Tag Archives: First Armoured Division

THE ART OF DIAGNOSING GOOD HEALTH vs DIAGNOSING ILL-HEALTH

Posted on by
Reply

THIS PORTRAIT OF ADI SHANKARA DEPICTS HIM IN PERFECT, GOOD AND POSITIVE HEALTH.  

THE LEGEND ABOUT ‘BHAJA GOVINDAM’ : 

Adi Shankara, an Indian philosopher of 8th century CE, born in the southern Indian state of Kerala is well-known for his doctrine of Advaita Vedanta which he had established using Upanishads for reference. Shankara had established the ‘SMARTHA’ tradition to which I belong. He had recommended devotion to both Shiva and Vishnu and also the worship of other gods and goddesses. His poetic composition popularly known as ‘Bhaja Govindam’ deals with issues of human existence and the problem of death. Shankara had renounced the comforts associated with materialistic existence and had become a ‘Sanyasin’( Hindu ascetic) at a very young age and had walked across the length and breadth of India on foot. He had lived by accepting the offerings(‘biksha’) given by the community which often involved walking along the streets in places where he had lived. While he had lived in the city of Kashi also known as Benares or Varanasi, the legend claims that he had composed the twelve verses of Sanskrit poetry. He was accompanied by fourteen of his disciples who had also contributed a verse each and these songs are collectively known as ‘Bhaja Govindam’. The legend describes that Shankara had encountered a man teaching the rules of Sanskrit grammar to his students. In India, the teaching technique often involves learning by rote. A phrase is repeated several times to let the students put it into memory. As this Sanskrit Grammar teacher was repeating the phrase ‘Du krun kariney’, Shankara, a man of great spiritual insight, had instantly recognized that the Sanskrit teacher was actually facing the threat of death and the teacher himself was not aware of the threat to his physical existence. Shankara who had mastered Vedas and Upanishads was aware of the many sources both external and internal that endanger human physical existence. This particular ability of Shankara to diagnose the health of an individual interests me because of my educational experience and training in the ‘Art of Diagnosis’. Unfortunately, Shankara died at the very young age of 32. A mystery surrounds his death. The place of his death is disputed. He was always followed by his disciples. Some accounts claim that he had died in Kedarnath in the Himalayan mountains of Uttaranchal State. Others claim that he had died in the southern Indian city of Kanchi. What had contributed to his premature demise is not known. His portraits always depicted him in good and positive health. 

THE ART OF DIAGNOSING GOOD HEALTH : 

To diagnose ill-health is easy. The sick person may describe his ailments. In addition to a person’s subjective symptoms, ill-health shows objective manifestations. The art of clinical diagnosis in sickness and disease involves the use of signs and symptoms attributable to specific conditions that affect the state of health of an individual. However, the mere absence of ill-health does not necessarily mean that the person is positively healthy. Health, like beauty is often a matter of subjective impression. But, while beauty is in the eyes of the beholder, the diagnosis of perfect and positive health is a verdict rendered after a carefully executed medical examination. 

The important object of medical inspection and examination of Armed Forces personnel is to ensure that they are healthy and are able to perform the tasks assigned to them. As the medical officer providing medical cover to units in the Armed Forces of India and The Sultanate of Oman where I had served, I was responsible for assessment of health of all personnel under my care. To ensure that the troops are in good health, I was required to medically inspect all personnel under my care periodically and diagnose that they were in good health. Good health demands that a person should appear well nourished. In stature and build, a person should represent an average example of his race and class. The person should not present any evidence of emotional hyper-excitability. Temperamentally, the individual should exhibit reasonable aptitude and behavior consistent with the expectations of his occupation. Most importantly, the face of the person should reflect the bloom of vigorous health. A person in good health should appear cheerful and be full of vitality. The entire individual is carefully examined to assess the health status. I had acquired the practical skills of the ‘Art of Diagnosing Good Health’ by carefully carrying out regular, periodic health inspections of all men under my care. Armed Forces insists upon Medical Inspections for a variety of reasons and individuals who are subject to the Rules and Regulations that govern Service in Uniform cannot refuse the mandatory Medical Examinations. Medical Inspection of all the men including all food handlers of the Unit is done typically once every month. In addition, men newly posted to the Unit( New Arrivals), men before proceeding on and returning from Courses of Instruction/Leave of Absence/Temporary Duty, and after Hospital Discharge are Medically Inspected. Recruits posted to the Unit after completion of Recruit Training, and men joining their Units after serving abroad are subjected to Medical Inspections. Thorough, detailed and specific Medical Examinations of military personnel is required under the following conditions : 

1. All troops proceeding on ‘active service’ or troops proceeding overseas. 2. Individuals proceeding on permanent transfer to another Unit. 3. Men desirous of an extension of service or re-engagement. 4. Troops for transfer for the Reserve Duty. 5.Officers at the time of initiation of Annual Confidential Reports, entry to Staff College, any Course of Instruction, Fitness for Special Duty. 6. Men under arrest and undergoing sentence and before disciplinary action. 7. Men posted to serve at High Altitude. 8. Special examination at the outbreak of an infectious disease. Typically, I used to examine at least twenty known contacts of each case of Malaria or Viral Hepatitis. 

Medicine is not merely the Art of Diagnosing ill-health and it is equally the Art of Diagnosing Good and Positive Health. I had perfected this skill by meticulously repeating the task of conducting Medical Inspections thousands of times during the course of my service in the Armed Forces. This had also contributed to my ability to diagnose ill-health and in the next several posts I would narrate a few specific instances when I had diagnosed an impending outcome of death during my service and there are instances when I had diagnosed Good Health and made individuals to perform their assigned tasks and did not allow them to escape from the obligations of Military Duty. Sometimes, my acute power of observation was better than that of Physicians more qualified than me. During 1973, I was admitted to Military Hospital, ROORKEE for an intestinal infection. During my hospital stay as a patient,while I was standing in the lobby of the Officers’ Ward one particular evening, I had seen a young, male patient coming into the Ward after his admission. When I had looked at him from a distance, and the manner in which he was walking, particularly his gait and the position of his right hand over the right lower quadrant of his abdomen, I had suspected his medical problem. After he came into the Ward, from his facial appearance alone, I had recognized him as the younger brother of an Officer who was then serving with me in my Unit. Both of them belonged to the Corps of Engineers. I had introduced myself and he had confirmed his relationship to the Officer who was then serving at my Unit. I had asked him about his medical ailment. He was getting treatment from the Hospital Physician( Medical Specialist) over the last several days and was
already seen by the Physician twice in the Out-Patient Clinic and was not responding to the medicines that were prescribed. I had looked up at the Hospital Admission document. He was admitted to the Military Hospital with the provisional diagnosis of Fever Not Yet Diagnosed. I told him that Fever was not the real issue and that he was suffering on account of a common well-known surgical condition called Acute Appendicitis. I had confirmed this diagnosis by performing a simple test on this young Officer patient and told him that he would need immediate surgery and that his ‘APPENDIX’ should be removed without any delay. I proceeded to contact the Duty Medical Officer who had admitted and sent this individual to the Officers’ Ward. The Duty Officer had simply admitted this man based upon the written opinion given by the Physician. The Duty Medical Officer came over to the Officers’ Ward and he repeated the test I had performed earlier and the diagnosis was very clear. He immediately called the Duty Surgeon, who came over and repeated the test I had conducted and confirmed that Appendix should be removed. The appendix was removed and the Surgeon came back and told me that the appendix was highly inflamed and was at the risk of a RUPTURE which could pose a greater threat. While, Appendicitis is a common surgical emergency among young adults, Medical Specialists are not trained to treat this condition and sometimes they may fail to look for it. I was less qualified than the Medical Specialist but I had trained myself in the Art of Diagnosis which would be of use in diagnosis if not in delivering the special treatment a medical condition requires. Whatever may be the outcome, a Good Diagnosis is as relevant as a Good and proper Treatment. Roorkee was the hometown of this Officer patient. Later his father came to the Ward to meet me and was particularly excited with this chance coincidence ; I knew his first son and then I was in Roorkee at that precise moment and intervened as his second son was arriving at the Officers’ ward. 

