I recall a conversation that some friends and I were having more than twenty years ago, on the eve of America’s bombing of Iraq months after Saddam Hussein had moved into Kuwait.  We all agreed that war was engineered into the American psyche:  the country seemed then, as it is now, to be on a war footing.  The bombing seemed imminent and thousands were bound to die, reduced to the indignity of being viewed as mere “collateral damage”.  Someone then remarked that while the United States was busy bombing other countries into submission, relegating them (as one American official declared with much pride) to the stone age, enough people were being killed on American streets from gun-related violence.

Another Olympic Gold for the US

Another Olympic Gold for the US

The newspapers carry the story of yet another massacre, this one at a community college in Oregon.  Lovely small-town America has had its share of mass killings and the end is nowhere in sight.  The killer, Chris Harper Mercer, is now reported to have taken nine lives before being killed in a gun battle with law enforcement officers.  Rather predictably, we are now being told that the gunman was a “loner” with quite likely a history of mental illness.  A Washington Post headline sums it up, “Oregon shooter left behind online portrait of a loner with a grudge against religion.”  The lack of “community”, the inability to forge relationships with others, the desire to go down in glory:  all these are the stable ingredients of a story that has been foretold.  Thus, we read, “Mercer was a quiet, withdrawn young man who struggled to connect with other people, instead seeking attention online or, ultimately, through violence.”  In nearly all such instances—the Charleston shooting, most recently, comes to mind—there is mention of the killer’s real or alleged membership in neo-Nazi groups, or other so-called “fringe” groups which bear a grudge against the de-whitening of America, and the Washington Post is unfailingly true to form in this respect.  The article states that “Mercer’s e-mail address referenced an iron cross, a symbol often associated with Nazis.”

The aftermath equally will hold no surprises.  All of America will come together in grief, there will be much hand-holding and some soul-searching, and a few noises will be made about gun control.  The country will be unanimous in declaring Mercer a “coward”:  there are, of course, much stronger words to be used for a mass killer, but cowardice is always deplorable and one can expect consent around such a characterization even amongst those who might otherwise disagree about the killer’s motives, the relative responsibility of an individual and society in such cases, the desirability for gun control, and so on.  In about a week’s time, or perhaps as soon as the funerals of the victims have been held, the news will have disappeared from the media.  The Pope will no doubt be saying a few prayers seeking God’s mercy for Mercer, particularly since the killer appears to have borne a grudge against “organized religion”.

We are being told that at least one thing is already different about the aftermath of this shooting, namely that President Obama is now coming out with all his guns blazing.  His acolytes, mindful of the ‘fact’ that he is no longer hobbled by the need to appease Republicans, argue that Obama is now showing true grit and determination, and according to some liberals he has already been redeemed by the political positions he has embraced over the course of the last year.  His comments on the Oregon shooting have been described by the media as displaying his “rage” and frustration, as he asked the American people to reflect on how they could get the government to change gun ownership laws and give young people at least an opportunity to grow up.  Obama, according to the New York Times, took a “swipe” against the NRA with these rather modest words:  “And I would particularly ask America’s gun owners who are using those guns properly, safely, to hunt for sport, for protecting their families, to think about whether your views are being properly represented by the organization that suggests it is speaking for you.”  But Obama, evidently still smarting from his resounding defeat by legislators from both parties to introduce gun control in 2013, admitted that he was powerless to change anything at all.

Only in the United States would Obama’s remarks be viewed as “radical”.  They are in fact nothing more than another instantiation of the pussyfooting which for decades has characterized what rather comically and tragically passes for ‘debate’ on gun control.  There will be the usual arguments about background checks and the desirability of keeping guns out of the hands of criminal elements and those who are mentally unsound; others will discuss whether schools and colleges should implement safety precautions; and there will be mention of a lengthier waiting period.  Thus, in this fashion, the ‘debate’ will go on ad nauseam—not moved an iota by the news that thirteen firearms were found in the possession of the gunman Mercer, all acquired legally.

Debate and Discussion in a Free Society:  Bullet-Proof Vests for Children in the Land of the Brave

Debate and Discussion in a Free Society: Bullet-Proof Vests for Children in the Land of the Brave

The Big Gulp:  More is Better

The Big Gulp: More is Better

Meanwhile, the NRA will go on the offensive, though the sheer idiocy of its position may be gauged from the comment put forward by Wayne LaPierre, the NRA’s long-time executive vice president, in the aftermath of the school shootings in Newton, Connecticut:  “The only thing that stops a bad guy with a gun is a good guy with a gun.”

Wayne LaPierre, Messiah of the Gun Lobby

Wayne LaPierre, Messiah of the Gun Lobby

One hopes that we will be spared the usual indescribably stupid remarks that are bound to follow from one spokesperson or another of the NRA and its supporters in Congress, something akin to this:  ‘Guns don’t kill, people do.’  What has been indubitably clear for decades is that the NRA makes or breaks political fortunes, waging a jihad against its opponents that has taken far more lives than the acts of terrorism ordinarily termed jihad.

What is called for is simple:  The National Rifle Association should at once be declared a terrorist organization.   The preponderant portion of even those who favor strict gun control, whatever may be meant by that phrase, will at once ferociously object that many members of the NRA, whose membership in 2013 was announced at 4.5 million—joined by “tens of millions supporters”, according to the NRA’s own spokesperson—are not only law-abiding citizens but recreational sportsmen who use their guns for simple pastimes such as hunting.  The rights of the hunter are, in America, described as sacrosanct.

