Heady with an inflated sense of achievement on acquiring a medical seat, a new medical student often gets a rude shock in the morbid world of human anatomy. The unclaimed corpses of the homeless who inhabit our cities laid out on dissection tables, human parts stripped of their coverings, the putrid smell of formalin, and the agonisingly long lists of tendons, muscles, bones and vessels do not fit the romantic image of medicine that they had. In every batch of new entrants, there are a few who feel so revolted by what they see in the anatomy dissection hall that they opt out of the course, or at least seriously contemplate doing so. All in all, anatomy can be boring and demoralising.
My encounter with Anatomy began in 1979 when I entered the precincts of that imposing institution called the Seth GS Medical College in Mumbai, along with a bunch of 179 other starry-eyed kids. After a rather staid and predictable welcome address by the Dean on the first day, we attended an introductory lecture by Dr ML Kothari, the Head of the Department of Anatomy, a day later. I did not know him at all and expected a stern, professorial figure, who would most likely deliver a didactic sermon on the importance of the subject. When Dr Kothari walked in, the first thing I noticed was the way he was dressed. A white khadi shirt, dull grey khadi trousers— and chappals. With a smile on his lips and a flourish of the hands, he proceeded to deliver an hour-long lecture in a stylish accent, occasionally betrayed by a Gujarati accent and tinged with a nasal twang. The lecture was a piece of oratory, and liberally peppered with quotations and historical references. Although I cannot remember the precise lines, he started by saying something like, “Modern medicine is an illusion. It is powerful and tyrannical. Your job is to challenge it. Medicine was never learnt in classrooms. If you have any delusion about this, please drop it here and now.” And he continued along these lines, quite oblivious to the stunned and maybe even amused looks on the faces of the shocked students in his class. Strangely, not once did he refer to the subject of anatomy, the syllabus, the MBBS course or his department.
The batch of 1979 slowly settled into the tedious and regimented routine of the first-year MBBS course. Well-meaning teachers from the anatomy, physiology and biochemistry departments provided us with volumes of incredibly detailed information in monotonous voices. Dr ML Kothari, or MLK according to the peculiar convention in medical colleges, would appear periodically to hold a class. Every discourse was a repeat of his introductory address. Lecture after lecture, while we waited for him to finally come to the subject of anatomy, he steadfastly stuck to his unusual script – a flowery mixture of philosophy, history, poetry, news and humour, with only fleeting references to some fact related to anatomy. He quoted incessantly and liberally from Shakespeare, the Gita, Kant, Einstein, the Upanishads, Illich, Vivekananda, Tolstoy, Ramkrishna and many others. Sometimes, his entire lecture was just a string of quotes, which had but a tenuous link with each other. It would take the listener a considerable effort to decipher his meaning, if indeed, there was a thread at all. I must admit that after a point, I began to wonder what lay behind his conscious attempt to avoid the subject. I had been schooled in a rather didactic and examination-oriented style throughout my life, so I remember being quite uncomfortable with MLK’s persistence in not even remotely addressing core anatomy. I also occasionally wondered whether this reflected an inadequacy of knowledge or a disdain for the ordinary. Later, I heard from senior students that this was exactly how he had been for years together. Soon, I started getting the feeling that there was some method in his “madness”, and that he was trying to convey an alternative message. Towards the latter part of the year, I began to perceive some threads of thought in his eloquent outpourings and the quotes. In the course of my increasing interactions with him over the next 20 years, at the GS Medical College and KEM Hospital, I discovered slowly that his oratory was not just a matter of using high-flown language or sharing random thoughts; it reflected his life and maybe his angst.
The department of anatomy, on the second floor of the building, had a famous notice board on which MLK would put up a new quote, written in chalk, every day. These were sharp one-liners pregnant with meaning and often scorchingly accurate. Every comment was succinct and original. Only a highly original thinker could have managed this every day of the year. Later on during my undergraduate studies, MLK retired but continued as Professor Emeritus. This did not alter his relationship with the college as he continued to spend all his days in the department, teaching, guiding and often just chatting with the students and staff. For many years, he occupied a corner room in the Anatomy Department, where he and Dr Lopa Mehta, who worked together with him on much of his writing, explored their subject and wrote the books that they are known for. They also played host to a wide variety of visitors, with whom they chatted and laughed over a cup of tea. I was one such visitor. I often used to meet them for selfish reasons, in times of crisis. Whether it was a matter of seeking his advice on a ticklish situation that arose during one of the strikes led by us (the resident doctors) or a spat with the Dean, MLK was not just available, but supportive as well. I even remember approaching him when I needed funds for my first visit abroad for higher training in 1993. MLK had friends in educational trusts and a phone call from him helped me garner the funds.
