Two founders of Bombay neurosciences: Dr. Ramchandra G. Ginde and Dr. Menino De Souza
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.205924
Source of Support: None, Conflict of Interest: None
Dr. Ramchandra Gundopant Ginde (28th July 1912 – 3rd May 1974)
The Gindes hailed from Shahapur, Belgaum, then a small pocket under the Rajasaheb of Sangli in Bombay Presidency. Dr. Ginde's grandfather, Mr. Ramchandra, was in the Post and Telegraphs Department of the Government of India and was frequently transferred from place to place. His father, Dr. Gundopant Ramchandra Ginde, obtained his Licentiate College Physicians and Surgeons (LCPS; a recognized medical qualification in India before 1946) from the B. J. Medical College in Poona and started his practice in Belgaum. Dissatisfied with his practice in this city, he moved to Bailhongal, a small village 27 miles away and settled there. He earned a reputation as a caring physician and a social worker. As Chairman of the village municipality for 9 years, he effected long-lasting improvements that attracted the attention of the visiting British government officials. He was appointed the Honorary Judicial Magistrate. Dr. Gundopant Ginde had 9 children of whom Ramchandra, born on 28 July 1912, was the eldest. His friends and colleagues called him 'Ram'.
Dr. Ram Ginde's initial studies were in Kanarese (though his mother tongue was Marathi). He proceeded to Belgaum for higher studies and completed his matriculation in 1928 from the University of Bombay. By then, he was playing the harmonium, the flute and the dilruba. (See the note below on how he helped his younger brother, Krishna, develop into a classical musician of repute.). Ram Ginde moved to Poona where he studied at the Deccan College. In preparation for entry into the medical college, he moved to Bombay and studied at the Wilson College. This is where he developed his love for tennis.
He joined the Seth G. S. Medical College in Bombay and studied under such masters as Dr. Rustom N. Cooper, Dr. Nathubhai D. Patel, Dr. P. C. Bharucha, Dr. Gopalrao Deshmukh and Dr. N. A. Purandare. Dr. Rustom Cooper was especially fond of him and called him, 'Sonny'. He obtained the M.B.B.S. degree in 1934, standing first in the University of Bombay.
He took post-graduate courses in advanced anatomy, physiology and other subjects during the two years (1938-1939) spent in England. He passed the primary examination for the Fellowship of the Royal College of Surgeons (FRCS). The outbreak of the World War made it necessary for him to return to India before he could appear in the final examination for the FRCS. On his return to India, he obtained the M.S. degree in 1940 from the University of Bombay. He won several prizes, medals and scholarships. His proficiency in tennis and music continued to develop. He won the Bombay University Intercollegiate Tennis Championship in 1935.
He developed an interest in blood transfusion – then in its infancy in India. Together with Dr. S. M. Nadkarni, he set up the first blood bank at the K. E. M. Hospital. His expertise soon prompted surgeons such as Dr. Cooper to ask him to supervise transfusions on all their patients. He served his alma mater as the Honorary Assistant Surgeon, K. E. M. Hospital and Lecturer in Surgery, Seth G. S. Medical College, Bombay from 1942 to 1948, when he left for Montreal.
His interest in the neurosciences appears to have been stirred by his study of the slides brought by Dr. V. R. Khanolkar from the laboratory of Dr. Santiago Ramon y Cajal. He applied for the scholarship offered by the Government of India for training in Neurosurgery. He was selected from among the forty candidates who applied for the scholarship, and preferred working under Drs. Wilder Penfield and William Cone to travelling to British centres. During the two years (1948-1950) spent in Montreal, he impressed his teachers by his enthusiasm and dedication. Dr. Penfield made arrangements for him to visit several American and European centres following the completion of his stay in Montreal.
From the left: Dr. Ram Ginde, Mrs. Penfield, Dr. Wilder Penfield, Mrs. Sarala Ginde during Dr. Penfield's visit to Bombay in 1957
On his return to Bombay, he was appointed Honorary Surgeon, K. E. M. Hospital and Lecturer in Surgery, Seth G. S. Medical College, Bombay. He estimated that 75% of his work was in Neurosurgery. In 1953, he was appointed Lecturer in Neurosurgery, Seth G. S. Medical College, Bombay
Dr. S. D. Bhandarkar, who later headed the Department of Endocrinology at K. E. M. Hospital, recalled his experiences as a student: 'I attended his outpatient department (OPD) No. 5 clinic and used to be amazed at the diagrams he used to draw on the blackboard… Once he set his heart on learning something, he did not stop till he had mastered the subject.'