The Hunter's Moment of Sublime Pleasure:  The Peace and Quiet of the Gun

The Hunter’s Moment of Sublime Pleasure: The Peace and Quiet of the Gun

Indeed, it is a reasonable supposition that Bernie Sanders, who represents Vermont in the US Senate and is now being projected as the radical or at least socialist wing of the Congress—the idea that there is a “socialist wing” is laughable, too preposterous for words—has often voted against gun control legislation because Vermont has a disproportionately large number of hunters and heavy gun ownership.  The ethical arguments against the slaughter of animals for pleasure aside, the days of Davy Crockett are long gone. As for those who point to the Second Amendment, its anachronism must go the same way as those odious measures which for centuries kept women, African Africans, and native Americans in subjection. When religious-minded people are prepared to concede that passages from their scripture or holy works must be rejected if they are repellent to the conscience, absolutely nothing requires allegiance to a portion of the US Constitution that is obsolete.

When, moreover, an organization is deemed to be a terrorist outfit, consequences must follow.  The NRA’s members might be given 30-60 days to comply with the ban on their organization and surrender their arms, and failure to do should lead to a freeze on their bank accounts and the issuance of an alert by Interpol which would prevent their travel outside the US.  Perhaps a leaf should be taken out of the methods routinely deployed in Maoist China:  a long stint, extending over several months and perhaps much longer, in a re-education camp for offenders would be highly desirable.  LaPierre and his fellow gun enthusiasts might perhaps learn that in all of Japan, there were two firearm-related homicides in 2006; in 2008, the number had gone up to a staggering, comparatively speaking, eleven—about the number killed in Oregon.  Private ownership of guns in Japan is nearly impossible.  With a population that is more than 1/3rd of the US, the number for 2008 might proportionately be raised to about 30—compared to 12,000 firearm-related homicides in the US the same year.  Lest the NRA dismiss the Japanese as “Orientals” who do not understand the spirit of American democracy, it is worthwhile noting that a background paper on gun ownership and gun fatalities released by the Council on Foreign Relations in June 2015 shows that the US has 88.8 guns for every 100 people, Australia 15, and the United Kingdom 6.2; the firearms-related homicide rate for every 100,000 people is 3.1, 0.14, and 0.07, respectively.

The NRA does not, of course, even remotely represent all firearm owners in the US:  as Obama himself noted in his remarks some hours ago, there is “a gun for roughly every man, woman and child in America.  So how can you with a straight face make the argument that more guns will make us safer?”  Moreover, the problem of guns in the US runs exceedingly deep, and the same militarism that has turned the US into a lethal military machine has every relation to the pervasive culture of guns that has turned the US into a country of gun shows, ammunition shops, firing ranges, massive gun ownership, and of course the mass killings that mark the exceptionality of the US.  The NRA is the most visible face of this barbarism and must be a dealt a blow which would render it extinct.

Veneration fora Poet:  The Tomb of Hafez in Shiraz.  Photo:  Vinay Lal, April 2010

Veneration fora Poet: The Tomb of Hafez in Shiraz. Photo: Vinay Lal, April 2010

It is no surprise that much of the discussion around the “Iran Deal” between Iran and a group of “world powers” led by the United States has hovered around several questions, none of which have any substantive bearing on the needs of the Iranian people or the consequences of the decade-long sanctions regime upon the people of Iran.  Now that Obama has weathered the storm, and evidently made it nearly impossible for Republicans to jeopardize the agreement, the discussion is focused on Obama’s attempts to secure his “legacy” and his surprising string of successes in recent months.  In the days preceding last week’s successful repudiation by the Democrats of the Republican endeavor to compel Obama into submission, public discussions revolved around other axes, such as the intense lobbying effort carried out by the American Israel Public Affairs Committee (AIPAC) and its powerful friends and supporters to deliver what was hoped to be a crushing defeat for Obama.

For nearly six months since the Iran Deal, or the Joint Comprehensive Plan of Action (JCPOA) as it is formally known, was announced in Lausanne on April 2nd, the New York Times has featured an extensive series of full-page ads in support of or, as was largely the case, in opposition to the agreement.  There may be no greater cliché which bedevils the Jewish community than the commonly held view which at once links the “Jew” to the world of money and banking, but here at least Jewish money seemed to be flowing as supporters and detractors attempted to set forth their case.  (A full-page ad in the New York Times runs to $150,000.)  One of the more interesting and yet bland ads appeared on August 11, headlined “We are all connected”, and carrying the signature of prominent Iranian-Americans.  Something more singularly insipid can scarcely be imagined, if we are to confine ourselves only to this emphatic declaration, “We are all connected”, the meaning of which is uncertain.  Are we connected merely by virtue of the fact that we are “human”?  Is there a tacit reference to the supposed fact that technology has brought us closer, or that technology has at least made us aware of the various ways in which we might be “connected”?  Or do the signatories of the ad suppose that there are certain universal norms—the feeling for the divine, some commonly accepted notions of parental love, and so on—which connect us to all other humans?  There is yet another strand of questions, prefaced by these two queries:  Is it always a virtue to be connected?  Why might we wish not to be connected?

However insipid and bland the ad, it is not without interest; it is certainly an object lesson in the limitations of American political discourse.  The twenty-four signatories commence their appeal thus: “Dear fellow Americans:  We are Americans of Iranian descent.  Like all Americans, we’re proud of our great country, and we vigorously defend the U.S. ideals of freedom and opportunity.  We’ve worked together to make this the best country in the world.”  In one stroke, American exceptionalism is affirmed:  the US is unambiguously pronounced to be “the best country in the world”, and tacitly it is suggested that the “ideals of freedom and opportunity” are best witnessed in the US.  From there, the ad moves on to an affirmation of another cliché that is now unquestionably part of the liberal consensus:  we, the signatories, do not agree on everything, but (like reasonable people) we can agree to disagree; but we do agree that “solving problems through communication is better for the world than conflict.  In the past few decades, wars have cost Americans thousands of lives and trillions of dollars, and conflict has persisted.  When we achieve America’s goals through diplomacy instead of war, we all win.”  Since the message is directed to fellow Americans, it is perhaps reasonable, many will argue, that the ad thus far is resoundingly about American lives and American objectives.  There is some uncertainty, too, about the “we” in “we all win”:  is the “we” a reference only to Americans of varying political disposition, or is it inclusive enough to include not just Iranians but perhaps all those who deem themselves citizens of the world?

