My maternal grandfather Dr. Kesava Pai was determined to become a doctor despite parental opposition. He was supported by his teachers at St. Aloysius College, Mangalore, who persuaded his parents. He finally left home to travel to Madras where he studied at Madras Medical College. At the end of his course of study he topped his graduating class and won the Johnson gold medal. Choosing pathology as his specialization, he joined government service. He spent his early professional years on research, first on anti rabies and tetanus vaccines at the Pasteur Institute, Kasauli, leaving his wife and small children in Mangalore. Returning to Madras he joined the King Institute, at Guindy, Madras, specializing in research and treatment of tuberculosis. He rose to become the first Indian Director of the King Institute where he made a name for himself as a specialist in tuberculosis. TB was then one of the major killer diseases, along with cholera, smallpox and typhoid. It attacked all strata of society from the poorest to the well to do. Many of Dr. Pai’s patients were prominent Indian residents of Madras, and many came to consult him from distant places in Tamilnadu.
Long before streptomycin was used successfully to combat TB early diagnosis, fresh air and a nutritious diet saved those who could afford treatment. But there were many of his patients in the government hospitals who looked to him for a cure, as the disease relentlessly consumed them. Consumption was an apt other name for tuberculosis. In the 1920’s Dr.Pai went on what would now be called a sabbatical, visiting TB sanatoria in Switzerland, Germany and the Scandinavian countries, meeting his counterparts, specialists in tuberculosis in Europe and England. On his return to India he was appointed Director of the King Institute and the British government awarded him the title of Rao Bahadur.
His grandchildren – we were three little girls, and often our cousins joined us – enjoyed the warm security of the home our grandfather built in Pudupet, Madras. The red brick two- storey mansion, with a small garden in front, had two drawing rooms on the ground floor, one of them, to the right as one entered through the car porch, was called the “gosha room” exclusively for grandmother’s women guests many of whom were “gosha” – women in purdah- from the Muslim elite of Madras city. All of us in the family, women and children, were strictly forbidden from entering the rooms to the left on the ground floor, for these were grandfather’s consulting rooms. Grandfather was always worried about infection from his coughing sick patients and during the hours of consultation he was out of contact with any of us. At other times of the day and on Sundays we were invariably with him in his study, and spacious bedroom next to an airy terrace at the back of the house.
Our education was enriched by our talk sessions with grandfather with his many interests, other than medicine. Evenings on the beach, observing the clear night sky, we learned to recognize the constellations, learned about the tides, and the monsoons. At home, seated in front of the horn of the old HMV gramophone, (emulating the iconic dog!) we listened to bhajans and learned about Tukaram, Dhyaneswar, Kabir and Surdas, the saints of the Bhakti movement, their life stories and their poetry.
Above all, we were subjected to all the prophylaxis, inoculations against typhoid, cholera and malaria; health and hygiene was always a primary concern. Having seen the horrors of hydrophobia at the Pasteur institute in Kasauli, he would not allow us to have a pet dog. We asked about X-rays and he explained this miraculous invention that allowed one to see inside the body, the underlying bones and tissues. He showed us the X-rays of one of his patients whose lungs were eaten away by consumptive TB bacilli. We learned about Pierre and Marie Curie and their relentless search for an element they called radium.
In 1940 my sister became seriously ill with pneumonia. In consultation with our family physician, he agreed to try the new “sulpha” drug that had been introduced by May and Baker. Named MB693 the drug had been used with great success on wounded soldiers on the war front fighting gangrene. My sister recovered rapidly. Stimulated by the urgency of the war medical science had made rapid progress in its research on new chemical combinations for healing medicines.
Dr. Kesava Pai was born on December 21, 1879 – incidentally he shared his birthdate with Josef Stalin. He died in 1965. In his lifetime he had seen the Wright brothers lift their flying machine off the ground, emulating a bird in flight. Before he died he had seen Russian Luna 2 crash land on the moon. (Neil Armstrong took his ‘one small step’ on the moon ten years later). He had seen two world wars, which were followed by extensive scientific research, especially in medicine, impact on the health and life of human beings. Penicillin, streptomycin and a host of new antibiotics have saved countless lives. A shrinking of the world through improved communication has facilitated the sharing of knowledge among different countries of the world.
Today, almost fifty years after Dr. Kesava Pai died, I lay on a gurney in a hospital waiting to be wheeled into the radiology department of a large hospitalfor a “scan”
SCANS have brought in a new medical vocabulary, acronyms like CAT scan, PET scan, CT-guided FNAC, bewildering in the diverse instruments of technology, and completely silencing the questioning mind, ignorance forcing one into submission to awe-inspiring technology. Trying to understand all these procedures I do what most of us do in this computer guided education – Google it.
“A Computerized Axial Tomography scan, or a CT scan as it is more commonly referred to, is a special x-ray technique that produces images of your internal organs that are more detailed than is possible with conventional x-rays. While both types of x-rays produce images using beams of radiation, the way they use those beams is what makes them different.
CT scans are used in situations that require more detailed images than those created by conventional x-rays. For instance:
• To diagnose and locate tumors or masses in the body.
• To identify areas of infection or the presence of abscesses (pockets of infection).
• To guide procedures such as biopsies and radiation therapy.
• To monitor diseases such as cancer. “
I had already got a humble X-ray – just as grandpa would have done it. Remove all jewelry, watch, metallic objects, undress, wear a striped hospital robe, press the chest against a plate Take a deep breath and HOLD IT.. DON’T MOVE! That’s it. You are done now. A very short wait and I am clutching my X-ray in a stiff envelope. I take a peek… No grandpa, I don’t have TB-scars in my lungs.
But the doctor is not happy. The X-ray only shows me one dimension of the lung, she says… You need a CT scan so I can see the other sides. (Nowadays we can see the other side, behind the moon too. So, why not?).
I am nervous. I have a canola piercing my wrist for an intravenous injection. I am wheeled into a white, cold room, awed by a huge machine like a giant doughnut. Another gurney with a white sheet, on which I lie, before they slide me into the maw of the doughnut. An injection into my wrist suffuses my body with warmth. As the machine whines, overarching lights twinkle like the stars in the night on Madras beach. A disembodied voice on a speaker instructs me “Take a deep breath and HOLD IT. DON’T MOVE” No, not my grandfather speaking from heaven above, but a sweet young nurse from Kerala, with a name tag, JAICEY, handles this machine that dwarfs her. She pulls me out like a cookie on a tray, and smiles. ”You are done!” she says and she helps me get down and find my slippers. I get dressed and am relieved to have my cell phone to communicate at last after a lonely wait in the Radiology dept. waiting with other people like me in striped gowns and pain-pricking canola in their wrists. I call my son to tell him I am ready to go home. I find a text message from JAICEY to tell me she is praying to Jesus Christ that I will soon be healed. I realize why her mother would have given her that unusual name conjugating two initials JC, — and I realize I am blessed!!