Dr. Ginde was soon frustrated by the lack of interest shown by the authorities on his proposal for the creation of Departments of Neurology and Neurosurgery. Even so, he struggled to do his best and in 1954, published a survey of the neurosurgical work at the K. E. M. Hospital over the 27 years from 1926-1953, together with an analysis of the patients treated by himself since 1951. (See Journal of the Indian Medical Profession 1954:1;81-88).
It is of interest to note that the first spinal cord tumour was removed by Drs. Cooper and Ginde in 1940, the localisation having been made by air myelography. Laminectomy for prolapsed lumbar disc at L2-3 was first carried out by Drs. Cooper and Ginde in 1945. The disc contents were excised through the transdural approach.
Drs. A. P. Bacha and G. V. Deshmukh had attempted surgery on brain tumours from 1927 but they had to rest content with taking biopsies and performing decompressions. Dr. A. V. Baliga successfully treated trigeminal neuralgia surgically in 1940. Dr. R. N. Cooper performed the first prefrontal leucotomy by the trans-temporal route of Drs. Freeman and Watts in 1945.
Breach Candy and Bombay Hospitals
As Dr. Ginde's personal needs made themselves felt, he placed a request for better monetary returns to the Municipal Corporation of Bombay. Playing true to form, the bureaucrats in charge failed to respond. Dr. Ginde resigned from the K. E. M. Hospital and moved to the Breach Candy Hospital, which welcomed him with open arms. He was provided his own operation theatre and other necessary facilities. He continued treating patients here even after he joined the Bombay Hospital.
Dr. R. N. Cooper, dismayed by the treatment meted to Dr. Ginde by the authorities at the K. E. M. Hospital, prevailed upon Mr. G. D. Birla to appoint Dr. Ginde to the Bombay Hospital in 1954. This hospital had been set up in 1949 and was inaugurated by Sardar Vallabhbhai Patel.
Dr. Ginde started at the Bombay Hospital with four beds in the general wards and was allowed surgery on three half days each week. As patients started pouring in from all parts of the country, expansion became inevitable. Dr. E. P. Bharucha joined him and developed the Department of Neurology.
Dr. Eddie P. Bharucha later recalled: 'The Departments of Neurology and Neurosurgery were started at the Bombay Hospital by the late Dr. R. G. Ginde. In the beginning, an occasional bed was available. Now, on an average nearly 10 percent of the hospital beds, that is about 60 beds, are occupied by patients under various neurologists and neurosurgeons. A separate operation theatre for neurosurgical work was started in the main hospital building in 1959…' (The Times of India 8 June 1978, page 9).
By now Dr. Ginde attracted patients from most of northern, central and western India.
He was the editor of Neurology India from 1959 to 1964. Dr. Singhal was often called upon to help and recalls the painstaking manner in which Dr. Ginde studied each paper sent to him and when he found one worthy of publishing, he did his best to improve it, making corrections wherever necessary.
Dr. Singhal recalls watching him in the operation theatre and admiring his meticulous surgery. He always taught his assistants of the need for patience during surgery. There was no scope for hurry, as any error would result in considerable harm to the patient. Dr. Ginde often reminded his residents, 'Do not even think of closing the dura till you see the irrigation fluid return without any trace of blood. The presence of blood should warn you of an open vessel. Find it and obliterate it before you irrigate once again.' Unlike some other surgeons, he insisted on doing his postoperative dressings himself so that he could monitor the progress of the wound.
Dr. D. S. Dadhich was deputed by the Bombay Hospital to train in neuroradiology in Scandinavia. Myelogram and skull radiology tables were installed on his return. He proved a great help to Dr. Ginde and maintained all his radiology records. Unfortunately, during a spell of heavy rains in Bombay, the basement of the Bombay Hospital, in which these folders were preserved, was flooded, leading to destruction of films and case notes.
Drs. Noshir Wadia, Gajendra Sinh, Vijay Daftary and Vijay Dave were later appointed to cater to the many patients who now attended the Bombay Hospital.,, Drs. Bhagwati and Bhim Singhal joined the hospital in 1962. The neuropathology services were streamlined when Dr. Darab Dastur and Dr. Daya Manghani moved in from J. J. Hospital.
