Registered with the Registrar of Newspapers for India under R.N.I 53640/91
Vol. XXXIII No. 9, August 16-31, 2023
Tribute to K.S. Sanjivi – 1903-1994
-- by M.K. Mani
(This is an obituary that the author wrote for the National Medical Journal of India in 1995.)
K.S. Sanjivi studied at the P.S. High School, the Presidency College, and the Madras Medical College, Madras. He took the M.B.B.S. in 1927, and joined the Madras Medical Service in 1928. He then went on to take his M.D. degree in 1932. He served in various institutions, including the Erskine Hospital in Madurai and the Tuberculosis Sanatorium in Madanapalle, and then worked as Director of Tuberculosis to the Madras Presidency. He was Professor of Medicine, first at the Stanley Medical College, Madras and then at the Madras Medical College from which post he retired in 1957. He was appointed Professor Emeritus in Medicine in the same college. He founded the Voluntary Health Services in Madras, was its first Honorary Secretary and later became its Director of Projects.
He published 60 scientific papers and wrote six books on medical topics – three in Tamil and three in English. He was awarded the Netaji Bose Gold Medal by the Association of Physicians of India, the B. C. Roy award for sociomedical relief, the Padma Shri and the Padma Bhushan.
In 1951, my father was Secretary for Health to the Government of Madras, and I was a student in the Intermediate in Arts and Sciences course. Medical officers of the Madras Medical Service were expected to look after the families of senior government officials living near them and Dr. K. S. Sanjivi was our authorized medical attendant. One night, I developed a high fever. At 6.30 a.m. my father rang up Dr. Sanjivi and asked him to come and see me on his way to the hospital. Dr. Sanjivi refused. This is my admission day, he said, and I am just leaving for the outpatient clinic. If you are worried about the boy, please bring him to the hospital and I will see him there. If you think it can wait, I will see him in the evening after the day’s work is done.
This conversation would be unbelievable to the officers of today’s Tamil Nadu Medical Service. I have seen my chief waiting for two hours in the Casualty Department on his admission day, neglecting all his hospital patients, because he got a message that an Indian Administrative Service (IAS) officer was coming to the hospital with a headache. (Meanwhile, the IAS officer went to the office of the Dean, where he was examined by another physician.) Dr. Sanjivi would never have wasted his working hours like that. His task was to look after the health of the public who came to the hospital; they were his VIPs.
My first acquaintance with him was therefore as my doctor. He was a gentleman, soft spoken, and had a self-deprecating sense of humour. Dr. Sanjivi is a timid man, he used to say, but nothing was further from the truth. He did what had to be done in spite of any contrary opinion or pressure. Most educated people in our country think they know a lot about medicine, and my family was no exception. Many a time they wanted Dr. Sanjivi to prescribe a particular drug they had heard about from some friends or relatives. He would listen to the whole story of how it had produced a wondrous cure in a person whose symptoms were exactly the same as those of his current patient, and would then quietly write his own prescription. He carried such authority that no one disobeyed him.
I joined the Madras Medical College in 1953, but came in touch with him only in 1955, when I moved to the clinical side. As Professor of Medicine, he thought the most appropriate introduction to medicine was a discourse on medical ethics and the history of medicine. He took teaching seriously, and read assiduously. He would dictate to his secretary copious notes from various journals which he used to prepare his lectures. I had my first clinical posting with him and found he was a thorough but not a brilliant physician. His lectures and clinics were also not scintillating – many of my classmates preferred to be taught by others. However, he was an inspiring man, and had many superlative qualities that were apparent to only those who were privileged to know him well.
He also recognised talent in his students and juniors. My father was an asthmatic. When Dr K. V. Thiruvengadam returned to Madras from the United Kingdom after specialising in chest diseases, Dr. Sanjivi brought him home to see my father, and told him that his former assistant knew more about the chest than he did. Similarly he used to refer all the neurological cases that came to him to his former assistant Dr. G. Arjundas.