BHAJA GOVINDAM – PART-I : 

While the Art of Diagnosis interests me, I constantly remind myself that Good Health is due to the GRACE and MERCY of the LORD and Indians love to identify the LORD as GOVINDA. While we exist because of MERCY, when the existence is threatened, we have no choice other than remembering the LORD. 

Bhaja Govindam, Bhaja Govindam, 

Govindam Bhaja muudha matey, 

Sampraaptey Sannihitey kaaley, 

Nahi Nahi rakshati Du krun karaney. 

Dr. R. Rudra Narasimham,

Kurnool Medical College, Kurnool, A.P., India.,

M.B.B.S., Class of April, 1970.

 

FIGHTING AN ENEMY – A STORY FROM SURATGARH RAJASTHAN

Posted on by
3

Description: This micrograph depicts the histo...

Image via Wikipedia

 

Vulpes bengalensis - Indian Fox

Vulpes bengalensis - Indian Fox and Rabies Infection.

 

Bullet shaped Rabies Virus

Bullet shaped Rabies Virus

 

Structure of Rhabdovirus that causes RABIES

Structure of Rhabdovirus that causes RABIES

 

Rabies Evidence - Negri body

Rabies Evidence - Negri body

 

Brain Inflammation - Negri bodies

Rabies Encephalitis-Brain Inflammation - Negri bodies

 

Mahajan Firing Range, Suratgarh
Mahajan Firing Range, Suratgarh, We have weapons to fight our external enemies.

 Indian Armed Forces train and conduct Military Exercises in Suratgarh region of  Rajasthan with a sense of ‘excitement’ induced by the preparation to confront the enemy. The attack by an ‘invisible’ enemy is manifested by the medical symptom of mental excitement.      

SURATGARH - A STRATEGIC POST

FIGHTING AN ENEMY - SURATGARH - A STRATEGIC POST

 

Canis aureus, Golden Jackal

Canis aureus, Golden Jackal and Rabies Virus Transmission.

 

Suratgarh-Vedic Bhumi-SARASVATI RIVER

Suratgarh-Vedic Bhumi-The Land of Legendary SARASVATI RIVER

 

SURATGARH, RAJASTHAN – THE LAND OF RIG VEDA  :      

Suratgarh is in Sri Ganganagar District of Rajasthan. Around 3,000 B.C., Suratgarh is believed to be a lush green pasture land due to the presence of Sarasvati River which is repeatedly mentioned in Rig Veda and is described as “Ambi ta mey, Nadi ta mey, Devi ta mey, Sarasvati” meaning that River Sarasvati is Best Mother, Best River, and Best Goddess.      

Fighting the Enemy – The Excitement at Suratgarh  :      

Suratgarh is of strategic importance. I had visited and camped in this area several times during the period from 1976 to 1978. It was not a picnic. My visits were mostly related to military training and exercises that would prepare me to fight the enemy in a battle. Battle preparation always induces a sense of excitement. Apart from the body, the mind would be put on an alert to accept the challenge and confront the enemy. I had never missed that feeling on any day that I had spent in Suratgarh. During 1977, I had camped at Suratgarh for three months where we had opened a ‘Desert Driving School’ to impart training to military drivers. The sandy desert terrain poses a challenge to the man aswell as the machine. The driving lessons were imparted by instructors from Army Service Corps which provides provisions(rations) and transportation in the conduct of military operations. We had established a very small camp in tents on the Suratgarh-Sri Ganganagar Road. I had set up a very modest Medical Inspection Room in a bunker to provide medical services to trainees at our School. I had posted a sign on the road near our School to encourage others to visit my Medical Inspection Room if they needed any help. I had always liked the idea of preparing for the battle. The success in actual war depends upon the skills a person acquires while training for the battle. I thought that it was important that I must learn to drive and operate all types of vehicles that Indian Army would use in the desert terrain. Like all other trainees at the School, I drove a 3- ton Lorry, the basic workhorse of Indian Army. I had successfully finished my training and was issued a Military Driver’s License. Apart from 3- ton Lorry, I also operated all other vehicles like Jeep, Jonga, and 1- ton trucks. The driving tracks included regular surface roads and plenty of cross-country driving over sand dunes and desert terrain. It was exciting to face the challenge and be prepared.      

Fighting an Invisible Enemy – A Challenge to Human Existence  :      

Fighting a visible, external enemy is easier rather than fighting an ‘invisible’ enemy. The Rhabdovirus that causes the fatal disease of RABIES is one such invisible enemy. The virus has a characteristic ‘bullet’ shape. It is described as a neurotropic virus as it chiefly attacks the central nervous tissues and causes brain inflammation. While a person is alive, the infection is always diagnosed on clinical grounds.After death, the evidence for this infection is demonstrated by the presence of microscopic, the oxyphilic inclusion bodies called the ‘Negri Bodies’ found in the cytoplasm of the brain nerve cells. The disease once manifested, has no cure and the mortality is 100 percent. The disease was eradicated in Britain and Australia, but is still prevalent in India. Rabies is primarily a disease of a variety of animals( the Canidae tribe) and man is secondarily infected. In India, furious canine rabies causes most cases of the disease in man. The virus also attacks the salivary glands and the virus is present in the saliva of the infected animal. For man, the immediate source of infection is essentially the rabid domestic, street, or pet, dogs, and cats. The infection could also spread from wild animals like Jackals and Foxes. The virus is transmitted to man either by the bite of an infected animal or by contact through the mucous membranes or breaks in the skin such as cuts, abrasions, and open injuries that get licked by the animal.The virus cannot enter the body without some trauma to the skin or mucosa. However, the virus can gain entry if it contacts intact conjunctiva of the eyes. Transmission by ‘droplets’ has also been demonstrated. Once within the body, the virus travels using nervous tissues and attacks the brain. Depending upon the site of entry into the body, the disease can manifest itself in about 10 to 90 days.      