The appointments of Dr. Homi Dastur at the K. E. M. Hospital and Dr. Gajendra Sinh at the J. J. Hospital brought into existence, two new neurosurgery departments. These academic departments soon took over the care of poor patients and flourished.
Dr. Arjun Sehgal often invited Dr. Ginde to New Delhi to see his patients and operate upon them.
Director of Neurosciences, Grant Medical College and Sir J. J. Group of Hospitals.
Dr. Ginde had an excellent relationship with Mr. Yeshwantrao Chavan, Chief Minister of Maharashtra.
In 1964, came an announcement that surprised many. Dr. Ginde was appointed Director of Neurosciences at the institutions where Drs. Noshir Wadia and Gajendra Sinh had started the departments of Neurology and Neurosurgery, respectively. The Government of Maharashtra justified this appointment on the grounds of making available neurological services to poorer patients and to train neurosurgeons.
To say that Drs. Wadia and Sinh, who had started and developed their respective departments in these institutions run by the state government were upset, would be to make a grave understatement. Evidently, the appointments had been made at the highest level in the state government and there was nothing either Dr. Wadia or Dr. Sinh could do so they continued their work as usual.
Dr. Ginde soon learnt to appreciate the expertise of Dr. Darab Dastur, who headed the Indian Council of Medical Research backed Department of Neuropathology in these institutes. An interesting routine developed. On most occasions, as soon as the histology slides on his patients were ready, he would go over to the neuropathology department and examine them himself. Dr. Darab Dastur marveled at Dr. Ginde's expertise that the latter had acquired during his stay at the Montreal Neurological Institute and enjoyed verbal jousts with him on findings and interpretation. Over time, relations with Drs. Wadia and Sinh also thawed and the departments functioned smoothly.
Then, in 1971, came the news of the sudden termination of Dr. Ginde's appointment and dissolution of the Directorate of the Neurosciences. On 14th April 1971, the state health minister Dr. Rafiq Zakaria stated in the Maharashtra Assembly that Dr. Ginde had been retired as he had reached the age of 58. 'No department should depend on an individual.' Foreseeing other problems, he concluded, 'A director (as successor) was not appointed because of technical difficulties.' He noted that two directors would have to be appointed – one for Neurology and the other for Neurosurgery. (The Times of India 15th April 1971, page 9).
The Estimates Committee of the Maharashtra Legislature fulminated against this decision. '…Except for the initial appointment of Dr. R. G. Ginde as the head of the directorate, no other action was taken to implement the scheme. The sanctioned medical staff was not appointed and one of the operation theatres was allowed to remain unutilized… The committee has reasons to believe that there were deliberate attempts by departmental officials from the inception of the scheme to throttle it…' (The Times of India 13th April 1971, page 8). An editorial in this newspaper (21st April 1971) called the closure of the directorate 'inexcusable', 'since Dr. Ginde ran the only Neurology and Neurosurgery set up in the city' and, as a consequence, the people of Bombay were left without any facilities in this important branch of medicine.
Predictably, this elicited protest. The issue of this newspaper dated 24th April carried a letter by Drs. Wadia and Sinh, pointing out that Bombay had nine practicing neurologists and seven neurosurgeons, efficiently functioning Departments of Neurology and Neurosurgery at three teaching hospitals and that the Departments of Neurology and Neurosurgery at the J. J. Hospital were started long before Dr. Ginde had been appointed. Further emphasis was added by pointing out that following Dr. Ginde's retirement, the departments continued to work as smoothly and efficiently as before. This storm too settled and order was restored.
Dr. Ginde had drawn up plans for an institute of the neurosciences. His close connections with Mr. Chavan would have helped him to obtain land and other requirements for the requisite infrastructure. Alas! For a variety of reasons, his dream remained unfulfilled. With the wealth of neurological, neurosurgical and neuropathological expertise then available in Bombay, such an institute would have contributed greatly to the development of neurosciences.
Library and patient records
Dr. Ginde's personal library consisted of several hundreds of texts, monographs and bound volumes of journals. A significant percentage of these dealt with the history of the medical sciences with special reference to the nervous system. His son, Mr. Vijay R. Ginde, donated part of this library to the Department of Neurosurgery at the K. E. M. Hospital.
