PADMABHUSHAN AWARDEE PROF. DR. R.D. LELE “Pursuit of Excellence” is the apt title of the autobiography of the much respected physician, Dr RD Lele (RDL), a legendary doyen of medicine and nuclear medicine. I have known RDL only from his “post-55 era” (Jaslok days), that is, his second or third innings of medical tenure. This fact, and not being a clinician myself, I am perhaps less qualified, than many others, to attempt this Book Review! At the same time, my admiration cum respectful impressions of RDL, as a “walking and talking encyclopedia of medicine,” and as a teacher par excellence, makes me no less equal than others, to pen down this book review!
One may often brand (erroneously though) autobiographies as historical anecdotes, and question, what is in it for publishing a book review in a journal, that too in a medical journal, like Indian Journal of Nuclear Medicine. But behold, here is a simple, powerful narration of a life story of a physician, that would be, and should be, a great stimulus for a large number of professionals, young and old both alike, be it in medicine or in nuclear medicine (NM). RDL will be 90 in January 2018, and his book is meant to mark his entry into his 90th year of life. One cannot but admire the passion, energy, zeal, lessons, and messages, and what not in the entire book of RDL's autobiography, a compilation facilitated by Dr. S. V. Kulkarni, and published by Granthali Publications.
RDL belongs to the preindependence era of India and has surely plenty to cover. Yet, he has not opted to convey all the nitty-gritty details (rightly so), or indulge in only personal self-glorification, but touched on numerous specific points and stages of his personal and professional life, which would be of good to high value to the readers. He has, expectedly so in an autobiography, described his family life, from early childhood to college days, married life (with touching warm references to his wife who passed away in 2003), professional advances and recognitions, awards and medals, orations, etc. He has also not shied away from citing pieces, which could have easily been skipped and yet not made a difference to the book. For example, how many will know that he was detained in custody as a 16-year lad for nearly 24 h in a police station as a suspected miscreant (only to be released the next day upon finding him to be innocent)! Coming back to medicine, RDL learned it all in Urdu and using English books though! Yes, his days in Osmania University had Urdu as the medium of instruction. He went on from there to serve in several places – did his rural stint with fervor and in full – including the UK. Having had medical education in Urdu has had little effect on RDL! He managed to do much during his stay in the UK during 1955–1957, and quite surprisingly so, considering the conservative style of “British” educational (and medical) system, a hallmark of their own. It is good for RDL and India that he could achieve this, because the benefits accrued later to Indian patients and medical institutions through the skills and nuances acquired by RDL – be it the way he got an entry, out of turn, into Hammersmith Hospital (HH) – by getting the first rank in his DTM and H examination – or becoming a honorary clinical assistant to a high-profile hepatologist lady doctor. Reference to his UK period will not be complete without citing the coincidence of HH, London, having the first dedicated (vintage) medical cyclotron of the 1950s! More of this will come later, along with NM part.
RDL's post-UK period of life helped enrich and enliven the medical services and medical administration in a number of Indian institutions and places – Aurangabad, Nagpur, and (the then) Bombay (Mumbai in subsequent times and currently). His encounters with political personalities, bureaucrats, and commoners exerted a strong influence and also conditioned him to do what a clinician should do, “solve the issues” – be it getting sustainable water supply for JJ Hospital, or getting a huge volume of hospital uniforms stitched in record time of 15 days. Among the medical colleges and hospital institutions in Bombay, an invariable class feeling existed (exists too now) – with KEM having always an edge of glory/fame. RDL has been proudly the “JJ man,” and it was hence no mean elation for him, when a KEM professor sought to send his postgraduate students to attend RDL's clinic sessions! All along, his main mantra in his professional life (both clinical and teaching), and for his students and interns, has remained, ‘let us not simply be “sponges” (absorbing only what is known), but also become “finders and creators” of knowledge and information’. The dictum, “an inquisitive mind is an essential requisite for a clinician to arrive at the right diagnosis and line of treatment,” has been amply made evident from the real-life anecdotes of RDL dotted along the book. Interesting cases of patients are cited in several circumstances, enriching the reading value and lessons to learn. Another important lesson from his life is the crucial ability to make use of the influential contacts (high-profile human resources), and that plenty of scope and need may always be there to avail of them. An example is the narration of how he got a timely powerful message conveyed to the powers that be, by a well-respected leader, to counter an investigational action underway due to personal allegation by an MLA, and how RDL could go ahead to avail of an awarded foreign fellowship to study NM in Canada. He has an impressive (enviable) list of contacts and admirers that includes special personalities, from political leaders, to artists and film personalities to sports persons. Many may know RDLs’ passion for cricket, while his stints and engagement, from school and college days, in stage, music, and cultural programs, may be news to some other readers.
It is not uncommon among high-class medical fraternity to have a compilation made of their career contributions, achievements, books, and publications. What makes RDL's case special is his making the best of virtually every single opportunity in his long medical career, be it in rural setting, in urban centers, for government colleges and hospitals, in private hospitals, for national nuclear regulatory body, and what not. His penchant for R and D including nonallopathic modalities and instrumentation that came his way in his long tenure is overwhelming and inspirational. All these led him to making significant contributions in terms of a teacher, researcher, orator, publisher, etc., Naturally, these topics find their mark in a number of places in his autobiography.
