Dr. APJ Abdul Kalam, Former President of India recently delivered this speech in which he talks about his greatest achievement in life. He also talks about his experiences in various walks of life. We are reproducing this speech, which was delivered at the inauguration of OSMECON 2013 of Osmania Medical College Hyderabad on August 27, 2013.
I am very happy to participate in OSMECON 2013 a National Undergraduate Medical Conference held at the Osmania Medical College, Hyderabad. My greetings to the Principal, Faculty and students of Osmania Medical College. It has an important aim for promoting medical research among undergraduate medical students. I understand Osmania medical college is the only medical college in India where each medical specialty has a separate training hospital. I am very happy to see large number of undergraduate medicos including delegates and Faculty. I was thinking what thoughts I can share with such a youth. The topic I have selected the topic What I will be remembered for?
Task that leads to bliss
Friends, I would like to share with you, one experience which I had in year 2010. I was taking a class of 72 students both graduate and post graduate at the Gatton College of Business and Economics, Lexington, USA. We used to have 30 minutes earmarked for discussions on every class.
One day, a course participant Stephanie asked me an out of box question. She asked, “Dr Kalam, yesterday night I was reading one of your books. Kalam, you have done many tasks? Tell us what one task that gave you the bliss? How to answer? It is important for me to answer. Let me share with all of you. When we launched first indigenous satellite launch vehicle SLV-3 in 1980, it gave me lot of happiness! When AGNI reached the target at 2000 kms in 1989, it gave me different kind of happiness! When our team had successfully tested the nuclear weapon at the 52 degree centigrade in Pokhran desert in Western India during 1998, it gave me great joy! When our team prepared the Vision 2020 document for transforming the nation into an economically developed nation, it gave me a good sense of happiness. Here again, Stephnie reminded me, what gave you bliss in life!? I told her, that I am going to the real answer.
During my visit to one of the hospitals in Hyderabad, I found many children were struggling to walk with FRO (caliper) weighing over 4 kgs. At the request of Prof. BN Prasad of NIMS, Head of orthopedic department at that time, I asked my AGNI missile friends why can?t we use the composite material used for AGNI heat shield for fabricating FROs for polio affected patients. They immediately said it was possible. We worked on this project for some time and came up with a FRO for the child weighing around 400 gms in place of 4 kg, exactly 1/10th of the weight which the children were carrying. The doctors helped us to fit the new light weight FRO on the children and the children started walking and running around. Their parents were also present. Tears rolled down on all of their faces through the joy of seeing their children running with the light calipers. With the light weight device provided by the hospital they could run, ride a bicycle and do all sorts of things which they had been denied for a long time. The removal of the pain and the freedom attained by the children gave me a state of bliss which I never experienced during any other achievement in my life. This is a long answer to my student Stephanie?s question. All of you are fortunate to be in a noble profession to remove pain with compassion and experience bliss for the patients, family and you.
Friends, one and a half decades back, I was traveling in a non-stop train from Delhi to Dehradun. I was absorbed in a book “Man, the Unknown” written by Dr. Alexis Carell. There was a vacant seat next to me. Suddenly one passenger greeted me and he wanted to convey certain aspects. I asked him to sit by my side. He introduced himself and said he was working in a government office. His name is Mr. Jitesh. Jitesh said, “Mr. Kalam I want to thank you for giving to people like me Raju-Kalam stent which is fitted in two of my arteries. I was fitted with these stents in Hyderabad Hospital almost at no cost, since at that time, I could not afford a high cost imported stent. Thank you Sir. My family also would like to greet you.” His lovely family with the kids were all in smiles. The stent emanated through the working of missile lab and medical institution on a mission mode. It was a successful mission of medical and engineering teams. I thought of sharing this incident with you to stress the importance of medical and engineering teams to work together for developing medical systems, devices and equipments at an affordable cost as a societal mission. Medical costs are of concern both in developing and developed countries. I visualize Osmania Medical College collaborates with one of the Engineering Colleges and a research lab to develop innovative devices and system by harnessing both medical and engineering communities of the country. You should think big and you can achieve it.
Culture of Excellence
Let me now share a few words on the culture of excellence.
Excellence in thinking and action is the foundation for any mission. What is excellence? Friends, you all belong to a youth community, which should stand for a culture of excellence. Moreover, excellence is not by accident. It is a process, where an individual, (or organization or nation,) continuously strives to better oneself. The performance standards are set by themselves, they work on their dreams with focus and are prepared to take calculated risks and do not be deterred by failures as they move towards their dreams. Then they step up their dreams, as they tend to reach the original targets. They strive to work to their potential, in the process, they increase their performance thereby multiplying further their potential, and this is an unending life cycle phenomenon. They are not in competition with anyone else, but themselves. That is the culture of excellence. I am sure; each one of you will aspire to become unique with culture of excellence.
