Culture & Life · Fiction · History of Medicine · Medicine & Doctors

A riveting 1947 short story featuring India’s medical education system

Popular representations of medical systems, professionals, and of illness itself, are an important source of knowledge for historians of medicine. During my research into the history of the Indian (bio)medical profession in the post-independence period, I recently came across a very interesting short story, published in a Sunday edition of the Indian Express in October 1947. Since the type is hard to read and navigate in the original source (Google-digitized newspapers, page 7 here), I have reproduced the story below so that more people today can read it.

This story has several interesting aspects apart from the riveting narrative. There are many references to, for example, the nature of medical education in the India of the 1940s, the life of medical students, the gossip-laden canteen conversations, and the stress of practical exams. Veteran doctors will perhaps be taken down an intimate memory lane on reading this, and younger doctors will have much to relate to and be surprised by. As of now, I do not know the identity of the author (“Amar”), and perhaps we will never know, but I will update this page if I discover anything relevant in future.

[The story incorporates some ideas and theories on mental illness which are not mainstream today, and are widely believed to be incorrect and problematic.]

TWENTY pairs of eyes gazed with rapt attention at the Professor of Operative Surgery who was demonstrating a delicate abdominal operation on a dead body, in the anatomy dissection theatre of the Medical College, to a batch of final-year students.

To an outsider, the scene would have appeared to be forbidding, — perhaps, even macabre: a long, high-roofed hall flanked by tall glass windows; at one end of it, a Iine of porcelain wash-basins, and at the other, a row of five or six human skeletons, dangling from iron hooks bored into their skulls; along the entire length of the room two columns of wooden trestle-tables topped with metal sheets; on each table, sprawled in some fantastic attitude, a shrunken cadaver, which had been the living body of some destitute or derelict of society, and had now become an assemblage of ‘parts’ for the student of anatomy or the budding surgeon.

The operative surgery class came to an end, and the students straggled out of the musty hall in small groups, into the sun-shine. “Operation successful, though the patient was already dead,” observed Ashok, who had the reputation of being the wag and wit among the final-years. His cliche was greeted with a chorus of laughter from his listeners; but one of them, a tall earnest-looking young man, said in a serious tone, “Really, Professor Kadlekar is a marvellous surgeon! If I were to possess a fraction of his skill, I would feel proud of myself.”

“Why so modest, my dear Gopal,” inquired Ashok sarcastically. “When you have already won the gold medal in surgery awarded by Cuddly himself!” “Gopal is Cuddly’s curly-haired boy, and they form a mutual admiration society,” said Shankar, who had been a close second to Gopal in the surgery prize examination. Ashok glanced over his shoulder, and whispered warningly, “Shh! Here comes Cuddly!”

Professor Kadlekar overtook and passed the students with quick, short steps, his head cocked a little to one side, and his eyes fixed to the ground. He was a short, compactly-built man of about fifty-five, with a bulbous head sparsely covered by greying hair. His eyes were small, almost beady, but they shone with the light of an acute intelligence, and could almost emit sparks when he was angry — as his students often found out to their cost. Though they referred to him familiarly, amongst themselves, as Cuddly, they regarded him with awe and respect; but even those whom he lashed most with his stinging tongue knew that his words were without malice, and admitted that he was scrupulously fair as an examiner.

He nodded vaguely in response to the students’ greetings as he passed them, but when he happened to catch sight of Gopal he smiled slightly and raised his hand saying, “Hallo, Gopal!” When the professor was out of earshot, Ashok exclaimed, “You see! Gopal is the only name he knows; all the rest of us are merely numbers on the surgery answer-papers!” Shanker turned the topic saying, “Let’s go to the canteen and have some tea.” The other two agreed with alacrity, and they strolled towards a large zinc-roofed shed which served as a cafe, as well as an unofficial common-room for the five hundred students of the college.

It was almost deserted, however, when the three friends entered it. They chose a  table in a secluded corner, and ordered for tea and fresh, hot buns for which the canteen was noted. Shankar munched a bun, and murmured wistfully, “I shall miss this greatly when I leave college for good, next month.” “Cheer up!” exclaimed Ashok. “Perhaps you will have to stay a bit longer!” And then as if to atone for his unkindness, he added, “For my part, I don’t expect Cuddly will ever give me a pass in surgery.” Shankar said reflectively, “He is not really a bad chap, you know. The hardest of him is the crust, just like this bun… As a matter of fact, I heard from our surgery tutor a few days ago, the story of Cuddly’s private life and his family history. It is a tragic tale, and it provides the psychological explanation of his cynicism and irritability, and the general moodiness of his temperament.”

