Justice Markandey Katju-
Doctors in several hospitals in several states in India are agitating for getting security, following the beating up of two interns in a hospital in Kolkata following the death of an old patient. The patient’s relatives were of the opinion that death was due to doctors’ negligence.
While one must condemn violence on doctors, the time has also come for doctors in India to introspect. In an article titled ‘White Coated Corruption’ published in the Indian Journal of Medical Ethics the author, Vijay Mahajan, writes: “India is said to have one of the most corrupt medical systems in the whole world. The situation has become so bad that patients today approach doctors with mixed feelings–of faith and fear, of hope and hostility.”
Mahajan then goes on to give details, showing how greed for making money and utter callousness has afflicted a large section of the medical profession. While no doubt there are many upright doctors, others have no ethics, some heartlessly fleecing patients, some prescribing unnecessary drugs ( hand in glove with the pharmaceutical companies ), some performing unnecessary operations ( as highlighted in George Bernard Shaw’s play ‘Doctor’s Dilemma’ ), and some even indulging in illegal organ trade ( as depicted in the novel ‘ Coma ‘ by Robin Cook ). No wonder that a large section of Indians has no respect for doctors, a few even resorting to violence against them.
To once again be respected by society doctors must remind themselves of their Hippocrates oath, and develop a spirit of service, empathy for patients, and sacrifice exemplified by the life of Dr. Dwarkanath Kotnis. I am giving here an account of his death written by his Chinese wife:
The Death of Dr. Kotnis
By his wife Guo Qinglan
At 6.15 a.m. on 9th December 1942, Dr. Kotnis breathed his last. He was just 32 years old. He had spent over 4 years in China during the War of Resistance against the Japanese, treating the wounded and sick Chinese.
On 27th November 1937, at the suggestion of the eminent American correspondent, Agnes Smedley, Zhu De, Commander-in-Chief of the Chinese Eighth Route Army wrote a letter to the Indian National Congress leader Pt. Jawaharlal Nehru expressing gratitude for supporting the anti- Japanese struggle of the Chinese people and requesting for support in the form of a medical team and medical supplies from India. Consequently, Pt. Nehru proposed that a Medical Mission be sent to China. China Day was observed all over India on 29th June 1938. Dr. Kotnis, who had qualified as a doctor from Bombay Medical College, saw the demonstrations in support of the Chinese, and determined to join the Medical Mission. He went to Sholapur, his home town, and told his family about it. At first, they tried to dissuade him, His brother Mangesh said ” For the sake of our education father had to borrow a lot of money. Now our parents are old and need a helping hand.” However, when his father saw that he was adamant he said ” So, Dwarka ( Dr. Kotnis’ first name), you have decided to go. I would like to remind you not to let the Indian people down. Since you have decided to go, you must do a good job and good things to the Chinese people, and win laurels for your family and country”.
At midnight, September the 5 doctors of the Aid China Medical Mission, led by Dr. Atal, boarded the P.&O. liner, S.S. Rajputana. They were seen off by Mrs. Sarojini Naidu and others. On 14th September they landed at Hong Kong, and after a 17 days voyage reached Guangzhou. From there they traveled by road to Changsha, and then to Wuhan, where they were met by Zhou Enlai, who asked Dr. Kotnis ” How old are you ?”. ” I am 28″, replied Kotnis.
“Wonderful” said Zhou Enlai, ” You can do much work for friendly relations between India and China”.
They traveled then to Chongqing, which was the capital of the Chinese government under Chiang kai Shek. At Chongqing, Dr. Kotnis received a letter from his brother in India, which was handed over to him by Dr. Cholkar, the deputy leader of the Indian Medical Mission. It said, ” Father has passed away suddenly “. This was a bolt from the blue, and he could not stop crying. His colleagues tried to persuade him to go back to India, but he said that he will never let his father down, and the best way to commemorate him was to help the Chinese people eject the Japanese invaders. So, he continued with the Mission to Yenan, where they lived in caves. They spent the next 4 years treating the wounded and the sick Chinese.
During these 4 years, Dr. Kotnis had overloaded himself with work for a long period until his health completely broke down working for the cause of the War of Resistance against Japan and liberation of the Chinese people. He went without food and sleep for long periods, and endured extreme pain during this period, and sacrificed all he had till his last breath.
On 7th December 1942, he performed operations on 5 wounded patients. On 8th December he taught his students and performed a practical operation for over 20 students in the operation theater. He was operating on a hernia patient. The operation was difficult as the tissues of the patient were very adhesive. Sweat started oozing out of his forehead as he was very tired. After the operation, Dr. Kotnis was completely exhausted and hungry. He grabbed a bite of a stuffed pancake when he suffered an attack of epilepsy. Earlier also he had suffered epileptic attacks. After regaining consciousness, he convened a meeting to have a briefing of the day’s work.
That evening he returned to his dormitory-cum-office, and started the compilation work of his proposed book ‘Surgery in Detail’. At 8 p.m. he went to his room to be with me and our 108 days old child. As he was talking, he remembered that the younger brother of his landlady was seriously ill. He went there to treat the patient and returned after 2 hours totally exhausted.
