In the Bonesetter's Waiting Room (17 page)

As darkness began to fall, the buzz of the old city, like the hakims we met, continued well into the early hours, when more of their patients were freed from their jobs and family responsibilities. I chatted with Ramal about my impressions of the doctors we had met and their treatments. The sheer volume of patients who by-pass allopathic clinics and go to hakims on trusted recommendations pointed to how far Unani was built into the city's social and historical fabric. Just as throughout its history, what I saw was that Unani, and bone setting within it, was still embracing and imbibing innovations from other systems of medicine sharing its space in India today. Hakims who blend the ancient science of Hippocrates and medieval Arab doctors with biomedical diagnostics were evidently thriving. With clinics mainly placed in tightly knit, lower-income areas of the city, these doctors were very much acting as a first port of call within their communities. For these people who chose to pay hakims rather than the private sector mainstream medics (or opt for the free but generally avoided state ‘allopathic' offerings), value for money was clearly an important factor. But picking AYUSH over Western medicine was not simply about the amount of money changing hands.

‘That's the thing about Unani doctors I've studied,' Ramal told me, as our bandaged driver headed back towards her university at Hyderabad's Institute of Public Health. ‘There's a lot of trust. Many of these patients actually do not trust conventional doctors. These hakims whose families have been in practice for hundreds of years, these doctors know all about their patients – how many kids they have – they know how many kids their kids have. They really know their situations and talk to them about their homes and their lives, not just about the injuries they come into the clinic with.'

6

The Fish Doctors

TWO MONTHS AFTER
I visited Hyderabad's bone setters, I returned to its ‘twinned city', Secunderabad, geographically separated from Hyderabad by the immense, sixteenth-century Hussain Sagar lake. I had been invited there by Dr Harinath Goud, the head of the Bathini Goud family, who for generations had been carrying out a curative ritual the details of which, when related to me by an Indian colleague a year earlier, I had found difficult to believe.

It wasn't just, as he told me, that patients came to the Bathini Gouds to swallow live fish whole; or that they came in their tens of thousands; or that the recipe for the herbal medicine the family stuffed into the fish's mouths had been a secret for nearly 200 years. As a unique phenomenon in India, what I found fascinating about this apparently bizarre mass medication was that over half a million Indians had received it in the last decade; moreover, the government of Hyderabad's state was subsidising the unregistered treatment almost entirely. The reason I had waited twelve months to arrange a meeting with the fish doctors was because the ceremony took place on only one day each year.

Unlike the old Hyderabad of the Unani doctors and bone setters, Secunderabad was largely indistinguishable from any of the recently built bustling neighbourhoods of Indian suburbia. Though it was founded by the British as a military cantonment in 1806, few relics of its architectural origins remain: its iconic 1860 clock tower only narrowly escaped demolition in 2003, having nearly become a casualty of the local government's attempts to ease the unrelenting traffic congestion. Other historic buildings were not so lucky. Just two months before my visit, a 400-metre stretch of old properties between the clock tower and the railway station were undergoing demolition to remove a traffic bottleneck and to speed up the construction of a new metro rail project.

The Kavadiguda area, where Harinath Goud lived, was an ordinary-looking place, with houses of no great age, general stores selling plastic toys and household goods and a few small shops stocked with snacks and drinks. There were no signs of great wealth here. I watched as an old vegetable-seller struggled to push his wooden cart into the street behind us. The neighbourhood bordered Bholakpur, an area which only a decade earlier had been the epicentre of a serious cholera outbreak. The root of the problem was its slum-like infrastructure: when toxic chemicals from the town's illegal tanneries corroded its water and sewage pipes (which were laid side by side fifty years ago), drinking water become contaminated and hundreds contracted the disease. Luckily, the outbreak was contained by the local hospital, but remedying the infrastructure proved more difficult. In subsequent years the administrative meanderings of the agencies involved had resulted in the sewage pipes being replaced, but the half-century-old water conduits remained untouched. In the same way that central Mumbai slums occupied prime real estate, so that shanty houses sat close to five-star hotels, here poor dwellings built on inadequate, unhealthy infrastructure abutted the multistorey luxury homes of the well-to-do.

But the Goud family were evidently relatively new to this milieu. The house we pulled up outside formed part of a new three-storey apartment block, painted pale blue, with pretty flower designs running up its height. The entire front wall of its ground floor was decorated with dramatic gold swirls in bas-relief and, like a family crest, a fish motif – curling into itself so that its mouth and tail came together in an almost perfect circle – was embedded at its centre. Although I had undoubtedly come to the right place, the home of the ‘fish doctors', the gates were locked, and when I tried phoning, no one was at the end of any of their three phone lines.