Given that the signatories at the outset describe themselves as “Americans of Iranian descent”, the reader might reasonably expect that an invocation to Iran’s history or people is in order.  And the ad, in this respect, does not disappoint:  acknowledging that there are profound differences between the governments of Iran and “of the West”—the elision between the US and the West is noteworthy, presupposing as it does the firmly Anglo and Judeo-Christian nature of American dispensation—the ad states that “the people of Iran have a long history of tolerance, hospitality, creativity, and innovation that predates modern governments and religions—and these are values that Americans share.”  Governments may have differences, but “people” do not; or, to read the ad rather more forcefully, the differences that the signatories themselves have is not with Iran’s people but rather with its government.  Indeed, there seems here to be an invitation, even if disguised, to Iran’s people to reclaim their history and rid themselves of their government.  The ad concludes with a ringing declaration that “the people of Iran want peace, prosperity, and the pursuit of happiness just as much as Americans do.”  They may not consciously be aware of it, but the people of Iran are awaiting their Thomas Jefferson.  Join us, the signatories urge of their fellow Americans, “in embracing this unique opportunity for Americans and Iranians to connect.  Let’s make history.”

Among the signatories, I recognized the names of two scholars, Reza Aslan and Vali Nasr.  It is perhaps no little matter that Vali Nasr is the Dean of the Johns Hopkins School of Advanced International Studies, which, as I pointed out in a blog a few months ago, has been altogether shameless in accepting a gift that would help establish an institute in the name of the war criminal Henry Kissinger, no doubt to honor his skills in diplomacy and peace-making.  The American university has been selling its bricks, buildings, and mortar to the highest bidders for many years now, so there is perhaps nothing spectacular here.  I doubt that Vali Nasr would even recognize the slightest discrepancy between his appeal for peace and diplomacy and his joyous celebration of the gift to honor Kissinger.  But it is perhaps no small matter that Vali Nasr is also the son of Seyyed Hossein Nasr, one of the world’s most eminent scholars of Islamic science and philosophy, Sufism, and comparative religion.

Wondering what Seyyed Hossein Nasr might think of this matter, my mind came to rest on an image that I am unlikely ever to forget as I thought of the plea issued by Iranian-Americans to their fellow Americans.  In 2010, I had occasion to visit the tombstone of Hafez, 1325/6-1389-90 [also Hafiz], whose name is attached to the city of his birth and death, Shiraz [thus Hafez-e Shirazi].  Whatever the Iranian Revolution that brought the ayatollahs to power has accomplished or destroyed, it has been unable to shake the extraordinary affection in which ordinary Iranians hold Hafez, whose poems celebrate wine and women and mock the hypocrisy of the mullahs and the religious elite.  I never quite fathomed the veneration a people might have for their poet until I visited Hafez’s mausoleum.  Mobbed by people throughout the day, its visitors take their turn besides Hafez’s gravestone; many of them stoop down to kiss the cold stone, and then they plant themselves alongside it, opening their pocket version of Hafez’s Divan to their favorite poem.

The Mausoleum of Hafez in Shiraz, twilight hour. Photo:  Vinay Lal, April 2010

The Mausoleum of Hafez in Shiraz, twilight hour.
Photo: Vinay Lal, April 2010

Watching the spectacle unfold before my eyes, I thought to myself whether anything even remotely resembling such reverence for a poet might ever be witnessed in the United States.  What poet would receive such veneration?  Whitman?  The same Whitman who wrote, “I Hear America Singing”?  Where is he buried?  I am clueless and, I am quite certain, so are the vast majority of Americans.  Or might it be Robert Frost, who has endeared himself to at least one American president and who is sometimes thought of as America’s most homely poet?

Tribute to Hafez-e Shirazi.  Photo:  Vinay Lal, April 2010

Tribute to Hafez-e Shirazi. Photo: Vinay Lal, April 2010

The tomb of Hafez, in Shiraz.  Photo:  Vinay Lal, April 2010.

The tomb of Hafez, in Shiraz. Photo: Vinay Lal, April 2010.

The veneration for a poet may have nothing to do with the Iran deal.  But I am dazzled by the talk of those American politicians and commentators who speak of bombing Iran into submission, or those who have raised the prospect of nuclear armageddon if the deal goes through and Iran is permitted relief from sanctions.  With what arrogance and insolence do some Americans speak of Iran, which has gifted the world a Hafez, the Shahnamah, and a Saadi, as a rogue state?  Emerson recognized Hafez as a “poet’s poet”, and it was Hafez’s Divan which moved Goethe to compose his own West-oestlicher Divan.   Our Iranian-Americans are too reticent in their appeal to fellow Americans:  on the one hand, their appeal overlooks the now widely recognized role played by the United States and Britain in instigating the coup d’état that led to the overthrow in 1953 of the government of Mohammad Mosaddegh; and, on the other hand, they ignore the fact that the civilizational claims of Iran supersede any claims that America might advance on behalf of itself.  One knows, too, that the realists will find the very thought of civilizational claims comical, outlandish, and—at best—romantic.  Poets may not be the unacknowledged legislators of the world, but they are much less oppressive and stupid than those who rule the roost as politicians, policy makers, and political pandits.