HYDROPHOBIA – THE FEAR OF WATER : THE CHARACTERISTIC FEATURE OF RABIES :      

During the very initial phase of infection which may last from 1 to 10 days, the disease is manifested as increasing restlessness, excitement, anxiety, and irritability. After the initial period of 1 to 10 days, the symptoms and signs of Hydrophobia appear in the man. This is a characteristic feature of the disease only in man and does not occur in dogs or other animals. The fearful manifestation of Hydrophobia includes violent contractions of the diaphragm and other respiratory muscles if the individual attempts to drink water. The muscles of throat go into spasm and the victim would be unable to drink water despite extreme thirst. The sight of water or even the sound of water may precipitate these very distressing spasms and attacks of panic.Man has no natural immunity against the infection. Anti-Rabic Vaccine treatment is useful during the incubation period. The Vaccine treatment has no value if the Rabies Virus reaches the brain. Once the symptoms of the infection appear, no treatment is possible. Rabies is prevalent in India, but the incidence is very low in the Indian Armed forces. We had 59 reported cases of Rabies from 1944 to 1964, about 3 cases per year. There have been cases of Rabies transmitted by corneal grafts taken from people who had died of undiagnosed Rabies.      

THE INVISIBLE ENEMY’S ATTACK IN SURATGARH :      

While I was attending to patients at my Medical Inspection Room at the Desert Driving School, a Non-Commissioned Officer(NCO) came to our Camp to seek my assistance. He belonged to the Corps of Electrical & Mechanical Engineers(EME). He being a member of the SIKH religious community could be immediately identified by the turban that he wore and his beard. He was well-groomed and was in proper military attire and had very good physical stature and appearance. His Unit had sent a small detachment to Suratgarh area in preparation for some training event. They were camping nearby. His Unit was not affiliated to the military formation which had set up the Driving School. During that time, Suratgarh had only a Primary Healthcare Clinic.  I was the only Army Medical Officer providing services to military personnel stationed in that area. As he walked in, I could see that he was excited and I had immediately assured him that he should have no apprehension to seek my services and the Unit affiliations are of no consequence and he should totally feel free to discuss his medical problems with me. He had a very brief medical history. For some unknown reason, he was feeling restless, excited , and becoming anxious about his restlessness. He had no headache, no fever, and no other problems. He was apparently performing all his tasks very well and had no quarrels or arguments with his colleagues. I could easily see his attitude and military bearing. He was displaying a very disciplined behavior, a respectful attitude while coping with a serious and troubling condition. I could immediately rule out the possibility of overt or occult ‘Malingering’. He was a NCO who had spent some years in military service, he was very well-adjusted to his military life and had no particular problems with superiors or colleagues of his Unit. I spent time to fully medically examine him and evaluating his general condition and exploring the reasons for this sudden onset of mental restlessness in an adult who had no prior medical problems. He was not disgruntled, cynical or bitter. He was speaking and answering all of my questions in a very coherent manner. He was not expressing any bizarre ideas or thoughts. He was not hallucinating, not deluded or demented. His personal habits were good and he did not consume alcohol or any other mood altering drugs. He was not any medications. He was not experiencing a ‘STRESS’ disorder and appeared to be having good stress resistance. He had no pressing domestic concerns or problems. I could not discover any physical factors like Heat or infections like Malaria or metabolic disorders like diabetes which may explain his condition. Through careful interrogation, I could exclude Psychiatric illness or disorder. After spending some time, I could not still come to any conclusion and I was unwilling to send him away with some symptomatic treatment to relieve his anxiety.      

MEDICAL COMFORTS  AND  MEDICAL DIAGNOSIS  :      

Unlike in civil medical practice, the army medical practice gives attention to the individual and not exclusively to the disease. At Medical Inspection Rooms, we very often provide ‘Medical Comforts’, to all people who visit us, as needed. The Medical Inspection Room is entitled to draw rations like sugar, tea leaves, and milk powder and very often we serve hot, and refreshing tea while people wait at the Clinic. Suratgarh is an extremely hot place. I was drawing blocks of ice to keep my Clinic cool as there was no electricity or air-conditioning. I was also serving chilled water to all visitors and consistently encouraged everyone to consume more fluids.      

After my initial, inconclusive evaluation of my patient, I wanted to provide him some ‘Medical Comfort’ and offered to him a glass of chilled water as it was already very hot. He had declined my offer and showed no interest to drink water. He was not being rude or impolite. He was too excited and was not in a mood to relax. But, that very simple act of offering water as ‘Medical Comfort’ and his refusal made me to contemplate about his condition. It suddenly occurred to me that I could be dealing with a case of Rabies. He had no symptoms or signs that could be identified as ‘Hydrophobia’. He had no such concerns or problems at that time. However, I had decided to fully explore that possibility. I again started my interrogation to find out if he had any contact with any animal. He never had pet animals. He was never bitten by any animal. He was never licked by any animal. I carefully examined his skin and could not discover any cuts, abrasions, open wounds or healed injuries. His skin was intact and it would not be possible for Rabies Virus to enter his body through his unbroken skin. I had no other options left and I was not able to exclude the possibility of Rabies infection as the cause of his medical complaints of restlessness and anxiety. I had no choice other than acting upon my suspicion even though I had fully trusted his statements about never being licked or bitten by any animal.      

