From triple helix - Easter 2008 - Indian summer [p21]
We met by chance in 2002 and agreed an evening of opera together. Afterwards we talked about the Christian Medical College in Vellore, south India and Andrew, an old school friend and fellow surgeon who helps with postgraduate UK training for CMC surgeons, promised to put me on the programme.
Thus in January 2003 I had my tourist, seven day overview of CMC. What an amazing place! The vibrant but small medical school has only 60 students in each year, 30 women and 30 men. Forty eight are sponsored from Christian churches within India and a few neighbouring countries (Nepal, Sri Lanka, Malaysia, Bangladesh among others) and 12 places are filled from the highest ranking school leavers in India.
The hospital was founded 107 years ago and has 2,100 beds. The pathology amongst the 1,500 new outpatients seen each day is mind boggling. No 'worried well' here! Of the surgical patients, 65% travel over 1,000 miles for treatment, and in some disciplines research and specialisation are well advanced. There is a college of nursing, a rehabilitation unit, and essential support services. The funding mechanism is complex and has to make a profit for CMC to survive. Outside aid is only used for new developments and to provide free medical care for the poor.
Chapel Compline services are sensitively led by students, and the hospital worship with midweek ward prayer and Bible study meetings gives CMC an inescapable spirit of Christian love and service. Uniquely, over 80% of graduates stay in India and 55% practise in rural communities.
On my last day I was asked to consider running the Department of Surgery for five years: 'We can sort out the visa situation'! Their second line of approach was to ask me to run colorectal surgery since they were committed to forming six sub-specialties.
My wife Margaret had travelled with me and we were able dispassionately to discuss retirement opportunities in India. I was approaching 60 and we had both bought 'added years'. I was being encouraged to retire – too outspoken about NHS reforms, increasing bureaucracy, lack of patient care and staff support, and university disinterest in undergraduate education and mentoring.
I decided I could make no decisions without a longer visit to see what life was really like when not a 'visitor'. I thus saved up as much holiday and sabbatical as possible and returned for nine weeks the following January. During the intervening year, when beset by frustrations in an NHS and university which seemed to have lost the plot, I found hugely positive the prospect of doing something different overseas on a specialist colorectal unit, struggling to establish itself but with enormous research and training opportunities.
This Gideon's fleece period had moments of enormous fulfilment: helping with a difficult pouch operation, planning potential research projects, climbing some local mountains, praying with Christian friends, and introducing to students the concept of a 'risk benefit' analysis for patients a long way from home and with limited financial resources. On the other hand, there were moments of great loneliness; I missed my wife, our rapidly growing grandchildren and our springer spaniel.
I had a new edition of a surgical textbook to produce, which would have been well nigh impossible at home. I also identified some viable research projects and filled hours writing protocols and ethics committee submissions. Weekends needed some planning; for clinicians at CMC they did not usually begin until 4 pm on Saturday. From then until 6 am Monday there seemed a long siesta punctuated only by three or more worship opportunities for the very committed Christians! I hired a bicycle, unearthed a walking group, discovered the magic of the Indian train as the best way to explore distant locations, and found a driver as definitely the best option for local excursions.
Even after nine weeks on the treadmill CMC remained for me an amazing place. The glove seemed to fit perfectly. My 'call' was clearly meant, but when should I start and how long would it last?
I returned home and in March 2004 handed in my notice since future four to six week visits three times a year were not possible while employed. In August 2004 I stopped fighting the NHS and university and over time was able to forgive. CMC has been a real healing experience.
Visitors are confined to a six month tourist visa and returning home periodically not only provides time for family but helps networking. I need to stay on the GMC Register and continue in private practice whilst at home. I keep up to date by speaking or presenting research at postgraduate meetings. My 2006 appraisal was with Benji, the head of the colorectal unit at CMC! I supervise research, have written a student text book with an ex-student, and co-ordinate student elective projects. To pay air fares I act as an expert witness.
I have been visiting CMC regularly now for five years and get withdrawal symptoms if I stay away too long! CMC is probably the best thing I have ever done; it has certainly changed my life and provided real fulfilment in early retirement.