The viva question arrived without warning, delivered by a junior doctor who had no particular authority and no reason to expect a serious answer. Dr. A.P. Jain had spotted Paresh Desai during a ward round and, in the casual register of a man testing a hypothesis, asked the houseman to explain G6PD deficiency. The room contained postgraduates, residents, nurses, all of whom waited.

Paresh answered: the enzyme’s role in the hexose monophosphate pathway, the production of NADPH, the mechanism by which red blood cells maintain their defence against oxidants, the consequence when the pathway fails, the drugs and dietary items that exploit the vulnerability. He spoke clearly, without performance, for the length of time the explanation required. When he stopped, Dr. Jain was quiet for a moment. The postgraduates exchanged glances. Nobody had expected the houseman to produce a response of that quality, not because he was unknown to them, but because the question had been asked as a test and the test had been answered as though it were simply a question.

Dr. Jain said nothing directly. The episode became, in its quiet way, a kind of threshold. From that point, Paresh Desai was understood to be someone whose clinical knowledge exceeded his designation.

Churchgate to Worli

He was born on 26 August 1960 in Navsari, Gujarat, but grew up in Bombay — Churchgate first, then Grant Road, then Andheri, then Worli, where he still lives and practises. His father, Chandrakant Desai, worked in the sales office of Laxmi Vishnu textile mill in Fort. His mother managed the household and the family across its various moves through the city’s changing geography. The family’s Bombay life had a particular quality of forward motion — each move a small increment upward, each neighbourhood better positioned than the last.

He schooled at Hansraj Morarji Public School, where the curriculum included horse-riding, swimming, debates, and scouting alongside the conventional academic programme. The effect was a student who could present an argument in public without flinching, which is a skill more useful in medicine than most medical schools choose to teach. After Hillgrange High School and Wilson College, he applied to Bombay’s medical colleges and fell short. Dentistry at St. George was offered. He could not bring himself to accept it. He sat for national entrances.

Nisha Shah, his SIES classmate, was already at MGIMS. She spoke of it as a serious institution, not a fallback. He applied, qualified, and arrived in Sevagram with Nalin Chaudhary as his train companion from Nagpur — a journey that ended, for Nalin, on the last possible day of admission, and for Paresh, a week earlier with rather more composure.

The Shaved Head and What It Changed

Ragging at MGIMS in 1980 had taken on a quality that the preceding batches had not quite managed to restrain. The 1978 batch, in particular, had developed a practice of demanding that incoming students shave their moustaches as a gesture of submission. There was no violence, no physical harm, but the principle — that humiliation was the proper currency of initiation — sat badly with certain members of the new batch.

Three of them decided to refuse differently. Paresh Desai, Nalin Chaudhary, and Vinod Yadav appeared the following morning not with their moustaches shaved but with their heads shaved entirely. They had not shaved their moustaches because they had chosen not to, and their choice was visible, irrevocable, and somewhat magnificent in its bluntness. The seniors were furious. A strike broke out. The campus buzzed with the debate about tradition and its discontents.

What followed, gradually, was the effective end of physical ragging at MGIMS. The batch of 1980 made a quiet collective decision not to pass the culture forward. The books, notes, and operating-theatre wisdom that seniors had previously shared as reward for compliance were now unavailable through that channel. The batch found its own sources and managed without them. As a decision, it was practical, principled, and had consequences that lasted well past their graduation.

Paresh’s reputation as a defiant student spread quickly. Some seniors muttered. He walked the campus without bowing. He had, from early childhood, a straightforward relationship with his own opinions, which he held clearly and stated plainly, and found no particular reason to moderate when the opinion concerned institutional fairness.

Three First Ranks

The examination results were consistent in a way that retrospectively seems inevitable but was, in the living of it, the product of a particular study method. He read for understanding rather than reproduction. In anatomy, he could trace the relationship between structures because he could see them spatially, not because he had memorised the words in order. When a question arrived that had not been directly rehearsed, he could work from principle to answer. This served him well in every examination he sat.

