I request all doctors to read this long speech

• Dr D Tiwary
  National Vice President IMA

Dr. Farokh Udwadia is a venerable, sage-like figure in the medical field. His age is just 94 years. Sharing his oration during centenary celebrations of seth GSMC & KEMH last year. Relevant to current times when medical field is having many complex issues to deal with.
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Dr. Medhekar, you have spoken very highly of me. I am grateful to you. I have only one request for everyone—please turn off your mobile phones and maintain silence, so that I can think clearly and speak.
Respected Dean Madam Dr. Rawat, distinguished dignitaries on the dais (many of whom are my long-time colleagues), all faculty members of the college, hospital administrators, student friends, and brothers and sisters—
The subject of my lecture is—’The Changing Face of Medicine’.
I am going to speak on three aspects: the past, the present, and the future. The past represents my journey with this prestigious institution. I spent 8 to 9 years of my life here, from 1948 to 1956-57. These are among the happiest years of my life.
I want to tell you about what the face of medicine looked like in those days. None of the things we take for granted today were available back then. However, we had our eyes, our ears, and our hands. And we used these tools—something that many doctors today do not seem to do.
The tests available to us in the Pathology department were extremely elementary. In the Radiology department, there was only the X-ray; the most advanced tests beyond that were a Barium Meal and Intravenous Pyelography—that was it. Of course, Penicillin existed. I think I was in my third year when Alexander Fleming visited our college. He was an extremely gentle and humble personality. Along with Penicillin, we had Streptomycin, Para-Aminosalicylic Acid, Isoniazid, and Chloramphenicol had also just arrived. That was the extent of our antibiotics. There was no such thing as a “specialty.” When we were housemen and registrars, we examined not only male and female patients—whose numbers were huge—but we also examined young children. Doing a venesection on the saphenous vein of a one-year-old infant used to terrify me. Such were those days. Those days passed, medicine advanced further, and after 1970, there was a virtual explosion in medical progress.
Now let’s turn to the present. Due to unprecedented progress in science and technology, the face of medicine has completely changed. Today, massive miracles are unfolding before us. At least back when we were studying in this college in 1948 and 1950, they would have been considered nothing short of miracles. There is no need to list them; you already know them. To give one example: organ transplantation. Today, there are countless medicines and surgeries for innumerable diseases. A surgeon’s gloved fingers can enter any part of the body. There is laparoscopic surgery and robotic surgery. I will not list all of these, as you are well aware of them.
Today, I am going to speak about the other side of medicine—the dark side. Because I believe it is my duty to speak about it. An author named Roy Porter has written a beautiful book on the history of medicine. The title of this book is ‘Medicine: A History of Healing’ (or ‘The Greatest Benefit to Mankind’). I fully agree with the author.
But there is another side. My question is—why is there such a feeling of opposition, suspicion, and disillusionment towards medical science and the medical fraternity today? People are setting hospitals on fire. They are assaulting resident medical officers. People come to hospitals and create chaos. They attack doctors. Why is all this happening?
This is a double paradox. In our time, doctors were held in very high esteem. In those days, science had just begun to emerge, and the medical profession had not achieved any massive milestones—nothing compared to today. Yet, doctors were highly respected. The entire medical field enjoyed great prestige. In fact, it wouldn’t be wrong to say that the respect doctors received was second to none. But what about today?
Despite medicine achieving such great milestones, and despite science embracing medicine so tightly, what do we see?
The respect for the medical profession has diminished significantly. The image of the medical profession has deteriorated greatly. Have you asked yourself this question—why has this happened?
One reason for this is that the science and technology within medicine have overpowered the ‘art’ of medicine. Medicine has somewhat strayed from its path. It has lost its vision. It has lost human values and humanity. Today’s medical professional is less in touch with his patient and more in touch with machines. In fact, today a machine stands between the doctor and the patient. And the irony is that even the doctor, instead of connecting the patient to himself, is connecting them to the machine! A patient comes in and says, ‘Doctor, my head has been hurting for two weeks. I want an MRI done.’ Look, the patient is telling the doctor what they want! And the doctor listens. When this starts happening, the human value and humanity in medicine are lost. The relationship between the doctor and the patient weakens and eventually snaps. And this relationship matters a lot! Especially in the case of critically ill patients. This relationship builds trust and faith in the doctor, and these things are incredibly important for a patient’s recovery. Extensive scientific research is now underway regarding the contribution of trust and faith to the healing process.
Unfortunately, due to the tremendous progress in science and technology, newly graduating doctors today are captivated by the allure of these machines. Enchanted by those shiny machines and the beautiful images provided by endoscopy, CT scans, and MRIs, doctors have forgotten that medicine is meant to be learned and taught at the patient’s bedside. A machine cannot teach you medicine, no matter how advanced that machine may be.
