‘I would like to be born as a woman’

Prof K. Srinath Reddy is president,Public Health Foundation of India,and former head of department of cardiology at All India Institute of Medical Sciences.

What does spirituality mean to you?
I would say it is about three things: a set of values guiding a person’s life,not only in terms of individual conduct –which would be very limited- but also in relation to the wider society,to nature,to our planet. Then it is about the ability to introspect and see how best one’s conduct is consistent with those values. And finally,it is about reorienting one’s behavior whenever there seems to be some inconsistency between the two.

When and how did you define those values?
Values evolve. Some I imbibed from role models,some I developed over time with experience.

Several came from my father and some of his friends. He was a lawyer,for a part of his life also involved in politics. He was a member of the Rajya Saba for 18 years,and a member of Indira Gandhi’s cabinet for ten years from 1967 to 1977. During the 90’s he was Governor of West Bengal and Tripura. He was an intellectual in politics who saw himself as an enabler of social transformation. Honesty,compassion on a wide societal plane,hope to see an equitable society were his core values and principles. Along with them came tremendous simplicity.

Being an only child,books were actually also tremendously important companions and inspirations. One of my favorite books of all times is “To Kill a Mockingbird”. I read it as a child,and have read it many times over the years. I always keep a copy close to me and whenever I feel a bit low in spirits,I reach out to it. It has been like my spiritual anchor,seeing the integrity and self-effacing courage of Atticus Finch,the values of Scouts,the compassion of Boo Radley,understanding how good human beings can transcend the most distressing situations. Those are the kinds of values I would like my children and I to have. And I would want them to pervade society. When I see people tear themselves apart over caste,religion,or regional conflicts,it is obviously a far cry from it.

Actually,it often seems that people with the least values are those who succeed most in society,isn’t it?
Well,you have first and foremost to be comfortable with yourself. At the end of my life,I do not want to look back and regret all the compromises I would have made along the way. Of course I want to achieve as much as possible,contribute,and be recognized,respected for it,but not at the cost of my principles. If I can be comfortable with it at the end of my life,then I will be a happy person.

But so many people get bruised and blocked because they stand up to their beliefs?
I may have achieved greater success if I didn’t stick to some principles,if I had decided to market myself much more for instance. But I could not have respected myself. And I would not have kept the respect of my dear ones. In fact,my strongest critic is my wife. The moment I seem to slip a little,she is the first one to point it out. She doesn’t push me in the social whirlpool to go up the ladder. She is the one who constantly brings me back to my principles and values. As did my parents in childhood. And as do my children now.

Why did you choose medicine and health issues?
My father was a left of centre politician and I was quite influenced by Marxist ideas. I may not have had an urge to jump into politics but at least I wanted to be active in the public space. My father simply encouraged me to study a useful profession with that idea in mind. So I chose to become a doctor. As my career evolved,I began looking beyond individual clinical medicine,venturing into wider preventive cardiology and public health issues. As a result,I became even more aware of the social,political and economic determinants of health. Many of the health issues have social origins and social solutions. So even as a doctor you can engage in social and political science and my childhood’s yearning to engage in those domains has therefore not remained unfulfilled.

I see myself as a socially useful individual,as a doctor tending to patients and now trying to build a public health architecture. So yes,there was a political influence,but it found other pathways to manifest than conventional politics.

You head the Public Health Foundation of India,you are involved in a large variety of Indian and international organizations,as well as in research,teaching and advocacy activities – when and how do you have the time to introspect?
Flights and airport lounges are wonderful places to do that! When attending a conference,you are a lot with yourself and those are good times for introspection. Also,I like to walk,and I love to discover new places walking,which is a wonderful time to be with your thoughts. Otherwise,it’s mostly at the end of the day,when I am on my own. Besides,I continue to read a lot,and books stimulate you to think about life.

Looking at the way your life unfolded,do you see it as destined or preordained?
I grew up as a non-believer,this being my father’s influence mostly,whereas my mother is religious – but not ritualistic. My wife believes I am an agnostic and not an atheist and I won’t argue with her. But I don’t believe in destiny as something prewritten. I believe that when you have some objectives in life,you must prepare yourself for them,then face opportunities and obstacles as they come. Destiny for me is essentially dependent on your level of determination,and your courage to proceed with your objectives. We create barriers for ourselves also. But much of it comes as random events. It is not a fully written script.

Is there some kind of a force or divine energy beyond us?
When I look at nature,life,the universe,I cannot claim I comprehend all of it and how it functions. Evolution and science explain a lot and I do not need to invoke a Creator to understand it. But a solely Cartesian view of the world is obviously way too reductionist. You cannot take any element in isolation. The framework has to be holistic. It makes you humble and creative,because the truth has not been reached yet,and you need to find ways of achieving a more complete framework.

