My medical student years!

A few days back as I was walking around the property where Anna and I live now, I noticed this coffee plant with many seeds, some turning red, almost ready for harvest! We have five coffee plants in the garden, all planted in 1963, if I can recall correctly. That is the year, when I finished the schooling moved on to my years in college. I remember walking around in the property with my father looking for places to plant the coffee saplings. He chose places where there is some shade, yet open to the sky! 

The coffee plants bear the history of fifty-five years coinciding with the beginning of my college life. Suddenly in a flash of moment, there was a train of thoughts connected with my college life, particularly of the Medical Student years!

I began my college life, studying the one year Pre-university course at the Union Christian College, Alwaye in 1963, after completing my schooling at the St Thomas High School at Keezhillam. My parents were keen for me to study medicine and my interest was in another direction-humanities. So during the one year course, I did drift from focussing on science to subjects of humanities. I felt inclined to think about the future in journalism! My parents could not be reconciled to that. Having not qualified for medical course in Kerala, when there were only two medical colleges with 300 seats,  I was ‘sent’ to Nagpur to study the first year BSc course, the marks of which was considered for admission for undergraduate medical course in the state of Maharashtra. 

The way my parents decided to send me to Nagpur was indeed a sudden through a coincidence.  While in the railway station for some work, my father happened to meet a student at S.F.S College, Nagpur returning after his vacation, to apply to the Medical College for admission. This student Mr T.G.Varghese, who is now a well known surgeon, was able to persuade my father about the prospects of getting into medical college, if one qualifies with a high first class. So in two days, I was made to get ready to go to Nagpur.  I was unwilling and confused. It was to be my first journey outside Kerala and the longest train journey that too in an unreserved compartment in the train. Travelling in the Trivandrum express to Chennai and then in the Grand Trunk train to Nagpur was a tiring and difficult journey with little food or any form of comfort in the summer of 1964. 

I accompanied TGV to a home in the CPWD quarters at Katol Road, Nagpur, where a bachelor Mr Sam lived. My parents had given me a pineapple and two packets of banana chips. I felt awkward to hand them over to Mr Sam, but left in the staircase, for him to find it. When he found it, he gratefully accepted it, but also sensed my anxiety state, of having come away from home. I remember his efforts to comfort and encourage and TG’s effort to be utmost helpful. The next day, I accompanied TG to the SFS College and found admission in the college and its hostel.  That was the beginning of the next eleven years of stay at Nagpur till I finished my post-graduate training in Paediatrics. 

I too got eligible marks to join the Medical college and began my medical studies in 1967. There was no hostel accommodation available for the first year medicals students, which meant staying in the YMCA at Sitabuldi, five kilometres from the college. Five of us bicycled to the college every day. The evenings were spent visiting friends and playing badminton, table tennis, etc.. I found the study of Anatomy and Biochemistry difficult and boring. My efforts to catch up with the class work did not seem to be enough. 

I got distracted by a left wing leader, late Mr A B Bardhan, who later became the national general secretary of the Communist party of India, who used to hold a weekly ‘durbar’ for young people to sensitise them about societal injustice and exploitation of the labourers and the weaker sections in the society. I was drawn into the heart of this philosophy and got involved with student protests and agitations, whenever the university increased the tution fees or passed any order that would inconvenience the students. On one such occasion, the students marched along the main road, blocking the traffic, to the Nagpur University premises. Just as we were reaching the University, the police dispersed us by using force. I received a few blows on my back with a cane, as I could not flee in a hurry, as I had my bicycle with me. I was bruised and bleeding, but hesitated to go to hospital for fear of being captured by the police and charge sheeted. It took about two weeks to recover form this physical and emotional trauma. The agitation was against an increase of two rupee in the monthly fees in the arts and science colleges. Some students who were arrested were put in to jail for three weeks.

After the heat of this settled and after Mr A.B.Bardhan referred to this  as the beginning of a long fight against the government and its policies, some sense dawned on me about the futility of this form of protests and the wasteful indulgence of my precious time. I felt guilty and awfully disturbed, but here was none to talk to at that time. By then I had lost out even more, having missed college for several days. I tried to catch up with learning in the remaining five months, but it was not possible to make up enough to pass Anatomy. That was the first experience of failing in an examination. 

By then, I was marked by the professor of Anatomy for missing classes and performing poorly in the class tests. With the revolting spirit my communist ideology had created in me, I spoke against the ragging of the first years to the senior students! So they too were angry. All  the first  boys have had to shave their head, wear white uniform and bow their head whenever we met a senior student. Some suffered cruel forms of ragging including physical assault when they resisted while being ragged. So I was left with no friends and I could not use the grace period to pass Anatomy in such a state of confusion and self anger for the way I got carried away by the communist philosophy of life which sounded hollow on close encounter.  

