He used to start his OPD at nine in the morning and work without stopping until eleven at night. Three examination tables. Two assistants. Patients presenting with the full spectrum of what small-town medicine could send him \u2014 Medical, Paediatric, Gynaecologic, Surgical. He treated a patient with sixty percent burns. He amputated a gangrenous limb. He lanced abscesses without ceremony and set fractures without apology. “Those days were unbelievable,” he said, looking back across three decades. He was not boasting. He was describing, with the flat precision of someone who was there, what it meant to be a general practitioner in a Vidarbha district town in the 1980s and 1990s \u2014 the years before specialisation completed its conquest of the profession and left the generalist without a recognised territory.<\/p>\n\n\n\n
The Daal Mill Family and the Road to Nagpur<\/strong><\/p>\n\n\n\n Makhan was born into a business family in Khamgaon, Buldhana district \u2014 his father owned a daal mill, the kind of enterprise that anchors a small town’s food economy and requires, in its management, a particular combination of physical stamina and financial shrewdness. He attended Kela Hindi High School, Khamgaon, then moved to Mungilal Bajoria School, Akola for his higher secondary years. His premedical education was at Radhakisan Laxminarayan Toshniwal (RLT) College of Science, Akola \u2014 the same college that sent Vijay Kherde, Kailash Murarka, and others to GMC Nagpur in 1973. He entered GMC that year.<\/p>\n\n\n\n In his first years at GMC, between 1973 and 1974, he shared a room at 360, Hanuman Nagar with Inder Ostwal. The address is offered with the specificity of a memory held close \u2014 the particularity of the room number, the building, the street, which is the way one remembers a place that mattered. He was from the outset a member of the Saptrishi group: seven students from Akola and Buldhana district who travelled together and looked after one another with the loyalty of people who knew they were far from home and that the institutions of home were not available. Vijay Kherde, Kailash Murarka, Nandkishor Salampuria, Makhanlal Gupta from Akola; Nandkishor Taori from Malkapur; Indra Ostwal and Ajit Jadhao from Khamgaon. Later Dhulip Tajne joined. The group was not a formal arrangement. It was the kind of fellowship that forms when young people from the same geography find themselves in a large and unfamiliar institution and decide, without discussing it, that looking after one another is simply what is done.<\/p>\n\n\n\n After graduating, Makhan went to Mumbai for house jobs in Medicine, Paediatrics, Surgery, and Gynaecology at MGM Hospital and St George Hospital. He had already decided, quietly, not to pursue postgraduation. The plan was always to come back \u2014 to Akola, to the Buldhana belt, to the kind of town that had produced him and that needed a doctor who understood it.<\/p>\n\n\n\n Three Friends, Three Towns, One Beginning<\/strong><\/p>\n\n\n\n In 1981, almost simultaneously, three members of the Saptrishi group began their private practices: Nandkishor Taori in Malkapur, Ajit Jadhao in Jalgaon-Jamod, Makhanlal Gupta in Akola. The synchrony was not arranged. It was the product of three people who had, at GMC, arrived at the same conclusions about what they wanted to do and where they wanted to do it, and who now acted on those conclusions at the same moment because the moment had arrived.<\/p>\n\n\n\n Makhan’s early years in Akola were extraordinary in their scope. The hours were long \u2014 nine in the morning to eleven at night \u2014 and the work was broad in the way that only a general practitioner operating as the primary and frequently the only point of medical access could be broad. He saw Medical patients, Paediatric patients, Gynaecologic patients, and Surgical patients. He performed minor procedures in his own OT. He treated serious burns. He amputated when amputation was necessary. He did not turn patients away because their conditions were outside a notional speciality boundary, because in Akola in the early 1980s, that boundary was a luxury the town could not afford.<\/p>\n\n\n\n The GMC years had prepared him better for this than he may have realised at the time. The broad clinical training that government medical colleges of that era provided \u2014 ward rounds across specialities, the experience of seeing complicated cases without specialist backup readily available \u2014 turned out to be the exact training for a general practitioner in a district town. The man who could handle everything because he had been taught to handle everything was the man that Akola needed.<\/p>\n\n\n\n The Change That Hurt<\/strong><\/p>\n\n\n\n He watched the transformation come, and he named it with controlled precision. The doctor-patient relationship he had known \u2014 built on trust, on the accumulated evidence of competence over years of service, on the kind of loyalty that brings three generations of a family to the same consulting room \u2014 gave way to something less stable. Patients arrived with searches done on mobile phones, with expectations calibrated by television medical dramas, with a readiness to attribute any adverse outcome to negligence rather than to the inherent uncertainty of medicine. Local journalists discovered that medical stories sold papers. Local politicians discovered that doctors made useful adversaries.<\/p>\n\n\n\n “Those who wear tolerance the way Helen used to wear dresses in our college days,” Makhan said \u2014 reaching, with the ease of someone who has learned to convert pain into wit, for the most precise image available. Helen was the item dancer of 1970s Bollywood, notorious for the brevity of her costumes. The comparison is exact: tolerance had become minimal, and its absence was on display. He decided, with the same quiet logic that had governed all his major decisions, to step back. The practice was handed to his assistants. The daal mill his son had started in 2011 needed oversight. He would give it that instead.<\/p>\n\n\n\n What Remains<\/strong><\/p>\n\n\n\n His daughter Pooja completed her BE in Computer Science, went to Ohio State University for a Master’s, and now works at Qualcomm in San Diego. His son Bharat manages an electrical and electronics supply business in Akola’s MIDC industrial area. The family that came from the daal mill owner’s household in Khamgaon sent one child to California and kept one in Akola \u2014 which is, give or take, what most families of the first professional generation do. Makhan in Akola still, the practice quieter now, the fourteen-hour OPDs a memory.<\/p>\n\n\n\n He was part of a generation of doctors \u2014 many of them from the GMC Nagpur class of 1973 \u2014 who practiced medicine in the small towns and district centres of Vidarbha and Madhya Pradesh without fame, without institutional backing, without the recognition that accrues to those who publish or profess. They were simply present, in places that needed them, doing the work that needed doing. The medical landscape of central India in the last three decades of the twentieth century was shaped, in ways that cannot be easily measured, by the accumulation of their daily presence. Makhanlal Gupta was one of them. He lanced the abscesses and set the bones and kept the OPD open until eleven at night, and the town was healthier for it.<\/p>\n","protected":false},"excerpt":{"rendered":"