from anthropology to human genetics
Prof. Suraksha Agrawal
Professor and Chairperson of the Department of Medical Genetics (retd.)
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
Email ID: surkshaagrawal@gmail.com
Geneticists believe that anthropologists have decided what a race is. Ethnologists assume that their classifications embody principles that genetic science has proved correct. Politicians believe that their prejudices have the sanction of genetic laws and the findings of physical anthropology to sustain them. (Lancelot Hogben)
ME
A new year has started, seventy-four years and the journey continues. After reading and writing for decades on various themes, I thought of writing something about myself but realized soon, how difficult a task it is to declaim about oneself. One needs to tread through the memory lanes, recall everything without vacillation, rip off the hesitation and start writing. The most difficult question was from where to start - to find out why my existence was possible, what experiences shaped me and, who all influenced me to become what I am today?
I think the best place to start my story is from my mother as she is the one who created me, shaped me, acted as a cradle, held me in her arms, and stopped me from falling during my tough times. During my fears, she gave me the strength to stand up. Life was not simple, but I am lucky that my mother always left me alone to make my own decisions but returned in my tough times. Dear mother, you will keep on appearing in my story as it will proceed from childhood-adolescence-adulthood-old age.
Let me start with my childhood. I was born on 18th September 1948 in Shimla, the former summer capital of British India, and the present capital of Himachal Pradesh. Shimla is blessed with all the natural bounties and its colonial history adds an element of exotica to it. Its scenic lush green hills in summer and snow-capped peaks in winter have enthused the imagination of poets and painters alike. However, it is not Shimla, but a small town called Uchahar in Uttar Pradesh where I spent my childhood that I recollect most vividly.
I have an elder brother and sister. Being the youngest in the family, I was a privileged, most favourite, pampered child. My sister still considers me a baby. She continues to mollycoddle me oblivious to several strides that my name may conjure today. She continues to take care of me as she did when I was a toddler. My brother was 11 years older than me. He was very compassionate and behaved like a father to me. His demise in mid-life due to a kidney ailment left me completely devastated. I immersed my sorrow in my academic learning.
My father was never a role model for any of us as he was not actively involved in parenting. But in retrospect, I find him to be a protector and a disciplinarian. He was compassionate and empathetic and never denied anything to us. Being the youngest in the family he often indulged me but I remained somewhat aloof. He was a bright and hard-working engineer. He lost his hearing during the Iran- Iraq war as he was posted there, thus was not verbally expressive. This could be the reason that all of us were not intimate with him. He was a very well-read man and a devoted follower of Vivekananda. He would meditate every day and had a premonition about the date and time of his death. His death due to sudden cardiac failure created a great void in my life. It was an emotional shock and I then wished had he lived longer, my bond with him may have strengthened.
My mother whom I adore and revere was a beautiful, intelligent, strong, compassionate, authoritative, supportive, and loving person. Her mother expired when she was barely ten years old. My grandfather married again but his second wife never accepted his children from his first marriage. My mother had a difficult childhood and adolescence. Her journey was full of hardships, but her resilience, resolve and stoic silence are exemplary. She became a role model for me. I often think of writing a biography on her life.
In 1979 I got married to Dr Sushil Chandra Agrawal. He was a gentle and caring person and a most loving and caring father. In 1981, we were blessed with a daughter. Sushil had immense potential for research and my desire to pursue research was motivated and supported by him. Being trained in sociology, he got a research award to work on rural development. He developed modules for bioenergy and biogas processing. We were a happy family when just after nine years of togetherness, my life again changed forever with his sudden death. I was devastated, numbed, and shocked. After ceremonies on the 4th day, I looked at my daughter while she was sleeping and gathered the strength to fight against all odds and never turned back. Once I decided to be on my own, nothing was impossible. Swati was sensitive and became my friend and, her adjusting nature was a great help to me. My job at SGPGIMS gave me financial independence but many times I was emotionally drained and stressed. I got a few offers to work in the Pvt. sector at Delhi, but I refused those offers as I was scared to work alone in a big city like Delhi.
