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CORRESPONDENCE
Year : 2017  |  Volume : 65  |  Issue : 2  |  Page : 443-445

Organized neurosurgery: Additional facts


Department of Neurology, Trivandrum Medical College, Thiruvananthapuram, Kerala, India

Date of Web Publication10-Mar-2017

Correspondence Address:
K Rajasekharan Nair
Department of Neurology, Trivandrum Medical College, Thiruvananthapuram, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.201844

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How to cite this article:
Nair K R. Organized neurosurgery: Additional facts. Neurol India 2017;65:443-5

How to cite this URL:
Nair K R. Organized neurosurgery: Additional facts. Neurol India [serial online] 2017 [cited 2017 Aug 24];65:443-5. Available from: http://www.neurologyindia.com/text.asp?2017/65/2/443/201844


I read with interest the Presidential oration by Dr. CE Deopujari CE on organised Neurosurgery.[1] While reading this paper, I remembered two such previous papers dealing with the topic in the same manner - Dr. Ram Ginde's paper presented on the 20th anniversary of the Department of Neurosurgery of Madras Medical College (Souvenir published on the 20th anniversary of the Department of Neurosurgery of Madras Medical College. 1971) and Dr. Asoke Bagchi's paper with a very provocative title 'Neurosurgery in the subcontinent: Before and after its truncation' (published in the Journal of Association of Neuroscientists of Eastern India. 2000; 5: 87-93). I refuted Dr. Bagchi's publication in the same journal which published his paper (Journal of Association of Neuroscientists of Eastern India. 2001; 5: 55-57).

By convention, orations are usually not commented upon, but when a paper deals with history, that too the history of our society, it is necessary point out the inadequacies, inaccuracies, omissions and errors, however minor they may be, and supplement the facts with extra data, if available. If this is not done, the paper will be naturally accepted as being completely representative of the valid history of the organisation by later generations. The general unavailability of the relevant data in this context is understandable but that does not justify not addressing the inaccuracies in history.

1) I presume that the author intends to deal only with Neurosurgery in India. If so, he should have confined himself to the evolution of Indian Neurosurgery, leaving out the Neurological Society of India (NSI) and its journal, Neurology India, as these are not the sole concerns of neurosurgeons of India. The founders, though only four in number, (Drs. Jacob Chandy, B. Ramamurthi, Baldev Singh and S. T. Narasimhan) had the great vision to call the society they formed in Madras on 8th Dec 1951 as Neurological Society of India - incorporating all disciplines of neurosciences. As everyone knows, Dr. Baldev Singh was a neurophysician. Incidentally a point should be stressed here. Dr. Jacob Chandy, after his training in Canada and the USA, took up the job at Christian Medical College (CMC), Vellore on 14th April 1949 (Page 49 of his autobiography 'Reminiscences and Recollections,' 1998. Kottayam, CMS Press). Dr. B. Ramamurthi joined Madras Medical Service on 24 Oct 1950 (Page 137 of his autobiography 'Uphill All the Way'. 2000. Self Published). But earlier than that, in 1948, Dr. S. T. Narasimhan had returned after his neurosurgical and electroencephalography (EEG) training from New York, USA and had started his neurosurgical and EEG services in Madras (Page 147 of Dr. B. Ramamurthi's autobiography). In the 1980s and 1990s, I had personally discussed many times this matter with Dr. B. Ramamurthi and he recounted the same story. A write up about this silent worker has been published previously.[1] Having had their training in the USA, all four of them had definite knowledge of the separate divisions of neurological sciences- Neurology, Neurosurgery, Neuropathology and Neuroradiology, and the society they planned included all these categories and not selectively Neurosurgery. Though belated in nature, we should acknowledge the fact that it was Dr. S. T. Narasimhan who initially started neurosurgical and EEG services in India. He was only a medical diploma holder (LMP) at that time but later passed MBBS and finally became Professor of Electroencephalography at the Madras General Hospital, a few months before his sudden death in 1959. Of course, it was Dr. Jacob Chandy who started the first academic neurosurgical service in India, closely followed by Dr. B. Ramamurthi.

