Metamorphosis of Medicine

by | May 1, 2021

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. 

MORE FROM THE BLOG

Look far ahead

Look far ahead

Since last month, I have been reading a rather scholarly book, The Book of Why, written by Israeli-American computer scientist Judea Pearl with Dana Mackenzie. The book deals with the often elusive relationship between cause and effect…

The Mystical Language of Numbers

The Mystical Language of Numbers

Is there an occult, divine or mystical relationship between a number and one or more coinciding events? In ancient Greece, Pythagoras propagated the idea that reality at the deepest level is essentially mathematical. He and many after him believed that a system of principles existed behind numbers…

A Moment of Civilisational Pride

A Moment of Civilisational Pride

I was born in 1955 in independent India. When I look back today, without hesitation, the best moment in public life I witnessed is the construction of a grand temple and the consecration of the idol of Shri Rama Lalla in Ayodhya on January 22, 2024…

33 Comments

  1. Respected Sir Thank You very much for blog , This write up is finest & simplest amalgamation of various discipline , Which stimulates many simulation in mind ,Aiming universal healing touch to all sentients being . In lockdown ,I binged watching YouTube videos one of them was yours lecture (Link https://www.youtube.com/watch?v=9Lnw3HHlH-o) in IIT BHU, where you shared many wisdom.

    While reading your articles , I do haves feeling of journey ,From Nobody to Somebody… on contents of blog ,As you talked in linked lecture .As after churning there are elixir , butter etc depends on extent & Kind of churning , Similarly there is peace & calmness after health struggles , Which yours smiles & confidences reveals in your write ups & Talk. I was not aware of your face off with health issue .

    Your blogs always touches many dots ( Science , Technology , Humanity & Glorious Journey of our Institutions) In viscous less way almost free from jargon { If there is jargon ( Now not to mention arrhythmia Tachycardia Amiodarone)….There would be a curious story behind it …Just like Immunity for disease, which acts indemnity for fear of loss of interest in subject..}. Which are indispensible ingredients of almost all product in all fields , Like क्षिति जल पावक गगन समीरा…. for any tangible & Intangible object of universe .

    Few days ago somewhere I read ,” Our experiences are our resources….” It is upto us how to react & Interpret to ensure its utilizations , Your articles tells a lot about it .

    Dear Sir ,In your blog you often recalls & Introduces us many kind soul & their act , I shows how much you value them .They don’t know us all , But through you ( As a Nimitt निमित्त), We gets to know them , Respected Sir Thank you , And thank them on behalf of all your reader .

  2. A thought provoking insight into the trends in Medicine, Prof Tiwariji !

    Your embedded optimism for the heart to exercise equally with head in this noble profession will come true to provide the much needed healing and caring !!

  3. Thank you Sir for sharing this wonderful article. It is always a pleasure to read about your enriching life experiences. Amiodarone is indeed a wonderful life-saving drug in arrhythmias and I was amazed to know that you were given the very first doses of it in India.

    Like you rightly said, medicine is a sacred profession. It is being misused and made commercial. But the sacrifices of the true and dedicated doctors in times of the pandemic make us realize the true beauty of this profession. I hope it stays the same and is less tainted with the money-minded corporate world.

  4. Wonderful narratives of your life, Sir. It’s amazing that you overcame difficult health crises. I agree with you that doctors and nurses are risking their lives during this pandemic to save others. You are also right in pointing out that some doctors purchased their medical seats and later, they try to recover their investments from patients which is very unfortunate. It is like a vicious cycle of poverty. Greed for money is the root cause of all evil.

    I am amazed to learn that the Telugu Diaspora were in Myanmar since a Century ago. David has been telling me that his grandparents used to have a Burma returnee Telegu cook in Cuttack. Now, I can connect your story of Telegu Diaspora in Burma (Myanmar). The Tamilian Diaspora gave me and my friend Romita a warm welcome in Myanmar in 2019 and I never knew that Telegu Diasporic community still resides in Myanmar. It is interesting to know that the Rangoon Medical College in Myanmar is an exact replica of the Andhra Medical College at Vishakhapatnam (called Waltair by the British). It reminded me of my visit to the University of Texas at El Paso, USA (Mexico border) where the campus buildings are an exact replica of the sub-Himalayan kingdom – Bhutan. The architects meticulously constructed the campus buildings in Bhutanese style.

