transcript of talk given by Yogesh Kalkonde during OYE TALKS 1.0 on 12 August 2018
We’re almost getting into the afternoon and I have this
challenging task of speaking at the last after such fascinating talks.I heard Shubham
and I thought, what was I doing when I was in 10th grade?
For some of you who might think that you missed the bus, I am
an example of someone who is still figuring out how to live life. I’m a slow
learner – a very slow learner. I’m a guy who is still trying to figure out what
it means to live. We are all given life only once and it’s like a journey. A
journey starts when you are born. One day you’re going to be dead whether you
like it or not. So we have one chance to live this life and we’re here to
figure out, how to live it. This is sometimes seen as a philosophical question
and sometimes thought of as a very hard question. But the key is, if we do not
think about ourselves who else will?
So I’m going to share with you this journey and the thoughts
behind this journey. People think that I’m crazy to quit what I was doing in
the US and come back and work in rural Gadchiroli. People think that’s something
very different. So what I’m going to share with you is why I did this, why I
did this stupidity. Essentially, it’s a search for a mission and meaning and
it’s a search for myself that I am still continuing.
I’ll start my story: I grew up as a child in rural Marathwada
and Vidarbha. My Dad was working in State Bank of India, so he would keep on
travelling from one place to another like a modern nomad. All my schooling
until I came to 9th or 10th grade was in different places.
When I look back at my life, I realize that as students we are all facing
confusion: Whether I should take this branch or that branch. We are constantly pestered
with this thought. When I started as a child, I was fortunate that I started
with a period of no confusion. So when I was growing up as a child in rural
Marathwada it came to my mind that I want to be a doctor. It was pretty simple –
I met a village physician who was practicing there and I was so motivated by
him that I said I want to be a doctor. The journey started and it was a fairly straight
But in the medical college, a thought came to my mind that I
want to do something different. I don’t know where this thought came from. But
that thought came – that I want to do something different. And one of the images
that would come to my mind often is that I don’t want to be a sheep in the
sheep herd. I don’t want to live like everyone else. And that’s just a thought,
I still don’t know where it came from but that was a very bothering thought in
my mind. So then, while I was studying I was trying to grapple what subject I
should study. At that time it was very hip to be a cardiologist. In our
profession you have God then you have cardiothoracic surgeon and then you have
cardiologist. So everyone wanted to be a cardiologist. And my mentor who was a
Professor of cardiology made sure that I visit all the places, important places
in India to learn about cardiology. And after the visits he said “Yogesh, do
one thing – be anyone else but a cardiologist.” I was very puzzled, why is this
guy, a professor of cardiology, trained in the US, very eminent cardiologist in
India, he’d sent me to all the big cardiology hospitals and then he’s saying that
be anything but a cardiologist!? So he said, ‘Go into a branch where you can
make a difference’. So the two branches that came into my mind were IMMUNOLOGY or
PUBLIC HEALTH. At that time immunology was a very new science in India and I
got fascinated by immunology because I liked the books. I found a book on
immunology which was very pictorial. You guys might find this strange but in
those days books never had pictures. So this was a really pictorial book that
through cartoons explained immunology. I thought, this looks like something
exciting – I should look into it. And the other was PUBLIC HEALTH.
Public health is where you work with communities to improve
their health. As a doctor we are sitting in the clinic and we see one patient
at a time and try and make a difference. While in community health you go and
you use strategies to improvise community health. So I had these two options. I
had a fork, decision fork and I had to make my mind whether it is IMMUNOLOGY or
PUBLIC HEALTH. I like both subjects very much. In fact public health, I liked
it so much that in my exam I had this habit of drawing a diagram. If you don’t
know, like all students know how to answer questions we get in exams. So I had
a trick to solve the questions, I would draw a big diagram. And in that diagram
I would just cover whatever I had to say and then just write a few lines to
cover it up and in public health we had a short note on something called as
iceberg phenomenon. What it means is that as a doctor you only see the tip of
the iceberg, the rest of the problem is in the community and it is a huge
problem. So I was so fascinated by that, that I thought I would draw a very
good diagram. So I sat there and drew an iceberg, drew a ship and drew a doctor
with binoculars you know looking at the iceberg and then I drew I diver – completely
drew a diver then labelled it as an epidemiologist, meaning someone who
understands the community. And what was the end result? I really liked the diagram;
I spent almost 30- 45 minutes of the exam time drawing that diagram. So you can
expect what the result would be! I was very fascinated by it. And the reason
was in my public health or community medicine I ended up scoring 45 marks out
of 100 in theory. And that was the first time I ever got 45 marks. In those
days it used to be called condo. So you pass by condo meaning that’s you know
grace. I was very shocked because I lost the university’s gold medal because of
these 45 marks and I was very down. My Grandfather said a very important thing.
