Prof. A K Banerji

(1965-1995) presently Emeritus Professor Neurosurgery

“It was May 1965 that I came to Delhi from Vellore where I was a lecturer, to appear for a Union Public Service Commission interview for the job of Reader at G. B. Pant hospital, Delhi and All India Institute of Mental Health, Bangalore (later to become NIMHANS). I was the only candidate and was asked at the end as to which place would I prefer. I chose Bangalore. Just before leaving for the interview, I had gone to see Dr. Baldev Singh and Dr P. N. Tandon (PNT) at AIIMS to pay a courtesy call. They were sharing an office and I suspect eagerly waiting like spiders, to catch a victim in neurosurgery, who could stick on at AIIMS, which at that time had actually nothing no space, equipment or staff. After a little talking about general things, suddenly, Dr. Baldev Singh asked me to think whether I at all wanted to go for the interview, as AIIMS could possibly offer me a job, I of course declined the proposal as a bird in hand was better than two in the bush. Then Dr. Tandon asked me to come home for tea that evening. I left for the Union Public Service Commission office. Today when I see large number of candidates for a job interview my own experience seems miraculous.

Coming back after the interview I recounted what happened to Gopal and his wife Radha (Dr. G.K. Vishwakarma was then Asst. Professor Orthopaedics and later became D.G.H.S. of Government of India) Insidious pressure started from them to come to AIIMS and forget about Bangalore. Incidentally Bangalore had a working, full fledged department with Prof. RM. Verma and he tried hard to get me there even after I joined AIIMS.

That evening I spent at Tandons. Dr. P. N. Tandon had been my Anatomy demonstrator in 1952 while Mrs. Leela Tandon was my lecturer in Obstetrics and Gynaecology at Medical College, Lucknow. I had met Dr. P.N. Tandon in 1963 at the annual Neurological Society of India meeting in Calcutta. For both of us it was the very first meeting that we had attended of NSI. Dr. P. N. Tandon had established the department of neurosurgery at AlIMS 2 months before in March 65. He had been promised equipment but nothing had arrived in the two months. He was eager that I should join but was frank to say he did not know how things would eventually develop. After returning to Gopal's house, Radha and Gopal took me to see 'My Fair Lady' at Sheila Theatre which then was the best in Delhi, if not India. After returning well past midnight we slept on the roof and went on talking about what I should do. I think it was near the break of dawn that I finally succumbed to pressures from Gopal and Radha and said OK I'll come to Delhi if the job was offered. Next morning before I left Delhi Dr. Baldev Singh took me to meet Prof. K. L. Wig then Director AIIMS. Our liking for each other was instantaneous and the bond carried throughout.

I joined as adhoc Assistant Professor in June'65. There was one office of Dr. Baldev Singh in which in addition to Dr. P. N. Tandon another chair and a small table was put for me. The process of starting a department began really from scratch. Space was allotted on the first floor by the side of anatomy lecture theatre. I and Dr. V. Virmani (my opposite number in Neurology) sat down to draw maps and carve out rooms in the large halls. At that moment, our vibes were bristly to say the least. Dr. Virmani was considerably senior in age plus she had known Dr. Baldev Singh since Amritsar days and she also held the trump card of being Punjabi speaking which was then the lingua franca of AIIMS. Over the years our relationship mellowed and we did develop mutual admiration and respect for each other. I hit upon the strategy in our dealings at that time of building the departments, of saying exactly opposite of what I wanted. Dr. Virmani would of course, reverse my suggestions much to my advantage. Today when I look back it all appears so childish. But then it was great fun. Slowly collecting items like pins, chairs, tables, almirahs and make real offices was a new challenge for which I was not trained. Anyway we built the office cubicles, laboratories and got the OPD on the 4th floor in ship shape. It was so gratifying after two years of joining that we had a place of our own.

We started with surgical instruments which actually were of World War II vintage which included an operation table. Burr holes had to be made by a brace in 4 stages and both Dr. Tandon and I developed the art to perfection. To begin with we had no beds. Both for Neurology and Neurosurgery, Prof. K.L. Wig and the Pediatricians generously allowed us use of their beds in what is now the nurses hostel. There was so little clinical work that it was terribly frustrating in the beginning. I started taking clinics for the MD students of medicine, pediatrics and radiology. I slowly became quite popular to the extent that one day Dr. Wig called me to see one of his patients in his office. I must have impressed him no end as after that on several occasions he would ask for my opinion on patients. This was a small matter for him but a great boost for my confidence for which my gratitude goes to him.