My visualization of great Healthcare centers
Now, let me visualize how a dynamic healthcare centre or a hospital should be.
Dear friends, I visualize a great healthcare center with the following characteristics:
1. Patient is the most important person in the hospital. When the patient enters, the hospital presents an angelic look and all the team members of the hospital always wear smiles. The patient feels that “I am going to get cured”.
2. The hospital consumes less electricity and less water by adopting green building for all modernization tasks. The choice of the power source is solar and wind.
3. The hospital premises are totally noise free.
4. All the test reports and treatment schedule get attached to the data base of the patient through Electronic Medical Record without the need of the patient or the relatives to search for the reports. The data-base is updated and authenticated every hour.
5. Maintains the database of all the cases treated by the hospital in the past which are easily retrievable.
6. Patient is not subjected to diagnostic pain.
7. The surroundings of the hospital are green with full of trees with seasonal flowers and the pleasant wall paintings.
8. Further expansion of the hospital is in vertical mode leading to fast movement of the patient and doctors for medical treatment.
9. There is no case of hospital induced infection to the patients due to bio-contamination.
10. The patients feel that this is the best place to get treated.
11. The hospital is fully IT enabled leading to virtual connectivity of the patient to the doctor, nurse and the chief of the hospital 24×7. Hospital is also networked with other hospitals nationally and internationally for seeking expert medical advice on unique cases.
12. The daily medical conference, attended by the Chief of the hospital, doctors, nurses, paramedics, and relatives of patients of unique cases, reviews problems of the patient and find integrated solutions.
Primary Health Centers
All the Primary Health Centers in the country have to be reformed and operational with the leadership of able Doctors. Since PHCs are mostly in rural areas, it is essential the young medical doctors, like you, should serve at least one or two years in rural areas. Friends, I would like to share with you the experience of two doctors who excelled in their profession and contributed in a big way to the society.
Lead Kindly Light
I have known Late Dr. G. Venkatasamy for over three decades. He is known for his silent contribution and bringing light to thousands of people. All his life, he has worked for total elimination of avoidable blindness. He has brought with the Aravind Eye Hospital, the best of technology and management. He has established a network of Aravind Hospitals and also the mobile clinics. He has created many leaders in the field, who are spread in various parts of the world. Whichever eye hospital I visited in India, I met a number of people, who had been trained by Dr. Venkatasamy?s institutions. It was amazing to see how even in his eighties he was radiating enthusiasm and perseverance for realizing his vision.
Dr.Venkatswamy championed the community ophthalmology service in Tamilnadu and surrounding region. This was at a time when there was tremendous amount of cataract back-log, and there were not enough specialists. Using a systematic approach to mass screening and surgery he infused both science and discipline in mass surgical eye camp. The mass movement for treatment of cataract shifted from improvised operating rooms to hospital operating room facilities. Aravind has successfully integrated their core competence of community ophthalmology with modern medical treatment and research.
Dr Venkataswamy implemented his principle that the Aravind hospital must provide services to reach rich and poor alike, yet the eye care facility must be financially self-supporting. The entire Aravind Eye care system is conducting on an average 800 eye surgeries per day and annually treat over 2.5 million patients. They are providing for every 30 paid patients, free treatment for 70 patients who cannot afford. This principle is achieved through high quality, large volume care and a well-organized system.
The world has recognized Aravind’s contribution. Recently I was happy to see many researchers from different parts of the world as partners while inaugurating Venkataswamy Research Centre at Madurai. The life of Dr. Venkataswamy gives the message to all of us and particularly the aspiring medical graduates, how commitment to a vision can make missions happen.
Reaching the Unreached
Friends, in the present circumstances and environment in our country, it was inspiring to see, how a doctor has put all his dreams in mainstreaming the tribal citizens of Karnataka for the last 25 years through Vivekananda Girijana Kalyan Kendra (VGKK), at BR Hills. When I visited BR Hills in 1998 and subsequently in 2006, I could see substantial developments in that area. I could see a “New Tribal Hospital”, Roads and education environment and above all the earning capacity of the tribal citizens have been increased with the technology resource centre as a base. Dr. H. Sudarshan, is the inspiring architect of this societal transformation. The mission which he has started has spread to many parts of the country including the Andaman and Nicobar Islands and Arunachal Pradesh. Dr. Sudarshan and his team have been selecting difficult regions and making a difference to the people of that region by their own way of life which was started in a small hut. The nation needs thousands of Dr. Sudarshans for providing healthcare to our rural citizens. I am sure some of many doctors may emulate Dr. Sudarshan in this noble mission.