    I like the way you concluded your article by emphasizing on nurturing human relationships.

  5. Dear Sir, what a wonderful narrative of your spectacular journey. I am happy to be part of your Care Foundation part. Working with Burmese Doctors was such a pleasure – excellent human beings and very hard working and meticulous.

    Ultimately, both our understanding of and personal approach to the patient-physician relationship depends on our perception of what it means to be human and of the purpose and meaning of human life. If there is any profession that requires its practitioners to be truly altruistic, it is the profession of medicine.

    Dr Kalam so clearly said during one of his visits to Care Foundation, “Medicine became distinguished when specialised knowledge was used for the benefit of the patient. It became noble when the needs of the patient held sway over the interests of the practitioner.”

  6. Sir, The narratives on evolving deep humanism is fascinating. It seems so natural and intuitive on the one hand but deep and profound in effect. These tumultuous times demand enough caring for oneself and healing everybody through love. The stories and ideas you weave do it. Integrating love and care with medicine, IT, Computer and Project Management is what the world needs now.

  7. Dear Arun Sir, Thank you so much once again to a very thoughtful blog. As always, your books and blogs makes me feel like am in a journey with you!

    The current situation certainly make humanity to awake on their perspective of everything thing in life – Not just in India but also across the planet.

    This blog highlights one the most common and highest realisation that there is a great need of unparalleled medical and health infrastructure for humanity. We learn through life and situation that comes along the journey – may this pandemic elevates us all together to a much greater heights in terms of us being more human, at the same time be more prepared in all aspects – including facing the reality of life – death!

    Thank you once again for this great blog. Keep sharing and keep inspiring! Regards.

  8. Dear Sir, An excellent summation of the present state of affairs in Health care sector in India. Munavvar Rana puts it very simply and bluntly the experience of going through the corporate hospitals. He says:

    ऐसे उडूं कि जाल न आए खुदा करे,
    रस्‍ते में अस्‍पताल न आए खुदा करे।

    May I escape to God without any hinderance
    I should not be admitted into a hospital before dying.

    Each one of us should ask for a simple end, otherwise we will complete our tenure of hell in these big corporate hospitals. Apart from buying the seat at UG and PG level, the doctors are surrounded by two important lobbies one pharmaceutical industry represented by their omnipresent medical representatives and pathological and radiological labs with fixed percentage returns to the doctors and to justify their action. “CONSUMERS ACT” comes handy. So for everything they need to carry out the TEST so that their skin is saved. But all said and done, it is the patient who suffers. But Doctors Like Dr P. Krishnam Raju and Dr G.N. Rao of LV Prasad Hospital are like Light Houses offering a lot of hope. And there are doctors in smaller places who do their duty for the love of the profession and for the patient, honouring the Hippocratic oath they have taken during their studies.

    Coming back to your journey, what a wonderful journey you had, mechanical engineering to titanium bottle design to Aaksh missile to metallurgical engineering to design of stent to going through o Harrisons Medicine book to William Osler to your Stint in Care Hospital with Dr B. Soma Raju to the present. It is an amazing journey sir! Your ability to grasp things which have no connection with your core specialisation, makes you a different and special person. Your ability put these complex and divergent subjects so clearly is amazing. I would once again quote the share of Munavvar Rana which aptly describes Prof Tiwari:

    खुद से चलकर नहीं ये तर्ज-ए-सुखन आया है,
    पाँव दाबे हैं बुर्जुगों के तो फ़न आया है।

    This style of writing has not come on its own
    I have served my seniors to receive this talent.

    This blog shows , your great effort behind your mastery over divergent topics. It is great pleasure to go through your blogs. Please keep posting your blogs which will benefit most of us.

  9. Dear Dr Tiwari, very illuminating and apt description of our current scenario. However, there seems to be no light at the end of the tunnel with pharma, insurance and business driving healthcare. While these have their advantages with money invested in research and technology that does benefit scores of patients, one of the golden rules I have heard during training is that “what is more important is to know what to do but know when not to do”. In fact, one of the most humbling one-liners I have learnt from our chairman Dr GN Rao of LV Prasad Eye Institue is “Go forth and do well, but more importantly, do good…”

  10. Thank you for this wonderful reflection on the state of healthcare in India. Many opportunities for improvement there and worldwide with the advent of new digital and other technology innovations.

