Rachna Singh, Editor, The Wise Owl talks to Dr Anand Gokani, a multi-faceted personality who balances roles of a doctor, creative writer and artist with elan. Dr Anand Gokani is a Consultant Physician with Diabetes and Metabolic Diseases as a speciality.  He has practiced at the Bombay Hospital and the Breach Candy Hospital in Mumbai for the past 36 years. Dr Anand Gokani’s role as a Trustee at the Bombay Medical Aid Foundation is a testament to his dedication to providing care and support to those in need. He founded a Palliative Care Ward at the hospital to care for terminally ill patients to give them comfort and dignity in the last months of life.

An avid traveller, Anand writes and reads various subjects and enjoys sports and photography. He has authored a book on The Role of Vegetarian Diet in Health and Disease (1988). He has also compiled a book on pictures and aphorisms titled ‘At The Crack Of Dawn’ (2022). His latest title ‘A Fistful of My Sky: Memories of Jawhar’ (2024) is an experiential book that documents his experiences as a medical intern in Jawhar, a small town in Maharashtra.

Thank you for taking time out of your busy schedule and talking with The Wise Owl about your book ‘A Fistful of My Sky’.

RS: What inspired you to document your experiences as an intern in Jawhar and transform them into A Fistful of My Sky? Could you share the moment or realization that prompted you to preserve these memories in writing?

AG: Since my childhood I was fond of writing and reading. Having read so much over the years I realised that time is short and it’s high time I started to write too. I have had a chequered life with its share of ups and downs and I always thought that, one day, I will pen my thoughts and my life’s events for the next generation to read. I thought, if my experiences help someone to learn and move on higher than where I left off, it would mean I lived my life well. So, I picked up my pen to record my life and my thoughts. A chance trip to the adivasi region of Jawhar to scout for an appropriate location to hold a social service school camp suddenly brought me face to face with my past experience there as an intern. This visit brought back all the memories of my time spent there during my training as an intern and, when I saw that the life of the poor peasants of Jawhar had hardly progressed since we had left the area in 1981-82, inspired me to do something for them. This motivated me to make my first foray into the literary world. Writing this book has not only re-ignited my memories of one of the best times in my life, but has also aroused in my heart the strong desire to do something for the people of Jawhar. I wrote this book to apprise the Haves about the Have-nots so that it may awaken the desire amongst many more to do something for our fellow humans.

RS:  How did the time spent in Jawhar shape your perspective as a young doctor and as an individual? Did the experience influence the direction of your medical career or your philosophy as a healthcare provider as well as an individual?

AG: After finishing MBBS, we are mandated to do a year-long internship wherein we are given supervised freedom to treat patients. We have to spend six months in an urban setting and six months in a rural setting. I selected Jawhar for my rural stint with a sense of trepidation and guarded excitement. I didn’t know what I was in for and was not being helped by my colleagues’ constant chiding for having selected a tough centre to do my rural stint. However, as is evident in the book, I was drawn into the magic of the people and the environs of Jawhar and very soon, I was completely immersed in work and involved fully in the life of the hospital. What I learnt there was the value of hard work, the meaning of gratitude, simplicity in living, and innovation in high pressure situations. The raw materials for this learning experience had been accumulated in the urban setting. These qualities were honed to sharpness in this setting of unremitting adversity. This experience helped to shape in all of us the desire to serve the lesser fortunate, to continue to learn and innovate even as we grow in practice, to be content with what we have and to give ‘till it hurts’ (to quote Mother Theresa). This stint taught me that ailments can afflict anyone regardless of post or privilege and that our religion is to serve, no matter what.

RS: You mention stories of grit, gratitude, and innovation in your book. Can you share an anecdote from the book that epitomizes these qualities? For instance, the story of Dhavali or the medical case involving Shiva—what made these moments stand out for you?

AG: Grit, gratitude, innovation, resilience and persistence we learnt unequivocally. But, unbeknownst to our conscious appreciation we also learnt the four pillars of stoic philosophy—wisdom, justice, temperance and courage. Every day and every patient reinforced these lessons in our minds and finally made them second nature to our being.

When Dhavali arrived at our doorstep, we were expected to send her to a higher centre in Thane, ostensibly for better treatment. But that fact was for the books. In reality she was on the verge of death. If something was not done immediately. She would have NEVER survived the long and arduous journey to Thane civil hospital in her present condition. We were constrained to make the hard decision to keep her and give her our best despite all odds, and that paid us rich dividends in the form of a life saved. That gave us such a huge dose of confidence and fulfilment.

Similarly, in Potya’s case we were feeling our way in the dark, drawing on whatever pooled experience we could muster and exerting our every resource to save his life. The value of courage in the face of imminent danger and failure, persistence despite all odds and a kind of equanimity amidst adversity were lessons learnt on those nights where we soldiered on with a prayer on our lips and hope in our hearts.