RDL has had a prolonged association with DAE and AERB, and in more than one way. This is best cited by the fact that the foreword for RDL's autobiography is written by none other than Dr. Anil Kakodkar (Director of BARC 1996–2000; Chairman of AEC 2000–2009).
Coming back to my nostalgic sojourn, let me ruminate! I met RDL for the first time in Jalsok while bringing him the tin-113-indium-113m generator, the then emerging short-lived radionuclide, from BARC, as directed by my boss, Dr. R. S. Mani, Head of the Radiopharmaceutical Programme at BARC. RDL has narrated several firsts of NM days in India, but had overlooked the indium-113m story and let me cite it here. His quick grasp of how the acidic indium-113m chloride eluate injection can directly lead to blood pool imaging in patients (formation in vivo of In-113m-transferrin complex) helped perform many nuclear cardiology procedures, though the low-energy collimators of the then gamma cameras did not support the wider use of 393 keV emitting indium-113m. The growth of NM across the globe, literally in leaps and bounds, propelled by the advances in radiopharmaceuticals and imaging instrumentation, has been phenomenal in the past four to five decades since 1970s. That is exactly the period of RDL's prominent presence in NM, starting from his Jaslok days, where he established several firsts of NM procedures and accomplishments in India, outlined in his volume. It is said that the specialty of NM is best utilized when you are an excellent physician first, and an NM expert next. RDL amply met this requirement and it helped him to articulate powerfully to every stakeholder in medicine, hospitals, medical colleges, Ministry of Health at State and Centre, R and D centers, DAE management, etc. RDL was willing to begin with whatever was available as product, technique, tool, rather than waiting for an ideal situation to emerge. Naturally, this helped him make an early entry, as well as an impact, facilitating further resources flow and further strengthening of infrastructure, facilities, etc., in every institution that he served. Take the case of RDLs’ nuclear stethoscope for cardiac patients in the early years, or the case of Tc-99m-glucoheptonate being shown as poor man's fluorodeoxyglucose for certain brain tumor imaging, in this context, and you can see the astute clinical mind of RDL. RDL had seen the very early work at HH, London, on cyclotron-produced radionuclides used in medical research, for example, oxygen-15 used in neurology for brain activation studies and realized the immense potential of positron-based tracers of biological elements. Though NM field had to wait for a pretty long time to utilize positron emission tomography (PET) in regular clinical medicine, RDL's appeals and articulations to DAE, while reviewing in 1998 the radioisotope program in its entirety, and to many other stakeholders, have significantly helped the first MC and PET established in Parel-Mumbai in 2002 and the subsequent growth of PET across India. An understandable anguish for RDL cited in the volume is the lack of timely progress of the DAE's 30 MeV medical cyclotron project in Kolkata (that has been very badly affected by the vicious cycle of multiple contractual issues, cost escalations, revised approvals, time overruns, etc.).
“Perform, and perform now,” seem to drive him always (even now); naturally, he showed no sympathy or softness for people, who like to wait for the best, or have other alibis to not performing. Naturally, there would be some among the medical and NM stakeholders, who may have seen only the rough and tough stand of (an impatient) RDL, going always with his sole intent “to progress and continue to progress” and seldom opt to wait.
The list of single-authored 12 books written by RDL, and covering a wide range of topics of medicine and NM and beyond, such as on Ayurveda, Homeopathy, Computers in medicine, medical profession and law, rural reconstruction, would be too difficult to be matched or emulated by anyone today. The inspirational message from that impressive list should itself suffice to motivate willing younger professionals to aim truly high in professional life.
The list of RDL's lectures/orations, and the 120 cities visited by him for delivering these talks, as well as the 52 foreign tours, etc., are there for those looking for finer details. For completion of his professional pursuits and philosophies, reference to coverage of allied topics such as his inspiration from Gandhiji, doctor–patient relationship, medicolegal aspects, Medical Council of India, religion-related issues, etc., can be cited. More importantly, reminiscences and comments of RDL's associates, students, and family members are also there in the compilation. They give a nice flavor of the degree and depth of influence that RDL exerted on many people in his long career and reiterate the inspiration to be derived by going through the volume. There is also a strong prodding from RDL in terms of citing all the “unfinished agenda” in his career (for his followers to pursue matters to a logical end), be it India-Islam topic at a social level, or Tc-99m-labeled aptamers for specific imaging of TB at technical level, or Mission Mumbai Health at an ambitious visionary level, as they are truly “an agenda for entire India” now in its pathway of progress and development agenda.
It is inescapable to mention some avoidable editorial errors and typos in the book. In a lighter vein, the term “housemanship” has got cited as “horsemanship” - alluding to perhaps the hard days of medical interns in the early years! It would be nice to have these typos and edits addressed and fixed as errata or similar means, to set the records right in the future prints of this fine volume.