Shankar paused to find out whether he was holding the attention of his audience. Being apparently satisfied on the point, he continued, “Cuddly was married when he was still a medical student, and a couple of years later his wife bore him a son, who proved to be their only child. Cuddly was deeply attached to the infant, and doubtless hoped that it had inherited his own intelligence and would grow up to become famous in some field of knowledge. He was severely disillusioned when he discovered that the child was mentally backward, almost an imbecile. When the boy, (whose name was Ganesh), was eight or nine years old, he began to display criminal propensities, — stealing things, wilfully destroying other people’s property, and assaulting younger children for the sadistic satisfaction of watching their distress. On one occasion, when he was trying to stick a pen-knife into another child’s face, the instrument injured his own cheek, leaving a permanent scar which gave him a grotesque appearance. You can imagine how acute Cuddly must have suffered, but he bore his cross bravely, and lavished his love all the more upon his half-witted son.”

Shankar interrupted his narrative to sip his tea. He selected another bun, and resumed. “One day, when Ganesh was about fifteen, Cuddly was visited at his house by a wealthy merchant, accompanied by his  wife and seven-year-old daughter. The lady happened to be wearing a valuable platinum ring set with three diamonds, and at Cuddly’s wife’s request she took it off her finger and offered it for inspection. The ring passed from hand to hand, and  was somehow forgotten for a while in the course of conversation. When the merchant’s wife looked for it again, it was nowhere to be seen; but the little girl remarked that Ganesh had held it last. Cuddly searched the lad immediately, and on failing to recover the lost article, he insisted upon the visitors making a systematic search of the house and all its occupants. But the ring was not found, either then or later. When Cuddly called for  Ganesh to question him again, the boy had also disappeared. The police were informed, and rewards were offered, but Ganesh never returned, and no trace of him was discovered.”

Shankar ceased talking. The others had finished their tea; so he drained his own cup, grabbed the last bun and put it into his pocket, and then rose to his feet. As they left the cafe, Ashok said in a subdued tone, “No wonder Cuddly is so crabbed and vicious at times!” and added “Perhaps he still hopes his son will turn up some day.” “I don’t think so,” said Shankar, “for it is now fifteen years since the boy vanished, and it is hardly likely that such a disfigured and mentally deficient individual could have survived for so long even if he begged for a living.” Gopal kept silent but it was evident from the expression on his  face that Shankar’s strange story had moved him profoundly.

A fortnight passed, and the final-year students were engaged in frenzied study and last-minute speculations regarding the qualifying examinations which were less than a week away. Gopal, also, studied late into the nights. He knew he had no cause to fear a failure, for he had always managed to secure one of the top three places in the periodical class tests. What he was trying for, now, was to achieve the first rank in the final examination, — not for its own sake, but because it would help him  to obtain a scholarship for higher studies abroad. His parents were poor, and his college education had been made possible only by his own industry which had won him free scholarships year after year.

The great ordeal commenced at last, and for ten days Gopal went through a grueling series of tests, — written papers, practicals, clinicals, and orals, — having to appear, in turn, before six examiners in each of the three final-year subjects. On the morning of the last day, as he walked towards the anatomy dissection theatre, he felt he could be reasonably certain of his ambition being fulfilled; he had done very well in all the subjects so far, and the only one that remained was his strong point — the operative surgery practical.

On arriving at the dissection hall he was  gratified to find that Professor Kadlekar would be his examiner; and when the slips of paper, each containing the name of an operation, were distributed among the  candidates, Gopal’s heart leapt with joy at his good fortune, — for the operation that fell to his lot was the removal of the appendix, a procedure in which he had assisted Professor Kadlekar on several occasions at the hospital, besides having practiced it on the cadaver. He was assigned a table near one end of the hall, and he noticed with satisfaction that the dead body on it was a fresh one, with supple skin and elastic tissues which would enable him to perform the operation almost as neatly as on a living subject.

Processor Kadlekar came to Gopal’s table to watch him making the skin incision and the separation of the underlying structures, and then he wandered away to inspect the progress of the other candidates. Gopal worked quickly, deftly, with precision and confidence. And, as his fore-finger dipped into the abdominal cavity, feeling for the appendix, there rose in his mind a vision of himself sailing for distant lands, working with world-renowned surgeons, and returning to dedicate his knowledge  and skill to the service of his own country.

His cogitations were cut short suddenly, when his probing finger touched something round and hard, in the region of the appendix, — something which should not be there at all. He palpated it carefully, through the thin wall of the intestine: it was smooth and circular, like a narrow metal band. Gopal’s memory jerked, and his eyes turned involuntarily towards the face of the corpse, which was covered, as usual, by a piece of cloth soaked in oil, in order to keep the skin and subjacent tissues in good condition. The dead body was that of an emaciated man of about thirty, with a rather small head. Gopal lifted the cloth a little, and he saw, running obliquely across the right cheek, a huge scar which gave the face a repulsive, almost hideous appearance…. Instinctively, Gopal knew beyond doubt that the dead man was Ganesh, the professor’s son; and that the object lurking in his appendix was the ring which he had stolen, and evidently swallowed, fifteen years ago.

