CHAPTER XIV NMO SPROUTS – MY INTERNSHIP AND ‘HOUSEPHYSICIANSHIP’ (1980-82)

CHAPTER XIV

NMO SPROUTS – MY INTERNSHIP AND ‘HOUSEPHYSICIANSHIP’

(1980-82)

            My final year classes and Sunday free clinics in the Harijan village, Chhapaki along with the Shakha in the campus were going on. The NMO being dormant in files, due to the utter disappointment and also lack of money, I did not go to the Bangalore conference of the ABVP. Later on, Om Prakash informed me with joy that my thesis on technical forums had finally been accepted there. Govindji had ankylosing spondylitis and he was recovering in Bombay. 

            He expressed his concern over rising menace of the Progressive Medicos Federation (PMF), a left wing organisation that had the intention to turn medicos agitators like trade unions instead of harmonising them with the spirit of service, as we in the NMO desired. Now the PMF is known as the All India Medicos Federation (AIMF).  He also wished in his letter of  22nd September 1979 that after my final examination, I should make a systematic approach towards it.

            I responded positively to his sincere appeal.  After examinations were over, the parleys began.  A meeting was held in room no. 4 of the old hostel of the Patna Medical College, where Baidya Nath Mishra, the Office Secretary of the Patna unit of the NMO, (1977) resided.  Friends from Muzaffarpur had also joined.  Later on, we had a meeting with Govindji at Vijay Niketan (Sangh Karyalaya) also.  It was felt that no official intimation to all concerned was sent. 

            Yet, we had finalised some preliminary things such as the NMO should operate in Bihar* only as a sponsored organisation of the ABVP. Again we met in the Bihar* State Conference of the ABVP at the Ram Mohun Roy Seminary, Patna**. But the meeting was inconclusive. Some new faces were adamant on its Hindi nomenclature. Dr. Chiranjiva Khandelwal was reluctantly submissive but I did not agree. I had the notion that we were to revive the dormant NMO and not to create a de novo synthesis. My roommate Arvind suggested to me wisely leaving it for the moment. I returned to Darbhanga.

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* Including Jharkhand

** Much later in 2005,Dr. Baidyanath Mishra  informed me that the girl  medicos of the PMC -   Shikha Gupta, Lata Shukla, Saroj, etc. had gheraoed Ma. Madan Das Devi and Ma. Govindacharya demanding that their organisation , the  NMO , should be allowed to run to which  both  assured  them positively.

  

            The journey to Patna in those days was tedious – you had to cross the Ganga by a steamer and then run for catching the bus or train first for Muzaffarpur and then for Darbhanga.

             The ABVP Bihar* State team met at Maithon (near Dhanbad).  Dr. Khandelwal was there. There it was felt that undue procedural delay was not good and so a final circular was issued on 14th Jan. 1980 by Sushil Kumar Modi, Secretary Bihar* State, ABVP, convening     a meeting of important medico workers at Patna on 26th Jan. 1980.

            I was in a fix, whether I should attend that meeting at all, apprehending no conclusion and that too after such a tedious journey to the State capital. Chandreshwarji assured me that this time the cart would move. I with Ashoka of the DMC went to Patna.  My roommate Arvind told me to bring a copy of the Hindi Sahitya Sammelan’s publication, Aayurvigyan Shabdabali. I thought this time, I would accept a translation of the NMO also, along with its original name and to cover the nearest meaning, I translated it as ^jk"Vªh; vk;qfoZKku Nk= laxBu* (Rashtriya Aayurvigyan Chhatra Sangathan).

            Besides me and Ashoka  from the DMC; Om Prakash and Winay Siddhesh from the SKMC, Muzaffarpur; Baidya Nath Mishra from the PMC; Vishnu Prasad Agarwal from the NMC (who were subsequently designated as the office secretary and the treasurer); probably Vijay Krishna and Amitabh from the MGMMC, Jamshedpur were present and all were nominated for the State Executive Committee of the NMO.  The name of Vishwamohan from the RMC, Ranchi was also included on the advice of  Sushi Kumar Modi, but he never joined the NMO. I was asked to work as the convener of the committee and there we decided to hold the first conference of the NMO at Patna on March 30-31, 1980. (Initially, the dates proposed were Feb.24-25, but being the College Days of the PMC, the idea was dropped and instead, the meeting of the Executive Committee was fixed on Feb.27, which took place accordingly).

