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Bangur Institute of Neurosciences: A premier neurosciences institute of Eastern India
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.181550
Bangur Institute of Neurosciences is one of India's oldest teaching institutions in the field of neurosciences. It has contributed richly over four decades in training and research in Neurology and Neurosurgery. Situated in Kolkata, the City of Joy and the Cultural Capital of India, and run under the aegis of the Government of West Bengal's Ministry of Health and Family Welfare, it remains one of the highest-volume neurological and neurosurgical centers in the country. This is a humble attempt to illustrate the history of this Institute and to provide a vignette of the many illustrious neurologists and neurosurgeons who were intimately involved in the setting up practice of Clinical Neurosciences in Eastern India. Keywords: Bangur Institute of Neurosciences; history; Kolkata history of Neurology and Neurosurgery
There was no specialized teaching and practising of neurosciences (neurology and neurosurgery) in the pre-independence era. In West Bengal, general surgeons taught the management of head trauma and physicians taught some elements of neurology. At that time, the only teacher of note was Dr. Bidhan Chandra Roy. Dr. Tarit Kumar Ghosh had the good fortune of serving as his House Physician and was later appointed by Dr. B.C. Roy as a research scholar in 1940. The idea of developing a neurosciences institute in West Bengal was the brain child of Dr. B.C. Roy [Figure 1] and [Figure 2].
Dr. B.C. Roy was a great visionary. He visited New York in the year 1947 and met Dr. I.S. Wechsler, Chief of Neurology and Neurosurgery at Mount Sinai Hospital. He discussed with Dr. Wechsler the possibility for training an Indian incumbent in neurology and neurosurgery. Soon after his return and appointment as Chief Minister of West Bengal, Dr. B.C. Roy called his student, Dr. Tarit Kumar Ghosh and asked him to travel to New York. Soon after independence, in 1948, Dr. T.K. Ghosh went to Dr. Wechsler for his training in neurosciences. Dr. Wechsler welcomed him and arranged for his training in neuropathology under Dr. Joseph Globus, in electroencephalography (EEG) under Dr. Hans Strauss, in neurophysiology under Dr. Brickner, in neuroradiology under Dr. Schlesinger, in neurosurgery under Dr. Ira Cohen, and in experimental neurology under Dr. Morris Bender. Dr. Wechsler himself taught him clinical neurology and supervised the entire program.[1] In addition, Dr. Ghosh attended several seminars and conferences and later visited the Neurology Departments at Johns Hopkins Hospital, Massachusetts General Hospital and Philadelphia Medical College and Hospital. At the end of his training program, Dr. Ghosh was invited by Dr. Wechsler, Dr. John Fulton and Dr. Joseph Globus to stay on as they promised him a bright future in New York. However, realizing the needs of his own country, Dr. Ghosh declined their handsome offer and returned to his motherland in 1949, the same year in which the legendary Prof. Jacob Chandy started the first specialized center of neurosciences in the country at Christian Medical College (CMC) in Vellore. On returning to Calcutta in 1949, Dr. Ghosh communicated his desire to start a neurosciences center to his mentor, Dr. B.C. Roy. He could manage to find a place in the Presidency General Hospital (PG Hospital, established in 1770, the oldest General Hospital in India, conducting the practice of modern medicine and meaningful research) for the development of neurosciences training [Figure 3].
The Institute of Postgraduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, colloquially known as the PG Hospital or SSKM Hospital, is a tertiary referral government hospital in the state of West Bengal, India. It is a national research institute. Sir Ronald Ross made his seminal discovery of “the life cycle of the malarial parasite” in this hospital. He was awarded the Nobel Prize in physiology and medicine on December 10, 1902 [Figure 4],[Figure 5],[Figure 6],[Figure 7]. Bangur Institute of Neurosciences (BIN) is adjacent to and functionally attached to this institution.
