Mentoring in Surgery—Mentor, Parshuram, Dronacharya, Krishan

Abstract

Success in any profession has no well-defined predictors. Knowledge, skills, training, and talent come in plenty but fail at times to achieve the universal goal of success. Some attribute it to luck. Apart from the tangible ingredients of a successful career, the intangibles like luck or something ill-defined is a real challenge. The intangibles seem like a chasm, an abyss, or a phantom obstacle. Presence of a guiding spirit who can handhold you to overcome these is essential for success. The aim of a professional is to learn, earn, and yearn for creativity. Practice of surgery is an ideal career to pursue the learning, earning, and yearning. More than any other profession, the guiding handholding spirit is required in surgical profession, the concept of mentoring. Originating from the Greco-Roman times when kind Odysseus left his son Telemachus under the care of his friend, mentor, it has become a universal defining necessity for a successful career in surgery. Indian history replete with such examples of mentorship, good as in the case of Dronacharya to Kaurvas but bad as denied by an able, competent, aspiring student like Eklavya. In the medical profession, there are very few Indian role models of mentorship. One name that comes to our mind is Dr. Krishan Mahajan. The more said is less revealed about him. “Knife before wife” was his commonly spoken advice to all who sought his mentorship. “Hard work is not easy but it is fair” so said a famous boxer, Larry Holmes. It is more than true for our profession as it is better to prepare and prevent, rather than repair and repent.

“It wasn’t the ‘miracle of engineering’ that is the human body that was filling me with a mad desire to live my days and nights in a pair of scrubs”– Caterina Scorsone, Actress, Grey’s Anatomy

Surgeons for long have been enlogised and idolized in literature, cinema, and TV serials [1]. Thought to be better looking, they have been subject of scientific studies by nonsurgical colleagues for being smarter [2]. A survey published in Times magazine found surgeons to be the most attractive, most datable genera of doctors with the respondents believing them to be the most practically minded, possessing a high IQ, having the ability to remain calm in difficult situations, and above all for likelihood of being “good with their hands” [3]. These facts are enough to make us all feel good despite being skeptical of these attributes being possessed by us. But, if there has been one surgeon who graced these virtues, it was Prof. Krishan Chand Mahajan. He was respected, feared, envied, and sought in equal measure by the community at large beyond the medical profession. His stature and leadership was not confined to the self-congratulatory clinical associations or incestuous social glitterati. He shone above all as a lone star and stood as a lone wolf, according to the circumstances. He romanced the society at large with his passion for knowledge, currency of being informed, clairvoyance bordering intuitive abilities, pursuit of perfection in surgery, and missionary zeal to enhance medical academics in India, with a vision to erect institutionalized structures that will outlast any projections. His role in the foundation of Delhi’s first all gender medical college, i.e., Maulana Azad Medical College, and establishing the status of a benchmark institution in the private sector, i.e., Sir Ganga Ram Hospital, is a living testimony to his vision [4].

Born to Dr. Ram Chand Mahajan and Smt. Shakuntala Mahajan, at Lahore on 12 June 1923, he graduated from King Edward Medical College, Lahore, followed by the Fellowship of the Royal College of Surgeons (FRCS) of England, ahead of minimum mandatory period. During the 1947 riots when most of the Hindu Medical students were killed, and after being saved by the college principal (who smuggled him to his home, wrapped as a carpet), he chose to stay back till rescuing all Hindu nurses, despite his family having moved to Delhi. From 15 to 26 August 1947, he single-handedly ferried all Hindu nurses to safety across the Indian border. It was his innate human quality that made him a mentor for three generations of surgeons, who have all become leaders in themselves at the contemporary surgical scene. “A leader takes people where they want to go, a great leader takes people where they don’t want to go, but ought to be (Rosalynn Carter).” He was one such leader, who identified talent and nurtured it selflessly to put them in saddles of landmark opportunities. India’s first Department of Academics and North India’s torch-bearing organ transplant program are result of such leadership. Mentoring, as a concept is irrevocably married to medical science, especially to the field of surgery. He mentored talent with principles of ensuring faculty commitment to postgraduate teaching, emphasis on collegiality and camaraderie with residents, evidence-based clinical practices, and nurturing atmosphere of research. All this was possible because of his inexhaustible energy, sharp memory, and absolute clarity of his mind even in 9th decade of life. He preached and demanded excellence.

Being an admirer of Dr. SK Sen and Sadar Patel, he would often quote General Patton “If everyone is thinking alike, then somebody isn’t thinking.” He would say “Excellence can be achieved if you care more than others think is wise, risk more than others think is safe, dream more than others think is practical, expect more than others think is possible.” His advice to surgical academician was comprehensive from “The history of Surgery” to basic and clinical research and continued innovations with preemptive assimilation of technological advances. He believed a surgeon to be a well-read person besides medicine, a person of literature, arts, possessing leadership qualities in nontechnical subjects such as emotional skills, communication skills, and resilience. He would often quote Sir William Oster “One who only knows medicine, not even medicine knows.” He would encourage reading nonscience books, watching movies, etc. etc.

