Professor Inder Sen Jain: Master and commander: Reflections from the diary of a former ophthalmology resident : Indian Journal of Ophthalmology

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Professor Inder Sen Jain: Master and commander: Reflections from the diary of a former ophthalmology resident

Pandey, Suresh K

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doi: 10.4103/ijo.IJO_2009_22
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Dear Editor,

The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.” William Arthur Ward

I read the article “Professor Inder Sen Jain: Master and Commander” with great interest.[1] I congratulate all of the authors, Prof. Amod Gupta, Dr. Mrittika Sen, Dr. Sandeep Jain, and Dr. Santosh G. Honavar, for publishing details of one of the most influential ophthalmic researchers of the present era in the “Tales of Yore” section of the Indian Journal of Ophthalmology.

The published article[1] highlighted several aspects of the personality of the great academician Professor Jain who was a decade ahead of his time. This article shares reflections from a diary of ophthalmic trainees as well as the influence of Professor Inder Sen Jain’s teachings after his retirement from PGIMER, Chandigarh.

Professor Jain had several qualities, the most unique of them being that he always believed in clinical observation, a meticulous ocular and systemic examination, relevant investigations, and contributing ophthalmic (medical) literature, and not copying/duplicating from published western research. Most of his publications were entirely based on his own clinical observations and research. Professor Jain published more than 300 papers that were extensively cited in System of Ophthalmology by Sir Stewart Duke-Elder, Cataract Surgery and Its Complications by Norman S. Jaffe, and other contemporary ophthalmic books and literature. The list of his original observations and contributions is very vast and most of his research is summarized in the article by Gupta et al.[1] In addition to several important contributions of him, as mentioned in the article,[1] Professor Jain (and co-authors) also published articles on miotic iridocyclitis, hyperuricemic uveitis, early onset of presbyopia, cataractogenic effect of hair dye (clinical and experimental study), ocular hazards during birth (Purtscher retinopathy and corneal abscess), pigmented mass lesion on the cornea presenting as fugal keratitis, ocular cysticercosis, eclipse retinopathy, etc.[234] Professor Jain encouraged faculty members of PGIMER, Chandigarh, to observe, document, and publish their unique findings [Fig. 1]. This was a time before the digital revolution (internet, online journals, online submission of articles), making the research and publication much more challenging and time-consuming.

F1
Figure 1:
Professor Inder Sen Jain with Prof. Amod Gupta, Prof. Mangat R. Dogra, Dr. Sandeep Jain, and Prof. Surinder Singh Pandav

Professor Jain was a teacher for all times and trained hundreds of ophthalmologists who have carried forward his legacy all over the world; many of his students went on to occupy distinguished chairs and play a major leadership role. He taught, by his own example, very important lessons of observation, meticulous examination, documentation (taking notes), investigation, and much more before the digital era of PubMed and Google Scholar. For every clinician, he always insisted to follow the bedside round, making notes about clinical findings, evaluating the patient systemically (not liming to ophthalmology or a specific organ), discussing the clinical/investigative findings in clinical rounds, and documenting each and every major and minor finding and never forgetting to publish it. India is producing the largest number of ophthalmologists in the world, and the All India Ophthalmological Society has now become the largest society of “life members” in the world. If our ophthalmologists’ colleagues follow the footsteps of Professor Jain, Indian ophthalmology can surely achieve the most respectable position in the ophthalmic world.

I joined the department of ophthalmology at PGIMER, Chandigarh, in January 1995 as a junior resident, about five years after his retirement. However, I was fortunate to meet and interact with Professor Jain during his visit to the department and also during the ophthalmic conferences. The department at PGIMER was very different due to the great influence of Professor Jain even after his retirement. The first thing that left an impression on me was the punctuality, teamwork, and strict discipline of all faculty members, residents, and staff members. The residents are trained to adopt a strict system of history-taking, detailed ocular/systemic examination, and documentation of clinical findings and all necessary investigations on the patients’ clinical notes. Most of the faculty members, including the chairman (professor Amod Gupta), would reach the institute at 8 am sharp. I was very fortunate to be taught by faculty members (Dr. Jagat Ram, the late Dr. J. S. Saini, Dr. Mangat R. Dogra, Dr. Kanwar Mohan, Dr. R. K. Bansal, Dr. Ashok Sharma, Dr. Surinder Singh Pandav, Dr. Arun Jain, Dr. Usha Singh), many of whom were trained by professor Inder Sen Jain himself. Every resident would need to prepare for the grand round of case presentation very sincerely and some of us would start preparing for the grand round one month in advance. It is important for all residents to present the case in detail with all ocular/systemic findings and investigations. The residents would also read about the case by finding such cases reported in the literature after spending a lot of time at the Tulsi Das Library of PGIMER, Chandigarh. I have shared lessons learned during the ophthalmology residency period at PGIMER in a few publications.[5678]