Seminal achievements

  • The first formal neurosurgical course was started at CMC, Vellore. The degree awarded at that time was not M. Ch but M.S (Neurosurgery). The first person who took that degree was Dr. K. V. Mathai (1961). Others in subsequent batches also got M.S (Neurosurgery) degree from CMC, Vellore. It was only after a few years that the name of the degree was changed to M. Ch. As noted by the author, the D.M course was started later in Madras University. Two candidates (Dr. G. C. Mithra of CMC, Vellore and Dr. K. Srinivas of Madras Medical College) passed the DM Neurology examination in 1969 for the first time in India
  • It was in 1974 that NSI decided to have a continuing education (CME) program along with its annual conference. The first formal CME program of NSI was organised by Dr. S. Kalyanaraman of Madras in 1977. He continued to spearhead its organisation for quite some time. I still remember, both as a delegate and later as a speaker in those CMEs, the methodical approach and the punctuality of Dr. S. Kalyanaraman in starting these sessions exactly at 7. 30 AM. Even with very tight fiscal policies, Dr. S Kalyanaraman, along with many others like Dr. Sunil Pandya, brought out the proceedings in a book form on many occasions. In fact, the editions brought out by Dr. S. Kalyanaraman and Dr. Sunil Pandya were treasures of historical notes about the NSI. From 1985 onwards, for a few years, Dr K. K Sinha of Ranchi and his team started publishing the very well edited 'Progress in Clinical Neurosciences.'
  • It is pleasant to see the changing facsimile of Neurology India. But indeed, times were quite tough for the earlier editors to bring out the journal regularly with as much sophistication as was possible then. After Dr. B Ramamurthi (1952- 1957), Dr R. G. Ginde (1958- 1964), Dr. Anil Desai (1965-1978) and Dr. P. N. Tandon (1979-1982) became editors. Then, for a brief period, its publication was erratic till Dr. S. Kalyanaraman (1985-1990) took over the editorship. Perhaps the present-day editors do not understand the terrible plight of those editors faced with the monumental task to get/invite papers, get them peer reviewed, and publish them despite great financial difficulties. No corporate funding was available to them, but the final product was pleasant and beautiful by the then prevailing standards. The help from various advertisers was difficult to come by. Still, the 'blue journal,' as some of us used to call it (against the green journal Neurology of USA), did carry very useful and relevant research data. I wish the author had included at least one picture of the front-piece of the old journal. Dr. Sunil Pandya's excellent book has been mentioned. This is still the best reference source book on the historical aspects of Indian Neurosciences
  • Even in a fleeing overview about Indian neurosciences and NSI, omission of the mammoth effort to conduct the World Congress of Neurology (and the 18th International Epilepsy Congress by Indian Epilepsy Association - whose members were mostly NSI members too) that immediately followed the World Congress of Neurosurgery by NSI in 1989, is not excusable. No country prior to that ever dared to conduct these three international congresses of neurosciences in a series like what India did in 1989. Every one of us in neurosciences in India at that time, chipped in wholeheartedly. Even the annual elections of NSI were held in abeyance for it, and Dr. S. N. Bhagwati and Dr. M. Sambasivan continued to hold their offices so that the efforts required for the World Congresses would not be mitigated. Not only Dr. A. K. Banerji but also Dr. J. S. Chopra and Dr. M. C. Maheswari, are to be congratulated for their efforts. I recall proudly the efforts of a large number of (then) young neuroscientists, who worked day and night in different parts of India to make these conferences successful. Thousands of abstracts sent for these conferences had to be evaluated for accepting or rejecting them; or, for classifying them into various categories of presentation. All this work was done by us without even getting a word of acknowledgment from anyone. Nor did we expect any gratitude, as we were doing this work as a part of our duty towards our society. Further, let me note one more point. The contributions to the World Neurology by Indian neurologists were significant even in those days when communications and finance were meagre and the governmental restrictions to go abroad were quite strict. The papers, not only from major cities like New Delhi, Madras, Chandigarh, Calcutta, or Bombay but also from smaller cities like Lucknow, Calicut, Trivandrum or Pune, captured international recognition. It is sad to note that the important role they played in enhancing the value of Indian Neuroscience in the world arena is no longer remembered
  • According to the author, the decision of the NSI to rotate the post of the President of the Society between the various disciplines has not been regularly followed since the 1990s. In the history of NSI, except for once or twice, this practice had been regularly followed until around the year 2000. I was elected as the President (in 1999) after a neurosurgeon's term. Every one of us, neurologists, neurosurgeons and experts from allied fields like Neuropathology and Neurochemistry, thought that the society represented all of us equally. Of course, changes did occur later on. As a member (and also as its past President) of Indian Academy of Neurology (IAN -1996), I feel that it my duty to point out that IAN never tried to compete with NSI. According to the figure put up by the author, among a total of 2658 members of NSI, neurophysicians still constitute about 19.5% of the total membership. When did the society declare that it belonged to one group only? The office bearers and all formal documents of NSI should represent all the members of the society at all the available forums- the Presidential oration included
  • If only Dr. Sunil Pandya of Bombay had been consulted during the data collection for this paper, he would have certainly given a few more unavoidable references. Some times in middle of 1990, there was a mishap and all the official records of NSI became unavailable for some unknown reason. When I was elected President of NSI, I had the formidable task to re- record the entire history of NSI from its inception. I thought that this plain compilation of data would not suffice for posterity. It was with this intention that I wrote to all the past Presidents of NSI to note down major events of their life and times with emphasis on the evolution and development of neurological sciences in their regions.[2] It was certainly not an easy or pleasant job. Except for Dr. B. Ramamurthi and a very few others, many did not oblige. Some refused outright. But quietly, I continued with my work. The material I got from many of them either needed to be edited or rewritten almost in its entirety. Very few of them wrote good essays. Gradually, the people who had initially refused to participate in the project, realized the progress that my work was making and the historical relevance of the proposed endeavour. They then pleaded with me to give them a few more days after the cut-off date to send their write ups. The finally collected data were large and I published them in the form of a book titled 'Evolution of Neurosciences in India.'[3] It was prohibitively expensive to publish it while maintaining its academic standards but fortunately it could be done. This is the only publication which gives all the relevant data about the history of the society, year and place of each conference, the name of the different office bearers and their officiating dates, thus updating Dr. Sunil Pandya's compilation, which covers up to the year 1988.[4]