Gopal’s mind raced against time… In a few moments, Professor Kadlekar would be coming round to see the completed operation, and he would of course want to examine the appendix to find out whether it had been correctly removed. If the ring was still inside, he would certainly cut  down on it, and discover the identity of the corpse. On the other hand, if Gopal were to open the appendix himself, without revealing to the professor the reason for having done so, his action would surely appear to be an operative blunder which was unpardonable in an academic examination. Gopal’s choice was limited to two alternatives, — securing a first class for himself, while breaking the professor’s heart; or sparing the professor, at the cost of a downright failure for himself: for the operative surgery part of the examination required a separate minimum of marks for a pass in the whole subject and Gopal knew that Professor Kadlekar was too rigidly conscientious to give him any grace-marks on the score of his past record.

Gopal looked across the length of the hall, and saw Professor Kadlekar turning away from a table at the far end and walking slowly towards him. The professor’s face was sternly-set, lined and careworn, but to Gopal it seemed, somehow, strangely sympathetic, serene and graceful, and he could not bear to think of the change it would undergo at sight of the platinum ring, or the scar on the cheek of the corpse. He knew he had only to dispose of the ring, for the professor would not raise the cloth from the dead man’s face, nor would he visit the dissection theatre again until the next term, by which time the whole cadaver would have disappeared under the hands of the second-year anatomy students… Gopal picked up his knife, and slashed at the appendix. From within the cavity of that organ, three lustrous diamonds, set in a slender hoop of platinum, sparkled and winked at him. He extracted the ring and put it into his pocket.

When Professor Kadleker came to his table a minute later, Gopal did not look up at him The professor seemed to sense that something had gone wrong, for he did not begin with the customary questions. He glanced at the loop of intestine lying on the dead man’s abdomen, and held out his hand for the appendix. Gopal placed it on his palm. The professor spoke, without lifting his gaze from the mutilated organ. “Have you any explanation to offer for performing an appendicectomy in this manner, Gopal?” he asked, in a low, vibrant tone. Gopal made a slight gesture of hopelessness and said, “No Sir, — except that I couldn’t help it. Professor Kadlekar put the appendix down on the table and said, “Then you may go. I have no questions to ask you.” He turned away, and with his face still averted from Gopal, he added, “Please see me in my office at two o’clock this afternoon.”

*    *    *     *    *

At the appointed hour, Gopal entered Professor Kadlekar’s private office in the college, and found him standing at an open window overlooking the lawn. He turned round and greeted Gopal with a smile, and then seated himself at his desk, motioning Gopal to do likewise. In a calm, level tone, he began. “I have not called you, Gopal, to admonish or to question you regarding  your performance in the examination this morning. I am sure you know what its only possible consequence could be; and I shall not be revealing any great secret in telling you that I have given you a zero in your operative surgery practical.”

Gopal found himself trembling at this abrupt announcement, even though he had anticipated and resigned himself to such a result in his own mind. The professor rose from his chair and paced to and fro, while he continued, “I can understand how much this failure means to you, and I sympathize with you, deeply. But I want you to understand that it is not mere sympathy which actuates the suggestion I am going to make to you… I have watched your career in college, and I feel convinced that your talents, industry, and strength of character mark you out for the greater achievements of life.” He halted in front of Gopal, and said, “I have no children; and I have more money than I need. I would be very happy, Gopal, to enable you to go abroad for a couple of years to complete your education, and to obtain experience, as well as higher qualifications, in surgery.”

Gopal wondered whether he was dreaming: his thoughts and emotions were in a chaotic state. He managed to say, “I am very grateful to you, sir, but I would like to consider your offer for a day or two.” “Of course, my boy,” said the professor, “You can come and see me whenever you  like.” Gopal got up and walked towards the door, but stopped suddenly when he heard the professor say. “Oh, Gopal! If you have brought the ring with you will you please give it to me so that I may return it to its owner?”

Gopal stared in astonishment and consternation at the professor, who went on, “When I visited the dissection theatre, early this morning, to inspect the arrangements for the practical, all the cadavers were uncovered; and I noticed, on the face of one of them, the scar which I knew so well. Later when I saw the apparent mess you had made of your operation, I guessed that you must have found the ring inside the appendix, and removed it. I am aware that the circumstances of my unfortunate son’s disappearance are commonly known among my students, and no doubt you wished to spare me any added distress… Yours was a noble self-sacrifice Gopal; and even though it happened to have been unnecessary, I am sure God will reward you for it.”

Professor Kadlekar turned again to gaze out of the window. Gopal took the ring from his pocket, placed it on the desk, and went out of the room.

Courtesy Alamy. “Mahatma Gandhi and hospital assistant Shankaranji at the microscope observing leprosy germs at Sevagram Ashram ; c 1942”

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