A Tribute to Dr Manu Kothari by EPW

A tribute to Dr Manu Kothari (1935-2014), Emeritus Professor of Anatomy, Seth G S Medical College, Mumbai, a pioneer of the propagation of fundamental truths about cancer.

Published in Economic & Political Weekly (Vol. 49, Issue No.45, November 8, 2014)

by Sthabir Dasgupta (sthabir@yahoo.com) (one of Kolkata’s leading oncologists)

One of the pioneers of the propagation of the fundamental truths in medicine, and cancer treatment in particular, a prolific writer, eloquent orator, a teacher of teachers and a medical-philosopher colossus, has passed away at his residence in Mumbai at a “viable, die-able age”, in peace.
The inevitable has happened, but all who came across this gentle colossus as students, as colleagues, as patients or even as simple acquaintances are destined to cherish his memory, his evergreen smile and sharp wit. His profound knowledge and yet, his simplicity, his uncanny interest in exploring an uncharted sea, his humour, his enviable grasp of the philosophy of medical science would certainly enthuse his students for decades to come. Unconventional as he was in thinking, after having qualified as a surgeon with flying colours, he opted for a post of a teacher in anatomy in his Alma Mater, for anatomy was for him, akin to the science of Atma (An-atmi).
His long, uninterrupted, 60 years of association with Seth G S Medical College, Mumbai, first as a student and finally as Professor Emeritus in anatomy, has enriched everyone around. His brilliance as a mere student took even Dr Hamilton Bailey, the world famous author of textbooks in surgery, by pleasant surprise. In December 1955, while still an undergraduate student, he wrote to Bailey about his own observation that in inflammations of the hip, how the deformity could be measured visually without moving the patient’s painful limb as was advised. The great author had appreciated it in the 13th edition of his Demonstrations of Physical Signs in Clinical Surgery in 1960.
This humane approach remained the leitmotif all his life. He was a pioneer from the eastern world to challenge the then US President Richard Nixon’s call for a war against cancer by publishing his huge tome as early as 1973, The Nature of Cancer. In this work of research he had unmistakably shown, even with the help of the conventional literature that cancer is a normal stage of a dividing cell that has a “cancer genome”. A cell endowed with the cancer genome pushes it into the cancerous state and therefore, the only sustainable difference between a normal and a cancer cell is in its behavioural pattern. Having proved this, he had exposed the myths around cancer, its early detection, the methods of treatment and the results thereof. This led him to declare not to trouble this trouble of cancer, unless trouble troubles us, and to trouble our trouble only to the extent that it troubles us.
Ivan Illich, the famed philosopher and maverick social critic, while saying that Dr Kothari’s work was a “revolution within the politics of health”, suggested a condensed version of this book. Thus, Cancer: Myths and Realities of Cause and Cure was published in English, German and Dutch in 1979, and in Gujarati in 1988. The same version was edited and published in 1994 as The Other Face of Cancer which has been translated in a number of Indian languages till date, for its immense popularity and appeal to the lay and the learned alike.
Needless to say, despite respectful reviews of these books, the cancer establishment has chosen to remain blissfully unaware of the concept of “cancerrealism”. It has never rejected the thoughts and arguments of Dr Kothari with counter­arguments either. It has simply ignored him. However, it is interesting to note what in 1977 the then director of the famed Sloan Kettering Institute, New York, Dr Lewis Thomas, an equally famed bio-philosopher, had to say after having a long discussion with Dr Kothari: “You are largely right about cancer. But we are so politically committed to the cure of cancer that we have no courage to tell the truth to the public.”
It is more interesting to note that today various cancer experts from the western world are admitting the basic tenets of Dr Kothari, saying for instance, that the war on cancer was misplaced, surgery triggers the spread of cancer, early detection is a myth and a hoax and cancer is a social obligation, for one in five persons in the human herd runs the lifetime risk of having cancer. We are amused to see that Dr Kothari’s name has still remained conspicuously absent in these western literatures. We are more amused to see that the so-called Indian experts are still keeping themselves ignorant with contemptuous silence. However, we also know that they are destined to accept him, in time, because for them whatever emanates from the West is the best.
It is true that today’s shifting winds of fashion will fail to measure the stature of this archaeologist of ideas, but those who are fortunate to have worked with him will now find it hard to replenish the void. His numerous students spread all over the globe will always remember that anatomy is not just a study of the structure of the human body, but a study of a work of Art of nature. His teachings must have been engraved in their minds that “bipolar harmaphroditism” is the very nature of a somatic cell and “the basis of its being and becoming”. His erudite editorials in various medical journals remind us of Richard Feynman who said: “Science is the belief in the ignorance of experts.”
The Himalayan contribution that he has made to the intellectual, medical mind while travelling through the various terrains of medicine with ease was only possible because of his simplicity and the happiness that emanated from the core of his heart. He used to say off and on that “truth is simple while falsehood is extremely complex”. In the same tone he used to tell his students: “Don’t strive to be happy; be happy”. This happiness, despite the grieving experiences in his personal life, drove him to write dispassionately with a scientific temper and speak endlessly and untiringly on life, disease and death. Thus Death: A New Perspective on the Phenomenon of Disease and Dying was published in 1986 from the UK and the US. Its Indian version, published in 1992 as Living, Dying, drove home the point that death and disease are independent: while death is a function of time, disease is a function of body.
Humane Approach
Any serious reader, while going through these books, will understand how disease and death have been commercialised in the modern world, in the name of scientific achievement. They will understand the utter falsehood of the medicos and medical writings which portray disease as a conquerable enemy, and death as an avoidable nuisance. He successfully exposed this paranoia of over-investigation and overtreatment, producing astronomical bills and “iatrogeny”, that is, disease caused by treatment, and thus causing further disease and ultimately, a painful death.
This humane approach, along with a critical, scientific mind, drove him to write books like Revisiting High Blood Pressure, HIV-AIDS Revisited, Immunology Revisited, The Fourth Gender, and Gaia’s Will: The Dying Declaration of Mother Earth. All these writings have opened the windows of newer, intellectually sounder orientation and put the laymen into the position to use expert advice rather than to be used by the experts. It is to be mentioned, however, that most of his writings were co-authored with his student and later colleague, Dr Lopa A Mehta, while a few are also by Dr Atul Goel, Dr Vatsal Kothari and Dr Jyoti Kothari.
The present writer has always regretted for not having a teacher like him in his entire medical career, but felt most fortunate at the same time, for being able to be associated with him very closely for the last 10 years or so, academically and also professionally. It seems difficult to forget his words that a good death, a happy one at that, is “a crowning glory to a good, happy life”. He has indeed lived a happy life and enjoyed it to the hilt with his wife, a gynaecologist, his son, a well-known physician, his daughter-in-law, a paediatrician, and his most lovable, five-year-old granddaughter.
One is aware of T S Eliot saying “Where is the Life we have lost in living? Where is the wisdom we have lost in knowledge? Where is the know­ledge we have lost in information?” Dr Manu Kothari, however, was a typical antithesis who said, “At birth, the cosmic completeness takes shape as a carnal being, which at death once again merges into the cosmic completeness. Completeness IS.”