It was the last week of January 1995, my first month when I joined the department of ophthalmology PGIMER, Chandigarh. I was sitting in the outpatient department (OPD) as a junior resident and saw a middle-aged female with complaints of headaches. I examined her vision, and intraocular pressure in the anterior and posterior segments (which were normal) and showed my findings to my senior resident (Dr. Mrinal Anand) who advised an X-ray of the skull (antero-posterior and lateral view). The patient came after the X-ray skull and I only saw the official report from the department of radiology. It had “normal study” written on it. I the showed the film and report to my senior resident who placed the X-ray film on the illuminated view box and noticed an enlargement of the pituitary fossa, loss of definition of the floor of the sella, and erosion of the posterior clinoid. Later a CT scan (head) was advised and the patient turned out to have a case of pituitary adenoma. I learned a very important lesson to see very carefully the investigation report so we can minimize the chances of missing key findings.

While pursuing the ward round during the first month of my time there, I had been asked by my senior residents if I knew the association between hair dye and cataracts. I had not read this kind of association in ophthalmic books but this was a research done by professor Jain that had been published in the Indian Journal of Ophthalmology (IJO) and Annals of Ophthalmology. Dr. Norman S. Jaffe also cited the relation of hair dye with cataract research in his famous book titled Cataract Surgery and Its Complications. When I returned after pursuing my fellowship training in USA and Australia and started working at the SuVi Eye Hospital, Kota, I tended to a 45-year-old bank manager who came to me with a white cataract. In a few months, I had seen a few more cases (women aged 45–55 years who belonged to the affluent society and presented with white cataracts from using hair dyes), I immediately recalled the teaching of my ward round regarding the association of cataract with hair dye and shared this with all of these patients. All of these patients had consulted many ophthalmologists but no one had informed them of hair dye as a possible cause of cataracts. All of these patients had been using hair dye for more than 10 years. This was the influence of Professor Jain even after two decades. Professor Jain’s observations were based on a clinical and experimental study of the effect of hair dye (paraphenylenediamine) on the lens, published in the Indian Journal of Ophthalmology in 1981.

Professor Inder Sen Jain was a true academician and inspired each and every person who came in contact with him. As one of the most influential ophthalmic surgeons, published researchers, and contemporary Indian authors of ophthalmic literature, Professor Jain’s work will live on indefinitely. Ophthalmologists, optometrists, and vision professionals around the world will remember him forever, for his priceless contribution to the field of ophthalmology. Professor Jain has left behind a legacy of honesty, integrity, punctuality, equity, and excellence. His legacy is still continued at the Advanced Eye Centre of PGIMER, Chandigarh.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1. Gupta A, Sen M, Jain S, Honavar SG Professor Inder Sen Jain:Master and commander Indian J Ophthalmol 2022 70 2781 3
2. Jaffe NS, Jaffe MS, Jaffe GF Cataract Surgery and Its Complications Mosby Publisher St. Louis, USA 1997
3. Jain IS, Jain GC, Kaul RL, Dhir SP Cataractogenous effect of hair dyes:A clinical and experimental study Ann Ophthalmol 1979 11 1681 6
4. Jain IS, Jain GC, Kaul RL, Dhir SP Cataractogenous effect of hair dyes. (A clinical and experimental study) Indian J Ophthalmol 1981 29 283 8
5. Pandey SK Diary of an ophthalmology resident:Recollections from Post Graduate Institute, Chandigarh Indian J Ophthalmol 2021 69 160 1
6. Pandey S.K. Secrets of Successful Doctors: A Complete Guide to a Fulfilling Medical Career New Delhi, India Maple Press 2019
7. Pandey SK, Sharma V A Hippocratic Odyssey:Lessons from a Doctor Couple on Life in Medicine, Challenges and Doctorpreneurship New Delhi, India Bloomsbury 2020
8. Pandey SK Entrepreneurship for Doctors:How to Build Your Own Successful Medical Practice New Delhi, India Maple Press 2021
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