Dr. T.K. Ghosh's efforts to establish a Neurology Unit got the approval of the Government of West Bengal, and on May 2nd, 1951, the first such unit with ten beds for neurology patients and an adjoining EEG lab were formally inaugurated by Dr. B.C. Roy. The office of the Neurology Unit and EEG lab were allotted a derelict and decrepit corner in one of the dilapidated buildings (Woodburn Block), which he soon refurbished into a workable laboratory [Figure 8].
In 1954, the posts for one senior neurosurgeon, two junior neurosurgeons, one neurologist, and one psychiatrist were sanctioned by the Government of West Bengal for appointment at the PG Hospital. Dr. B.C. Roy, during his visit to Vienna around this time, persuaded Prof. (Dr.) Herbert Kraus of Vienna General Hospital to come to India for a year to develop the Neurosurgery Department in PG Hospital and train Indian neurosurgeons. This eminent and most lovable neurosurgeon came to Calcutta in February 1955 to occupy the post of Professor of Neurosurgery and Director of the Department for a tenure of one year [Figure 9].
A full-fledged Department of Neurology (including Neurosurgery and Psychiatry) was established in May 1955. The Department included Prof. Herbert Kraus as the Director, Prof. T.K. Ghosh as the Professor of Neurology, Dr. Ramendra Nath Chatterjee as the Assistant Professor of Neurosurgery and Dr. Ashok Kumar Bagchi (a pupil of Dr. Kraus) as the Lecturer in Neurosurgery.[1],[2],[3],[4],[5] During the period from 1955–1956, one of the patients referred by Dr. Ghosh to Dr. Kraus for surgery for a brain tumor (meningioma) was from a leading commercial family of Calcutta (the Bangur family). Following the patient's successful surgery, his family donated Rs. 300,000 to Dr. T.K. Ghosh towards establishment of an Institute of Neurology. The money was donated to the Government of West Bengal, and with the active support of the erstwhile Chief Minister Dr. B.C. Roy, the foundation stone of the proposed BIN was laid on June 10, 1962, in a plot of land inside the premises of the Bhowanipore Mental Observation Ward, adjacent to the PG Hospital [Figure 10],[Figure 11],[Figure 12].
Dr. Ramendra Nath Chatterjee was interested in the surgical management of central nervous system during his tenure as a postgraduate student in surgery. During his surgical career in the PG Hospital, he was attracted towards managing patients with head injury. He joined the Neurology Department under Prof. Kraus in 1955 and started his neurosurgical training [Figure 13].
In 1956, Dr. Chatterjee went to Vienna and continued his studies under Dr. Kraus. He also visited Prof. Hugo Krayenbuhl in Zurich, Prof. Tonnis in Koln, and Prof. Herbert Olivecrona in Stockholm. He rounded off his stay in Europe with visits to France (with Prof. Le Beau and Prof. Kleine), and the Institute of Neurology, Queen's Square, London. On his return to Calcutta, he rejoined the Neurology Department as Assistant Professor in Neurosurgery at IPGMER in 1957, alongside Dr. T.K. Ghosh and Dr. A.K. Bagchi. He, along with Prof. T.K. Ghosh, played a vital role in popularizing neurosciences in Calcutta and also in developing BIN. Later, he became the Head of the Department of Neurosurgery from 1965 to 1974. After his retirement, he continued as Emeritus Professor until the time of his death in June 1984. His work on the surgical treatment of spinal vascular malformations was appreciated and recognized in different international meetings [Figure 14].
