MD/PhD : Gauhati Medical College and Hospital, Guwahati
University of Minnesota, Minneapolis, USA
Mayo Clinic, Rochester, USA
Asian Institute of Gastroenterology, Hyderabad
The broad picture of a doctor that comes to one's mind is a person who would see patients or operate and perform procedures on them. Even though physicians and surgeons in India are involved in clinical research in select centers, bench research by them is a rarity. Interestingly, clinicians conducting bench research in India are frequently bundled as exotic species!
Looking back through one and a half decades and more, I now reckon that my interest in research probably started right from my high school days in my hometown Guwahati, the capital of the northeastern state of Assam. The newly encountered words like genetics, molecular & cell biology fascinated me a lot, though there was no one at that time to guide me on what these 'jargons' were all about. Therefore, I did not have a direction on how to go into research at that time. Nevertheless, I used to read books on these topics during my higher secondary days (also later on during medical training) and I remember imagining the cell and the complex machinery inside. Eventually I enrolled into medical training at the Gauhati Medical College, Guwahati (I always wanted to be a doctor) and I still remember often going out of my syllabus to understand more and more into the molecular mechanisms of physiological, biochemical, pathological and pharmacological processes even during my undergraduate medical training. In fact, many a times few of my teachers used to say after my semester examinations that I write too much of unnecessary details in my answers!!
After my MBBS and internship, I joined the All India Institute of Medical Sciences, New Delhi as a post-graduate student. As I could not get a seat in a purely clinical subject, I decided to opt for anatomy, which had an advanced genetics laboratory (with an intent to pursue genetics as a career). However, I left anatomy after 6 months since I was put in a non-genetics research project. Moreover, I did not have any specific research questions at that time and probably I was also missing patient care. After this, I pursued post-graduation in internal medicine at the Gauhati Medical College. Now I was getting more focused and realized that I was increasingly getting interested in immunological and gastrointestinal sciences. I could see a future career direction! During my post-graduation years, I was involved in a few clinical research projects; and in this context I must acknowledge my mentor then, Prof. P. C. Bhattacharyya, who encouraged me to be involved in research and write my first paper, which was a case report, during my first year of post-graduation.
After post-graduation, I wanted to pursue a superspecialty career in immunology, but narrowly missed a seat into the Doctorate of Medicine (DM) course in Sanjay Gandhi Postgraduate Institute in Lucknow, the only institute offering a two seat course in the country at that time. My second career option was gastroenterology and I subsequently joined Pushpawati Singhania Research Institute in New Delhi as a senior resident under the mentorship of Prof. RakeshTandon, an internationally reputed gastroenterologist with specific interest in pancreatic diseases. It was here where my interest in the pancreas grew immensely. Now that I had a better understanding in cell biology and biological processes, I started getting more and more intrigued by the intracellular mechanisms and the gaps in knowledge on the pathogenesis of human pancreatic diseases. Again, I was involved in clinical research and published few papers during my training under Prof. Tandon.
Then came the tide when one afternoon he asked me if I was interested in bench research in pancreatic diseases (with a warning that I won't be seeing patients during the research period!!). At that time I was way ahead into a clinical career, but his offer pumped life into the dormant and sleeping 'research bug' within me. That was an opportunity, which I had been subconsciously waiting for! Since now I had specific research questions on the pathogenesis of pancreatic disease, I knew I won't miss patient care. It was November of 2006 when I said yes without any reservations, and on 2nd March 2007, I was at Prof. Ashok Saluja's lab at the University of Minnesota. I had no prior bench research experience, and had to go through a grilling learning curve through 4-6 months after which I embarked on studying the molecular mechanisms of acute pancreatitis. As truly warned by Prof. Tandon, rats and mice were my friends for 2 (short) years!
Acute pancreatitis is an inflammatory disease of the pancreas (a gland that is responsible for secreting digestive enzymes and insulin) that occurs due to autolysis of the gland by its own trypsin. For several years, it was believed that trypsin was the principal mediator that leads to injury and death of the pancreatic acinar cells. In my research under the mentorship of Prof. Saluja, we could show that trypsin is only partly responsible of acinar cell death and could dissect out a novel paradigm of cell death of pancreatic acinar cells beyond the activity of trypsin. Following my post-doc period at the University of Minnesota, I went back to clinical sciences when I was offered an advanced pancreatology fellowship at the Mayo Clinic, Rochester, USA, the only institute that offers a dedicated training program on pancreatic diseases. The bench research experience as a post-doc definitely gave me an edge in getting into the much competitive fellowship program at the Mayo Clinic.
I returned to India and joined the Asian Institute of Gastroenterology, Hyderabad as a Clinical Pancreatologist, when I came across the potential opportunity of a Wellcome-DBT Research Fellowship. This rekindled my flare to pursue bench research in India and without saying, understanding pancreatic disease biology was the natural choice.The Asian Institute of Gastroenterology, through its research wing Asian Healthcare Foundation provided me with space and mentorship to initiate my research in pancreatic biology. This was a unique opportunity, and adding to this was the Intermediate fellowship that the Wellcome-DBT provided me. Almost all the studies on the pathophysiology of acute pancreatitis were based on animal models since procuring human pancreas for research has been difficult. However, data from rodent studies may not necessarily be relevant to humans. I took the advantage of the high volume of pancreatic surgery at the Asian Institute of Gastroenterology, (thereby providing a respectable volume of pancreatic samples for research); and presented the proposal to study the molecular pathogenesis of acute pancreatitis in humans. I take this opportunity to thank the Wellcome-DBT India Alliance and all the reviewers of my proposal for having trust in me and offering this fellowship.
With my odyssey of clinical and bench research on top of patient care, I can now say with conviction that I see pancreatic disease (all medical ailments for that matter) from a much holistic perspective than I used to before I went into research. Through this website, I would like to strongly encourage physicians to get into research, be it clinical or laboratory based, because research would not only contribute to the existing knowledge of biomedical sciences, but also improve patient care.