THE ROAD JOURNEY FROM SURATGARH TO ABOHAR , PUNJAB:      

I made a decision to medically evacuate my patient to a military medical facility located about 95 Kilometres away at ABOHAR, Punjab. We made no such prior plans to evacuate patients from the Desert Driving School to Abohar. I had to make that decision on my own keeping the best interests of my patient in my mind. I had also decided to transport the patient myself and to drive the 1 – ton truck ambulance.I wanted to assume the full responsibility for taking the vehicle to Abohar. As we were getting ready for this road journey, I checked and found that I had only 2 ampoules of Injection Chlorpromazine hydrochloride(LARGACTIL), a drug of choice to alleviate anxiety. It can tranquillize the patient without impairing his consciousness. Largactil has a marked sedating effect without causing stupor. However, I had only two ampoules in my Clinic. I quickly ran to Suratgarh Primary Healthcare Centre and met the doctor there to get some additional ampoules of Largactil. He had none in his dispensary. So, I prepared my patient for the road journey after administering the medicine that I had and none for the duration of the journey. The road was in a very bad shape with pot holes. My patient could not be fully sedated with the dose I had administered. While I was driving the ambulance, I had kept the partition glass window open to check on the patient. Two of my medical assistants were with the patient, and the ambulance driver was in the co-passenger seat in the front. The bumpy ride caused a bit of stress and my patient was constantly shouting from behind asking me to slow down and sometimes he was directing me to speed up. I was happy to hear his voice and finding that his condition was still stable without any worsening of symptoms. By the time we entered the Hospital at Abohar, it was already dark. I had contacted the Duty Medical Officer who had immediately sent word to the Hospital Surgeon to evaluate the patient. The Surgeon carefully examined him and there were no clinical grounds to diagnose Rabies at that hour. The possibility was there. In any case, the patient needed Hospital admission simply on account of his extremely excited condition. I gave the postal address of my Unit and obtained an assurance from the Surgeon that he would communicate to me the Medical Diagnosis of my patient. After that assurance, the patient was duly handed over, I left Abohar and returned to Suratgarh. A few days after this trip, my three months of stay at Suratgarh had concluded and I had returned to my Unit and had assumed the duties of Unit Adjutant. I had received that unfortunate Medical Diagnosis in the mail. The Surgeon wrote to me stating that the Medical Diagnosis of Rabies was confirmed after conducting an autopsy and the demonstration of ‘Negri Bodies’ in the brain nerve cells.      

BHAJA GOVINDAM - PART- V   :      

The human body is very vulnerable and could be attacked in several manners. In this particular patient, the deadly virus  might have gained its entry into his body through the conjunctiva of his eyes. The saliva, the droplets carrying the Virus from an infected animal like a Jackal or Fox could have entered his eyes while the animal was in his vicinity but escaped from being noticed by him. We camp outdoors and sometimes fail to notice an imminent threat. I would suggest to all of my readers to use protective goggles while camping outdoors and introduce its use on a regular basis while conducting military exercises and training in areas where infected animals could be present. After taking all these precautions, we still need the help, the help of our LORD, the help that a sweet name like GOVINDA could offer to protect and defend our human existence.      

Bhaja Govindam, Bhaja Govindam,      

Govindam Bhaja muudha matey,      

Sampraapte Sannihitey Kaaley,      

Nahi, Nahi Rakshati Du Krun Karaney.      

Dr. R. Rudra Narasimham,     

Kurnool Medical College, Kurnool, A.P., India.,     

M.B.B.S., Class of April, 1970.      

LIVING UNDER THE SHADOW – A PRESCRIPTION FOR DEATH

Posted on by
3

SUNFLOWERS, HELIANTHUS ANNUUS,BELONGS TO COMPOSITAE/ASTERACEAE, THE FAMILY OF DAISY FLOWERS, NEED FULL SUN TO GROW WELL.   

 

    

 

   

  

PADMA SUNDARJI LIVED UNDER THE SHADOW OF GENERAL K S SUNDARJI

PADMA SUNDARJI LIVED UNDER THE SHADOW OF GENERAL K S SUNDARJI

 

LIVING UNDER SHADOW :   

Shadow gives us protection or shelter from external danger. In India, women before their marriage live under the shadow of their fathers. After marriage, women are expected to live under the shadow of their husbands. Indian Tradition demands that a married woman should be subjected to live under the influence or domination of her husband. Very often, women love to bask under the glory of the position, the status, and the power wielded by their husbands. But, living under shadow should not endanger the very existence of the individual who is seeking the protection. Sunflowers bloom and thrive only when exposed to full sun. These plants cannot grow well under shade or shadow. Every individual has a fundamental Right to exist. No individual should dominate or influence another individual to an extent that compromises the Right to Life.   

A PRESCRIPTION FOR DEATH :   

General Krishnaswamy Sundarrajan,PVSM ( popularly known as General Sundarji) was India’s Chief of Army Staff from February 1, 1985 to May 31, 1988. I had spoken about him in my blog post titled ‘WINNING PEACE – THE ART OF PREPARING FOR WAR’. He was married to Padma Sundarji when he was a Major serving with the MAHAR Infantry Regiment in the Army. She spent the best years of her life living with him and had kept his company throughout his various postings. I met Padma Sundarji for the first time in my life in the year 1978. At that time, General Sundarji was serving as General Officer Commanding (GOC) of First Armoured Division. It was a rare distinction of great honor for an Infantry Officer to Command an elite Armoured Division. I was serving as a Medical Officer in the rank of Major under the Command of General Sundarji.   

I had met Padma Sundarji at the General’s official residence. I went there to personally administer intramuscular injection of Streptomycin which is exclusively reserved for the treatment of Tuberculosis. Three drugs are concurrently used as first-line drugs in the Initial Phase of treatment of Tuberculosis and the daily injections of Streptomycin are used for about three months. Pulmonary Tuberculosis is a “NOTIFIABLE” Communicable Disease in the Armed Forces. Statutory legislations have been made at various levels for imposing legal obligations on all people to facilitate control actions to prevent the spread of the infection in the community. ‘OPEN’ or infectious cases of Pulmonary Tuberculosis are always treated in an ‘Isolation Ward’ of a Hospital. Padma Sundarji was getting treated at her home and hence would not be considered as an ‘open’ case. It also means that there were no Mycobacterium tuberculosis Bacilli ( Gram Positive, Acid-Fast Bacilli) in her sputum. Apparently, she was diagnosed as a case of Pulmonary Tuberculosis simply based upon an interpretation of her chest X-ray films. There was no conclusive evidence to claim that she was having Tuberculosis infection. Tuberculosis is prevalent in India but it is less common among people serving in the Armed Forces. I had mentioned in my earlier blog post that we routinely medically inspect all personnel to detect illness including infections like Tuberculosis. While she lived at the General’s residence, there was no practical chance that she would come into contact with an ‘open’ case of Tuberculosis who could transmit this infection to her. Apart from that, we routinely vaccinate all individuals to protect them from Tuberculosis. These facts were not used in establishing her medical diagnosis. She was diagnosed as a Pulmonary T.B. case by a Medical Specialist who had no special training in the diagnosis or treatment of Lung Cancer. A Medical Specialist while looking at a chest X-ray film would tend to diagnose T.B. and not Lung cancer. This Medical Specialist had misdiagnosed Padma Sundarji as a case of Pulmonary T.B. as he had no experience in the diagnosis of Lung cancer. She was given the Standard Anti- T. B. treatment and if the treatment was correct and appropriate, she would show improvement day after day. She would have felt a little better after each day of her treatment with those very powerful drugs. She had NOT shown any encouraging response to her therapy and in fact her condition was deteriorating day after day. The Medical Specialist was very convinced with his diagnosis and he had never bothered to check upon her while she was religiously taking these daily doses of intramuscular injections of Streptomycin and other drugs.   

