Two patriarchs of Indian Neurosciences: Professor Baldev Singh and Professor Jacob Chandy
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.198174
Source of Support: None, Conflict of Interest: None
Professor Baldev Singh
(April 6, 1904 to February 2, 1998)
Call it a quirk of circumstances, the whim of a middle-aged man in search of his first love, or simply the Divine Will, the foundation of Neurology in India as a formal discipline owes a great debt to Professor Baldev Singh, nationally nick-named as “Father Neuron.” He was born on April 6, 1904 in a rich landlord agricultural family without any tradition for academic inclinations at Zaffarwal Datta Village in district Sialkot (now in Pakistan). His mother was the only daughter of affluent parents whose father, Sardar Ganda Singh, was the first Honorary Captain in the British Army. Dr. Baldev Singh, thus, spent his childhood in his maternal grandfather's place in the village, Gandasinghwala, in the outskirts of Amritsar. He studied in the village school up to the third standard and later joined Government High School at Amritsar. The school possessed an excellent science teacher who aroused his interest in Physiology. This was further strengthened by a teacher in Biology in the Dayanand Anglo Vaidik Mahavidyalaya (DAV) College, Lahore.
In a traditional family of that era, he would have pursued the career of an agricultural zamindar. But his elder brother, Sardar Shamsher Singh, himself not highly educated, prevailed upon his obedient younger brother to become a doctor. Not one to disobey his elder brother, whom he greatly respected, Baldev Singh sought admission to King Edward Medical College at Lahore (now in Pakistan) in 1922. He obtained his MBBS degree in 1927 along with a number of gold and silver medals and other academic prizes. Here also, his teacher in Anatomy, Col. P.B. Bharucha chose him to be a prosector responsible for conducting dissections of the brain. Even though the standard textbooks those days had very sparse writings on any aspect of neurosciences (even the word was coined later on!), Dr. Baldev Singh's interest in the subject was aroused by a Professor of Medicine. Notwithstanding his brilliant academic record, he failed to get admission for his postgraduate studies in the medical college of Lahore, but still eager for postgraduate studies, he quit the job and decided to go to England to get his MRCP degree. Being married by now, his family was against this move. It was only due to support from his elder brother that he managed to go abroad.
In London, his efforts to get admission to the regular course for preparing for MRCP at the London Hospital, Guy's Hospital and St. Bartholomew Hospital failed. He decided to take some short-term speciality courses, one of which was in Neurology at the famous Queen Square for 3 months (several of our senior neurologists including Drs. Eddie Barucha, Noshir Wadia, Jagannathan received at least a part of their training at this hospital). Here, he came in contact with Drs. Collier, Kinnear Wilson, and others. He appeared in the MRCP examination and cleared it in the first attempt – not a mean achievement!
Watching Sir Percy Sargent operate on the brain during his stay at Queen Square, stimulated his desire to learn more about Neurosurgery. He found out that Dr. Norman Dott, after working with Dr. Harvey Cushing, had returned to Edinburgh. Baldev Singh went to meet him. He worked with him for a couple of months. He was impressed with the skill and care with which Dr. Dott handled the brain. He now toyed with the idea of taking up Neurosurgery as his career. Unfortunately, a message from home regarding his wife's illness forced him to return to India.
Back home, with his outstanding academic credentials, he had a number of job offers, but his mother prevailed upon him not to leave Amritsar. This forced him to start a private clinic at home practicing as a general physician. Soon his practice picked up and he was recognized as a reputed consultant-physician and even as a cardiologist. Patients came to him from all over Punjab and neighbouring areas. People who knew him those days told me that at the time he was dressed like an English consultant in a pinstripe suit, bowler hat, carried a black doctor's bag and a neatly folded umbrella, and moved around in the latest car model – a real “Dandy.” We, who saw him in his new “avtar,” could hardly believe our eyes. His practice soared!