By 1968 we were having a ward in the OPD block (ward IX) and we were well settled. The operation theaters were in the College of Nursing Block. Radiology to begin with was in the nurses hostel, and only in 1968 shifted to its present location. That was the time when we had Dr. S. K. Ghosh in radiology from 1965 to 1968 and he was a great help. Very often we started the day at 7.30 A.M. with ward rounds, dressings and stitch removals, followed by neuroradiology  (ventriculograms angiograms etc) and then this was followed by surgery which would invariably end by 7 or 8 P.M., particularly if it was a posterior fossa tumour. At night one of us i.e. PNT or myself would sleep in the doctors room adjacent to the main O.T. block. From 1966 onwards Dr. B.B. Sawhney and Dr. M. Gourie Devi, now Director and Vice Chancellor NIMHANS who were residents in neurology would help us out by doing night duties and also assist in surgery as we did not have regular residents of our own. The role played by Col. G.C. Tandon, the Professor of Anaesthesia, was unforgettable. Dr. Hattangdi's lectures in anaesthesia helped us enormously and he also shared our burden in looking after patients, sometimes relieving us of our daily chores. The two films I saw with Anjali, my wife, during the time was courtesy of Hattangadi. Before I proceed I must tell of my first day in the operation theatre block (MOT) in the consultants changing room, where I went on my own apprehensively, to discover its ambience. The only person there in OT dress was reading an Agatha Christie paperback with great seriousness. On entering he asked me as to who I was and then got up with great cordiality and shook me by the hands. That was Dr. Satish Nayyar, Assistant Professor in Surgery well known as he was a Hallet medalist in the primary FRCS examination. Dr. Satish Nayyar gave me a cup of tea and then said that I must cultivate some hobby (his was reading mystery novels) as Assistant Professors had nothing to do as the Professor usurped all the work which was worthwhile, while all the minor work was done by the Registrars (later called residents). I went into depression from which it took me a long time to come out. Within a week I took courage in my hands and went to talk it over with PNT. We decided that alternate cases would be operated by us while the other would assist. Matters went on well but I was perturbed over the fact that if he assisted, he would go out and talk to the patients attendants before I could come out. Again I went to him in 1968 and PNT graciously agreed he wouldn't do so. This was a remarkable thing at AIIMS. My struggle for identity of Assistant Professors went on to the faculty over such oligarchy and it was ultimately in 1970 that I was able to change the nomenclature of hospital units which hitherto were identified with the head, to that of the departments. Thus Prof. P.N.T's unit changed to Neurosurgery unit-a practice which continues today. I have always felt that to obtain the best from colleagues a measure of democracy and participation should be the prime substance PNT's contribution towards this was immense which allowed me to put my heart and soul in developing the department and later the Neurosciences Centre. I guess the role of wives is also very great. Our families (Tandon and Banerji) were close to each other and even today no major decision in the Banerji family takes place without Tandons consultation. I guess this meeting was lucky for both of us.

In 1969 Dr. S.K. Ghosh left for Goa on promotion as Professor and Neuroradiology was taken over by Dr. R.K. Goulatia for whom a separate post was created in neuroradiology. In mid 70's Dr. S.S. Saini was persuaded to join Neuroanaesthesia and this started the nucleus of a comprehensive clinical setup. Fortunately we were able to persuade (Mrs. D. Saini to join as our OT sister incharge and thus there was a feeling of family and belonging, so important in the development phases of any new venture. Dr. Subimal Roy was spending considerable time in Neuropathology to complete the picture. I had a vision of Neurosciences Centre akin to PNT, however I knew that basic neurosciences can never develop on its own because of economic compulsions. My emphasis was on developing clinical neurosciences and bring in basic neurosciences within its umbrella.

By mid 70's both neurosurgery and neurology had relocated itself on the main hospitals 4th floor and we were lucky to have separate independent wards. Mrs. M. Bindra joined us as sister I/C of neurosurgery ward and her dedication eventually made our ward the talking point of nursing care in the Institute. She eventually rose to become the Nursing Superintendent of the Neurosciences Centre.

