What institutions remember—and forget

The end, when it finally came, was a study in contrasts.

On one side was my work family—the people who kept the hospital going. The office superintendent, the matron, the biomedical engineers and the pharmacy chief organized a modest farewell in the MS Office on January 21, 2023.

It was unpretentious, practical and deeply felt.

I spoke in Marathi for nearly twenty minutes. I began with a confession: I had come to the MS Office reluctantly.

I was a physician, a teacher and a researcher. I knew how to look after patients, teach students and do research. I knew very little about running a hospital. Yet here I was, thirteen years earlier, sitting in the MS chair and trying to work out what I was supposed to do.

What helped me in those early days was something I had learnt almost by accident. While helping develop the hospital information system, I had begun to look at the hospital through its numbers. How many patients came each day? Where did they wait? How long did they wait? Which beds were occupied, and which lay empty? Where did work pile up? Where did patients lose time?

The numbers could not tell me everything. But they often told me where to look.

Over the years, I learnt to use them to make small changes. Sometimes they worked. Sometimes they did not. A few looked promising on paper and fell apart when they met the real hospital. I had my share of dreams and nightmares, expectations and disappointments, successes and failures. The COVID year provided enough of each to last a lifetime.

I spoke about the gap between ideas and reality. We would make a plan in the morning and discover by afternoon that the hospital had other plans. Some plans survived. Others quietly went the way of many good intentions.

Through all this, I tried to keep one person at the centre of the hospital: the patient. I kept asking a simple question: would this make things easier for the patient? Sometimes it meant reducing a queue, removing an unnecessary step, making information easier to find or redesigning a system that had become more convenient for us than for the people we served.

I did not always get it right. Hospitals are complicated places, and they have a way of exposing the flaws in simple solutions.

What I learnt, above all, was to listen.

The useful idea did not always come from the person sitting at the head of the table. A plumber could tell me why the hospital had run out of water. An electrician could point to the fault that left the ICU hot and humid. A clerk knew which file had vanished and where it might turn up. A pharmacist could explain why a patient hesitated at the counter when offered a generic drug. A nurse knew what happened to a patient after the consultant had left the ward.

A driver knew which road would save an ambulance precious minutes. A social worker knew which family had gone home because they could no longer afford the treatment. An office attendant knew which small problem had been irritating everyone for weeks.

Each saw a hospital that I could not see from the MS Office.

I listened to them. Sometimes I acted on what they said. More often than I care to admit, they were right.

Almost everyone supported me, regardless of where they stood in the institutional hierarchy. I came to understand that a hospital is not run only by those whose names appear on the organization chart. It is kept alive by hundreds of people doing their jobs, solving small problems, noticing what is wrong and, every now and then, rescuing an administrator from one of his better ideas.

I cited the stanza “Ae Maalik Tere Bande Hum” from the 1957 Hindi classic Do Aankhen Barah Haath, directed by and starring V. Shantaram. Its simple moral message expressed what I believed we owed to the people we served: honesty, humility and a sense of responsibility. These were also what our colleagues and patients had every right to expect when they came to the hospital or worked there.

I had spent thirteen years in that office. I had made mistakes, changed my mind, learnt from others and, on a good day, perhaps made a few things better.

That was all I could claim.

I was determined not to become emotional. I wanted to leave quietly, with the dignity I had tried to bring to the office for thirteen years.

Colleagues spoke next. They recalled midnight emergencies, long days that blurred into nights, and small victories that rarely made it into reports. Shaily then presented me with a beautifully crafted frame, a collage of photographs from my years in office.

Only later did I learn what Manish Hazare, the office attendant, had done. He had collected photographs of me over the years—speaking at meetings, cycling to work, sitting in the MS Office, examining patients, teaching medical students, and listening to the crowd in the registration OPD. He took them to Dafe Framing House, a fifty-year-old framing shop in Wardha, and persuaded the owner to keep the shop open well past midnight so that the collage could be completed in time for the farewell.

He had told no one what he was doing. Only Shaily knew.

That small act of kindness undid me.

Messages also began arriving—from former students, from Sister Genie, and from Abhishek Raut. They wrote generously about my years as Medical Superintendent and my decision to leave. Reading them, I felt reassured that I had chosen the right time.

Later that day, I published a reflection on Facebook. I described my years as Medical Superintendent through the language I knew best: cricket.

“This morning, I hung up my shoes. I stepped down as medical superintendent of the MGIMS hospital. Thirteen years ago, I became a reluctant MS… catapulted straight into test cricket, forced to make my debut at Sabina Park without ever having played first-class cricket… The pitch was treacherous, the sky overcast… Over weeks, I learnt where my off stump was…”

I wrote that I wanted to leave at the right time and hand over the reins to a younger, brighter faculty. I quoted Vijay Merchant: “Retire when people ask why and not when.” I also wrote about what I hoped to do next—to teach, care for patients, particularly those needing palliative care, return to research, and spend more time reading, writing and being with my grandchildren.

Writing those words felt liberating.

Then came the other side of the contrast.

There was no formal send-off from top management, no acknowledgment from the institution I had served for four decades.

I had not expected a ceremony. But I had expected a handshake.

The silence hurt more than I had anticipated.

Perhaps that was my final lesson as Medical Superintendent. Institutions remember work differently from people. They need people intensely while they are there; once they leave, the machinery moves on. The work remains in the records. The people move on with their lives.

What stayed with me was not the silence at the top but the warmth below it—the people who had worked beside me, shared the difficult days and remembered the small things.

I left the MS Office behind. I surrendered the designation without regret. I carried with me ten thousand kilometres of cycling, countless patients seen, students taught, crises survived, friendships made, and the hope that the hospital was a little better than I had found it.

The “SP” bookshelf remained.

The letters on the door changed.

And I was free.