Despite this professional success, his heart was still in an academic mode. He had the best personal library, which he later gifted to the Neuroscience center of AIIMs, New Delhi. He established a research lab where he experimented on small animals. He established an animal model of anemia, and investigated the differences between tuberculosis and Hodgkin's disease. He also studied the nail bed capillaries under the microscope. Every month, he travelled to Lahore to attend the local “British Medical Association” meetings. He was appointed as an Honorary Physician at the local Medical College headed by his teacher Colonel (later General) Amir Chand. Postgraduate students, not only from Amritsar but also from Lahore, came to him for guidance for their thesis. He, along with his friend Prof. P.K. Kitchlu – Professor of Physics at Government College, Lahore, attempted to rig-up an electroencephalography (EEG) machine, even though they were unsuccessful in their attempt (He had an abiding friendship with Prof. Kitchlu who was a Fellow of the Indian National Science Academy (INSA). I know that during his stay at the All India Institute of Medical Sciences (AIIMS), the two would meet every Sunday. It was under Dr. Kitchlu's influence that he became aware of the INSA. He was elected Fellow of the Academy in 1967. After 18 years of busy practice, he ultimately succumbed to his lust for neuroscience. He found money coming too easily but without any intellectual satisfaction. Learning about Dr. S.T. Narsimhan and his EEG machine at Madras and Dr. Chandy's arrival at Vellore, he visited them to gain first-hand knowledge of their work. Dr. Chandy encouraged him to join him and advised that he should get some training in EEG. Dr. Baldev Singh got in touch with Dr. H. Gibbs in Chicago, who promptly accepted him. Much against the wishes of his family and even his teacher Col. Amir Chand, he took the most unconventional and unbelievable step of giving up his very lucrative practice and a well-settled family life to go to Chicago for training under Dr. Gibbs. He spent two years (1950–1951) there. On returning to India, very eagerly, he went to Vellore and joined Dr. Chandy as an Associate Professor on a “fat” salary of Rs. 500 per month. This changed his whole life. Influenced by the prevailing environment at Christian Medical College (CMC), Vellore, he adopted a life of a “sanyasi,” unattached to his family and to worldly goods. This is how he spent the rest of his life. He helped Dr. Chandy in looking after all Neurology and EEG-related work and in establishing a Neurophysiology laboratory. Clinical Neurology and Neurophysiology were thus “born in India” and he acquired the honorific title of “Father Neuron.”
On a call from his teacher Col. Amir Chand, he and Dr. Chandy agreed to move to Delhi to the newly established Tirath Ram Hospital. Because the CMC authorities finally acceded to Dr. Chandy's principled conditions for setting up the department in Vellore; and, Dr. Baldev Singh was adamant about not going back on his words to his teacher, the two parted company but not their friendship. He joined the Tirath Ram Hospital, New Delhi in 1955, and that became his “karam bhoomi.” He once again started his practice – but now kept it restricted to Neurology – and continued his Spartan life. He, however, satisfied his intellectual craving by continuing to participate in teaching and research in an honorary capacity at the Lady Harding Medical College, Willingdon (now Ram Manohar Lohia) Hospital, and the Irwin (now Jai Prakash Narain) Hospital. At the same time, he joined hands with Prof. B.K. Anand (initially at the Lady Hardinge Medical College and later at AIIMS) for Experimental Neurophysiology. Because he was not really interested in his practice, and he also did not know how to restrict it, he devoted less and less time to it, even though the demand for his time in clinical practice was growing steadily (He personally confided to me when we were together at AIIMS that he was really developing an aversion to practice and was dissatisfied by the results). Finally, in 1965, at an age past the prevailing age of superannuation, he was persuaded to accept the responsibility of developing Neurology at AIIMS. He was appointed a Professor in the newly created department (in sharp contrast, I at the young age of 37 was selected as a Professor of Neurosurgery at the same time). This coincidence was a real boon for me and the two departments. Though officially these were independent departments, till he retired 3 years later, the two departments worked as one, sharing all the academic activities including the clinical rounds, outpatient department, seminars, and journal clubs.
Three years is a short period, but by the time he retired, the department was well established. The postgraduate DM course was initiated. A number of interdisciplinary research projects were undertaken. This also helped in his increasing interaction with Dr. Anand and his department.