Prof. Asoke Kumar Bagchi, who was a noted neurosurgeon and scholar, had ventured out of India absolutely on his own to learn neurological surgery at Vienna in 1951 under Prof. (Dr.) Leopold Schoenbauer, the Chief of Neurosurgery at the famous Vienna General Hospital, and his first assistant, Dr. Herbert Kraus. Prof. Bagchi considered Dr. Kraus as his beloved “Guru.” Dr. Bagchi instituted an award within the Neurological Society of India in honor of Dr. Kraus. His enthusiasm for philology led to the publication of the volume entitled “Sanskrit and The Modern Medical Vocabulary: A Comparative Study.” This book remains a work of reference. His interests were quite varied, from neurosurgery to the history of medicine, and from philology to philately.[6] These three neurosurgeons formed a team that was headed by Prof. Kraus. All of them joined hands to form the first Neurosurgical Unit of Eastern India in Calcutta. In 1965, Dr. A.K. Bagchi left IPGMER to join Nil Ratan Sarkar (NRS) Medical College to take charge of the newly sanctioned Department of Neurology. In February 1957, the annual meeting of the Neurological Society of India was held in Agra, which was attended by Dr. R.N. Roy from CMC Vellore under the leadership of Prof. Jacob Chandy. Prof. T.K. Ghosh also attended the meeting. Prof. Wilder Penfield, the celebrated Chief of Montreal Neurological Institute in Canada, was a guest at this meeting and had expressed the desire to visit Calcutta. After a few days, he visited the newly-formed Department of Neurology at the PG Hospital, headed by Prof. T.K. Ghosh [Figure 15].
In 1958, Dr. Ranendra Nath Roy joined the Institute's Department of Neurosurgery, followed closely by Dr. M.B. Bhattacharya (Neurology) and Dr. Ajita Chakraborty (Psychiatry). After completion of housemanship training in September 1954, Dr. Ranendra Nath Roy was looking for an opportunity to specialize in surgery. On the advice of Prof. Panchanan Chatterjee, his teacher and the erstwhile Head of the Department of General Surgery at Medical College Calcutta, he traveled in February 1955 to CMC, Vellore as an ICMR-Rockefeller fellow for training in neurosurgery under the celebrated Prof. Jacob Chandy.[2],[3],[4] He was the first Indian trainee in neurosurgery under Prof. Chandy. After joining IPGMER and SSKM Hospital in 1958 as a temporary Medical Officer, he spent a few years in other medical colleges (NRS Medical College and Calcutta Medical College in the Departments of General Surgery) until 1962, when he rejoined the Department of Neurology at the PG Hospital. A few months later, he was offered an Austrian Government Scholarship for further study and training in related aspects of neurological sciences. He spent a year in Vienna (1962–1963, under Dr. Herbert Kraus) and another year at the Edinburgh Royal Infirmary with a British Council Fellowship (1963–1964, under Prof. Gillingham, on the recommendation by the eminent American neurosurgeon Prof. Paul Bucy). Thereafter, he visited many European centers of excellence in Neurosurgery and attended several conferences and symposia [Figure 16] and [Figure 17].
He returned to Calcutta in 1964 and was promoted in 1965 to the post of Assistant Professor, Neurosurgery at the PG Hospital. He subsequently became the Professor of Neurosurgery in 1972, and the Head of the Department in 1974. Subsequently, he became the Director of IPGMER and BIN in 1984 until his superannuation in 1986. He continued to serve IPGMER and BIN as the Honorary Professor and Consultant till 1990. He had the unique privilege of witnessing the growth of the Department of Neurology from the earliest days at the SSKM Hospital to its development into a full-fledged Institute of Neurosciences at BIN Kolkata. Prof. R.N. Roy, considered to be one of the founders of neurosurgery in the city, continued to lead from where Dr. Ghosh had left off, and his tireless efforts, along with the able assistance provided by his contemporaries and students, helped BIN achieve a place of eminence in neuroscience in India. A revised teaching set up was sanctioned in 1967 by the Government of West Bengal for IPGMER wherein the erstwhile Department of Neurology was bifurcated into the Departments of Neurology and Psychiatry, headed by Prof. T.K. Ghosh with Dr. M B Bhattacharya as Lecturer (Neuromedicine) and Dr. Ajita Chakraborty as lecturer (Psychiatry); and, into the Department of Neurosurgery headed by Prof. R.N. Chatterjee and Dr. R.N. Roy as Assistant Professors and Dr. Durgadas Roy Chowdhury as Lecturer [Figure 18].
