Salute to the Father of Nuclear Medicine in India

Padmabhushan Professor Dr. Ramchandra Dattatraya Lele is regarded as the Father of Nuclear Medicine in India. This legendary personality left us for heavenly abode on June 24, 2022, leaving behind a lifetime of work that made an indelible mark in the world of medicine in our country, and touched the lives of innumerable medical students and doctors, who attempt to carry forward his legacy.

Professor Dr. R. D. Lele [Figure 1] was born in Hyderabad, India, on January 16, 1928. He was nurtured by the strong value systems of his mother from whom he believed he inherited his intelligence and principles, his father who inculcated in him the values of sportsmanship and leading an upright honorable life, and the influence of Gandhiji right from preindependence India.[1]

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Figure 1 Padmabhushan Prof. Dr. Ramachandra Dattatray Lele

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He completed his MBBS at Osmania University and went to London, U. K, where he worked at the London School of Hygiene and Tropical Medicine, Hammersmith Hospital, and earned the degrees of DTM and H (Eng), MRCP (Edin), and FRCP (London). His resolve to serve his motherland, brought Dr. Lele back to India. He came back armed not only with knowledge of medicine but kindled with a passion for research. India in those days, struggling in its emergence from colonial rule, had little financial resources to devote to research, but that did not deter Dr. Lele. He believed and demonstrated in his life that scientific pursuit of an idea with judicious use of available facilities with innovative methods can bring forth effective results.

Dr. Lele was an excellent physician and practitioner of medicine, who believed in the power of meticulous clinical skills as the key to disease diagnosis. He imparted this important lesson of detailed history taking and clinical methods to thousands of his students at Nagpur Medical College (1957–1968), as Professor of Medicine at JJ Hospital, Mumbai, and for many years thereafter as Professor Emeritus at Grant Medical College Mumbai, Director Emeritus at the Department of Nuclear Medicine, Jaslok Hospital, in addition to heads of various medical and academic bodies in the country. He is known as “Teacher of Teachers” who trained many excellent future professors and practitioners of medicine in India. He taught by example, by cracking unusually difficult clinical cases with his clinical acumen, as if putting together pieces of a jigsaw puzzle, making him a most revered teacher, and a respected physician for his patients. While he had several dignitaries as his patients, he actually spent most of his years in the public hospitals serving the poorest, with humane compassion.

Prof. Dr. R. D. Lele was bestowed the Padma Bhushan, the third highest civilian honor of India by the President of India, Shri R. Venkatraman, in 1992 [Figure 2]. He was also a recipient of the Dhanvantari Award from the Governor of Maharashtra State in 1997, the first Gifted Teacher Award from the Association of Physicians of India in 1991. In his long career, he received multiple awards and felicitations including Lifetime Achievement Awards by the Society of Nuclear Medicine, India, and the Association of Physicians, India.

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Figure 2 Dr. R.D. Lele honored by Padmabhushan by the President of India, Dr. R Venkatraman

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In 1962, when Bhabha Atomic Research Centre in Mumbai started providing radioisotopes for medicine for the first time in India, Dr. Lele attended a training led by the great scientist Dr. Homi Bhabha himself. Later, he completed a fellowship in Nuclear Medicine in Canada. In 1973, when Jaslok Hospital one of the earliest tertiary care hospitals in India was established, Dr. Lele was requested to come as a special scientific officer from JJ Hospital. He joined as Hon. Chief Physician, and it here at Jaslok that he set up the first Nuclear Medicine Department in a private hospital in India.

At the Department of Nuclear Medicine at Jaslok Hospital, Dr. R D Lele established the first practice of Nuclear Cardiology in the country. Beginning with MUGA scans, nuclear stethoscope, and later myocardial perfusion scans, it became the most famous center in India for Nuclear Cardiology and other diagnostic nuclear scans. It was the first center in the country to have a triple-head gamma camera, and brain SPECT imaging was extensively used by the strong team of neurologists at the hospital. Treatment of patients with radioiodine was started at Jaslok in 1977. Over the years, many doctors came to train in this very exciting new branch of Nuclear Medicine under Prof. Dr. R. D. Lele, and the hospital became a leading center for Nuclear Medicine training under the National Board of Examinations for the DNB degree. He mentored close to 70 students of Nuclear Medicine at Jaslok, who are now practicing all over the world. The growth of this pioneering department and specialists in this modality, spurred the development of other Nuclear Medicine departments all over the country. Most importantly, Dr. R D Lele being a leading physician in the country, acted as the perfect exponent to introduce the concepts of this new diagnostic and therapeutic modality to the clinician community.

