My Initial Years in Medicine and Psychiatry

Down Memory Lane

Volume 12 Issues 7 July, 2022

The year was 1971.  Medical education was highly coveted in India. Kerala had only three Medical Colleges at that time- Trivandrum, Calicut and Kottayam besides the private TD Medical College, Alleppey (which was later taken over by the Govt in 1973). Kerala had only 400 medical seats (excluding Alleppey) of which 60% were reserved for BSc graduates. Thus, there were only 160 seats for the +2 group, of which only 80 were available for open merit. And I was lucky to be one among them!  Doctors were held in high esteem and getting a seat in Medicine was considered a sign of brilliance and course fortune. All the candidates were selected based on their performance in the +2 and BSc exams.

We joined Kottayam Medical College in 1971. I was one of the youngest in the batch at just 17 years, hailed from a remote rural village of Chettuthodu, Kottayam District in Kerala and was the first person from the village to gain admission for Medicine. My father K A Abraham was an MA, and LLB from Aligarh Muslim University (where he was a favourite student of Dr Zakir Hussain, who later became the President of India). He had practised law at the High Court of Kerala at Kochi for a brief while when my grandfather died. My father had to leave his law practice and settle down in our rural village to take care of his ancestral properties. My mother Ammini belonged to the first batch of BA from Mount Carmel College Bangalore. She was my dedicated teacher in my school days. I was the 2^nd among 9 children and we were entitled to no special privileges.

Kottayam Medical College was the ‘Supreme Court’ for Medicine in Central Travancore at that time. I used to have a steady stream of patients from my village and used to attend to them well and the villagers were fond of me irrespective of caste, creed and religion. When I travelled home by bus, people used to vacate their seats for me, which of course, always was refused.  This is narrated here just to convey in what high esteem Doctors were held in India, even half a century ago in contrast to what we hear now about attacks on doctors and hospitals on almost a daily basis!

I joined Psychiatry by chance. After completing my MBBS in 1976 and internship in 1977, I joined Malankara Medical Mission Hospital (which is now a highly reputed Medical College), Kolenchery, Ernakulam as a senior house surgeon in Medicine. In 1978, the resident in Psychiatry had left for PG and the hospital administration wanted one of us among the four residents in Medicine to go to Psychiatry. None of us was keen about this. The next day, hospital Director Dr KC Mammen (a former Professor at CMC Vellore) called me and said, “Psychiatry is the speciality for the future. I have noted your talents which will be suitable for Psychiatry. Hence, I am sending you there”. His words were prophetic! The only psychiatrist in that young department was Dr VMD Namboodiri who was trained at AIIMS, New Delhi. He was a kind and loving person and put me at ease from the first day. I gradually recognised this was my vocation and I had no chance in life to regret my choice.

I was trained in Madurai Medical College for DPM from 1978-1980 under the eminent Professor A Venkoba Rao. I went to Madurai on the advice of Dr K A Kumar. At that time, Psychiatry was a neglected branch in Kerala with no MD course and the subject was neither popular nor sought after.  My studies in Madurai is an unforgettable experience. I was very young, and neither knew Tamil nor the people. But it mattered little as Madurai turned out to be my 2^nd home. We had an excellent department and great camaraderie among the PG residents. The grand rounds and classes by Prof Venkoba Rao were much sought after and it was a great learning experience. Besides, his wife Prof S Parvathi Devi hailed from Palakkad in Kerala, had a special affection for me and treated me like her son. My seniors and classmates like C Ramasubramanian, J Venkatesan, N Thiagarajan, R Rajkumar and others made life enriching. I not only learned learnt Psychiatry but also Tamil fluently.

My first appointment was as a lecturer in Psychiatry (ad-hoc) at Medical College, Alleppey. The Professor was Dr James T Antony who was not only a very good clinician but also a great human being. He gave me a free hand, put me in charge of the male ward and gave me a big learning opportunity. Although the facilities were inadequate, patients were flocking into the hospital as there was no psychiatric service anywhere near. Thus, I grew up with confidence and clinical skills. To this day, Dr James Antony has been my best boss- always kind and generous. After a year, I got a permanent appointment in Kerala Health Services and was put in charge of the Psychiatry unit at District Hospital, Alleppey. The two years in Alleppey were a period of personal growth and accomplishment. I also became the youngest Secretary of Alleppey IMA in 1981.

In 1982, I was selected for MD Psychiatry at PGIMER Chandigarh. It was a dream come true to join this department which was considered India’s Number One.  I had to shift gears to a period of intense learning, hard work and committed performance. We had a great opportunity to learn under Prof Vijoy K Varma (Head), Dr P Kulhara (Associate Professor), Dr Savita Malhotra (Asst Professor) BM Tripathi (Lecturer) and loving and caring senior residents. I was the first PG to do thesis research under P Kulhara (who had just returned from the UK). My fellow PG residents like Sudhir Bhave, Kishore Chandiramani, and RA Singh were very helpful, supportive and encouraging. So too were seniors like PSVN Sharma, NK Sharma, PS Gill, Sunil Mittal and those belonging to the next batches like Rakesh Chadda, Prasad Rao, Suresh Kota, Sushil Kherada, Rajesh Nagpal and others.  An interesting, yet perplexing incident took place during this time. While undergoing a Neurology posting, I was called for an interview by the Kerala Public Service Commission for a permanent appointment and had to go to Trivandrum to attend this, but knew, the Neurology Professor will not give such permission. So, I left by flight informing the other faculty in Neurology. I came back in two days but Prof JS Chopra was very angry (and rightfully so). I was in great difficulty. My only solace was Dr Kulhara who heeded my request, took me to Prof Chopra and resolved the matter. Otherwise, it could have had serious implications. I am ever obliged to Dr Kulhara for this kind gesture. Of course, if I had not attended the PSC interview, I would have never become a faculty or Professor during those times!

In 1985, I joined the faculty of Psychiatry in my alma mater, Medical College Kottayam. I have served as Professor and Head of Psychiatry at Thrissur and Kottayam Medical Colleges and in 2009, I became Principal of the Kochi Medical College. I relinquished this administrative post after nearly two years and joined as Professor and Head at Pushpagiri Medical College, Thiruvalla in 2010. I became the General Secretary of the Indian Psychiatric Society (2002-06) and President (2012-13). I have served as the Secretary General of the World Psychiatric Association, Geneva (2014-2020) and President of the World Association of Social Psychiatry (2016-2019). I have much to speak on all these, which I will reserve for another occasion. In the end, it was the journey of an ordinary village boy far and beyond! It was possible only due to the help, support and blessings of many who are named and not named here! My gratitude to all of them.

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