At that time, patients, both of medical and surgical subspecialities were distributed into the wards of the main building of the SSKM Hospital and radiological studies were carried out in the main Radiology Department again housed in another building. The operation theater (OT) of the Woodburn ward was utilized for neurosurgical operations. Some years later, a separate OT was opened in the main block, which was shared between the Departments of Neurosurgery and Plastic Surgery [Figure 19].
This system for patient care was found to be rather unsatisfactory, and a search for an alternative arrangement was initiated, where all aspects of patient care including investigation, treatment, teaching, and research could be undertaken under one roof. The concept culminated with the establishment of BIN. The foundation stone of the institute was laid by Dr. Bidhan Chandra Roy on June 10, 1962. Due to various reasons, work on the making of the institute buildings did not progress satisfactorily, and the pace of construction was slow. The Neurology and Neurosurgery Departments in PG Hospital continued functioning as before. Operations were conducted in the new operation theatres (OT) constructed at the main building of the PG Hospital. In this new OT complex, space was shared with the Department of Plastic Surgery. BIN, Calcutta became operational in 1970 as an institution for postgraduate training and research in different disciplines of the specialty of neurosciences in the newly erected two storied building with 20 indoor bed facilities sanctioned by the Government of West Bengal.[5] The building handed over by the Public Works Department to the hospital authorities had only two floors, the ground floor containing within a small area, the outpatient department (OPD), EEG lab, offices of the Professors, the hospital store, and the physiotherapy, neurochemistry, and neuropathology units. The first floor accommodated two wards for 20 patients, an X-ray setup with an angiography table, the OT complex, and two private rooms. Initially, only OPD services and some radiological investigations were started, and the majority of the work continued at the PG Hospital. The OTs were inadequately spaced for any major operation, and anesthesiologists were only available from the PG Hospital on a rotational basis according to the need. To further extend the facilities, administrative approval was accorded in November 1971 for the construction of two additional floors over the existing two-storied structure and for refurbishment of the existing structure. The construction was completed and 70 beds started functioning in 1975. This newly constructed complex was inaugurated by the Hon. Health Minister of West Bengal, Mr. Ajit Kumar Panja. The new facility contained a properly laid out OT area, postoperative recovery room, teachers' rooms, cabins for patients, a library, and other facilities to cope with the growing demands of the future. Former teachers of Neuromedicine and Neurosurgery Departments of IPGMER were posted at BIN although they continued to provide patient care on an ex-officio basis at the IPGMER and SSKM Hospital [Figure 20] and [Figure 21].[4],[5],[6],[7]
The government was made to recognize the special needs for such a super-specialty institute by the incessant efforts of its faculty members. In 1978, the academic strength of the institute was upgraded keeping in mind that the ultimate objective of such an institute was to achieve excellence in research and the training of doctors aspiring to acquire postdoctoral degrees in neurology, neurosurgery, and allied specialties. Several posts of teachers in neurology, neurosurgery, neuroradiology, neuroanesthesiology and neuropathology were sanctioned but could not be filled up due to the paucity of qualified persons willing to take up the job. By 1980, Prof. A.K. Dutta Munshi joined the Institute and took up charge of the Neuroradiology Department. Prof. Amna Goswami also joined as a Neuroanesthesiologist working exclusively for BIN. A computed tomography (CT) scanner was installed at BIN in 1980. After completion of the construction work and appointment of adequate teaching and nonteaching staff at BIN, a proposal was sent to the government for starting DM (Neurology) and MCh (Neurosurgery) degree courses at BIN and IPGMER under the aegis of the University of Calcutta. The university forwarded the proposal to the Medical Council of India and the MCh Neurosurgery course (of two years duration) was started in 1978. The DM Neurology course was started under the University of Calcutta in 1975 but only acquired MCI approval in 1978. Dr. M.K. Bhattacharya was the first Postdoctorate in Neurosurgery from BIN and the University of Calcutta, and he obtained his MCh degree in 1980 [Figure 22],[Figure 23],[Figure 24].
