World of medicine, then and now

Rakesh Kochhar

In a few days, our batch of medical students will be meeting for a get-together after 50 years. Studying in a Central university, we had batchmates from all over the country. For 18-year-olds — most of us hostellers — the rigours of medical studies were quite challenging. But we sailed through, holding one another’s hands and relying on guidance from our seniors. Right from the dissection hall to the first patient you encountered in the OPD or the first one assigned to you in the ward, you looked askance at them.

It continued when the first intravenous line was to be inserted or later, when the first procedure was to be done. Fifty years ago, there were fewer medical colleges and a doctor had an exalted status, with greater responsibilities to uphold. Our journey corresponded with the development of specialities like gastroenterology, cardiology, endocrinology and neurosurgery.

There were just a handful of antibiotics, penicillin being the most sought-after for serious illnesses. There were only limited investigative tools, with no ultrasound, CT scan or MRI, no angiography or endoscopy and even blood and pathological tests were limited. Immunological and genetic tests were hardly available. Treatment of cancer was rudimentary. Yet, patients got well and we were trained as new developments and discoveries unfolded.

In my field, I have seen pathbreaking changes. A simple peptic ulcer was difficult to treat and, often, required surgery. Now, it is cured with a course of pills. The discovery of hepatitis viruses, their treatment, newer targeted anti-cancer treatments, revolutionary therapeutic endoscopic and radiological interventions and liver transplantation, to name a few, have changed patient outcomes in ways which were in the realm of fantasy decades ago. And that holds true for all specialities.

When I talk about my medical career with my daughter, a paediatric pulmonologist in the US, she updates me on newer molecular diagnostics and intricacies of sleep medicine. That reminds me of the conversations I used to have 50 years ago with my father, who had donned his white coat in 1945 when the emphasis was on fighting malnutrition, diarrhoea and malaria. But an MBBS doctor was also called upon to do Caesarean section, appendicectomy and cataract surgery. He would visit the patients, walking on foot or riding a horse, in remote areas of Himachal Pradesh. Fast-forward to the present: doctors have started using robotics, artificial intelligence and gene editing to treat patients, like what was once seen only in fiction films.