Formally retiring in February 1968, he joined the Department of Physiology as an Emeritus Professor, but his involvement with all clinical neuroscience programs of the Departments of Neurology and Neurosurgery and allied subjects such as Neuroradiology and Neuropathology continued unabated. Of course, his involvement with the programmes of the department of Physiology was total, where his research participation increased perceptibly. It made little difference to his commitment and enthusiasm even after Prof. Anand left the Institute. Believe it or not, until I retired in 1990, two decades later, he continued to join me in my outpatient clinic. That was the time when I got to know from him about the latest advances in Neurosciences since he was still reading the latest journals.
He continued to serve the Institute till his health permitted, that is, when failing vision, and musculoskeletal infirmities made his independent living impossible. He left AIIMS in 1992 to the loving care of his daughter-in-law. It may be worth recording what he once told me that, “it was at AIIMS that for the first time in his life, he felt fulfilled.” He research interests covered a variety of subjects. The most important areas were related to epilepsy, clinical, and experimental studies on sleep, consciousness, yoga, behavioral consequences of exposure to high altitude, heat hyperpyrexia, and brain edema.
He was a recipient of a large number of awards and honours. He is the only person to be elected twice – in 1962 and 1971 – as the President of the Neurological Society of India. He was conferred the Basanti Devi Amirchand Award by the Indian Council for Medical Research (1961); Air Marshal Subroto Mukherjee Award; Sir Nilratan Sircar Oration (1960); and National Academy of Medical Science Oration (1965). He was a Fellow of the National Academy of Medical Science (FAMS) and of the Indian National Science Academy (INSA). He was an Honorary Fellow of the Aeromedical Society of India and the American Neurological Association. He was conferred the honorary rank of Brigadier
by the Indian Army, was Honorary Physician to the President of India, and was awarded Padma Bhushan in 1972.
While paying a tribute to him, I had stated “Prof. Baldev Singh had become a legend in his life-time and has left a permanent imprint on the neuroscience scenario of the country. It is no exaggeration to say that few could match the depth of his knowledge or his untiring commitment to advance the frontiers of neuroscience in the country. Yet for all his accomplishments, he remained a gentle soul, a friend to all without a trace of ill will for anyone.” Prof. Baldev Singh was a multifaceted self-effacing personality – a mild-mannered, dignified, highly cultured, and principled gentleman in the classical mould. Undoubtedly, the most well-read physician, with an unquenchable thirst for knowledge, who even to his last days, though nearly blind, continued to keep up with the current literature with the help of his daughter-in-law. Although he was able to afford a luxurious life, he lived a life of simplicity verging on saintly renunciation. His love for poetry – both Urdu and English, and his ability to sing were well-known to his friends and associates like the present author. He shunned praise, publicity, and popularity and had an unbelievable strength to cope with personal adversities like the untimely loss of his wife, young son, and a son-in-law.
My personal bond with Prof. Baldev Singh
I had heard about Dr. Baldev Singh as the pioneer of Indian Neurology soon after he joined Dr. Chandy at Vellore, while I was working at Delhi at the Irwin Hospital. I briefly met him at Willingdon Hospital with my friend, Dr. Amar Nath Mehrotra, soon after my return to India in 1961. This first meeting left a permanent impression that made it clear to me that I was meeting an unusual individual – simple, self-effacing, highly respected, and deeply committed to academic medicine, though officially a private practitioner.
My next encounter with him was during my interview for selection as a Professor of Neurosurgery at the King George Medical College, where he was an expert. His opening remarks at this interview reflected his unique human qualities. He told the Committee that he was familiar with my praiseworthy work and found no reason to travel from Delhi just to testify to it. “However since I was coming here, I have collected some problematic cases. I thought I would seek his help in resolving these cases.” He proceeded to show me radiographs of some of his patients and asked me what could be done for them. What a polite way of conducting an interview! Of course, I was selected.
I faced him again during my interview for selection as a Professor of Neurosurgery at AIIMS, New Delhi. When replying to a question by the Chairperson, Dr. Sushila Nayyar (then Minister for Health), I confessed that the mortality for surgery for brain tumors in my hands was still in the range of 20%. He promptly commented, “Dr. Tandon should be congratulated for knowing that our patients come for treatment in an advanced stage of the disease.” I was selected.