Dr. Ginde's case records remain exemplary models. A former student recalls an interesting incident: 'I was registrar to Dr. Gajendra Sinh in the Department of Neurosurgery at the Sir J. J. Group of Hospitals. Dr. Ginde was head of the other unit and was also the Director of Neurosciences. One evening, as I was completing my rounds, I was told by the staff nurse that Dr. Ginde wanted to see me immediately. His formidable reputation and insistence on strict discipline induced some anxiety as I wondered what prompted this summon.'
'Dr. Ginde was seated by the table separating the two halves of Ward 25. Standing next to him was his registrar, Dr. Narayan. The sober expression on his face was not encouraging.' 'Dr. Ginde smiled and commended me on working in the ward at that late hour. “I was about to show Narayan how an operation note should be written and wondered whether you'd like to see this too.”
'He then proceeded to write his account of the operation he had just concluded. He started off with details on the patient – name, age, sex, indoor number…The first few paragraphs were a summary of his history and findings on clinical examination. Then came the clinical diagnosis made by himself. The next few paragraphs summed up the findings on investigation and the diagnosis made before surgery. The interpretation of findings on X-ray films was made in considerable detail.'
'By now, he had already covered a full sheet in his neat handwriting. Only after this, did the actual operation note commence. He put down the title of the operation – Right frontal craniotomy for excision of intracerebral glioma. Details on anaesthesia, the position of the patient, the incision made, the various steps of the operation, findings at surgery, macroscopic description of the tumour, the final steps of the operation, closure of the wound, blood loss during the operation… followed. He concluded the operation with his post-operative diagnosis, proposed drug therapy in the postoperative period and in the long term, and other therapy that the patient might need and his prediction of the postoperative progress of the patient.'
'As he collected the sheets he had filled, he was not yet done. He now picked up a fresh sheet and made illustrations showing the key findings, especially with reference to the tumour itself. An hour had passed and we had not recognized this passage of time. He revised his note and then pinning the sheets together, placed them in the patient's file. He then addressed Dr. Narayan, “You must improve on this in all your future operation notes.” Accepting our thanks with a wave of his hand, he hurried away to his next appointment.' (Typed case notes on his private patients as well as those written in his own hand, have been gifted to the Department of Neurosurgery at the K. E. M. Hospital by Mr. Vijay Ginde).
Dr. Ginde married Sarala Herekar in 1936. They had three sons. Arun, born in 1942, followed in his father's footsteps, trained in Neurosurgery and settled in Canada.
Dr. Ram Ginde's role in ensuring the musical education of Pandit Krishna G. Ginde
Their father, Dr. Gundopant was very fond of music, and especially admired the songs of Bal Gandharva, the famous exponent of Marathi Natya Sangeet.
Krishna, the 8th child in the Ginde household, was born on 26th December 1925.
The Ginde household had regular musical evenings each Thursday where devotional songs in Kannada and Marathi were sung. Whenever he was at home, Ramachandra, then a college student, would provide accompaniment on the dilruba and a younger son, Govind, would play the tabla. Krishna was allowed to keep time with cymbals almost as soon as he was old enough to hold them, and would do it very well by the age of three. Recognizing his extraordinary ability, Dr. Ram Ginde ensured that Krishna was initiated in music when he was of the age of four years.
After Ramachandra qualified as a doctor, he met Mr. V. N. Bhatkhande – one of the leading musicologists of the day – and sought his suggestions for Krishna's musical studies. Mr. Bhatkhande suggested that Krishna be taken to his disciple, Acharya S. N. Ratanjankar, who was then Principal of the Maris College of Music in Lucknow.
Krishna was put under the tutelage of Acharya S. N. Ratanjankar in Lucknow from the age of ten and was fortunate to receive intensive training for over thirty years. In 1951, Krishna, nicknamed Chhotoo by Mrs. Ratanjankar, heeded his guru's advice that he serve as a teacher at the newly formed school of music at the Bharatiya Vidya Bhavan, Bombay. He remained on this faculty up to 1962, when he was appointed Principal of the Vallabh Sangeet Vidyalaya. When Pandit Ginde's sixtieth birthday was celebrated, Pandit Bhimsen Joshi, Kumar Gandharva, Purushottam Laxman Deshpande and other celebrities in Indian classical music graced the function. Pandit Ginde died in Calcutta on 13 July 1994, at the age of 78, from a massive heart attack, soon after he had concluded a lecture-demonstration.