  11. Thanks Arunji for presenting both the sides of the modern healthcare.. How some advances have been life saving and at the same time how the commercialisation aspect of healthcare taking away the humane angle anchoring around investors and insurers. It is always humbling to read about likes of Dr P Krishnam Raju who are among the rare ones these days to bring in compassion angle to treatment.

    I remember an incident from few years back where one of our close friends in mid twenties had both his kidneys giving up. Post couple of years of twice a week dialysis, he decided to go for kidney transplant. The operation initially seemed successful but then body didn’t seem to accept the new kidney. Eventually, things took a downturn. The friend came from a very very humble family. Basic insurance cover they had was possibly used up on day 1. The hospital bills were soaring but health kept on deteriorating.. And I personally saw the worse of it all when the body had turned green completely taken over by fungal infection, chances of survival very bleak and hospital recommending parents to arrange for 6 injections costing Rs 13k each as last resort with zero guarantee of improvement. Few of the injections were arranged & administered but of course, without not much positive change in condition. What a dilemma & dharma sankat a family has to go through in such times! Doctors may be right, going by the books, to keep looking for every possibility theoretically to save life even if practical chances of survival being close to zero. In the process hospitals, pharmacy and healthcare industry benefit but likely in good number of cases the patient loses life anyways and family drains up all their savings.

    An affordable healthcare with compassion & humanity is truly rare these days!

  12. As usual, I learned so many things from your blog. Your interactions with Dr. Kalam, Dr. Krishnam Raju, Dr. Soma Raju, and Dr. Kakarla Subba Rao reveal many fascinating dimensions of their personality and their dedication to a higher purpose in life. Your interpretation of those interactions is very engaging. We also get a glimpse of your own head and heart while reflecting on your blogs.

    Undoubtedly, the medical profession is one of the two noblest professions – Teaching and Healing. Luckily, there are some doctors who are embodiments of that nobility. My gratitude and thanks for writing this inspirational blog in this gloomy period of a pandemic.

  13. Hari OM Arun Tiwariji. Thank you for sharing your post on “Metamorphosis of Medicine”. Your experience of Dr.Kalam Sir ensuring the Sanjeevani of Amiodarone reached Dr. Soma Raju in your critical moment of need was very beautiful and as I read, I i felt felt almost in that moment.

    The second on your direction into the civilian spinoff which again resulted in another remarkable achievement.

    Both these two events remind me of the guru stuti and also indicate your love/respect for Kalam Sir. Though he himself preferred to treat you as ‘buddy” …

    ध्यान मूलं गुरु मूर्ति , पूजा मूलं गुरु पदम्.
    मन्त्र मूलं गुरु:वाक्यं , मोक्ष मूलं गुरु कृपा।

    The Root of Meditation is the Form of the Guru, the Root of Worship is the Feet of the Guru, the Root of Mantra is the Word of the Guru, the Root of Liberation is the Grace of the Guru.

    Prayers for the pandemic to be over soon. Unfortunately it does look like a storm is coming.

    Hare Krishna

  14. A wonderful blog post- Both insightful and promoting self-reflection.

  15. I am too young to comment on such a profound question. But I have seen you working with so many top doctors and on projects that would help ordinary people. You encouraged me to get into the medical technology area after my graduation in Computer Science Engineering.

    My first opportunity was a project which I did for my engineering third-year under Prasad sir (Care Foundation) on “Acquisition and Retrieval of ECG on Mobile Platforms” back then I didn’t know that after engineering I will be following the same field of work.

    I also recall my internship at the Institute of Nuclear Medicine and Allied Sciences (INMAS) where I learned about Nuclear Magnetic Resonance. I am now working at a global medical technology company Murata Vios, Inc.

    The Vios Monitoring System (VMS) is a wireless, FDA-cleared, internet of things (IoT) patient monitoring solution designed to improve patient outcomes and reduce costs. It enables clinicians to continuously monitor a patient’s 7-lead ECG, heart rate, respiratory rate, pulse rate, SpO2, and posture. It also accommodates the manual entry and input of blood pressure and body temperature data.

    There is no doubt in my mind that there is an immense possibility modern technology offers to make healthcare delivery better, efficient, and even less expensive. The problem is with the people who have infested hospital systems and medical supply chains with the sole purpose of making money. And some doctors are patronizing them.

