Dr. Tehemton E. Udwadia: A tribute and eulogy

‘Be such a man, and live such a life, that if every man were such as you, and every life a life like yours, this earth would be God’s Paradise’.

Phillips Brooks

Dr. Tehemton Erach Udwadia passed away on 7^th January 2023 in Mumbai. He served as the Editor-in-Chief of Journal of Minimal Access Surgery (JMAS) from its inception (2005) to 2017, and then as the Emeritus Editor-in-Chief till his passing. The word ‘legend’ tends to be used casually, but no other word does Dr. Udwadia’s stature justice. He was a master surgeon, a passionate teacher, a pioneer, an influencer of Indian and world surgery and an inspiration to countless surgeons.

Dr. Udwadia was born in Mumbai on 15^th July 1934 in a middle-class Parsee family. Perin, his mother, was a homemaker and Dr. Erach, his father, a general practitioner. In his autobiography,^[1] he recounts the profound influence his parents had in shaping his life values. He received his education from St. Mary’s School, Wilson College and Seth Gordhandas Sunderdas Medical College in Mumbai. By his own admission, young Tehemton was an average medical student, but thoroughly enjoyed and excelled at extracurricular activities.^[2] In his undergraduate years, he captained the cricket as well as athletics teams, helped the college win an inter-collegiate debating trophy, and was the General Secretary of the G S Medical College Gymkhana. Subsequently, he worked as a surgical resident in King Edward Memorial (KEM) Hospital and Tata Memorial Hospital. Learning from surgical greats of the time such as Dr. A V Baliga, Dr. Karmarkar, Dr. R N Cooper, Dr. Arthur D’Sa and Dr. G M Phadke, he developed surgical skills across a wide spectrum of specialities. As a registrar to Prof. P K Sen, a visionary who had the greatest impact in shaping him, he was introduced to animal-based research, medical writing and the importance of presenting research at scientific meetings. During his time at J.J. Hospital as the head of one of the surgical units several years later, Dr. Udwadia inculcated these disciplines in his residents, to ensure, what he believed, was a well-rounded surgical education.

He travelled to the United Kingdom in 1962 and cleared the fellowship examination of the Irish College of Surgeons within a few months. He then worked at the Liverpool Children’s Hospital for around a year. After receiving the Fellowships of the Royal Colleges of Edinburgh and London in 1963, he returned to Bombay. He was soon appointed an Assistant Honorary Professor of Surgery at Grant Medical College and Assistant Honorary Surgeon at JJ Hospital – a large public hospital. His mentor, Prof. Sen, was keen for him to work at his alma mater – KEM Hospital and he concurrently joined there as a research fellow. He published and presented several papers during this early stage in his career. Over the next several years, he was appointed to prominent private hospitals in Mumbai including Breach Candy Hospital, B D Petit Parsee General Hospital and P D Hinduja National Hospital. At the same time that he developed a stellar reputation as a fine surgeon and a busy clinical practice in private hospitals, Dr. Udwadia continued his academic work at J.J. Hospital. He kept himself abreast of the surgical advances by regularly attending conferences abroad and taking sabbaticals to visit eminent surgeons such as Prof. Thomas Starzl, Dr. Irving Lichtenstein and Dr. Edward Shouldice. Although his forte was gastrointestinal surgery, he performed a wide spectrum of general surgical procedures with equal meticulousness and aplomb. He always prided himself on being a true ‘old-fashioned’ general surgeon. Through the 1970s and ‘80s, he became one of the most respected surgeons and sought-after speakers in the country. The honours he received are too numerous to count. The notable ones include the Hunterian Professorship of the Royal College of Surgeons of England (1984), Surgikos Lecturership of the Association of Surgeons of Great Britain and Ireland (1988), Pandalai Oration of the Association of Surgeons of India (ASI) (1988), Dr. R G Ginde memorial Oration of the International College of Surgeons (ICS) (1991) and Sir James Ross Lecturership of the Royal College of Surgeons of Edinburgh (1992). With his charismatic persona, masterful oratory and flair for leadership, he spearheaded and guided several surgical associations in a Presidential role. These included the Society of Gastrointestinal Endoscopy of India (1987), ASI (1988), ICS – Indian Section (1987–1988) and ICS-World Body (1989–1990). He also served as the Chairman of the Indian Chapter of the Royal College of Surgeons of Edinburgh.

