Chapter Five — Sankara Nethralaya: The Temple of the Eye

How Dr Sengamedu Srinivasa Badrinath kept a promise to a Boston guru, woke his wife before dawn and cancelled America, sold a house on Chamiers Road, and built a not-for-profit hospital whose philosophy is still read like a prayer.

People often write it Shankar Nethralaya. The name on the gate is Sankara Nethralaya — Sankara for the command of the Kanchi Acharyas, Nethralaya for a temple of the eye. The chapter uses the name he gave the building.

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A relative who could not see

Triplicane, Madras. 24 February 1940. An engineer father in government service; a mother from an advocate’s house in Nerur. Both parents died while he was still in his teens. He finished medicine at Madras Medical College on insurance money and on the kind of stubbornness that does not announce itself.

As a child, a relative who was blind in both eyes came to stay. The boy watched the hands search a familiar room. Decades later he would say that picture sat in the subconscious and chose his specialty for him.

P.S. High School. A science teacher, C.T. Kuppuswamy Iyer, lit the first fuse. Intermediate at Loyola. Then the long American years: Grasslands Hospital, New York University’s postgraduate school, Brooklyn Eye and Ear Infirmary. In Boston, at the Massachusetts Eye and Ear Infirmary, he sat at the shoulder of Charles L. Schepens — the man the world called the father of modern retinal surgery.

Schepens gave him a fellowship with a condition that sounded, in 1968, almost cruel.

“You will return to India.”

Indians before him had taken the training and stayed. Badrinath was the first of Schepens’s Indian fellows to keep the word. In 1966, in Brooklyn, he met Dr Vasanthi Iyengar, a paediatrician and haematologist. They married on 3 June 1967. In March or April 1970 they landed in Madras with a toddler, a thousand dollars, and a vitreoretinal craft almost no one in the country yet practised.

“I always wanted to come back,” he said. “The feeling was there even in 1963, when I left.”

The morning they did not go to the consulate

The first Indian years were not a hymn. Voluntary Health Services in Adyar. H.M. Hospital. Vijaya Hospital. Complicated cases, yes. Household life in 1970s Madras, also yes — electricity bills, plumbers, the seven-year wait for a scooter. Quality of life, Vasanthi later admitted, looked better in America.

A friend in Texas made an offer. El Paso. Papers moved. The appointment at the U.S. consulate was 15 May 1973.

At half past four that morning he woke his wife.

“We are not going to the consulate,” he said. “We are not shifting.”

He could not name the reason in a sentence that would satisfy a visa officer. He trusted a feeling in the gut. They stayed.

That same season, at the first-year celebration of H.M. Hospital, M.S. Subbulakshmi walked up to Vasanthi.

“Badri must practise here,” the singer said.

And in 1973 the Kanchi Maha Periyava, Sri Chandrasekharendra Saraswathi, chose this still-young surgeon — not the city’s established doyens — for a cataract operation. For nearly a month the doctor lived close to the sage. The horizon of the work changed. A man who had learned the retina in Boston learned, in Kanchipuram, that an institution could be a form of worship.

Sri Andavan Swamigal walked two hundred miles from Trichy to be operated by him. Years later President R. Venkataraman, after a Geneva check, was told that even if Muhammad Ali punched the repaired eye, nothing would happen. Badrinath told the story without ornament. The point was the stitch, not the celebrity.

“We started the hospital without money”

In 1976, at a meeting of young doctors, Sri Jayendra Saraswathi of the Kanchi Kamakoti Peetam gave a command that did not sound like a suggestion.

India needed hospitals that offered world-class care at a cost the citizen could bear. They should be run with a missionary spirit. The same quality for those who have and those who do not.

Badrinath tried, first, to gather doctors for a general hospital. The gathering failed. He knew eyes. He would build for eyes.

6 September 1978. Vinayaka Chaturthi. Sixteen beds. One theatre. Three consultants, including himself, working at first on Vijaya Hospital’s premises. A unit of a new Medical Research Foundation. They named it Sankara Nethralaya — the Temple of the Eye.

“We did not have money,” he said. “We started the hospital without money.”

Vasanthi explained the rule that kept the temple from becoming a shop.

“He reasoned, if you take a loan, the focus would turn to money, because you would be under pressure to repay it.”

The first donation came from another seat of Sankara — Sringeri. Then corporates and families arrived of their own will: Jaslok, Tulsi, Tata Trusts, Sanmar, L&T, Kotharis, Ambanis. Nani Palkhivala and his wife Nargesh would, in time, leave property and savings to the institution. Palkhivala called it the best-managed charitable organisation in India.

Badrinath sold the big house on Chamiers Road and put the money into the hospital.

Andhra Bank helped them buy land. In 1979 they moved to their own premises. A new inpatient block in 1982. Within a decade, a seven-storey building for the outpatients who would not stop coming, and a rural outreach on the city’s edge.

The philosophy was written so that no one could pretend they had not read it:

Let the word Sankara of Sankara Nethralaya ever remind me and my associates His Holiness’ command that there be a missionary spirit in the project.

Let the word Nethralaya constantly remind me and my colleagues that the place of our work is an Alaya. Work will be our worship, which we shall do with sincerity, dedication and utmost love.