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* Including Jharkhand

     

            The whole meeting was held in a cordial atmosphere. The NMO’s name with Hindi translation was approved.  It was decided that the name of the ABVP would not be printed on letter-heads, receipts, etc. and its membership would be independent and there would be no unit of the ABVP in the medical colleges.  However, any willing person was free to seek membership of the ABVP.  It was also decided that the ABVP’s divisional-in-charge or anybody senior to him/her or a person designated by him/her only could guide a college unit of the NMO from the coordination point of view and the convener of the NMO’s college units would be an   ex-officio member of the town committee of the ABVP for wider co-operation.

    Govindji was also present and he delivered the concluding address. It was my humble opinion from the beginning that the NMO’s membership should be open even to those who do not subscribe to the Sangh’s ideology as the health is the most universal thing and I used to say that sponsorship by the ABVP was like that of the UNO’s sponsorship to the WHO which had its own constitution and separate membership. China was a member of the WHO since 1948 but came in the UNO much later.

    Om Prakash and I had made out a draft constitution of the NMO at Varanasi itself in 1977 and it was later presented to our executive committee meeting on 28th Sept. 1980 at Patna with some modifications therein.  In this we accepted ex-officio membership of the secretary and organising secretary in the state executive committee, on a reciprocal basis with the ABVP.  However, we could not get our organisation registered for want of money, skill and time to devote at Patna.  It was this meeting where the publication of the Aayurvigyan quarterly was also approved. I spelt it with Aa so that it might come on the top of the medical journals when arranged alphabetically.

    Though the NMO was dormant since 14.2.1978, it could sprout as an organisation on 26.1.1980.  The first conference was quite close and hectic efforts were required for the success of the conference as well as organising the NMO’s college units in that short span of time.  It was amazing and also amusing to note that we were not only successful but also it was a grand success.

    142 delegates from all 10 medical and dental colleges of Bihar* attended the conference except from Dhanbad where, in fact, we could not reach before the conference. Dailies flashed it including an editorial in The Indian Nation. If participation of Bihar* in successive conferences is analyzed, the first conference was the best. The conference was financially balanced. Doctors of Patna and Darbhanga remembered our cyclone relief work and donated for the NMO generously.

            Octogenarian Padmabhushan Dr. Dukhan Ram’s Deep Prajjawalan on 30.3.1980 was the most memorable moment for me and for many of the medicos who were wishing      to see this dream  fulfilled  for long.

I remember the reaction of Dr. C. Khandelwal, on the receipt of the first introductory booklet sent by me as a token of ‘Deepawali gift’ in 1980.  “It is the finest gift I have received in my life,” he wrote   from Varanasi as then he was doing his   MS there. Dr. J. K. Jain of the Deendayal Research Institute, Delhi was overwhelmed emotionally while delivering his talk as the chief guest.  Personalities like Dr. Lala Suraj Nandan Prasad, Dr. B. N. Das Gupta, Dr. S. N. Varma, Dr. C. P. Thakur,  Dr.  S.  N. Arya, etc. addressed the scientific session.  Talks by the editors Deena Nath Jha and Jaya Kant Mishra and RSS organisers Shrishankar Tiwariji and Madan Dasji were equally thought- provoking.

 

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* Including Jharkhand

              The medical world therefore had welcomed the NMO.  The chairman of the reception committee was Dr. R.V.P. Sinha, a nationally known surgeon. Dr. B.N. Sinha, President, IMA Bihar* State had showered his good wishes through a message.

The NMO also found its real President, in Prof. S. J. Kale, more a rishi than a doctor and an anatomist from Jamshedpur, under whose guidance we could make the organisation truly national again in the 1986 conference at Jamshedpur.

    I, myself, opted for the post of organising secretary and liked Om Prakash to be the secretary, who was the ablest. The slogan of “LokLF; lsok! jk"Vª lsok!!  (Swasthya Seva! Rashtra Seva !!)”, was the outcome of his fertile mind. I had chided him for not going on a scheduled tour of Dhanbad, which remained without any representative, but I liked him very much. He expressed his inability, I think due to his strained relations with the ABVP. 

Then, my choice shifted to Winay Siddhesh as he had laboured much for the conference and had intense love for the NMO. I remembered we had gone to the temple of Lord Hanuman near Patna station on the sprouting of the NMO on 26.1.1980. At that time the temple was much smaller than it is today. Though Chandreshwarji and I had taken his consent, I was later asked by Sushil Kumar Modi to change our mind for a person from the capital, and a person from a non-Brahmin group. 