Over the years, he trained a number of residents both in public and private hospitals and most of them later became successful surgeons in various institutions across India and abroad. Upon retirement from J J Hospital in 1994, he was honoured with the position of Emeritus Professor of Surgery. From 1987 to 2019, he worked at the P D Hinduja National Hospital, a premier tertiary care hospital in Mumbai, where he mentored several general surgical residents as well as those doing their Fellowship of the National Board in Minimal Access Surgery.

In 1971, on observing a gynaecologist colleague, Dr. Narges Motashaw perform a diagnostic laparoscopy Dr. Udwadia became fascinated with this technique.^[3] He travelled to Germany in 1972, met with Dr. Karl Storz – the renowned instrument manufacturer – and acquired a few basic laparoscopic instruments. He used this set at JJ Hospital for over 20 years for performing peritoneoscopy (as laparoscopy was called back then) and helped thousands of patients by hastening the diagnosis and treatment of abdominal pathology before the advent of modern imaging. Being facile with diagnostic laparoscopy for nearly two decades, it was but natural that he was the first surgeon to perform a laparoscopic cholecystectomy in India on 31^st May 1990 at J J Hospital. Convinced that this was an advance as relevant in a developing country like ours as it would be in the Western world, Dr. Udwadia started presenting his series of cases and demonstrating this novel surgery at conferences and workshops in India. With missionary zeal, he also travelled to countries such as Nepal, Bhutan, Bangladesh, Pakistan, China, Myanmar, Singapore, Kenya, Egypt, Japan and Russia and conducted over 50 workshops. With the aim of promoting and spreading laparoscopic surgery throughout India, Dr. Udwadia, as the Founder President, and a group of like-minded surgeons established the Indian Association of Gastrointestinal Endo Surgeons (IAGES) in 1993. This association today boasts over 8000 members and has been primarily responsible for the propagation of laparoscopic surgery to the remotest parts of the country. In 2004, the IAGES bestowed upon the ‘Father of Laparoscopic Surgery in India’ their Lifetime Achievement Award.

Dr. Udwadia’s pioneering efforts in establishing this specialty in India and across the Asian subcontinent brought him several laurels as well as enhanced his international fame. The Indian government honoured him with the Padma Shri (2006), the Padma Bhushan (2017) and Dr. B C Roy National Award. He received the Millennium Award for Surgical innovations from the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) (2000), Honorary Memberships of ICS (1994), Nepal College of Surgeons (1995), German Society of Visceral Surgery (2006) and The American College of Surgeons (2010), the SAGES George Berci Lifetime Achievement Award (2014) and the Lifetime Achievement Award of the ASI (2020). He was elected President of two prestigious international bodies: Endoscopic Laparoscopic Surgeons of Asia and International Federation of Societies of Endoscopic Surgeons – the first Indian surgeon to have occupied those positions. Her Majesty Queen Elizabeth II conferred upon him the Officer of the Order of the British Empire in 2006. In 2017, the Genius 100 Foundation invited Dr. Udwadia, as one of the greatest minds in the world, to contribute to the first three-dimensional printed book ‘Genius: 100 visions of the future’.

Surgeons are often considered to fall into three categories: those who are skilled craftsmen, those who are the master of the written word and those who are forceful speakers. Dr. Udwadia was a rare combination of all three attributes. In his long surgical career spanning six decades, he published over 90 papers, contributed chapters to 30 books, gave over 250 keynote addresses and plenary lectures at conferences, and delivered several orations. He had three published books to his credit: laparoscopic cholecystectomy (1991), laparoscopic surgery in developing countries (1997) and his autobiography – More than just surgery – life lessons beyond the OT (2021). Another (unpublished) book ‘One way to live’ which he completed in the final 8 months of his life provides an intimate glimpse into a person who loved life and lived it fully and on his own terms.