He said, “If you really want to make a mark in public health go do public
health. Don’t crib about that gold medal.” I took up that message. So, these
were the two things that I had to face. All of us are always confused while
choosing an area, whether I should do this or I should do that. If I want to understand what immunology is, how do I do it? The
answer is very simple, go work in immunology. During the time I started looking
where I can do immunology, there was only one institute in the country, known
as SGPGI Lucknow. It’s a postgraduate institute and it was the only place in
the country which had an immunology department. I went there and I told the
professor that I want to work in the lab. And the professor said “Are you
crazy? You’re a doctor, you’re supposed to treat patients.” I said no, I want
to work in the lab. He replied “Okay, but your salary will go down from 20
thousand a month to 5 thousand a month, are you okay?” I said I’m fine with it
because I love immunology and I really want to understand it. I made a switch
from clinical care, from seeing patients, to completely working in the lab and
took a salary of 5 thousand and I was really fascinated by it. To the extent
that my professor who questioned me, said that “I think you are really
fascinated by it. Go work at a higher place”. So I went to the National
Institute of Immunology in Delhi and from there, the journey took me to a place
called University of Texas, Health Science Center in San Antonio. And I was
working on the role of certain molecules in the brain and it was absolutely
fascinating. Imagine! You are the first one in the world who is working on that
molecule, who is trying to figure out how that molecule works in the brain and
it was an uncharted sea.
So, everything looked very fascinating, I was very happy,
living in the US. Although I was not making too much money, I was very happy
with a very comfortable lifestyle until I had an experiment which failed. Failing
of experiments is the routine, right? Whenever we say we are experimenting
there’s a very large risk of failing. So we were used to failing of experiments
in the lab. You work on a project for a year and you might get one positive
finding. So you know you are geared towards constantly working, constantly
thriving for that one important result. But this experiment was slightly
different. And how was it different? I ended up spending two thousand dollars.
I was trying to purify a protein and the whole kit cost two thousand dollars. I
finished the experiment; two thousand dollars were washed away in four-five
hours and I had a question from inside: do I have a right to do this? As an
Indian, within a span of four hours I blew away two thousand dollars. Two
thousand dollars in those days were one lakh rupees. So in those one lakh
rupees I could have saved 500, 600 lives. So instead of doing that, I was just
doing something just for my own intellectual kick.
And suddenly, I found life again unsettled. So, I wondered what
do I do? How do I solve this problem? And it raised a bigger question: how do I
spend my life? So the choice I had was something I was doing for my own
intellectual kick versus something more useful. And so, to seek answer to this
question I made a visit to SEARCH: an NGO run by Dr. Abhay Bang in Gadchiroli
in 2007. At that time, I was working in a place called Baylor College of Medicine
in Houston, which is the biggest medical center in the world. You might have
heard of a place called MD Anderson Cancer Center: it’s a huge institute with
40 other institutes which are in this area. My journey has been a transition
from the world’s biggest, largest medical center to Gadchiroli, a large area of
forest and farming communities. I had an opportunity to meet someone called
Anjana Bai who actually initiated me into public health and that remains the
important image that changed my life. She was supposed to take care of new born
babies, as infant mortality rate is a huge problem that we have. A large number
of children do not make it to their first year. In Gadchiroli there are no
Doctors, Dr Abhay Bang trained the army of community health workers. Like Anjana
Bai educated till 7th std because her father couldn’t support
education further. I saw Anjana Bai washed her hands with soap and she was
standing with her arms in air, and I was puzzled thinking why is she standing
like this. So I went and asked her, to which she replied: if I use a towel it
will get dirty again. And I was shocked. It hit me that, in US people do follow
protocols and here is a lady in a place like Gadchiroli, following protocols.