  16. Yes, I agree with you. We do want some specialists but huge number of physicians are needed – the ‘the good old family doctor’ to listen to us, console, cajole and threaten us …all with COMPASSION. The compassion is mostly innate, but it needs to be developed in this new world. Best wishes to all and take care.

  17. Dear Sir, If there is a god who we can see who can resurrect a life its a Doctor, whom we believe, trust and follow for life time. There are so many doctors like Dr. P Krishnam Raju who are dedicated and put patients first and not money.

    The challenge is few who have fallen into the trap of corporatisation of the hospitals and advocating medicines/procedures based on pharma company /lab priorities for monetary benefits.

    Hopefully this pandemic will also open the eyes of the few who are seeing health is much more than wealth.

  18. Wonderful story Prof. Tiwari of your early history and struggles which I was not aware of. I can only imagine how much you treasured each day after your bout with Tachycardia.

    Healthcare indeed is a huge part of the economy. I hope and pray that technological advancements in such areas as medical imaging and AI-enhanced drug discovery will bring down the costs of healthcare to have a broader reach.

    As I read the Mother Teresa quote “The greatest disease … today is not TB or leprosy; it is being unwanted, unloved, and uncared for” it reminded me of an article I read stating that over 1.8 million children in the Philippines are abandoned, unwanted, unloved. A quick search online tells me India has nearly 30 million children abandoned – a rate slightly above that in the Philippines. There are many problems in this world, but the caring for children and healthcare for all should be a priority. May God grace us with more esteemed professionals like Dr. Krishnam Raju.

  19. Reading about the hardships you have faced and the achievements you have accomplished feels so unreal, Sir. You’re very humble and bright. One cannot imagine all that you’ve been through.

    It is unfortunate that Medicine has become a ‘business’ nowadays, but let’s trust and hope that there still are good doctors, like Dr. Krishnam Raju, that practice the art of medicine as it is meant to be—by serving and helping people heal. I aspire to be one of them, every single day.

    Thank you for reminding us about the moral necessities of medicine and doctors, Sir. As a blossoming doctor myself, I find your writings very inspiring.

  20. An article that describes the healthcare system in India precisely from the roots. Admissions in medical colleges up for sale, private hospitals extorting money as much as they could from it’s patients pushing them into financial hardships, insurance companies dictating the level of healthcare available to common man! All these depict frailty of Indian healthcare system. It is high time that we focus on building a healthcare system that best suits the needs of the public.

  21. Dear Arun, like every time, your blog has stimulated the readers’ mind. Medical profession in India has turned into business, aiming to recover investments made as quickly as possible. In turn patients have become the customers of doctors/hospitals.

    If you recall, when we took admission in GBPUA&T, Pantnagar, many engineering and medical colleges were not there in the country. Admissions were on the basis of merit and competence of the students. In these colleges students were coming from all strata of society, poor as well as rich. Students were aspiring to secure their future by looking for a decent job and earn a decent livelihood. Recovering the investments made in becoming doctor or engineer was not on top of their minds. But, now a days, the trend has changed especially in medical education. It has become very costlier and only rich students, wards of rich doctors take admissions in these costly colleges. After completion of study, they start “recovering their investments”. This trend has to be changed; we need to produce compassionate doctors, dedicated doctors in India.

    For a patient and his/her family, doctor is like a God. Walking on the path of trust and compassion doctors can become the messenger of God. Today, in tough times of pandemic, everybody needs to be Messenger of God and extend the helping hand to the needy. Wish you all the best.

  22. Dear Prof. Tiwari, William Osler’s quote in your blog “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 head” – simply put means “passion” and “service to the humanity”. Each profession involves both art as well as science, if we take a broader definition of science.

    As you rightly said, medicine has become a business enterprise driven by insurance companies and corporate, 5-star culture of private hospitals, where focus remains on billing. Added to this is the questionable quality of medical professional graduating from private medical colleges (the same concern remains in other profession also). You have rightly projected the threats to medical ecosystem in the country coming from “management” quota professionals and private hospitals run as business enterprises. One can add one more category of professionals coming from ‘reserved’ stream.

    The doctor-patient relationship is sacrosanct. If a doctor follows the ‘hearing- healing-loving-caring’ principle, half of the illness of a patient goes away. You have been lucky to have Dr. A.P.J. Abdul Kalam as your mentor and the guidance and support of the great professionals leading you to make significant contributions to the missile program of India. Well done. Warm regards.