Dr. Ginde and Meher Baba
Dr. Ginde greeting Meher Baba
Meher Baba (meaning compassionate father) was the name later given by his followers to Merwan Sheriar Irani (1894-1969). At the age of 19 years he underwent a seven-year long process of spiritual awakening. He studied under five reputed spiritual leaders, including Sai Baba of Shirdi. He spent long periods in seclusion, during which he fasted and meditated. He served the poor, those afflicted with leprosy and the mentally ill.
Gradually, disciples gathered around him. He imparted to them what he had learnt during his meditations. It became necessary for him to participate in discussions with larger groups and address gatherings. In 1925, he undertook maun vrata – a vow of silence – and now communicated only through gestures or, at the most, through an alphabet board. In time, he was revered as a spiritual leader, many considering him an avatar and he had innumerable followers in India and abroad.
He suffered accidental injuries in 1952 and 1956 that caused limb and pelvic fractures and left him in severe pain.
Eruch Jessawala described the relationship between Dr. Ginde and Meher Baba. (http://www.avatarmeherbaba.org/erics/lastginde.html). I recommend a visit to this site for a detailed account of the first meeting between them in 1960 when Dr. Ginde was called from Bombay to treat Baba for severe trigeminal neuralgia. There is an excellent description of the pressure under which Dr. Ginde worked then.
'I remember Nariman (who was deputed to get Dr. Ginde to Ahmednagar) telling us about it later… Instead of having an interview with Dr. Ginde in his office as he had expected, he found that Dr. Ginde was too busy for that. Nariman ended up following Ginde around the hospital as he made his rounds, talking to him in between patients. Dr. Ginde was very abrupt, almost rude, but it was just that he did not have time for the social niceties. So Nariman followed Dr. Ginde around and explained the situation, and the latter agreed to come. Dr. Ginde had never met Baba before and, of course, at first wanted Baba to come to Bombay, but Nariman told Ginde that Baba couldn't come to Bombay and that Ginde would have to go to Ahmednagar… After coming in contact with Baba, Dr. Ginde was a completely different person, but this was how he was with us in the beginning. Very abrupt, very curt….'
A description of how Dr. Ginde agreed to inject the trigeminal nerve in Meher Baba's room, the procedure of paralyzing the nerve using alcohol, and the sequelae, follows.
Mr. Jessawala continued: 'In subsequent years, Dr. Ginde saw Baba many times, but not as a doctor, and grew to love him very deeply. You know that at the very end, on the 31st of January 1969, Dr. Ginde was the last person, Baba remembered.'
Dr. Ginde's talks on Meher Baba have been made available by Mr. Raymond Lee (email@example.com) at mandalihall.org. He has kindly invited us to listen to them and even download them thus:
To download any talk from mandalihall.org, simply:
The Times of India on Sunday, 5th May 1974 carried the headline: 'Dr. Ginde, noted surgeon, dead' and informed the readers that he had died on Friday, two days earlier, at the age of 62, from a cerebral haemorrhage.
Dr. Ginde suffered an episode of myocardial infarction a few months before his death. He had been overworking as always and this illness made him reduce his hours of work. He went on to have episodes of diplopia and unsteadiness, leading his neurophysicians – Drs. Eddie Bharucha and Bhim Singhal – to diagnose transient ischemic episodes in the vertebrobasilar artery territory. He was put on low molecular weight heparin. In May 1974, he was admitted in a coma from a major infarct involving the brainstem and cerebellum with possible haemorrhagic transformation. A lumbar puncture had shown blood, which probably led to the erroneous diagnosis printed in The Times of India.
Dr. S. N. Bhagwati honoured him by instituting the annual Ginde Oration at the Bombay Hospital. Eminent neurosurgeons from abroad are invited to deliver it. The oration is associated with live demonstrations of complex neurosurgical operations by the orator, and also a workshop. Dr. Chadrashekhar Deopujari, the organizer for this event had chosen Dr. William Couldwell of the University of Utah, USA as this year's orator. The workshops are usually held at one of the teaching hospitals – Dr. Ginde's alma mater or the place where he was Director of Neurosciences or, as in this year, at the B. Y. L. Nair Hospital. There are no charges for registration at these orations and workshops
Mrs. Sarala Ginde passed away on 30th May 1983.