First MBBS: first in the batch. Biochemistry distinction. Second MBBS: first again. Third MBBS: first again. When Dr. Jain told an external examiner, “This boy is exceptionally brilliant — ask him anything,” it was a form of institutional pride that Paresh received with the same composure he brought to everything. He understood it as accurate rather than flattering, which is the most useful way to receive a compliment.

Between examinations, he extended the same care to classmates that he had received from Nalin Chaudhary’s particular form of friendship. He shared books without accounting. He bought instruments for batchmates whose circumstances were constrained. He lent money when it was needed and did not track debts. The carbon paper system — a sheet under every notebook page during lectures, producing a duplicate set of notes delivered to Anil Ballani each evening — was a small daily act of generosity that continued for years, unremarked and never asked about.

He was not drawn to extracurricular life. Plays, sports days, hostel debates — these occupied others. His evenings belonged to medicine. His leisure, when he took it, was quiet: walking, reading, the particular companionship of friends who did not require him to perform sociability. When Anil Ballani became more than a note-recipient, when the friendship deepened into something the both of them could feel settling into permanence, it was as natural as everything else in those years. The bond lasted; Anil and Bindu Bansal married, and Paresh and Jayant Vagha stood nearby.

Why Children

After MBBS, the conventional expectation was Medicine. Three years, then cardiology or neurology or nephrology — the prestige paths, well mapped and well remunerated. His teachers encouraged it directly. He thanked them and chose Paediatrics.

The reason was not complicated. Children were honest. Their bodies had not yet developed the layered ambiguity of adult illness; their responses to examination were direct; the satisfaction of getting a diagnosis right and watching a child recover was clean and complete. He had known, watching ward rounds during clinical postings, that this was where his interest genuinely lay. He did not mistake his interest for anything less than what it was.

His co-resident was Jayant Vagha. He covered for Jayant on weekends, consistently and without complaint, so that the newly married man could spend time with Sunita in Nagpur. Years later, Jayant has said he is still trying to account for this generosity; Paresh has said there is nothing to account for. Both statements are true.

He completed his MD, cleared the examination on his first attempt, and returned to Bombay. He joined Bombay Hospital for a year, then set up a small chamber near his home in Worli for ₹2,000 a month. The referral economy that sustains most urban speciality practices — the percentages, the reciprocal arrangements, the quiet financial architecture of city medicine — he declined to enter. He paid no commissions. He sought no referrals. He relied on his diagnosis.

The Clinic on Worli Road

Seventy percent of his patients come from the slums adjacent to Worli — Dharavi, Worli Koliwada, the cramped chawls of a neighbourhood that contains, within walking distance of one another, extraordinary wealth and extraordinary poverty. He has always charged the poor differently from the wealthy, not as a policy but as an instinct. He examines before he investigates. He diagnoses with his hands and ears before he orders tests. He is, in the most direct sense, a clinician of the pre-digital school: his stethoscope is still the first instrument he reaches for.

When a mother brings a thin boy coughing to his clinic and Paresh asks the child to walk from his mother’s arms to a chair, he is watching the shoulders, the chest expansion, the work of breathing — all of which, in a right lower lobe pneumonia, tell their story before the X-ray confirms it. The mothers notice this. Word has reached Dharavi, and Ghatkopar, and parts of the city he has never visited, that the doctor in Worli will look at the child before he sends you for tests. This is not a marketing claim. It is simply what he does.

His father practised medicine in Bombay for decades. His son practises medicine in the same city. The generations are connected not by a shared address or a shared specialty but by a shared seriousness about what the work is for.

Dr. Paresh Desai completed his MD in Paediatrics from MGIMS, Sevagram. He returned to Bombay and established a paediatric practice in Worli, where he has worked for over three decades. He is attached to Asian Heart Institute, Hinduja Hospital, and Mahavir Trust. He lives in Worli, Mumbai.