At midnight he asked me for some boiled water as he was thirsty. Having taken it he felt better, but an hour thereafter I was suddenly awakened by the groans of his pain, only to discover that all his four limbs were severely twitching. His complexion had turned pale. He had suffered another attack, and it was serious. I staggered all the way to the Medical School for assistance. After a while, Principal Jiang Yizhen reached our house in a great hurry. On regaining consciousness Kotnis said ” Principal Jiang, thank you for your visit. I am sorry to interfere with your rest. Please do not worry about me and go back to rest. ”
Principal Jiang was aware of the convulsions Dr. Kotnis had suffered in the past, which never exceeded 3 to 5 minutes. This time the convulsions would not stop, foam oozed out from his mouth, and he went into a coma. Dr. Jiang gave him morphine and camphor liquid but to no avail. The doctor then tried spine puncturing, but it was of no use. Dr. Kotnis breathed his last at 6.15 a.m. on 9th December 1942. He was just 32 years old.
I cried bitterly with my infant Yinhua in my arms and fainted a couple of times. He parted from me and our infant boy , his wounded patients who were waiting for him, his international friends, and the army and civilians of the Shansi-Qahar-Hebei Border Region who were engaged in a bloody battle with the Japanese on the battlefront. I glanced at the table only to see the manuscript of ‘Surgery in Detail’ that he had written up to page 175.
After his sudden demise, Dr. Kotnis’ dead body was kept inside a courtyard on a flagstone.
Dr.Kotnis had spent the last period of his life in Tang County, treating patients day and night. There was not a single person in this area who did not know him.
The sudden demise of Dr. Kotnis left everyone in the Tang County in grief, and even the Tang River wept. The people in the County felt they were rendered orphans. An atmosphere of grief shrouded the entire valley. The villagers of the Ge Gong valley came to our place from all directions. Everyone who came was crying in the streets and in the courtyard, where his body lay.
Shortly after his death, the Bethune Medical School, the Third Divisional Command of the Middle Hebei Military Region, and the County Committee of Tang County organized a funeral committee.
On 17th December 1942, around 1 p.m. the Shansi-Qahar-Hebei Military Region convened a mourning ceremony at the southern square of Ge Gong village. There was an ocean of people inside and outside the square. People from Shennan, Shenbei, Niangzishen Doufu, and other neighboring villages walked to the mourning ground wailing and weeping. Some of the country folk were even stamping the earth and crying bitterly. People had never witnessed wailing and weeping of such intensity, and that too over the demise of a foreign doctor. Many fainted with grief.
As for me, my grief was even worse. All my tears dried up and I fell unconscious. I lost my hunger, thirst and sleep, and became very weak.
The memorial ceremony was conducted in accordance with the Chinese traditional funeral. A canopy was put for the departed soul, in the middle of which hung a portrait of the deceased, and to both sides of the coffin lay the floral wreaths and mourning couplets offered by people from all walks of life. An oblong sheet of silk was hung with the words ” Doctor who rivaled the glory of Dr. Bethune”. The place was filled with posters stating ” Learn from Dr Kotnis “. The memorial committee consisted of representatives of Commander Nie, Zuo Huaiying, Cheng Zihua, Wang Ping, etc.
The memorial ceremony started with funeral music played by a military band, followed by floral tributes and bowing in silence, and then speeches commending Dr. Kotnis’ outstanding achievements and spirit. This was followed by a grand funeral.
Among the crowd were many elderly men and women burning incenses and paper money. Some people sang a song which they had composed for the occasion :
” You came from the shores of the warm Indian ocean
To brave the cold of North China
For the world of tomorrow
You fought four autumns in China
Alas! At the end of a long night
The fountain of your life ran dry
Oh, Comrade Kotnis, our beloved
Your image will always be with us
And your memory will live forever in our hearts”
The news of Dr. Kotnis’ death was soon carried to Yenan. On 18th December 1942, Zhu De, the Commander-in-Chief of the Eighth Route Army, and Peng De Huai, the Deputy Commander-in-Chief communicated the sad news to Dr. Kotnis’ family. The news was flashed in the Liberation Daily newspaper published in Yenan, carrying an article by Zhu De.
On 30th December, a memorial service was held addressed by Zhu De. He said ” Dr. Kotnis, our Indian friend, came to China from afar to assist us in our War of Resistance. He worked for four years in Yenan and North West China, giving medical treatment to our wounded and sick, and died owing to constant overwork. The army has lost a helping hand, and the nation has lost a friend. Let us always bear in mind his internationalist spirit “.
Zhou Enlai sent a message of sympathy to Dr. Kotnis’ family:
“Dr. Kotnis is a symbol of the friendship between the great Indian and Chinese nations, and a shining example of the Indian people, who are taking an active part in our common struggles against Japanese militarism and world fascism. His name will live forever in the hearts of the two great nations to whom he dedicated his life.”
Soong Qingling, the widow of Sun Yatsen and Chairperson of the China Defence League, also wrote to Dr. Kotnis’ family:
“His memory belongs not only to your people and to ours, but also to the whole roll-call of fighters for the freedom and progress of all mankind.”
[Justice Markandey Katju is former Judge, Supreme Court of India and former Chairman, Press Council of India. The views expressed are his own]