MY ACADEMIC JOURNEY
My early education started in Uchahar. It is a town in the Raebareli district in the Indian state of Uttar Pradesh. I was a very restless child and sitting in one place for long was very difficult. This presented quite a challenge to my personal tutor. It was my mother who taught me Hindi and Mathematics. Studies never interested me, rather I was inclined to spend my days playing and then napping amongst tree branches. My tutor had a hard time! Eventually, I started formal schooling at Ambala. I studied in a government school with Hindi as the medium of instruction. I was admitted to 4th grade, based on my performance in the admission test. Whatever I had learned was due to my mother’s diligence and ability to teach a restless child. Her coaching ability was extraordinary as she never received any formal schooling. Her stepmother never allowed her to go to school. The knowledge she acquired was through listening to a teacher who used to teach my step-grandmother. I salute my mother and the skills of the teachers of that era.
In 1954, my father decided to settle in Chandigarh. He constructed a large house for the comfort of the family. After passing 5th grade, I moved to Chandigarh and continued my studies. Botany as a subject attracted me in 12th grade, primarily because of my passion for nature. Later, I developed an interest in medicine and wanted to be a doctor. After completing my pre-medical, I got selected in Christian Medical College Vellore to pursue my M.B.B.S. However, my mother was not very keen to send me so far away; hence, I continued doing my graduation in science with biology as the focus area. When I dropped the idea of pursuing medicine, not even for a moment it occurred to me that I will be spending a substantive part of my career in a medical college.
After my graduation, I joined M.Sc. Anthropology as I was keen to learn about the social and physical behaviour of human beings. I am indebted to the discipline as it provided me with an opportunity to study human evolution, its variability, and adaptations to environmental stresses. Using an evolutionary perspective, I was able to learn not only the physical form of humans - the bones, muscles, and organs - but also how they function to allow survival and reproduction. I was fortunate to have a mentor like Prof. Vijinder Bhalla of the department of anthropology, Panjab University. He is a passionate teacher and his lectures inspired me to pursue my doctorate in Human and population Genetics. Prof J.J. Jolly, the Head of Department for transfusion medicine at PGI Chandigarh became my co-supervisor.
I developed skills in transfusion medicine during my training at PGI Chandigarh. After completing my PhD degree, I returned to the department to work in the field of lectins. After my marriage, I left Chandigarh and moved to Lucknow in 1979. I joined Prof S.S. Agarwal, Department of Medicine at King George Medical College, Lucknow where I continued working in the field of Lectins. From 1985 to 1986, I worked as a scientist in the Dept. of Immunogenetics, University of Klinikum, Essen, Germany. I received training in HLA typing for renal and bone marrow transplant services. I also received training in Recombinant DNA Technology Hybridoma Techniques at Heidelberg.
In 1986 I joined as an Assistant Professor in the Dept. of Medical Genetics from where I finally retired as a professor in 2017. I completed another training in Essen in molecular typing of HLA after I joined Sanjay Gandhi Post Graduate Institute of Medical Sciences, (SGPGIMS, Lucknow). It is one of India’s premier medical institutes providing tertiary medical care and functions as a centre of excellence for medical research. During my tenure at this institute, I was the Chairperson of the Department of Medical Genetics for 18 years. Many would think that I had broken a glass ceiling creating a niche for a non-medico among the closed inner circle of medicos. I was privileged to receive unconditional support from the administration and faculty of this prestigious institute. I have been entrusted with the responsibility of chairing the purchase committee of the Institute for two years. No questions were ever raised about my non-medical background while assigning responsibilities in various capacities in the governing body, and various academic boards. I also had the responsibility of being the chairperson of the Central School enriching my experience of learning and sharing knowledge.
My regular assignments included managing the department of medical genetics and looking after the Immunogenetics lab. I had the freedom to plan my laboratory budgets and administer research grants and supervise the Immunogenetics lab (Transplant Biology). I also got several opportunities to supervise several other projects too. What I enjoyed most was providing diagnostic advice to clinical colleagues and training the medical and scientific staff in various Immunogenetics techniques. I worked on several research projects as a principal investigator. The duties that I enjoyed most were planning and executing regular courses for post-MD/MS biotechnology programmes. I remained actively involved in the formulation of different courses and teaching Immunogenetics, Population Genetics, Molecular Genetics, and Cancer Genetics to DM PhD students. I have a passion for teaching and enjoy interacting with students helping them nurture the love for shared goals.