So my search for meaning had begun. I was brought up in a home where Bible reading and prayer times were regular practices. I too had a personal interest to read and feel connected with the stories of Jesus of Nazareth. At this time, as for me I was doing the medical course which I did not choose. I was recovering from the embarrassment of failing in Anatomy examination. I did not feel connected with friends any more. There was a sense of loneliness and purposeless setting in. I returned to read the stories of Jesus from the gospel of St John, which made a new appeal to me. The 'I am statements' of Jesus became meaningful and refreshingly rejuvenating. 

I had to travel to Kerala during the summer holidays to visit my parents. I had not booked tickets for travel and the summer rush of travel made it difficult to find a sitting place in the unreserved compartments. I approached the travelling conductor for a berth in the reserved compartment, who readily allotted one to me, which to me was more than a 'miracle' ! This unusual provision 'worked' on me during travel and made me  thinking about the story of 'five loaves and two fish', a miracle Jesus of Nazareth performed to feed five thousand people. By the time I arrived home, I was ready to 'let go my life into the hands of God and His purpose'. That was the beginning of a new journey of faith and hope in a pilgrim journey with a keenest to follow after the person and teachings of Jesus of Nazareth. This experience restored confidence and enthusiasm and I returned to Nagpur with a new mind set to make the best of opportunity to learn and re-orient myself to the profession of medicine.

Having cleared Anatomy, I joined another batch of students who were warm and friendly. That was a good beginning of new friendships and relationships. From then, there was no turning back. I did well in all the subsequent examinations and returned to be 'myself' and to be at peace and restful. It was around this time Mr L.T. Jeyachandran had come to Nagpur as an officer in the Indian Engineering Service, who  was a good bible teacher and prayerful person. The local Evangelical Union he  helped to establish, became a rallying point for some of us to be nurtured in our faith journey. The weekly meetings of study of the Scripture and prayer times became formative in my faith journey. 

These friends, went on a retreat with Mr Jeyachandran and Mr P.T.Chandapilla, the general Secretary of the Union of Evangelical students of India for three days and came back enriched spiritually. Although I could not go due to the forthcoming examination, meeting with Mr Chandapilla was useful because he reminded me of the opportunity to befriend medical students to encourage them to consider the teachings of Jesus, in order to bring 'healing' to patients and not just medical care.  This was the beginning of an interest that grew within me to meet medical students from other medical colleges who have a similar interest to follow the teachings of Jesus in the practice of medicine. I expressed this interest to Mr Chandapilla in a letter who directed my letter to Dr Frank Garlick, professor of surgery at CMC Hospital Vellore, who had by then resigned to visit medical students and doctors in order to encourage them to study and practice medicine with a sense of vocation! 

One another person, who influenced me to understand more about the role and call of the mission hospitals in India, was Dr. Howard Searle, who was a surgeon at Achalpur mission hospital, who visited me periodically. It was through him Anna and I got to know Dr Ray Windsor, a cardiac surgeon from New Zealand, stationed at New Delhi as the international director of the Bible and Medical Missionary Fellowship, who was then organising the some mission hospital leaders to come together to create the Emmanuel Hospital Association, an umbrella organisation to create a federation of mission hospitals in North India for the mission hospitals to stay together in their vocation! Dr Ray Windsor was the founding director andDr Howard Searle took over form him. I remember being told about this move and their interests to look for Indian medical specialists for the hospitals, as the overseas personnel working in the hospitals were made to leave India, as visas were denied to them. In that connection, Dr Ray Windsor visited Anna an myself, when we lived in Pune in 1975 to persuade us to join EHA, train at John Hopkin's University in public health and prepare ourselves to be involved in the leadership of EHA. We were more inclined to be fully available to the Evangelical Medical Fellowship of india,  as we were involved with it from its pre-formative stage, which did not happen as its leadership declined that offer. The mission hospitals continue to function in many parts of the North India, because the EHA became a stable organisation in the last fifty or so years to provide an affirming leadership to the mission hospitals.   

Dr Garlick came all the way to Nagpur to meet me in June, 1971 and stayed in my room for four days during which time, there was a common interest shared between us about getting in touch with medical students in some medical colleges to pursue their interest in 'health, healing and wholeness'! Dr Garlick himself was going to spend most of his time travelling to meet doctors working in mission hospitals to give them professional and personal support. That was the beginning of a common interest and long years of friendship that formulated the thoughts about the formation of the Evangelical Medical Fellowship of India, which actually took place in 1978.