Biology of Beliefs
Now friends, I was asking myself, is there any inputs and research which is coming from both, physio-psycho and brain researches, because of the advent of neuro-sciences coupled with quantum theory. I have studied recently a book “The Secret Path” by Paul Brunton. According to the author now the conscience is explained scientifically for the reason that the thinking process and biological processes converge through quantum mechanics. He says that Physics and Biology are interlinked and that “At atomic level matter doesn?t even exist, it only has a tendency to exist”.
Now recently, a friend of mine who is a scientist sent me a book ?Biology of Beliefs? by Dr. Bruce Lipton. The author is one of the greatest scientists in the bio-science and after 20 years of research he attributes the origin of human diseases and their cure have a basis on our intrinsic thinking and the relationship with our bio cells. The book talks about a new approach which highlights the importance of placebo effect and how it is actually a powerful belief effect. The author says “Doctors should not regard the power of belief as something inferior to the power of chemicals and scalpel. They should let go of the belief that the body and its parts are essentially stupid” .
Brainstorming in John Hopkins Hospital
Friends, Institute of Health in US in a survey found that 95,000 deaths occur per year in the United States due to medical errors. Though this information can be debated, this information was found to be very disturbing. It was recognized that there is a need for change in approach in medicare to improve the safety and quality of care to patients. In this connection, it was felt that it is important to train the doctors, nurses, paramedics, technicians and everyone connected with medicare. Modern hospital is a very complex organization and there are challenges ahead to improve the safety of the patients. Quality medicare is possible only when people work together as a team. Recently, a seminar was conducted in John Hopkins where there was a brainstorming session between the doctors, medicare personnel, patients and the relatives of the patients which brought out all these factors very clearly.
I will be very happy if our super specialty hospitals conduct such type of review periodically in the combined meeting of doctors, nurses and paramedical staff. I am telling this to the medical community, because this type of integrated conference has been conducted after the occurrence of tragic incident in John Hopkins Hospitals. A child?s life was lost because of judgment in their diagnosis. The mother of the child briefed the whole incident to the combined gathering of the hospital team. It was a moving experience of the mother. There is a CD, which my friend has sent to me from the John Hopkins Hospitals. I would like to share with you, particularly while attending the cardiac patients in pre operative, operative, post operative and recovery period, large number of sophisticated instruments and monitoring systems are used. In this scenario, experience of treatment and the problems have to be shared together on fixed days of the week and the results documented. It will become a teaching wealth for cardiac care specialists.
Six virtues a care giver must possess
Friends, in conclusion, I would like to share my experience with Choakyi Nyima Rinpoche, the Chief Monk in Kathmandu and a medical researcher. After nearly a kilometer of walk, I reached the white Kumbha where the chief Monk and his disciples were waiting to receive me. After reception the Chief Monk said, let us go to our study room and I followed him. He climbed the first floor, the second floor, the third floor, the four floor and the fifth floor, just like a young boy. Probably the life style has a positive impact on the mind and body. All along I was following and following. When I reached his chamber, I saw a laboratory and a spiritual environment over-looking the Himalayas. What surprised me was, his research students come from different parts of the world. Particularly he introduced me to his co-author David R Shlim, MD who is working on a research area, Medicine and Compassion. The Chief Monk Choakyi Nyima Rinpoche and myself exchanged few books. The Monk has written with Dr. David R. Shlim a book titled “Medicine and Compassion”. I liked this book and read it during my journey from Kathmandu to Delhi. This book gives six important virtues which a medical practitioner has to possess towards their patients.
First virtue is generosity; the second virtue is pure ethics; third is tolerance, fourth is perseverance, fifth is cultivating pure concentration and the sixth virtue is to be intelligent. These virtues will empower the care givers with a humane heart. I am sure, the medical community assembled here, practice all these six virtues as a habit while dealing with the needy patients. This itself is a great example of synergy between mind ? body and medicine.
Since I am in the midst of young future professionals, I would like to put-forth a thought: What would you like to be remembered for? You have to evolve yourself and shape your life. You should write it on a page. That page may be a very important page in the book of human history. And you will be remembered for creating that one page in the history of the nation ? whether that page is the page of evolution of a new technological systems, the page of innovation in a way of working, or the page of creating action oriented missions for the people or the page of triumphing over diseases which have afflicted humanity for ages, or the page of contributing towards inclusive growth of the nation in a time bound manner.
My best wishes to all the members of Osmania Medical College success in the mission of providing quality and cost effective healthcare.
May God bless you.
Dr. APJ Abdulkalam
NOTE: This speech was delivered by Dr. Kalam on August 27 and was first published here.