We were doing a portocaval shunt. It involved producing a direct surgical communication between the inferior vena cava and the portal vein.
“Put the partial occlusion clamp on the cava and pull it toward you, it’s the only way you’ll know if it will reach. You have to be able to feel when the tension is just right,” said Sharma.
He stood across from me, over the animal in his operating room in the R.O. Burrell Laboratory. We had many very different surgical models together over the years. We published quite a few papers together as well. Sharma would give me the history behind each medical instrument we used as we proceeded with the surgery of the day. This was always pleasant and it would occasionally distract me but Sharma made sure my mind didn’t wander too far. In less stressful times, he would tell me about the history of India and how he had come of age during the independence from Britain in 1947. I can imagine him then. Medium height, thatch of black hair, leaner of course, deep brown eyes. He’s somewhat heavier now and his hair is white, but his eyes must be the same. Working with him each day, I was impressed that he made no unnecessary moves, either in surgery or in his life.
Chamba Valley to Dalhousie
In 1910 Nathu Ram Sharma moved from the 800-year-old city of Chamba to the hill station of Dalhousie. Nathu Sharma, who owned a tobacco shop in Dalhousie, obtained the contract to provide hay for the British Army mules.
Although Nathu Sharma lacked a formal education, he progressed from a supplier of hay and labor for track maintenance to a military contractor for the British. He taught himself English, prospered, and on July 18, 1927 his son was born and called Gyan Prakash Sharma.
From the front window of Sharma’s home, the Pir Panjal range of the Himalyas could be clearly seen on most days. Sharma always wanted to hike the pass alone and see for himself what the valley looked like on the other side. This was a wild and desolate place, and his father strictly forbade him to do so. The uplands surrounding the town were oak and cedar forests. There were always bears in the forest, but attacks on humans, even children, were virtually non-existent. In the fall when shepherds would bring their animals down to lower elevations, plains leopards would follow the flocks, ending the children’s play in the forest. In the spring the rhododendrons bloomed in profusion, followed by apricots, peaches, apples, and walnuts.
In many ways it was an idyllic life for the residents of Dalhousie. It was less crowded than the more popular hill-stations of Simla and Darjeeling. Many of the Indians born there would spend their entire lives without leaving and be content. This was not to be the case for the boy Sharma. He was about to have two epiphanies which would forever change his life.
There was a surgeon attached to the cantonment at Dalhousie and he had a scientific interest in goiters. The Kashmiris who came south to Dalhousie to sell their labor for construction were frequently affected with goiters. The British surgeon made an arrangement to operate at no cost so he could study the nature of the affliction since the cause of goiter was unknown at that time. At one point he invited Sharma and two other boys to observe the operation. They watched the incision, the removal of the goiter and the final suturing. At the conclusion of the operation, Sharma would make one of two decisions that would affect the rest of his life: he would be a surgeon, a decision that would later put him at odds with his father. The second epiphany happened in the British library. Sharma found himself staring at a poster of Lake Louise in Alberta and he made a second promise to himself, “I will stand in that place.”
Dalhousie to Lahore and Back
There is no good time or place to be in conflict with your father. In India, where marriages are still arranged, parental guidance is taken for granted. The most natural thing would have been for Sharma to join his father and no doubt they would have been highly successful in the contracting business. The elder Sharma’s contracting business continued to thrive and had offices in Dalhousie and Jhelum, 200 miles northwest of Lahore. But if the father was firm, the son would not budge. Sharma then applied to Balak Ram Medical College. There were 4,000 applicants for 55 openings. Sharma placed 12th in the competition in 1944 and received a full scholarship. He was obliged to move in with a family in Lahore.
Political changes were coming and in 1947 it was apparent that the country was coming apart. It was not clear where the new lines would be drawn. With the waning of British power they would draw the new political boundaries. Jinnah, leading the Muslim League, would rule Pakistan, that was clear. What was less clear was what kind of government would emerge there.
Sharma and his classmates were functioning as volunteers, treating Hindus and Sikhs in Lahore and were under police protection. In the next few months, the political situation deteriorated rapidly. The Indian Army contingent protecting the hospital was ordered out. Ganga Ram Hospital had become the last refuge for Hindus and Sikhs seeking safe medical help, but the net was clearly closing in on the students running the medical station. With the political fate of Lahore in the balance, tensions were high. In Aug. it was decided by Cyril Radcliffe, working for Mountbatten and the British government, that Lahore would be in the new country of Pakistan and Calcutta would go to India. Partition came on Aug. 14, 1947. It had become clear to the students that their lives were in jeopardy and they were quite possibly the last Hindus in Pakistan.