I sat on their
thinnai
– a traditional raised, shaded platform between a house and the street meant for weary passers-by – and waited. It was to be a long wait and a futile one. In the three hours I was there, other visitors to the Gouds came by, including several young men who arrived hoping for ‘passes' to circumvent the crowds due to turn up the next day for the medicine; a woman whose father had been successfully treated by Dr Harinath's fish and who had travelled 800 kilometres with her young family from Chhattisgarh in Maharashtra; and two of the Gouds' family friends in Brahmanic robes and priestly paraphernalia, who arrived on a motorcycle. All had fixed appointments with Dr Harinath that afternoon and I watched the increasingly familiar pattern unfold as they arrived, waited, tried phoning and left.

Those who knew the family were unsurprised by their absence. I was told that the Gouds were, as they were every year, at a temple close to their other address – a place in what had once been their traditional family village, now enveloped by the narrow lanes of Hyderabad's old city. The temple prayer ceremony was where their secret herbal mixture would be offered to the gods before it could be offered to their patients. Because their product was chemically unknown and untested, in recent years the fish medicine had been restyled as fish
prasadam
– something (often edible) that had been offered to the gods. In the same manner as some popular, off-the-shelf Ayurvedic formulations; when referred to as prasadam this fish medicine took on the guise of a dietary supplement, avoiding any regulatory restrictions. This year, their gods must have taken longer than expected; either that or the family were stuck in the horrendous traffic that had been building all day in preparation for street party celebrations of the first anniversary of Hyderabad's Telangana state. I waited a little longer, tried their phones several times again, chatted to more of their hopeful patients and then decided to return later – something I was warned against. The evening's celebrations were predicted to clog the roads for miles around.

As I drove back, disappointed, to the university where I was staying, roads were being closed to all but pedestrians and a series of grandstands at various levels of completion were appearing along the banks of the Hussain Sagar lake. The speakers hoisted around them blasted popular music as we continued along the roads from Secunderabad and back into Hyderabad. Despite my determination to ignore the locals' advice, I realised that they were right – a return journey would not be on the cards that night.

The next morning I got a call from my friend Dr Nandu Kanuri, an academic at Hyderabad's Indian Institute of Public Health. Translating a section of a report published that morning in a Telegu newspaper, he told me that the Gouds' old family village was called Doodh Bowli and it seemed that the family would be staying there until the time came to hand out the medicine, which was scheduled, according to their astrological calculations, to begin later that day at eleven forty-five p.m. The exhibition ground loaned to the Gouds by the state for the event was in Nampalli, Nandu told me. ‘That's very close to Doodh Bowli. So I don't think they will be going back to their new house in the next day.' Nandu and I decided that my best bet was to try to track them down in the old city. He added a couple of points the papers had detailed: that there would be a 1,500-strong security force at the evening's event; and that a crowd of 50,000 was expected.

The newspaper report did not give an address for the Gouds' home, which was understandable: I had heard of frenzied stampedes in past years and of attempts to get to the family that had ended in injury, or even death. If the anticipated number of patients was to be believed, it was not difficult to imagine the potentially lethal crush of those seeking the fish medicine. I got into the taxi Nandu had called for me and gave the driver vague instructions to get us to Doodh Bowli. Once there, we were going to have to be creative.

The drive took us very near to one of the bone setter's clinics I had visited two months earlier, deep into the old part of the city, down narrow streets where women in full purdah walked slowly through markets, men milled round the mosques, and children, oblivious to the call to prayer, chased goats that roamed the alleyways. On a main road a funeral passed, the cadaver just visible under its shroud, carried high by men who were taking it to the cemetery opposite. We stopped several times, asking locals if they knew the whereabouts of the Gouds' family home. Many told us that we would need to go to the Nampalli Exhibition Grounds that night, if we were after the fish medicine; others nodded in recognition of the name of their famous medical neighbours, but their vague hand signals told us to continue in various conflicting directions.

A man directed us down an extremely narrow lane leading to a maze of tiny houses, which occasionally opened up into small squares, or ran past formerly grand buildings and arabesque gateways behind immense outer walls, faded to sepia. My driver was sceptical. A short way down the road he asked again and a young boy confirmed the route.

‘To the fish medicine house, you can go that way, left into that
gali
,' he said.