I consider it my privilege to pen down the above book review for Dr. RDL, my mentor cum “remote teacher.” Dr. Lele rang me up some weeks ago mentioning about the release of his cherished autobiography. I could not resist seeking an autographed copy for my personal collection. He obliged me promptly and the volume will be adorning my new book shelf, now under fabrication for my home in Mysore. I agreed to write a Book Review for him, which sent me down on a long nostalgic journey down the memory lane, as our association is very long since 1973–1974 (his Jaslok days). I trust that the autobiography volume of Dr. RDL will be found a very useful reference material by many colleagues, medical students, and other stakeholders in the field of medical education and management. I wish Dr. RDL continued active life, fine health, and happiness in the years to come.
A Legendary Doyen of Medicine
The Teacher of Teachers
Prof. Dr. R. D. Lele 🙏🏼
CME INDIA Presentation by ⚜ Dr. M. Gowri Sankar, MD, Senior Assistant Professor, Dept. of General Medicine, Government Medical College and ESI Hospital, Coimbatore.
Today’s History Feature:
Dr. Ramachandra Dattatraya Lele 🇮🇳 The Pride of India 🇮🇳
(Born – January 16, 1928)
💠Father of Nuclear Medicine in India
🔹Lele was born on January 16, 1928 in a lower middle class family in Hyderabad. Lele and his 3 elder sisters and 1 elder brother were brought up by imbibing Gandhian principles by his parents.
🔹Since childhood, Lele was good in studies, music and sports – especially in cricket. After his schooling, he enrolled to study medicine in Osmania Medical College through Urdu medium and graduated in 1949.
🔹Then he involved himself in rural services for around 5 years and thereafter went for his higher studies to the United Kingdom.
🔹In the UK, initially he got trained at The London School of Hygiene and Tropical Medicine and did his post-graduation in Hammersmith Hospital, where he got trained under an astute clinician and hepatologist Dr. Sheila Sherlock. There, he continued his study about a new subject – hospital based cyclotron and radioactive isotopes.
🔹After his return from UK in 1957, Dr. Lele joined as a Reader at Nagpur Medical College and became a Professor of Medicine in 1963. There he created a clinical museum, diabetic clinic and handed many research projects on common medical conditions.
🔹Meanwhile, Dr. Lele had undergone a specialized training in Nuclear Medicine for one year in Canada. While he was Dean of Grant Medical College and J. J. Hospital, he was also attached as a Chief of Nuclear Medicine of Jaslok Hospital and Research Centre, Mumbai.
🔹During 1970’s, Prof. Lele established a first full-fledged Nuclear Medicine Department in Jaslok Hospital in collaboration with the Health Physics Division of the Bhabha Atomic Research Centre (BARC).
🔹He was the first in India to introduce:
🔅Intravenous use of Technetium-99.
🔅Nuclear Cardiology in 1978.
🔅Nuclear Stethoscope in 1982.
🔅Single Photon Emission Computed Tomography (SPECT) in 1988.
🔹Moreover, he was associated with Lilavathi Hospital, Mumbai for 16yrs (since 2002). There he introduced many innovations using radio-immunoassay. In collaboration with Dr. Shashank R. Joshi, an eminent Endocrinologist and Diabetologist, the duo did many research projects in the field of diabetology.
🔹Prof. Dr. Lele was also the early propagator of Donar Umbilical cord-Placenta Bank. He influenced both the state and central Government for public health which led to the introduction of Non- Communicable Disease Control Program.
🔹Furthermore, he has published more than 100 scientific papers and 11 books on topics such as clinical medicine, nuclear medicine, computer technology and medicine and Ayurvedha.
🔹Among his books, “Clinical Science and Clinical Research” (1993) and “Clinical Approach” (Oxford University Press, 1997) have been widely acclaimed as worthy companions for the practicing doctor.
🔹For his immense contributions, he has received galore of awards, some are:
🔅Gifted Teacher Award from API in 1991.
🔅Padma Bhushan Award from the President of India in 1992.
🔅Homi Bhabha Lifetime Achievement Award from the Indian Nuclear Society in 2008.
🔅Prof. M. Viswanathan National Award for Medical Teaching and Medical Care in 2011.
🔹The publication of his autobiography “Pursuit of Excellence” is a powerful narration of the life story of a true son of mother India. It’s a must read inspiring book and teaches the way he approached medicine as well as his life. It was published in 2017, on the eve of celebrating his entry into the 90th year of life.
🔹Throughout his career, Prof. Dr. Lele has suggested the importance of learning bedside manoeuvres, skills and researches. He is undoubtedly a walking encyclopedia of medicine who lives with the principle of “Think as if you are going to live forever, act as if you are going to die tommorow.”
A Legendary Doyen of Medicine
The Teacher of Teachers
Prof. Dr. R. D. Lele 🙏🏼
Block your Date & Time : Date - Sunday, 22nd January, 2023 Time - 10:00AM - 12:30PM
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