Tabiyat - Medicine and Healing in India and Other Essays

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This book, aptly titled 'Tabiyat' which translates to 'health', `nature', 'temperament' or b'disposition', is a collection of nine masterly and thought-provoking essays which explore some important discoveries, dwelling on their relevance in our daily lives. Including essays on War and Medicine, Medical Ethics, Music and Medicine, Nursing and Death, the book encompasses various fields of human endeavour and aspects of life and living which influence and impact medicine.

Dr Farokh Erach Udwadia is a distinguished physician of international acclaim in the field of Respiratory and Critical Care Medicine. He is at present Emeritus Professor of Medicine at Grant Medical College and JJ Hospital, Bombay; Senior Consultant Physician and Physician in charge of the Intensive Care Unit at the Breach Candy Hospital as also Senior Consultant Physician at the Parsee General Hospital, Bombay.

Besides over 55 contributions to national and international journals, Dr Udwadia has written several major monographs including on Emergency Medicine, Respiratory Failure, Pulmonary Eosinophilia, Tetanus and Principles of Critical Care. The latter work is the first book of its kind in India and among the very few published in South-East Asia. It is the standard text and reference for critical care all over the country and is now in its third edition. Another monumental monograph titled Man and Medicine: A History traces and relates the history of medicine in relation to the history of civilization. It is the only book of its kind in this part of the world. Another important compendium, Principles of Respiratory Medicine (2010) is a landmark book in our country.

In 1987 the President of India conferred the Padma Bhushan award on Dr Udwadia for his contribution to medicine. In 1996 he was awarded the Dhanvantri award, the Dr. B.C. Roy National Award for the year 2000 in the category of 'Eminent Medical Teacher', 'The Third Claris International Critical Care Achievement Award — 2005' by Critical Care Education Foundation during the 4th Indo-Australian Training Program in Critical Care Medicine held at Kolkata, December 2005 and 'The Citizen of Mumbai' award by Rotary Club of Bombay, 2008.

He is an astute active physician and remarkably enough, his expert opinion on complicated medical cases is sought after by both, patients and other medical practitioners in our city and country.

My earlier book, The Forgotten Art of Healing and Other Essays (2009), has been a great success. I have succumbed to the request of many friends and patients to write another volume consisting of nine further essays on subjects related to medicine but divorced from its scientific and technical aspects.

The title that I have chosen for this book is Tabiyat: Medicine and Healing in India and Other Essays. The same heading is also the subject of the fifth essay in this volume. This essay is an edited version of a recorded extempore talk given by me at the Prince of Wales Museum (renamed Chhatrapati Shivaji Maharaj Vastu Sangrahalaya), on the occasion of the public viewing of exhibits related to the subject; the exhibits were brought to Mumbai from the Welcome Collection through the kindness of the Welcome Trust.

Among the many prevailing medical systems Indians use to preserve health and combat disease, Ayurveda remains the most important traditional system of medicine in this country. It is not sufficiently realized that from an overall perspective, many people in this country rely on Ayurveda and on other traditional medical systems rather than on Western medicine.

This essay traces the roots of Ayurveda, its philosophy, its rise and its achievements. It also discusses reasons for its stagnation after the eighteenth century in contrast to the rise of Western medicine from this period on. The essay mentions other systems of medicine prevailing in the country, with an added stress on folk medicine, which almost certainly must have preceded all other systems of medicine both in the East and West. It further goes on to compare Ayurveda to the Western system of medicine and submits that though Ayurveda even today remains a useful science and art in India, it cannot combat the numerous life-threatening illnesses that afflict Man.

`The Fight against Infection: The Microbe Hunters' describes the work of four great heroes in medicine. Three of these great men revolutionized the science of microbiology and infectious diseases and the fourth revolutionized the practice of surgery. It is of interest that these discoveries were made by observation, experimentation, intuition and by single-minded dedication. Interestingly, double blind randomized trials and evidence-based medicine, the ‘mantras’ of modern-day clinical medicine, was non-existent in that era of great discoveries.

The essay on 'Medical Ethics' was rather difficult to write, but I felt it imperative to do so, as there is indeed a sharp fall in the standard of medical ethics in our country. It is disheartening that the mutual trusting relationship between the physician and the patient—the doctor–patient bond, which lies at the heart of medicine—as also the bond between the medical profession and society stand eroded.