‘But can we drive down there?' My driver looked worried for his car, which was nearly as wide as the road. The boy assured him that cars did drive down the alleyway, so despite its precarious angles and the livestock and local residents who competed for a foothold along its length, we went ahead.

Where the alley finally widened into a market square, we stopped and asked after the Gouds once more. A tiny old lady, clad in a sari and with gold rings in her nostrils and ears, agreed to leave her vegetable stall and come with us as our guide. She seemed unsure about how to get into a motor vehicle, and a little uneasy once in it, but, true to her word and for a small fee she directed us straight to their street.

In among the predominantly Islamic homes, mosques and public architecture, the way she indicated appeared to lead to some sort of Hindu temple complex. A man urinated against its walled entrance, framed by a dramatic archway. At least sixteen feet high, it was coloured a vibrant shade of blue and displayed painted sculptures of Hindu deities, lotuses, conch shells, other iconic symbols and motifs. As soon as the car turned in, the temple came into view. With tall and ornate pointed domes, it was profusely decorated – much like its gateway – with painted sculptures depicting gods and goddesses and scenes from the Hindu scriptures, with enormous doors made of opulently carved wood. Inside, its elderly priest, dressed simply in a white lungi waist-cloth, held a burning lamp as smoke billowed from the censer he swung.

It was clear that our car would not be able to navigate the even tinier alleyways behind these walls, so I got out and, heading down a medieval-looking street filled with khaki-uniformed policemen, I found myself directly outside the Gouds' home, walled off from the street and with a red door that opened directly onto a family courtyard. Standing outside, answering questions and listening to the requests of patients who had arrived a day early, was an elegant man in his forties, dressed in a simple white cotton kurta and wearing a tilak of bright red powder on his forehead.

Still a little jet-lagged, I explained to him that I had landed in Hyderabad the previous morning after an 11,000-mile journey especially to meet Dr Harinath Goud, but that the appointment we had arranged hadn't quite worked out. The man introduced himself as Gauri Shankar, Harinath's nephew, and invited me to come back to their home that evening, to attend the prayer ceremony that was to take place before the medicine was distributed. I could then watch as the fish treatment was dispensed. ‘Come at nine-thirty,' he told me kindly. ‘We will talk more then.'

At nightfall, when the day's heat had abated to a relatively refreshing thirty-four degrees centigrade, I found Gauri Shankar talking to a group who had gathered in the streets outside his ancient home. The atmosphere seemed surprisingly calm, though from inside the doorway I could hear sounds of a crowd. Gauri Shankar whisked me past the house and through a door leading to his neighbour's compound. The narrow passageway opened up into a courtyard, around which apartments were assembled in the manner of traditional homes in Damascus or Moorish era Granada, or like the old riads of Marrakech.

I followed him as he skipped up a steep staircase, onto a terrace. ‘You'll have to jump over this wall,' he said as he adroitly leaped from his neighbour's roof terrace onto his own. I followed suit, only realising the reason for the complicated route when I landed on a roof that was already filled with waiting patients sitting cross-legged in neat lines. When I looked down into his courtyard below, it was clear it had long since filled to capacity. The prayer ceremony was about to end and there was a celebratory mood among the crowd: I could hear throaty laughter and singing before, improbably, an enormous, cream-covered cake emerged to cheers and the refrain of ‘Happy Birthday to You'. It was then that I caught my first glimpse of the elusive head of the family, Dr Harinath Goud. Bearded, in orange robes and with long hair, Harinath looked the image of India's traditional sadhus, respected men of God. The courtyard crowds previously seated now formed an orderly queue as Harinath and his wife, an elegant, jovial woman dressed in an orange sari, began to distribute the medicine. Many of the first to receive the blessed herbs seemed well-practised and I recalled hearing that those invited to the Gouds' home were neighbours, family friends and previous patients.

Giving the medicine out was not an easy process – the helpers of Harinath and his wife took an unsuspecting, finger-sized fish out of the container in which it swam, prised its mouth open to insert a small amount of soft yellow herbal paste and handed it back to the couple. The Gouds then instructed the patients to open their mouths wide in turn. Holding the wet, wriggling fish so tightly I wondered how they weren't crushed, the fish doctors inserted their fingers deep into the throats of those waiting in line. An inevitable chorus of gagging ensued as the living fish wriggled down to their death by digestion. For many of these second- or third-time visitors the process took just a few seconds and looked deceptively effortless – barely worse than swallowing an aspirin. For others, the procedure was clearly a far less comfortable one.