Mention must be made of the untiring efforts of Prof. N.N. Sarangi (an eminent Neurologist), Prof. M.K. Bhattacharya and the entire faculty of BIN under the leadership of Prof. R.N. Roy, which culminated in making the entire endeavor a success in such a short duration (1975–1978). The institute was upgraded from time to time, as was felt necessary by the government, to reach its present state. To meet the increasing demand, a new five-storied building was constructed and became operational from May 18th, 2002. In the year 2004, a new post of director (exclusively for BIN) was created and Dr. Trishidananda Roy (Professor of Neurology) joined as the first director of this institute.
The institute has the facilities that include a well-equipped library with a broadband internet connection, a record room, a server room, and a seminar room. There are services for EEG; electromyography/nerve conduction velocity; CT scan; magnetic resonance imaging (3 Tesla) with capability for spectroscopy, angiography, and tractography; bi-planar DSA machine used for diagnostic as well as therapeutic purposes; C-arm image intensifier; neuromonitoring (intraoperative) equipment for cranial and spinal surgery; neuronavigation platform; ultrasonic surgical aspirator; and, sophisticated neuroanesthetic and critical care equipment [Figure 25],[Figure 26],[Figure 27],[Figure 28],[Figure 29],[Figure 30].[3]
BIN has its own physiotherapy unit. Specialty wings of neurology and neurosurgery departments at the SSKM Hospital continue to render their services for the medical and surgical management of emergency and trauma patients. Recently, thrombolysis for ischemic stroke has been started at SSKM Hospital under the aegis of the Department of Neurology, BIN.
Courses
BIN was the first teaching institute of Neurosciences in Eastern India under the administrative control of a state government (Government of West Bengal).[7] Residents have to attend an extensive and comprehensive training program including classes in clinical meetings and case presentations, journal clubs, neuroradiology sessions, mortality meets and audits, seminars, teaching ward rounds, and electrophysiology. Faculty members
Neurology
Neurosurgery
Hospital services
Neurology (Bangur Institute of Neurosciences)
Neurosurgery (Bangur Institute of Neurosciences)
Neurogenetics lab (Bangur Institute of Neurosciences)
Specialty clinics under neurology department, Bangur Institute of Neurosciences
Bed strength (Bangur Institute of Neurosciences)
This institute was started from the very grassroots and has a long history of patient care. Its growth and development have been slow but steady, but it still has a long way to go. BIN serves patients from all over Eastern and North Eastern India and has the unique distinction of being one of the neurological and neurosurgical centers in the country with the highest volume of patients. We, at BIN, still have a long way to go. Facilities for stereotactic surgery and neuroendoscopy, long awaited at BIN, are due to be launched soon. BIN is still to acquire capabilities for functional neurosurgery and stereotactic radiosurgery. We would also like to mention that BIN is a state government institute and its faculty members get transferred in and out of the institute. Thus, the stability of jobs of the faculty members continuously in one institute is not guaranteed. Apart from this, limitation of resources is another factor that makes comparison with National Institutes difficult. Despite all these limitations, BIN is continuing to pursue various research activities and produce quality publications. Acknowledgments We are extremely indebted to Prof. R.N. Roy for his constant guidance and advice in writing this history of BIN Kolkata. We also acknowledge the invaluable help of Dr. Kaushik Roy, Associate Professor, Department of Neurosurgery and an alumnus of BIN. We also acknowledge the help of Dr. Abhijit Chatterjee, a senior neurologist of Kolkata and an alumnus of BIN, for sharing some rare photographs from his collection. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17], [Figure 18], [Figure 19], [Figure 20], [Figure 21], [Figure 22], [Figure 23], [Figure 24], [Figure 25], [Figure 26], [Figure 27], [Figure 28], [Figure 29], [Figure 30]
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