Dr. Bhim S. Singhal kindly provided information on Dr. Ginde that I was hitherto unaware of. I have included the information in this write up. I am grateful to him for studying my essay and in helping me to improve it. Mr. Vijay Ginde enriched the Department of Neurosurgery at the K. E. M. Hospital by his gifts of Dr. Ginde's books, case notes and neurosurgery instruments. Dr. Dattatraya Muzumdar kindly looked up references to Dr. Ginde in this department.
Dr. Menino De Souza (1904 – 1996)
Dr. Menino De Souza was of Goan extraction. Born on 6 July 1904, he lost his father at a young age and was raised by his mother. After schooling in Arpora, in Goa, he came to Bombay and studied at St. Xavier's College. Dr. De Souza settled in Mazagaon, close to Byculla and the location of his medical alma mater. This is especially appropriate. In an essay on the locality, we learn: 'The word Mazagaon has been derived from the Sanskrit Matsya Gram, meaning fishing village… in 1572 the King of Portugal granted the island in perpetuity to the de Souza e Lima family, from whom the De Souzas of Bombay trace their descent…'
He graduated in medicine from the Grant Medical College in 1930. He was appointed Tutor in Medicine and held this post from 1931-1937. In 1934, he obtained B. Sc. in physiology and in 1935, M.D. of the University of Bombay from the same institute. His wit and humour were on constant display. He recounted the competitive examination where he was awarded the Hemabai Wakatchand Gold Medal. 'This is because I was the only candidate competing for it.'
During his tenure as Tutor, he worked under the guidance of Dr. A. J. Kohiyar, a greatly respected consultant in Medicine. Dr. De Souza recounted an incident that was to have an important consequence. A patient was referred to Dr. Kohiyar from Portuguese East Africa and was admitted to the JJ Hospital. She had been sent with a diagnosis of anxiety neurosis. She could only converse in Portuguese. Dr. Kohiyar asked Dr. De Souza to study this patient as he had doubts about the earlier diagnosis. Dr. De Souza diagnosed myasthenia gravis. Dr. Kohiyar confirmed his findings.
In 1937, Dr. De Souza was appointed as Professor of Medicine and Honorary Physician at the Grant Medical College and its associated the Sir Jamsetjee Jejeebhoy Hospital (JJ Hospital). This was the first time in the history of these institutions that a person with local qualifications was given this position.
Dr. De Souza continued to demonstrate his expertise in Neurology. A patient suspected by one of the physicians to be suffering from the consequences of cervical ribs was discussed at a clinical meeting. Dr. De Souza suggested the diagnosis of syringomyelia and justified this by demonstrating the signs. The patient preferred treatment in England, where Dr. De Souza's diagnosis was confirmed. In yet another patient, Dr. De Souza uncovered a tumour of the cauda equina in a patient labeled as suffering from tabes dorsalis.
Impressed by his clinical abilities, Dr. Kohiyar recommended him to the Dean of the Grant Medical College for further studies in England.
The Dean obtained a grant from the Government of India so that Dr. De Souza could travel to England and train at the National Hospital for Nervous Diseases and the Institute of Neurology, Queen Square, London in 1947. Dr. De Souza recalled the influence that teachers such as Dr. F. M. R. Walsh, Dr. Purdon Martin, Dr. MacDonald Critchley and Dr. Russell Brain had on him.
On completion of his studies, Dr. De Souza returned to Mumbai and resumed his duties as Professor of Medicine. In mid-1948, the state government instituted a Department of Neurology under his charge and sanctioned twelve male and six female beds for the purpose.
In his response to a questionnaire, he stated that this Department of Neurology was 'the first of its kind in India.' He pointed out that the Department of Neurosurgery had been established at the Christian Medical College and Hospital, an year earlier.
Dr. E. P. Bharucha recalled that with the exception of Dr. Menino De Souza's department at JJ Hospital, there was no specialization in Neurology in Bombay. One of the early electroencephalographs in India was installed at the JJ Hospital at his instance. Insistence by the government that this unit be purchased from England resulted in his getting the Marconi unit instead of the Grass machine he had requested from U.S.A.
