A Compassionate Healer – Dr. S.M. Chandramohan as I knew him

A leader in innovative gastrointestinal surgery with globe-spanning distinctions can justifiably feel accomplished, but Dr. S.M. Chandramohan put humility ahead of his achievements.

His sudden passing on July 6, just 11 days ago, came as a devastating shock to me. There was a certain solidity about him, bringing comfort to patients and friends alike, a quiet confidence that was always reassuring. He had a wide circle, and we spoke and met frequently. I admired his medical expertise, and he always discussed his many community outreach programme ideas, often over a small meal.

As I shall narrate later, he played a crucial role in my own welfare. There are thousands of people whose lives he touched, saving many from ruin and death, relieving others of misery, and imparting to young talented surgeons his own expertise. That he is gone so quickly is a staggering loss foremost to his loving family, but also to humanity. When a life-saver passes on, it decisively changes the fortunes of so many. Every day that he lived, many could live on, rescued from severe health disasters including cancers by his skill and experience.

In the 21 years that I knew him, I always thought Dr. Chandramohan’s highest achievement was his professional surgical work, transforming lives of misery, such as those of people who tried to kill themselves by drinking household cleaning acid.

He helped these people survive, painstakingly replacing their burnt food pipe and stomach with a part of their own gut. Some of them had to sacrifice their ability to speak, as the acid had destroyed their larynx. But he ensured that they could eat again. Of course, there were so many others with other afflictions, including severe cancers, whose lives he restored. To his friends, he would provide advice even for a bad cold and a viral infection. After all, just a visit to his clinic and a chat would feel like a cure.

In his accomplished life, he touched so many: patients, friends, colleagues, peers – I am just one of them. He had a role for everyone he came across, and who he thought was open to collaboration. No one in this group would ever be embarrassed by any confidence lost. No secrets were ever betrayed. No mutual friends discussed. The only thing you had to prepare for was to run at his pace.

Such a kinship has abruptly ended. It is naturally difficult to believe, much less accept.

I met him first as a patient, after an episode of food poisoning in 1999. A public-spirited, talented GI surgeon in government service, his contribution to the field at the Government General Hospital was just emerging in the public sphere. In The Hindu his superlative work was brought to life by my friend and dedicated colleague, G. Pramod Kumar, who introduced me to him. It was an era when newspapers reigned supreme, news television was taking baby steps and news websites were more like experiments relying on dial-up internet. It was also a time when young journalists were keen to learn, and people like Dr. Chandramohan were always ready to teach.

He particularly liked a profile that Pramod wrote of him in the “Meet” column, in what used to be the newspaper’s grey and intellectual Metro section. I think he viewed it as a touchstone, in spite of numerous other reports across the media. He had it framed and put on display in his clinic, first at Sundaravadanan Nursing Home, and later at his own facility at Brooklyn Centre across the road. It was still there on July 6.

My food poisoning episode led to a further medical review, and although I thought everything was fine, Dr. Chandramohan lost no time in alerting me to something in the lab reports. I should investigate it further, he said. New Year 2000 had suddenly turned cloudy for me, but I took his advice. Through that year, and into the next, he was keenly watching as Dr. Sunil Shroff and Dr. Georgi Abraham, who became mentors and close friends over the next two decades, investigated the puzzle. Complementing our circle was Dr. J. Amalorpavanathan, a mutual friend and a zealous campaigner not just for health, but peace and democracy, and Pramod who was transitioning to a career in the UNDP.

A visit to Ooty

In 2001, Dr. Chandramohan must have concluded that I was quite depressed with all the investigations, and suggested that I join him, with my family, in a medical camp for the rural population in Ooty. He told me that he had discussed with [his wife] Dr. Rema how worried I seemed to be. A change of scene would be good.

On the visit to Ooty.

