Dr. Manu Liladhar Kothari (M.S., M.Sc.): 19 November 1935 - 16 October 2014SK Pandya
Former Professor and Head of Neurosurgery, KEM Hospital and Consultant Neurosurgeon, Jaslok Hospital, Mumbai, India, India
Correspondence Address: Source of Support: None, Conflict of Interest: None PMID: 25511228
Source of Support: None, Conflict of Interest: None
I met Manubhai for the first time in 1956 in the company of Dr. Ashok B. Vaidya. As an undergraduate student of medicine at the Grant Medical College and Sir Jamsetjee Jejeebhoy Group of Hospitals, it was my privilege to take them (along with the late Dr. Ajit Phadke, renowned urologist) through the wards of my alma mater, showing them 'interesting patients'. They had asked me to point out ward patients from whom we could learn the art and science of medicine. To have these three keen clinicians as my mentors at that formative stage of my education was a unique blessing. They elicited valuable nuggets in each case history; then examined the patient gently and with infinite courtesy. The icing on the cake, of course, was how they coupled and analysed the facts and findings of history and examination to reach a diagnosis. They proved to be lasting influences on my life and work.
Manubhai was, by then, already well known for his razor-sharp mind and unconventional thinking. He had suggested to Mr. Hamilton Bailey, (British surgeon and teacher - author of several famed text-books), a novel method for measuring the fixed adduction deformity in the diseased hip joint. Manubhai did so with some trepidation as he was still a student and Mr. Bailey was notoriously intolerant of fools. Manubhai's suggestion, duly tested, was impressive enough to be included in Mr. Bailey's Demonstrations of Physical Signs in Clinical Surgery - 1960. Very soon, characteristically, the two became friends. Mr Bailey passed away in 1961, and Mrs. Veta Bailey visited India later as Manubhai's guest. She instituted an annual bequest named after her husband for Manubhai to aid medical students and departments in India. Our Department of Neurosurgery at K. E. M. Hospital - one such beneficiary - received some much needed texts.
Manubhai obtained his MS from the University of Bombay in 1963, and was appointed Lecturer in Anatomy at his alma mater. Collaborating with his pharmacology professor, Dr. U. K. Sheth, he and Dr. Ashok Vaidya studied the acid secretion of the human stomach, as also the effects of extra salt intake on gastric acidity and on the common cold. Their findings were published in The Lancet, Indian Journal of Surgery, and Indian Journal of Medical Sciences - 1963-1966. Particular about how studies were to be carried out, Manubhai insisted on being the prime subject whenever possible. It is not recorded how many insertions of the nasogastric Ryle's tube he underwent for this study.
With Dr. D. S. Pardanani, he studied guinea-worm infestation. One publication resulting from this study dealt with the intra-uterine development of guinea-worm larvae (1971). Manubhai, Dr. Pardanani, Dr. Lopa Mehta and Deepak Kothari reported their experience in Annals of Tropical Medicine and Parasitology-1975.
He rose progressively in the department of anatomy, to professor-1976 and head of the department-1981. On his retirement in 1993, the status of Professor Emeritus was conferred on him. His love for the institution that had nurtured him ensured it of his continued services in various capacities to his very end.
His tenure as Chairman of the Ethics Committee for Research on Human Subjects at K. E. M. Hospital brought to light an exceptional facet of the man. He ensured the highest of standards in the studies sanctioned, and in the dealings with bureaucrats and grant-givers.
Two topics often clouded his otherwise sunny nature - he expected honest and ethical medical practice from our noble profession. In the passing decades, the paradox saddened him. After acquiring what he termed 'obscene wealth', posh flats, opulent farm houses and swanky cars, there was a decline in ethics and social conscience. This prompted him to ask: 'How can doctors be so heartless, especially when dealing with the poor patient?'
Pondering our politicians' doings, he quoted Gujarati poet-educationist Karsandas Manek's haiku, written around 1948:
Thou petal of freedom
Chewed you up!
His early and lifelong interest in cancer led to his first publication, Genesis of cancer, a temporal approach-1968, and a stream of publications, all written with Dr. Lopa Mehta. The two served as sounding boards for each other, bouncing ideas and concepts between themselves even as they delved deeply into the published literature on the subject. His photographic memory and their wide range of reading (medicine, literature, history, biography, philosophy...) saw them quote from sources as varied as the Gita, the Upanishads and The Torah, William Shakespeare and Peter Medawar, Aldous Huxley and Mahatma Gandhi, Eric Partridge and Macfarlane Burnet. Their magnum opus was The Nature of Cancer-1973, referred to as 'The Green Book' from its cover.