Almost all the pioneers of NSI were alive then. I had an excellent personal rapport with all of them, and with their help, the missing links could be reviewed. Still, there were some lacunae. Details of couple of past Presidents (Dr. W. Grillmayr - 1955- 1957 and Dr. Menino de Souza- 1957- 1958) were unavailable but at the last moment, I could gather some information about Dr. de Souza. I am more or less certain that this kind of data gathering is impossible now. Hence, I have a suggestion. I wish (and I can give permission) that the book 'Evolution of Neurosciences in India' may be republished by the NSI either as a book or be digitized for future reference. Perhaps minor changes and additions may be required as a few of the Past Presidents have passed away after the publication of the first edition. The IAN followed my example and brought out a similar book 'A Saga of Indian Neurology,' that is available on the internet.

I should mention the publication brought by Dr. M. C Maheswari et al., of AIIMS, New Delhi in 1998 entitled 'Neurology India- Abstracts: 35 years, 1953-1987.' The work which Dr. Maheswari and his team did, at a time when computer and other such gadgets were unavailable, was laudable. That books lists all the titles/abstracts of papers published in Neurology India during its formative years. It would be interesting to compare the perspectives of Indian neurologists on the same topic- ''Evolution of Neurosciences in India.'[5]

Let me add a note of optimism. There still exists a fairly good camaraderie between different categories of neuroscientists in India- neurosurgeons, neurologists and experts in allied fields of neurosciences. Every one of us should try to foster and improve it. Parochial thinking will be detrimental to the society, hence this suggestion.

Further the wise words of Winston Churchill need be remembered, 'The farther back you can look, the farther forward you are likely to see.'

 
  References Top

1.
Deopujari CE. Organized Neurosurgery. Neurol India 2016;64: 1129- 35.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Nair KR. Preserving the legacy: The history of Indian Neurosciences. Natl Med J India 2013; 26: 359-360.  Back to cited text no. 2
    
3.
Nair KR. Evolution of Neurosciences in India: Biographical sketches of some indian neuroscientists. Nair KR, editor. Thiruvananthapuram\: Neurological Society of India; 1998.  Back to cited text no. 3
    
4.
Pandya SK. Neurosciences in India- Retrospect and Prospect. Trivandrum. Neurological Society of India; New Delhi. Council of Scientific and Industrial Research 1989.  Back to cited text no. 4
    
5.
Mishra S. Trikamji B, Singh S, Singh P, Nair KR. Historical perspective of Indian Neurology. Ann Indian Acad Neurol 2013;16: 467-77.  Back to cited text no. 5
[PUBMED]  [Full text]  




 

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