For the first time in my like, I thought there is hope in India.
When I ran away to US, I was disappointed thinking nothing
can happen in India, and here was Anjana Bai, who was 7th grade
pass, showing me the way.
With the help of such community workers SEARCH could reduce
infant mortality rate by 50% at the cost of 7 dollars per life saved.
I call Anjana Bai my guru because she showed me the way – by
doing the right things you could do magnificent things in life.
And then after meeting her in 2007, while we were still
working in US, my wife Mrunal and I saw this and thought, we would quit and
come back. And I was fortunate enough to have Mrunal by my side, who agreed to
my decision. So, we had to complete our training and decided to come back.
What helped us make this transition: There is
chapter in Mahabharata called Yaksha Prashna, which are difficult questions of
life, which Yudhishtir had to answer before the Yaksha could make the other Pandawas
alive, because they died as they could not answer all the questions.
So, I am very thankful to people who asked me questions,
because this transition was possible only because I was able to answer these 4
questions and we could adopt the right attitude. Let me share them with you –
The first question was “But you are a neurologist and there
are no CT scans and MRIs in Gadchiroli how would you even work there?” A very
valid question which was restricting me from choosing my mission. Your
education should empower you, what was happening here was the degree was
disempowering. So we said I am also a neurologist not only a neurologist.
Neurology is my tool, I am a master of. Before neurology I am MBBS, Bachelor of
medicine and bachelor of surgery, and being MBBS I could help many more people.
And zooming out I am a human being. And to save lives you don’t have to be a
doctor. And we decided let our specialization not be the restriction, but we
should just look at it as a tool in our armory.
The second question was – What about Naxals and snakes and
malaria? It’s definitely a valid question but it is based on fear and we
Indians are the most fearful people in the world. We have most evolved
philosophy regarding death in the world yet we are extremely fearful of death. The
choice here was dying in Houston vs dying in Gadchiroli. There was a wrong
assumption that death was less likely to come in Houston, than Gadchiroli, so
we decided that if our mission is important, we would choose dying in
The third question was a trick question – “But you are
helping poor patients in the US too. Why are you going to India for that?” This
was a difficult one that we had to think through, so I fast-forwarded life –
imagine that I have lived my life and I am about to die and I have to look back
at life in 5 mins, summarize my life, how would I do that, and what would be
the narration? So, one narration could be I went to the US, did research, did
great things, had kids who were healthy and happy and died; or the second
narration was went to US, got trained in the world’s best institute, came back
to Gadchiroli, worked for the tribal people who don’t have access to care and I
died. The second narration made more sense. We decided to rather serve the rural
and tribal in Gadchiroli.
The fourth question was the most difficult one: “What about
your son’s education?” It’s a very strange thing- education is supposed to
empower us, it is supposed to liberate us from fear. But what was happening
here was, education was creating fear in our minds, because education has been
converted into an industry. Unfortunately, it’s an industry which started
thriving on fear just like insurance industry. So, we looked back and thought
that it is a very valid question but with an assumption of having a poor
education in Gadchiroli because it was a poor area. So, the corollary of this
is if you go to the most expensive, best school you will get best education.
Second assumption is if you go to school you will get education. So, we sent
our son to a government school.
We picked up some attitude which helped us travel this path.
The first was – 1. We are working in rural area for our own
sake, no one has invited us here.
2. 1/1.3 billionth of India’s problems are mine.
3. We will be solution-centric, not problem-centric.
4. We will be goal-centric not path-centric.
5. Do not get frustrated. Frustration is like putting a
scooter on stand and raising the accelerator – it doesn’t take you forward.
And last if you want to see a better India by bringing about
change…be the change!