On an October evening in 1977, Manubhai received word of the unexpected demise of his younger brother Dipak, an orthopedic surgeon based in New Jersey.  Manubhai has described his brother in Living, Dying thus:  “Dipak was a tall, handsome person, athletically built and inclined.  He had neither diabetes nor high blood pressure, nor excess weight—none of the ‘risk’ factors.”  No one in the family had ever complained of anginal pain; and, yet, at 30 years of age, Dipak had suffered a massive heart attack and passed away in his sleep.  It was a “rude shock” for Manubhai, but then “the head consoled the grieving heart, persistently driving home the point that death’s mathematics does its task governed solely by Pascalian probabilities, irreverent in the face of medical attempts at prevention, diagnosis and treatment.”  On reading this, I was reminded of Ralph Waldo Emerson’s starkly beautiful essay on “Compensation”, where he described the loss of his small son as akin to the “loss of a beautiful estate, no more” (or words to that effect).  He wrote of his experience, “I cannot get it nearer to me”, words that have disturbed his detractors and some of his admirers who opine that Emerson was unable to feel anything.  Quite to the contrary, Manubhai, as Emerson much before him, had a deeper understanding of death as a soulmate, a profound awareness that the laws of compensation cannot be denied, and that what appears as a tragedy in one’s own personal life “is but a part of the impartial, fully just, greater order.”  It would be superfluous to add that, as with the case of cancer, Manubhai remained an unrelenting critic of coronary care, which he did not deign to redeem even as a form of dignified plumbing.  His conclusion to the article that he wrote on “Coronary Care” for the aforementioned The Future of Knowledge and Culture sums up his views:  “Our advice to the lay and the learned is to stay away from the well-conceived but useless and harmless procedures comprising invasive coronary care.  The cardiologists and coronary surgeons are riding a tiger they fear to dismount, lest the dollar Niagara come to a sudden end.  Angiography, by itself untrustworthy, inevitably spawns—plasty and/or bypass, the trio comprising costly iatrogeny on a global scale.  A wise person avoids any assault on the coronary tree, no matter how sophisticated the laser, reamer, rotor or what have you.”

Any tribute to Manubhai that does not acknowledge his wry sense of humor, erudition, love of literature, and cheerfulness would be woefully incomplete.  I last saw him, I believe, in or around March 2009.  He invited me to a leisurely breakfast at his home with him and Jyotibehn and two memories of that visit will persist with me to the end.  We had been discussing politics in Gujarat, and he was just as bothered as I was by the obscenity of some of the violence perpetrated in 2002.  Quite suddenly, Manubhai threw this question at me:  ‘What do you think is the holy book of the Gujaratis?’  I knew that he did not have the Bhagavad Gita in mind, nor the Tulsidas Ramacaritmanas, certainly not the Vedas; for a moment, I thought he might have had in mind the songs of Narsi Mehta, the great devotional poet.  But somehow I also sensed that Manubhai was laying a trap for me; and yet I could not bring myself to think of an answer beyond the ordinary.  I don’t now recall what I said; but whatever it was, it was not a patch on the brilliantly funny and incisive answer Manubhai had:  the cheque book!  We had a hearty laugh.  Later that morning, as we left his apartment, we made our way to the train station: for years, Manubhai had taken the local to KEM Hospital.  It was absolutely characteristic of him that he should travel in modesty:  however dreadful the cliché, “simple living, high thinking” seemed to furnish the motor to his life at every turn.

Manubhai died as he lived; moments before his death, I am told, he had been chatting and laughing away.  Not accidentally, one of the men he admired the most was J B S Haldane, a polymath who made significant contributions to physiology, genetics, evolutionary biology, statistics, biometry, and various other fields; more to the point, Haldane, an Englishman of considerable pedigree who was educated at Oxford and had published his first scientific paper at the age of 20, migrated to India in 1956 and eventually took up Indian citizenship.  Haldane, to Manubhai’s mind, stood for the other West—a West that was critical of its own past, tolerant of dissenting traditions, aware of the homology between colonial dominance and the suppression of women, religious minorities, and people of other ethnicities, a West with which, in other words, India could enter into partnership.  Haldane thought of India as a freer country than any other, and some of his thoughts may be surmised from his observation that “the people of Calcutta riot, upset trams, and refuse to obey police regulations, in a manner which would have delighted Jefferson. I don’t think their activities are very efficient, but that is not the question at issue.”  Percy Bysshe Shelley, be consoled:  it is not only poetry that makes nothing  happen.  Haldane passed away in 1964, but not before he had written a poem on his hospital bed, “Cancer’s a Funny Thing”, from which Manubhai quoted frequently:

I wish I had the voice of Homer

To sing of rectal carcinoma,

Which kills a lot more chaps, in fact,

Than were bumped off when Troy was sacked . . . .

Cancer could be “rather fun”, says Haldane,

Provided one confronts the tumour

With a sufficient sense of humour.

I know that cancer often kills,

But so do cars and sleeping pills;

And it can hurt one till one sweats,

So can bad teeth and unpaid debts.

sort of laughter, I am sure,

Often accelerates one’s cure;

So let our patients do our bit

help the surgeons make us fit.

Manubhai was far ahead of his times, and it may take a few generations or more for us to understand the manner in which he lived and how he helped us all to become “fit”.

Coda:  Shortly after I finished writing this, by sheer coincidence my friend Ajay Singh sent me the following joke:

कार्डियोलोजिस्ट और गब्बरसिंह में क्या समानता है?
दोनो यही सलाह देते है कि तूने नमक खाया है अब गोली खा ।
(What is common to the cardiologist and Gabbar Singh?  Both come forward with this advice, ‘You ate salt, now bite the bullet.)
To audiences familiar with the world of the commercial Hindi film, this joke will resonate strongly:  The outlaw Gabbar Singh, featured in the immensely poplular film Sholay (“Embers”, 1975), shoots dead one of his henchmen, one of those who ate his salt, when he finds him no longer competent in discharging his duties.
See also parts I and II

In 1973, Dr. Manu Kothari and his associate, Dr. Lopa Mehta, published their voluminous tome, The Nature of Cancer, which I am tempted to describe as a war on the “war on cancer”.  The military metaphor has, of course, long been regnant in the US:  for well over a decade the American public and people overseas have been hearing about the “war on terror”, but this war was preceded by the “war on drugs”.  Neither war has been concluded; neither war is likely to be brought to a close; indeed, neither war has a foreseeable end, and the prosecutors of such wars, and their allies and friends in and out of government, have too much to lose if either war was brought to a decisive end.  All this is certainly true of the “war on cancer”, which has consumed hundreds of billions of dollars, perhaps trillions of dollars, thus far.