During the same selection the next day, when the Committee did not find a suitable person for the post of Professor of Neurology, the Committee turned to him pleading that he accept this position. With great reluctance, he agreed but only on the condition that he would join only if I also joined.
Thus, we came together to start the Departments of Neurology and Neurosurgery at AIIMS in March 1965, with him as a very senior and well-acknowledged leader, and I, as a beginner. From day one, we functioned as a joint team, even though officially, the two departments were independent entities. For quite some time, we shared a common office, conducted the outpatient clinic and the ward rounds together, and our teaching exercises were common for the postgraduate students of Neurology and Neurosurgery. As a matter of fact, I would get a call from him every morning just before 8 AM to check if I was ready to go to the hospital and we would walk together to the wards. In the early days, he would even stand behind me while I operated and followed the patients postoperatively with our team. It led to a taunting comment from a faculty member, “The Professor of Neurosurgery goes around as a house-surgeon of the Professor of Neurology.” When it was brought to my notice, I did not hesitate to state, “I deem it as an honour!”
As recorded elsewhere, while planning my research, I discussed it with him, and on several occasions, received valuable guidance and practical help. Soon these bonds of friendship extended to my family. Our one-and-a-half-year-old son spontaneously called him “Nanaji” on his very first encounter with him. Even after he retired from the Neurology Department, and until he left Delhi in 1992, not a day would pass when we did not meet each other. We specially looked forward to these meetings on Sundays, when after my hospital round, I would go to his office in the Department of Physiology, learn about some Urdu poetry, or even hear a song from him in his high-throated, melodious voice. Of course, we kept in touch through correspondence or telephone throughout his stay at Amritsar. As he was becoming visually impaired, his letters had to written by his devoted daughter-in-law. I and my family have considered it a blessing to have come in contact with such a kind soul.
Professor Jacob Chandy (1910–2007)
Professor Jacob Chandy, the founding father of Neurosciences in India, was born in 1910 at Kuzhikala in Kerala. His father was a priest in the Anglican Church. He lost his mother at the age of 7 in the absence of any medical help due to puerperal sepsis. This motivated him to study medicine. He studied at Alleppey until high school. He was selected to be a member of the choir. For his college education, he moved to Kottayam. Throughout this period, he was deeply involved in the Student Christian Movement, became its General Secretary, and participated in Sunday school and Evangelical tours. According to him, “It was during these two years at college that I had definitely made up my mind to do mission service, if the opportunity arose.” Armed with a fellowship and his participation in missionary work, he managed to be admitted to the Madras Medical College, from where he graduated in 1936.
His search for a job in a Mission Hospital did not succeed as he was found “too highly educated.” These hospitals wanted individuals with a licentiate qualification. The influence of the prevalent nationalist movement and his deep missionary zeal prevented him from seeking a government or military job. He ultimately decided to go to eastern Saudi Arabia to join an American Oil Company (Aramco) hospital. In spite of receiving a good salary, he was dissatisfied with the work he was doing and decided to return home after a year.
On his way back, he missed the boat at Bahrain, which led him to the local Mission Hospital run by Dr. Paul Harrison. This fortuitous meeting proved to be the turning point in his life and proved to be a boon for Indian Neuroscience. Dr. Harrison persuaded him to work with him. Realizing Dr. Chandy's keen desire to serve in a Mission Hospital back home, Dr. Harrison charted a course of training for him and helped him in every possible way to make it happen. Having worked as a house-surgeon with Dr. Harvey Cushing, Dr. Harrison motivated and arranged for Dr. Chandy to take up Neurosurgery with a view to serve at Christian Medical College (CMC) Vellore.
During this time, Dr. Chandy returned home, married (Miss) Thangam, who belonged to an orthodox Syrian Christian family and was a graduate from the Women's College in Trivandrum. They were married on September 4, 1991 and returned to Bahrain. Dr. Harrison advised Dr. Chandy to pursue postgraduate studies in the United States and arranged for his admission (and finances) to do a course in General Surgery at the University of Pennsylvania at Philadelphia. He not only successfully completed this course but also obtained an M. Sc. degree.
