Dr Sneh Bhargava is the first and only woman director of the All India Institute of Medical Sciences (AIIMS), in its history spanning 69 years. Bhargava served at AIIMS from 1984 to 1990, and has spent the last 30 years in a private hospital and in offering valuable lessons to budding doctors at special sessions in AIIMS. In her 90s, and active, Bhargava is loath to describe herself as a retiree.

The Wire spoke to the doctor, who has compiled her memoirs in a recently released book, The Woman Who Ran AIIMS: The Memoirs of a Medical Pioneer. Edited excerpts are as follows.

At the outset, I am really curious to know what led you to write your memoirs at this age.

When I was confined to my home during the COVID-19 pandemic, my friends kept on telling me that I should write an autobiography. And I told them that I have not kept any records that I can refer to! 'So how could I write the autobiography,' I thought. I could only write my memoirs. Thus the journey began.

The next challenge was to recollect almost 60 years of my active life. It is difficult to explain how it happened but when I started putting pen to paper, things started coming back.

On the first day of your assuming charge as director at AIIMS, Indira Gandhi was assassinated in Delhi. I wonder if there could have been a more dramatic, or challenging, start...

She was brought immediately to the hospital. She had no pulse. I asked the surgeons if we could put her on a heart lung machine to revive her. We did that. 

My other concern was that if we delay anything in the emergency ward, where she was bought, a crowd may gather on the hospital premises. So we decided to shift her to a floor above, where the OT was. This would also give surgeons at least a chance to do what they wanted to. 

How much pressure did you feel?

My predecessor, Dr H.D. Tandon, was still there. And he and I worked together with the medical superintendent to take care of the crowd that was coming, kept in touch with what was going on in the operation theatre, and looked after Sonia Gandhi [Indira Gandhi's daughter-in-law].

You were dealing with surgeons, you were dealing with crowds, you were dealing with private secretaries of India Gandhi, and you were dealing with her family members, as you describe in the book. It must have been overwhelming for you, especially, because it was the first day of your directorship.

I had been at AIIMS for 24 years before becoming its director. So I knew every corner of AIIMS. I could ask every faculty member to help me sort things out. So it was a team effort. Without the team, you can't do anything. 

It was unfortunate though that the prime minister could not survive.

You also describe the challenges of the anti-Sikh riots, which happened in 1984 in the immediate aftermath of Indira Gandhi's assassination. How did you deal with them?

The patients from both the communities would be landing up at AIIMS – the Sikh community as well as the Hindu community. The Hindu community members were coming with injuries caused by the Kirpans. They did not have, broadly, any other kind of injuries. The Sikh community members coming with burns. It was challenging to manage such a big inflow of patients but we tried doing our best. I was only supervising what the faculty members were doing. Again, it was a team effort.

You also describe in your book that the AIIMS had, at least, two or three Sikh faculty members. What did you have to do so that their confidence was not shaken and they could do the duty of a doctor?

I called them and said that if they felt unsafe, they could come to my house on the campus.  My own chief  technician, who was in charge of the radiology department, was a Sikh named Arjun Singh. 

None of the Sikh faculty members came to my house and remained in their homes, though. I was able to talk to the chief of police in Delhi. He sent a group of police personnel who I accommodated in the guest house so that the campus could be safe.

You describe the challenges in your selection as the first woman director at AIIMS-Delhi in detail. You credit Indira Gandhi, especially, for your selection because she faced resistance from many corners but decided to put her foot down. How do you feel about this decision when you look back?

I had been seeing Indira Gandhi as prime minister as she would visit the hospital on many occasions. So I had had a fair amount of exchange with her. Besides heading the radiology department prior to my appointment as director, I had also been given the charge of the hospital management board at AIIMS. I think that could have given her a chance to justify the edge in my application [over others].

Do you think that Indira Gandhi would herself have been under a lot of pressure from various lobbies?

I'm sure she would have been because my competitors were very strong politically. 

Did you ever experience gender bias otherwise?

Rarely, but I can recollect an event, which does not strictly fit the definition of ‘gender bias’. A secretary[-level officer] of the external affairs ministry called my office. My personal secretary put him through the call. I said, 'Hello’. And he thought that his office had connected me to some staff member at the director's home. 

I corrected him and said he was very much speaking to the AIIMS director. He was magnanimous enough to say ‘sorry’ and accepted his male chauvinism prevented him from accepting that a woman was heading AIIMS.