However, the war on cancer differs from the war on drugs the war on terror in some fundamental respects.   The war on drugs is increasingly being recognized, except by the Republican Party – not, it should be noted, by some outlandish or extreme members of the party, since such a view presumes that there are sane or even intelligent members of the Republican Party, which is very much to be doubted—as an egregious error which has needlessly committed hundreds of thousands of Americans to prison terms, and similarly the war on terror has had more than its share of detractors.  But the “war on cancer” is construed, by every sector of the American public, as a holy mission:  to be sure, there are those who think that there might have been some scams, and a few people have doubted whether all forms of cancer research have been productive, but there is an overwhelming consensus that cancer is a deadly disease that must be exterminated and that no effort must be spared to stamp it out.

Cancer research draws in more funding than any other medical endeavor; the war on cancer has its foot-soldiers and generals; and donors and philanthropists, whose wealth is often ill-begotten, easily become heroes and celebrities in a culture where donations in the name of cancer research earn one goodwill and, if the gift is substantial enough, cultural capital in the form of a building or institute named after the donor.  It is a telling fact that in his highly celebrated “biography” of cancer, The Emperor of All Maladies, the talented writer and doctor, Dr. Siddhartha Mukherjee, entirely succumbs to this dominant narrative.  On reading him, one inescapably reaches the conclusion that if we soldier on, achieve “early detection”, and eliminate the scourge of smoking—but apparently not bother with the monstrous-sized polluting SUVs and pick-up trucks with which America has an undying love affair—victory will be at hand.

Dr. Manu Kothari had an entirely different view of cancer and what passes for “cancer research”.  His views would be distilled in two much shorter works, both co-authored with Dr. Lopa Mehta:  Cancer:  Myths and Realities of Cause and Cure (1979) and Living, Dying:  A New Perspective on the Phenomena of Disease and Dying (1992).   He unflinchingly put forward the view, which certainly did not win him any friends from among those in the cancer(ous) industry, and even gained him the opprobrium of establishment doctors alarmed at his broader views about the nature of disease, that the billions of dollars expended on finding  a cure for cancer had not advanced our knowledge of the “disease” an iota.  Writing on cancer for The Future of Knowledge of Culture:  A Dictionary for the Twenty-first Century (Viking Penguin 2005), co-edited by Ashis Nandy and myself, Manubhai put the matter quite succinctly in expressing his agreement with the view of some patients that the “treatment [was] worse than the disease.  Macfarlane Burnett, the Australian immunologist of wide renown, summed up in the 1970s the outcome of all cancer research in just two words:  precisely nil.”  As Manubhai was to add towards his conclusion, “On the medical claims about the early diagnosis and treatment of cancer, one could invoke Churchillian rhetoric:  Never in the history of science has so much untruth been told by so few to so many for so long.”

How, then, was Dr. Kothari inclined to think of cancer?  His views may, at first, seem wholly unpalatable:  “Cancer—far more benign than malignant mankind—is what it is, and does what it does, because of unalterable, unabrogable biorealities that attend this fascinating phenomenon.” Manubhai took it as an imperative that we must first understand death and look at it not something that is to be feared, delayed, managed, ostracized, and repelled but rather as a friend, even as something that is to be revered.  He was critical of medical science for representing one disease or the other as the cause of death:  as he put it in Living, Dying, “Disease and death, in fact, are inherent components of man’s development, are governed by time and regulated by the herd, behave independently of each other and, in essence, are causally unrelated, death by itself being a programmed normal function performed by a living being.”

He argued that cancer occurs throughout the human lifespan; moreover, it is very democratic, and cancer’s “benevolence” could be inferred from the fact that it occurs everywhere “but in excess nowhere.”  He described cancer’s distribution as one in five:  one person bears the cancerous cross so that the other four might live.  Manubhai does not ask of us that we love cancer; but he does ask of us that we not hate it.  Once one understands that cancer is always with us, the very fibre of our being, we are no longer inclined to seek treatment:  he entirely rejected the idea of early screening, and deplored chemotherapy and radiotherapy as “despicable overkill by medicine.”  The fact that as a doctor, one remembered by his students as a very good one who did his profession proud, he was able to advance such views is a remarkable testament to his courage.  What is not less striking is that he had been articulating such a position for over four decades:  not surprisingly, one of his most ardent admirers was Ivan Illich, whose own Medical Nemesis, published one year after Manubhai’s The Nature of Cancer (1973), still remains the most trenchant critique of institutionalized forms of modern medicine.  Illich would go on to write the foreword to Manubhai’s smaller book on cancer.  Interestingly enough, the most recent exhaustive study on “early detection” all but confirms Dr. Kothari’s claims:  as reported by the New York Times on 20 August 2015, in an article headlined “Doubt Is Raised Over Value of Surgery for Breast Lesion at Earliest Stage”, “As many as 60,000 American women each year are told they have a very early stage of breast cancer — Stage 0, as it is commonly known — a possible precursor to what could be a deadly tumor. And almost every one of the women has either a lumpectomy or a mastectomy, and often a double mastectomy, removing a healthy breast as well.  Yet it now appears that treatment may make no difference in their outcomes. Patients with this condition had close to the same likelihood of dying of breast cancer as women in the general population, and the few who died did so despite treatment, not for lack of it, researchers reported Thursday in JAMA [Journal of the American Medical Association] Oncology.”