In October 1945, Dr. Chandy managed to get a Junior Resident's position at the Montreal Neurological Institute (MNI), then considered a Mecca for Neurosurgery. Believe it or not, it carried a “fat” stipend of 20 Canadian dollars plus free board and lodge. Notwithstanding the heavy workload, he managed to prepare for FRCS (C) Neurosurgery, which he successfully obtained in 1946. After spending another year at the MNI, on the advice of Dr. Penfield, Dr. Chandy moved to Chicago as Chief Resident with Dr. Rasmussen, who himself had gone there as Chief of Neurosurgery after working at the MNI.
His heart was still in search for a job in a Mission Hospital in India. Dr. Cochrane, the erstwhile Director of Christian Medical College, Vellore, offered a position to Dr. Chandy to start Neurosurgery there. However, there was a caveat that the College did not have funds for the necessary equipment. Once more, Dr. Harrison came to help. He arranged for two cheques, amounting to $13000 and advised Dr. Chandy to cable to Vellore, “Joining CMC, bringing necessary equipment.” Thus, Dr. Chandy joined CMC Vellore in April 1949 and India got its first fully trained and qualified Neurosurgeon. But the real struggle, the fate of all pioneers, began after his joining the hospital.
In Dr. Chandy's own words, “Before 1949, there were no organized Departments of Neurosurgery or Neurology… When I came back to India after my schooling in Neurology and Neurosurgery, I found that all Heads of surgical, medical and basic science departments considered Neurosurgery, Neurology and its ancillary branches – Neuroradiology, Neuropathology, Neurophysiology and Neurochemistry as irrelevant under our circumstances.”
Struggling against all odds and defying all sceptics, he progressively developed full-fledged departments of Neurology, Neurosurgery, Neurophysiology (added EEG facilities) and Neurochemistry to create the first composite Department of Neurosciences in the country. Working single-handedly, surreptitiously looking for patients in other departmental wards, he proved that neurosurgical disorders were not “rare” and demonstrated that Neurosurgery was not only the appropriate treatment but was also possible and safe. He finally managed to have his own separate ward of Neurology and Neurosurgery in 1954, with funds obtained from the Irwin Young Foundation, USA.
Meanwhile, Dr. Baldev Singh joined him as a Neurologist in 1951. An EEG lab was established in 1952. It was only in 1957 that there was another valuable addition to the Department, when Dr. B.K. Bachhawat, a fully trained Neurochemist joined the team. He established the first Neurochemistry laboratory in the country. In the same year, Dr. Wilder Penfield visited the Centre and inaugurated the expanded Neuroscience Block.
Even though in the earlier years there was no formal neurosurgical education programme in the country, Dr. Chandy encouraged young surgeons wishing to pursue Neurosurgery specialty to work with him. Thus, Dr. R.N. Roy from Calcutta, Dr. Gajendra Sinh from Bombay, Dr. R.S. Dharkar from Gwalior, and Dr. M.G. Sareen from Jaipur received their initial training in Neurosurgery under him. However, it was only in 1957 that the Madras University approved an M.S. Neurosurgery degree. Dr. K.V. Mathai was the first regular postgraduate to be followed by Dr. Jacob Abraham the next year. In 1966, this programme was changed to M. Ch. degree. M.D. (Neurology) was changed to D.M. Neurology programme, and was initiated in 1958. The galaxy of his trainees spread all over the country – initiating new departments and proceeding to join the list of 'who-is-who' in Indian Neuroscience, specially in Neurosurgery and Neurology.
Over the years, Dr. Chandy had added responsibilities in the College as a Treasurer, Deputy Director, Medical Superintendent, and the President (Dean) of CMC. Not surprisingly, he was greatly sought after by organizations and institutions like the Indian Council for Medical Research, the World Health Organisation, All India Institute of Medical Sciences, National Academy of Medical Sciences, Department of Health, Government of India, and Medical Education Committee, to name a few.
He superannuated from his glorious service at the CMC at the age of sixty in 1970. There is a rather shameful story associated with this event – so characteristic of the Indian administration. Notwithstanding his stature as well as life-long dedicated and selfless service, while away in Geneva as a consultant to the Christian Medical Mission of the World Council of Churches, he (in his own words), “received on 23rd January, 1970, from Mr. Webb (then Director, CMC) on my birthday, a two line, one sentence letter, stating that I had been retired in accordance with the University Regulations at the age of 60 years, a wonderful birthday gift!”
