The Y.R. Gaitonde Center for AIDS Research and Education (YRG CARE) has already been introduced to anyone following this blog (or if not, read Sukhie Sandhu’s posts here, featuring a great personal reflection on the organization, and here, discussing disparities in novel HCV treatments). I don’t want to retread all the finer points that she has shared regarding YRG CARE, but just to briefly recap, it is an organization based in Chennai that is a leader in HIV and Hep C treatment across India. They have research collaborations with a very impressive set of medical centers in the US and beyond. It’s a really cool place that’s worth getting to know.
I wanted to log a specific reaction to one portion of what we heard during our visit, which is the story of YRG CARE’s founding. As I imagine the case to be for most visitors, this for me was one of the more memorable portions of the day. We had the fortune of hearing the story from Dr. Sunil Solomon, the current head of the center and son of the organization’s founder, Dr. Suniti Solomon. In the mid 1980s, the HIV epidemic was still coming to be fully appreciated and continued to be bogged down in a misconception globally that only certain marginalized groups were susceptible. Few believed that India had the virus. Suniti Solomon had a suspicion otherwise. Sunil described the story of his mother going personally to a police detention center early in the mornings to solicit serum from sex workers who had been detained over the course of the night. There was a sense of humor to the way he told the story, with the humor seeming to flow from audacity of the whole effort. I imagined that it was the type of story that captured a lot of who Suniti Solomon was as a woman, in the best possible sense. The result was the first diagnosed cases of HIV infection in India, in 1986. It turned a lot of blind assumptions on their heads.
I think everyone must have their own pet terms to describe how they’re impressed by a story like this. The word that I couldn’t stop thinking about – which was maybe a bit odd – was ‘entrepreneurial’. Entrepreneurial, not in the sense of being profit-oriented or competitive. Entrepreneurial, in the spirit of having encountered a problem, had an idea, and bet on one’s idea. While I’ll admit I don’t know the details of the other individuals that contributed to this undertaking, the investigation would never have been possible without a lot of independent initiative on Dr. Solomon’s part to start it and gumption to see it through. This felt more like the founding mythology of a business more than a clinic – a Kroc story as much as a Salk story.
It is only natural after this type of experience to reflect on my own forays into research, which have a decidedly more institutionalized feel. Find a faculty member. Find a project. Put in the time. Publish, hopefully. I am confident this is the case for most residents, and of course, it’s valuable in numerous ways. It also feels, however, like it lacks some dynamism that Dr Solomon’s story manages to capture. It’s exhilarating for a moment to get back to thinking of clinical investigation as the pure grammar-school level scientific process that it should be at its core: curiosity, observation, hypothesis, inquiry.