An AIIMS Director's Experience of Dealing With A Combative Health Minister

Sometime in end-May 2004, the new, first-time minister for health and family welfare, Dr Anbumani Ramadoss, was taking charge. A function was hastily put together at Nirman Bhawan for the key figures in various government medical facilities to meet with him. I looked at this as a great opportunity to meet with the young leader and establish common ground. Given the pre-eminence of AIIMS as a teaching institution, and the minister’s position as president of AIIMS, I also had our dean, Prof. H.K. Tiwari, a respected ophthalmologist, accompany me. I presented a bouquet to the minister and after shaking hands tried to say a few words. He was, perhaps, preoccupied and rather short in his acknowledgement. We took our seats and waited for the meeting to begin. Just then, a friend of the minister’s came in, and after greeting him warmly, he looked around to seat him. The chairs at the table were all taken up, and the minister gestured to Tiwari peremptorily to vacate his seat and move to another. I was taken aback and quite upset that a senior professor of his standing had to be moved like this. Tiwari—God bless his departed soul—was a very happy-go-lucky man and tried to make light of this on our way back to the institute. He even joked that it was probably his friendship with the minister’s predecessor in the previous government, Sushma Swaraj, that had brought upon the ‘go to the back of the class’ order!

Sometime later, we were all set to inaugurate a railway ticket-booking counter at AIIMS. This was a much looked-forward-to addition on the campus; as you can imagine, it would offer the utmost convenience to out-of-town patients, their relatives and the AIIMS staff. As Lalu Prasad Yadav was railway minister at the time, he was to do the honours. Lalu wanted that the health minister be there as well, given that he was in effect the ‘host’ as he was designated AIIMS president and the facility was in the AIIMS premises. Ramadoss did not respond initially, and then his office questioned the need for the railway minister’s presence. It was a prickly situation, and we did not know what to do. Word of this perhaps got to Lalu Yadav, and he called up Sonia Gandhi, who in turn sent a message to Ramadoss to be present. On the morning of the inauguration, a massive crowd gathered at the site; Lalu Yadav was a big draw! Since we got information that he was on his way, the health secretary, J.V.R. Prasada Rao, and I decided to go across to the AIIMS guest house to fetch the health minister, who was housed there. We were shocked to see that he was not ready by then, and mentioned to him that we would accompany him. We waited for him and he came along, but was visibly irritated by the jostling crowd. Prasada Rao and I had to use security to shepherd him to the venue, where he stood by ill at ease. Lalu entered around the same time that we did and we went ahead with the formalities. At the tea that followed, Lalu in his inimitable style pulled me aside to ‘introduce’ me to his counterpart. Again, the response was terse.

As you would have noted in the above paragraph, the minister had housed himself on campus in the guest house that was otherwise used to accommodate visiting faculty, examiners and important conference attendees. This was done unilaterally, and without any discussion with me, as would normally be expected. The move also entailed making modifications to the facility and bringing in staff from the outside. It generated an inordinate to-and-fro of vehicles as his political coterie camped there, and people visited him at odd hours on an otherwise quiet campus. This development was unprecedented, and sent ripples through the faculty and staff who stayed on campus. I even received some representations from them, questioning this and asking if it was going to be the way of things to come. One incident actually had everyone clutching their sides— the AIIMS estate office had received an indent from the AIIMS president’s office for some 500 idli pans, some 100 large vessels and dosa griddles to be supplied to the guest house! I was nonplussed and did not know what to make of the situation where I could see my minister in his pyjamas literally in my backyard as I walked through my vegetable garden!

Gradually, word started spreading that he was calling some faculty members directly to the guest house, and the coterie around him was fanning all kinds of political activity on campus. As much as I wanted to keep myself above all of this, I felt as though I was getting pulled into a cesspool of subversive currents, with false complaints about the administration flying around, strikes being facilitated and various sections of the faculty and staff beginning to feel hounded. In fact, the faculty association was split down the centre with its president playing ball with the minister’s coterie and facilitating a strike that was not approved of by the association’s general body. Things came to a head late one night.

Around 11 p.m., I was woken by the phone at my bedside. Given my work, I would always keep all phone lines open. It was the minister’s personal assistant, whose mother I had treated, giving me a ‘friendly’ alert on the side that the minister was at the casualty ward. I had no official intimation of this, and felt uneasy that he should do something like this without my knowledge. I got dressed in a trice, only pausing to make a quick call to Mayank Sharma, senior financial advisor and acting deputy director (administration), to be there, and dashed across to casualty. As I neared, I saw that he was just entering, and his presence had already caused consternation among the doctors who were scrambling like crazy to attend to the patients being wheeled around in all conditions and from all directions. If you have ever had the misfortune of visiting casualty at AIIMS, you will know what I mean. I walked up quickly and enquired of him, ‘What happened? What brings you here at this hour?’ He walked farther in and started saying loudly, ‘How many doctors are here on duty? Why do we have patients waiting?’ I quickly called out for the doctor-in-charge to line up all the doctors on duty, and then turned to him to point to the strength we had on the spot. He walked around in the manner of inspecting things and I could sense the doctors’ resentment. I then offered to take him on a round of the other facilities so that he could be satisfied about whatever he was looking for.

That night, we walked through the Dr Rajendra Prasad Centre for Ophthalmic Sciences and then towards the cardio-neuro centre. I walked him up to the ICU, the CCU, the wards and then to the sixth-floor private wards, all the while pointing out all the staff present and busy at work. We must have spent about two hours that night walking through the hospital. When we came out of the building, he gestured to the patients waiting on the kerbs and said, ‘Why can’t we do something about this?’ By now, I had lost my patience and riposted, ‘Yes, why don’t we?’

I knew I was being belligerent; I was at the end of my tether with the finger-pointing by someone who should have been collaborative rather than combative, and I felt pushed to the wall seeing the intimidating stance that was adopted with the doctors in casualty. I also knew that he was within his rights as AIIMS president to walk through any area of the hospital, but professional courtesy called for his asking me to join him or, in the least, letting me know even at the last minute that he was going to take a surprise round.

The next morning, I sought to meet with the Prime Minister and the President with the intent of offering my resignation if we were to continue with this manner of operation. Both of them were gracious enough to meet me instantly. I candidly shared my misgivings at the trend that things were taking and stated that I was not willing to compromise either my dignity or that of my colleagues. They refused to accept my resignation and assured me that they would look into it. Naturally, word of this got around and things turned more vindictive.

The cabal in the AIIMS guest house now grew further. A retired police sub-inspector came down from Chennai and was appointed as officer on special duty (OSD) to the AIIMS president. Under this garb, he started meddling in the affairs of this premier educational institution. He would hold meetings with dissident factions, encourage disruptive elements and even communicate with me on decisions that were outside his purview. In general, he was successful in creating a climate of disquiet and mistrust that held the institute in a vice-like grip through all of 2005.

This excerpt from Heartfelt: A Cardiac Surgeon’s Pioneering Journey by P. Venugopal and Priya Sarkar has been republished with permission from HarperCollins India.