We stayed at one of the erstwhile fancy palaces in the hills turned into a guest house, with green vistas, gardens and ornate woodwork. Every detail of the visit, from travel, stay and camp work was personally checked by Dr. Chandramohan. The district administration welcomed him and his team warmly – it is not often that a highly trained specialist is available to screen and treat large numbers of citizens at a free camp in a hill town.

That visit was just the start of a long association. Around the same time, his work to save people who had ingested acid was gaining in prominence. One of them was a young man, Ramesh, from Warangal, whom he had rescued through the reconstructive surgery that he had pioneered. He presented Ramesh to everyone at Royapettah Hospital, highlighting the power of reconstructive surgery for acid ingestion. Always, such meetings involving acid survivors and cancer survivors would end with a strong message of social solidarity against depression and suicide.

The article, with the story of Ramesh of Warangal, who was saved after drinking acid.

For those interested in the deeper elements of his work, they can be found in journals in GI surgery: Dr. Chandramohan and his colleagues described a new entity in the field, the gastrocele, which is caused by corrosive damage to the oesophagus with double strictures.

The Warangal youth’s story appeared prominently. I wrote it in 2003 In The Hindu, although some professional limitations prevented me from using my own byline. The surgical miracle worked by a government surgeon in Chennai for acid poisoning made waves across the country, and patients were coming from far and wide.

As a talented teacher – he was teaching even during the COVID-19 pandemic over video – Dr. Chandramohan made sure that the surgical innovation involved was explained not just to his peers and students, but to journalists, particularly the Tamil media which had a strong reach in the audience most affected by the acid-drinking scourge.

Timeless advice

Some of his advice over the years is timeless: Don’t drink your beverage too hot, it can trigger disease in your food pipe; avoid pickles which too harm your gut; don’t reuse cooking oil, since it can be carcinogenic; maintain your intestinal flora through natural foods like yoghurt, and if you have had a bad stomach, have some probiotic supplement; above all, don’t ignore symptoms, see your doctor, delays can be costly. I recall he made many of these points to a large gathering at The Hindu too on one occasion, and was swarmed by the staff later. He always swore by evidence to prescribe treatment. These are imprinted in my mind.

In late 2003, Dr. Chandramohan should actually have lost interest in me. Changes at the workplace altered my profile and responsibilities. But he somehow wanted to talk even more often.

Helping the tsunami-struck

The Asian tsunami struck in 2004, and he was quickly planning a health camp in Nagapattinam. Once again, I was on the trip with him. He obviously was not looking for media support, because I would not have been of much help. But he nevertheless wanted me to come. We were in a hotel overnight, and moved to coastal villages over the next couple of days, where he was helping the stricken communities. Everywhere, word had gone out in advance of the specialist who was coming. All those who came to the camps got an attentive hearing, immediate advice or follow-up recommendations.

If every super specialist could spend a weekend in such remote communities, even periodically, we would have much better insight into the state of health, disease and well-being in India, and many would benefit from expert advice. Recognising the potential, Dr. Chandramohan launched several telemedicine initiatives too later.

Enthused by the experience, Dr. Chandramohan launched many high-visibility public programmes over the next several years. He started high profile meetings on ending suicide; preventing cancer; No Tobacco Day; Nurses Day; Palliative Care Day; Republic Day; Independence Day; ulcer awareness week; awareness of GI cancer; Digestive Health Day.

On January 6, 2011, he launched a patient support group for gastrointestinal issues. In 2012, he scaled up public participation in his programmes with an essay competition on “Food for Healthy Life” timed for Independence Day.

During a conference organised for Independence Day at Royapettah Hospital a decade ago.

He was indefatigable, launching competitions, public events and so on, without ever giving up his own focused surgical practice. Neither was it just public events – his research was getting published in peer-reviewed journals.

Some of his work involved the molecular biology of oesophagogastric carcinogenesis, and work on the influence of stem cell pathway and GL12 in oesophageal cancer. This was commended by the International Society of Gastrointestinal Oncology, USA. In more recent years, he coordinated a multinational trial on using advanced automated devices in gastrointestinal anastomosis.

