My Romance with Medicine: A Physician's Ongoing Journey of Advocacy

By Surendra K. Varma M.D.

From the bustling streets of post-British Raj in Lucknow, India, where his passion for healing ignited, to the hallowed halls of MIT and Harvard in Boston, where his academic prowess soared, Surendra Varma's path was one of unyielding determination and unwavering ambition. Arriving in Boston with only two dollars and fifty cents in his pocket, he epitomized the immigrant spirit—resilient, hungry for knowledge, and driven by a passion for healing.

 

But his pivotal move to the dusty plains of Lubbock, Texas, during the tumultuous 1970s tested his mettle. Confronted by discrimination and the sometimes-ugly politics of medicine, Surendra blazed a trail of change, fearlessly advocating for the most vulnerable—the infants born in the state—by crafting a groundbreaking bill. His tireless efforts led him to testify before the Texas Congress, ultimately championing legislation that transformed the landscape of neonatal care and forever altering the destiny of countless lives.

 

Surendra's evolution from a naïve young physician to an esteemed professor and a revered global advocate underscores his dedication to innovation and inclusivity. His journey has shaped medical curricula and transcended borders, leaving an indelible mark on healthcare systems worldwide.

 

My Romance with Medicine is an inspiring testament to the strength of the immigrant experience, offering invaluable insights into the intricacies of medicine and the power of advocacy. A compelling narrative that underscores the transformative impact of perseverance, compassion, and steadfast determination in the realm of healthcare, this memoir is a must-read for every medical enthusiast, aspiring professional, and anyone captivated by the relentless pursuit of healing and equity.

• Language: English
• Publisher: MC Varma Publishing LLC
• Release date: May 9, 2024
• ISBN: 9798990477001

Book preview

Advance Praise for My Romance With Medicine

D

r. Surendra Varma

came from a traditional, highly educated, and disciplined family that instilled in him life values grounded in Indian soil. He traveled offshore to work with diligence and clinical passion at Boston Children’s, Massachusetts General, and Harvard, finally settling at the Texas Tech Medical Center. His commitment to clinical care, teaching, and research for over six decades is surpassed only by his international initiatives. He successfully transformed neonatal and pediatric care globally, especially by introducing the neonatal program for hypothyroidism, a screening carried out worldwide. It is no wonder he has earned high praise at Texas Tech University and received honors, recognitions, awards, medals, and esteemed titles from respected institutions and organizations worldwide. Indeed, he raises the Indian flag high on foreign soil.

I wholeheartedly congratulate Professor Varma on this treatise. My Romance with Medicine: A Physician’s Ongoing Journey of Advocacy summarizes his long journey with life experiences that are both sweet and sour. The book is sure to inspire medical and non-medical fraternities equally well. Readers will thoroughly enjoy picking up the many pearls of his life.

Prof. Devendra Gupta

MBBS

,

MS

,

M

.

C

h (

AIIMS

),

D

.

S

c (Honoris Causa),

FAMS

-India,

FCS

(Sri Lanka)

Hon.

FRCS

(Glas.), Hon.

FRCS

(Edin.), Hony.

CICOPS

Fellow (Italy),

Hony.

FAMS

(Romania)

Former Professor and Head

Dept. of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India

Vice Chancellor- King George’s Medical University, Lucknow, India

Director and

CEO

- Postgraduate Institute of Child Health, Noida, India

Hony. Professor -Centre for Biomedical Research, Lucknow, India

My Romance

with Medicine

A Physician’s

Ongoing Journey of Advocacy

Surendra Varma, M.D.

MC Varma Publishing, LLC

Copyright © 2024 by Surendra Varma

All rights reserved. No portion of this book may be reproduced, scanned, or distributed in any printed or electronic form without written permission. Please do not participate in or encourage piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions.

Events and conversations in this book come from the author’s recollections. As such, they are not intended to read as word-for-word transcripts and unequivocal facts but retold in a way designed to evoke meaning and emotion. In all cases, the author has attempted to honor the essence of dialogue and happenings as accurately as possible. Some names and identifying details have been changed to protect individuals’ privacy.

