In a candid conversation Dr Parvez Koul (MD, FACP, FCCP, FRCP ,London)Professor & Head, Department of Internal & Pulmonary Medicine,SKIMS talked to Zia Darakshan, Associate Editor INS about his life, gains and losses, health sector of the state and how a tweet could get him barred from travelling to United States of America. Even though he still cherishes the offer life had thrown to him to be in US long back but he preferred to stay in the valley.
ZD: How do you see health care scenario here and how do you place yourself in it?
PK: The scenario of healthcare system in Kashmir is not great and there is a scope for huge improvement. However, it has improved to a significant level. The surgeries which used to be only the domain of super specialty hospitals, are being carried out now in district and sub district hospitals. The capacity of those centers has been augmented substantially. Those centers are doing better and are improving day by day however there is a lot that needs to be done.
SKIMS is doing a lot by contributing hugely in the management of cases that are referred here. It has also contributed immensely by producing trained manpower that man the peripheral health care institutions of the state now and there is a tangible difference in the peripheral health care. But then there is huge scope for improvement and that improvement can and must come.
To be honest, I am not satisfied with the healthcare system of Kashmir. We have not given best to the patients. We have to understand that we are a poor state in a poor country. We lack in infrastructure, human resource and the biggest impediment is money. We have to strive for the things that are a routine in many centers across the world.
Private sector needs to be developed and people have to realize that healthcare comes at a cost. Medical insurance has to more routine.
We need five such hospitals, SKIMS pattern, in the valley itself not to mention J&K. We are way behind from where we should actually have been. But we mustn’t lose hope and we must chip in with the best we can.
ZD: A medical case in your professional life which has come as a challenge?
PK: For a doctor every single day and every case is a challenge. But there are few which really make you scratch your brain and test your knowledge.
We had a case of respiratory failure of an 18 year old girl who was admitted in the Intensive Care Unit.
Her profile fitted in a condition that had never been described here and was not known to exist here. I thought to the diagnosis, called renal tubular acidosis.
The patient was about to be airlifted to Delhi but I requested my seniors to give her sodium bicarbonate which is very simple to give. I was a junior those days hence wasn’t taken very seriously. Nobody agreed to my suggestion.
However a few members of the team said that there is no harm in giving that and it worked. She recovered and actually that single case and her treatment transformed the whole thinking of medical fraternity here regarding the presence and treatment of RTA in Kashmir and later on we published a lot of literature on that.
I would also derive a great degree of satisfaction from suggesting a diagnosis of thiamine deficiency to my pediatrician colleagues who were regularly seeing patients with heart failure in breast fed babies and these had a high mortality.
They started treating them with thiamine and that has actually changed the whole scenario of these babies who lead a normal full life.
I may take a little credit for investigating respiratory infections in Kashmir. We never knew that influenza infection even existed there. I worked a lot on getting a lab to the institute and got it funded through CDC, USA .The lab is up and running and has been actually the back bone of influenza testing for the past eight years. We have done more than 13thousand tests till now, all free of cost. The test normally costs upto 6500 rupees in the market. So in essence, we have done free of cost tests worth more than 7crores and the Government or the patients did not have to pay a penny for these.
While I would applaud myself for that, I maintain that it is the institution that is much bigger than the individual working within.
ZD: People know you as a doctor but as a person who is Dr Parvez. How would you define yourself?
PK: A bit impatient, impulsive or an outspoken person. I am candid in thoughts and speech but do get annoyed if I feel something is not right or up to the mark.
I want truth, call a spade a spade, even if it takes to speak against people in higher positions. I won’t hesitate and would express myself regardless of consequences or you can say I am unmindful of consequences.
I once tweeted to Donald Trump: “Why don’t you just leave? You have made a mess of America”. It did not cross my mind that this could imperil my travel to the US.
The present scenario of our state haunts my conscience. Despite curbs, I do express myself on social media in my personal capacity. Medical research, I love it. I make it a point to answer each e-mail. I also get angry quickly, agreed, this is a negative part of my personality.
God has been extremely kind to me, he provided for me more than I possibly deserved. I rose to become the head of the department where I joined as a junior resident. On the academic front, I have the highest number of publications in the medical fraternity in Kashmir and that in journals that people dream to publish in.
I established a laboratory in SKIMS that has equipment worth crores that was entirely funded by the CDC(Centre for Disease Control and Prevention),USA.
When I am gone and from up there, I see a young person working in my lab, that will bring peace to my soul. I don’t want it to be named after me. I believe that institution is always greater than the person and above all of us.
ZD: With all those traits in personality, was becoming a doctor your ambition?
PK: I opted for non-medical stream in 9th standard as selection of subjects was done in that class previously.
My elder brother chose the medical stream.
Call it a mere coincidence or destiny, that one day classes of Non-Med and Med were clubbed due to a teacher’s non-availabilit.
I got a chance to listen to the lecture of physiology, it was interesting. I made up my mind then and there, to change my stream from non-med to med. That was the most important U-turn of my life.
My mother left for hereafter when I was only 7 years old and it had been her wish to see me as a doctor.
