A Research Odyssey

A boy with a curious collarbone (1986)

Strange as it may sound, my entry into medical writing did not begin with a grand hypothesis or a randomized trial. It began with a single sheet of paper—and a young boy with an unusual collarbone.

It was 1986. I had finished my MD five years earlier and had just been promoted as Reader in Medicine at MGIMS. A case report we had written—“Cleidocranial Dysostosis with Grand Mal Epilepsy”—was published in the Indian Journal of Radiology and Imaging.

To be honest, the paper was less my brainchild and more the product of good luck and seniority. Dr Sharad Pendsey, my senior from my house-officer days at GMC Nagpur, had driven the work. When the reprints arrived—ten neat pairs, wrapped in brown paper—I opened the packet like a child opening a prize.

My name sat at the end of a list of six authors. Not exactly the stuff of legends. But holding those reprints in my hands, I felt something shift. The ward work we did every day could live beyond the bedside. It could travel.

And it could stay.

Before journals, the bulletin (late 1980s–early 1990s)

For the next decade, my “research output” looked different from what people usually mean by research.

I wrote more for the MFC Bulletin (Medico Friend Circle) and the local press than for indexed journals. The topics were not glamorous—rational use of drugs, the political economy of health, and the everyday unfairness of rural medical care.

These pieces were not peer-reviewed in the strict sense, but they taught me something important: how to look at medicine with my eyes open. They trained me to ask why things happen, not just what happens.

In those years, I did not have sophisticated tools. But I was learning to think.

The pivot: McMaster, Berkeley, and a new lens

The real change came in the mid-1990s, when I was exposed to McMaster University and later did my MPH at UC Berkeley.

Until then, like many doctors of my generation, I practised a lot of what can politely be called eminence-based medicine—you trust your teachers, you trust the textbook, and you hope your experience fills the gaps.

McMaster and Berkeley introduced me to evidence-based medicine and clinical epidemiology. It was exciting—and slightly unsettling. Suddenly, “common sense” was not enough. A hunch needed proof. A treatment needed outcomes, not reputation.

I returned to Sevagram with a different kind of confidence. Not the loud kind. The quiet kind that comes from knowing how to ask a question properly—and how to test the answer.

A simple rule: give students the credit

Back home, I realised one thing quickly: research in Sevagram could not be a solo hobby. It had to become a habit. A culture.

I began guiding a large number of residents for their MD theses. In many medical colleges, a thesis becomes a heavy file that nobody reads again. I wanted ours to become something else—a piece of work that could stand outside the examination hall.

We chose questions that grew out of daily practice:
Does this clinical sign really predict pneumonia?
How accurate is this rapid test for malaria?
What puts rural Indians at risk for heart attacks?

We did diagnostic accuracy studies, risk factor work, and prognostic studies. But just as important as the methods was the ethics of authorship.

My friend and collaborator Madhukar Pai gave me a rule that stayed with me: the student does the work, the student gets the credit.

So the resident became the first author. I stayed in the background as corresponding author. Watching young doctors see their names in print—often for the first time—gave me a satisfaction that no “impact factor” can match.

When Sevagram entered big trials

In the early 2000s, the horizon widened again.

MGIMS became part of major international collaborations led by Dr Salim Yusuf and the Population Health Research Institute, through colleagues like Dr Prem Pais and Dr Denis Xavier at St John’s, Bangalore.

It was a leap of faith. Could a rural hospital in Vidarbha match the discipline and documentation required for multicentric global trials?

We proved we could.

We contributed to studies like INTERHEART, INTERSTROKE, and POISE. What pleased me most was not the prestige. It was the thought that data from our patients—farmers, labourers, housewives—was helping shape global understanding of disease.

Wardha was quietly entering the textbooks.

The people behind the papers

No research journey is a one-man show. Mine certainly wasn’t.

Two collaborators shaped my work deeply: Rajnish Joshi and Madhukar Pai.

Rajnish was my student from the 1992 batch. Over time, the teacher-student line faded. He went on to Berkeley for his MPH and later a PhD, and eventually we worked as colleagues. Watching his growth—from Sevagram to global health—felt personal, like seeing your own story rewritten in a sharper script.

With Madhu, I entered the world of tuberculosis research and “clinical operations research”—not only asking does it work? but also can it reach the patient who needs it? Some of that work contributed to questioning—and eventually stopping—the use of inaccurate TB serology tests. That felt like research doing its real job: protecting people from bad medicine.

What I see when I look back

Today, if I look at my PubMed list, it looks like a tidy record—titles, journals, years.

But I don’t see it that way.

I see residents collecting data late at night, fighting sleep and ward chaos. I see patients in Kasturba Hospital allowing us to learn from their illness, without ever asking what they would get in return. I see long email threads with co-authors debating one line in a table as if it were a life-and-death decision.

My research journey began with a case report of a boy with a collarbone defect.

It grew into something larger—a way of thinking, a way of teaching, and a way of staying honest in medicine.

And it taught me one lasting lesson: if you listen carefully at the bedside, the paper almost writes itself.

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