Yamaraja’s brother – Mani

by Janaki Venkataraman

Yamaraja’s Brother – An Autobiography of Dr. M.K. Mani.

I don’t usually like reading books penned by practitioners of medicine. They scare the hell out of me. All right, I read A.J. Cronin when I was a teenager, but then his were romantic novels. Besides, I was of an age when I thought I was immortal. Now, however, I generally prefer to skip books, however well-written, by cardiologists, cancer specialists and the like.

Dr. M.K. Mani.

The autobiography of Dr. M.K. Mani, well-known Chennai nephrologist, is a welcome exception. First published in 1989, it was reprinted and released recently, along with a newer book, Letters from Chennai. The latter is a collection of Dr. Mani’s opinions on a variety of subjects. The autobiography spans the six decades of the doctor’s career, from the time he entered medical college in Chennai, moved to Australia, returned to India to work in Mumbai and then back again to Chennai where he now practises. This book is not just about sickness and healing but about the various environments in which Dr. Mani studied and worked and his acute observations on the ways of the world around him. What shines through the writing is a precise and very sharp intellect and an engaging and wry sense of humour.

Dr. Mani’s book does not exactly have a welcoming title: Yamaraja’s Brother. Nor does the little Sanskrit verse he has chosen to introduce the reader to the book.

“Hail to thee, Oh physician,
Brother of Yamaraja,
Elder brother, for Yama takes life
While you take life and money too.”

However cynical the sentiment of this little piece of poetry, it is one doubtless shared by many patients visiting hospitals today.

Dr. Mani was seven or eight years old when he decided to become Yamaraja’s brother. At an age when boys aspire to more outlandish careers, such as acrobatics or space travel, young Muthukrishnan (as he was named by his parents), chose medicine. The immediate reason for this decision was the influence of a young doctor, Dr. Purushottaman, who was a guest for some time in his father’s Tughlak Road residence in Delhi. Muthukrishnan hero-worshipped him to such an extent that he decided to study medicine himself. And he never once swerved from that decision, though the elders in his family never approved of it.

Dr. Mani comes from a well- known family of Mylapore lawyers, judges and civil servants. Mani’s grandfather liked to call the place ‘My-law-pore’, as it was so full of lawyers, who looked down on every other profession and on lawyers who lived elsewhere. Mani’s intention to join medical college was therefore met with strong opposition. His grand uncle, K. Balasubramania Iyer “was convinced that the medical college was a den of inequity and… my entry into it indicated that I was depraved,” recalls Dr. Mani. His only ally in this matter was his father, T.M.S. Mani, who had, when young, nursed a secret desire to study medicine, but had given in to his father’s wish for him to enter the Civil Services. (T.M.S. Mani was Health Secretary in the Tamil Nadu Government and is also credited with founding Neyveli Lignite Corporation).

In talking about his childhood, Dr. Mani fondly recalls his grandmother, K. Saraswathy Ammal, who authored several novels and short stories in Tamil and told her grandson stories about her own father, V. Krishnaswamy Iyer, who rose from advocate to High Court Judge to a member of the Governor’s Executive Council. He was also a Congressman who organised the Madras session of the Congress in 1908; founded the Indian Bank, the Mylapore Club, the Madras Sanskrit College, the Ayurvedic College and the Venkatarmana Ayurvedic Dispensary – every well-known Mylapore landmark, in fact! Grandmother Saraswathy also told Muthukrishnan about the famous doctor of her times, S. Rangachari, whose patient list included the who’s-who of Madras. His treatment was equally available to the needy as well. When his Rolls Royce glided down Luz Church Road, people could stop him to request him to see a patient. If the house was big enough, the Rolls Royce would stop in the driveway. If the house was in a lane, Dr. Rangachari, would get out and walk the distance to the patient’s house. He was generally believed to have a healing touch, apart from being hugely knowledgeable, never demanded a fee but accepted whatever was given to him. If, however, a patient asked him what his fee was, then he would mention the full, rather forbidding amount. There was one thing he would never tolerate in a patient – lack of faith.“Woe betide the patient …who sought a second opinion. He had made an enemy for life.” Perhaps the stories about Dr. Rangachari also fuelled young Muthukrishnan’s desire to study medicine.