I did not agree with him in everything he said or did. He insisted that a doctor has no Sundays and no holidays. He wanted us to attend the wards every day of the year. I, for one, did not obey that instruction, and preferred to enjoy my days off. Though he often asked me why I did not come, he never ordered me to report to hospital on Sundays. He himself never took a day off unless he was physically unable to come to work.
The University of Madras, for reasons best known to its inner councils, never invited him to be examiner in medicine for the MD examinations, though he was sought after by almost every other university in the country. He was disappointed about this, and used to deplore the fact that communal considerations should gain entry in an educational institution. Merit was all that mattered to him.
The Government of Madras has never paid much attention to a person’s special aptitudes. He would have been the obvious choice for the post of Director of Medical Services, being the seniormost in the service, but when a vacancy arose, he was ignored and Dr. V. R. Thayumanuswamy, who had already retired, was recalled and given the post. This upset Dr. Sanjivi and he took premature retirement. His habit of never taking a day off, together with the fact that the service rules then in force allowed him to accumulate privilege leave indefinitely, meant that he could legitimately have been on leave for years. In any case, he was due to retire in 16 months, so he took that period of time as leave. He was so upset when he left the college that he made an uncharacteristic statement in his last lecture class. Bidding farewell to his students, he said, “The next class will be taken by an ectopic focus.”
Having been his patient long before I became his student, I was closer to him than most of my colleagues. He often asked me to drive him in his car to the camps of the College Rural Service League, and we could spend hours in conversation. He never allowed me to get above myself about this. On such a long drive, he used to say, any company is better than none.
In retirement, he did not allow his talents go to waste. He set up the Voluntary Health Services (VHS), and introduced the concept of a sort of health insurance. People paid 0.25% of their income to join the VHS, and in return got a free medical check, and concessional rates when they needed investigations or treatment in the hospital. The man who never asked a favour for himself became, in his own words, a beggar, going to the wealthy to raise funds for the hospital he built. He conceived the idea that people from rural areas should contribute to the institutions that looked after their health, and thus the mini Primary Health Centres were born. He sought the stamp of official approval and funding for the scheme. The Government of India recognised the great work he had done by awarding him, first, the Padma Shri and then the Padma Bhushan. He accepted these honours as an acknowledgement by the government of the excellence of the institutions with which he was associated. Characteristically, he shrugged off all compliments with the remark that he had a sure recipe for success, which was to find a group of young, intelligent and dedicated people, entrust the task to them, let them work without interference, and then sit back and take the credit. All who knew him also knew this was untrue.
He remained in practice for some years after his retirement. Not many know that during this period he retained only Rs. 1,000 of his income each month for himself, and gave the rest to the VHS.
Dr. Sanjivi never spoke about himself. He did not need to. His actions spoke volumes. His patients were always treated scientifically. His clinical acumen was great, and every patient was examined thoroughly by a master who could usually deduce the diagnosis on the basis of the history and the physical examination alone. An investigation was asked for only when it was essential to further the diagnostic process, or if it would make a difference to the treatment that was being given.
Dr. Sanjivi’s scientific contributions were well known and highly respected, and the Indian Council of Medical Research often consulted him. His devotion was to the task he had undertaken, not to the personalities who ruled. He thought of ways in which the services offered to patients could be improved, and he set up special clinics for asthma, and introduced BCG vaccination against tuberculosis. The VHS was possibly his greatest achievement. Once the Surgeon General of the United States of America gave a state of the art lecture to the Public Health Association of the USA during which he spent 15 minutes of that hour long address speaking of Dr. Sanjivi and his work.
Dr. Sanjivi loved his students. When I was at the Jaslok Hospital, he made it a point to call on me on every visit to Bombay, and always enquired with interest about what I was doing. I could find out about him only by persistent questioning. He was a true patriot. Even as he learned about the services I had established, he always reminded me of my greater duties by asking how it would affect the life of the common man. He was a true Gandhian, a believer in plain living and high thinking.
We have had many great teachers, but of only a few can it be said that they were not merely preceptors but also exemplars. Dr. Sanjivi’s life and work stand as an ideal example for all of us.
