Book Review: A Urologist’s Journey. The inspiring story of a doctor and a pioneer

A Urologist’s Journey. The inspiring story of a doctor and a pioneer. Sharad D. Bapat. Dimple Publication, Mumbai, 2023. 400, 210 pp. ISBN 978-93-92419-68-3.

The quotations from Sushruta (page 5) and Sir Robert Hutchinson (page 7) provide us with an inkling of the philosophy of the author and the principles that guided his practice.

From the notes provided by Dr Bapat and Dr Chaudhary, we learn that he had decided to write this autobiography after passing the age of 89 years and recovering from a major hepatic operation. Urologists in particular and all physicians will remain in his debt for this effort––difficult at any age––he has made to place before us his life and work. Indian medicine is sadly in need of similar accounts by those who have made major contributions to our science and who provide us inspiration through their concern and care of patients—especially those of small means.

Dr Bapat was born in Satara on 25 October 1932.

His father, with a postgraduate degree in mathematics, worked for the Western India Life Insurance company and was subject to transfers on work from time to time. Thus, young Sharad was a rolling stone who studied in Lahore, Poona (now Pune), Satara, Bombay (now Mumbai) and Ahmedabad. Dr Bapat remembered the Frontier Mail journey from Bombay to Lahore in April 1944 as this was the longest distance he had ever travelled on a single train. Lahore then had a majority population of Hindus (over 51%). The anecdote of the train journey from Rawalpindi to Peshawar is also of interest.

With his aptitude for languages, he was soon fluent in several tongues and in later life this was a boon for his patients who came from different parts of our country. The family was fortunate in that the senior Bapat insisted that his children (five sons and two daughters) study English, Sanskrit, Marathi and mathematics. Both of Dr Bapat’s sisters obtained their PhD degrees.

Dr Bapat’s mother developed tuberculosis whilst he was a child. Good nutritious food and a dry climate were the only available measures of treatment. She was kept in Sholapur till she recovered. Dr Bapat’s observations as a child––especially those when an important person visited the village and was bathed in curds (page 23) and his mother’s cure for Dr Bapat’s inordinate fondness for sweets (page 25) remain of interest. We learn that watching a Tarzan film in the local movie theatre cost one anna (1/16th of a rupee).

When studying in Ahmedabad, Dr Bapat learnt that all colleges in that city were affiliated to Bombay University and all examinations were conducted by it. Stuck in his memory is the book he enjoyed whilst there––The dumb wife of Cheapside by Ashley Dukes.

At Dr Sharad’s request, Dr Madhav Chaudhary of Akola has written the foreword to the present volume and in it he provides several glimpses into their 73-year-long friendship. It started when Dr Bapat entered Seth Gordhandas Sunderdas Medical College as a student in 1950. Dr Chaudhary was his senior by three years. Dr Chaudhary sums up Dr Bapat’s life and work in 4 pages.

Dr Sharad Bapat had stood first in the entire ‘B’ group appearing for the intermediate science examination, winning the Gibbs Prize in physics. He had a noteworthy undergraduate career in medicine, standing first in the 1st and final MBBS examinations and topping the list in surgery.

Dr Bapat recalled Drs Koppikar and Kurulkar in Anatomy and Dr P.D. Anjaria in Physiology. I was sorry to learn that Dr Bapat almost chose neurosurgery as his chosen specialty but, as events turned out, what was the loss to neurosurgery was the gain to urology. He describes the Silver Jubilee Function of his institutions in 1950 (pages 51–52). His experiences with tonsillitis and headaches from his wisdom tooth can be found on page 52. Towards the end of the book is a section on the Golden Jubilee get together (pages 190–191).

I was especially sorry to learn of his experiences with Dr N.D. Patel (pages 54–55). This facet of Dr Patel’s personality has not been commented on by others thus far. It was only after he came under Dr Baliga’s tutelage that Dr Bapat recovered from the trauma. (Details on Dr Baliga are found on pages 55–57, 61–63, 66.) His comments on ‘two young surgeons, Dr P.K. Sen and Dr Vasant Sheth’ on page 58 make for interesting reading. The description, on the same page, of Dr N.S. Vahia mimicking a patient is hilarious.