Like Mentor to Telemachus, son of Penelope and Odysseus, he gave his every bit of personal self to his mentees. His commitment and involvement with the personal lives of those around him, sets him many notches above the common percepts of mentor or guru. Continental history is much more elaborate about “Guru-Shishya” (mentor-mentee) connect than the short-lived Greek, Telemachus experience. Krishan, the boss or Dr. Mahajan, as he was known to us, blessed his mentees to outshine him like Ramkrishan Paramhans and Vivekanand. He was more understanding and compassionate than even the legendary Dronacharya. Mentoring in surgery requires not only professional equipoise but also a sense of special responsibility towards those who have been traditionally neglected in surgery such as women and left handers [5–7]. Dr. Mahajan mentored everyone, irrespective of handedness or gender, approaching him, directly or indirectly, irrespective of seeking his permission, consent, or being from any social order, and never demanded or accepted anything in return, what to think of a retributive thumb asking of Eklavya. He believed in the saying of Osho Rajneesh, “Because without trust, love is not possible.” His limitless trust in his mentees made him absolutely benevolent even when that trust was found misplaced. This made him rise above as the modern day Parshuram, who cursed his mentee Karan, of a lapse of memory, when the practice of learnt was to be called upon, in the most demanding of circumstances. He would take care of the needs and responsibilities of his mentees beyond the profession’s call. He will address the family by their first names and ensure that their children went to the best institutions in the world. When needed, for professional enhancement, he would send his mentees to other surgical leaders across the globe, a quality that is of Indian tradition. For, it was Arjun asking of Krishna, the reason of their 12 year exile that Krishna replied in the necessity of trials and tribulations to emerge in life as a fit persona to take on higher challenges. Similarly, Dr. Mahajan would task you to testing unpleasant situations. At times he, by proxy, would test you by fire further, as was the case of Arjun. Arjun, once in penance, while being attacked by a wild boar, shot an arrow but found the boar already gored by a preceding arrow charged by an apparent maverick. Realizing the supremacy in priori of arrow shooting, Arjun prostrated at the maverick to be revealed as Lord Shiva, who asked Arjun to seek further skills from Lord Indra. When under Indra’s training, Arjun refused to be seduced by Urvashi, whom he considered mother. Thus pleased, Lord Indra commanded Urvashi to train Arjun further in music, arts, dance, and Kama to remain unaffected by these charms, if used by enemy as strategies. Similarly, Dr. Mahajan would demand and inculcate social skills beyond surgery in his mentees.

He would keep their excitement in academic pursuit alive by allowing them to rub shoulders with the social glitterati et al. I wish to share one such moment when Devanand handed him his autobiography “Romancing with life.” He called me, and giving the book in my hand, asked me to write something on it, as if I was gifting it to him. And I wrote “To Sir with Love-Brij.” His social repertoire transgressed the boundaries of any expressive vocabulary.

Summing up a life as benevolently lived as by Dr. Mahajan is an awesome balancing to be done between assuaging the bereavement and cherishing the blessed memories that inspire those left behind. Do they belong to the mentor alone, no, for the mentor got credits for training Telemachus, the son of Queen Penelope with King Odysseus, while in reality it was Athena, the Greek Goddess of war who took the form of a mentor to raise Telemachus. Similarly, Dr. Krishan Chand Mahajan is not only the namesake of Lord Krishna but probably embodied his spirits to mentor many generations of surgeons. I feel as one of the specially blessed as he spent his last few hours alone with me. He sat with me as if in pink of health; he spoke with a clarity of voice that I had not heard in the last decade; his thoughts were as engaging as ever; he was as self-unconscious as ever and as indulgent towards me as ever. He did not betray even an iota of his illness; he enquired about each of my family members by name and had only one request for himself. That request was to take him out of CCU, to take him around the hospital, with a mother-like eagerness to see her child. He was not just a mentor, he was beyond Goddess Athena, was he like Krishna? But no, Krishna had only one Arjun, he has left behind many. Was he Bhishm Pitamaah? No, his dedication was not limited to building only one institution. Who was he then? He was Rama, Krishna, the son of Ram Chand Mahajan. Like Rama, he was committed to righteousness whenever it was, in whosoever it was, he was there by side with an equipoise to righteous people sans personal stakes. Like Rama, he completed his vanvaas on 18 January 2015 to return to the holy abode he belonged to. He was born on a Tuesday and consigned to energy on a Tuesday. He was a supersoul and he lives on. For the soul never dies. I continue to feel the warmth of his presence as I write this. Obituary is derived from “obitus” meaning “departure” or “encounter.” We continue to feel your continuous encounter with us in all our actions to guide the future. We will carry forward your dreams as perceived in my last encounter with you hours before your departure echoing “What dreams may come, When we have shuffl’d off this mortal coile, Must giue us pawse.” We will wear your dreams as our second skin.

Love you Sir.