Chapter 4  |  Page 2
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The Rhythm and the Record

A Tribute to the Invisible Pillars of Medicine

The Rhythm and the Record

5 min read

In the early decades of MGIMS, the Department of Medicine rested not on titles but on temperament. Two men—Kiran Munjewar and Sudhakar Bijewar—carried no MD degrees after their names, yet the wards leaned on them the way an old house leans on its central beams. If they were absent, the place felt slightly unstable, as though a screw had come loose somewhere.

They had arrived when the institute was young and stayed long enough to grow old with it. As a resident, I depended on them without knowing it; as faculty, I depended on them knowingly. They were always present—on Sundays, on Diwali afternoons, during monsoon nights when the power failed and the generator coughed into life. They did not speak of dedication. They simply reported for duty and began work.

In a hospital that loved meetings and memos, they believed in neither. Their loyalty was to the next patient, the next strip of paper, the next slide under the microscope.

The ECG Room and the Earthing Ritual

If you mentioned an ECG anywhere in Sevagram, someone would say, “Ask Munjewar.”

The ECG room was small, warm, and faintly metallic in smell, like overheated wiring. In one corner stood the old BPL single-channel machine—cream-coloured, heavy, and stubbornly reliable. It did not forgive carelessness. A clean tracing required patience, good earthing, and a steady hand.

Munjewar treated that machine the way a priest treats an altar.

Before every recording he went through a quiet ritual. The green earthing wire was clipped firmly to a water pipe or sometimes to a copper rod pushed deep into the soil outside the window. The patient’s skin was rubbed with spirit until it shone. The brass electrodes were pressed down carefully, as though he were persuading them, not forcing them.

Then he waited.

If the patient was anxious, the baseline trembled. So he would rest a hand lightly on the patient’s shoulder and talk about something ordinary—how far the village was, whether the crops had survived the rain, whether the bus had been crowded. The heart rate would slow. The line would settle.

Only then would the stylus begin its slow, scratching journey across the thermal paper, burning the rhythm into a grid with a soft skritch-skritch sound.

Today machines interpret and print diagnoses in bold letters. Munjewar interpreted faces first, then hearts.

Geometry, Not Waste

Paper, to him, was not expendable.

Where a young resident might waste half a roll waiting for the leads to settle, Munjewar moved through them with quiet precision—I, II, III, then the augmented leads, then the chest leads—each switch timed so perfectly that the entire twelve-lead ECG fit into half the length we would normally use. Watching him was like watching a tailor cut cloth without leaving scraps.

He could spot trouble before the rest of us found our pens. A faint ST depression, a shy heart block, an evolving infarct—he would tap the strip and say, “Something is changing here,” and nine times out of ten he was right.

Over the years he must have recorded hundreds of thousands of ECGs. The P waves and QRS complexes were not abstractions to him; they were old acquaintances.

The Side Lab Republic

If the ECG room belonged to Munjewar, the side laboratory belonged to Bijewar.

It was a cramped, dim room that smelt permanently of stain, spirit, and warm glass. No automation, no screens, no reassuring beeps. Just benches, microscopes, slides, bottles with handwritten labels, and residents who learnt quickly or suffered.

Every Medicine resident passed through that room like a rite of passage.

Residents estimated haemoglobin with Sahli’s tubes, squinting to match colours. They made smears by hand and hunted for parasites under oil immersion until their eyes watered. When a patient came in with suspected meningitis, they did not wait for a central lab report. They carried the CSF straight here, counted the cells ourselves, and made decisions on the spot.

Medicine, stripped of glamour, looked like this: stained fingers, bent backs, and the smell of Leishman’s dye.

Bijewar ruled this republic with quiet authority.

The Gospel of Frugality

He believed waste was a moral failure.

To ask for an extra slide invited interrogation. “Why two?” his raised eyebrow seemed to ask. “One is enough if you know what you’re doing.” Coverslips were washed and reused. Reagents were measured like precious medicine.

If someone spilled stain or used too much Benedict’s solution, he noticed. He never scolded loudly. The reckoning came later, in a soft voice, with accounts demanded like a shopkeeper balancing a ledger.

At the time we found it excessive. Later, working in resource-poor settings, we understood that he had been teaching us something more important than thrift. He was teaching respect—for material, for labour, for the small economies that keep a rural hospital alive.

Clinical excellence, he seemed to say, begins with not wasting what you have.

The Great Purge

Around the year 2000, when we were converting the old ward into an ICU, I decided that the Medicine office needed cleaning. “Cleaning,” I imagined, meant order. To Bijewar, it meant catastrophe.

The office had become a geological site. Files from the 1970s lay under files from the 1980s. Leave applications from doctors who had long retired slept peacefully beside circulars announcing Independence Day celebrations from another century.

One Sunday morning I gathered a group of residents. Sleeves rolled up, we attacked the room with revolutionary enthusiasm. Old forms, yellowed notices, ancient mark sheets—out they went. For three hours we cleared, dusted, rearranged, and admired the sudden space as though we had discovered land.

On Monday at nine, Bijewar walked in.

He stopped at the door.

His eyes scanned the shelves the way a man scans the aftermath of a burglary. “Where are the files?” he asked quietly. To us they had been junk. To him they were history, proof, continuity—the paper memory of the department.

There was a brief protest, a small lament for vanished documents, and then acceptance. But for days he handled the new shelves like a man learning to live in a house rebuilt overnight.

We called it decluttering. He probably called it vandalism.

What Remains

Today both men have slowed. Age has done what administrators never could.

Bijewar walks carefully now, Parkinson’s and osteoarthritis negotiating each step, yet the old half-smile survives. Munjewar spends his mornings in his garden, coaxing tomatoes into ripeness with the same patience he once used on anxious patients.

When I meet them, we speak of ordinary things. They never list achievements. But whenever I look at a clean ECG or a neatly prepared slide, I see their handwriting.

Machines today are faster, cleverer, almost arrogant. They announce diagnoses before we think. Yet sometimes, standing in a modern ICU full of screens and algorithms, I miss those two men and their deliberate ways—the careful folding of a strip, the measured drop of stain, the sense that tools deserve respect.

They did not merely record rhythms or count cells. They taught us how to practise medicine without noise, without waste, and without drama.

The department still stands on the foundations they laid, though most of us realised it only after they had quietly stepped aside.