He was elected President of the Neurological Society of India in 1957. (His address to the Society, entitled The human mind was published the next year.) In it, he pointed out that the Neurological Society of India, 'barely eight years old, having started with a small membership of 5 and having now reached 35' was small when related to the vast population of our country.
Sponsored by the Government of India, he represented India at the foundation of the World Federation of Neurology in Brussels in 1957.
The Society then held its annual conference together with those of the Association of Physicians of India, the Cardiological Society of India, the Association of Pediatricians of India and the Indian Association of Chest Physicians. Dr. De Souza made a statement that has, unfortunately, lost significance in recent decades. 'Although our four associations have independent existence of their own, yet, they have long realized the value of meeting jointly together, at least once a year, on a common platform. After all, the human body is an integrated whole, and whatever affects one part is bound to have its repercussions on the rest of the body, and no method of treatment can claim to be really scientific, if it does not always keep in mind its possible effects on the system as a whole. Specialized treatment, although desirable, is not to be water-tight. Hence, the necessity of these joint conferences.' Alas! We are now so highly specialized that our neurologists separated out from the parent society and even neurosurgeons now have their own association, each group with its own separate annual conference.
In his address, he asked, 'What do we know about the fundamental factors that govern our memory, of the location of consciousness in the brain, of our spiritual mental processes or of the human soul which is regarded as a positive fact by so many authors? Is it merely a function of the brain, a sum total of mental processes, as maintained by most neurologists?' We continue to search for answers to questions he posed sixty years ago.
His comments on Neurosurgery in 1957 are of historical and even prophetic significance. 'The modern methods of investigation by electro-encephalography have opened a large field in the localization of growths in the brain. Such localization was once considered of little more than academic interest, but is now a matter of urgent practical importance upon whose correct solution the life of a patient depends. The surgical treatment of brain disorders until recently was a human torture; but today, the operative mortality has fallen so low compared to a decade ago, that in skilled hands, it is less than ten per cent. There was a time when a good number of such cases were diagnosed as mental disorders, and were confined for treatment in asylum, with no prospects of recovery. Tumours of the brain are among the nervous conditions that have a peculiarity to mimic totally dissimilar diseases. Thanks to electro-encephalography, most lesions of the brain are easily detected today, and thanks to neurosurgeons, the removal of the cause of the trouble enables a man to live, without a handicap, to a normal span of life… The day will surely come, with the growth of our resources, when we will be able to give the highest training in every branch of medical science in this country, and provide facilities which will bring every kind of treatment, no matter how difficult, within the realms of the humblest in our land.'
In his concluding remarks, he focused on the need to recognize the importance of yoga. He termed it 'neurological science in its highest form, enabling those gifted in it to have a control over their bodily functions and on the involuntary movements in their system.' This science needed to be explored by neurologists for its valuable contributions on the control of the autonomic nervous system. He ended his address thus, 'Let this wisdom be given to the West in exchange for the benefits the East has received in the various branches of Science, so that one day the whole of mankind may attain a high level of spiritual perfection and live peacefully as one great family.'
The full text of this Presidential address has been reprinted in Dr. K. Rajasekharan Nair's book (1998).
As greater number of patients with neurological ailments were coming under his care, Dr. De Souza pondered about devoting himself full time to Neurology. Surgeon General Bhandare counseled him against such a step. He asked him to continue as Professor of Medicine but permitted him to spend more and more time on developing Neurology.
Dr. De Souza prevailed upon the government to appoint an assistant neurologist. Dr. Noshir Wadia, Tutor in the London Hospital, was selected without being interviewed by the College Council. Dr. De Souza was a pillar of strength to him, diverting all his patients with neurological illnesses to Dr. Wadia and offering him beds in his own ward where Dr. Wadia could freely admit, study and treat patients. He continued to encourage and supported Dr. Wadia even after Dr. Wadia got his own wards and a separate department. Dr. Wadia later recalled: 'He was all kindness and encouragement, giving me unadulterated freedom to develop Neurology further from where he had initiated.'
Dr. De Souza retired as Professor of Medicine in 1959 and Professor of Neurology in 1962. He was appointed Emeritus Professor of Neurology – an honour later bestowed on Dr. Wadia as well. He was elected to the Senate of the University of Bombay in 1946 and was appointed as Dean of the Faculty of Medicine in 1951. He also served as a Municipal Corporator from 1952-1957.