What about the influence of the mind on health?
Of course. We know now how parts of the brain affect immunity and so many other health issues,how emotions have profound influences on health,and so on. You can see how people’s willpower can help them defeat disease beyond anything medicine could ever forecast or comprehend.

What about things like prayer and meditation,do they influence health?
They can help. Let’s take stress for instance. It is a protective phenomenon devised in earlier times when fight or flight were the two possible reactions to a challenging situation. Today most of the time you can neither fight nor flee whenever there is a perceived threat. Let’s say your boss says something that angers you. You cannot scream at him or beat him up,nor can you escape. You internalize the stress which gets reflected in high blood pressure and all sorts of other things.

Then,if you put music on,read a book,meditate or pray,those are different pathways to insulate yourself against the triggers of stress,or downplay them so they don’t release a heightened stress response. So you can say that religious and spiritual practices like prayer and meditation are in a sense stress-protection mechanisms. If I say,I will not feel the stress because God protects me,I reduce the stress ! So whether there is an external protective agent or not,you are protecting yourself through a variety of mechanisms that reduce the harmful effects of stress.

But let me add this – I can give you examples of people believing in god men who survived the bleakest prognostics against any scientific logic – and crediting a spiritual belief for it; and I can also tell you stories of people who believed in the same god men and were defeated by illness nonetheless.

At moments of acute stress,do you ever call for such “outer protection”?
I do not reach crisis points very often. And mostly I am mentally prepared for them. But there are times when I wish some help would come from somewhere. For instance when trying to resuscitate a patient,especially a young one. But even if something does seem to come and help,I cannot say what it is.

Do you get emotionally attached to your patients?
Many in the medical profession preach detachment.

Yes,many say you have to steel yourself because otherwise you cannot treat efficiently other people. I do not agree with it. You need to be emotionally alive with your patients. You should not be so distraught that your confidence or commitment would be affected,but you have almost a duty to connect emotionally.

Don’t you get drained?
You get drained temporarily. But then your commitments,your way of life help you to carry on. You are not committed to that patient only. You are committed to society. Some you can reach and touch,others you can’t. But your life has a purpose,a meaning,a value. And you cannot reject that value merely because you lost that person. But as long as that person is alive,you must respect the person and try to make his or her life better,healthier,and dignified whether in health or death. And for that,you need to emotionally connect.

So going back to the larger meaning of your life is what recharges you and enables you to move on?
Absolutely. I do not know what will happen after my death. But I believe life has a purpose. And the purpose as a collective entity is to advance our life to a better stage. We are all connected and it is important to keep our planet alive and healthy. In that context,my life is a link part of a chain. Ultimately I may just be burnt embers. But regardless,it does not absolve me from my responsibilities to act as a valuable link in this chain of life on earth.

So the purpose of my life as I see it is to add value to this planet in general,and to the human family in particular. As a doctor,I can try and reduce some suffering,as a public health planner I can plan systems so people don’t fall ill,as a person interested in the social dimension I may articulate for certain social changes,I may try and pass on those values to others around me. So if I live my life according to those tenets,then I have served a useful purpose. And what happens after death doesn’t matter.

If there were such a thing as God,and you could ask one question,what would it be?
Given the diversity of life-forms on this planet and in the universe,why did You create such a huge diversity: was it an urge for experimentation or was it to facilitate progressive evolution so that someone in this entire creation would reach a state where he or she can replace You.

If there were such a thing as rebirth,what would you choose for the next round?
I would like to be born as a woman,in a society where women have a much greater say in the affairs of the world,and contribute to resetting some of the skewed coordinates that men have created.

What is your idea of happiness?
It comes from the smallest joys to satisfactions that stretch over years. It is about accomplishing the things I have wanted,the way I wanted,bringing greater value to my life and those of others around me without hurting or harming others.

But engaging in public health is a never ending task,how could you ever achieve your goals ?
You can’t reach them. But you know when you move towards them. I can derive happiness from every individual accomplishment.

Would you say you are content?
I think I am. I would like to do more. But I am reasonably content with what I have done and what I am doing. I have reason for satisfaction. I guess when I am much older and do not do most of what I am doing now,I will be content. Because at every stage of my life,I did what I believed in,even though many people around did not understand it: I was a practicing clinical cardiologist,and left to venture into preventive cardiology when almost nobody was touching that field; then as I was holding one of the most prestigious positions in the country (head of cardiology at AIIMS),I walked away to get involved in a public health career. And I like to write,so I may turn to it one day.

You have to keep looking for fresh opportunities,repositioning yourself so that you can create and do different things,all of them having values for yourself and hopefully for society in a larger way as well. Then you remain content and happy !