Please do not misunderstand me. I am a proponent of science and technology, not an opponent. It is with the help of science and technology that medicine has reached its current advanced state in this century. Science and technology have increased our life expectancy—not just in Western countries, but in our country and even in countries poorer than ours. There is no doubt about it. But today I want to tell you, and tell you from the bottom of my heart, that there is much more to medicine beyond science and technology. No technology can ask for a patient’s history. No technology can perform a physical examination of a patient. Technology cannot talk to a patient and comfort them. It cannot reassure a patient suffering from a major illness. It cannot alleviate the anxiety in the minds of the patient or their relatives. All these things are part of the ‘art’ of medicine. This art is now getting lost in the arrogance of technology.
You might ask, what exactly is this ‘art’? It is not easy to define. It is difficult to measure. This ‘art’ originates from the qualities residing in a doctor’s mind and heart. It is because of this ‘art’ that a doctor empathizes with the patient, and this art contributes to the patient’s speedy recovery.
I feel this art is dying. I express my hope that it does not become entirely extinct. If it disappears, it will not be in the interest of either the doctor or the patient.
Now you may ask me, how do we put this ‘art’ into practice? The answer is very simple. Asking about the patient’s illness, which we call ‘history taking’, is the first part of this art. The art of ‘history taking’ is also fading away.
To be honest, whenever I cannot figure out what is wrong with a patient, I delve deeper and deeper into the patient’s medical history, and from a mere fragment of conversation, I discover exactly what has happened to the patient! ‘Taking a history’ means talking to the patient, listening carefully to what they say, and then asking them questions. Remember one thing, given the kind of life we live today, many ailments that we consider physical diseases actually stem from mental stress and tension. And if you fail to realize this, you will never understand what is wrong with the patient. It will only result in a waste of the patient’s money. When you talk to a patient, you must gauge what kind of patient they are. Is this patient exaggerating their pain? Are they downplaying it? Are they hiding something? All these things are extremely crucial, and unfortunately, modern medicine has forgotten them.
After taking the history, a thorough physical examination must be conducted. Unfortunately, hardly anyone does that today. A cardiologist examines the heart, but does he strike the knee with a hammer to check reflexes? Does a pulmonologist examine the heart? Does a neurologist palpate the abdomen? A physical examination is truly invaluable. It is partly an art, partly a science. Through ‘art’, clinical signs in the body are revealed, and through ‘science’, the correct diagnosis of the disease is made based on those signs. This is very important. Therefore, I request all the medical students sitting here: use your senses. Your eyes, your ears, your sense of touch. Store the information obtained through them in your brain. Recall the sensations from diseases you treated sometime in the past, and compare them with the sensations you are receiving now. From that, you will find the diagnosis. If you ask me what the most important thing in medicine is, I will say—diagnosis, diagnosis, and only diagnosis.
I am speaking about the ‘art’ of medicine. I want to give you an example from my personal experience. I am going to talk about a situation where a machine is of no use, where technology is futile. A subtle point obtained from the patient’s history, a rare sign that a machine will fail to notice—when you assemble the evidence gathered from that context, you get the answer to your question. Every good doctor possesses a kind of intuition. Rationalists may not accept this, but through that intuition, a doctor senses what is wrong and what needs to be done. A patient must be looked at holistically as a complete human being. It is wrong to divide the body into different organ systems and treat it in fragments. Unfortunately, this is what is happening today. The art of medicine is the art of ‘healing’ the patient, not just ‘treating’ them. It is not merely a process of ‘eradicating a disease’. Medicine triumphs only when art and science join hands. Only when a doctor recognizes his patient as a fellow human being can he truly understand what is wrong with them. If the approach toward the patient is holistic, only then does the diagnosis appear clearly before your eyes, mistakes are avoided, and a strong bond is forged between the doctor and the patient—a bond of trust. A bond that has endured for centuries, tested and validated by time. This is what constitutes the ‘art’ of medicine.
Now I need to speak a bit more about the other side of medicine. Yes, the dark side. Earlier, I said that when humanity is absent, mutual trust between the doctor and the patient fractures. And if the majority of doctors in society start behaving this way, what does it mean? It means that the relationship between the medical profession and society is no longer what it should be. The humanity and compassion required for the medical profession are lost.
This is the first stain. The second dark stain on the face of the medical profession is that this profession is no longer a profession; it has become a business. This is a matter of profound grief. It hasn’t just become a business; it has become a dirty business. Money. Money is the root of this evil. The greed for money has brought the medical profession to this state today. No one speaks about this openly, but you all know it. There are many doctors in this city who pay commissions to procure patients. This is a highly shameful practice. I do not know how we will rid ourselves of it.
What is the third dark stain on the face of the medical profession? The exorbitant cost of treatment. Today, falling ill means inviting monumental expenses. And if the illness is serious, do not even ask. But if doctors realize that we can diagnose diseases using our eyes, ears, and hands, that we can diagnose using simple tests, and treat without using expensive drugs—that there is no need to use a drug simply because it is new in the market—then a massive reduction in medical expenses can be achieved.