(to be continued)

See also Part I on this blog


I have a reasonably good recollection of the exact circumstances under which I first met Dr. Manu Kothari (1935-2014), or Manubhai as he was known to his friends and others accustomed to the mode of address common among Gujaratis.  I had heard of him many years before I had the pleasure of setting my eyes upon him:  as with many of the most interesting people I have met either in India or a dozen other countries, I was first introduced to the work of Manubhai by Ashis Nandy.  I had been advised by Professor Nandy that no visit to Bombay was complete without a stop at the home of Manubhai, described to me as a superb doctor who was nonetheless a radical dissenter from the medical establishment and as an intellectual maverick who was as much at home in the classics of English literature and Indian philosophy as he was in the technical literature on cancer, anatomy, and genetics.

Through a set of fortuitous circumstances in September 1999, I found myself staying with another common friend who lived across from Manubhai and Jyotibehn’s flat on Swami Vivekananda Road in Santacruz (West).  My wife and I were returning from Pune with our baby daughter and we were being hosted by the late Jayesh Shah, a kind soul and magnanimous man who had given up an extremely lucrative career as a stock-broker to found the fiercely independent journal Humanscape, to which Manubhai and I were both contributors.  Manubhai and I both served in later years on the journal’s editorial board.  When I expressed a desire to meet Manubhai, Jayesh just walked me over to his home!  That visit is etched in more than my memory:  Manubhai was being visited by his long-time associate and colleague, Dr. Lopa Mehta, and at the end of the day they gifted me a copy of their magnum opus, The Nature of Cancer, with the following inscription:  “To Dr. Vinay Lal, with warm regards for a kindred spirit.”  While being extraordinarily moved by their gesture, I was also greatly intimidated:  900 pages in length, the Nature of Cancer is fortified by some 6,000 references and dense discussions of carcinoma, immunotherapy, chemotherapy, and much else; more to the point, as a cultural historian, even (as at least I imagined) one with wide-ranging intellectual interests, I was entirely clueless about cancer beyond knowing how to spell the word.   However, with a twinkle in his eye, Manubhai gave me an assurance that I was none the poorer for being ignorant about the literature on the subject; as I was to find out in short order, Manubhai held to the opinion, one which he would defend to the end of his life with great vigor, that the tens of thousands of researchers who had dedicated their lives to cancer research had not contributed an iota to furthering our understanding of the nature of cancer.  As Manubhai might well have said, they were barking up the wrong tree.

The academic and intellectual career of Dr. Manu Kothari is better described by those who were fortunate to know him as a colleague or as a fellow traveler, even if a dissident one, in the medical fraternity.  Our friendship, which led me to a heighted awareness of the extraordinarily radical nature of his thinking, arose from very different considerations.  Though Manubhai was a doctor by training, he had an abiding interest in literature, philosophy, and a broad swathe of what one might describe as humanist writings.  He belonged to a small fraternity of people in India who were seriously questioning the received categories of thought and probing the politics of knowledge systems.  Though the conditions under which medicine is practiced in India are vastly different from those which obtain in the US or the affluent nations of western Europe, what has been true of the social sciences is also the case in medicine:  the concepts found in textbooks generated in the West have been adopted wholesale for use in Indian medical colleges, and with respect to medicine on the ostensibly more justifiable grounds that physiology is a universal science.  The neuroses and psychoses of the white man, if one may put forward such an example, were thus to furnish the models by which the neuroses and psychoses of colored people were to be diagnosed and treated.

To be sure, Manubhai was critical of the commercialization of what is called “modern medicine”, and he was fully aware of the nexus of interests that bound hospitals, pharmaceutical firms, manufacturers of medical equipment, philanthropists, and all too often medical practitioners, some more than others, together in an unholy alliance that compromised the health of those very patients in whose name “medical research” and expensive cures were carried out.  But had this been the extent of his grave misgivings about the modern medical establishment, Dr. Manu Kothari would scarcely have been alone.  He adopted unusual positions about the superflousness of most medical treatments and even what are called ‘investigations’, the imperative for the doctor to learn from the patient and indeed recognize the patient as oneself, and the necessity of understanding “disease” as something not alien and repulsive to oneself but rather as intrinsically a part of one’s own being.   Dr. Kothari’s views led him to some fundamental epistemic breaks with the models of modern medicine emanating from the West; indeed, he questioned whether there was anything intrinsically “modern”, apart from some obvious technological interventions, in modern medicine, and similarly he held such conceptions as “holistic medicine”, favored in the West by those who are critical of allopathic medicine and its vivisectionist tendencies, to be little better than tautologies.   Health is holistic; if it is not, one is speaking of something else.  In a word, Manubhai was sharply critical of modern or rather commercialized medicine’s deep grounding in violence.

By the late 1990s, when I met Manubhai, there was a growing if still distinctly minority indeed miniscule literature which questioned the wisdom of conventional thinking on such matters as treatments for cancer and heart disease.  In India, “five-star” and “super specialty” hospitals were just beginning to mark their presence on the scene, catering to the medical “needs” of not only the super-rich but growing numbers of middle-class and affluent Indians who had been the beneficiaries of the neo-liberalization policies of the preceding decade.  The Fortis Hospitals, now a vast enterprise with over fifteen hospitals in India’s metros, initiated its operations with a hospital in Mohali in 2001.  But nothing furnishes a better gauge of the tide against which Manubhai was swimming than the meteoric rise of Dr. Naresh Trehan, a cardiovascular surgeon who had returned from a career in the United States to establish the Escorts Heart Institute in Delhi in 1988.  By the mid-1990s, Dr. Trehan had become a celebrity, a cult figure on the Delhi party scene who hobnobbed with film stars, media moghuls, and powerful politicians when he was not performing surgeries or otherwise building his medical empire, and it became virtually a badge of honor among the monied class in the city to claim that Dr. Trehan had performed a triple or quadruple bypass on them.  To have had one’s arteries worked upon by Dr. Trehan, an aggressive proponent of surgical intervention for patients with cardiac problems, was rather like being admitted to an elite club.