At the time of his retirement five years ago, he was the head of the Institute of Surgical Gastroenterology at the Madras Medical College. He later taught at a private university and had his own practice.

The diplomat

He was always the diplomat. Dr. Chandramohan took care never to fall foul of the establishment. The public health message was never lost in the events he conducted, but Ministers from whatever party was in power, and bureaucrats, had no complaints. He turned the spotlight on Tamil Nadu’s famed public health system, and its bank of talented government doctors during these programmes. Government is often seen as a barrier to high-profile work, but he was adept at leveraging its strengths. It must have involved a lot of hard work and constant updating of contacts.

I was baffled that he often gave his own personal phone number for public programmes. “How can you take public calls all the time,” I asked.

“If I can’t answer, someone else will,” he assured me. That confidence revolved around his devout research graduates.

Over the last decade, Dr. Chandramohan brought the corpus of his work online, mainly through EsoIndia, a portal for gastroenterology. Through all this effort, he relied on tremendous support from Dr. M. Kanagavel, who earlier worked with him in government service, among so many others.

When EsoIndia was soft launched on Chithirai day in 2012, it was meant to grow into a unique medico-social institution, attracting research talent in GI issues, supporting patients and survivors. EsoIndia launched a channel on YouTube, and planned to go on Instagram too. He themed his last spectacular public event on cancer and good health around the stirring slogan, Vizhithezhu!, or Arise with awareness! It was a gala show with music and glitter.

In 2019 January, the Vizhithezhu event on cancer awareness was held as a spectacular musical treat for survivors and the general public.

Dr. Chandramohan presided over the prestigious Asia Pacific Gastroesophageal Cancer Congress in Chennai in February 2020. He was greatly relieved that the event narrowly escaped the impact of COVID-19. Many senior specialists who attended were from South East Asia, which was the first to be hit by the virus. This was the last time I was with him in person, speaking a few times over phone during the lockdown, and finalising his media article on elective surgeries in the times of the pandemic.

After retirement five years ago, he began travelling more intensively, attending professional conferences and taking his academic and research work to peers elsewhere in the world. The encumbrance of having to approach bureaucrats to allow him to travel in government service no longer existed.

A few things struck me about him. One was that he did not sleep much. He told me: “Others may need more, but this is sufficient for me.” He would sleep between about 11 in the night and 4 in the morning, when he would be off for surgery. On some occasions, he would simply switch off for a day.

Another aspect was his deeply held opinions of men and matters. He was always polite, but never pliable. I recall, for example, that he said he would never go to work for a particular big corporate hospital in Chennai.

Clear about his choices

He also had a clear choice of places, people, and even numbers. It was the Ambassador Pallava, the Cosmopolitan Club, Savera or, in later years, his own office in Brooklyn Centre, when we had to have a chat. Managers were always informed in advance, and the facilities were set up, along with the food. The few cars that he had rose in value and sophistication with a roughly decadal change, and the chosen number was 9595. After he acquired a black Jaguar, he once demonstrated its immense power with a short burst of speed on Anna Salai. “We work so hard. We need to also live life,” he said. He loved to travel internationally in business or higher. He did work very hard, and his work was unique.

On one occasion two years ago, he told me that at all critical moments, when everything else seemed to offer little hope, he looked to Vellaichamy for divine support. “He always finds a way out for me,” he said. He was referring to a local deity in his Thanjavur village.

A portrait of Vellaichamy sat inconspicuously, among many other souvenirs, honours and portraits, at his clinic at Brooklyn Centre on PH Road in Chennai. An image of the rural deity was in his black Jaguar too, a small icon on the dashboard.

Dr. Chandramohan added life to his years, which he said was the best way to live. But I can never understand why Vellaichamy chose to end his benevolence too early.

The Vellaichamy temple in the Thanjavur village. The picture was sent by Dr. Chandramohan to the author in 2018.

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