*The Intellectual Legacy of Dr. Manu Kothari, Part III: Gabbar Singh and the Cardiologist

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.

A spot of laughter, I am sure,

Often accelerates one’s cure;

So let our patients do our bit

To 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.
(concluded)
See also parts I and II

1 thought on “*The Intellectual Legacy of Dr. Manu Kothari, Part III: Gabbar Singh and the Cardiologist

  1. Vinay—thanks for the fascinating tribute to Dr. Kothari. He does appear to be the Gabbar Singh of the medical community, both in spirit in and in deed, even if he admirably restrained himself from administering barood-bhari गोलीs to (the likes of) Naresh Trehan, who would have saved the world much trouble by remaining in the U.S., where he could have had an equally rewarding career working for evil, show-me-the-money outfits such as the FDA.

    Like

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