Post-retirement, Dr. Chandy moved to Kottayam, where he was appointed as an Emeritus Professor at a local Medical College. In his heart, he was, however, still longing to be of service to the local mission hospital and through it provide rural health care. He succeeded in persuading the University to start a B. Sc. course in Health Sciences (In this connection, he wrote to the author (PNT) to persuade the University Grants Commission to promote the initiation of such a degree all over India. Few would know that now this degree course has been started in many parts of the country).
In addition, he was actively involved in the church activities and was a guiding spirit of the Kottayam diocese. While in retirement, he was diagnosed to be suffering from carcinoma of the prostate gland, which was successfully treated. He later developed a mild stroke involving the left side of his body. By God's Grace, he managed to live a happy life till the ripe old age of 97. He left for his heavenly abode on 23th June, 2007.
Dr. Chandy and the Neurological Society of India
One can only admire his audacity or faith in himself to take up challenges most others would not dare to perform or would even consider to be fool-hardy to undertake. One such audacious step was the creation of the Neurological Society of India (NSI) at a time when the country did not have a dozen neuroscientists. Just a couple of years after he was at Vellore, he and Dr. Ramamurthy at Madras initiated this specialty; he, after discussing with Dr. Baldev Singh, travelled to Madras to meet Dr. Ramamurthy and Dr. S.T. Narasimhan to establish a society comprising all neuroscientists – clinical or basic. Those four met initially at Dr. Narasimhan's place and later at Dr. Ramamurthi's residence, where late in the evening, over hot cups of coffee, the quartet gave birth to NSI, which has today grown to include nearly 3000 members. Dr. Chandy accepted to be the Founder President, persuaded Dr. Ramamurthy to be the Secretary, and Dr. Narasimhan to be the Treasurer (For a detailed history of NSI refer to Neurosciences in India: Retrospect and Prospect by Prof. Sunil K. Pandya).
In addition, Dr. Chandy was a Founder Fellow of the Indian (later called National) Academy of Medical Sciences and actively contributed to the formation of the Indian Association for the Advancement of Medical Education.
Dr. Chandy and his family
As mentioned earlier, Dr. Chandy was married to Ms. Thangam on September 4, 1991. They had two sons – Mathew and Varghese, and a daughter, Accamma. Mathew followed in the footsteps of his father and is a distinguished Neurosurgeon, who for years occupied his father's chair at CMC Vellore, and is currently working at Khoula Hospital, Muscat. Varghese is an accomplished Chemical Engineer working in Australia. Accamma, married to a Business Executive is happily settled in Hyderabad. Dr. Chandy had been blessed with several grandchildren.
Distinctions and Honours
He was the Founder President of the Neurological Society of India (1951), the Founder Fellow of the National Academy of Medical Sciences, the Elected Fellow of the Indian Academy of Sciences, Bangalore, Chairman of the Academic Council of AIIMS, was awarded Padma Bhushan, and was awarded the Scroll of Honour by the World Federation of Neurological Societies in 1989.
Selected quotations from his autobiography: “Reminiscences and Reflections” published in 1988 include:
A quote by one of his students – Dr. M. Sambasivan, who remained close to Dr. Chandy throughout his life, is as follows:
“Tall, dark, rough looking and rough voiced, giving a different impression at first sight, Professor Jacob Chandy was a perfect person with a loving heart. As an artistic surgeon, he was a Leonardo da Vinci; as an administrator, he was a Bismarck; as an avid planner and organizer, he was a Winston Churchill; as an erudite teacher, he was a Nagarjuna; as a devotee, he was John the Baptist; and, as a visionary, he was a Ashoka. A rare combination of several virtues in one individual indeed!”
The photograph of Professor Baldev Singh is retrieved from the article: Srivastava MV, Dash D. History of neurology at All India Institute of Medical Sciences. Neurol India 2015;63:751-6.
The photograph of Professor Jacob Chandy is retrieved from the article: Rajshekhar V. History of neurosurgery at Christian Medical College, Vellore: A pioneer's tale. Neurol India 2016;64:297-310.