A Royal Healer of the Mind and Brain: The Story of Dr. R. Marthanda Varma

In 1921, in the royal family of Mavelikkara in Kerala—closely linked to the Travancore royal house—a son was born to Aswathynnal Kutty Amma Thampuran. They named him Ravivarma Marthanda Varma, often called Raja Marthanda Varma or simply R. M. Varma. Privilege surrounded him, yet he chose a path of rigorous science and service rather than palace life.

After graduating in medicine he travelled to Britain. At the University of Bristol he completed his master’s degree, then earned the Fellowship of the Royal College of Surgeons of Edinburgh. When he returned to India in the late 1950s he was one of only five trained neurosurgeons in the entire country.

In 1958 he joined the All India Institute of Mental Health (AIIMH) in Bangalore as its first neurosurgeon. The facilities were rudimentary—a converted ward served as the operating theatre. Single-handedly he built the department. On 7 January 1958 he performed what is recorded as India’s first chronic subdural haematoma operation; soon afterwards he removed the first vestibular schwannoma. Within two years the annual surgical load rose from a handful of cases to more than 130.

His most original contribution came in the treatment of Parkinson’s disease. In 1963 he developed a minimally invasive technique—later known worldwide as “Varma’s Technique.” Using X-ray guidance and a percutaneous approach through the foramen ovale, he could reach the subthalamic nucleus or thalamus and create a controlled chemical lesion. The entire procedure lasted less than twenty minutes under local anaesthesia. For patients crippled by tremor and rigidity it offered dramatic, almost immediate relief without the risks of open brain surgery. He presented the method at international meetings and it became part of the early repertoire of functional neurosurgery in India.

In 1969 he became Director of AIIMH. Five years later, through his persistent advocacy, the institute was amalgamated with the old Mysore Mental Hospital to create the National Institute of Mental Health and Neurosciences—NIMHANS. Varma served as its Founder-Director until 1979 (with a brief interlude as Deputy Director General of Health Services in the Government of India). Under his leadership NIMHANS grew into one of Asia’s foremost centres for mental health and neurosciences. He also served as Dean of the Faculty of Mental Health and Neurosciences at Bangalore University, adviser to the Government of India, and Honorary Surgeon to President R. Venkataraman.

Colleagues remembered a gifted surgeon, a patient teacher who began at the student’s level and lifted them upward, and an administrator of quiet determination. The Bangalore Neurological Society instituted the R. M. Varma Oration in his honour. Among his many awards were the Karnataka Rajyotsava Prashasti (1969), the Citizen Extraordinary of Bangalore Award (1967), the IASSMD Distinguished Achievement Award (1982), the Sir Visvesvaraya Award (1998), and the Padma Shri conferred by the Government of India for his services to medicine.

He married Dr. Malathi Varma; they had two sons—Dr. Ravi Gopal Varma, who followed his father into neurosurgery, and Shashi Gopal Varma. After retirement he continued as Professor Emeritus at NIMHANS.

On 10 March 2015, at the age of ninety-three, Dr. R. Marthanda Varma passed away in Bengaluru after a brief age-related illness. He left behind an institution that continues to heal thousands every year, a surgical technique that once brought sudden stillness to trembling hands, and the example of a royal-born doctor who spent his life in the service of the most vulnerable—the mentally ill and the neurologically afflicted. In the history of Indian neurosciences his name stands among the very first and the most foundational.