Inheriting surgeonhood and its challenges

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I wanted to become a neurosurgeon before I knew how to spell the word. My father, Dr Keki E Turel, who has been a practising neurosurgeon for over 40 years, was already a distinguished name in the field when I was in primary school. In the 1980s, he pioneered microneurosurgery in the country at a time when the brain was being operated on with magnifying loupes. He was also credited with extracting the largest brain tumour in the world at the time, using training techniques acquired in Germany. Given his schedule, we, the family, hardly saw him. My brother Burgese and I would be in bed by the time he got home, but my mother ensured that she revived us as soon as she heard the sound of his 240D Mercedes Benz in the garage three floors below. I remember rubbing my eyes into the bones of my face, wishing him good morning or good night, depending on which side of 12 he arrived.

"What did you operate on today?" I recall asking him routinely. His face would light up as he plugged in the VCR tape of the day's surgeries. On most occasions, he'd have a single malt in his hand, and it was hard to tell which of the two brought him more joy. We spent several nights each week watching videos of brain and spine surgeries, red blood cells whirling around his instruments. He'd enthusiastically explain the details of the wondrous anatomy palpable under the magic lens of the microscope, and I'd nod as if I, at 13, had an understanding of what was going on.

"What are you doing today? Come with us?" I graduated to asking him on the weekends as I grew older, hoping he would take us out. "Why don't you come with me instead?" he'd say. I relented and thus began my frequent visits to the operating room. I watched him operate laboriously for hours with very little movement visible on the screen that was relaying the operation. That's the difference between general surgery and neurosurgery: the former is fun to watch, the latter is fun to do.

"Are you sure you want to do neurosurgery?" he had asked me cautiously after I waltzed through medical school at Grant Medical College in Mumbai, also his alma mater. I nodded as if it were a given. "It involves tremendous hard work, discipline, and sacrifice. I urge you to think hard before you devote your life to it," he suggested. It was like walking a horse through the desert, and, on finally reaching a wild pond, putting in a word of caution about consuming only safe drinking water.

He was mindful of ensuring that I carried out my neurosurgical training away from him. I got into Christian Medical College, Vellore, where a visionary called Professor Jacob Chandy had established the first department of neurosurgery in the country way back in 1949. I graduated five years later with a gold medal that had Prof. Chandy's name embossed on it. It made my father proud.

After I have established myself as an independent surgeon, people still speculate on why father and son don't work together. Maybe, this was my father's way of helping me become a credible, honest surgeon without his persona eclipsing me. He wants me to blossom in his sunshine and not his shadow.

Mumbai is filled with doctor families. In some, the medical profession runs down 200 years. Just like disease can be transmitted genetically, there has to be a 'profession' gene that, when 'turned on', evokes the desire in children to follow their parents' vocation. There's an inheritance of advantage but also a disadvantage when you talk about dynastic fields. What if you are unable to live up to the legacy? Are the comparisons even fair? What was considered state-of-the-art surgery 50 years ago is barbaric today, and what's cutting-edge now will be obsolete by the next decade.

Medicine is at a challenging juncture in our country. Its nobility is being corporatised, politicised, even jeopardised. Patients are paying for a service and they demand a certain kind of hospitality, which, when it falls short, makes them quickly hostile. It is probably because of this as well as the difficulties in securing admission into medical colleges, the insane cost of capitation seats, and the long and arduous years of training with no surety of a successful practise that many doctors today prefer that their children take up alternate careers.

I love what I do - every single day. But would I want my daughters, now three and five, to become doctors? I, too, would probably think twice. I'd want for them to chart their own path. My wife, however, feels they'll end up being the first sister neurosurgeons in the world.

The writer is a practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals

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