It was the culmination of her wishes that ended up me joining medical profession and on the contrary my brother became an engineer.
ZD: Any intriguing experiences?
PK: In my 12th standard, I chose Mathematics as an additional subject and would go to Khawaja-Yarbal (near Central Jail, Srinagar) to study from Prof.Mohiddin sahib.
One day, it was snowing heavily and once I came out from the tuition, I met a man in ragged clothes. He asked for direction towards Lalchowk.
I accompanied him to show the right way.
He had a long brown pheran and carried a ‘Kang’ with live embers in it.
“Why are you wasting time by coming here, you will become doctor like Ali Jan one day .You don’t need to come here,” he surprised me with these words.
How did he speak about it, still baffles me? Spirituality that must be. He boarded a bus near Nowhatta. I haven’t seen him since.
Let me narrate another incident.
I got selected to move for professional work in Saudi Arabia. I had just returned from Delhi and had kept my passport in my suitcase wrapped in a polythene bag.
I somehow lost it, couldn’t find it even after thorough searchs and eventually received a letter of rejection since I could not report on time.
I was badly upset about the loss and lodged a mandatory FIR with police for the same.
The day I received the letter of rejection, I was looking for something and suddenly my eyes dazzled upon the polythene that had my Passort. Quickly opened that and there it was.
But by that time I had already joined SKIMS and my rejection had deprived me of an opportunity to work in Saudi Arabia. Looking back, I firmly believe that God had wanted me here to serve my own community. I always take it as a heavenly order. I believe in destiny, its part of our faith.
ZD: What has been your inspiration?
PK: My role model have always been my parents. My father was a clerk in Taxation department and he worked hard and tirelessly to provide us, 4 brothers, and a sister, a good life and education.
Besides, his job he set up a small business of shawls to further his income. My elder brother is an engineer, younger brother did his KPS and my sister has done post graduation. My father saw to it that we study well even when we lived in an area where educating children was rather uncommon.
I believe if, for my children, I can do only 5% of what my father did for us; I would be best father in the world. He had a very good command on grammar (English, Urdu and Arabic). He would give English tuitions in the evenings to make some extra-income to take care of us.
I recall that I and my brother used to go to professors which costed us Rs 850 per month and his net salary for many months was less than that, I can’t fathom how he managed.
I was his favorite child.
I still remember that when I went to medical college, an Aid Society used to help to provide old books for students who could not afford to buy the expensive books. Though I belonged to average lower middle class family and it was almost impossible to buy new books, my father made it a point that I always have new books.
I can’t ever repay my father who, in spite of limited means, toiled hard and left no stone unturned to provide us all the needs of our life.
The only discomfort I have today is that my father couldn’t see our prosperity and his dreams realized (voice choking and eyes moist).
He died on 3rd Feb,2005, the year when I got fellowship for US. It was the first time that I was travelling to USA. He died five days prior to my departure from India.
ZD: Happiest or saddest moment of your life?
PK: Happiest moment possibly was the day I got selected for MBBS and when I completed the degree. Now, its all about family, when they do well and are happy, it is a happier moment for me.
And saddest moment of my life was when my mother passed away in 1969 and then my father in 2005.
ZD: What was the turning turning point in your life?
PK:That physiology class I just told you shaped up my future. That one question in the physiology class: what is a system? invoked such a curiosity in me for the subject that it changed the whole gamut of my career.
ZD: Describe your family.
PK:I have a wife, and two kids (daughter and son). My son is doing MBBS and my daughter is doing B.tech in Civil Engineering and my wife is a medical doctor, she is working in the Government Health Sector.
Ours is a closely knit family. My brothers and I live together at same place in Lal Bazaar. Again thanks to our father, we share same compound wall but live in different houses.
ZD: Satisfied or Dissatisfied with your profession and staying back in Kashmir?
PK: I believe that there is a price tag for everything you do. Had I been in America I would have possibly excelled more in research, but then I would not have the comfort of having my own people around. By staying back here I lost chances of a better academic career. Had I gone to Saudi Arabia, I would have earned a lot of money. But the minus would have been that I would not have been able to do research the way I conducted it here.
So you always lose out on something whenever you take anything. One should always look at the people who are below and not at the people who are at the top. You should aim going at the top but that should not make you uncomfortable to the extent that you feel dissatisfied.
I am not dissatisfied because I derive my strength from my faith and Iman in Taqdeer or destiny: whatever is destined to happen, it will happen for you. That’s our Islam.
I have observed it practically a number of times. The patient we surmise is likely to die, walks out mocking at our understanding whereas the guy we believe is likely to go home the next day, is wheeled out dead on a stretcher. So there is something called destiny, The power called Allah.
ZD: Any decision you regret?
PK: Yes, I always think why did I not go to US and settle there. I had been given the option of staying their along with my family. The sole reason is that possibly I could have given my kids a better educational system.
For my decision, however, my kids pay the price but then they are two of thousands who live here and we are no way special.
I comfort myself with that reason but deep down, I must confess it is a bit tender to think of.