When I first met Padma Sundarji, I had immediately diagnosed that she was not in Good Health. Her face lacked the expression that is typically associated with the vigor and bloom of Good Health. I had instinctively known that she was not responding to her Anti-T.B. treatment. I spoke to her mother Smt. Indira Rao. This elderly lady had openly expressed her disbelief in the diagnosis. She was utterly unhappy with the Anti-T.B. treatment that was being given to her daughter. She was already feeling helpless and anxious about her daughter’s life. If Padma Sundarji had been the wife of any other person, I would have immediately sent her to the Hospital and would have obtained an opinion from a different Specialist. In my previous blog post I had narrated as to how I had intervened at Military Hospital, ROORKEE and had publicly exposed the incompetence of the Medical Specialist there during 1973. Padma Sundarji was living under the shadow of her husband. If you are in someone’s shadow, you receive less attention and seem less important. I was less qualified than the Medical Specialist, and I was not in a position to convince General Sundarji to disregard the opinion and the treatment recommended by this Medical Specialist. Padma Sundarji needed urgent re-evaluation. I had asked Smt. Indira Rao to take her daughter to the All India Institute of Medical Sciences at New Delhi and obtain a second opinion. Indian Traditions stood in the way of this battle for life. Women are not expected to act on their own even if their own life is at a great risk. She could not act upon my sincere suggestion and my desire to protect the health of a person to whom I was asked to give an injection. I had administered the injections for only a short period of time and the duty was resumed by another Medical Officer. I had no further contact with her or her mother. Eventually, Padma Sundarji was transferred to Army Hospital, Delhi Cantonment. She died of Lung cancer in 1978. She was cremated in New Delhi. She never had a chance to return alive to the First Armoured Division and to her existence under the shadow of her husband, the General who later became the top Military Commander of Indian Armed Forces.   

THE BATTLE OF LIFE vs DEATH :   

In 1978, the medical community and the general public were not aware of the dangers of ‘SECOND-HAND’ tobacco smoke. People who inhale ‘second-hand’ smoke are exposed to the same cancer-causing agents as smokers. Second-hand tobacco smoke also causes Lung Cancer. By the time symptoms appear, Cancer may have begun to spread. Hence, early diagnosis of Lung Cancer is very important to improve the chances of survival of Cancer victims. I am not claiming that Padma Sundarji would have lived forever if I had admitted her to a Hospital promptly. I could have definitely helped to prolong her life by a few hours or even a few more months. General Sundarji who had repeatedly inspected and tested the Medical Unit under his Command in the First Armoured Division clearly knew that his Medical Officers at their very best could only protect and prolong the lives of his men for a few precious hours. During those precious moments, we evacuate our casualties to the nearest Hospital. If we succeed in doing so, we most certainly save some lives. In the battle of Life vs Death, a few hours makes a huge difference. Padma Sundarji who had lived under the shadow of a General did not receive the benefit that I was trained to give to the men under his Command. She was excluded and I did not evacuate her to the nearest Hospital which could have added a few more hours to her life.    

BHAJA GOVINDAM – PART – II :   

At First Armoured Division, we took pride in our training and preparedness to defend our country from the threats of external aggression. Apart from the threats posed by external enemies, human existence faces several challenges. Many times, we are not aware of the threats faced by our loved ones who live under our shelter. The Art of Diagnosis interests me,but there may be no escape from the threat and hence the ultimate refuge still remains the same, the sweet name of GOVINDA.   

Bhaja Govindam, Bhaja Govindam,   

Govindam Bhaja muudha matey,   

Sampraapte Sannihitey kaaley,   

Nahi Nahi rakshati Du krun karaney.   

http://bhavanajagat.wordpress.com   

Nyctanthes. arbor tristis,Night-flowering Jasmine, The tree of Sorrow.

Nyctanthes. arbor tristis,Night-flowering Jasmine, The tree of Sorrow.

 

Dr. R. Rudra Narasimham,  

Kurnool Medical College, Kurnool, A.P., India,  

M.B.B.S., Class of April, 1970.  

THE FREEDOM FROM SICKNESS-SARVE SANTU NIRAMAYA

Posted on by
2

THE FLAG OF INDIAN ARMY MEDICAL CORPS: DULL CHERRY WAS THE COLOR OF THE ROYAL ARMY MEDICAL CORPS.SIGNIFIES POSITIVE HEALTH AND FREEDOM FROM SICKNESS. BLACK WAS THE COLOR OF INDIAN HOSPITAL CORPS. SYMBOLIC OF BIRTH AND DEATH. OLD GOLD WAS THE COLOR OF INDIAN MEDICAL SERVICES WHICH EXISTED BEFORE 1943. IT IS THE SYMBOL OF SUN GOD AESCULAPIUS, THE GOD OF MEDICINE. ARMY MEDICAL CORPS CAME INTO EXISTENCE ON JANUARY 26, 1950.

SARVE SANTU NIRAMAYA :

The motto of Indian Army Medical Corps is “SARVE SANTU NIRAMAYA”. This is an idea expressed in ‘UPANISHADS’. The hymn appears as a benediction to invoke “PEACE” and hence is known as a ‘Shanti Mantra‘. It reads as follows:

OM, Sarve Bhavantu Sukhinah,

Sarve Santu Niraamayaah,

Sarve Bhadraani Pashyantu,

Maa kaschidh duhkhbhaag Bhavet.

May everybody be blessed with happiness,

May everybody live in perfect health free from sickness,

May everybody be assured of well-being(lead a life that is safe and secure),

May there be no mental thought that could arouse sorrow or grief.

POSITIVE HEALTH AND COMPREHENSIVE HEALTH CARE :

The ideas of freedom from misery and sorrow, and the state of happiness are clearly associated with freedom from sickness and complete well-being of an individual. Health is defined as ‘the state of complete physical, mental, and social well-being, and not merely the absence of disease’. The health care program must embrace all the three aspects of a disease; the preventive, the curative, and the restorative care of an individual.These three aspects of physical, mental, and social well-being are interrelated, interdependent and contiguous. The medical care should be ‘patient centered’ rather than being ‘disease centered’. Comprehensive Health Care can be described as the health promotive, health preservative, preventive, curative, and restorative health care of all individuals, at all stages of life from conception to the grave, and in all spheres of life such as home, school, work place and in the community. In the Armed Forces, the medical practitioner gives attention to any condition considered responsible for deterioration in health or likely to affect adversely the health, morale, and welfare of the personnel under his medical care. The Medical Officer in the Armed Forces not only promotes, preserves and protects the health, but also he periodically carries out an assessment of the environmental, living and working conditions of the personnel under his medical care. The threats to human health and well-being come from several directions and tragically very healthy individuals may sometimes succumb to sickness and the causative factors of several diseases still remain a mystery. Cancer is one such disease which poses a challenge to our motto of achieving ‘freedom from sickness’.