Following the visit of Dr Garlick, I got even more interested in clinical learning and spent the evening hours in the wards to take history and examine patients. It was during that time in the evenings, there were many contacts with doctors who played a significant role in expanding my clinical interest. Dr Wachlekar, Dr and Dr Mrs Shivde, Dr Sainani, Dr puniyani, Dr N.K.Deshmukh, Dr Mrs Deshmukh, Dr A .M. Sur, to name a few. I was fascinated by their approach to clinical examination and bedside clinics. 

This new understanding of clinical medicine as a means to be in touch with the needs of patients and their unspoken needs made me even more curious to attend to the academic lectures with fervour. The surgery lectures which Dr Kadasane took, the medicine lectures which Dr B.S.Choube took, and the Ophthalmology lectures which Dr Iswarchandra took, are still outstanding  in my memory! As I was used to writing notes, it became a practice to go to the library in the evenings after the visit to the wards, and spend time till 10 pm habitually to catch up with what I lost in the initial two years by my indifference.  I felt good to have been asked in my final year by professor Marwah to pursue post graduate training in surgery and by Professor Sainani in Medicine and by Professor Deshmukh in Paediatrics. I knew that I had returned to the main stream in clinical learning and the teachers were appreciative of my efforts. 

I remember an embarrassing occasion when Professor Sainani was taking his grand rounds for hundred and fifty students, when I was asked to present a patient with Cirrhosis of liver. After a presentation which was appreciated for its content and clarity, when it came to demonstrate the sign of fluid thrill of ascites , I asked another student to keep the hand over the midline of the abdomen of the patient. Professor Sainani stopped me and asked me to request the patient to keep his hand over his abdomen rather than ask someone else to do it. Following this, a remark, by him, 'even good students make such omissions to apply themselves' was both a complement and a call to be more alert in developing good clinical practices. 

The final year was a fascinating year and I felt naturally inclined to spend most of my time in keeping up with all that needed to be done. My academic grade had moved higher because of which teachers offered to help me further with clarifications and brief conversations. I felt encouraged by the cohesion of facts and informations that made studying easier and stimulating. It was my habit to set apart time from Saturday evening till Sunday evening to reflect, pray, attend the Bible study and write letters to many medical students whom I had got in touch with through letters or visits. On an average, I would have written 20 inland letters each week end to stay in touch with friends in CMC Vellore, Manipal, Pune, Bombay, Coimbatore, etc. I recall the contacts with Suseel Tharien, Isacc Jebraj, Geeta Gananolivu, Prasanna Elias, Kuruvella George, James Chacko and some others as part of creating a net work of medical students. I feel grateful for the personal encouragement I received from Dr Garlick, Dr Sheela Gupta, Dr A K Tharien,  Dr Jacob Cheriyan and Dr Victor Chowdharie during my student years.  

I was directly involved along with Dr Garlick, in the planning of a medical missionary conference in December, 1974 at Chennai, for which I spent Sundays writing letters or preparing charts and display materials for the conference to make the delegates familiar with the health scenario in rural India. My friends, who saw me do this two months before the final exit examination thought I was getting distracted like what happened to me in the first year and dissuaded me to 'waste' my time. But I returned to the rhythm of learning from Monday. When there final year results came, I was myself surprised by the high first class marks that I had scored in all subjects except in Ophthalmology!

I recall the final year examination. There were special prizes for the highest scoring student in medicine and surgery. I was quizzed separately to be considered for that. I was glad that I was one of the three considered eligible.  As I scored well in practicals, professors of surgery and Medicine persuaded me to consider being a teacher in a Medical College.  

The one year of internship was a hands on learning experience. I felt distressed by the several Medical Termination of pregnancy I watched or assisted. Following a conversation with my professor of Obstetrics about my difficulty due to ethical reasons to be directly involved in the termination of pregnancy, I was relieved of that and given another responsibility to be in the 'labour room' for 12 hours. I felt privileged to be directly involved to welcome babies and prepare the mothers for the initial care of their babies. As I was considered to be dependable I was given the post-operative care of critically ill patients in surgery, which too was a rewarding experience. In Medicine, I was given the responsibility of looking after twenty patients and do  procedures such as Bone marrow aspiration, Lumbar puncture, Splenic pressure monitoring,  etc.  The community health posting too was stimulating as I was by then getting more interested for further training in community Medicine. One difficult part of internship was when I decided to abstain from the strike and continue working, which the residents organised for forty days for pay increase. I invited anger and reactive behaviour from colleagues and faculty on account of this as I was the lone intern at work.

