One evening, My daughter Amrita once looked at me with that devastatingly clinical gaze children reserve for their aging parents.
“Papa,” she said, with a bluntness that would have made the late Vinod Mehta proud, “your likeability quotient has significantly diminished during your tenure as Medical Superintendent.”
It was a classic Lucknow Boy observation—candid, stinging, and inconveniently true.
For three decades, I had lived on a steady diet of affection. In the wards of MGIMS, I was the “good doctor”: the teacher who was accessible, the physician who listened, the colleague who lingered. I moved through the hospital corridors in a warm haze of smiles and familiar nods.
The Medical Superintendent’s chair altered that landscape overnight. It is a peculiar piece of furniture—upholstered in thorns. The moment I sat in it, my role changed. I was no longer the man who said yes to a patient’s recovery; I was the one who had to say no to a colleague’s request.
In a small, close-knit ecosystem like Sevagram, a “no” is rarely received as a professional decision. It is felt as a personal withdrawal. I sensed the change quickly. Smiles tightened. Conversations shortened. Invitations thinned. I began to feel less like a colleague and more like a fixture—functional, necessary, and quietly avoided.
One relationship, in particular, taught me how swiftly roles can eclipse history. A senior colleague I had admired since my student days had once been a mentor, almost an elder brother. Our bond had been forged long before I occupied an administrative office. But once I did, expectations shifted. He saw me as an ally who would smooth paths and bend rules; I saw myself as a custodian answerable to a hospital with limited resources and many competing needs.
When I could not oblige, it was not perceived as administrative integrity. It was read as personal betrayal. We continued to speak, but the ease was gone. What replaced it was a polite distance that neither of us named.
A similar chill crept into another relationship—with a colleague who had once been my student and later my neighbour. I had recommended her for leadership with genuine hope. I imagined a department that would move beyond laboratory walls and work shoulder to shoulder with clinicians. Policies meant to be evidence-based were experienced instead as intrusion. Boundaries hardened. Conversations thinned. What remained was a silence that spoke louder than disagreement.
The sharpest lesson came from a much younger colleague, once part of my earliest teaching years. Ambition, which I respected, collided with timing. My presence in the chair became, in his eyes, an obstruction. I did not understand this at the time. What I felt instead was an inexplicable cooling—averted eyes, conversations that stopped short.
The tension finally surfaced in a meeting where voices rose and restraint failed. I left the room with a heaviness in my chest that was physical as well as emotional. Tests later showed that my heart was sound. It was my spirit that had taken the blow.
The MS chair has a curious alchemy. It turns friends into factions. You become a manager, and in doing so, you risk losing the man. You absorb the frustrations of an entire institution. If oxygen runs low, it is your fault. If tea is cold, it is your fault. If a promotion stalls, it is your fault. You spend your days firefighting, and eventually, you smell of smoke.
And then comes the after.
In Sevagram, power is always on lease. When the lease expires, the man returns. The day I stepped down, the fog lifted with almost comic speed. Old warmth resurfaced. Conversations resumed. Affection returned without explanation, as if those strained years had been nothing more than a bad monsoon.
What surprised me most was how easily relationships healed once the chair was vacated. The disputes that had once seemed immovable dissolved into insignificance. Time, it turned out, had not damaged friendships; position had.
I learned, late in life, that the real villain is often the chair, not the person occupying it. The chair distorts vision—yours and everyone else’s. It creates a temporary amnesia of the heart.
Why I Stepped Down
After nearly thirteen years as Medical Superintendent, I decided in the summer of 2022 to step aside. My predecessor had served for a decade; I had already exceeded that span. Longevity, I realised, is not a virtue in itself. Institutions, like people, need renewal.
The decision was neither sudden nor easy. Administration had once energised me. I enjoyed complexity—balancing departments, negotiating crises, ensuring that patient care held steady amid uncertainty. But over time, fatigue crept in. The excitement of experimentation gave way to routine. I found myself becoming cautious, even conservative. Burnout rarely announces itself; it dulls curiosity long before it drains energy.
More troubling was the quiet distance growing between me and the roles that had first drawn me to medicine: teaching and patient care. Administrative demands crowded out time with students and at the bedside. Patients began to see me less often. Some drifted away. I could not blame them. That slow erosion of connection was the clearest signal that it was time to return to my roots.
Institutional strains added weight to the decision. Leadership structures showed signs of fatigue. Decision-making slowed. Difficult conversations were postponed. Faculty concerns often went unheard. Growth pathways stalled. Over time, talented colleagues began to look elsewhere, drawn by institutions offering clearer trajectories and greater autonomy.
The numbers reflected both effort and limitation. Admissions rose modestly over a decade; outpatient visits grew more steadily. The hospital was not failing—but it was no longer stretching itself. Institutions rarely collapse overnight. They stagnate quietly, one deferred decision at a time.
By then, it was evident to me that younger leadership was needed—people with energy, imagination, and the freedom to question settled assumptions. My staying on would not resolve deeper structural issues. It might even delay their resolution. Stepping down felt less like an exit and more like an act of stewardship.
Around that time, I encountered a line by Morgan Housel that found its way into my resignation letter:
“Those we admire most… knew when it was time to quit, time to pass the baton, time to disappear, in a way that preserved—even enhanced—their reputation.”
Leaving was painful. But staying would have been harder.
Today, as I walk the campus, the likeability quotient has returned to its natural state. We are back to being what we were meant to be—friends, healers, fellow travellers in the dusty lanes of Sevagram. The friction was the cost of the office. The relationships were the profit of a lifetime.d have been harder—to justify, to sustain, and to defend. Sometimes, the most responsible leadership decision is knowing when to step aside.
And so, I did.