They made a run for the border on Sept. 12, 1947. In six days they traveled 26 miles, moving at night, terrified. They hid by day in sugarcane fields. On Sept. 18, they reached the Pakistani army checkpoint at Atari with the Indian Army close by. They Pakistani army allowed unmolested crossing by all 80 students after confiscation of all their possessions, as well as their stethoscopes.
The students were now in India. At a soup kitchen in Amritsar, they had their first solid meal in six days. India was also in chaos. The principal, D.H. Roy, of Balak Ram College had copied the students’ transcripts and sent them to Delhi. The medical records soon came through and Sharma traded the hot dry plain of Lahore for the sea coast of the Bay of Bengal.
From Andhra to Winnipeg
Sharma went to Andhra in Madras province to finish his medical degree. With his family’s fortune gone, he subsisted on 64 rupees a month in the form of a loan from the province. He lived in a hostel where payment was based on how many meals were eaten. He found he could restrict himself to one meal a day which left more time for study, a practice he continues to this day. Here Sharma met the woman he would later marry. They married in 1951, and after paying the costs of the wedding they had exactly five rupees left. The wedding party all walked back to the hostel and shared a cup of tea in celebration.
Both Sharma and his wife, Sakuntala, wished to continue postgraduate studies but money was scarce, so Sakuntala continued her studies and Sharma joined the Indian Army as a medical officer. The pay was good and he spent three years as doctor in the Indian Army while they built an airport and a road to Nepal.
Although the workload was heavy, it was a good time in his life. The splendor of scenery was spectacular. The work was interesting. He had a DC-3 at his disposal for an air ambulance, one of the few in the country. He dealt with lightning strikes and bear bites. Medical aid was also supplied to the Nepalese.
In 1956, Sharma came out of the army a captain and returned to Andhra and applied for his specialty training in thoracic surgery. He became an assistant professor of surgery and in 1960, a lecturer in surgery. He received a fellowship in 1963 to go to the University of Kentucky to work with Dr. Ben Eiseman for training in surgical research.
This was Sharma’s first trip to the U.S. He went as a research fellow with a contract from the Indian government to return and establish a laboratory in India. The year in Kentucky went quickly and soon Sharma returned to India with a NIH grant to establish a research lab. It was unfortunate, but in those days, the Indian bureaucratic system made it virtually impossible to import equipment, hire staff, or do the necessary groundwork to establish the laboratory, so the funds went unutilized. In 1967 however, Sharma received a letter from the University of Minnesota. A surgeon was required to help establish a critical care facility and Sharma was recommended for the job. There was some confusion about the starting date and the upshot was that Sharma was offered another job, in Winnipeg, Canada at St. Boniface General Hospital as director of what would become the R.O. Burrell Surgical Laboratory. Sharma left India with $7, that he was allowed to take out of the country because of the currency controls and came to Winnipeg in July of 1967.
In the next 20 years as director, his benefit to his students and the community was incalculable. I met him eight years after he came and I was his last student. He taught me to write and think as a scientist. He also tried to teach me surgical techniques but my innate awkwardness made the task difficult. I dedicated the first medical textbook I wrote to him and remarked how strange that a man born in Dalhousie, India and a man born on the same day in San Juan, Puerto Rico 21 years later would meet in Winnipeg to work together.
“Fate,” he said, “it was our fate.”
He made it to Lake Louise in 1968. It had taken 35 years. He drove his car across the Canadian Prairie to the Rocky Mountains. He and his wife stood in the place he had been drawn to all those years ago.
“In the Himalayas,” he said, “you are always in awe and very aware of your insignificance at the scale of things. At Banff in the Rockies and especially at Lake Louise all you see is the beauty.”
Sharma retired in 1989. Like all the events in his life it was well planned in advance. He made sure that everyone he had worked with over the years had completed the investigations in his laboratory. For those of us who stayed behind it was an emotional experience, but Sharma just smiled and left. Three weeks later he flew to India, went to Dalhousie, hiked over the Pir Panjal range of the Himalayas alone and looked down into the valley.