A doctor charts out the ills plaguing health care

“Ideals? In today’s world! Absurd!” my friend said, her pessimism heightened in election time.

I guess cynicism has become part of our world view. In his recently re-printed autobiography Yamaraja’s Brother (www.pragati.com), Dr MK Mani, Chief Nephrologist, Apollo Hospitals, Chennai, talks about how his patient, Jayaprakash Narayan, the last idealist in Indian politics, whose herculean labours toppled the Indira regime and installed the Janata government, soon became irrelevant to the new rulers. The doctor adds, “JP’s greatest failing was also Mahatma Gandhi’s, that he could not inculcate the selfless patriotism in most of us.”

The book’s title is from a Sanskrit verse (“Physician! Elder brother of Yamaraja! He takes only life, you take life and money too.”) The author explains how the system crams useless knowledge into medical students, fails to train them to treat the common ailments they would face in everyday practice. Ignorance and malpractice flourish as interns stumble along, with little guidance for procedures like draining fluid from the lung. True, there are great teachers in class and hospital ward, but few tolerate dissent. Role models of brilliance and integrity keep hope aloft but the problems, particularly in the public sector, seem endless — ill-equipped labs, overcrowded hospitals, thieving staff, greedy doctors taking cuts for referrals, specialists squeezing patients dry, exploitation of organ donors, unscrupulous kidney brokers…

However, the book also records a pioneering nephrologist’s commitment to professional ideals, which sometimes invite criticism and rancour, his admiration for veterans with medical ethics. With acidic bluntness Dr Mani condemns apathy and avarice in places high or low. Nor is he afraid of being politically incorrect. “Each politician or official who produced a mediocre doctor by using personal influence or following a wrong policy, should be treated only by that doctor. He should not be allowed to seek the best doctor in the country when he has condemned his constituents to be ministered to by the second-rate.” No, Dr Mani does not question social justice, only the unjust means adopted to promote it. He refuses to be cowed into striking, as he believes that a doctor has no right to abandon his patient, whatever the provocation. He insists that long-term preventive measures are vital to promote public health. 

Yamaraja’s Brother has no sleeve note with Dr Mani’s profile, his list of honours and awards — the doctor’s self confidence equals his humility. He spares no one, including himself. As he describes case histories and experiences in evolving methods of treatment in several work places including Sydney and Jaslok hospitals, we get insights into the doctor’s dilemmas, and into human nature at its best and at its worst. Knowing his “pigheadedness” in treating every patient alike, we are not surprised at his distaste for VIP patients, and their fussy entourage. Or for ditherers who oscillate between different doctors and systems of medicine. 

I am looking forward to reading Dr MK Mani’s second new book Letters from Chennai because I know that he is an idealist pure and simple, but his suggestions are pragmatic and commonsensical. His crisp, jargon-free writing is shot with wry humour. Even as we are moved by his visions of redressing past wrongs by enabling oppressed communities to reach the highest intellectual levels, his dreams of national unity in creating the best educational system and best opportunities for everyone, he adds this caveat, “But I told you at the beginning that I do not believe in dreams.”

He doesn’t have to. He has a strong hold on reality — family values, empathy for the less-privileged, and the feeling of responsibility to serve the people of his homeland.

The author is a playwright, theatre director, musician and journalist