Radheshyam Gupta who was selected as such though had worked for the conference, proved virtually a non-starter as the secretary.  It is my candid opinion that a person should be selected on his ability only in any committee of any organisation.

    I remember, the tour of Bhagalpur where I reached very late in the night.  I had to halt with a fellow passenger in his shop of electric decoration.  I had not introduced myself to him but later I saw him again near the conference venue at Patna and invited him to join the conference. 

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* Including Jharkhand

  

    I know, many workers thereafter have spent their nights on the floors of the platforms otherwise we could not have established this organisation having minimal resources. Many of them were from well-off houses.  The taste of social service lies in dedication and austerity and not in the status or show.  I used to joke that when I had visited Goa in 1981, the whole group had slept on the moonlit platform and had experienced Goa, as Vasco-da-Gama himself might have probably experienced.

    The day I left for Bhagalpur, I had applied for the provisional registration with the Medical Council of India at Patna and on returning to Darbhanga, I joined internship on 18.3.1980.  I heaved a sigh of relief, as I would now be getting a stipend.  I had my first quarrel with my elder brother as early as 1978, when I had returned from the Andhra cyclone relief work.  I was under his financial support.  He rated it as a sheer wastage of my monthly allowance due to my association with the NMO work and, thereafter, I had to severe financial relations with my family members forever.  I made up my mind not to have money from the family thereafter – rather I would give as and when I earned.  Then initially my loan scholarship helped me and so did the stipend of internship and ‘housephysicianship’ later.

    So from 1980 to mid-1982, I could work satisfactorily.  The tours were also limited to few colleges of the State and the correspondence was also not much.  The NMO also grew to be self-reliant. Seed money of  Rs. 200 had once been given by the ABVP, which I wished to return but they did not accept.  However, we used their office and they also helped us with whatever was possible.

    In the days of 1977, I had, no doubt, spent from my monthly allowance __ mostly on correspondences numbering one hundred and odd.  Some of those mails were also registered.  I lived on  a notion that I never misused the money as I did not visit cinema or hotel like my other friends and thus my brother had no right to ask me how I spent my allowances.  I knew that it was not a fixed sum and my family’s money was kept in my bank account and I was free to use it as per my discretion.  I feel sorry but it was an unfortunate event that the NMO had to be dormant and as far as the gratitude to the family is concerned how I could repay that which had brought me up and allowed me to work for the society?

    Yet, I missed my occasional visits to the Sweet Home of Laheriasarai and evening snacks in order to compensate for the expenditures on the NMO.

    The days of the NMO have changed.  Only a few days back (on 12.11.1989), we planned for an ambitious collection drive of Rs.10 lakh for the Central Office at Ranchi that had started in 1977 at Varanasi with pieces of few papers from a copybook.

    But money is not an indicator of our success. It is the warm affection that the medicos developed for the NMO and only due to that the conference at Patna could be held under my ‘convenership’ though I was a student from Darbhanga. A change also came in me in as much as even the colleges hitherto thriving on capitation-fee were included in the NMO with the result that the first function of the sprouting NMO was held at Muzaffarpur on 17.2.1980, early in the morning, after the day of the full solar eclipse, as if the eclipse of the NMO had also passed off.

    The sun had a total eclipse on 16.2.1980 and my roommate Arvind was busy in experimenting on the dilated eyes of rabbits and I was preparing notes for the next day’s meeting at Muzaffarpur.  How I could change my skill of experimentation into social instrumentation, God only knows!

    I became unsocial, yet I preferred to attend the executive committee meeting of the NMO at Patna on 27.2.1980 to the yajnaopavit ceremony of my sister’s son and for this I was chided by my elder brother.

    I was very close to my mother. I purchased a small transistor for her and started visiting my village off and on to be with her.

    Any worker devotes most of his time to the place of his dwelling and I was no exception.  Dr. S. M. Mishra had long back suggested to me to organise non-controversial things like symposia and it was wonderful to recall that the Darbhanga unit of the NMO had organised over a dozen of such monthly symposium and the campus was thrilled with its consistent rhythm.

    I had the opportunity to meet each and every teacher, including retired ones, in some or other connection related to the NMO.  I had the habit of meeting workers of the NMO everyday in hostels widespread in the campus and I think I must have a record for wandering in these beehives of medicos, without being bitten anytime by anyone.

     The NMO work needed time and till my ‘seniorship’, I preferred night shift duty for that.  Though some of my friends were also fond of it, but for some other reasons … to have closeness with the staff of wards whom I always preferred to address as ‘sisters’ but surprisingly once a widow nurse protested at being addressed as ‘sister’.  During my ‘juniorship’ they were taunting me, as I did not allow them to enter my chamber in nights on the pretence of taking water from the tap. I had never been a member of any tea club as I did not take tea and was usually an absentee in the parties like farewell.

