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)