What were your immediate priorities for AIIMS?

My predecessor, Dr Tandon, told me I should have had three priorities. Housing, housing, and housing – for AIIMS faculty members on the hospital campus.

My other immediate responsibility was the hospital itself. So I started taking rounds of the hospital. Consequently I understood how the hospital required far more nurses than what we had.

So how did you deal with these two challenges, housing and nurses?

Apart from money to the engineering section, which looked after housing, whatever budget we got wasn't enough. 

At one point I got to know through the media that Prime Minister Rajiv Gandhi was offering flats built for the Asiad Games to artistes and teachers. So I thought, well, my faculty were both artistes and teachers, so why shouldn't I apply and try and get these flats for them?

Rajiv Gandhi used to have a 'darbar,' in the morning at seven or eight o'clock wherein common people could meet him. I decided to go to the darbar and tell him that I wanted houses. So I stood in line. As he walked down the queue he saw me and asked, “Doc, what are you doing here?". So I said to him, “Mr. Prime Minister, I've come to beg for housing for AIIMS faculty members.

What was his response?

Immediately he took the pencil and paper and wrote, ‘One hundred houses to AIIMS’ and gave me that piece of paper.

He asked to meet Sarla ji [Sarla Grewal]. She was his private secretary. I knew her because she had been a secretary in the Ministry of Health [ministry] for a short while and I had interacted with her. She said she would do the needful. She would have to route the request through the ministry. That was the usual procedure as well.

But then came the catch. The ministry played foul with us. They took out 50 houses from our quota and gave them to other departments of the government. I was away in Geneva at that time when they sent a note to the hospital saying 50 houses were allotted to us. When I returned and I got to know this, I wondered if I should approach the ministry again and ask them how it was that the the PM promised us 100 [houses], and only 50 were allotted to us.

But then I thought I would risk the 50 houses also. So I decided to settle with them.

What about the nurses situation? 

Well, we had to go to the bureaucracy again to get more nurses sanctioned. The clinicians at two departments which required far more specialisation than others, helped me prepare the necessary data.  These departments were neurology and neurosurgery, and cardiology and cardiac surgery.  

So they helped me work out how many surgeries they were doing and how many nurses were needed –  all the data that the ministry or the bureaucracy wanted. Armed with that homework, I approached the health ministry, asking for not only nurses but also requesting resources to establish independent centres for these two departments.

Did the bureaucrats at the health ministry agree to provide more nurses?

They did not. But we were able to get money from the Swedish International Development Agency (SIDA) through the Ministry of External Affairs.

There were 13 applicants from various parts of the country competing for SIDA grants. The Agency found our project was the best and we got the entire chunk of the grant. 

Thus, we were able to recruit more nurses, and also establish independent centres for cardiology and neurology.

You were working with the radiology department at AIIMS and helmed it before becoming AIIMS director. But you say that establishing a full-fledged radiology department was not easy. Why?

The struggle was mainly financial. Unless we had the equipment, and necessary technology, it was impossible to work. To buy technology [advanced equipment], we needed money. 

Now, the budget for the AIIMs was supposed to be very good, but the equipment that the radiology department needed was expensive. The health ministry was not the benefactor that I could have looked up to. So I got in touch with the finance ministry and a couple of others. It was quite a bit of a journey but over a period of time, we were able to get some advanced technology and establish a full-fledged department of radiology.

Your book reveals you were a child of Partition. Did that event shape your dreams of becoming a doctor?

It did. It made me feel that I have to contribute to society because I saw the sufferings of people coming across the border. Perhaps it was because of this that I thought that I should become a doctor.cIt inspired me to serve all society members irrespective of caste and creed or whatever else you call it – because everyone suffered during Partition beyond these social divides.

Marriage is a crucial deciding factor in the trajectory of women taking up professions like doctors. Especially, because the study of medicine is particularly prolonged. Did you face pressures to get married early, and how did you cope?

It came naturally to me. I was able to handle the home, the pressure, and the workload. 

You married a cardiologist. Do you feel you could manage your personal life and your professional life because you married a doctor?

Yeah, that is right. It's difficult to explain to a non-doctor the challenges of being in the profession of medicine and the service that you have to give to society. My life would have definitely been different and difficult otherwise.

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