Dr. Vasugi G A @VasugiDr - Twitter Profile

If we map the scientific landscape of India, we wouldn’t expect to see a small town in the Konkan region of Maharashtra called Mahad. One man, however, single handedly put his hometown, not only on the Indian research map, but on the venerated pages of the Lancet. Himmatrao Bawaskar was born in rural Maharashtra in a small village to poor parents. His father, realized that the only way for social mobility is education. Bawaskar imbibed this mantra and worked hard. His childhood was marked by hardship - he worked odd jobs to supplement his family’s income. Like a flame that always aims upwards, Bawaskar constantly tried to improve. This trait landed him in the Nagpur Medical college, where he did MBBS. His college days weren’t filled with fun and frolic and he felt like a square peg in a round hole. He completed MBBS and joined a PHC (primary health center) in Raigad district. Here’s where Bawaskar would encounter the same shabby situation many Indian doctors are intimately familiar with - poor motivation, lack of sanitation and resources. He came to see the ravages of bites - especially scorpion bite. For someone richer, this problem might trigger an instinctive “othering”. After all, the homes of the rich aren’t exactly teeming with scorpions. Bawaskar’s poor rural background proved to be a blessing in disguise - which enabled him to take “ownership” of the issue. The scorpion bites weren’t someone else’s problem, it was something he was quite familiar with. He collected data, sometimes from villagers and sometimes from experts in medicine. The gaps in knowledge worried him. He started reading more and to equip himself to deal with the problem, he enrolled in MD Medicine. Many of us are attracted to medicine because of its cerebral nature - the jerks and murmurs, the genes and molecules excite us. Bawaskar did so to solve a societal problem. His study of the scorpion sting involved careful observation. He noted important findings - the blood pressure spiked in the children which was accompanied by priapism - prolonged painful erection of the penis. The children died of pulmonary edema. He realized that this could be due to catecholamine storm, much like the cytokine storm we hear in COVID19. He sent his observations to an Indian journal. The reply shocked him - “Your English is not good enough”. What he did next, perhaps explains why his parents called him Himmatrao (Himmat means courage). Instead of sending it to an even more obscure journal, he sent it to Lancet, one of the world’s most respected journals. He got a reply in 8 days - the paper was accepted with minor corrections. The British Journal cared more about science than English grammar. He had broken a glass ceiling, inadvertently. While the existing treatments were like putting speed breakers in front of a speeding out of control car, Bawaskar wanted to stop the accelerator from working. With the confidence of parents, he tried sodium nitroprusside first. After a tense few hours, the child improved. However, Bawaskar wasn’t satisfied. Nitroprusside is cumbersome to administer and he started looking for alternatives. He zeroed in on Prazosin - an alpha receptor blocker. The early experience was overwhelmingly positive. Out of the 28 children receiving Prazosin, none died. He became a prazosin evangelist and started propagating its use. The imprimatur of a Western journal, can add great weight to what you are saying. People starting using Prazosin more frequently and soon childhood deaths due to scorpion bite had become rare. Bawaskar didn’t invent Prazosin. He reinvented it. He didn’t search PubMed to find a research topic. He solved a problem he saw with his own eyes. He didn’t have a swanky tablet or EMR to collect data - just good old pen and paper. And he sure as hell didn’t speak Oxbridge English. Bawaskar would go on to tackle other public health problems including snake bite and systemic corruption in medicine. Even after achieving critical acclaim, he stays back in Mahad. He even visited Jipmer to give a lecture during my UG days. To honour him, Indian govt gave him the Padmashri award. Too many medical challenges remain unsolved, because there’s no incentive for a company to solve it and many doctors think it is someone else’s problem. Globally too, funding for research in diabetes or obesity, far outstrips funding for say, malaria. Just like there are orphan drugs, there are orphan problems - problems of those without voice, problems that plague the corridors of the powerless. To all those want to solve these problems, Dr Bawaskar is an inspiration.