Dr. De Souza was passionate about teaching and was soon a much-loved teacher. His book entitled How to examine a patient went into three editions and six reprints. In the preface to the first edition (1955), he wrote: 'The importance of methodical examination of a patient cannot be overestimated…' He expanded on this theme in the foreword to the second edition (1960): 'History taking is an art which must be acquired by experience. No detail is unimportant and the correct diagnosis often rests on a careful balancing of probabilities….a well-elaborated anamnesis practically establishes the diagnosis in several cases. The converse is also true – a history taken hurriedly and aimlessly without any data or properly obtained facts is not only valueless but often misleading…' In the preface to the third edition (1970) he foresaw our present sorry state: 'The zeal of a modern physician to indulge in the aid of electro-medical gadgets might discourage a young student from sacrificing sufficient time to elicit signs and symptoms under the mistaken impression that the ultimate diagnosis rests on mechanical gadgets. This pitfall must be avoided by one who wishes to be a successful clinician…'
He published papers on headache, sciatica, convulsions, cysticercosis and encephalitis.
His extra-curricular activities included the field of biomedical ethics. An auditorium has been named after him in the Biomedical Ethics Centre in Bombay. He also headed the Medical Welfare Trust, founded in 1970.
Twelve scholarships were established in his name. These were awarded to the best scholars in the medical sciences, one male and one female, in each of the three medical colleges in Bombay. He also served as Chairperson of the St. John's Medical College in Bangalore and helped collect funds for the construction of the College building.
His services to the Catholic community earned him the Papal Knighthood of St. Gregory the Great in 1971.,,
An anonymous reporter wrote of a meeting with the 90-year-old, Dr. De Souza: 'He has a needle-sharp mind that can discuss the latest drugs introduced for the treatment of the sick, explain the ups and downs of the share market and recount a racy anecdote.'
'Born without the tiniest piece of silver cutlery in his mouth on the 4th July 1904 in Aldona, Goa, he was reared by a young widowed mother. Intelligence and diligence pay rich dividends and that was true for the indefatigable Dr. Menino…'
'He had a dream – To help the less fortunate in every way I can, for as long as I can.'
'He practiced medicine up to the age of 87 years, making him the oldest practicing medical man in Bombay He then hung up his stethoscope but many a patient continued to call plaintively for him…'
'It has been a full and glorious life with Alice, his wife of 57 years, as his constant support. A man can count his laurels by his living legacy. Besides the innumerable doctors and neurologists who have been trained by him, he has inspired his own family to enter the medical fraternity. His second daughter, Stella Martins, is a psychiatrist. His only son, Mario de Souza has inherited his practice, and his grandson. Nikhil Cunha, is a radiologist. He has three grandsons – Ravi Cunha, Karl and Roy Martins. And his flair for writing has passed on to his daughter Anne, the writer and journalist.'
'Like a fire that has grown old in the earth, he has put forth branches that will endure.'
On a personal note, I must refer to his innate graciousness. In 1983, I requested him to respond to a questionnaire prepared to elicit biographical and other details for inclusion in an essay on him. This essay formed part of the series on Presidents of the Neurological Society of India published in the Continuing Medical Education books edited by Dr. S. Kalyanaraman. Here are some excerpts from his letters to me:
23 December 1983: 'I do not know what opinion you will have of me for not even acknowledging your letter dated 3.11.83 for so long. The fact is I was on a holiday… On the very day of my arrival in Bombay (20 November), I began to get such severe giddy spells that I could hardly move about… I'm much better now and the first thing I'm doing is to thank you for your kind letter… I shall be much obliged if you could give me some time… as I still feel a little giddy and cannot move about freely…'
On 29 March 1984, he wrote: 'Forgive me for not having sent my bio-data so far. The fact is my giddy spells lasted till the end of January 1984 and as I was preparing the paper, my son-in-law got a heart attack and expired on 26th Feb. I have now recovered from this unexpected shock and have already begun finalizing my paper…'
I am grateful to Mr. Ravi Cunha, Dr. De Souza's grandson, for his kind help, for providing the reprint of the anonymous essay in The Coastal Observer and the photograph reproduced above.