‘War and Medicine' deals with a fascinating subject. The unmitigated horrors of war, the horrific mutilation of human bodies, and the destruction, famine, pestilence and death that war entails are best illustrated by the First and Second World Wars. Yet, war has brought in its trail medical innovation and discoveries not only in the treatment of wounds and injuries but in many other branches of medicine and surgery. What amazes me is that out of this cauldron of death, destruction and disaster, some good can and did accrue.

`A Knowledge of the Humanities and History Makes a Better Physician' is the first of the nine essays in this book. It is based on an oration delivered to the public and the medical profession at the behest of the Research Society of the Sir Ganga Ram Hospital, Delhi. The recorded talk, with minor editorial corrections, forms the content of this work. It is unfortunate that very few in the medical profession have a reasonable acquaintance with the humanities and history. A study of the humanities, in my opinion, improves clinical judgment, allows a deep insight into the understanding of human nature, and breeds compassion and care. It allows a more holistic study of Man and their manifold responses to disease, and enables the physician to realize that medicine is in equal measure both an art and a science.

`The Lady with the Lamp' is the story of Florence Nightingale and the story of nursing as it exists today. It is the story of a young girl who dreamt to serve mankind by nursing the sick. It is a saga of courage, devotion and care, a magnificent obsession that was ultimately realized.

I have a passion for music and have truly enjoyed writing on this subject in the essay 'Music, the Mind and Medicine'. Music perhaps is the greatest of all art forms, even superior to literature and the visual arts. Music is related to every one of the many other art forms, in that like all other art forms, it has an aesthetic beauty. Yet, it is also unrelated in that it cannot be seen, is comprehended but cannot be translated, and bears no relation to the external world. I have given in this essay some thoughts on the origin of music, the mystery of music, the effects of music on the mind, music's inherent power and its relation to medicine. Finally, I end this essay with a philosophical discussion on the significance of music in our world.

`Medicine in the Renaissance Era' reflects on how the Renaissance was one of the great eras of human civilization that followed upon a period, in history often termed the Dark Ages. It was as if humans, after groping through dark alleyways for several centuries, had at last opened the door to a beautiful sunlit garden. The Renaissance, chiefly known for its great contribution to art and culture, also produced great rebels who liberated medicine that had been fossilized by galenic beliefs for over a thousand years.

Last but not the least, we come to the essay on 'Death', the culmination of this work. Death is the only certainty in life, but is death the final irrevocable end or does it mark the beginning of a new life? We will never know, as no man or woman who has died has ever returned to tell the tale. The essay is a mixture of conjecture, philosophy and poetry. Let readers form their own opinions on this subject.

I have read and consulted many books and a number of references while writing these essays. They are too many to acknowledge singly but I need to especially acknowledge the book War and Medicine from the Welcome Collection (2015). I have also used many cross-references in several chapters of this book. Among other books that were of great help were Music and the Brain: Studies in the Neurology of Music by Macdonald Critchely and R. A. Henson (1977), Music and the Mind by Anthony Store (1992), Musicophilia: Tales of Music and the Brain by Oliver Sacks (2007), Music Quickens Time by Daniel Barenboim (2009) and The Joy of Music by Leonard Bernstein (1959). I have also consulted my own book Man and Medicine—A History (2000), as and when necessary.

The references I need to specially acknowledge are 'Deadly Comrades: War and Infectious Diseases' by M. A. Connolly and D. L. Heymann (2002) published in The Lancet; 'Is war good for medicine?' by Christopher Connell (2007) published in Stanford Medicine Magazine; 'The Neurochemistry of Music' by Mona Lisa Chanda and Daniel J. Levitin (2013) published in Trends in Cognitive Sciences; and 'Mozart, Music and Medicine' by E. K. Pauwels, D. Volterrani, G. Mariani and M. Kostkiewics (2014) published in Medical Principles and Practice. There are a number of poets, authors and quotations that I have consulted when writing on 'Death'. It is not possible to thank them individually but I acknowledge with gratitude the help they provided.

I owe a debt of gratitude to my wife, Vera Udwadia, for her patience and forbearance during the preparation of this work and for her reading and correcting the manuscript several times over. My very sincere thanks to Dr Khyati Shah, my research assistant, who has been associated with this work from its very inception. Her diligence and devotion were largely responsible for the completion of this book. I must also express my gratitude to my dear friend and distinguished surgeon, Dr Hirji S. Adenwalla. He has not only read the manuscript but offered excellent suggestions, many of which I have incorporated. My thanks to Neeraj Chavan for helping in the typing of the manuscript. I wish to acknowledge and thank the Welcome Trust for the permission to print the pictures that illustrate the book. Finally I thank OUP for their unstinted help and co-operation in publishing this work.