“Cent per cent error-free Lab does not exist anywhere,” says Pathologist Dr. K. Lakshman

By N. Niranjan Nikam

Mine is not a hotel that I can give statistics as to how many patients come, as some people come here without telling their wives for tests. And I also have such a bad memory, unlike my father, Dr. N. Kannan, who even today at 82 has a sharp memory, that in an absurd way, I find my bad memory is a boon. Because if somebody has done something bad for me and he comes back a few days later, I will have forgotten about it and moved on,” said Dr. K. Lakshman, sitting in the air-conditioned Kannan Diagnostic Centre, Mysuru, which is celebrating its Golden Jubilee (May 5, 1968 to May 5, 2018), even as he signs the test reports and keeps peeping into the microscope.

After he passed out of Mysore Medical College (MMC) in 1988 and did his MD in Pathology from Kasturba Medical College in 1992, Dr. Lakshman returned to join his father in the Lab. “I had done very well in my MD and passed out. But when I came and joined my father, I realised I practically knew nothing. It was just bare bones. I learnt 90 per cent of the practical aspects from my dad, who himself was a teacher,” he said.

Many of his colleagues had asked him to go and learn the ropes from somewhere else. “When I already had a ready-made teacher and with immense practical experience, I realised that it was better to stick here and learn the ropes under the guidance of my father than under somebody else,” he said.

Two main points that stand out in my life that I learnt from my father — the first one was his sense of justice of what is right is right and he has never spared me and has taken me to task in front of the patients, if I have done something wrong. The same rule applied to all, including my brother, which is why when he speaks we listen. And secondly there is no question of compromise and you have to work hard.

“Even if there is a smallest mistake, he wanted us to feel bad and learn from it and not brush it off. He would feel bad for a week and I initially for a day, but caught up and the mistake kept playing in my mind,” he said and added “Perfection is my father’s middle name.”

For instance, a simple thing like TB stain, he used to prepare it himself until it is correct. However, the knowledge of correctness comes from experience. Both my brother Dr. Praveen Kumar and I have imbibed this quality of him in us. “If things are not okay, they are not okay, there is no compromise, just throw it, the question of adjustment does not arise at all,” he said.

Why is Kannan Diagnostic Centre the most sought after by doctors and patients even after 50 years? The answer that Dr. Lakshman gives, explains it, “When a person says my Lab is 100 per cent error-free, he is lying. Such a Lab does not exist; it has never existed and will never exist. Knowledge of errors and minimising it by hard work and maintaining constant presence in the Lab is the only way to minimise errors. It is an ongoing process.”

“Everyday we have to check the machines for the accuracy, check the workings of our staff and our own working and we have no choice in this. How we check our own working is by reviewing slides and finding out if we have we come to the same conclusion. These are all the things in quality control. Only then we can say it is an accurate Lab. The word accurate Lab means you are right most of the time,” said Dr. Lakshman.

According to Dr. Lakshman, in the beginning almost everything was done manually as equipment suppliers were few and service of it was non-existent in a place like Mysuru even when he joined his father in the 1990s. Slowly, they started upgrading. Dr. Kannan used to write all the reports by hand in spite of his arthritis problem.

“I realised the problem and the first thing I did was buy a computer and put a typist to type out reports and the accuracy improved. Besides, the reports were stored in the computer,” he said and recalled, “It was my good friends Ranjith Sanath, Kamala Prabhushankar and Eshwar who wrote the first software programme tailor-made for my Lab. They put in a lot of effort and made my efforts at computerisation easy.”

“I bought my first computer for Rs. 80,000 and today with all networking and sophistication, we have firewalls. I feel that all the hard work has paid off,” he said and added “Then we started investing in bigger instruments to do blood sugar testing, thyroid hormone testing by RIA (Radio Immuno Assay) for which we needed permission from Bhabha Atomic Research Centre, Mumbai. Then we started investing in other instruments followed by histopathology, the cancer study of tissues and then the Lab was modernised.

“I started bar coding in which the patient’s bar code is stuck on their Lab tubes which in turn avoids all errors of labelling. However, we have to type the report and that led to transcriptional or typing errors. To avoid this we did interfacing in which, when the tube is run in the machine, it gives the result. Here, the bar code that is stuck to the tube, communicates to the server and asks what tests have to be done, does the test and sends back the report to the computer. Hence, you don’t need to type. This is very important for instance during Dengue outbreak when there is huge number of platelet counts. Imagine typing 19,000 for 1,90,000. Here this does not occur. Interfacing brought our headaches to a minimum. So we could expand to newer tests,” Dr. Lakshman said.

Asked about how he got the patients as he and his brother have followed the principles of ‘No Commission,’ he said, “Most doctors really work hard to save their patients and when it comes to nitty-gritty, they themselves say, go to Kannan Lab for tests. Any Lab can still run without commission. And also the top doctors are very concerned about their patients. Finally, they need to give proper treatment and they are not going to compromise. I see even Post-Graduate students in Cheluvamba and K.R. Hospital giving money for the patients and sending them to me for tests. Then they call and tell that the patient is poor, can you do it free and I have helped more than 1,000 such patients. They do not want any commission. These are the examples which show the humanity that doctors have.”

“I have been here for 21 years. We had only the Lab but then we added the Radiology and Ultrasound division which includes scanning, X-ray, Echo, TMT and we increased diagnostics. My field basically is foetal medicine, which is pregnancy scans, as that is my interest and that is the reason why I have not ventured into CT and MRI,” said Radiologist Dr. K. Praveen Kumar, taking a little time off from doing the scanning of the patients.

Asked what the challenges were in foetal medicine, he said, “The patient’s age is increasing and that is the reason why it is more demanding. I am the only one involved in radiology here and we get more patients because of referrals and not because of commissions. There may be our father’s name but we have to keep it up by following his footsteps and his ethics. Ultimately, when you go home you have to have a good night’s sleep.”

“People still wonder how we are able to run the Lab without commissions. We do not look at returns and if look at it then we will be like any other Lab,” said Dr. Praveen Kumar echoing his father and brother.

Dr. Lakshman said it is only because he believes in such doctors that he is in the profession and the moment he does not believe, there was no point in continuing in his profession. And all of them first had the patient’s interest at heart.

Another reason why we are trusted is, “I draw almost 95 per cent of the blood samples, which my father did also in his heydays and I personally see the slides, whether it is blood or urine. Besides, I attend to patients myself and clear their doubts,” said Dr. Lakshman, even as he answered a patient, who had just then come with the report and told him not to worry as it showed a good result.

NOTE: Refer ‘Star of Mysore’ dated May 5, 2018 for the special interview with 82-year-old Pathologist Dr. N. Kannan, the pioneer who started the first private Pathology Lab in Mysuru.—Ed

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