Life in NIMHANS
After CRC completed MD course, he was appointed as General Duty Medical Officer (GDMO) in July 1979. He worked in the community psychiatry unit, participating in many outreach programs. Later, in May 1981, he was appointed as lecturer. He was promoted as Associate Professor on January 1, 1986, as Additional Professor in July 1992, as Professor in July 2000 and as Senior Professor on July 1, 2009.
He was motivated by his teachers like Dr. R L Kapur, Dr. H S Narayanan, Dr. Mohan K Isaac and Dr. C. Shamsundar to take up community psychiatry. Dr. Kapur introduced this concept for the first time in India, which was the taking of psychiatric services from the hospital into communities , by providing services across a geographical area through rural/community mental health centers, treating the patient in a domiciliary setting, training local primary health care professionals to treat mental patients and involving the local community.
When CRC became a faculty member he encouraged many of his students to take up community psychiatry work. Most preferred to practice in the comfort of the hospital, rather than face the challenges in community work : the lack of acceptance of psychiatrists by people; being asked to wait in the patient’s home, while the person was out working in the field; the expectation of patients that they would get better immediately and if that did not happen, their stopping of treatment; their blind belief in black magic, evil spirits, miracles and religious rituals, and so on. But on the other hand, once a patient became better, it made local people accept the doctor. Many of his students went on to do both hospital work as well as some community oriented work – setting up satellite clinics or medical camps, or working with NGOs.
CRC also benefited from the practical training in psychotherapy introduced by Dr C. Shamsundar. He also got trained in counseling.
From 1978 to 1990 he worked in community psychiatry and propagated the message among his students to counter the growth of biological psychiatry (an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system), and the attraction it held for students. The rural team of NIMHANS consisted of 2 doctors, 2 psychologists, 2 social workers and some MD students. His rural background and his writing helped him to understand and relate to rural folk. He would work in NIMHANS OPD only once a week.
R. Srinivas Murthy, Isaac Mohan and CRC worked together in several research projects. The three were the core team of community mental health unit. All the three lived in staff quarters in the campus. Their families grew close to one another; team meetings were often held over dinner at one of the homes. The team broke up over time – Srinivas Murthy voluntarily retired five years before he was due to retire and Isaac quit two years before CRC was due to retire.
After this, CRC did not take up any independent research projects. The change in the environment in NIMHANS played a role in this. Earlier, there were no restrictions on doctors taking up projects. But later several regulations were introduced; also there were restrictions on taking up projects with foreign funding. The new reporting and accounting were cumbersome.
After 1990, he took up more of hospital work. From 1980 to 2013, he taught students. He continued community psychiatry work through the training of doctors and college teachers and by participating in mental health camps organized by NIMHANS and other organizations.
He took up the cause of educating the public on mental health as part of his career. He trained his students through role play on how to communicate to lay people. Students were asked to speak on a topic to rest of the class, treating them as a lay audience.
He has visited almost all towns and taluks of the state, as part of community psychiatry, or to give lectures in institutions. He has been educating the public from 1980 through community work, lectures, his writings, radio & TV programs.
He was given administrative post of Deputy Medical Superintendent in 1998. He was responsible for the legal aspects of treatment and general administration. He held additional charge of position of Medical Superintendent for around one and half years; he did not want to take up the position full time as it would have meant sacrificing clinical work.
In 2011 he was offered the post of Dean of Behavioral Sciences. The Dean was responsible for academic affairs including examinations. This would have required CRC to come in at 8 in the morning and work till six in the evening or later. During this period, Rajeshwari had developed multiple health problems, including diabetes, hypertension and bronchitis; CRC declined the post.
He retired from NIMHANS on June 30, 2013. During his last week he was given farewell parties separately by his department, the institute, the faculty association, and the administrative staff of the department.
He was never been interested in joining a private hospital. He believed that he got more freedom in NIMHANS than he would get in a private institution, where physicians are under pressure from the management to increase billings by ordering unnecessary investigations and admissions. He valued the freedom given to doctors in NIMHANS, where doctors were respected and free to decide in matters of admissions and course of treatment.
Dr. C. Naveen Kumar and Dr. Suresh Bada Math were his students in MD course at NIMHANS. They joined CRC in community health work. Despite lucrative offers from private institutions, they elected to stay in NIMHANS. Naveen is involved in National Mental Health Program activities. Suresh was the first to get Ph. D. degree from NIMHANS in forensic psychiatry. He works on legal issues related to psychiatry at NIMHANS.