This is not a book about medicine, though medicine runs through every page. It is not a book about rural India, though Sevagram — Gandhi’s village — is its setting. It is, in the end, a book about choices: the small accidents that begin a life, and the larger decisions that quietly shape it.
I did not set out to write a memoir. For years the idea felt unnecessary, even faintly vain. My days were spent inside a rural hospital, looking after patients who would never make headlines. What story could that possibly hold? But colleagues, students, and friends kept telling me to write before the details blurred and the people disappeared. I resisted for a long time. Then, one day, I began.
What follows is the story of a middle-class boy who drifted into medicine, arrived in Sevagram on a salary of ₹650 a month, and never quite left. I came with more enthusiasm than skill. I stayed because the work mattered. Along the way I learned medicine, unlearned certainties, made mistakes, changed my mind, and tried again. I have tried to write about the failures as honestly as the successes.
Forty-four years on, I am still here. I have changed four homes, all on the same campus, but the campus has not changed me nearly as much as I once expected it might. I teach in the same classrooms. I round the same hospital wards. I bank at the same two branches — Central Bank of India on one side of my house, State Bank on the other, both within a handshake’s distance of my front door. I post my letters at the same post office. Most days, I still walk down the same stretch of Gandhi Ashram Road.
Even my barber has not really changed — he has, from father to son, while I have simply gone on sitting in the same chair. Our house help still comes from the same village it always has. My children trained in the hospital where I taught. My wife served in that hospital too. Now my son works there as well — and so does my daughter-in-law.
The book moves through thirteen parts. It opens with my birth, my childhood, my school days, a brief and largely forgettable year in a science college, and then nine formative years at Government Medical College, Nagpur, where I earned an MBBS and an MD in Medicine, and picked up a lifelong respect for teachers who demanded more than textbook answers.
From there the story moves to Sevagram in the summer of 1982, where I arrived expecting to stay briefly and somehow never left. The later chapters trace my years as a teacher, physician, researcher, and administrator at the Mahatma Gandhi Institute of Medical Sciences, and include some of the work that has mattered most to me: keeping the drug industry’s influence out of medical education, helping build a hospital information system before computers were fashionable anywhere in rural India, starting a palliative care service where none existed, shaping the physical spaces patients and students move through, and trying, always, to teach a style of medicine built on evidence, restraint, and plain common sense.
The book is not only about hospitals and institutions. It is just as much about family — my parents, brothers and sisters, my marriage to Bhavana, our children, their schooling and their marriages, and the ordinary domestic life that ran alongside the demands of medicine, all finding their place here.
There are clinical puzzles, research studies, and ethical knots with no clean resolution. There are malaria wards and snakebites, traditional healers and new machines, deaths we could not prevent and the occasional recovery that felt like grace. There are shortages of money, of staff, and sometimes of common sense; bureaucratic tangles and the small absurdities that keep public institutions alive regardless. Above all, there are people — students who arrived eager to change the world, colleagues who became friends, and villagers whose quiet resilience kept the rest of us going. Some names have been changed; the stories themselves are true.
This is not a textbook or a policy document, and it offers no grand theory and very little advice. Nor is it a sermon. Poverty here is neither romantic nor picturesque. Rural India can be generous and cruel within the same hour, and I have tried to show both.
If you are a young doctor, you may find here an honest account of practising medicine where investigations are few and judgement matters more than either. If you work in public health, you may recognise how policy actually looks from the ground, where a missing drug or a delayed decision can alter a life. If you are simply curious, you may meet a village and its hospital as they are, without embellishment.
Do not expect heroics. Most days in medicine are made of smaller acts — listening carefully, making the best decision with the tools at hand, admitting uncertainty, learning from error. Medicine, in the end, has less to do with drama than with steady work done well, day after day, for a very long time.
The chapters move roughly in time, though each stands on its own, and you may read them in order or wander as you like. Some pages describe suffering and failure plainly, without softening, because medicine does not soften them either. Pain, too, is part of the truth I have tried to tell.
Memory is unreliable. Conversations are reconstructed, motives interpreted, events filtered through my own lens on them. Wherever I could, I checked records and spoke to colleagues; where I could not, I relied on recollection, and tried to be fair to others and to myself in equal measure. If I appear occasionally foolish or wrong in these pages, it is usually because I was.
Many stories remain untold — confidences that must stay private, wounds better left unopened. What is here is what could honestly be told.
This book exists because others insisted that it should. I stayed in Sevagram because my family accepted a modest life without complaint. I learned from patients who trusted me and students who challenged me. Whatever I gave this village, it returned to me many times over.
That is the truest thing I can say, about this book and about my life: I did not design it. I simply never left it.
Since I first wrote these words, one more change has arrived: on 1 September 2026, forty-four years after I first rode through these gates, I handed over my duties as Director-Professor and became Emeritus. The title is new. The ward rounds are not.
Sevagram, September 2026
SP Kalantri