The Burnout
By the summer of 2022, I had served as Medical Superintendent of Kasturba Hospital for nearly thirteen years. My predecessor had held the post for a decade; I had surpassed him in time, if not in patience. But calendars mattered less than the persistent heaviness in my gut. I was tired in a way that sleep did not cure.
Administration had once energized me. I enjoyed the complexity—budgets, people, crises that demanded quick decisions. Over time, that energy thinned. I found myself losing touch with the two things that had brought me to Sevagram in the first place: patients and students. To patients, I was no longer the physician they sought out. I was the official who was “never available” in the OPD.
My wife Bhavana noticed it before I did.
“These days our colleagues no longer smile in the hospital corridors. Many simply look away.”
She was right. The daily friction of administration—saying no to colleagues, managing expectations, firefighting without pause—had hardened me. I could feel cynicism seeping in, quietly, like a leak in a boat that still appeared seaworthy.
The institution, too, seemed to be losing its momentum. Decisions took longer. Younger faculty found better opportunities elsewhere. Some of our most energetic clinicians were frustrated by the lack of space, equipment, or freedom to pursue their plans. Our urologists, for instance, had ideas and ambition but struggled to find room to put either to work. Bright young people in surgery, pediatrics, and medicine were steadily moving to institutions such as AIIMS.
The hospital was not failing. That was perhaps the problem. It was stagnating.
I had begun to wonder whether my continued presence as Medical Superintendent was helping or merely postponing the inevitable need for change. Institutions rarely decline in one dramatic collapse. More often, it happens through a series of decisions deferred.
Around this time, I came across a line by Morgan Housel that struck me with the force of a diagnosis:
“Those we admire most in sports, business, politics, and entertainment tend to share one quality: They knew when it was time to quit, time to pass the baton, time to disappear, in a way that preserved, even enhanced, their reputation. Nothing diminishes past success like overstaying your welcome.”
I recognized myself in that sentence.
I had played my innings. Staying on would not solve the deeper problems. It might even delay their resolution.
Months passed. Conversations with management were cordial but circular. I was reassured that I was “irreplaceable”—a word that often means “convenient.” My resolve hardened. This time, I would not negotiate with myself.
On January 4, 2023, I finally wrote the letter.
I said simply that the cumulative weight of administration had begun to erode my peace and purpose, and that my family—wisely—insisted that health come before titles. I asked to be relieved within days, not months. I invoked Vijay Merchant’s old advice: retire when people ask why, not when they ask why not.
On January 15, Dhirubhai came to Sevagram. After discussions with Mr. P.L. Tapdiya, Dr. B.S. Garg, Dr. A.K. Shukla and me, Dr. Poonam Verma Shivkumar was chosen to succeed me as Medical Superintendent, with Dr. Ramesh Pande as her deputy.
Leaving was not easy.
But staying would have been harder.
Stepping down felt less like retreat than stewardship: giving the institution a chance to renew itself, and giving myself a chance to return to the work that had first brought me to Sevagram—teaching students, caring for patients, and having some control over my own life.