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Observations BMJ Confidential

Samiran Nundy: Tackling India’s corruption

BMJ 2018; 360 doi: (Published 17 January 2018) Cite this as: BMJ 2018;360:k105


Samiran Nundy, 80, is an Indian gastrointestinal surgeon who trained at Cambridge and worked at leading UK and US hospitals until returning to India in 1975. He has no regrets—despite describing Indian healthcare as a choice between underfunded, inefficient public hospitals and potentially rapacious private ones. He worked at the All India Institute of Medical Sciences (AIIMS) until 1996 and then at the Sir Ganga Ram Hospital in Delhi, where he is now emeritus consultant. He is a fearless critic of corrupt practice in Indian medicine, such as taking kickbacks for referrals and forcing doctors in private hospitals to generate profits. This year he was co-winner (with Zulfiqar Bhutta) of the BMJ South Asia Award for outstanding achievement.

What was your earliest ambition?

My maternal grandfather (a lawyer and an anglophile snob who had the British title of Rai Bahadur) wanted me to be a diplomat because he considered doctors socially inferior. But my father, a surgeon, wanted me to be a doctor. I chose to study medicine.

What was your best career move?

Returning to India at my wife’s insistence, to “help the poor.” This was after I’d been educated at an elite boarding school in Darjeeling and trained in medicine at Cambridge, London, and Harvard. Adjusting was difficult, but I was lucky to have a supportive wife and ended up having an interesting and fulfilling career. It’s been a great experience to work in a poor country, where I could use my rather refined background and feel needed and appreciated.

What was the worst mistake in your career?

Having been passed over for promotion—unfairly, I thought—at the AIIMS, a friend arranged for me to see someone in the prime minister’s office to investigate the matter. This gentleman told me that I should have come to see him before the selection committee meeting and that he would have fixed my promotion. It was humiliating.

How is your work-life balance?

Mainly work. I used to play the classical guitar but can’t do this any longer, as I’ve become tone deaf.

How do you keep fit and healthy?

Fifteen minutes of exercise in the mornings: Royal Canadian Air Force and a stationary cycle.

What single change would you like to see made to the NHS?

I can’t answer this with any authority, but I’m amazed, after a recent experience with a British resident niece, how wonderful the NHS is. In India, patients worry so much about whether they can afford medical treatment.

What do you wish that you had known when you were younger?

That being poor (I used to earn about £11 a month in 1975 and couldn’t afford to eat meat more than twice a week) wasn’t such a big deal.

Do doctors get paid enough?

Yes. In India we have patients who are poor, and we can’t expect to be as rich as American surgeons.

To whom would you most like to apologise?

To my wife and children, for not seeing enough of them. My wife struggled with cardiac amyloidosis for 28 years, and I continued to work relentlessly at my job—although I stopped travelling outside Delhi during the last three years of her life.

What do you usually wear to work?

A shirt and trousers. No jacket, even in winter, except for formal occasions.

Which living doctor do you most admire, and why?

Yogesh Jain, a paediatrician I taught as a student at AIIMS, who has set up the Jan Swasthya Sahyog health centre in rural Chhattisgarh, where he organises medical care for villagers and tribal people.

What is the worst job you have done?

Senior house physician at Guy’s, where I worked for non-academic, anti-intellectual, mediocre bosses.

What single unheralded change has made the most difference in your field in your lifetime?

Healthcare privatisation in India. Despite widespread corruption the quality of treatment in the best hospitals is often of an “international” standard. Now hardly anyone goes abroad for medical care.

What new technology or development are you most looking forward to?

Widespread use of electronic medical records in India, so we can find out what our medical problems actually are.

What book should every doctor read?

The Citadel by A J Cronin.

What is your guiltiest pleasure?

Taking a 20 minute nap in my office in the afternoon. I was advised to do this by Dr P K Sethi, of “Jaipur foot” fame, who said that Winston Churchill took afternoon naps during the second world war.

Where are or when were you happiest?

On a camping holiday in the Loire Valley in France, in a beat-up red Volkswagen Beetle with my wife and 9 month old son.

What television programmes do you like?

I don’t watch television now, but The World this Week on New Delhi Television was an all time great.

What personal ambition do you still have?

To complete the Oxford Gastrointestinal Surgery Library of nine volumes, with Dirk Gouma of Amsterdam.

Summarise your personality in three words

Unimaginative, conventional, but hardworking.

What is your pet hate?

Boiled carrots; and milk with cream floating on top.

What would be on the menu for your last supper?

Kyauk swe, a Burmese dish, followed by butterscotch ice cream.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

Recuerdos de la Alhambra by Francisco Tarrega, played on classical guitar by John Williams.

Is the thought of retirement a dream or a nightmare?

A nightmare. I wouldn’t know what to do.

If you weren’t in your present position what would you be doing instead?

Full time editor of a medical journal.