A Tea Break in Memphis
In December 2016, I sent an invitation from my desk at Kasturba Hospital to a name I had only recently learned: Dr. Ramasubbareddy Dhanireddy, a neonatologist in Memphis, Tennessee. The connection had travelled through Bhavana’s family before it reached me. Her aunt, Dr. Nilima Manudhane, a neonatologist at Stanford, and her sister Shailaja Asawe had decided, between them, that our paediatric and neonatal wards in Sevagram needed modernising — and Nilima knew exactly who could do it.
“He has spent his whole career leading neonatal medicine in Tennessee,” she told us, “but he has never really left India.”
Five Miles, Barefoot
Dhanireddy’s own beginning explained the rest of him. He had grown up in rural Andhra Pradesh, walking five miles to school every morning without shoes, and had lived with an uncle so he could stay within reach of an education. He trained at Osmania Medical College in Hyderabad, then left for the United States in the late 1970s for his paediatric residency and neonatal-perinatal fellowship at Georgetown, before settling into a long faculty career at the University of Tennessee Health Science Center in Memphis.
He liked to tell one detail about that departure with visible amusement. When the American consulate handed him a ten-year visa, he pushed it back across the counter and asked for one year instead. He was certain, he said, that he would finish his training and come straight home.
The one year became forty.
A Fortnight at a Time
Between February 2017 and 2023, Dhanireddy made roughly a dozen trips back to Sevagram — not as a visiting dignitary passing through for a photograph, but as a working neonatologist who moved into our institute guest house for a fortnight at a stretch and walked over to the NICU before most of us had finished our morning tea.
His mission, each time, was the same: to loosen our nursery’s grip on the antibiotic. In a rural neonatal unit, the antibiotic is often less a drug than a tranquiliser — for the anxious parent, and sometimes for the anxious doctor. Dhanireddy worked at the bedside with our paediatricians, Dr. Manish Jain, Dr. Akash Bang, Dr. Smita Jategaonkar and Dr. Varsha Chauhan, teaching them to read the clinical signs rather than reach for the prescription pad — to hold back broad-spectrum antibiotics in a febrile newborn who showed no toxic signs, and to stop an empirical course promptly the moment a sterile blood culture came back clean.
He did not let the teaching lapse when he flew home. He logged in for hour-long video calls across twelve time zones, reviewing our charts, mentoring our residents, and quietly correcting our management plans from a desk eight thousand miles away.
Tea and the Upanishads
Between his ward rounds, he would often drift into my office. My days as Medical Superintendent were usually a tug-of-war between clinical work and institutional plumbing, and his visits were the finest interruption. We drank tea, arguing unhurriedly about clinical epidemiology, health economics, and ancient philosophy in the same breath. He could quote the Upanishads and the Bhagavad Gita from memory in one sentence and weigh a likelihood ratio in the next, never once mentioning his American titles unless pressed. He arrived instead with books tucked under his arm—gifts, not credentials. I still keep the copy he gave me of Saroo Brierley’s A Long Way Home, the memoir later adapted into the film Lion.
The Wall He Could Not Move
Institutional change rarely travels in a straight line, and Dhanireddy found that out the hard way. On one visit, he tried to see how well our ancillary departments actually served the nursery — because a doctor who wants to withhold an antibiotic needs a gram stain, a blood culture, and a portable X-ray back quickly, not by evening. He ran straight into Microbiology and Radiology, and spent days counselling, cajoling, and negotiating with both, only to find Sevagram’s bureaucracy every bit as stubborn as its reputation suggested.
“Changing a laboratory’s habits,” he told me once, with the dry amusement of a man who had also treated septic shock for a living, “is harder than treating septic shock.”
What He Left Behind
He never did win that particular fight. But the clinical footprint he left in the nursery was real and lasting. He showed a small team in rural Maharashtra that world-class neonatal care was not a matter of budget. It needed clean hands, a watchful eye, and — the harder discipline of the two — the nerve to withhold a drug the room was begging you to give.
I think of him now less as a visiting professor than as one more name on the long list of people who came to Sevagram for a fortnight and left something behind that outlasted the visit.
During his final visit, Dhanireddy came home for dinner. Over an unhurried meal, our conversation turned to the institutional health of Sevagram. He spoke with quiet sadness about a growing misalignment between the management, the faculty, and the residents. To him, an institution built on Gandhian ideals could survive only if the administration and the bedside clinicians were in continuous, transparent dialogue, working in concert rather than in silos. Dhanireddy was aging—he had crossed seventy-five and had undergone major spinal surgery just a year earlier. Gently, without drama, he told me that this would be his last journey to Sevagram. When he stepped into the night and I saw him off at the gate, I had a lump in my throat