MLK was not always sharply political and confrontational. He would often respond to controversies with quotes and historical references. However, I remember one instance when he spoke in a distinctly partisan manner. That was when we had led a strike against the establishment of private medical colleges in Maharashtra. At one of the many stormy meetings in the grand Main Lecture Theatre (MLT) of the college, he went up on stage and declared before the stunned audience, “I support this strike. We must stop goddess Saraswati from being degraded and humiliated.” Although difficult to classify, MLK was primarily a contrarian and politically a humanist. He was a great and consistent critic of modern medicine in its current form. He was, therefore, also a natural opponent of market medicine, but more in a philosophical rather than political sense. His scathing and comprehensive attack on the approach of modern medicine to cancer – distilled in his magnum opus, which was originally published in 1973 with the title The nature of cancer – is, of course, well known. Different editions, and also versions, of this book came out later. Many thought that he had overstated his case, but I guess some degree of excess was necessary for his opinion to be heard in the din of assertiveness and arrogance characterising the world of oncology. In one of the eloquent obituaries written after MLK’s demise, Dr Sthabir Dasgupta, one of Kolkata’s leading oncologists, has described how the official cancer establishment chose to ignore him (1).
When Dr Sunil Pandya (SKP), the then Head of the Neurosurgery Department at the hospital, launched the IJME from his office in 1993, it was but natural that MLK would get involved. Though they never wore it on their sleeves, SKP and MLK shared a Gandhian background and were great friends. MLK supported the journal in its early days in various ways, including obtaining direct and indirect funding. He convinced a close friend, Jayesh Shah, who already ran a publication called Humanscape, to allow the IJME to use his office and staff for a few years. He contributed intermittently to its pages over the years, with letters, reviews and an occasional article. Surprisingly, though, he never became a member of the editorial board. I wonder whether it was his reticence or our failure to draw him in, but he remained close and yet far. It could have been that he was exploring a broader canvas and was perhaps busy writing one of the many voluminous books he penned together with Lopa Mehta.
In December 1998, I left KEM Hospital. On my last day there, I went to meet MLK. He spoke to me at length and signed a copy of his book, The nature of cancer. We continued to meet. On many occasions, I went back to KEM for some function or the other in the MLT, and MLK would be there. He was there when KEM started a humanities cell and arranged for a lecture by Jonathan Fine, the founder of Physicians for Human Rights. When there was a condolence meeting for one of the staff members, MLK was there. When we felicitated organ donors, MLK was there. When the Department of Anatomy invited me to address a new batch of first MBBS students around four years ago, MLK was there.
I last met MLK when I visited my alma mater to participate in a panel discussion on “Corruption in medicine” during a student festival called Confluence. My batch mate, Hemant Morparia, and I arrived early and decided to meet Dr Kothari. MLK had moved to a room on the ground floor, next to the MLT. He greeted us warmly. Among other things, he recollected in detail how we had travelled together many years ago to attend a meeting near Mumbai and how we had chatted about everything under the sun on the way there and back. As I walked out of his room, I remarked to Hemant, ‘This is how I saw MLK 30 years back – the white khadi shirt and dull grey trousers, sitting amongst a pile of books; Lopa Mehta with him. Nothing has changed at all!” Well it did change soon. In a few weeks, MLK passed away, suddenly but peacefully.
This intellectual rebel, who strode the stage of Seth GS Medical College and Indian medicine, held sway over thousands of students with his oratory and his ideas over the course of five decades. When the batch of 2015 enters GS Medical College, anatomy will continue to be the difficult subject that it has always been. The corpses in the dissection hall are still likely to be the unclaimed bodies of the homeless of Mumbai. The lists of nerves, tendons, bones and vessels will still need to be memorised painfully. What will be missing, though, is a subversive figure dressed in khadi, with a deceptively sweet smile, exhorting the new students to rebel against, question and mock the hubris of modern medicine.
- Dasgupta S. Dr Manu Liladhar Kothari (1935–2014). Econ Pol Wkly. 2014 Nov 08; XLIX (45).