(to be continued)

Review of Yasmin Khan, The Raj At WarA People’s History of India’s Second World War (Gurgaon, Haryana:  Random House India, 2015).   Published as “When the War Came Home”, The Indian Express (29 August 2015), p. 25, with slight modifications.  .

World War II has never much been on India’s horizon, excepting of course the role thought to have been played by the Indian National Army and Subhas Chandra Bose, who remains a legendary figure, and not only in his native Bengal, in moving India closer to liberation from colonial rule.  Most Indians have long believed that this was not their war, and there is a case to be made for the view, notwithstanding the mobilization of over two million Indian soldiers who served in Europe, Africa, and Asia, that the Second World War is best understood as part of a long history of bitter struggle for supremacy in Europe.  In the nationalist narrative, it is the Quit India movement that hogs the limelight.

Yasmin Khan, an Oxford-based historian whose previous book on the making of India and Pakistan, The Great Partition, was well received, notes in her introduction that while researching the Partition of India she came to the awareness that the war years were critical in helping shape the political conditions that would lead to negotiations for independence.  She subscribes to the argument that has been advanced by many scholars and commentators that the Congress, owing to its declared position of neutrality and its consequent banishment into political wilderness, found itself confronting political realities at the end of the war that it could not comprehend (308). Jinnah openly declared that the war “proved to be a blessing in disguise” (135):  the Muslim League found itself ascendant and took every opportunity to reiterate the threat of a Hindu Raj.  At Aligarh Muslim University, the entire atmosphere had changed within a few years such that by 1942 the idea of Pakistan commanded wide allegiance among Muslims (136).  But Khan avers much more than that, making bold to state that in the aftermath of the war there was a “new belief in the power of violence to release India from colonial control” (x), and she conveys the centrality of the war as an Indian experience with the argument that “the war delivered decolonization and the Partition of 1947—neither of which were inevitable or foreseen in 1939” (xvi).

Independence, as we know, did not occur overnight, and Khan is quick to recognize “the considerable achievement of the nationalists over the long duration” (xvi).  The strengths of this volume, however, lie elsewhere, in the mass of material that Khan has assiduously gathered from numerous archives and hundreds of sources and in the extraordinary stories, often juxtaposed with startling effect, which lend credence to her view that “Britain did not fight the Second World War, the British Empire did” (xiii).  Her book is unprecedented in scope, peopled by a motley group of characters, and rich both in detail and in its unique insights into the socio-cultural and military history of the war years. Her endeavor, in the first instance, is to underscore the signal part played by India in the war, to make visible to those who remember, for example, only the Blitz the contributions of the “Asian merchant sailors who kept the British ports going” (319), not to mention the back-breaking labour of those who built the 500-mile Ledo Road through the mountains of northern Burma to link India to China (259-63).

British Indian Troops in Florence, Italy.

British Indian Troops in Florence, Italy.

Secondly, she strives to show the untold number of ways in which the war impacted ordinary people throughout the country:  recruitment officers often made their way to the remotest villages, the “War Fund” imposed burdens on people already living at the brink of poverty, paddy fields were requisitioned—usually with inadequate compensation—to build over 200 aerodromes, and wardens patrolled the streets of major cities to ensure that blackouts were being observed.  Khan’s India in the war years had room enough for 10,000 Poles escaping ethnic cleansing by the Soviets and Nazis (123), a camp in Ramgarh, Jharkhand, where over 50,000 Chinese soldiers received training (271), and 22,000 American black servicemen who, already intimately familiar with racism, encountered a Calcutta where at the only service swimming pool there were “white days and black days” (268).  Many histories have sought to convey the impression that the war barely touched India, once we leave aside Subhas Bose’s theatrics; but the effect of Khan’s narrative is to suggest the near total immersion of a society into a war in which, wrote Orwell, India had become, “it is hardly an exaggeration to say, the centre of the world” (93).

African American Servicemen Riding Rickshaws in India, July 1943.  Source:  National Achives, Wsashington DC.

African American Servicemen Riding Rickshaws in India, July 1943. Source: National Achives, Wsashington DC.

What lends Khan’s history poignancy is her ability to draw the reader into the lives of common people and her ear for nuance and irony.  One of the most sensitive subjects for Indians was the recruitment drives, and Khan notes the moral pressure that women, in a patriarchal society, were successfully able to apply “in determining whether their sons left home for the war or not” (227).  In Rajinder Dhatt’s family two brothers who fought for the empire returned home safely but the third, whom the mother kept close to her bosom, died of typhoid (312).

The Bengal Famine, with the numbing accounts of bodies littered on the streets, the proliferation of beggars who had been reduced to skeletons, the acute shortages of food and clothing, and the requisitioning and destruction of boats that eviscerated a people and their lifestyle, appears and reappears throughout Khan’s book.

The Bengal Famine 1943:  A British Holocaust in India.

The Bengal Famine 1943: A British Holocaust in India.

The Bengal Famine Inquiry Report, Khan says, was published the same week that VE Day was announced.  Even as Khan indicts the British for their cynicism and callousness, she hints at the enormity of the tragedy in quoting a British woman in Calcutta who, when shown pictures of starved concentration camp inmates from Buchenwald, commented thus: “The German atrocities apparently do not compare with the Bengal famine so the pictures don’t shock the folks out here” (299).