    I disapproved of photography for personal grandeur and I do not remember barring one event of group photography in the second year, if I was present in any.  Even in the farewell of my ‘seniorship’, I was an absentee for which the teachers were sore at me. I did not know why this attitude developed in me but only later I was able to change my habit.  Probably in the past it was all for avoidance of unusual pomp and show.

    Yet, people liked me. I remember a young man whose mother was in a serious condition. We had a token strike and when I resumed duty at mid-night, the relieved senior resident told me that Prof. N. P. Mishra had already conveyed to the relatives of the fatal outcome and whatever was needed, had already been done.  Around 3 a.m., the young man knocked at my chamber.  I went to see his mother and asked to bring injectable digitalis.  The murmur was 6/6; for the first time I could see the patient where such  a murmur was audible without a stethoscope, like a wheeze.  Intravenous digitalis had its effect and by the morning round of the professor, she had improved much, contrary to his predictions.  I think she had not been fully digitalised. The Prof. was very much pleased with me.  That boy used to come to me on and off for consultations.  When his mother was to be discharged he wished to offer some donation.  I told him to donate a book on the ECG. That boy still has much reverence for me.

    But another colleague of mine took the book he donated to the unit and I became angry and finally left that unit and joined ‘seniorship’ in Prof. Mohan Mishra’s unit.  Long back, that friend of mine had   a quarrel with another colleague.  Prof. N. P. Mishra scolded him saying, “Because of you, my best house-physician has left my unit.”

            Initially Prof. N. P. Mishra had an impression that I had no interest in work but later he saw my punctuality even in knee-deep waterlogged hospital in rainy days. Also, he found that I was able to find some unusual things like ‘silent gap’ in the auscultation.

            Once, I also disagreed with his diagnosis in the evening round for a hemiplegics (he had ascribed it to the embolism from mitral stenosis).  I stamped it functional, which proved later on to be correct.  On my subsequent diagnoses of functional cases, he commented that young Dhanakar diagnosed functional cases more in ladies and he should better know to manage them.

    But I had also lost a lady of middle age branding her functional but later on I could conclude that it was a septicaemic shock.  But it was too late and in spite of the intravenous infusion of antibiotics and steroids, I could not save her on that fateful night.  Prof. N. P. Mishra used to say, “Never brand a case functional unless you have excluded all other possibilities.”  She was a rural middle-aged lady, not a charming lady from a town.  (I do not mean that rural do not have psychiatric problems in contrast to that hemiplegic lady).  But Prof. N. P. Mishra used to appreciate my diagnosis of Psychiatry, which would have been a scientific entity not to label them merely as  ‘F. N. D.’ and giving painful injections as placebo.

    I also  worked on a patient of S.L.E. during ‘juniorship’. I said to Prof. N. P. Mishra, “If tuberculosis has multi-drug regimes, why not S.L.E. should have one which may reduce the dose of steroid.”  He allowed me to do so.  I followed her for three years and a paper was published on this case in the Pat. Medical Journal 1987; 61 (II): 230-232.  Such work in highly developed renal lesion was not done at that time anywhere else.  Even an immunologist like Dr. A. N. Malviya, from the AIIMS appreciated my venture in a meeting at Ranchi in 1984.

    On a rainy day while I was alone with Prof. Mishra, he told me that he was pleased with my work and suggested to me that it was an appropriate time for my marriage.

    Joining ‘seniorship’ in Prof. Mohan Mishra’s unit was interesting.  My friend from Tripura, Tarun Palit, was going to be replaced by me and so he was worried. I explained to him why

I had to leave that unit but he could not understand.  The Asst. Prof., M. P. Singh attached to Prof. M. Mishra was worried that  I was  a leader-like person and I would not work properly and so he asked someone to call me so that I could be prevented from joining his unit. The messenger friend apprehended how I could work there if the Asst. Prof. was not willing.  I told him that I would be meeting him with the joining letter the very next day and in due course of time; the teacher was amongst the closest to me due to my sincere work.

                        During ‘seniorship’, I recall how a brother could be intimately attached to a brother, a patient having berry aneurysm and I also saw how an old man was happy in his illness to find all his four sons near him like Ram, Laxman, Bharat, and Shatrughna.  I do not know whether we four brothers living far away from our parents will have this fortune?