Having been an Editorial Board member of several national and international surgical journals, he was invited to be the Chairman of the Editorial Board of the Indian Journal of Surgery (IJS)-the official journal of ASI. He served in that position from 2001 to 2003. Bhattacharya and Kumar in their recent Editorial in IJS, recount his admiration for and supportive outlook towards the rural surgeons, the numerous contributions he made and the progressive measures he adopted in the working of the journal.^[4] In 2005, he was a natural choice to be the Editor-in-chief of JMAS, the newly launched journal of IAGES. This was the first English language journal from India and the Asia-Pacific region dedicated to MAS. Although the number of international articles submitted to and published in JMAS rose steadily over the years, the journal always proudly maintained a strong emphasis on showcasing MAS as practiced in India and the developing world. By the time he handed over the Chairmanship to Dr. Pradeep Chowbey in 2017, JMAS had become a widely read and respected journal, was indexed with PubMed and had seen a steady increase in its impact factor.

It would have been easy for a septuagenarian who had achieved so much to rest on his laurels, but not Dr. Udwadia. Being cognizant of the lack of a good surgical training facility in India, he convinced Karl Storz, Tuttlingen to help him set one up. With a generous educational grant from them, Centre of Excellence for Minimal Access Surgery Training (CEMAST) was established in Mumbai in 2011, with Dr. Udwadia as its Chairman. The training centre initially housed in a 4500 square feet area later moved to a 12,000 square feet facility. Dr. Udwadia remained at the helm till just before the beginning of the COVID pandemic. Despite his busy clinical schedule, he used to make it a point to spend a few hours each day at CEMAST. This centre, as he often liked to say, was run ‘by the surgeons, for the surgeons, not for commerce, not for profit’. In every Basic Laparoscopic Training Course, he diligently took the lecture on ‘Laparoscopic cholecystectomy’, the students listening to the pioneer with rapt attention. After the pandemic, the centre reopened under new patronage as the Institute of Medical and Minimal Access Surgery Training and has till date trained over 12,000 doctors from disciplines as varied as general surgery, urology, gynaecology, paediatric surgery, Ear, Nose and Throat, thoracic surgery and orthopaedics.

Dr. Udwadia, a giant although he was in the surgical sphere, carried his fame lightly. His daily attire, crisply ironed white trousers and a white shirt, was replaced by a suit only on formal occasions and at conferences. His sense of humour, often the self-deprecating kind, put those around him at ease and brought smile to their faces. Humility marked all his interactions with colleagues, residents and patients. A born leader, he commanded great respect and loyalty from his team – in his surgical unit, in the hospitals where he worked, as also in the numerous organisations he led. This was in no small measure due to the courtesy and support he afforded to all those around him irrespective of their status. He was especially appreciative of his students and often expressed his pride by saying ‘My greatest joy is to see my residents perform far bigger and better surgery than I could ever do’. No wonder then that he evoked an unwavering sense of adulation in his associates; we, the authors who had a long association with him, are no exception. Those who knew him well were careful, however, not to mistake his kindness and good-humoured nature for meekness. He never hesitated to speak his mind or stand his ground steadfastly for things he believed in. When the need arose, he wielded his strongest weapons, words – both written and spoken, with fervour and wit to great effect.

He was a family man and loved dearly his wife of 64 years, Khorshed, his children (Rushad, Dinaz and Ashad) and their families. Although he battled ill-health for about a year before he passed away, he never bowed down to the ailment. He continued performing a few surgeries and attending an outpatient clinic each week at Breach Candy Hospital even in the final few months. Almost as much as surgery, golf was a passion. He had been playing it regularly for several years at the Willingdon Club and looked forward to a round with his friends whenever the opportunity arose during his travels. Just before the COVID pandemic, well into his eighties, he got a painful knee replaced simply so that ‘he could play a few more rounds of golf’! A short video shot a few months before he passed away circulated on social media. It showed him teeing off at a golf course wearing a Bipap mask, a heavy machine in tow. It perfectly captured the essence of the man – he was a fighter.

He touched tens of thousands of lives and undoubtedly left the world a far better place than he found it. He will be missed by his family and all those who had the privilege of knowing him. Although he is not among us, the extraordinary life he led will continue to provide inspiration to his patients, colleagues and students alike. May his soul Rest in Peace. His life can be summed up by these words of Henry Wandsworth Longfellow: ‘Lives of great men all remind us, we can make our lives sublime, and departing, leave behind us, footprints on the sand of time’.

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