The scene of gratitude that touched the core of my being was when Laxmi’s husband came to thank us after we had saved her life despite her being so advanced in the complications following a snake bite. I can never forget how he untied the corner of his dirty cloth deliberately with a thoughtful and grateful expression on his countenance and pulled out an old, soiled, one-rupee note and, placing it on the table, smoothing out the creases gently, he presented it to us, saying that he had nothing more to give us by way of gratitude. The memory of that day, that moment, still brings a lump to my throat. And finally… in Shiva’s case, we learnt the true meaning of ‘Fortune favours the brave’ and nearer home…Dar ke aage jeet hai !

RS: This memoir is a blend of medical, cultural, and personal narratives. What was your approach to weaving these threads together? How did you balance the technical aspects of medicine with the emotional and cultural storytelling?

AG: Life is a blend of medical, cultural, personal and so many other narratives. Don’t you agree?… Hence, since this was a ‘fistful of my Sky’ meaning ‘a bit of my life’ it wasn’t difficult to weave these emotions as they occurred in my life, in my mind. I have simply related my mind’s state in the midst of all these events and the emotions that they aroused. And…since this book was aimed at everybody, medical or non-medical, I kept the style simple and easily comprehensible. I feel, heavy technical jargon in any situation is contrary to the sustenance of interest and attention… and this was the guiding principle in keeping the text simple yet absorbing for the lay reader as well as a medical professional.

RS: Our readers would be curious to know if you plan to write more about your experiences in medicine or explore other themes in your future work? Are there other aspects of your journey as a doctor that you feel compelled to share. Do you see yourself continuing with non-fiction, or are you interested in exploring other genres?

AG: As I have had an extremely eventful and rewarding career in Medicine, I have truckloads of experiences that i can share with people. Hence I am very comfortable penning my thoughts on my experiences in Medicine and the learnings that I accrued from those experiences. These inputs would then border on issues of ethics, values, and philosophy in addition to the myriads of medical events. The state of Medicine and medical practice …what it was and what it is … would be another issue I would love to touch upon in future. Particularly since the entire health care scenario has taken an about turn with the advent of new technologies and the commercialisation of health care. I would love to delve into the world of fiction but haven’t given serious thought on the genre I’d like to pursue.

RS: Looking at your books, it is clear that you have nurtured your creative side even while you worked as a doctor to alleviate suffering and disease. Your photographs in your coffee table book are stellar and your book ‘A Fistful of sky’ has lyrical flow that is rare. Tell us, we are curious to know, how you nurtured your creativity?

AG: Thank you for your kind words. I would love to live up to their implications. We all have a creative side in us…dormant or active. Historically it has been seen that those who achieved success, fame, honour and glory in life; those who, in Kipling’s words, opened up each unforgiving minute and filled it with sixty seconds of distance run, were those who had unearthed and exploited their creative side. The creative instinct needs a release, needs nurturing, needs encouragement …or else it perishes, shackled in chains of low self esteem, lack of confidence or fear of rejection. One of the most useful supports to the unleashing of one’s creativity is to have a pen and paper handy at all times. Bits and pieces, nuggets, masterpieces of creativity, flash across the mind’s landscape at any time, without any warning, only to be lost in the quagmire of oblivion unless caught on time and immortalised on paper. This rather dramatic description is the actual way I tried to harness my creative spirit. In times of distress, despondency, delight or depression thoughts would spring out, sometimes even poetic, only to be lost when the mood changed. Adversity is the mother of creativity and some of the best prose or poetry has been born in difficult times. Lock down afforded the time for introspection and the opportunity to give a tangible form to latent creativity. The rest is practice and more practice to get better and better at your endeavour.

RS: How do you see rural healthcare in India evolving today? Do you think the issues you faced in the 1980s still persist in rural healthcare today? What changes would you like to see to improve the lives of doctors and patients in similar settings?

AG: I feel that every society, in today’s times, is roughly divisible into urban and rural. We can add the word semi to both to account for the borderline classes. And I dare say, with a great deal of trepidation, that the urban society is forging ahead exponentially whereas the rural society is being completely denied any advantage of the progress being made around us. The stark divide is only becoming wider with the passage of time. The principles adopted for rural development are the same ones adopted for the urban society. There is no relevance in the measures being taken for rural development. The examples are many. For instance, the cottage hospital where I worked had been given brighter lights and granite-like flooring but the means of transportation to the hospital or the quality of doctors attending has deteriorated over the years. The plight of the adivasis remains the same. Deaths still occur for reasons that are unimaginable to the city dweller. What rural healthcare needs is a relevant programme that affords them with basic care. They need a good mother-child care network which is easily accessible, better transportation to the hospital or health centre, and better doctors who can deliver treatment. They don’t need granite flooring and sophisticated ICU and surgical theatres, nor do they need 200 bedded hospitals which are not connected to remote villages by regular buses or quick response ambulances. There is so much to do…but it needs the Will to do it.

Thank you so much Anand for taking time out of your busy schedule to talk with The Wise Owl. Our compliments for the tremendous work you are doing in palliative care and our best wishes for your creative journey.