ONCOLOGY – THE STUDY OF NEOPLASMS :

The word ‘Oncology’ is derived from the Greek word of mass which denotes a swelling or a new growth. A new growth or neoplasm could be ‘benign’ or ‘malignant’. The ‘benign’ growths are relatively harmless and they may not invade other tissues of the body but can contribute to some functional impairment. The ‘malignant’ growths are dangerous to life as they tend to invade other tissues and spread to other distant sites in the body. Apart from this ‘invasiveness’, the malignant cells display uncontrolled growth and could cause a very rapid deterioration in the state of health of a victim. The term ‘CANCER’ is used to describe a wide variety of malignant diseases. The factors involved in the causation of many of these diseases still remain unknown. Next to Heart Disease, Cancer is a most common cause of death. Cancers could be grouped into three major groups;1. the Carcinomas which arise in endodermal or ectodermal tissues known as epithelial tissues. Breast and Colon Cancers are well-known Carcinomas. 2. the Sarcomas are fleshy tumors, arise from mesodermal tissues, the connective tissues like bone, cartilage, and fat. Sarcomas of soft tissues constitute only 1 percent of all malignant tumors and they may occur at any location in the body. Roughly twenty different types of Sarcomas are described. 3. the Lukemias and the Lymphomas which are derived from the blood cells and the cells of the Lymphatic system. A fundamental principle of Cancer treatment is to establish the pathological nature of any growth suspected of being neoplastic before making decisions about its management. This usually involves a ‘BIOPSY’; taking a sample of the tissue from the suspected lesion and subject it to a microscopic examination and a histological evaluation to determine the nature of tissue and the cell type involved. While an early diagnosis is very helpful, the survival of the victim mostly depends upon the nature of Cancer.

TWO RARE CASES OF CANCER IN PERFECTLY HEALTHY INDIVIDUALS :

I had served as the Regimental Medical Officer at the Army Ordnance Corps Centre, Seunderabad, India from December 1978 to January 1984. I would like to narrate the stories about two individuals who had served at the AOC Centre who were in great physical shape prior to becoming victims of Cancer. The first case in 1979 involved Lieutenant Colonel D’ Souza, the Commanding Officer of No. 2 Training Battalion of the Centre. He was very tall, handsome, with a well proportioned body built. He was picture-perfect and had no unhealthy habits like smoking. He walked into my office around 10.00 A.M. with a slight expression of a concern on his face. He came to ask me about a pea-sized, painless swelling he had noticed on the gum pad of his left upper incisor tooth. The swelling was of very recent origin and could be easily noticed while brushing teeth. It looked reddish and there was no other discomfort caused by it. I had immediately diagnosed it as a neoplasm(new growth) as I could easily exclude all other possible conditions. He had perfect healthy teeth and gums and had no other medical problems. The Military Hospital and the Military Dental Centre are at a short distance from the AOC Centre. I had told him that I would not prefer to refer him to either of those two places. I had told him that the only way to know the diagnosis of that tumor would be by getting a Biopsy report and the earliest way to obtain the Biopsy report would be from the Osmania General Hospital, Hyderabad which is a Post-Graduate Medical Institution which conducts medical research. The Military Hospital has no qualified Histopathologist and cannot provide the report that I had wanted quickly. He proceeded to Hyderabad and had undergone the Biopsy test as recommended by me. I remember Col.D’Souza and my meeting him at AOC Centre Medical Inspection Room. He had returned to me with the report after two days. Col.D’ Souza fully understood the gravity of the situation and the report that he had in his hand. Apart from the Military Hospital, we had hundreds of Specialists in the twin cities of Hyderabad and Secunderabad. He never thought of asking any one or consulting any one about his illness. He had trusted me because he knew that I was truly involved and concerned about his welfare. The Biopsy report suggested that the tumor was an ‘Angiosarcoma’, a very uncommon malignant neoplasm derived from the blood vessels, the vascular endothelial cells that line the inner walls of the blood vessels. It is al
so an extremely unusual presentation for this type of tumor. When we had discussed the Biopsy Report, he was very calm, very well composed and took my advice without show of any anxiety. I am very happy for having met a brave man like Col. D’ Souza. On the very same day, I had arranged for his admission to the Military Hospital, Secunderabad and an immediate transfer to the Malignant Disease Treatment Centre in Pune. In spite of this early diagnosis and very prompt hospital admission and Cancer therapy, he did not survive and I had missed seeing him again.

The second story involved a very fine athlete who had already participated in several events both at National level and at International level and had won prizes. The top athletes who belong to the Army Ordnance Corps are usually posted at AOC Centre, Secunderabad and the Centre took a great pride in having them there. This had happened in the year 1983. This tall, well-built and muscular sportsman who held the military rank of Junior Commissioned Officer, had noticed a painless swelling, about the size of a small orange, on his trunk, on the back near his waistline and had immediately reported his problem to his Battalion Commander at the Centre. The Battalion Commander wanted to get the swelling treated immediately and took this athlete direct to the Military Hospital and showed him to Lieutenant Colonel TMB Nambiar, a Surgical Specialist.Dr. Nambiar, whom I knew personally, is a kind and compassionate person, soft-spoken and gentle in his attitude and bearing. This Surgical Specialist who was apparently preoccupied with his plans for leaving the military service made no attempt to arrive at a proper diagnosis. He had misdiagnosed the swelling as a pyogenic abscess and immediately performed a minor surgical procedure called ‘incision and drainage’ to empty the contents of that swelling on the back.He made no attempt to send a sample specimen to the Hospital Laboratory to ascertain the nature of infection if any.The Surgical Specialist had further prescribed a course of antibiotic injections for seven days and had assured the athlete that the problem would be resolved.I have problems with this type of case management. The lump/swelling in the back was soft like an abscess but the clinical findings suggested that the lump was seated in the muscles and there was no reason to consider it to be infective in origin. The patient had no underlying problems like Diabetes or infections like Tuberculosis, or poor nutrition or lack of personal hygiene that could have contributed to a pyogenic abscess. If it was an abscess, he still needed admission to the Hospital and a full evaluation of any underlying disease. It would be very exceptional for a healthy male adult to suffer from a large abscess. At the end of the antibiotic treatment, the Surgical Specialist was gone and was not available for making an evaluation of the patient’s condition. This fine athlete and his Battalion Commander came over to my residence in the evening to discuss this health problem. The Surgeon had assured them that the swelling would go away and it was not so. The swelling had not only reappeared after the surgery, it was also growing in its size.When they walked into my living room and as I asked them to be seated, I could immediately recognize that the athlete was in great danger and that was an insight, an impression I got from his facial expression. He had briefly explained his story and the treatment as an outpatient at the Military Hospital. I had examined the swelling on his back and could immediately diagnose it as a very serious case of a Cancer, a malignant tumor which had already invaded other tissues and had spread to the nearby lymph nodes. This Cancerous growth was in his back muscles and is often described as Rhabdomyosarcoma. I was astounded by the fact that a qualified Surgical Specialist in the rank of a Lieutenant Colonel at the Military Hospital had misdiagnosed the condition and had subjected this patient to unnecessary treatment. The diagnosis of Cancer was so apparent in this case, I did not need a Biopsy report to confirm it further. I regretted the fact that precious time was wasted by this Surgeon. I had arranged for his admission to the Military Hospital and an immediate transfer to the Malignant Disease Treatment Centre at Pune. Within a few hours of time, after consultation at my home, this great athlete who was in the prime of his Sporting career, boarded a train in Secunderabad on way to Pune for his Cancer treatment. Just like Col. D’ Souza, this Junior Commissioned Officer received my advice with a sense of calmness and I take pride in the fact that Indian Army has brave and courageous people who receive news about life threatening conditions with a sense of maturity and without show of any anxiety.

