Bal Gangadhar Tilak (1856-1920) was imprisoned from 1908 to 1914 on sedition charges by the British. Lokmanya famously dared the judge who convicted him saying, “There are higher powers that rule the destinies of men and nations; and I think, it may be the will of Providence that the cause I represent may be benefited more by my suffering than by my pen and tongue.” It was during this period that Lokmanya wrote the book, Gita Rahasya.

Many years later, when I visited Tilakji’s house in Pune, I saw a tableau of Lokmanya writing Gita Rahasya in the jail. It inspired me to write A Modern Interpretation of Lokmanya Tilak’s Gita Rahasya. The book was published in December 2017, and I consider it my best work. The book was released by the Chief Ministers of Uttar Pradesh and Maharashtra at a glittering centenary ceremony to mark the occasion of Lokmanya Tilak’s call of “Swaraj is my birthright, and I shall have it” at Lucknow in 1916. At the event, I met Lokmanya’s great-grandson, Shailesh Tilak. He hugged me affectionately. A line from Glass Palace surfaced in my memory, “Every life leaves behind an echo that is audible to those who take the trouble to listen.” I felt as if a strange loop got closed with that hug. 

I recently read another excellent book, The King in Exile, by Sudha Shah, published in 2012, narrating the saga of King Thibaw and focusing on the struggle of his family in exile, especially the Queen and the four princesses. It is a deeply moving book, with meticulously collected old photographs, offering a powerful testimony of how fate tosses human lives. Times have changed but not the reality of this world. 

The effect of COVID-19 on migrant workers is a great human tragedy that people are not even willing to talk about. Old and dilapidated buildings are regularly falling in the rains in Mumbai and elsewhere, rendering people homeless overnight. In North India, floods in the Himalayan rivers every year wash away whatever little people living in their basins have, forcing them to live in perennial poverty. 

In what has become a ritual, a cruel pattern indeed, is the announcement of a “relief package” after every flood. In what assumes a comic dimension, the State government demands a very large sum, say in billions, and the Central government provides a moderate sum, say in millions, and no one really knows what the people who lost their everything to the calamity get and to what effect. There is no long-term solution to manage floods, even contemplated. We remain predominantly a rain-fed agricultural nation taking “chances” with the monsoon every year to bring enough water so that we can grow our food. 

Is the era of empires over? Not at all. Let us look at the present world closely. I recently read a 2019 book, The Big Nine, by Amy Webb (b. 1974) about how nine corporations — Amazon, Google, Facebook, Tencent, Baidu, Alibaba, Microsoft, IBM, and Apple — are the new gods of AI and are controlling billions of people. These “systems” operating the world don’t share the motivations, desires, or hopes of humanity but operate for their own efficiency and wealth. What do we do with our Swaraj? People, even the affluent, are fast losing control of their lives and businesses. Children who are settled abroad for their livelihoods are indeed living in glorified exile. Many elderly people die alone, helpless, and powerless, like King Thibaw.

When the biblical king, Solomon, declared, “What has been will be again, what has been done will be done again; there is nothing new under the sun” (Ecclesiastes 1:9), it was not a world-weary complaint against life’s monotony, but a truth, stated plain and simple. The nature of human life and the world that humanity makes for itself is indeed cyclic. Did we not see the emptiness of living only for being alive during the year-old and still-on-roll COVID-19 pandemic? Living under a hypnotic spell is alright as long as we don’t forget what it is to be human.

One of my fond childhood memories is that of visiting the hydel station cum water pump at Bhola, near Meerut City with my father. We took a public bus, which was divided into two zones – the front and the rear – and there was a differential in ticket. The road was a mix of strips of masonry and asphalt. The sight of gushing water was amazing! There were massive fruit-laden trees. We returned in the evening. 

After my father passed away in 1979, that connection was severed. But my younger brother developed a spiritual bonding with Swami Vivekanand Sarasvatiji, who had an ashram in the vicinity of the hydel station, and I visited him many times. Awareness dawned upon me that the water stream was in fact the Upper Ganges Canal built during 1842 to 1854 by the East India Company, connecting Haridwar to Aligarh for irrigation and as a waterway.

Once, in 1969, while returning from Haridwar, we passed through the Solani Aqueduct in Roorkee. The driver stooped the bus briefly so that everyone could see how the Upper Ganges Canal was flowing over a 300-meter-long bridge crossing over the Solani River. One passenger announced that the song, “Nanha Munna Rahi Hun, Desh Ka Sipahi Hun” — from the 1962 film, “Son of India” was picturized at this location. Of course, I was more interested in looking at the pairs of large stone lions, placed at each end of the aqueduct.