In 1966 one day, walked into my office Dr. Brahm Prakash, who had resigned his Short Service Commission in the army and had married recently. He was at loose ends, asking my advise as to what he should do. He had earlier worked as my junior resident in general surgery at Medical College, Lucknow and the association was about 10 yrs. old. I persuaded him to join neurosurgery.  We were able to rustle up the required formalities for starting MCh course with bare facilities but boundless enthusiasm. He was the first trainee and later joined our faculty and went on to become the Director Professor at G.B. Pant Hospital and started his own MCh programme. The AlIMS MCh course went from strength to strength and eventually we were having both the 5 yr and 3 yr streams. Neurology D.M. had started already in 1965. Now AlIMS trainees are spread all over India. Several headed departments e.g? Dr. Gourie Devi became Director Vice Chancellor of NIMHANS, Dr. B. Prakash at G.B. Pant Hospital Delhi, Dr. B.S. Das at NIMHANS, Dr. S. Mohanty at IMS, BHU Varanasi, Dr. A. K. Reddy at NIMS Hyderabad, and Dr. M.A. Wani at SKIMS Srinagar. Many hold important positions in teaching as well as private sector. We i.e. PNT and I are inordinately proud of all who trained themselves with us and wish them all the best in their future endeavors. Our wish is that they better us in their achievements. A major breakthrough in our clinical services occurred in 1976 with the coming of Prof. H.W. Pia who did a course in laboratory microsurgery. In the next few years we started a microsurgery laboratory and operative microsurgery was initiated. In the Indian scenario we stole the lead. In late 60's with the help of our ENT surgeon Dr. S.K. Kacker we started trans-sphenoidal pituitary surgery which consolidated in the 70's and became a routine procedure.

The process of development of the Neurosciences Centre in collaboration with the Cardiothoracic Sciences Centre started in real earnest in early 70's. Dr. N. Gopinath of Cardiothoracic Surgery and PNT were the architects. Land allocation was done by Prof. V. Ramalingaswami, the then Director AIIMS. Ghosh and Pradhan Associates were appointed architects and their started the planning for the basement, ground floor and the operation theatre block of our centre. Hours and hours of meetings with the architects-designing and tearing plans, it went on and on. I heard my wife say that I started talking of planning even in my sleep. We were about ready to have the foundation stone laying. This was 1977 and Mrs. Indira Gandhi's infamous emergency was coming to an end. One afternoon, in PNT's office, Dr. N. Gopinath suddenly said it would be nice to have Mrs. Gandhi lay the foundation stone. I had recently treated Mr. Dhawan's (then the personal secretary to Mrs. Indira Gandhi) nephew and I said shall I try. I rang him up on the phone from PNTs office. Mr. Dhawan immediately said yes and wanted probable days and times so that it could be confirmed taking into account Mrs. Gandhi's tour programmes. Elections were round the corner and Dr. Ramalingaswami wisely asked us to go slow. Mrs. Gandhi lost the elections and it is possible that the Janata Government which followed may have taken offence and delayed the start of the Centre had we got Mrs.lndira Gandhi to lay our foundation stone. Eventually, President Mr.Neelam Sanjeeva Reddy lay the foundation stone in 1978. When the building started many problems surfaced e.g. we suddenly discovered that there were very few toilets while most of the patients of cardiology were on diuretics and required use of toilets frequently. Again to the drawing boardbreaking of walls, laying of new sewer lines and so new toilets came into being. I know the OPD and of course the toilets have today become too inadequate with increasing number of patients coming to the Centre.

The brief period of Janata regime from 1977 and 1979 saw the irrepressible Mr. Raj Narain come as the Health Minister. All work in the Ministry came to a halt as also our Centre which bore the backlash of erratic ways of Mr. Raj Narain. The only thing I remember was meeting him near the present Community Medicine Department late in the evening,  Mr. Raj Narain was coming to inaugurate, if I remember correctly, the Centre of Community Medicine. As usual he was hours late and the then Director Dr. L.P. Agarwal was standing with 3to4 faculty members. I tried slinking away but Dr. L.P. Agarwal called me and more or less forced me to stay on awaiting Mr. Raj Narain. He eventually came when the numbers of people waiting was not more than half a dozen. Before going to cut the ribbon he was introduced to all of us. He was highly intrigued with me and asked what would I find if I did have an opportunity to see the inside of the head of Mrs. Indira Gandhi. I made some polite comments though I was sure Mrs. Gandhi had a better quality brain than Mr. Raj Narain. Anyway he went on to narrate it with great gusto during a special convocation to award an Honorary D. Litt to Dr. Sewoosagar Ramgoolam of Mauritius. It was in such bad taste that Morarji Desai who was chairing frowned and all of us in the auditorium hung our head with embarrassment.