In both of these cases, I was very hopeful that they would survive and return to the Unit. Unfortunately, their Cancers were very aggressive in nature and the Cancer won this unfair battle during their initial course of treatment at MDTC, Pune.

MY RECOMMENDATIONS TO INDIAN ARMY MEDICAL CORPS :

I had reviewed the Manual of Health for the Armed Forces-1968 Edition. Chapter VI – Assessment of Health and Hygiene in the Armed Forces and Chapter X- Health Care deal with the duties of Regimental Medical Officer. We should involve the Medical Officer to a fuller extent in case management. It should be mandatory for the Medical Officer to visit his Unit personnel who are admitted to a Hospital and enter a written report about the case management. The Unit Medical Officer should be officially informed when his patients are placed on ‘SERIOUSLY ILL LIST’ or ‘DANGEROUSLY ILL LIST’. This official notification should constitute the authority for the Medical Officer to visit his patients in the Hospital and if required to proceed on Temporary Duty to the Hospital. The Medical Officer should be given additional training to provide psychological and grief counselling to his patients and to the immediate family members. The Medical Officer should be able to refer his patients and their family members for further appropriate psychological counselling. The rules for medical evacuation should be amended and we should authorize and provide qualified medical attendants to support the mental, and social well-being of individuals apart from providing routine curative care and management during the journey. The Army Medical Corps is not a Charity providing Compassionate Care. We have a duty to provide the Health care that we provide and we need to express the spirit of our Motto through our actions. If there is no freedom from sickness and disease, we can still excel in providing mental comfort and social support to our patients and their immediate family members. Kindly share my concerns with others who may be serving in Uniform and Army Medical Corps should deliver in accordance with its Motto. If you have any questions, please contact me using my e-mail address:

rebbapragada@sbcglobal.net

Bhaja Govindam – Part III :

The Art of Diagnosis has no further value apart from knowing the nature of the threat faced by humans and there are several medical conditions where the outcome ultimately depends upon the nature of the underlying problem. However, knowing the reality is equally important and it helps us to face the consequences and at the end the sweet name of ‘GOVINDA’ is the only consolation we have while preparing to lose the battle against Death.

Bhaja Govindam, Bhaja Govindam,

Govindam Bhaje muudha matey,

Sampraapte Sannihitey kaaley,

Nahi, Nahi rakshati Du krun karaney.

Dr. R. Rudra Narasimham,

Kurnool Medical College, Kurnool, Andhra Pradesh, India.,

M.B.B.S., Class of April, 1970.

NINE YEARS SERVICE MEDAL – A SALUTE TO THE LAW OF TEMPERANCE

Posted on by
3

John Milton (1608-1674). Milton wrote many of ...

Image via Wikipedia

NINE YEARS LONG SERVICE MEDAL AWARDED BY INDIAN ARMY SYMBOLIZES GOOD CONDUCT AND TEMPERANCE

THE LAW OF TEMPERANCE  :

John Milton (1608 – 1674), in his greatest poetic achievement of ‘PARADISE LOST’ describes Man’s First Disobedience of God, and the loss thereupon of Paradise wherein Man was placed. Adam, the first Man who was created in God’s image and likeness brought Death into the World. God declares that Adam and Eve could no longer abide in ‘Garden of Eden‘, the Paradise. God sends Angel Michael with a Band of Cherubim to dispossess them. Michael reveals to Adam the ‘Law of Temperance’ which could help him to live for many long years. Angel Michael also comforted Adam by assuring him that if he observes the ‘Law of Temperance’, Death would be like the gentle act of gathering a ripe fruit when fully mature.

PARADISE LOST, BOOK XI ( 520-540)  :     

 

 

 

In John Milton's epic poem of Paradise Lost, angel Michael explained 'The Law of Temperance' to Adam, the first created man to face the threat of death.

 

I yield it just, said Adam, and submit.

But is there yet no other way, besides

These painful passages, how we may come

To Death, and mix with our connatural dust ?

There is, said Michael, if thou well observe

The rule of not too much, by temperance taught

In what thou eatst and drinkst, seeking from thence

Due nourishment, not gluttonous delight,

Till many years over thy head return:

So maist thou live, till like ripe Fruit thou drop

Into thy Mother lap, or be with ease

Gathered, not harshly pluckt, for Death mature:

THE NATURE OF TEMPERANCE  :

The essence of Temperance is choosing moderation and deliberately avoid excess. In Indian Culture, and Tradition, living in moderation and living in virtue are almost identical. Socrates suggests that one should “choose that which is orderly and sufficient and has a due provision for daily needs”. He compares the intemperate man “to a vessel full of holes, because it can never be satisfied”. Socrates describes the temperate man as able to satisfy his limited desires, whereas the intemperate man of boundless desire, can never pause in his search of pleasure. According to Freud, when “the ego learns that it must inevitably go without immediate satisfaction, postpone gratification, learn to endure a degree of pain, and altogether renounce certain sources of pleasure”, it “becomes ‘reasonable’, is no longer controlled by the pleasure-principle, but follows the reality-principle”, which seeks ” a delayed and diminished pleasure, one which is assured by its realization of fact, its relation to reality”.

TEMPERANCE AND COURAGE  :  

 

 

 

 

 

 

Saint Thomas Aquinas and 'The Law of Temperance'.