Varma, Surendra K., 1939–

Summary: A physician’s extraordinary journey from Lucknow, India, through the prestigious academic halls of Boston’s

MIT

and Harvard, and onto the dusty plains of West Texas, where he embodied the immigrant spirit as he overcame challenges, confronted discrimination in the 1970s, and engaged in transformative advocacy that forever changed neonatal care and shaped healthcare systems globally.

ISBN: 979-8-9904770-0-1 (ebook)

ISBN: 979-8-9904770-1-8 (pbk)

ISBN: 979-8-9904770-2-5 (hardcover)

Cover design by Code Cherry Designs

Book design by Tabetha Hedrick

First Edition

To my family, mentors, and friends . . . with deepest gratitude

Contents

Foreword by Dr. Tedd Mitchell

Introduction

Chapter One: Auto-Rickshaws & Fathers

Chapter Two: Grandsons & Ministers

Chapter Three: Harvard, MIT & Harvard Hospitals

Chapter Four: Lubbock & Austin

Chapter Five: Screenings & Subcommittees

Chapter Six: Insurance & Academia

Chapter Seven: Rednecks & Invitations

Chapter Eight: Kamlesh & Oil

Chapter Nine: Leather & Boards

Chapter Ten: Grief & Sixty Years in Medicine

Chapter Eleven: Compassion & Opportunity

Did you enjoy this book?

Acknowledgments

About the Author

Honors

Photographs

Landmarks

Cover

Foreword by Dr. Tedd Mitchell

Today’s medical students

and residents, hustling through the hallways of the Texas Tech University Health Sciences Center as they make their way to lectures, labs, libraries, and patient rooms, will, on occasion, bump into a distinguished-looking octogenarian who has the appearance of a cross between Mr. Rogers and Gandhi. He speaks softly, with an accent that is a wonderful mixture of the Queen’s English, Indian, and more than a hint of West Texas slang (I’m certain that I’ve heard a y’all slip out of him every now and then). He is dressed nattily and, as with physicians of his generation, is always adorned with a tie. But students and residents alike must not let this quiet demeanor and warm personality fool them. This physician has been on a mission in the South Plains of Texas for the past five decades.

My first encounter with Dr. Surendra Varma was shortly after I became the eighth president of the Texas Tech University Health Sciences Center in 2010. I wasn’t from West Texas. I had been in a private clinical setting in Dallas, Texas, for nearly twenty years, so when Janet and I moved to Lubbock, it was indeed a new adventure. I was young to be a president, but I was ready to hit the ground running. I had (at least what I thought) brilliant ideas on ways to take the university to new heights, so I was eager to meet the faculty, staff, and students to get things rolling. What would have been helpful for me at the time was to remember the words of the Polish poet Stanislaw Jerzy Lec, who said, Youth is the gift of nature, but age is a work of art. I had the exuberance—and brashness—of youth, but what I needed was the perspective of someone who had seen things I hadn’t seen, someone who had lived experiences I hadn’t lived, someone who was tethered to the formative history of the university that I was only vaguely familiar with. That someone was Dr. Varma.

Into a large group of faculty and staff members in my conference room walked the distinguished Dr. Surendra Varma. I had done my homework on who he was—an outstanding academic pediatric endocrinologist with a sterling reputation as a clinician (he was friends with one of my old mentors from my training days at the University of Texas Medical Branch). What I didn’t know, and couldn’t have known, was that Dr. Varma called things as he saw them.

He was polite but direct. His first words to me were, Dr. Mitchell, if you were one of my residents, I would send you home.

I was befuddled.

Without saying a word, Dr. Varma reached up and touched his bowtie.

Reflexively, I reached up to my neck. It dawned on me that I was wearing an open collar. He immediately grinned, his point made. Like my father (who was a physician), Dr. Varma was never out of uniform and expected the same of those he trained. He has, ever since, been a mentor.

Dr. Varma’s journey to Lubbock and the Texas Tech School of Medicine is remarkable on many levels. His personal fortitude would eventually land him in West Texas, where he and his wife would raise their family. His clinical acumen would improve the lives of those under his care and the way physicians in the State of Texas practice medicine. His academic expertise would mold the educational experience of generations of young doctors, and his selfless service has been an asset to the university, the West Texas medical community, and the entire state.