In 1998, when Dr APJ Abdul Kalam went to the convocation of Roorkee Engineering College, now the Indian Institute of Technology, I assisted him in writing his speech. The speech recalled how this engineering college was started in 1847 to teach engineering to “the natives” to meet the need of constructing the Upper Ganges Canal and was later named The Thomason College of Civil Engineering. Dr Kalam thundered, “Those ‘natives’ have put a satellite into orbit and have now a Nuclear Weapon!” 

A nation moves ahead through big projects. The Manhattan Project that produced the first nuclear weapons decided the ending of World War II. Dr J. Robert Oppenheimer (1904 -1967) inspired Dr Homi J. Bhabha and Prof Vikram Sarabhai, whose leadership would later create BARC and ISRO. U.S. President, John F. Kennedy, on May 25, 1961, announced the goal of landing a man on the Moon by the end of the decade and it eventually happened. The construction of the Three Gorges Dam on the Yangtze River was a major project that put China on the road to become a World Power. 

So, where are our big projects? After the Light Combat Aircraft that made its maiden flight in 2001 could not be productionized till 2016 for political reasons, India is yet to see something big happening. Where are the new Nuclear Power Stations? The plan of Thorium-based reactors? Our passenger aircraft? Our Bullet Train? Why have we become a society continuously arguing on every little thing and unable to see the big picture and afraid to take strides? A big nation ought to think big, do big, and deliver big. 

What are the big dreams India can have? Becoming a 5-trillion economy is a neat, right, and doable dream. It is unfortunate that rather than a discussion on “how,” there is a chorus of naysayers, ridiculing the idea itself as if this nation must forever remain a nation of daily-wage farm labourers. Why not have ten of India’s higher education institutes in world ranking? A medical college with a 1000-bed hospital in every district? A house for every family? Tap water in every home? No open drainage in any city of more than a million people? If these things happen, the rest will happen automatically.

India must get rid of its perennial flood problem. This one “project” will transform our villages. Floods in India are turning more severe, unpredictable, and rather intractable every year. It is a no-brainer that hundreds of water courses originate from the Himalayas flooding Kosi, Gandak, Damodar, Brahmaputra and Mahanadi in Uttar Pradesh, Bihar, West Bengal, Assam and wash away properties and livelihoods of millions of people who as a result, live in perennial poverty. The Western Ghats have become the new flood zones and cloudburst-like situations are playing havoc every year. 

Why is the country of legendary engineer, Dr M. Visvesvaraya, shying away from discussing a River-linking project? We need to wake up to the fact that India accounts for 18% of the world population, which will become 20% and eventually 25% by 2050, and has about 4% of the world’s water resources, which will turn less than 2% in the same period. Which other solutions would solve the country’s water woes but to link our rivers? People getting killed by water in some areas and dying from dehydration in some other parts can’t be our destiny.  

Beyond water security, the canals as waterways would ease the stress on transport infrastructure, hydro power would feed grid, and fish farming would broaden income sources in rural areas. The cost of power generation by solar power is steadily declining and soon, say by 2025, renewable power would be available for water lifting/pumping, giving an advantage that was never there. But such an enterprise must be immune from electoral politics and declared by the Parliament as a National Mission.

The cost of not doing this is going to be existential. No national economy operates in isolation. People with vehicles at the petrol pumps swallow this bitter truth every day. The bumper crops in irrigated areas and dismal situation of rain-fed farming is a fact well laid out. I personally saw the chorus of “disaster” when the Sardar Sarovar Dam was created to better utilize the water of the Narmada in Gujarat. But now that it has happened, the transformation that has come is apparent and undeniable. We can’t condemn people living in river-basins to suffer every year and flourish as a nation. 

The Katha Upanishad declares, उत्तिष्ठत जाग्रत प्राप्य वरान्निबोधत – Arise, awake, find those who know and learn from them (1.3.14). The nation has seen enough of electoral bickering and petty politics during the COVID-19 pandemic. Finally, there is nothing for which any one can claim any credit. The system has exposed its inadequacies and the society, its organic defects. Why can we not come out of the hypnotic spell of words like “world leader”, “superpower” and the “largest democracy” and show something real for the good of the people, especially the poor and the powerless, who are fast losing hope.   

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.