 

Thomas Aquinas has defined Temperance as “a disposition of the soul, moderating any passions or acts, so as to keep them within bounds. Temperate refers to a man who abstains from bodily pleasures and delights in this very fact. A man not only acts temperately, but is temperate in character, when his desires are themselves habitually moderated to be in accord with reason. A temperate man is not pained at the absence of pleasure or by his abstinence from it. Temperance contributes the virtue of Fortitude which strengthens men against “the enticement of pleasure” as well as against the fear of pain. A man who is able to stand firm against the onslaught of pleasures is more able to remain firm against the dangers of death. And so “Temperance can be said to be Brave”. The endurance of pain is central to the nature of Courage. Temperance and Courage are not distinct virtues as both are based upon an ability to stand firm against pain and danger.

NINE YEARS LONG SERVICE MEDAL – A SALUTE TO THE LAW OF TEMPERANCE  : 

During my service in the Indian Army Medical Corps, I learned the values of Temperance, Fortitude, Courage, and delaying gratification of desires, and avoid seeking physical comforts and pleasures.

 

During the first nine years of my Indian Army Service, apart from taking part in the War of Liberation of Bangladesh, I had participated in a variety of Army Operations that keep the men ready and prepared for a battle. Military Training and Service can be best described as habituation for a temperate character. The nature of Army Operations and Tactics always demand overcoming the onslaught of sense pleasures and voluntarily delaying the gratification of personal desires. A life style based upon physical ease and comfort, and indulgence in food and alcohol is not compatible with the Army way of life. The nature of Army Operations is influenced by terrain, climatic conditions, distances and the availability of transportation. There is no scope to cater for physical comfort, relaxation, and entertainment. The supply of rations and food provisions is limited because of the problems of their bulk and weight. Army Rules and the Code of Conduct would emphasize that men should honor their commitment to serve more than anything else. Such commitment to Serve with Honor would only be possible only when the man in uniform lives in accordance with the Law of Temperance.

Dr. R. Rudra Narasimham,

Kurnool Medical College, Kurnool, Andhra Pradesh, India,

M.B.B.S.,  Class  of  April,  1970.

Related Articles

WINNING PEACE – THE ART OF PREPARNG FOR WAR

Posted on by
Reply

Flag of Indian Army

Flag of Indian Army (Photo credit: Wikipedia)

 

 

CHIEF OF ARMY STAFF, INDIAN ARMY February 1, 1985 to May 31, 1988.

 

GENERAL KRISHNASWAMY SUNDARRAJAN(SUNDARJI), PVSM.  

 

We can not win peace if we are not ready for war. There will be no peace until we are willing to stand up to the challenge posed by the enemy. People who arrive at the battlefield fully prepared are more likely to display courage and the well-prepared are more likely to win. 

 

IS WAR AN ART FORM ???  

 

General Sundarji served as the General Officer Commanding, First Armoured Division of Indian Army during 1976 to 1978 and I had served in 55 Medical Battalion of First Armoured Division during that time. He would not let us give an excuse for not being prepared for the combat operations. He would stand next to me to check the expiration dates of the life saving medicines we bring to the battle and very often count the numbers to make sure that we carry enough quantity of each item that is included in our operational plans. Without preparation, no plan could be executed to accomplish its goal. While serving under his Command, I learned the importance of preparing for war. Shortcomings and deficiencies should not be ignored and should never be concealed. Being fully prepared boosts up the level of confidence and keeps up the fighting morale of men.  I was fortunate to learn from his experience and his insistence and expectation that people under his command should excel in the art of preparing for war. He was an exceptionally good task master and would not permit any second guessing when he inspected Units to evaluate their battle preparedness. He paid scrupulous attention to every detail and no aspect of preparedness was considered trivial and no shortcoming would escape his attention. Under the leadership and stewardship of General Sundarji( whom I consider as my ‘Guru’) I learned the basic method of preparing for battle. He is described as the scholar General, military genius of India and is well-respected for his professional acumen and candor. He was the first and the only Infantry Officer in the Indian Army till date to command an Armoured Division. My learning experience started upon my posting to the First Armoured Division in 1976 while General Sundarji served as its Commander. In India, the classical literature had always described the use of weapons as an art which like all other branches of learning requires a ” GURU “(Teacher) and the act of preparing for war needs a proper attitude, discipline and application. Modern Warfare is like a Symphony Orchestra where different players come together, work in harmony to provide an alluring musical experience. The actual warfare may provide images of violence but the preparation for war is more of an art form. Just like the practice for a great musical performance, each player should learn the notes, tune the instrument to play the correct notes and synchronize their moves with the rest of the team. My service in the Indian Army had given me the opportunity to master this art of preparing for war and I would consider General Sundarji as a great Master of this Art. 

 

YOU WIN PEACE WHEN YOU ARE READY FOR WAR :  

 

In early 1979, as tensions between India and Pakistan had increased and in response to Pakistan’s military build up and aggressive postures, India had demonstrated its willingness to accept the challenge by moving its fighting forces and conducted a massive operation near the Indo-Pak border in the Thar Desert of the State of Rajasthan. I was deputed to witness this military exercise as an umpire and was asked to report upon the performance of a Medical Battalion. The Battalion was commanded by a Lieutenant Colonel and was supervised by an Additional Director of Medical Services, a Colonel. From my experience at the First Armoured Division and the mentor ship of General Sundarji, I had acquired a sharp eye and a passion for details. During the course of the exercise, I had submitted several reports to the Deputy Director of Medical Services at the Head Quarters of the Southern Army Command. I had frank and open discussions with the Officers and the men of the Medical Battalion about aspects of their training and preparedness. I had accurately pointed out their shortcomings in training and their deficiencies in stores and equipment. I was pleased to hear from all of them that they would not mind any hardship or inconvenience and that they would prefer to retrain and improve their battle preparedness. My reports had helped the Unit to identify the areas of weakness and later the Medical Battalion was provided with the necessary retraining.   

 

The robust military response from India at that time in 1979 had forced Pakistan into a retreat and eased tensions between the two countries and averted the possibility of a war. From this experience, I learned that we can win peace when we are prepared for war.   

 

Please also read the blog post titled ‘Blessings for Peace’.   

 

http://bhavanajagat.wordpress.com/2009/07/04/blessings-for-peace/   

 

Rudra N. Rebbapragada/ R. Rudra Narasimham, B.Sc., M.B.B.S.,

 

Ann Arbor, Michigan, U.S.A.,

 

Organization: http://www.facebook.com/pages/The-Spirits-of-Special-Frontier-Force/362056613878227 

 

Indian Army Armoured Corps T-90 main battle tank

Indian Army Armoured Corps T-90 main battle tank (Photo credit: Wikipedia)