8.2
The Battle for the Medical Soul
HCQ and the Mirage of Miracle Cures
While we were physically dragging beds into the old hospital building and fortifying our “Red Zones,” a second, more insidious front was opening: the battle for the medical soul. In the early weeks of 2020, the vacuum of knowledge was being filled by a toxic mixture of desperation, political grandstanding, and pharmaceutical opportunism. As Medical Superintendent, I realized that my most difficult task would not be procurement of masks, but the procurement of truth.
The atmosphere in the global medical community had become feverish. Across the world, doctors were “panic-prescribing.” The logic was seductive: “In desperate times, we cannot wait for trials. We must do something.” But at Sevagram, we viewed this logic as a trap. We knew that doing “something” without evidence was often more dangerous than doing nothing at all.
The Hydroxychloroquine Mirage
The first major contender for a “miracle cure” was Hydroxychloroquine (HCQ). It was a drug I knew well—an old, reliable workhorse for malaria and autoimmune diseases like lupus. Suddenly, it was being hailed as a magical shield against the coronavirus. The Indian Council of Medical Research (ICMR) had recommended it as a prophylactic for healthcare workers, and the President of the United States was endorsing it from the White House briefing room.
The pressure on me was immense. Staff members looked to me for the green light to start taking the pills. Families of patients begged for it. Even within our own faculty, there were voices arguing that we were being “too rigid” by waiting for data. But I sat in my office, late into the night, scouring the preliminary reports. The “evidence” was anecdotal, thin, and riddled with bias. We were witnessing the birth of a miracle through sheer repetition rather than rigorous proof.
I realized then that Sevagram had to take a stand. I reached out to my colleagues—Sahaj Rathi, Ashwini Kalantri, and Pranav Ish. We decided to voice our dissent not on social media, but in the highest court of medical opinion. We wrote a letter to The Lancet Infectious Diseases, warning that “scientific reasoning cannot be abandoned citing desperate times.”
When our letter was published on April 16, 2020, we felt like a lonely outpost in a stormy sea. We argued that the blanket endorsement of HCQ was a gamble with public health. We were mocked by some as being “armchair critics” while others were “fighting on the frontlines.” But for us, the frontline was the science. History, eventually, would prove us right—the drug offered no benefit and carried real risks to the heart. But in that moment, it was a battle for the very soul of how we practice medicine.
The War on “Irrational Cocktails”
As the first wave swelled, the list of “miracles” grew longer and more expensive. After HCQ came the tsunami of Azithromycin, Ivermectin, Zinc, Vitamin D, and eventually, Convalescent Plasma. It was as if the medical world had forgotten a century of progress and returned to the days of alchemy.
I watched with dismay as prescriptions from across the country—and even from within our district—became “cocktails.” Patients were being loaded with five or six unproven drugs simultaneously. This wasn’t healthcare; it was the monetization of fear. Pharmaceutical companies were prospering on the back of flawed, small-scale trials that wouldn’t have passed a first-year medical student’s scrutiny in normal times.
I remember a particularly heated debate regarding Favipiravir. It was marketed as a game-changer for mild cases, yet a full course cost ₹12,500—a staggering sum for the farmers and laborers who came to Sevagram. When I looked at the data, the drug shortened a fever by barely a day and had no impact on viral load or mortality. It was a classic example of a “low-value” intervention being sold as a life-saver.
The Poet as a Shield
In June 2020, reaching the end of my patience with traditional academic rebuttals, I turned to a different weapon: satire. I realized that when people are gripped by fear, data often bounces off them, but irony can sometimes pierce through. I wrote a poem in the voice of Favipiravir:
“My name is Favipiravir, I have made my mark In the world of Covid, I am a new patriarch… So what if you can’t locate me in Pubmed Haven’t I really painted the entire country red?”
I posted it on Twitter, which had become my digital “pulpit.” The poem went viral, sparking both laughter and outrage. But underneath the rhyme was a serious administrative policy: Sevagram would stand alone. We made a collective decision that our hospital would not use these “magic bullets” unless they were part of a sanctioned, high-quality clinical trial. We refused to be part of a system that sold false hope to the poor. We stayed the course with oxygen, steroids (when appropriate), and anticoagulants—the boring, evidence-based basics that actually saved lives.
The Twitter Front and New Alliances
This stand for evidence-based medicine brought me into a new world of “Digital Public Health.” I began connecting with a network of brilliant investigative journalists and activists—Priyanka Pulla, Rema Nagarajan, and Malini Aisola—who were digging into the regulatory failures that allowed these drugs onto the market. I found a kindred spirit in Dinesh Thakur, the whistleblower who had exposed fraud in the generic drug industry.
Together, we tried to build a dam against the flood of pseudoscience. My roles as Medical Superintendent and as an advocate for the poor were now one and the same. To protect my patients from financial ruin, I had to fight the very protocols being pushed by the state. It was an exhausting, often lonely journey, but it reinforced the core philosophy of MGIMS: we serve the patient, not the pharma company.
As the months passed, the “silent corridors” of the first wave were replaced by the “noisy war” of the second. But because we had fought the battle for the medical soul early on, we entered the next phase of the crisis with our vision clear. We knew what worked, and more importantly, we knew what didn’t. We were ready for the oxygen crisis, not with magic pills, but with the discipline of truth.