Books and papers flowed from his pen, as he co-authored on a variety of other topics as well - anatomy, embryology, genetics, evolution, immunity, medicine, semantics, the art of teaching medicine, dying and death. His thoughts on the structure and function of man posed continuing challenges to established dogma and stimulated thought. The nature of bones and joints-1990 is an outstanding example.
With his wife, Jyotiben, he pioneered a medical project in Sakwar village, 86 km. from Mumbai in 1972. The local folk there had no medical facilities. In an attempt to remedy the situation, and under the aegis of the Ramkrishna Mission, the encouragement and physical efforts of the Kotharis led to the digging of a well, constructing of a dispensary. Today, Sakwar's dispensary annually treats over 30,000 tribals, has a vocational training centre, an agricultural farm demonstrating techniques for better yields, balwadis and camps for youths and women.
Manubhai and Lopa shared an office on the second floor of Seth G. S. Medical College, which housed their books and journals, was the haunt of varied individuals from the college Dean to professors, resident doctors and even medical students. At lunch, one had the privilege of sharing their simple but wholesome meal, punctuated by conversation ranging from everyday topics to philosophical themes. The encounters were stimulating, encouraging, thought-provoking, never banal. An unannounced visitor would see Manubhai and Lopa on their respective chairs, Lopa reading, whilst Manubhai wrote, to a bhajan or an old classic by Juthica Roy, Pankaj Mullick or Saigal softly issuing forth from their radio-cum-tape recorder.
An incorrigible punster, he treated his college staff and students to a daily dose of these. The blackboard along the corridor in front of the anatomy museum served as his canvas for his daily punny and philosophic thoughts.
A child at heart up to the very end, simplicity governed his every action. He would marvel at the structure and function of a leaf, the beauty of a bud, the sunrise and sunset, a cloud... often quoting Joyce Kilmer's evocative poem Trees. He never understood the common urge for the trappings of power and wealth, combined, as they were, with total disdain for scruples and ethics. Pomposity evoked dismay in him - he used the local train and B.E.S.T. bus until his end. A complete lack of self-consciousness made him a greatly sought companion and speaker. He had the art of being on the same plane as a child, a humble staff member or an exalted academic, during conversation. During his talks, he rarely referred to notes - his prodigious memory enabled him produce facts with appropriate references. He could not help interjecting humour at every stage and when the setting was informal, often burst into an impromptu song, with the audience clapping along.
Like many more, I had the privilege of calling him my friend. Many years ago he honoured me with a request, which was to create awareness among his anatomy students of their medical heritage. He suggested I prepare a remedial talk on the history of the development of anatomical knowledge, scheduling it for a Saturday afternoon, once a year. This was a salutary experience for me for the young impressionable listeners, paid patient attention in the packed anatomy lecture theatre year after year.
A similar suggestion was to name each seminar room and lecture hall in the department after a great medical personality from the past. Then on, official announcements ran thus: Seminar on the nervous system in the Susruta Room; Seminar on the heart in the Harvey Lecture Theatre.
I quote from one of his essays: 'To die when you are fully fit to live, when you are manifestly in compos mentis et somatis… is to die actively, abjuring the body as an act of programmed will of the body, your final bow to the global audience before, like Rabelais, you… declare, "Let down the curtain…" The balancing opposite of and the highway to a good death is a good life, a yea-saying to life that ends with a yea-saying to death… (using) Schweitzer's concept - reverence for life… A genuine sense of reverence for the elements within and around us can help… living a good life, culminating in a good death.' Unwittingly, he summed up his own life and death.
He died exactly as he would have wanted to - amidst his beloved family. As his son, Vatsal, told us, he was joking a few minutes before his inbuilt timer prompted his generous heart to its well-earned rest. Spared of pain, lingering illness and dependence on one-and-all, his 'good death' however resulted in a great shock to Jyotiben, Vatsal, his extensive family and to his long-time academic associate, Lopa. We wish them the strength to bear their permanent loss.