Changes of heart: Debating the role of cardiology and cardiac surgery in India, 1948–1968

Abstract

In 1950, the leaders of independent India celebrated the contributions that surgeons could make to modernising India. Surgeons, however, faced a difficult choice. Some wanted to invest in generalist surgeons to make basic surgical care available to all Indians. Others wanted to invest in specialists to ensure that India participated in cutting‐edge surgical research and care. These debates shaped the emergence of cardiac surgery at two centres: the Christian Medical College in Vellore and the King Edward Memorial Hospital in Bombay. CMC invested in thoracic surgery in the 1940s to offer new treatments for tuberculosis. This gave surgeons the opportunity to explore new techniques of cardiac surgery. Debate quickly emerged about whether investments in cardiology and cardiac surgery made sense. In the end, the specialities were supported in order to attract paying patients. A parallel controversy took place at KEM, where the dean debated the Bombay Municipal Corporation about the role of surgical research at a public hospital. The Rockefeller Foundation influenced both sites, offering financial support if they adopted an American model of full‐time faculty clinician‐researchers. The two case studies reveal how unusual dynamics could contribute to the establishment of new medical specialities in India.

The historical sociology of medicine in India: Introduction to the special section

“…The paper by David Jones and Kavita Sivaramakrishnan (2024) highlights the tensions that emerged in the 1950s and 1960s over the balance that should be found between meeting the basic health needs of the majority of India’s population and the temptations for doctors to work in urban India and develop surgical and medical specialities that could provide state‐of‐the‐art treatments for at best a tiny minority of citizens. For Indian nationalists, both visions were important in how they imagined India’s future.…”