In 1953, M.K. Mani entered Madras Medical College. Dr. Mani’s thoughts on the efficacy of the selection process for admitting students, the unfortunate tendency of parents who are doctors to persuade their offspring to take up medical studies, even when the latter may have no real wish to, and the system of reservation quotas in college admissions, are interesting to read. “Is it fair to take a candidate who is academically inferior and put him in a course of study which would strain the best of students?” he asks. “How will this student ever master the subject, clear the examinations and graduate? There is only one way, and that is to lower the standard of the examination. There was a time when a graduate of a prestigious Indian university like Madras or Bombay was recognised with respect all over the world. Today our degrees are discredited.” Dr. Mani also offers a somewhat drastic, though tongue-in-cheek solution to this problem. “The solution will come only when the public learns enough to insist that each politician or official who produced a mediocre doctor by using personal influence or following the wrong policy, should be treated only by that doctor. He should not be allowed to seek the best doctor in the country or the world, when he has condemned his constituents to be ministered to by the second-rate”.

Dr. Mani describes his first day in the Madras Medical College thus: “We went first to a medieval looking red building which housed the Department of Physiology downstairs and Anatomy upstairs. Students called it the ‘Red Fort’, because like the historic redoubt, it was hard to enter, and once in, ever so much harder to get out of. The dissection hall was vast with rows upon rows of marble topped tables, each with its dried up occupant who had once been a human being. It was an inauspicious start to a career in which love for humanity is so important.” Love for humanity was the last thought in their minds as the students cut and explored the cadavers, memorised the details of human innards, mugged their way through the study volumes and lecture notes without thinking, their only purpose being to pass the examinations. In hindsight Dr. Mani observes that this was a wasteful way of studying basic medicine. “Now, if you want to teach a man to ride a bicycle, you would not begin with lectures on the internal combustion engine, followed by a ride in a Standard 2000, with finally a chance to steer the car while the teacher cautiously keeps a hand on the controls. This is what we are doing, for all our education deals with complicated heart, lung and brain disorders. I spent two years in general practice, and saw three patients of the type who would have come to me in my MBBS examination. I referred all of them to the hospital for further investigation and treatment. I saw hundreds of people with diarrhoeas and fevers, aches and pains, little injuries. No one ever taught me how to tackle these problems.” Unfortunately there is no reason to think medical education has become more enlightened in the years since Dr. Mani studied.

He did, however, get to meet and learn from a number of exceptional doctors and was able to study their brilliance and eccentricities at close quarters – Dr. Govinda Menon, Dr. Subba Reddy, Dr. U. Mohan Rau, Dr. K.S. Sanjivi, Dr. Krishnan Kutty… the list reads like a roster of brilliance in medicine.

After passing his MBBS in 1959, and after completing his training as an intern and house surgeon, Dr. Mani returned to Madras Medical College for his postgraduate studies and also managed a small private practice at home every evening. After getting his M.D. degree in 1962, Dr. Mani married. It was a marriage arranged by his parents. Rama, his wife, was also studying medicine. She later specialised in pathology and is a well-known pathologist in Chennai today.

While many of his class mates went to England for further study, Dr. Mani chose to join the Madras Government Medical Service, as an Assistant Professor and Assistant to Physician in the Government General Hospital. Then, as now, the hospital was impossibly overcrowded and dirty, and there was corruption everywhere. Food meant for the patients was being pilfered by the kitchen staff, the toilets stank beyond endurance, and drugs were often mysteriously in short supply. Sounds familiar?

Dr. Mani then joined Government Stanley Hospital to do his Ph.D. Stanley Hospital is unique among all hospitals in Tamil Nadu… A part of the hospital was once a jail, and the old wall still stands, a fortress with its ramparts. The blood bank occupied part of this old fortification. A large part had been a choultry and in years gone by, during times of famine, gruel had been distributed to the poor from here, hence its popular name of Kanji Thotti Hospital – Gruel Depot Hospital… the main hospital was a good enough building, airy and solid, but new constructions had risen haphazardly in the gaps between the old, and it was impossible to walk in a straight line between one ward and any other…. And the isolation ward, known as the Grey Ward, had come to be known as the graveyard. It was so far removed from the rest of the hospital that medical staff hardly went there, and a patient consigned there often languished unattended till the end came, and he was shifted to the mortuary nearby, recalls Dr. Mani.

Dr. Mani soon discovered that completing his Ph. D was going to be a Herculean task given the red tape that surrounded research work and he decided instead to specialise in Nephrology, a new medical field at the time. He applied for and got a placement as Senior Registrar in the Department of Nephrology in Sydney Hospital, Australia. In April 1968, he left with his wife and son for Australia.

(To be concluded)

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