What is the fourth dark stain on the face of the medical profession? Institutionalizing the medical profession is that fourth stain. Suppose Breach Candy Hospital has an MRI machine. The exact same machine is present in six other hospitals within a two-kilometer radius. What happens in such a situation? That poor doctor! He receives an ultimatum from the hospital administrators—what are you doing? How do we recover the cost of this machine? Consequently, he is forced to feed the machine. He is compelled to do so. If he doesn’t, he is dismissed. Then begins the malpractice.
Do you understand what I am saying? The values of the medical profession have eroded. Unquestionably. Such a situation never existed in the past. Granted, this degradation is not limited to the medical profession alone; it has occurred in all fields. A few years ago, a young, bright girl asked me a question—if malpractice is rampant everywhere, how is it possible for an island of integrity to survive? The question is very poignant. It is difficult, but it must be done. Because the medical profession is not like other occupations. It is a service-oriented profession. This fact cannot be overlooked. My young friends, please remember this. This profession must be carried forward with a spirit of service. The patient is the most important element. Everything else is secondary. I hope you will keep this in mind.
Finally, another dark stain on the face of the medical profession. I do not know if you have read the books of the author Ivan Illich. The title of his book’s first edition was ‘Medical Nemesis’, meaning the defeat of medicine, and his second book is ‘Limits to Medicine’. This man is not a doctor. He is a sociologist from Mexico. He decided to review medical science. The very first sentence of his book is—’The medical establishment has become a major threat to health.’ And he proves it. He studied all the necessary medical research, verified it, and only then presented his views. He mentioned three great sins of medicine. What are those sins?
The first sin—iatrogenic illnesses, meaning diseases caused by doctors. The harm caused by doctors, hospitals, and medicines. And this author is not wrong. There are so many medicines through which a person sometimes gets cured, and sometimes dies. It is the duty of doctors to weigh the pros and cons before administering such medicines.
The second sin—socially induced illness. What does this mean? A patient goes to a doctor for a minor complaint. They visit a doctor for a common cold. They run to a hospital for the simplest of grievances. This is not a good thing. They must learn to treat minor ailments themselves. These ‘socially induced illnesses’ are not in the interest of society. They might be profitable for doctors, but they are certainly not beneficial for society.
The third sin—culturally induced illness. What does this mean? Modern doctors often try their level best to keep a terminally ill patient alive at a massive financial cost, even when the patient’s chances of survival are zero, or when staying alive will only prolong their agony and suffering.
Now, a little about the future. Artificial Intelligence. AI is a very useful thing. But I have thought deeply about it. Can AI make new discoveries? Can it formulate a novel concept that has never been thought of before? No.
AI can provide you with data on thousands of patients stored in a computer, or it can summarize thousands of past events to present conclusions. But can AI generate a thought that no one has ever conceived before? No! Do you want an example? I will give you one.
Look at the research Einstein did. Einstein conducted a thought experiment. He said—’If I ride on a beam of light and travel away from Earth, what will happen to me? What will happen to the mathematics of time? How will the people down on Earth appear?’
He conducted another experiment—’If I am standing at a station and a train passes by me, will the time on my watch be the same as the time on the watch of a passenger sitting in that train?’
These are novel thought experiments. The world moves forward through such experiments. These experiments hold immense value not just in medicine, but in all fields. Imagine you put AI into a box and take that box to a patient. You ask the AI—tell me, son, what is wrong with this patient? If you do this, it means you have mortgaged human intelligence to AI, and you will never be able to reclaim this mortgaged asset. The information you feed into AI is gathered by humans. If that information itself is flawed—incorrect history, faulty examination—how will AI function correctly?
The most disturbing thing is the ongoing research into gene editing. The human race we see on Earth today is the result of billions of years of evolution. It will continue to evolve for billions of years to come. Whatever changes are meant to happen will happen naturally within us. What is science trying to do? It is trying to suppress and compress changes that take billions of years into just a few centuries. Altering a gene, removing a gene, replacing it with a new one—such experiments are underway. This means you will be transformed into an entirely different individual. This is truly frightening.
Great progress is being made in the medical field. But the most important thing is that this progress must have a moral and ethical foundation. If this is not adhered to, it will lead to our annihilation, the annihilation of humanity, and the destruction of this Earth. If we observe these ethical boundaries, a new dawn will emerge. But if we do not, we might enter a dark age trapped in the clutches of perverted science.
Finally, I take your leave by presenting a thought from the realm of philosophy. Science, spirituality, and philosophy are coming together today, which is a wonderful thing. I spoke about the past, I spoke on the present situation, and I also spoke about the future. But remember, as a great poet once said—the present is contained in the past and the future, and the future is contained in the past. Thank you.

8/7/26