  23. Arun, I read your blog well written in a concise way to highlight the issue in focus. Thanks for the kind words written referring to me. I suggest you write about the corona pandemic, its impact on the nation and the marginalised society. The tragedy of migrants labor is heart wrenching. Best wishes.

  24. Sir, Thank you for making us know more about Dr P Krishnam Raju. Unfortunately, medicine has indeed become not only commerce, but loot and doctors have become helpless in this money-making system.

    In the past, we spoke of patients, doctors, illnesses and compassion; we now speak of clients, consumers, providers, products, contracts, volumes and services. Today, doctors work in a world where the challenges imposed by the marketplace and self-interest are overwhelming.

    Advances in medical technology are enabling healthcare professionals to diagnose many conditions with modern investigative tools. The doctor’s involvement in this treatment is often only a technical one. It is hospitals and their owners who control everything.

  25. At a time when the subcontinent is bleeding due to the ravages of SARS-CoV-2 infection and the attending complications including death as the inevitable consequence, its heart wrenching to think of the pain the families affected are going through, Prof Tiwari and the people of the Bharat, please know we are hurting with you, our thoughts, prayers and condolences wont stop, that God intervenes in the best timely way possible.

    The article you posted is mind boggling first because of the reality it addresses; secondly what needs to be done in the circumstances at our disposal at such times as these. Generalization is not the most efficient of ways in dealing with a topic such as you have written about. The contribution that other disciplines of science have done to medicine can not be ignored, from NASA to what you write about as a ‘civilian spinoffs of the defense technology’, am blessed to have known and worked with a majority of the Professors you cited, their vast knowledge and innate abilities in sharing such knowledge at no cost is a lesson I shall never forget, Dr B Soma Raju, Prof Krishnam Raju, Dr Gopichand Mannam, Dr Srilamulu to cite a few.

    Essentially the best entry point in addressing any illness is addressing the causative factors if these are known, meaning bringing together the interplay of factors preventing diseases from developing rather than concentrating on the reversal of the illness once it has occurred, the former approach is very cheap all factors considered as compared to the later which consumes resources from the reserves of the index case and to those of family circles of close family members. Where possible investment should be prioritized in preventive strategies at the family level, if we are to expect sustainable outcomes in the community.

    Dietary habits are ignored while several illnesses have known linkages with foods being eaten or not being eaten. Lifestyles, it has been established that individuals who are sedentary run a risk of developing illnesses affecting vital organs such as the heart, endocrine glands, lungs and kidneys to cite a few. Drugs of abuse including alcohol are known to predispose to certain illnesses, not forgetting the habitual use of tobacco(nicotine)! The best solution: investment in prevention, through health education and community sensitization, then it can be expected that healthy bodies will be the results even among the economically disadvantaged.

    As said by Prof Krishnam Raju ‘As a doctor, if you lose the trust of your patient, you are finished’. When patients lose the link to you as humane provider of a solution to their problems, they will opt for an alternative and sadly whatever the cost. When all people look at themselves as potential patients, its not a problem realigning their attitude!

  26. Dear Sir, your article is most timely. The way people are suffering the COVID pandemic by the efficient system is shocking. It indeed shows a deeper malady.

    Medicine in India has become a business in the truest sense of the word. Physicians operate with impunity, knowing they are not accountable to anyone. While the General Medical Council (GMC) in the UK strikes a few doctors off its register every year for reasons of incompetence, negligence or unprofessional behaviour, rarely has the Indian Medical Association (IMA) cancelled a registration.

    On a personal level, no physician has the moral right to live extravagantly, driving luxury cars and live-in palatial houses. They must remember that they do so at the cost of thousands of patients; many of whom break their backs to undergo expensive medical treatment in private hospitals. Living modestly, being role models and remembering that medicine is a moral venture, rather than a business enterprise, should be the enduring ethos of all physicians. Salute to role models like Dr P Krishnam Raju.

  27. Excellent contributions to the field of science and healthcare by Arun Tiwari ji. The last para, as written, is extremely improtant to realise the underlying cause of increase in “mental health issues” amongst families globally. Mental wellness is key to the future of healthcare and we are determined to make an impact. Thank you for this article! Regards.

  28. Lovely read and very interesting insights. Do nice to know more about Dr P. Krishnam Raju garu, a brilliant, humble & principled cardiologist as I remember.

