Devoted healerBy BRENDA BENEDICT
Bullied and not allowed to practise, this petite woman was determined to prove herself to her countrymen when she entered the jealously-guarded male domain of neurosurgery in her native India. Dr T.S. Kanaka speaks to BRENDA BENEDICT about her distinction as Asia's first female neurosurgeon, her adventures in the operating theatre and the secret to being spry even when one is '71-years-young'.
SHE LOOKS more like an amiable aunt with whom you could string jasmines. But Dr Prof T.S. Kanaka’s smiling face and diminutive frame belie a steely character. Unknown to many, she holds the distinction of being Asia’s first female neurosurgeon.
Born in Madras (now known as Chennai), India, in 1932, Kanaka was fortunate to have had a father with foresight.
“In those days, most women stopped their education after secondary school. Having been an educational officer, my father was very keen on educating all of us. He allowed us to do whatever we wanted,” said Kanaka during a visit to Kuala Lumpur recently.
Her father encouraged her to pursue engineering as there were no women engineers then. Hence, she studied Mathematics, a core subject for the course. “But when I finished school, my mother discouraged me from pursuing it and told me to do medicine instead. I don’t know what made her (do that) but back then, we just listened to our parents. And Mother had the last say in the family,” she joked.
Her interest in neurosurgery was born out of concern for a family member. “My brother-in-law had epileptic seizures. There was a neurosurgeon then named Dr B. Ramamurthi and I used to go and ask him many questions about this condition. He told me to finish my medical course and then he would teach me neurosurgery. So that’s how I got interested in it,” she explained.
After completing her MBBS, she applied to study general surgery. “In those days, it was mainly a man’s domain. There were quite a number of women who did general surgery and then gave up because they could not ‘survive’. This is because they (the men who ran the course) would not allow you to practise. If you sat for an exam, they would not allow you to pass,” she says.
She explains that the examination system consisted of written and oral exams that a student had to pass. “And the examiners were not in favour of women getting in. Most who applied to enter these exams gave up and branched out to other fields. I had to go through the exam many times. But I had perseverance and the will power to win. That was what helped me,” she says.
Yet this was merely the tip of the iceberg. After having fought tooth and nail during the selections for general surgery, she had to deal with indifference in the operating theatre.
“The moment I entered the ward to do surgery, the chief fellow who was supposed to give me chances to practise, said to me, ‘I’ll see that you don’t become a surgeon.’ He had even given instructions to people that I should not be given a chance,” said Kanaka, who practised for 37 years until her retirement in 1990.
Given that her vocation required the deft usage of hands, Kanaka had to rely on other means to master her craft. “In general surgery, we had to be under the mercy of the chief surgeon and his assistant. Only by using our hands can we learn to operate on our own. However, I was given no chance to do surgery. So I had to learn only by watching.”
However, she got her break during the last three months of her post-graduate studies. The aforementioned chief fellow was replaced by a female surgeon. “She gave me all the chances. However, although she was a very good surgeon, she could not survive in the field and finally left it to pursue Anatomy,” explains Kanaka.
Upon graduation, she was posted to the Government General Hospital (GGH) as a surgical assistant. Luck was on her side this time as she was posted to work with a very helpful surgeon called Dr A. Venugopal.
“In fact, the first day I joined, he welcomed me and asked me to wash up and help him in the operating room. I was surprised as it was a major surgery. I told him I was raw and had not done much during my studies. He told me not to worry and that he would help me. I consider the two years I worked with him as the best years of my life,” said Kanaka. She added that she never felt nervous in the operating room and was instead constantly thrilled when asked to work on cases. When the China-India War of 1962 broke out, she volunteered to join the army as a general surgical specialist. This carried the rank of Captain.
“The army had only healthy people, so there was not much work to do. By the time we joined, they had already declared a ceasefire, so it was quite calm. But I was in a hospital where all cases used to be referred. So I had some chance of doing general surgery there,” explained Kanaka, who obtained permission to return to the civil service in 1964.
She then held a dual portfolio of assistant professor of Neurosurgery at the Madras Medical College as well as neurosurgeon at the GGH. By then she had gained enough experience and confidence to be able to handle operations alone.
“In fact, whenever foreign visitors came to the department, Dr Ramamurthi told me to perform the surgery so that they could see how I did my work. So I was able to demonstrate that I was not just a showpiece,” she said proudly.
