I tried to be a ‘physician’ but qualified for surgery

The lure of general practice appealed to me because I knew that the family had invested in me financially and emotionally and it was high time that I paid them back.

What you need to know:

  • Dr Khwaja inculcated the culture that the surgeon is no less brainy than a physician; he is endowed in addition with skill, a full pair of hands.
  • It was easy for me to accept the change in this favourable environment.
  • Also, as George Bernard Shaw said, ‘If you don’t get what you like, you start liking what you get!’
  • Let me admit it here and now that I have enjoyed every minute of my surgical career.

In a previous column, I told my readers how and why I became a doctor, both the phoney version and the factual one. I now wish to tell them what led me to qualify as a surgeon and, though there is only one version, I am sure they will find it equally interesting.

The decision was made in October 1953, when I reached an important milestone in my life and passed my MBBS from Grant Medical College. This change of qualification happened because, when I passed my LCPS from Miraj Medical School, the government abolished the diploma but gave an opportunity to diploma holders to join the “condensed” MBBS course, pass three exams and qualify with a medical degree.

MIDMORNING COFFEE

At last, I joined my favourite GMC, Grant Medical College, from the ‘backdoor’, as I have put it, to do my condensed course and qualified as a ‘proper doctor’ from where I could embark on any postgraduate course or launch into general practice on equal terms with my peers.

The lure of general practice appealed to me because I knew that the family had invested in me financially and emotionally and it was high time that I paid them back by providing a “doctor in the house” and bring in an income to augment the family finances.

Though my heart pointed me in that direction, my mind willed otherwise — to specialise as a physician. Dr Ranbhise in Miraj and Dr Sathe, who had done his MRCP in London and taught me at GMC, had planted the seed and as I approached my final examination, the vision had flowered; I wanted to be a physician like them, teach and leave a legacy.

The concept of medicine being a cerebral speciality, in contrast to surgery which was a manual science, and therefore medicine was taken by persons endowed with high IQ, had taken a firm root in my mind. Despite that great urge, I ended up as a surgeon and, before I explain why that switch happened, let me relate an amusing incident which occurred in my midwifery examination.

An essential part of viva-voce test was for the candidate to examine a woman with advanced pregnancy. Prof De-Sa assigned me a case and said: “You have 10 minutes to examine this case and check the fetal heart sounds.”

She then went for her midmorning coffee.

HEART RATE

As soon as she left, I got busy with my patient until I reached a point when I had to use the fetoscope, which was there, to check the fetal heart rate, for which the hourglass shaped gadget is used instead of an ordinary stethoscope. Perhaps, examination nerves were overtaking me and for the life of me, I could not remember which end of the instrument went on the woman’s abdomen and which end touched my ear. As the clock was ticking and the examiner’s return was becoming progressively imminent, I was getting more nervous, knowing that she would ask me to use the fetoscope and could fail me for not being conversant with this elementary procedure. The examination was being held on the first floor of the maternity wing and I coolly dropped the fetoscope from the window. What the eye does not see, the heart does not grieve! True enough, when the professor did not see the culpable gadget, she asked me to use the stethoscope and a catastrophe was averted!

Now finally to revert to the switch, JJ Hospital, to which Grant Medical College is affiliated, had six paid housemen’s vacancies for students who attained the highest marks in Medicine and Surgery. Among the six, the one who got the top marks and won a medal could choose the unit he or she wanted.

I wanted to work as Dr Sathe’s house-physician because I had worked under him as a student and had been impressed by his diagnostic acumen and clinical approach.

To obtain that position, I had to get the medal in Medicine and, to that purpose, I was swotting books on Medicine — Beaumont, Price and Seville — until two days before the start of the examination when I realised that I must get a modest pass in Surgery and pass the examination to be awarded the medal, and therefore started brushing up on Surgery. When the results were announced, I had obtained a medal in Surgery and not Medicine!

INVISIBLE SCAR

That put Dr Sathe out of my reach but the stubborn streak inside me decided to work under the surgeon of my choice, who happened to be Dr Khwaja under whom I had worked as a student.

Dr Khwaja remained cool, calm and collected in the operation theatre under the most aggravating circumstances and he helped me to settle down in his unit, despite the turbulence caused by the abrupt change to Surgery. He took my reluctance as a challenge and, as a great teacher, which he was, he taught me how to hold the scalpel, how to make a clean incision, meticulously catch all the bleeders and work in a dry, bloodless field. He took great pains to teach every step in operative surgery, taught me how to tie a knot in cramped spaces, which an abdomen is, and also save time, not by hustling and bustling but simply by avoiding purposeless and repetitive movements.

Finally, he showed me how to stitch the skin with neat sutures, leaving an invisible scar. His constant refrain was: ‘Leave it as you found it.’ He also taught me to say ‘please’ and ‘thank you’ to the theatre staff and earn their loyalty and co-operation.

Above all, he inculcated the culture that the surgeon is no less brainy than a physician; he is endowed in addition with skill, a full pair of hands. It was easy for me to accept the change in this favourable environment. Also, as George Bernard Shaw said, ‘If you don’t get what you like, you start liking what you get!’ Let me admit it here and now that I have enjoyed every minute of my surgical career.