Mary Poonen Lukose, a towering figure in India's medical history

Trailblazer tells the remarkable story of Dr Mary Poonen Lukose who, despite the deep-rooted stigmas and stereotypes of her time which relegated most women to domestic duties, made enormous strides not only in her personal life but also acted as a catalyst for the progression of society. She did so facing much discrimination from those who deemed it imperfect for women to be holding such a high seat in society and overcoming great tragedies and unkind tribulations to become a fearless soul committed to the developing of a modern public health system and an icon whose life will remain an inspiration forever to all. Hers is a story of relentless grit, and unwavering courage and Trailblazer does a stellar job in stitching together unfinished memoirs and memories of Dr Mary Poonen Lukose's close friends and the many whom she had helped to unravel the rich legacy that she had left behind.

Dr Mary Constance Poonen was only two months shy of her thirtieth birthday when news of her father's demise reached her in London. She was then working at a local hospital after completing her studies from the University of London. The news had come as a great shock to her. Life without her father, who had been all the world to her, was unthinkable. To return to a home made void by his passing did not appeal to her. A good number of friends and well-wishers counselled her against leaving England for a home in India which they knew was for her more forlorn than life in far-off England to which she had by then become assimilated. But something that prompted her to consider the long voyage home, and what was enjoined on her by her father, was that she should return to her home country and be of service to the less privileged sisters, the majority of whom had not till then known the real benefits of modern medicine and surgery. Notwithstanding the good scope for young aspirations to enter the medical profession in England at that time as the armed forces had taken many of the professional men or service in civil hospitals in the country, she decided to leave.

While gunshots reverberated in the bloody theatres of World War 1, Dr Mary had already chosen her mission and knew very well that she had another war, far more difficult to win, back home. She set off on the long voyage made perilous by the devastation of a war which was raging as ferociously on the seas as it was on land. On reaching home, however, she found her father's property stripped of all possessions. There wasn't even a cup to drink from. "I went to England like a princess and came back like an orphan,” Dr Mary Poonen Lukose later recounts to Aley, her daugter-in-law, in the book.

Royal family's favourite physician

Travancore Maharajah Sree Moolam Tirunal, to whom her father had been the physician, on hearing her plight summoned her to the Palace, the book informs us. "Now that your father is no more, you should consider me your father." After Sri Mulam Thirunal died, Setu Lakshmi Bayi, the Senior Maharani became the Regent and appointed Dr Mary Poonen Lukose as the Durbar Physician. She was the favourite physician among the royal household at that time.

When Senior Maharani ascended to the throne, she elevated Dr Mary P Lukose, Travancore's first woman graduate and a product of one of the best medical colleges in the West, from being surgeon in charge of the Women and Children's Hospital and her personal doctor, to the head of the Medical Department of Travancore. The hospital emergency bag which she had brought from London, and which contained precious essentials, had by then been put to good use and helped launch her illustrious career. Both Senior Maharani and Dr Mary P Lukose were instrumental in changing the landscape of Travancore and were living proof of the crown's commitment to female empowerment.

While in charge of Women and Children's hospital in Trivandrum, Dr Mary Poonen Lukose had to not only overcome the disability that lack of right equipment inflicted but also leap over societal tribulations that permitted women from seeking medical help, and certainly not from a hospital. The idea of hospitals as welcome centres for the relief of suffering by the use of modern methods of treatment had still not taken root in society then. There was, and quite understandably, a deplorable misconception of what hospitals stood for.

Even people, especially women from well-to-do sections of society, were reluctant to having recourse to hospitals for the treatment of diseases and maternity and lying-in. Even though there was untold suffering and enormous loss of life all around for want of proper treatment of a host of diseases and as a result of unskilled and primitive handling of midwifery cases, people viewed hospitals with a certain amount of suspicion. The facilities made available at great cost by the forward-looking rulers and their governments though well-equipped and comfortable failed to attract many.

The feeling had somehow gained ground that hospitals were, like poor homes, meant for the poor, the uncared, the abandoned and that confinement of a patient to a hospital was nothing less than sure death. The maternity cases brought to hospitals were, almost always, advanced septic cases reduced to such condition by ignorant, unskilled and unsanitary handling. And quite naturally nothing could be done by the doctors in hospitals to save either the mother or the child or sometimes both. In a situation like that there was an undiscerning prejudice against hospitals as a whole and, not any the less, against doctors – men and women – who were charged with the mission of putting the hospitals to work. There was yet another tradition firmly established in Indian families who required that the first baby be given birth to in its mother's home.

Infrastructure development

Also, conditions in hospitals in those days were not ideal. For all the exquisiteness of the buildings and the fitness of the furniture for the wards and appliances provided, Dr Mary Poonen Lukose and her band of sisters had to do without electricity for lighting and other purposes. In the book, there is an account of how, in the operation theatre, the large and ornate kerosene lamp that hung above the operation table did not allow for direct light to fall on the object as the doctor's head would often get in the way of the rays.

But what it lacked in modernity and skilled workers, it made up with the absolute devotion of those there to duty and willingness to help. Especially the European nurses who had sacrificed their many privileges abroad to aid those in desperate need of help. Dr Mary knew that with enough determination, a change could be brought about. The task she undertook was huge. She went from house to house and talked to people from her heart. She took with her trained hospital midwives and introduced them to the common folk. She also introduced private philanthropy on a wider scale, so that facilities at government hospitals could be improved. To her call for donations to give a facelift to the Women and Children's hospital, many reciprocated with huge sums. The revolutionary steps were well worth their effort, for the hospital soon transformed into a wonderful healing centre, rivalling other hospitals in the whole of India. Dr Mary also encouraged smart and service-minded women to study the fundamentals of midwifery. She started training girls for the nursing profession. She also got several education projects launched to enlighten society on the need for changing its attitude towards hospitals. Her committed efforts slowly and steadily yielded results, for she was able to perform the first Caesarian operation in Travancore as early as 1920.

Dr Mary Poonen Lukose admits later that if she had achieved anything, it has been primarily due to the advantage and opportunities that I had in my early days. "Looking back, I must truthfully say that the greatest influence in my life has been my father's. Two things I can vividly remember his instilling into me. One, the greater our advantages and opportunities, the greater are our responsibilities to society. The more we have received, the more we were obligued to give. Secondly, this watchword for me was service to humanity and to you sisters in particular. This was a rigid code of discipline under which I grew up and never had a chance to be pampered or spoilt as an only child could have been."

Dr Mary Poonen Lukose was a woman of sturdy mettle, one who fought with adversities in life, with a disarming smile and resolute mind. She is a towering figure in the medical history of not only Kerala but perhaps even India.

While Trailblazer paints a glorious detail of her this icon, it also dispels the idea of a ruthless colonial empire in India. Instead, it paints the detail of a rose-tinted image of how deep-rooted traditions of home melded coherently well with the far-reaching aspirations of the West, and how progressive Travancore really was in matters of education, civic sense, public health, hygiene and other concomitants of civilized life.

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