  29. Well here goes Prof. Tiwari on another tangent. All ‘aulias’ (friend, helper, supporter, patron and protector saintly spirits) do that. I happen to know two doctors mentioned in the piece above.

    1. Dr. S. Padmavati: She was working with Pant Hospital (govt. hospital) in Delhi and my 12 years cousin was under her treatment. What a tigress she was. Won’t tolerate a nonsense from anybody and what respect she commended from all around her.

    2. Dr. P Krishnam Raju: Prof. Tiwari only introduced me to him and I used to travel all the way from Delhi to consult him for my very serious heart condition requiring immediate intervention (as per couple of hospitals in Delhi). So much so that after my regular health chekup they insisted that I should immediately undergo the procedure and inform the family on phone to come over. Better sense prevailed and, on the suggestion of Prof. Tiwari, I visited Dr. Raju at Care Hospital in Hyderabad He did a through check up and prescribed some medicines. I asked him about the procedure. He said: I will tell me, if it is required. That was 6-7 years ago. No procedure has been done yet and I am doing fine.

    I have worked in American Hospitals also and there many malpractices crept in the medicare due to Insurance greed. Same thing is happening in India. But atleast for every 100 Kauravs, there are 5 Pandavas, who will eventually win.

  30. Dear Sir, “Health is Wealth.” However, this Wealth is now under control of big corporate hospitals and pharma companies. The doctors coming out from private institutions after paying huge amount for their medical degree are not serving the suffering humanity. They became an important tool of these big corporate hospitals and pharma companies. The prescriptions and treatment in hospitals are being managed by these doctors for the profitability of these institutions.

    It is one of the conspicuous trends in today’s world. There is widespread worry and will lead to myriad of concerns in the society. It has damaged the image of doctor’s in the eye of people. Attacks on doctors and health care institutions has been increased in past.

    The current Covid-19 situation has given an opportunity to the Healthcare workers to emerge as a warrior and regain the lost respect but the Iblis sitting on their head will definitely guide them to do something wrong, he will again sit in their mind and will say do it, make more money “कुछ नहीं होता” ।

    The doctors like Dr Krishnam Raju is the only hope to the suffering Healthcare sector and calling them to head this field from the top. Healthcare is very sensitive topic and should not be given to normal administrative officials to look into, they will behave like Eblis and will be making money. The recent Covid-19 bad situation after initial good control is a classic example that they had no idea about the basic management of diseases outbreaks, totally failed. Now, there is a time to review the whole system from top to bottom. Warm Regards.

  31. Dear Sir, thank you for this excellent blog. I consider myself fortunate to be taught by you at University of Hyderabad and introducing us to many great doctors including Dr P Krishna Raju.

    Medicine bridges the gap between science and society. Indeed, the application of scientific knowledge to human health is a crucial aspect of clinical practice. Doctors are one important agent through which that scientific understanding is expressed.

    In truth medicine is more than the sum of our knowledge about disease. Medicine is indeed a great art as it concerns the experiences, feelings, and interpretations of human beings in often extraordinary moments of fear, anxiety, and doubt. In this extremely vulnerable position, it is professionalism that underpins the trust the public has in doctors. The current trend of commercialisation is very harmful.

    Please take care and stay safe.

  32. In the modern world, patients want a more equal relationship with their doctor. The Internet supplies a wealth of information, not always accurate; science provides new technologies, sometimes potentially dangerous; management monitors and expects results in productivity, on occasions engendering unavoidable conflict.

    Dr P Krishnam Raju is a great role model of a doctor who keeps patients in their place using his immense knowledge, he is skeptical of interventions and relies on medicines and lifestyle changes by the patient, and he never succumbs to pressures of the hospital administration to write unnecessary tests.

  33. Dear Sir, It is indeed true that Medicine in India has become a highly commercialized business, where the bottom line is about profits and money. There is little or no regulation of medical practice or accountability for doctors. The overcrowding of public hospitals has been one of the major factors that have contributed to the commercialisation of medicine.

    Equally important is the lack of professionalism and integrity among doctors. They just think they are from some other world and treat others as dust particles. Not many doctors like Dr P Krishnam Raju are left to help patients with compassion. My respects to the great doctor!

Submit a Comment

Your email address will not be published. Required fields are marked *

Share This