I look back with satisfaction, recollecting diverse topics on which I supervised 40 PhD and 36 DM students. I was also actively participating in teaching translational biology to MPhil students at KGMC. In addition to the above scientific pursuits, I also looked after the exam cell of SGPGIMS for 2 years where my responsibilities included drafting and reviewing question papers for my specialization and overall management of DM and MD entrance examinations. The most exciting part of teaching and research is writing research and the thrill of publishing scientific papers and books. So far I have published more than 200 scientific papers, many of these published in prestigious scientific journals like Science, Human Genetics, Fertility, PLOS ONE etc. I have also authored six books. Serving on various committees, editorial boards, and multitasking to meet deadlines has its own challenges. Teamwork defines passage to success, I have worked with a team of scientists, publishers, and other editors to reach consensus in a time-bound manner.
For a successful career, it is pertinent to acquire communication skills, perfection, and accuracy. I have developed the skill to notice illogical thinking, inaccurate statistics, and the wrong construction of sentences. I have also acquired proficiency with different publishing programs. The vast experience has taught me to think independently and logically. My husband was a social scientist. Conversations I had with him motivated me to be engaged with a holistic understanding of human actions. I also developed a passion for learning different languages and acquiring proficiency in writing skills.
The journey is never-ending, and success is a journey and not a destination. These famous quotes define my academic pursuit from the department of anthropology, Panjab University to renowned Sanjay Gandhi Medical Institute. Knowledge of anthropology facilitated my learnings in the field of medical genetics. My knowledge of cultural anthropology became my inspiration in designing communication modules for genetic counselling. Ruth Benedict famously said the Purpose of anthropology is to make the world safe for human differences. I carried this learning to my knowledge of medical genetics and counselling. Department of medical Genetics at SGPGIMS, Lucknow, was the first medical institute in the country to start a course on genetic counselling. One of the success stories of my career is opening of several such counselling courses across the country and its popularity at SGPGIMS. Several other medical institutes have followed the lead and opened programmes for genetic counselling. I owe it to anthropology to provide me these visons and foresight to see its criticality in future.
I am convinced that students trained in anthropology have the potential to become successful genetic counsellors. Evaluation studies of genetic counselling seem to be a potentially ripe area for research by cultural/physical anthropologists, especially those medical anthropologists who have specialized in clinical settings. Biological anthropologists with appropriate training have much to offer in the clinical evaluation of individuals with genetic disorders or with dysmorphic findings. Anthropometry, morphometric analysis and related techniques and approaches are important in at least two areas-First, measurements may be used in conjunction with other clinical findings to establish a diagnosis. Secondly, anthropometric, and other clinical data may be utilized to delineate subgroupings of individuals with a heterogeneous genetic disorder.
The knowledge of anthropology gave me an opportunity to provide mental orientation to investigate the genetic diseases like Thalassemia, Haemophilia, single gene, or multi-factorial genetic disorders. I feel that most of my Ph.D. monographs have provided fresh perspectives. Success of these innovations could be measured by the fact that all my Ph.D. students are well placed nationally as well as internationally. There can be little doubt that medical genetics offers many problems and challenges for the interested anthropologist. Many biological anthropologists are already making a significant contribution in the field of medical research. The scope is immense. Young researchers looking for ideas may start examining the urgency of collecting data on normal children for traits commonly used in the evaluation of congenital abnormalities. Cultural anthropologists with an interest in the evaluation of medical services may become major contributors to the evaluation and ethics of genetic research. The ethnic differences in knowledge and understanding of genetic inheritance and cultural and subcultural influences on reproductive decision-making in response to counselling is another area for exploration. Future calling for genetic services is bound to expand. There is tremendous potential for research that young anthropologists may find exciting having research equity and service to humanity.
Before I conclude, let me admit that I am not a feminist. I titled this blog as a journey of a woman anthropologist not because the research journey should be defined by gender but only to emphasize that at times a woman may have to invest a lot more because of her circumstances. I lost my husband early in my married life and had the responsibility to take care of my young daughter and work harder to survive in a very competitive environment. I say this to tell younger women colleagues that there may be more challenges but if you enjoy your work and have a passion to succeed, nothing comes in the way!