He wrote the first Indian textbook on Nuclear Medicine titled “Principles and Practice of Nuclear Medicine” in 1984. In addition to Jaslok Hospital, Dr. Lele was also the Director of the Department of Nuclear Medicine and Radioimmunoassay at Lilavati Hospital, Mumbai, from 2002 till 2015 where he spearheaded many research projects, and innovative work using SPECT-CT scanning. Even in his 80s, he was guiding and mentoring projects in different institutes in the city and was on the Research Advisory Board and Ethics Committee of several hospitals and the Haffkine Institute. Dr. Lele was a member of the Atomic Energy Regulatory Board (AERB) for an unprecedented term of 12 years. He strongly supported the development of radioisotopes by BARC-BRIT by clinical use trials. He engaged with scientists for the development of newer radioisotopes, with particular focus on the development of imaging agents for our indigent needs – such as tuberculosis imaging, so rampant in our country. He received the Homi Bhabha Lifetime Achievement Award (from the Indian Nuclear Society) in 2008.

In addition to his clinical and academic excellence, Sir was an astounding administrator. He was the Dean of JJ Hospital, Mumbai, and later the Medical Director at Jaslok Hospital and Research Centre. He worked with a single minded focus on the good of patients. His years as administrator led these institutes to great glory. His futuristic mind and decisive actions marked the beginnings of many a great clinical service in these hospitals – such as the Department of IVF, Radioimmunoassay, and Nuclear Medicine at Jaslok. His ability to be authoritative and compassionate at the same time, is what made him a much-respected leader. He never compromised on his principles, but his humane touch would never allow a rule book to stop him from doing what was correct for his patients or institute, for example, fulfilling the wishes of a dying man in the intensive care unit by allowing his grandchild to visit him in the restricted entry zone. Having had vast experience at the grass root level too, his dream was to develop an effective way of health-care delivery to each and every citizen of India. He wrote a book on Rural Reconstruction in 1996, and conceptualized a health management and health insurance model called Mission Mumbai Health.

Dr. R D Lele was an orator par excellence. With his astounding memory and in-depth knowledge, he could enthrall his audience with extempore speeches. His sharp wit and his inherent sense of humor often came forth in these lectures, sending the gathering to a rapturous applause. Till the young age of around 90 years at which he was the “oldest practicing physician in India,” he delivered innumerable lectures and orations, wrote articles and chapters, and published several books. The Association of Nuclear Medicine Physicians of India has named their prestigious oration after Dr. R D Lele.

Dr. Lele had an insatiable quest for knowledge and till his late years was fully abreast with the advances in medicine, genetics, receptor biology, and molecular basis of disease. Even though he was a scientist and practitioner of allopathic medicine, he did not disregard the information of alternative fields like Ayurveda. He wanted to scientifically analyze the basis of various Ayurvedic drugs and guided projects using radiolabeled herbal drugs on animal models, to evaluate their pharmacological properties. Many would not know that he completed his study of medicine by doing MBBS not in English but in Urdu, which was the medium of education in Hyderabad state at that time. At the age of 90 years, he was keen to learn Sanskrit in order to better delve into the knowledge stored in our Indian medical texts! In March 2021, at the age of 94 years his last book “History of Medicine in India” was released by the Ministry of Ayush.

Sir's zest for life was exemplary – apart from his focus on clinical and research work, he was a lover of arts such as drama and classical music. He was passionate about cricket - always finding time in his busy schedule to keep up with these interests. His life is a book for everyone to learn something from – his quest for “not only acquiring knowledge like a sponge, but also have a probing mind and create knowledge of your own,” his impeccable discipline and time management skills, focus on the task at hand, total integrity and honesty toward patients, simple philosophy of doing what is correct even if meant dealing with challenges for the self, brutal honesty when the truth needed to be told, soft skills to deal with difficult situations, and a kind, warm heart that drove all his decisions in life.

In his foreword for Dr. R. D. Lele's autobiography “Pursuit of Excellence,” Dr. Anil Kakodkar (ex-Chairman of Atomic Energy Commission of India; ex-Director of BARC; and President, National Academy of Sciences, India) wrote “Clearly, Dr. Lele is one of the tallest personalities among such people who continue to inspire thousands of high calibre young professionals even as he enters 90^th year of life through his ever young enthusiasm, commitment to excellence, a nationalistic mind that keeps the problems of the last man in focus and infectious zeal for relevant research.”

We, his students of Nuclear Medicine in India, who have witnessed this great man at work are indeed fortunate and blessed, for legends like him are not born again. As one of his first students of Nuclear Medicine, Dr. Chaitanya Divgi states in his tribute on the ANMPI website “Dr. Lele strode the earth like a Colossus. He embodied the life well lived. The planet is so much the better for his having been on it.”

We, the Nuclear Medicine fraternity in India, are forever indebted to him for strongly establishing Nuclear Medicine as a practicing clinical specialty in India.