Paying patient and free patient received the same work-up, the same counselling, the same theatre standard. That rule has not been retired.

Subspecialties when India barely had the word

In 1978, ophthalmic subspecialty practice in India was almost a rumour. He insisted on carving the eye into its true rooms: vitreoretina, cornea, glaucoma, uvea, oculoplasty, paediatric work. Fellows came for those rooms. An army, he said, to combat blindness — not one hero with a torch.

Doctors worked on salary. Lingam Gopal, who joined in the fourth year and later chaired the place, put the miracle plainly: three consultants became eighty, held together not by bonus but by a common vision and a leader who did not live like a promoter.

Elite School of Optometry opened in 1985 — a pioneer in a country that still thought refraction was a side table. Research was aimed at Indian eyes, Indian diseases, not at reprinting Boston. A patent for corneal limbal stem-cell work would come years later. ISO 9002 in 1998 made them the first eye hospital in Asia with that stamp. Newsweek, much later, would rank them among the world’s top ophthalmic institutions.

Sunday free camps inside the building became a department that worked every day. Jaslok Community Ophthalmic Centre. School screenings. Buses that carried villagers in, operated, fed, lodged, and carried them home with no bill in the pocket. A Mobile Eye Surgical Unit — two buses approved to take the theatre to the village, rare enough that the Central Government’s nod became part of the legend.

Of the daily lists, a large share has always been free. In one documented season: 125 surgeries a day, 45 without charge; among complex retinal cases, a third in the free column. In later institutional counts, roughly a third of surgeries and half of some outpatient streams still travel on the missionary ledger.

Six or seven percent of the blind in India, he liked to remind visitors, needed only spectacles. A temple that cannot prescribe glasses has misunderstood the poor.

Kolkata, because the northeast should not have to ride a train for a retina

Three hundred patients a day were already arriving in Chennai from the east and the northeast. Many more could not make the journey.

December 2002: a collaboration in Kolkata, two hundred patients a day. 2007: Raja Subodh Mullick Square. 21 January 2009: a hospital of their own at Mukundapur, commissioned by Chief Minister Buddhadeb Bhattacharjee. An entire floor and earmarked theatres for those who pay nothing. Then Kamalnayan Bajaj Sankara Nethralaya at Rajarhat, opened in 2017 by Mamata Banerjee. Aditya Birla’s name on another Kolkata wing. Camps that screened hundreds of thousands across Bengal and neighbouring states.

Bengaluru. Tirupati. Rameswaram. Sri City. A fundraising trust in the United States whose only job was to keep the free list alive in India.

The institution learned to stand without living from donation to donation — self-sustaining, he said, though the donor’s cheque still opened a free theatre when a village arrived. Efficiency and charity in the same sentence. That was the demonstration Nani Palkhivala had named.

The man in the room

He was a perfectionist of an old Madras kind. When a programme of President Abdul Kalam had to be postponed, someone suggested sticking new dates on already printed cards. The suggestion did not survive contact with Badrinath. If the work is worship, the card is not a place to be shabby.

Patients told stories of a chief who still thought like a fellow of Schepens: the retina does not forgive approximation. Colleagues told stories of a man who could keep eighty salaried specialists from drifting into private luxury because the Alaya was more interesting than a clinic with one’s name on the board.

Padma Shri. Padma Bhushan. B.C. Roy. Consulting ophthalmologist to the Armed Forces. The titles sat lightly. The photograph of Maha Periyava in the room sat heavily.

On 21 November 2023 he died. Chennai lost a son who had refused El Paso at dawn. The hospital did not close. That, too, was part of the design. A temple that depends on one priest is only a shrine. He had spent forty-five years making sure the worship could continue at 8 a.m. without him.

What this chapter adds to the book

Apollo taught India a hospital could be a company.

Medanta taught it could be a multi-specialty city.

Narayana taught volume could drag a price toward mercy.

AIG taught the unglamorous organs they deserved a cathedral.

Sankara Nethralaya taught something older and stricter: that a hospital can refuse the loan, refuse the unequal theatre, refuse the American consulate, and still become, in Palkhivala’s phrase, the best-managed charity in the country — a place where the word Nethralaya is not branding. It is a reminder that the corridor is a temple and the work is the puja.

A reconstructed evening, late, College Road. A young fellow asks the old chief whether he ever calculates what El Paso would have paid.

Badrinath looks at the photograph on the wall.

“Schepens asked me to come home,” he says. “The Acharya asked me to build. A man walked two hundred miles for an operation. If I had gone to the consulate that morning, who would have been here when he arrived?”

The fellow has no answer. Outside, the outpatient queue for the next day is already a rumour in the dark.

That is how Sankara Nethralaya was planned: as a command, not a business plan.

That is how it was executed: sixteen beds, no loan, a sold house, three doctors, the same examination for the man who pays and the man who cannot.

That is how it expanded: by following the patients who could not reach Chennai, and by sending the theatre, on two buses, to the village that could not reach anyone.

The temple of the eye is still open. The philosophy is still on the wall. The work, as he ordered, is still the worship.