For me, that first encounter with a physician who wasn’t afraid to call it as he saw it and who had been here since the school’s inception helped me realize that my role as president would be made much easier by relying on the wisdom—and resolve—of giants like Dr. Surendra Varma.

Tedd Mitchell, M.D.

Chancellor

Texas Tech University System

March 13, 2024

Introduction

Two steps outside

the examination room, I paused over the patient chart.

Referral.

Congenital Hypothyroidism.

Age three.

My chest felt like the storage hook for a hundred radiology aprons. Life-altering diagnoses that were entirely preventable never failed to quiet my surroundings. A nurse breezed behind me. Her wake in the over-air-conditioned West Texas facility raised gooseflesh on my forearms.

A quick scan of the child’s record revealed her place of birth.

Uvalde, Texas.

Texas.

The morning had been hectic, but long ago, I had vowed never to let a patient or family member hear me out of breath, no matter how busy or far behind I was.

But this … this.

There was not enough air to get me inside that room.

All physicians make mistakes. The wise among us learn from those mistakes. Those with longevity in medicine—for me, sixty-two years—learn to forgive ourselves. In our reflective moments with whatever higher power we subscribe to, we ask that our mistakes are small and that they do not lead to fatal outcomes. We also aim to leave patients in a better state than when we crossed paths.

Though I had never met little Sophia Garza, everything about her chart pointed back to me.

The vial of blood from Sophia’s newborn hypothyroid screening heel stick, moments after her birth, would have traveled to a lab within the same walls for processing. A tech would have transferred a few droplets of her blood to filter paper. The hospital would have collected these acid-washed, cotton-lint papers for several days or a week to represent all newborns born under their roof and then shipped them in an indiscrete envelope marked for a small lab on the northeast corner of the Texas Tech University campus in Lubbock.

At intake, this cottony representation of all that was happening in Sophia’s body would have been processed by a Ph.D. biochemist with crooked eyeglasses and a wild mass of black curls atop his elongated face and an administrative assistant with sharp eyes and bangle bracelets that rattled when she typed. Dr. Varma, they would have said. We have one you should look at. Maybe two hundred times out of the two hundred and eighty thousand births in those years and subsequent years, they would have drawn my attention to a particular lint paper of a specific sample.

At such a sample, I would have phoned or faxed the child’s pediatrician—please send us another sample or process locally to confirm diagnosis—and, as a double measure, I would have initiated official-looking letters to the infant’s parents requesting further action. Just beneath the official Texas state seal, the letter would have contained phases like positive (abnormal) result suggestive of congenital hypothyroidism (

CHT

), and please do not delay, as this may impact treatment outcomes. New parents were easily spooked. To have added and result in severe intellectual disability would have invited panic.

But Sophia . . .

I dragged in a deep breath and entered the examination room.

I

never set out

to be a medical advocate. Sure, all physicians are such for their patients, but I speak about the level of advocacy that consistently delivers four hours of sleep per night, sets fire to professional bridges, muddies the hands after a thorough scrub, and rides a doctor’s white coattails the entire trajectory of his career—for better or worse. I did not wake up one day, turn to my wife, and say, I want to enact change that makes others uncomfortable. And yet, that’s what happened time and again.

At the beginning of medical school, I was ambivalent. I did not enjoy dissecting cadavers, but it was part of the anatomy curriculum. Mother had a phobia of cadavers, and when I went home, I had to shower and change clothes.

Father’s caustic, single-word question when I told him my decision to become a doctor haunted me: why? As if I had declared that I wanted to be a snake charmer and live in a woven grass tent in the Indus River Valley. As if he was not the only Indian parent who wished for such a lofty outcome for a child. I did not love medicine; it was not a calling. I simply wanted to remain close to my friends who did have the love and the calling.

They are gone now, all of them. And I remain.

Advocacy is a lofty word that means little more than supporting a cause. It is an act that implies intent. I view advocacy as the intersection between passion and opportunity—a moment in time when we are presented with a choice to move forward inside a pocket of ease and live life as it has been, maybe utter that’s such a shame, or someone should fix that, or to do something.

Those intersections find each one of us.

When I became an advocate at each intersection of favorable circumstances, I questioned whether one doctor could make a difference. Mountain ranges of policies, vast and