During the third year in medical college, his cousin introduced him to Vimal Gokhale, a student in the same batch. She later qualified as an obstetrician and gynaecologist and to Dr Bapat’s immense joy, consented to become Mrs Bapat in December 1956. She was an accomplished singer and both their daughters and grand-daughters have inherited her talent.

Dr Bapat considered Dr A.V. Baliga his ideal and mentor and imbibed the qualities of a sympathetic approach to patients, patience, systematic clinical examination and passion for teaching from him.

After graduation he worked in the departments of surgery and orthopaedics at King Edward VII Memorial Hospital (Drs R.J. Katrak and A.K. Talwalkar) and in the Sewri T.B. Hospital (Drs Kersi Dastur and Nemish Shah). He describes some of his innovations whilst at Sewri on page 65. The bed-shaking test is described on page 102. The following page carries the description of how an all-knowing X-ray technician almost prompted a misleading diagnosis.

His friendship with and admiration for Dr B.S. Gharpure, anaesthetist, started whilst he was a registrar to Dr Baliga (and on his retirement, to Dr C.S. Worah). These were to last throughout the rest of their lives. Whilst most anaesthetists were quick to declare a patient in King Edward VII Memorial Hospital unfit for anaesthesia, for Dr Gharpure the only unfit patient was the dead patient.

His inclination to study urology was furthered by his teacher, Dr Dara Karanjawala who helped him travel to Britain and recommended Dr Bapat to Dr Alec Badenoch. As it happened, in 1963, Dr Badenoch operated upon Prime Minister Harold Macmillan for an enlarged prostate causing acute urinary obstruction at the King Edward VII’s Hospital in Marylebone, London!

Dr Bapat reached London on S.S. Strathmore––a P&O liner. His experiences in Britain and Europe are described on pages 71–97.

On his return from Britain, Dr Bapat joined the Lokmanya Tilak Municipal General Hospital and its attached hospital as an Honorary Surgeon. Severe disillusionment set in when general practitioners contacted by him made it obvious that referral of patients would only occur when he paid them commissions for doing so. This was anathema to him. Over time, sincere attention to the illnesses of poor patients, teaching, innovating, introducing newer developments such as endoscopy and the results of his operations turned the tide. His system of maintaining records on each patient was soon copied by others.

From 1964 he started operating at a few nursing homes before he set up his own Endoskopik Klinik & Hospital in the building named Ameya owned by him. The German name was used as all his endoscopes were from Karl Storz in Tuttlingen. In 1997, his daughter Dr Anita, trained in endoscopy at the Urology Department, University of Leeds joined the Klinik. She started urodynamic studies there. His other daughter, Dr Gauri trained in sonography at the radiology department of K.E.M. hospital where she obtained her post-graduate diploma in radiology. She regularly does sonography of patients at the Endoskopik Klinik.

As time passed by and work at the Klinik burgeoned Dr Mrs. Bapat stopped her work and became his fulltime partner in urology there. Dr Gharpure continued as his anaesthetist.

At the invitation of Dr Vasant Randive, he joined the yet-tobe-opened Sushrusha Hospital as a consultant urologist and served it for many years.

To round off his career, he accepted the invitation to serve as a consultant and advisor to the Muljibhai Patel Urological Hospital in Nadiad. Starting as a humble venture, this is now one of the leading urological institutes in the country. Dr Bapat served it for 22 years as surgeon and Director of Postgraduate Teaching. (See also the first annexure on pages 187–189.)

We are fortunate in that he has included on pages 194–209 his essay on the history of urology in ancient India. This text and appended references will help many young students in this specialty to learn about the shoulders on which they stand.

He has had his share of national awards and served on many national and state committees to improve teaching and practice in his specialty. In 2000 he organized the Millenium International Urology Conference. The interesting story behind this is to be found on pages 179–184.

The chapter Approach to urological consultation and the one that follows on Art of communication must be required reading for all urology postgraduates. To these, I add Joy of teaching (pages 163–171). They are replete with practical wisdom.

My family (pages 143–152) provides a glimpse into the lives of his grandparents, parents and his own family. I wonder how many, like me, will wish it was more detailed.

The following chapter pays homage to his long-time associates.

The last chapter, once again based on his own belief and practice, is a plea for equal rights for women in every walk of life.