My two stints as Chief of Neurosciences Centre were significant in the development of the Centre. The first was a 2 year term as acting Chief of Centre while Dr. PNT was on Nehru Fellowship between 1984-86. This was the time when after the first phase of building (OPD, radiology wing, basement and OT block) we had reached a dead end as far as expansion of the Centre was concerned. Prof. M. L. Bhatia was the Chief of Cardiothoracie Sciences Centre. Our formal requests for funds were stiffly rebuffed by the then Joint Secretary Finance Adviser (JSFA) of Health Ministry. Ms. Sarla Grewal, widely nick named 'hunterwali' by her unkind colleagues, was the Secretary. We were advised not to try and influence her which could cause an unpredictable antagonism to our proposal. Anyway we went to meet her, placed before her, the developments till date, including our mounting clinical load, increasing public expectations, and the blockades experienced by us for expanding our Centres to what was originally planned. Ms. Grewal quietly listened to us, occasionally interjecting for a clarification. After we completed she asked for the JSFA who was the main stumbling block, to come and join the meeting. The moment he saw us his hackles were raised. On being asked by Ms.Grewal as to what were the problems in giving us the grant he started off with a long list of financial mismanagement by AlIMS in which our Centres had no role to play. (Most of the problems recounted were exaggerated to say the least). Ms. Grewal asked as to why our Centres were being penalised for what AlIMS had done. To this the JSFA said that this is a part of financial management for which he was responsible. Then we saw the legendary Ms. Sarla Grewal come into her elements. In chaste Punjabi she asked the JSFA as to who was the Secretary of the Ministry and how dare he speak to her like that. The poor JSFA spluttered and stuttered and tried to put in a word edgeways. Ms. Grewal asked him to leave the office and we knew that our battle was half won. However after leaving her office both Prof. M.L. Bhatia and I, as a matter of diplomacy, went to the JSFA's office. He was in the dumps. We nursed his hurt ego by asking for his help as we knew that he was quite capable of going to the Finance (Expenditure) Secretary and derail our proposals. I think the strategy worked as he did become a supporter. Of course things were helped as a few close relations of the JSFA fell conveniently ill at the same time requiring cardiac and neurosurgery. Funds eventually came though it took another year and in 1986 the remainder of the present Centre's building was started. Prof. P. Venugopal was a constant source of support in our endeavours. In the same period the next Union Health Secretary was Mr. Srinivasan, who was unenthusiastic about our Centres. His general impression was that we were overstaffed, our equipment underutilized and our clinical output low compared to other hospitals e.g. G. B. Pant Hospital Delhi, Christian Medical College Vellore, and certainly Apollo Hospital Madras which to him was the ultimate in financial management and output. Incidentally he was involved with the starting of Escorts Heart Institute which he clearly told us is a 'better bet than us'. Prof. Bhatia, Venugopal and I went through our records as well as what we could gather from the other institutions which Mr. Srinivasan thought had better quality and quantity of work. He had a meeting separately with our Neurosciences group to take stock. I had taken Dr. Baldev Singh and Dr. P.N. Tandon for the presentation made by me. By the end Mr. Srinivasan was convinced of the genuineness of our proposals. My plea at that time was to get financial grant equal to G.B. Pant Hospital whose output was half of ours. It was a landmark victory as our grants immediately increased, a trend which continued in the future.

My next stint as Chief of Centre was between 1988-95. Finances were forthcoming in good measure We had a CT scan and state of art angiography equipment. Our ICU was the best in the country. What we lacked was a MRI Scanner. I must pay special thanks to Mr. R.L. Mishra who was the Union Health Secretary in the latter part of my assignment. We had an excellent relationship and he was always positive in his approach. It is through his help that we got the NMR department setup at AIIMS, which was far more than merely obtaining MRI equipment. Incidentally even today the NMR Department has the only 2 Tesla machine capable of MR Scan and also MR Spectroscopy. The NMR department also has chemical NMR and the only experimental NMR in India today. It was an unique experience to create a whole department with the help of the then director Dr. S. K. Kacker who was always supportive.

It is during my tenure that proposals were sent to the Government for making the Centre the best equipped not only in India but in the Asian region. The Gamma Knife has started after I retired and I am sure PET scan and other newer equipment would come in due course.

I am often asked as to whether I have any regrets. My special regret is our offices being removed from the main Institute. It was originally envisaged that offices would remain where they were located i.e., adjacent to Anatomy dissection hall. The translocation has severed the umbilical cord to the other specialties in the Institute. This isolation does not augur well for the future of our Centre, as any branch of medicine to flourish requires interaction with sister disciplines. My other regret is the inability to have nonclinical neurosciences to come and establish themselves in our Centers new building. I had tried, even to the extent of keeping a floor vacant for one year under various pretexts.

My greatest gains were the colleagues I had - friends for life. I know I left alive vibrant active Centre which will only grow from strength to strength. Even today for anything I always say Neurosciences Centre, AIIMS is the best and with every breath only wish it the very best in its future endeavors.”