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Obituary
MADAKASIRA BHEEMARAO PRANESH. IN MEMORY OF A LEGEND(1937-2020)
The Neurology fraternity of the country lost one of its eminent and senior-most members recently. Prof Dr M B Pranesh, or Prof MBP to most of us, lost his battle to covid-19 in the early hours of August 1, 2020.
A man of tremendous intellect, Prof. MBP epitomized compassion, empathy and kindness to both patients as well as his students and colleagues. The breadth of his knowledge encompassed history, geography, medicine, religion, languages, art, and philosophy.
Prof. Pranesh was born in 1937 into a deeply religious family but with a modern outlook in Nanjangud town near Mysore. His father was the Superintending Engineer of the Electricity Board who brought electricity to vast parts of the erstwhile Madras province comprising Tamil Nadu, Kerala and Karnataka amidst challenging and trying circumstances. This pioneering spirit, dedication, and hard work of his father, and deep love and affection of his mother shaped Prof. Pranesh’s philosophy of life and work.
Prof MBP graduated from JIPMER, Pondicherry in 1963. He then worked as Registrar at Seth G.S. Medical College and KEM Hospital, Bombay during 1965-66. Subsequently, hegained MD in General Medicine from Madurai Medical College in 1968. Before he went on to do his neurology training, he worked as Asst Prof of Medicine at Coimbatore Medical College and Hospital between 1970 and 1976. Along with the head of the department of medicine, Prof T.K. Ganesan,he performed some pathbreaking work on hepatocellular carcinoma and fluorosis. In 1976, he joined the famed Madras Institute of Neurology (MIN), Chennai for his neurology training under some of the finest teachers and pioneers such as Prof G. Arjundas, Prof K. Jagannathan and Prof Zaheer Ahmed Sayeed from the neurology side and Prof B. Ramamurthi, Prof S. Kalyanaraman, and Prof Balasubramaniam from the neurosurgery side. Prof MBP considered this period of learning between 1976 and 1980 as one the best periods of his career. He then went on to do Stroke Research Fellowship at University of Pennsylvania, Philadelphia in 1980. Although he thoroughly enjoyed the academia of the US, and would have easily settled there, the weather did not suit him, and he kept falling ill. Upon his return to India,he joined as Assistant Professor of Neurology at the Coimbatore Medical College and Hospital, where he founded the Department of Neurology, and continued there till hisvoluntary retirement in 1994. He then joined as a fulltime consultant at KG Hospital, Coimbatore from 1995 till 2003. Later, he becameProfessor and Head, Department of Neurology at PSG Institute of Medical Science & Research (PSG IMSR), Coimbatorefrom 2004 to 2013. He continued there as Emeritus Professor of Neurology until 2018. Thereafter he confined himself to his outpatient clinic, where he worked right up to a couple of weeks before he fell ill.
Throughout his professional career only two things mattered: patient care and teaching the next generation.
Teaching medicine and neurology was his passion. He was a master in the art of history taking and clinical examination, and he passed on these finely-honed skills to his students with great enthusiasm and childlike delight. He always emphasized to his students the need to be empathetic and compassionate to patients. His skills in eliciting ‘soft’ neurological signs was unmatched. In an era when neuroimaging not freely available, these skills helped him diagnose, treat and save hundreds of patients. Of the very many such brilliant analyses, one incident stands apart: a 20-year-old male was brought unconscious following a severe headache to the emergency at the Coimbatore Medical College. Prof MBP glanced at him and quickly examined him for about 3 minutes and pronounced to a stunned student audience that this gentleman had most likely suffered a pituitary apoplexy. He then went on to demonstrate the prognathic jaw and large hands and feet to support his claim. He showed us the unilateral dilated pupil and abducted eye with absent oculocephalic reflex as a sign of 3rd cranial nerve palsy, suggestive of a multicompartmental pituitary macroadenoma with apoplexy which was confirmed later by a CT scan. He would not confine to just the bland facts of medicine and neurology but would delve into the history of the person who demonstrated the sign, the socio-cultural ethos and politics of that period. This broadened the mental horizons of students and made them to appreciate the world beyond just medicine and neurology. Such teaching demonstrations held the students in thrall, and it is no wonder that he inspired over 100 medical graduates take up neurology as a career, many of whom are now in top academic institutes and hospitals in India and around the world.
