The amazing advances in surgery over the last century are interwoven into this engrossing autobiography of one of the country’s most eminent surgeons, Tehemton Udwadia, father of laparoscopy in India. The charm of the book lies in the surgeon’s easy writing style, candour and complete lack of ego. He admits that some of his big breaks were as much luck as planned. There is a hint of sibling rivalry with his equally celebrated brother, physician Farokh Udwadia, who achieved success earlier in life. Tehemton’s warmth and humaneness was something he picked up from his father Erach, a kindly GP whose patients were mill hands. Erach taught him the valuable lesson that a patient is not an anonymous case, but a human being. Udwadia was not a star student but a middle-ranker who came up after some early struggles. What set him apart was his inquiring mind. He was ever ready to question what was taught to him. His mentors were great surgeons like Dr Baliga and Dr Prafulla Kumar Sen who, like him, sought to push boundaries. With Sen as his doctoral adviser, Udwadia researched myocardial revascularisation through the study of the reptilian heart to find out if it could be replicated in humans. His thesis was rejected and debunked by his examiners as absurd. But international scientific papers were later to acknowledge the pioneering role of Sen and Udwadia in formulating a similar procedure now in common use. In February 1968, professor Sen, with Udwadia on his team, performed the world’s sixth heart transplant and once again was pilloried by peers. Udwadia’s greatest achievement was popularising laparoscopy in India. He performed the first removal of the gallbladder through laparoscopy in the developing world. His introduction to laparoscopy was entirely accidental. In 1971, his anaesthetist was late for an operation so he peeped into the adjacent theatre where he saw a gynecologist conducting a procedure with one eye to a telescope. In a flash, Udwadia realised that the machine could be the perfect tool to diagnose patients with abdominal symptoms by reversing the table tilt. Without any institutional support, Udwadia, along with his wife Khorshed, travelled to Germany to meet the manufacturer of the technology which was still in its infancy. Since import duty for medical equipment was prohibitive in those days, Udwadia personally purchased the equipment and smuggled it back to India under his wife’s saris. From 1972 to 1990, Udwadia used laparoscopy only for diagnosis. He also travelled extensively throughout the country to explain the importance of his equipment to surgeons in the hinterland. In small towns and the countryside, where there was a lack of facilities, it offered a cost-effective diagnosis and was welcomed, unlike in the big cities where it was not well received at first. On May 21, 1990, Udwadia performed a laparoscopic appendectomy on a human. His orthodox colleagues remained sceptical and Udwadia had to transport his personal equipment from hospital to hospital. It was only in 1992 that mainstream hospitals finally acknowledged the worth of his bold initiative and, soon, laparoscopic procedure became routine. Coomi Kapoor is contributing editor, The Indian Express
