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Glorious 50 years

Indian Pediatr 2013;50: 68-70

Reminiscing the Past — For Glory of Future

BNS Walia

Professor of Pediatrics; and Former Director, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Email: [email protected]


The first question that I must answer is that Why I chose Pediatrics? In this context I am reminded of Mother Teresa’s answer to "How did you pick up your first destitute patient ?" The answer was – "He happened to come in my path. I also picked up Pediatrics, because it came in my path. In the MBBS final I had scored fewer marks than another classmate who opted for Medicine. As the only paid job that could enable me to do postgraduation was in Pediatrics, I had no choice. To tell you the truth, I wept, on that day. But we are unaware of Gods plans for us. My journey in Pediatrics was far happier and smoother than of my friend who got Medicine. Prof J N Pohowalla, was a very encouraging mentor and not only taught me pediatrics, but also shaped my character. He told me "You will be a happy man for giving up a Duchess and choosing a girl in rags." So do not curse your luck on an occasional failure but get up and start your work with a new vigor. You must do what you like and love what you do. Being in the wrong profession is like being in an incompatible marriage, with the additional disadvantage that you cannot change your path because you have already invested many years in it. I have no doubt, that it was my love for the kids that carried me the distance.

I joined the department of Pediatrics, at MGM Medical College, Indore in 1955. The department had only four members - a Reader (Dr JN Pohowalla), a Demonstrator and two House-physicians. The work load was heavy with an outpatient of about 150 patients and 18-20 admissions every day, for which the staff was grossly inadequate. Despite these constraints, Dr Pohowalla took upon himself to organize a conference of the Indian Pediatric Society, which placed a heavy load of work on all members of the staff, especially Dr Pohowalla. The conference was attended by about 60 delegates, but it left all of us exhausted. After the conference, one day I asked Dr Pohowalla, whether all the hard work he had put in was worthwhile and what was achieved as a result thereof ? His answer taught me an important lesson. He said "it is important to educate the medical educators and administrators." As regards the achievement, he said "We have taught the literate population of Madhya Pradesh how to spell Pediatrics."

Pediatrics used to be a unit of the Department of Medicine with a Reader as its head. A much respected Reader from the Department of Medicine, tried to dissuade me from joining pediatrics department by telling me, "You will not find it interesting. There are only two diseases that afflict children, diarrhea and pneumonia and there are only two medicines, oxygen and saline." Despite this well-meant advice, I joined Pediatrics and have never regretted my choice. In the last 50 years, Pediatrics has grown into a stimulating and exciting discipline which attracts some of the brightest students from the profession.

A matter of great concern in those days was that Pediatrics was not represented in the MBBS final examination and therefore students paid little attention to the subject. Our batch was posted for one month to the pediatric unit, barely three months before the 3rd professional examination. One of the students was not regular in her work in the ward. One day Dr Pohowalla asked her why she was neglecting her patients. She said our Pathology examination is so near so I am focusing on that. Dr Pohowalla told her "I can understand your pathological attitude to Pediatrics." The student retorted "No Sir, it is my physiological attitude to Pathology." Except the Nagpur Medical College and All India Institute of Medical Sciences at Delhi, Pediatrics did not find a place in the MBBS final examination till 1995.

In 1992, the Medical Council of India (MCI) formed a Committee to review the MBBS curriculum. Dr BNS Walia and Dr Jon Rhode who was the UNICEF representative in India were the two pediatricians in this Committee. This Committee recommended that Pediatrics should be a separate subject with a theory paper and practical examination. Dr B C Chapparwal who was Vice-President of the MCI, steered the proposal through the Executive Committee and General Body of MCI to make real a four decade old dream of every academic pediatrician.

During your professional life, you will come across numerous hurdles. Every hurdle is a challenge and every failure also has a lesson! Remember every hurdle does not require confrontation. Many of these obstacles can be bypassed and a lot of energy and effort can be saved. To give you an example when preparing the proposal for Advanced Pediatric Centre at Chandigarh, I was sure that if neurology and nephrology were included in the proposed plan for Pediatric Centre, it would be strongly opposed by the heads of adult departments of neurology and nephrology. Therefore, I chose the strategy of dressing up neurology with the name Developmental Neurology and avoid including nephrology altogether.

For success in your mission, you must know where you are going. The direction is more important than the speed of journey. Do not hesitate to get started. Every journey, howsoever long or arduous, starts with the first faltering step. Do not hesitate to change your course. Go on in the face of opposition. To quote Prof Pohowalla once again, he used to say "Let others do their dirty tricks, but they cannot stop us from working." Avoid conflict within the department as well as with other departments unless an important principle is involved. This is possible, if we are humble enough to acknowledge that, when we ourselves are not perfect, it does not behoove well of us to talk ill of others.