Prof MBP introducedhigh quality neurology service to Coimbatore and its surrounding districts and even to the neighboring districts of Kerala and Karnataka. He served the rich and the poor, the high and the mighty with equal compassion, and never sought favors from anyone. He was considered the final authority in neurology by patients and doctors alike.
Prof MBP had indefatigable energy and his working hours extended from 10am to 1am. In his early years of practice, it was not unusual for him to reach home to be greeted by the milkman delivering milk in the wee hours of the morning! The services he rendered to the poor was enormous. On several occasions, he transported sick patients at Medical College Hospital for a CT scan which was available only in the private sector at his own cost.He would often quote his teacher Prof B. Ramamurthi about poor patients, “if we do not take care these people, who else will?”
No wonder the poor considered him their god! He interacted with his fellow neurosurgeons in depth on surgical procedures and was keen on getting the best results postoperatively. His selection of surgeons for each case depended on the knowledge and skill of the individual surgeon cutting across institutions.He was very popular among the top neurosurgeons and expected handwritten communication about patients care, the practice that was routine in yester years by doyens like Prof B. Ramamurthi and Prof S. Kalyanaraman. He would prefer a ‘Thinking Surgeon’ over a mechanical surgeon for his patients. This characteristic was a gift to his patients and was the reason why he was considered to be the ‘last word’ in neurology in this part of the country. This partnership with the neurosurgical fraternity resulted in him being the pioneer in decompressive hemicraniectomy for malignant MCA infarctions right from the late 80s. This procedure helped save the lives hundreds of stroke patients but was not accepted for many years by the medical fraternity till the trials in 2007-8 proved him right!
Prof MBP was an authority in history of medicine and neurology. He was a voracious reader, and despite his long working hours, would devote 3 hours every day for reading. Not a day would pass without a quote of Sir William Osler, Jean Marie Charcot, his favorite physicians and Sir Wilder Penfield, his favorite surgeon. His introductory class on the importance of ward rounds to fresh students would begin with Osler’s famous quote ‘To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all’.
Prof MBP founded the Coimbatore Neurological Society, Osler Society of Coimbatore, and was member of Bharatiya Vidhya Bhavan. He was awarded as Eminent Teacher by KG Hospitals and recipient of Vocational Excellence award and For the Sake of Honour Award by Rotary club of Coimbatore. Tamil Nadu Dr MGR Medical University honoured him with LifeTime Achievement award. He received Prof. Arnold H. Einhorn Endowment Oration Award in 2011. He obtained Fellowship of the Royal College of Physicians of London (FRCP) in 2013.
The phenomenal achievements of Prof Pranesh would not have been possible without the tremendous loving supportof his wife Prof Indira Pranesh, who served as Professor and HOD of Pathology at Coimbatore Medical College, and two wonderful and brilliant children, both doctorates - Anand Pranesh, Product Development Manager at Bombardier, Hyderabad and Bhavani, Post-Doctoral Associate in Genetics at New York University, Abu Dhabi. They were a pillar of strength to him and supported him in every way although they could not spend much family time together because of his hectic and punishing work schedule.
Prof Pranesh’s demise is a great loss for thousands of patients, entire medical fraternity and the society at large. His passing away has left a deep void which is difficult to fill. He was a caring friend to all his colleagues. It is our deep regret that we, his students, could not be with him in his final moments and his last journey because of the severe covid restrictions in place. Prof. Pranesh is no more with us, but his memories will linger in our hearts forever.
“The embodied soul is eternal in existence, indestructible, and infinite, only the material body is factually perishable.” Bhagawad Gita
- Dr.B.Prakash. Former Professor and Consultant, KMCH, Coimbatore
- Dr. S. Dinesh Nayak, Epileptologist, Gleneagles Global Health City, Chennai.
- Dr. JKBC Parthiban, Consultant NeuroSurgeon, KMCH, Coimbatore.
For Communication :
Dr.B.Prakash. Neurologist.
Kasturi Neuro Diagnostic Centre,
89-A, East lokamanya Street, RS puram,
Coimbatore.
WhatsApp: 9789481179