Quiet voice – rare human

Referring to last fortnight’s numerous responses on the subject of the General Practitioner, a reader from Mylapore sends this piece titled ‘The Healer’ by VIGNESWARA in his column ‘Sotto Voce’ that appeared in Swatantra on April 23, 1949:

It is so unusual to find a popular favourite who is not a politician or a cinema star, but a young doctor whose death occasioned such sincere and widespread grief that it was something of a revelation to me. I had of course known in a general way that Dr. K. Sambasivan had built up a good practice, especially in Mylapore and thereabouts. But he had by no means the kind of personality that impresses the casual observer. And he had not been adopted as a mascot by the bon ton. He seemed to be totally unaware of the arts of advertisement. Quiet and unobtrusively efficient, he was the very antithesis of the immaculate clothes-dummy who beams down upon you from the fashion plates.

But the poor had taken him up. The rich did not condescend to him; the sophisticated relied on his judgement and spoke of him with respect; but the poor, while they shamelessly exploited him, loved him. When he fell ill they hung about the house at all hours of the day making anxious enquiries. They besieged the nursing home in their hundreds when he was passing through the first crisis. And when after a brief rally the end came suddenly they seemed for a short hour to go mad with grief. I had seen nothing like it since the passing of that Good Samaritan Dr. Rangachari.

* * *

Dr. Rangachari was a great physician; but he was a rather formidable personality. He had upon his clients and their loquacious relations the intimidating effect that is best expressed in Mathew Arnold’s famous tribute to Shakespeare: “Others abide our question ... thou smilest and art still.” Sambasivan, apart from being a much younger man, was not brilliant, but he was human in our unassuming Indian way. He reminded me of the country doctor in Alphonse Daudet’s Jack who, in spite of his good wife’s vigilance, contrived to forget more than half the visits he had made, and would lose his temper only with his old trap horse when the poor patient brute decided that his master had had enough of hard unrewarding work for one day and refused to budge.

* * *

At the memorial meeting held in Mylapore, a medical man suggested that at present the provision of medical relief was least adequate for the middle class. The State hospitals, he said, gave excellent service to the poor, and the rich could be left to fend for themselves. While that is theoretically true, such a career as Dr. Sambasivan’s shows that the general practitioner is sought after at least as much by the poor as by those who can better afford to pay. State hospitals are far too few, for one thing. And there is something chilling, almost inhuman in the sterilised, chloroform-smelling atmosphere of these public institutions that unnerves the timid who are unaccustomed to impersonal efficiency.

The poorest are supposed not to pay. But mamool is all powerful. And they find that the bakshish the insolent ward boy expects would more than suffice to meet the modest bills of the private practitioner up the street, who allows them to pay when they can. The belief is deeply ingrained in the Hindu mind that the physician’s dues are one of those debts that it is obligatory to pay. We no doubt often allow arrears to mount up, but we salve our conscience by telling ourselves that we shall pay – some day! Meanwhile, for the idler who is something of a hypochondriac, there is the daily visit to the doctor to look forward to – a pleasant break in the monotony of city life.

* * *

The poor, God knows, have no time to moon about. To lose a day’s wages would mean for most of them that the family would have to go without food. And of all the bureaucratic devices for wasting time none is so devastatingly thorough as a public hospital. You may be penned with a hundred others for the better part of a morning in the outpatient ward only to find that the spruce supercilious youth who signs the chits stalks off when you think your turn is at last coming. Your heart full of gall you trot off to catch the tram lest you should be late again at the office and the superintendent waxed sarcastic.

* * *

And when in a poor household somebody falls seriously ill, there is consternation, for the whole economy of life is disrupted. But more appalling than the material deprivations is the fear that clutches at the heart; for they have so little to take comfort in except each other. Like a dumb animal in pain they go about with a hunted look. And they crave for sympathy more than for anything else. The doctor who mixes his medicine with a little humanity is sure of a niche in their hearts.

Reader’s Note: Dr. Sambasivan’s practice is still continued in the same clinic and with the same spirit by his son Dr. S. Nageswaran and grandson Dr. N. Prahalad.

Certification possible?

Unless the doctor has attended on the patient during his last illness, how can he be compelled even legally to issue a certificate as to the cause of death (MM, November 1st)? My father Dr. N. Natesan had once been summoned at odd hours to the house of a “patient” who he found, on reaching the house, had already passed away. He refused to certify the cause of death.

Knowlegeable readers of MM may please throw light on this piquant and pitiable situation, as this would have been certainly covered under the Act laying down registration of Births and Deaths.

N. Dharmeshwaran
C-1, Sugan Villa,
Abraham Street,
Adambakkam,
Chennai 600 088

Existence certificate

The letter on ‘The Death Certificate’ (MM, November 1st) reminded me of the problems faced by senior citizens in getting another type of document called the ‘Existence Certificate’.

A particular insurance company requires its annuitants (people who had invested in its pension policies in return for periodic returns for a stipulated time or for life) to produce an ‘Existence Certificate’ in the prescribed manner. It involves meeting one of the suggested types of persons, signing a form in his or her presence, getting it countersigned by the person with official seal and sending the completed form to the insurance company. More often, the person is a stranger to the annuitant and is reluctant to assist. If this form is not sent for any reason, the payment of annuities is stopped.

Why is this procedure insisted on when a simple signature by the annuitant in any prescribed form can prove that the annuitant is ‘existent’? This is similar to cheques signed by an account-holder for an amount and accepted by bank.

This company wants the “Existence Certificate” every year, while the Life Insurance Corporation needs it every three years. Also, the types of persons in whose presence the annuitant has to sign differ from one insurance company to another. For instance, LIC allows annuitants to sign in the presence of any registered medical practioner, but the company I refer to does not permit this.

Will the insurance companies come out with an annuitant-friendly stipulation that an ‘Existence Certificate’ will be valid if it is just signed by the annuitant? This will save many senior citizens from avoidable agony.

D. Subbaram
Chennai 600 020

Other T’Nagar GPs

As an old resident of T’Nagar, the letter from reader V. Thiruvengadam (MM, November 1st) on the doctors of the area brought back waves of nostalgia.

However, he has left out one of the best known GPs of T’Nagar, who was not only respected by all his hundreds of patients, rich and poor, but was also a dashing cricketer. I refer to Dr. S.V. Tiruvenkatachary, or S.V.T. Chary as he was popularly known. His consulting room was full of cricketing photographs and, being a proficient wicketkeeper himself, he was a fan of Godfrey Evans.

His clinic was a sprawling ground floor house at the junction of Arcot Mudaliar Street and Thanikachalam Chetty Road. He had a dispensary attached to the clinic, with a ‘Compounder’ who used to make out the prescriptions at lightning speed, usually bottles of ‘mixtures’ of different colours which were ‘sealed’ with real corks.

As longstanding patients we had monthly accounts with the doctor, whose clerk used to come every month to collect the fees.

We lived in Arcot Mudaliar Street, and as a small boy I used to cut across his clinic to reach my house, to and from Ramakrishna Mission High School (Main) opposite Panagal Park. During Test Match days, he would call me from his window as I passed and ask for the latest score!

He had a lovely Buick car and the sound of its horn would tell the neighbourhood that Doctor had arrived. He lived on Raja Street, next to the Agastyar Temple, and was at his desk, rain or shine, every day without fail – and absolutely punctual.

Another well-known T’Nagar GP was Dr. Ramanathan whose clinic was on Coates Road. He used to present children visiting him with colourful blotting sheets which we used to hoard.

S.Rajaram
62 /1, MES Road,
East Tambaram,
Chennai 600 059