When I landed in the UK in 1978, it was a bad winter. I started working in acute medicine outside London. It had been very busy, with literally no time to study or relax. After 3–4 months, I decided to switch over to rheumatology as it was less stressful (I presumed). Even in 1978, rheumatology was neither a well-recognized nor a popular specialty in the UK. I decided to take up rheumatology as a career, and the prospect of being the first Rheumatologist of Karnataka was thrilling. I did work in some of the best rheumatology centers and with stalwarts. As I always wanted to come back to India, I returned in 1983 and started rheumatology practice in Bangalore.

It was very difficult. What is rheumatology was the most common question asked even by medical personnel. People told what was the need to have rheumatologists when there were orthopedicians?

My consultation fees in 1983 was INR 50, which was considered very high. I earned INR 600 in a whole year. I had to go to the UK to do locum jobs to sustain myself, for 6 to 8 weeks every year. I never met physicians or orthopedicians to advertise myself. It had always been referred by word of mouth from one patient to another patient, giving talks to small groups of GPs, orthopedicians, and general public, and writing articles in newspapers. It took 10 years to reach a stage when I founded Karnataka Rheumatology Association (KRA) in 1992 and conducted a CME program attended by Prof. A.N. Chandrashekharan, a father figure of Rheumatology, and Dr. G.H. Thilve (Late), the then president of IRA.

In 1997, I hosted IRACON in Bangalore. it was very difficult then without much help from the industry. However, my patients helped me, and it gave a lot of impetus toward rheumatology in Karnataka. Stalwarts such as Prof. P.A. Bacon, Dr. Ron Jubb (Birmingham University), Prof D.G.I. Scott (Past President of the BSR), Dr. Colin Pease from Leeds, Dr. Bhaskar Das Gupta, and Dr. Ralph Schoe Maker from the United States attended IRACON – 1997. Dr. Dharmanand and Dr. Chandrashekara moved to Bangalore at the time when I had persuaded Dr. Anupama Kumar to take up rheumatology in 1995, and today she is one of the leading rheumatologists in the city. I used to spend a lot of time educating patients, spreading awareness through public lectures, printed pamphlets, etc. I traveled extensively in Karnataka, Kerala, and Andhra Pradesh to spread rheumatology. Life was much easier for few more rheumatologists who came to the city because of the awareness of rheumatology among people.

Dr. Carol Black, who was the president of the RCP, came to India in 2002 and initiated collaboration with IRA. Dr. D.G.I. Scott, who was the president of the BSR, worked to cement IRA–BSR ties.

Dr. Lahita from the United States, Dr. Robert Fox, Dr. Sharad Lakhan Pal (immediate past president of ACR), Prof. Paul Emery, Prof. Peter Maddison, Prof. Joseph Smolen, Maxim Dougadas (France) came to this country, and they all have helped us gain more knowledge and insight into their respective areas of work in one way or the other.

It has also helped us to send some of our youngsters for short-term fellowships, observerships, and training. It helped us to globalize IRA and showcase our potential with immense clinical material and has given our bright young rheumatologists an opportunity to improve themselves.

As a consequence, today Indian Rheumatology is a force to reckon with and rheumatologists all over the world, particularly in Europe and United States, look at us with respect.

In 1997, I persuaded Prof. Bacon to come to Bangalore. It took another 4–5 years for us to start the Special Interest Group of Vasculitis (IRAVAS) in 2001. Dr. Ramnath Misra, Dr. Shivkumar, Dr. Debashish Danda, Dr. Pradeep Bambery, Dr. Binoy Paul, Dr. Krishnamurthy, Dr. Rohini Samant, and Dr. Rajeeva Gupta played significant roles in the growth of IRAVAS. The success of IRAVAS must go to Prof. Bacon who spent considerable time, energy, and his own money in coming to India nearly 50 times for the IRAVAS meetings. His patience, perseverance, and guidance helped IRAVAS immensely.

I come from a family of freedom fighters. I did dangle in politics for some time between 1989 and 1992. My forthright attitude and frankness made me a misfit there.

My wife Shashi is an artist (painter) and has tolerated my long absences. She and my children contributed for the success of IRACON – 1997 and 2002. Without them it was difficult to conduct these meetings. My eldest daughter Viplavi is a successful corporate lawyer in Birmingham in the UK.

My second daughter Anvesha is a brilliant nutritionist doing her PhD in South Hampton University in the UK, who has earned international awards and honors. My youngest daughter Prapthi is a very intelligent economist and part-time Journalist. They have all helped me prepare my talks and slides. I used to play cricket in college and badminton later. I am an avid reader – biographies and autobiographies mostly. Traveling is an endless hobby.

Professionals: be patient! You must be ambitious, but not greedy. Money and honor will come, but it takes time. Do not burn out yourself too soon in life, because your life is precious to your family and community. Spend time with patients and listen to them carefully. Be honest and frank, and do not give false hopes. Keep learning, attend CMEs, read the posters in meetings. Learning never ends, even after 39 years in rheumatology, many times I feel I am nearer the beginning rather than the end.

Rheumatology has been very rewarding for me. Whether the highest award of IRA or the BSR Fellowship or the Distinguished Fellowship of the Royal College or the state government honor or the distinguished alumni award of Bangalore Medical College – all came unapplied, unasked.

It gives me tremendous satisfaction when I look at the bright, brilliant, young rheumatologists across the country.

God bless.