Looking back over the years of undergraduate training, I know now that it  was a turning point in my life. I started my  training  hesitantly and drifted initially. I was given the 'grace of a new consciousness' of the purpose and mission in health care and was guided by friends and colleagues to embrace my training period as a formative experience in life. 

I have immense admiration for most of my teachers, who devoted their full time to teaching  without being distracted by private practice. It was common for senior teachers to come for the evening rounds and discuss ill patients with the undergraduates and post graduates. The patients were from poor socio-economic background and received good care under the leadership of able and efficient clinicians.

I was privileged to be in the debating society with Professor Lele as its leader. The opportunity to participate in some debates in the college and in the inter-collegiate competitions enlarged my  thinking skills. I had an opportunity to be included the college Basket ball team although I did not pursue it actively. The games of table tennis and Badminton were others that I enjoyed playing in the hosel. One special aspect of the clinical group I belonged to was the friendships that developed between us. Between the boys and girls in the group there was a healthy and supportive friendship that we spent a lot of time together in the wards learning form one another. Rani Kidambi, who married Abhaya Bung, and others girls in the group showed considerable caring attitude towards patients. They were advocates for distributive justice and inclusive health care. No wonder, Abhay and Rani went on to give leadership in tribal health through their organisation SEARCH at Gadchiroli, for which they recently received Padma Shree, a national recognition for their pioneering leadership.  

The hostel life was also an enlarging experience. The contacts with Ullas Jajoo and Abhay Bung were most inspiring as they came from Gandhian families, whose parents were involved in freedom struggle. It was in the third year, I started wearing hand spun clothes as a gesture of identifying with the spirit of the Independence movement. Later after fifteen years, although I abandoned it for the sake of convenience, it was a valuable experience to stay anchored in the  Indian context. During the internship when many of my friends chose to register with the General Medical Council, which was possible at that time, I felt comfortable not to do so. I am glad that I lived and worked in India. At the same time, I am glad for the opportunity to train overseas and get considerable help from colleagues overseas in pioneering the specialty of Developmental Paediatrics in India.

The villages around Nagpur had orange orchards. During week ends, in the winter months, it was possible to cycle to the orchards and pick up oranges that have fallen on the ground and collect enough to take back with us without having to pay for them. The oranges used to be sold for a packet of 100 for 20 rupees at that time. 

The city of Nagpur was small to travel from one end to the other at that time. There were some special residential areas like Dharampeth which was a planned part of the city. The temperature in the winter months dropped to 4 degrees celsius during the day time and touched zero level  at night. The special food, that I looked forward to at the Moti Mahal in Sadar was 'Chole and Bhatura' ending with banana milk shake. The caramel custard which was five rupees only in the Ashoka restaurant, was a special treat at least once a month. The Nagpur railway station restaurant offered western meals on Sundays which was a regular place some of us kept visiting. The coffee house in Sadar was a regular place I visited for breakfast after the Church service on Sundays at the All Saints cathedral.  The Christa Mahila Sadan, the meeting place for the weekly Bible study is a special place for me even now. 

The special friends whom I got to know are Sathu and Pushpa Waghmare, and Annie and Jimmy Samuel. During the student days, Alyosius philip was another good friend.  Late Mr A.S. karat and his family stand out as those with whom I had a special association and friendship. In fact when I met Mr Prakash Karat, his son recently, it was a delight to recollect the years of association with his family and father.  I recall  my contemporaries, Ray Thomas, P D Koshy, Mammen Cheriyan, and few others with whom there were many conversations and shared experiences. There were ups and down in relationships and communications, which looking back were also formative and helpful in finding the middle path in the journey of life 

Seven years spent at Nagpur during my undergraduate training and three years during the post graduate training are memorable and formative years in my life. I am glad that Anna and Arpit also had an exposure to the friends and acquaintances that I have had during my student years at Nagpur when they were at Nagpur during my post graduate training years! 

Life is a blossom, which ever way one looks at it..'What is that we have except what have been given to us'! I want to grow in gratefulness for what has been given, Anna, companion in this journey of life of learning, discovering and growing !

Life is an offering to others. I remain grateful for planting this consciousness through the way Dr Frank Garlick, Dr A.K.Tharein and Dr Ray Windsor related, cared and blessed us, as a couple  by sharing  their journey  experiences of life with us.  It is still a desire and I hope it would become more of reality in the years to come!


M.C.Mathew(text and photo)