One of her special interests was – and still is – stereotaxic surgery. This is a procedure by which surgeons can enter various parts of the brain through a small hole, after which small lesions can be made to stimulate (specific parts) and achieve the results the surgeon wants. “It is also called functional neurosurgery. It can be performed on spastic children, those with movement disorders, psychiatric illnesses and behaviour disorders, those suffering pain, and even for drug addiction. It is minimally invasive and does not carry morbidity or mortality. I was the first neurosurgeon in India to do chronic electrode implantation into the brain.” She has received much recognition for her work in this area and has travelled extensively overseas to speak at seminars and exchange ideas with her international peers regarding this issue.
Despite her abilities, Kanaka resolutely practised in Madras, shunning lucrative options overseas. “I am very patriotic. I wanted (people) to see what India could do. I also did not do any private practice outside because I felt that patients in the (government) hospital should be served.
“In the same way, I chose to be single so that I can do my work without any encumbrances. I’d be free to attend to my patients. I don’t regret that and I am happy,” she said.
An Indian woman refusing marriage was almost unheard of in her day. So how did her family react to it? “My mother was very supportive. I lost a younger brother to liver disease. For nearly three years we fought a losing battle with the disease and I used to be with him 24 hours a day then. So, my mother probably saw that and felt that I was only (suitable) for patients. She said marriage was not for me.” Kanaka admitted she practically lived in the hospital throughout her career. “I used to come back only two days a week. Neurosurgery is a very difficult area. There were not many people in the field. There were no specially trained people to look after the patient after an operation and anything could happen. Unless you acted immediately, you could lose the patient. So I stayed in the hospital and looked after my patients,” says Kanaka.
Given her tenacity and her dedication to her vocation, did she influence more women in India to follow in her footsteps? “I used to advise those who wanted to do general surgery not to tell anyone about it. This was because if they found out, they would discourage you from pursuing it.
“There were very few girls who did general surgery after me. It was only much later that more women joined this field.”
She said India now has about 25 female neurosurgeons – including Kanaka’s niece. In 1996, Kanaka was made the honorary president of the Asian Women’s Neurosurgical Association (Awna). It was also then that she was formally acknowledged as Asia’s first female neurosurgeon. “I never bothered about it because I am not for any ‘advertisement’. There was no celebration or anything. Even when I got my neurosurgery degree, my colleagues and brother just threw a small party for me. That’s all,” said the unassuming Kanaka.
The Awna currently meets biennially in various countries and Kanaka is often invited to present papers at these meetings. Her most recent presentation was in Jakarta in January, where she presented a paper entitled Conjugation of Skill and Will.
One would think that after almost a lifetime of performing complicated surgeries, presenting papers nationally and internationally, and travelling extensively to give lectures within India and worldwide, Kanaka would enjoy a laidback retirement.
Yet, the indomitable doctor continued to answer the call to help her fellowmen. Upon her retirement in 1990, she used her savings and her pension benefits to build the Sri Santhanakrishna Padmavathi Health Care and Research Foundation, which is named in honour of her parents.
“I only do consultancy now. I am particularly interested in those who are 30 and above. The world is not the same for them now as it was for us. We seniors had a contented life. You see me smiling all the time; I don’t have blood pressure or diabetes or other risk factors,” says Kanaka, adding that she attributes her well-being to transcendental meditation and yoga.
Her centre offers free medical check-ups for everyone above 30. This includes blood pressure and sugar monitoring, ECGs and eye check-ups. Alternative medicine such as acupuncture and homeopathy is also available.
The centre also hosts talks regularly on health issues besides creating awareness about old age and its attendant diseases.
“My current interest is prophylactic geron-tology. Gerontology is the science of ageing. Longevity has increased among people and is going to continue increasing in the years to come. I want to teach the seniors how to be comfortable to prevent morbidity in old age. Because if they fall sick and are bedridden, there may not be anyone to look after them,” she said, adding that she hopes to stem the disturbing trend of young people deserting their parents, which she objects to.
“Their values and lifestyle are entirely different. If they can only change that, they can have a healthy life.”
So what keeps the 71-year-old (she insists on the word “young”) ticking? “Actually I have no pastime because I have no time. But I enjoy what I do now. I don’t have a maid, so I have to do all the household work as well as run the centre. I used to exercise before; after an accident, I can’t do it anymore. I walk to a temple nearby daily and I meditate,” said Kanaka, adding that her only vice is an occasional afternoon nap.
As for the future, Kanaka has one fervent wish. “It (the centre) is like my child. I spend very little on myself because my needs are very few. All that I have I spend on the foundation.
“My siblings and their children have all been very supportive of me. The only thing is that no one has come to live with me yet. Somebody should come to continue this work.”
Given Kanaka’s illustrious career and achievements, that would be a tall order indeed – as who would not baulk at trying to fill her shoes?