    Prof. M. Mishra himself was known in the Doctor’s Colony as Shrawan Kumar for his utmost devotion to his parents.  But for his homesickness, he would have been in one of the best institutions of the world.  Methodical, scientific and specific in his approach, he was at the same time a great believer in Mithila’s glorious traditions.  Speaking in chaste Maithili with patients, public and even medicos, you could not flex him by any means. With a calculator in his pocket, he would find the statistical significance with ease as much as that of any sign or symptom of a disease. A master of the ECG and inquisitive to learn always, I sometimes think he was no doubt; a grand physician but he would have been a computer scientist par excellence.

    His senior and teacher, Prof. N. P. Mishra, had the rare faculty of consistency in efforts and by his assiduous labour he could reach any height.  Very popular as a teacher he used to bring patients like some other senior teachers from his personal clinic also.  For him no one was brilliant.  He used to say, “I need mediocre whom I will train to be fit in any institution.”

  

    A grand history taker and a meticulous clinical examiner, when he used to speak in post-emergency rounds, it might be difficult for you to keep standing if you were not accustomed to fasting.  How punctual he was in teaching that he told me when he had a cardiac attack (of multifocal extra systoles) that he felt something wrong was going on in his body during rounds in the ward but he had preferred teaching to retiring. A wonderful orator, Saraswati used to dwell on his tongue.

    I was really privileged to work under those masters.

    Internship period is said to be insignificant but I was impressed by the punctuality of Prof. H. N. Dwivedi, a friend of Prof. N. P. Mishra. Whether his batch was rarely gifted?  I had done five-suprapubic cystostomy, few hydroceles and many abscesses, etc.  Some of the operations were done in the torchlight (thanks to electricity dept.) even in humid climate during rains.  Prof. Dwivedi was eager that I should join Surgery.  He took me as his assistant in many major abdominal surgeries, lumber sympathaetectomy, amputation, and throidectomy, etc. My senior ‘housesurgeon’ was very much impressed to see that    I brought from the NMO’s drug-kit anti-diarrhoeal drugs for a beggar having carcinoma of rectum; probably none dared even touching him due to foul smell.

    I had given my choice for internship in Medicine in an insignificant unit to make free the RMO for his MD examination taking over all his routine work.  He was the same RMO, Dr. U. N. Singh, who had protested before Dr. Bajpai, my external examiner in the final MBBS. Dr. U.N. Singh was a socialist whose father died of peptic perforation during the National Emergency with  J. P.’s literatures under his head.   I managed the cases as per my choice and learnt more than an average internee.

            In Obst. & Gynae., my senior friend’s wife Dr. Kalyani Gupta, was the ‘housesurgeon’ who used to tease me, “You are to do P. V. in labour room, etc.” I experienced, the department had hardly anything in scientific fervour ... ladies used to talk more about their husbands and houses, knitting sweaters, etc. (Thank, my wife knitted a sweater for me before joining the Obst. & Gynae. department otherwise, she might have been at a loss to find a choice of the design)…But when my Bhabhi requested me to come for night duty at least for their safety,   I happily agreed. 

    The P. S. M. duty period, I mostly spent in organisational work for lack of infrastructure to work properly in the field. The big three white elephants (i.e. ambulances) were only suitable for the national highways which were far away from Darbhanga.  Once on the road, it broke the old iron curved name plate of the college.  I could know in due course that parts of some worth of those ambulances were utilized for private use like the staff cars of public servants.

            But there the atmosphere was educative with a good number of  dedicated teachers; clinics and wards full of patients with   varieties of diseases that I could learn well  and could nourish the sprouting NMO at the same time.

Internship — Relevant or Redundant

(Abstracts — Students’ session, NMOCON-91, Karnavati)

                Dr. (Miss) Navjot Gill who was adjudged the best speaker said that during internship students put into practice all that they had learnt during MBBS course. This offers opportunity to acquire experience and perfection of skill. In learning practical procedures the shortcomings are picked up by seniors and rectified, rather than learning at one’s own risk.

            As all are not going to do post-graduation it is time to acquire clinical skills and confidence. Even for would-be postgraduate students it acts as an experience. One can choose or change the subject of choice by working in difference departments.

            Dr. Jogesh Patel, an internee said that internship is a golden period of the life both for curricular and extra-curricular activities. During MBBS curriculum they have hardly any time for developing clinical skill besides preparing for examinations, which are more theoretical.

(Courtesy, the Aayurvigyan Pragati 1992; 12:2)