Pediatrics was well recognized in Ayurveda. There are chapters in the ancient texts dealing with illnesses of children. Modern Pediatrics in India was born in Mumbai in 1927, with Dr George Coelho, an outstanding physician taking over charge of the B J Wadia Hospital for Children in Mumbai. Numerous of his students like PM Udani, SM Merchant, MP Bhagat and JN Pohowalla, built on his legacy. Dr Coelho was a gentle soft spoken man. In spite of being bound to wheel chair, as a result of poliomyelitis, he found enough time to take care of children in the hospital, look after his busy practice and yet find time to edit the Journal of Association of Physicians of India!

Another giant who strode like a colossus in Kolkata was Dr KC Chaudhury. He set up his clinic in Kolkata on return from Vienna where he received his postgraduate training. I was told by Dr Pohowalla, who was a very close friend of Dr K C Chaudhury, that from the day he opened his practice, he started putting the fee received from the first patient of the day in a piggy box, which would be emptied periodically and the money transferred to a special bank account. It was this money that enabled him to buy land for the Institute of Child Health, Kolkata. His passion for building the Institute was such that he drained out his own bank account for construction of the Institute to the extent, that a cheque issued by him as payment for an Ambassador car, bounced. Here was a man with a clear goal who was willing to make any sacrifice for the sake of children of our land.

A few months after I joined the All India Institute of Medical Sciences; Dr PN Taneja took over as Head of the Department of Pediatrics. Prof Taneja was ‘energy’ personified. He was an inspiring leader not only of our team but soon assumed important role of Professor-in-Charge of College Section. No Dean or Sub-Dean had been appointed so far at the Institute. Prof Taneja established the entire system of curriculum plans of all departments for postgraduate education and for conduct of examination. He used this opportunity to persuade the Academic Committee to accept his proposal for introducing an examination for pediatrics in the MBBS final. This was a path-breaking innovation in the undergraduate medical curriculum and became possible only because of Dr Taneja’s persuasive skills.

Ability to tackle a crisis is one of the important tests of leadership. On one occasion, the safai karamcharis of the Institute went on strike from midnight. Before the men on duty at zero hour left their place of work, they choked the water closets with rags and gunny bags. When we came to work next morning, the drains were blocked and water spilling out in the corridors. Dr Taneja saw the situation and told the sister in-charge of the ward to bring some gloves. He donned the gloves and put his hand into the muck-filled water closet to take out the rags that were blocking it. Seeing him do this, Dr OP Ghai filled a bucket of water and I took a broom to wash the dirty floor. The place was clean in a few minutes and we resumed work. Other departments followed suit and the safai karamcharis had to come back to the negotiating table. Prof Taneja used to say you can influence the decision making in an organization only by working for it. If you willingly take additional responsibilities, you will be listened to. One of his famous quotes was "Energy can never be destroyed; it can only be transformed for a worthwhile purpose."

Unfortunately, Prof. Taneja resigned from his post after two years and academic pediatrics lost a charismatic leader. The pediatrics training programs for the undergraduates as well as postgraduates established by him are still being practiced with minor variations at the All India Institute of Medical Sciences. And that is the legacy of a man who combined outstanding clinical and teaching skills with leadership. After Dr Taneja left AIIMS, the Institute invited Prof Alex Stiegman of Mount Sinai Hospital, New York as a Visiting Professor. Prof Stiegman not only further improved the teaching program but also gave us important instructions for working as consultants or as departmental heads of the future. His advice that a departmental head has the additional duties of raising resources for the department and enabling younger members to achieve the departmental goals stood us in good stead at later stages of our career.

Pediatrics in India owes a tremendous debt to some of these stalwarts. There are many others like the ones mentioned in this narrative. We all pay homage to them in this 50th Golden Jubilee year of the Indian Academy of Pediatrics and vow to preserve their legacy.

MANDA MOOL NO KEEJAE JAY LAMBI NADAR NIHARIYAY (SGGS: 474).

Never hurt anyone, if you are farsighted.

I am sure if I am given another chance, I would like to work harder to improve my performance, so that residents do not have to discuss my shortcoming on the dinner table of hostel mess! But no one gets a second chance in one’s life, so whatever good you want to do, "Do it today." When you Dream, Dream it Big. You can’t hit the stars by aiming at tree tops. I shall be with you in all your dreams.

 

 

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