While there are theoretical and historiographic questions to be asked about what exactly are the contours a “people’s history”, Khan’s history has paved the way for a more complex understanding of the Second World War as India’s war too.

India in 1940.

India in 1940.

India and Pakistan are so close and yet so far apart.   One is tempted into saying that no two countries are so similar, and yet the two countries have gone to war, and have been nearly lured into war, on several occasions.   The distance from Amritsar to Lahore, the two greatest cities of the undivided Punjab, is a mere 53 kilometres.  A super-fast train, of the kind found in Japan, China, and in most of western Europe, would have traversed this distance in 10 minutes.  However, approaching the border from either end, travelers must navigate the shoals and eddies of the modern nation-state system at Wagah.  On the Indian side, the last station is Attari; from here, it is a mere 3 kilometres to Wagah; and, in between, one might say, is “no man’s land”, where the “formalities” that are necessary at border crossings are transacted.

The distance from Wagah to Lahore is 29 kilometres, and a tad less is the distance from Wagah to Amritsar.  But this is one crossing that is not meant to be navigated at will, and certainly not in a vehicle of one’s choosing.  One might cross on foot, provided one had a visa; more commonly, the crossing is attempted on the Samjhauta [Agreement] Express, as the train that ferries Pakistanis and Indians across the border is optimistically if not gallantly named.   But supposing one was looking to take a journey from Amritsar to Lahore in one’s own car, as one might from, say, Seattle (Washington State, USA) to Vancouver (British Columbia, Canada).   Google Maps tells me that on Interstate 5, I can cover the distance of 147 miles in less than 3 hours.  However, when I put in Amritsar and Lahore into Google Maps and sought directions, I was advised, as would anyone else who cared to undertake such an exercise, that the distance between the two cities by car is 5,385 kilometres and would ordinarily be covered in 110 hours!  If, like most drivers from South Asia, one cannot be even remotely bothered by posted speed limits, one might perhaps knock off a few hours, though I suspect that the continuous transgression of such limits, in certain parts of Tibet or the PRC, may pose some hazards.  Why, however, mention Tibet at all?   The stated route takes one not due west, but rather south to New Delhi (as if in tacit acknowledgement of the fact that no such trip would be possible without the mandarins that staff the corridors of power at the Secretariat), and from there southeast to Uttar Pradesh and thence to Nepal, and then west and largely north through Tibet and China to just east of the eastern border of Tajikistan before one makes one’s descent through Pakistan-Occupied Kashmir (POK, though, naturally, it is known as Azad Kashmir in Pakistan), Islamabad, and finally through Pakistan’s province of Punjab to Lahore.  What else need one say about the impossible distance that intimacy often creates?

Google Maps:  Driving Directiosns from Amritsar (India) to Lahore (Pakistan), a distance of 53 kilometres.

Google Maps: Driving Directiosns from Amritsar (India) to Lahore (Pakistan), a distance of 53 kilometres.

It is characteristic of the peculiar relationship into which Pakistan and India are now bound that Wagah chiefly occupies a place in popular lore as the site of one of the most unusual rituals of the nation-state system.  Tourists flock in numbers each evening to see, shortly before sunset, the Beating Retreat Ceremony:  across the divide, the two countries lower their flags and armed soldiers stage a highly orchestrated set of maneuvers.  For the ethnographer of nationalism, Wagah is as rich a site as any to comprehend the semiotics and rituals of the modern nation-state and the mobilization of symbols and sentiments in creating a nationalist sensibility.  Pomp and ceremony have long been handmaidens to nation-state exhibitionism; and there is, of course, no nation-state without a national flag.  What is most striking about the spectacle is that the audience, at either end of the border, are permitted the sight of the other but no more, the thought of intimacy but nothing that would occasion its realization.

Every Indian visitor to Pakistan has recounted the warmth with which he or she was received in that country; Pakistan feels very much like ‘home’.  Much the same can be said of Pakistani visitors to north India.  It is also apparent that, in some fundamental respects, the two countries, notwithstanding their shared heritage, have moved in different directions; nevertheless, the sense of what is common to both is overwhelming.  Why, then, the distance?  Many people are inclined to argue that the animosity that exists between India and Pakistan reflects not the sentiments of the people of the two countries but rather is an attribute of the logic of the nation-state system and the zero-sum politics that shapes the foreign policy of each country.  This is unquestionably true; and, similarly, there can be no gainsaying the fact that what NGOs describe as people-to-people contacts are likely to make a much greater difference in facilitating peace than ministerial-level dialogues, meetings between foreign secretaries and other bureaucrats, and yet more state-sanctioned conferences.

Still, once one has conceded that enhanced civil society interactions are the sine qua non of a peace between Pakistan and India, the nagging feeling persists that there is something a bit more  inexplicable which characterizes the relationship between India and Pakistan, producing distance when is there is so much intimacy.  In a number of his writings, Freud noted the tendency of people who are very close to each other to exaggerate what divided them:  he referred to this phenomenon as the narcissism of minor differences, sometimes substituting “small” for “minor”.  His magisterial essay of 1930, Civilization and Its Discontents, offers a commentary on this dynamic with an observation about “communities with adjoining territories, and related to each other in other ways as well, who are engaged in constant feuds and in ridiculing each other.”  Elsewhere he had occasion to comment, “Every time two families become connected by a marriage, each of them thinks itself superior to or of better birth than the other.  Of two neighboring towns each is the other’s most jealous rival; every little canton looks down upon the others with contempt.”  The Scots and the English, Shias and Sunnis, Serbs and Croats, Hutus and Tutsis:  to these pairs, and to the loveless rivalries that beset English football clubs, one might add Pakistan and India.  It may, perhaps, require more than the display of brotherly and sisterly sentiments to bring Pakistan and India out of the curve of enmity.


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