The Hippocratic Inspiration For Bollywood

It was an afternoon - evening in between times call from my dear friend Sushanta asking me to write something for our forthcoming and very ambitious project entitled 'URULI' , the dedicated ‘magazine’  being prepared to be published during the Durga Puja 2015 at Bengaluru by our very own and beloved Assam Association Bangalore...I also knew that much water had flown in this regard and it was a sensitive topic to broach to Sushanta whether we should call it a magazine or just a souvenir ... the dominating thought and consensus amongst the wise counsel agreed to it being called a 'magazine' ... so when i was asked and subsequently given the topics of health and travel to write on ... it was a pleasant surprise and yet a very big responsibility to make a slightly esoteric topic like 'health' interesting, enriching, invigorating and fulfilling...nevertheless here is a humble effort from my end and hope you enjoy the read ...

One of the most fascinating aspects of being a doctor is the unsaid oath that we as doctors globally take of ensuring the most ethical treatment protocols are followed as and when we treat a patient ... this is what is globally called the 'HIPPOCRATIC OATH' ... however, in India medical science has been very successful in straddling the celluloid screens with some very memorable and also hilarious outputs over the years ... truly time and again Bollywood does seem to get inspired from Hippocrates or to put it simply from Medical Science.

One of my first memories of how a film made against the backdrop of medical science became a blockbuster is that of the magnum opus called 'ANAND' (1971)... while everybody remembers the melodic singsong way in which Rajesh 'ANAND' Khanna calls Amitabh Bachchan 'Babu Moshai' I am sure many would not remember the dreaded terminal disease Anand is diagnosed with in the film ... any guesses folks ???  In the film itself Anand himself is heard explaining his disease and jokes about the name that, “kisi viceroy ka naam lagta hai. aadmi vividh bharati par announce kar sakta hai.”... the name being 'LYMPHOSARCOMA OF THE SMALL INTESTINE' , a type of abdominal cancer to put it mildly and simply. 

So was the fancy sounding form of cancer just thrown in for the purposes of character development? Or was it perhaps actually the name of a disease Hrishikesh Mukherjee, who was a Chemistry major student, stumbled upon by chance many years ago as a chemistry student? Whatever the reason, clearly no one on their crew knew the correct pronunciation of the word or the following it would develop. The tragic diagnosis then took on a cult status in Bollywood movies, memorable for its almost bizarre obscurity, and became de rigeur for anyone needing a terminal disease. It resurfaced most memorably in the smash-hit comedy Munna Bhai, MBBS (2003) about a Bombay thug-turned doctor who fights for the life of a patient with none other than…you guessed it, lymphosarcoma of the intestine ! Surely, this was a nod to the original “patient-doctor” film Anand.

Now where Bollywood takes a leap of another kind is making the disease a most dreaded and terminal type which is far from the reality. There’s probably a reason why you haven’t heard of lymphosarcoma of the intestine in real life.  A 1922 paper that discussed three cases of the disease in-depth in Annals of Surgeryremained the definitive word for many years. The paper described it as an extremely rare and obscure condition about which current knowledge was lacking (this was well before the age of DNA). Also discussed is how towards the end of the illness, the patient presents with severe constipation or vomiting—both unpleasant effects that Mukherji failed to include (they probably would not have gone over well on screen). 

Nearly 100 years later, the term “lymphosarcoma” is obsolete–by definition all neoplasms of the lymphoid tissue are cancerous and simply termed “lymphoma.” So what was perhaps once called the mysterious lymphosarcoma of the intestine is now recognized as intestinal non-Hodgkin’s MALT B-cell lymphoma. Still, this particular form of non-Hodgkin’s lymphoma occurs infrequently (only 8% of B-cell lymphomas), but retains a good prognosis if a particular chromosomal mutation does not occur. It can be caused by chronic inflammation from the bacteria H. Pylori, in which case, antimicrobial agents could cure you. Unfortunately for Anand, H. Pylori would not be discovered until 1982. Still, surgery and chemotherapy were available options for these patients, neither of which seemed to have been advised for Anand. For him, lymphosarcoma of the intestine remained an unavoidable death sentence. I know there too much of medical jargon I have used in the para above ... well that's just to say that misinterpretation of a medical condition to create a melodrama is not always advisable.  

And now you’re saying, so what? So Hrishikesh Mukherji made melodrama from an obscure fatal disease and didn’t stick with its actual forms of progression and treatment, big deal? Well, I’m here to say, for whatever it’s worth, lymphosarcoma of the intestine became ingrained under false pretenses in the imagination of Bollywood when knowledge about something more realistic and with a higher incidence might have actually served some benefit. What if he was just dying from End-Stage Renal Failure due to severe diabetes after a life of eating pure asli ghee? Yes, it’s a stretch. All right, a huge stretch. But someone had to say it.

Well Bollywood had much to offer apart from specific diagnoses, who can forget other iconic scenes such as a flashing red light outside the “operation theatre” (all my years as a medical student and later as a doctor I truly do not remember seeing that flashing red light apart from the one that is on the ambulance); the almost inevitable cure of blindness that occurs at the end after the eye bandage is removed etc. etc. (as brought to its height as an art form in Mere Jeevan Saathi.

Of course, the modern day Bollywood has made rapid strides into the inner realms of medical science by exploring many esoteric and might I say exotic medical conditions like Progeria as seen in 'Pa'; Asperger's Syndrome as seen in 'My Name is Khan' and before I forget  'Retrograde Amnesia' as seen in 'Ghazni' ...

Yes medical science can provide loads of inspirational stories and truly many of these have went on to become iconic movies winning laurels and awards for the sensitive portrayal of human frailties... some quick names that comes to my mind are 'Rainman' the brilliant Dustin Hoffman enacting Autism and Tom Cruise playing the perfect foil; 'Children of a Lesser God' a simple movie story that brings to focus beautifully the life and challenges of the deaf and the dumb and yes 'Outbreak', the epic on the ebola virus and how it is brought under control. In recent times, I did enjoy the 'The Curious Case of Benjamin Button' an interesting reverse take on Progeria wherein a person starts aging in reverse order.

But folks do not forget that it all began for us with the now iconic 'LSOSI' 😄