Dr. P N Behl – A tribute to father of dermatosurgery in India

Lives of all great men remind us

that we can make our lives sublime.

And the departed leave behind us

Foot Prints on the sands of time.

Henry Wadsworth Longfellow

It is lunch time. The building of Irwin hospital where outdoor patients of all medical and surgical specialties are treated is almost deserted. All rooms are empty, except a room in the corner. Around a dozen patients are still waiting for their turn. A smart young doctor in spotless white dress is still treating the patient with astute attention, oblivious of the time. He is an honorary skin specialist, who joined the hospital a year ago, to start and head the hitherto unknown department of Dermatology. In 1 year, he created a profound awareness among patients for a prompt treatment of skin diseases. Untreated, they can be a significant cause of morbidity and sometimes mortality. He emphasized that skin diseases can be cured by a skin specialist. This reflected in an ever-increasing number of patients seeking dermatologic advice. During 15 years of his stay as an honorary specialist, he established an independent department of dermatology along with a 10-bed skin ward, postgraduate training and other academic activities. His motto – an extra mile is never crowded – made him endeared among patients, students, colleagues and hospital staff.

Prof. Pran Nath Behl, born on September 23, 1923, had his initial education in Amritsar [Figure 1]. He then joined KE Medical College, Lahore, and the only medical Institution in the whole province of Lahore. Times of turmoil, struggle for independence, division of society on the communal basis, shortage of money – all made his studies more challenging. But the dedication of teachers and a disciplined approach of the students made him a good and responsible doctor. He graduated MBBS in May 1946 and joined as a house Physician in Sir Ganga Ram hospital, Lahore. Soon partition of the country forced him to migrate to Delhi, then to Bombay. The fate, however, always help the brave and the optimistic people. He got a chance to study and work (to sustain the studies) in England. After a dedicated hard work of 4 years, he passed Member of Royal College of Physicians from Edinburgh in September 1951, with dermatology as a special subject. Soon, he married a Welsh girl, Marjourie Marie Hopkins, with due sanctions from both side parents.

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Figure 1:

Dr. PN Behl.

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Sailing back to Bombay, he realized that it is quite challenging to independently establish a relatively new specialty. However, his grit, convincing powers and confidence got him an honorary Dermatology Professor appointment at Irwin Hospital, New Delhi. His one- man department was a single room on the first floor of the Outpatients’ Block. Putting his hard work, he created awareness that skin afflictions do have a definite and specific treatment, and can be prevented by certain measures. Soon, he transformed the specialty in a significant and much sought-after entity. In due time, he was able to create an independent huge out patients and indoor wards for admission of skin patients, along with several postgraduate doctors and paramedics.

Unfortunately, after 15 years of his dedicated work, he had to leave the hospital, as the honorary post of specialist was abolished, being replaced by regularly selected doctors. He had to hand over his huge outpatients, indoor ward, and postgraduate academic activities to his successors, and retire! It was another challenging phase of his life. He has to start afresh. Academics, research and dedicated teaching was the motto his life. In the year 1967, he restarted from Daryaganj – Behl House. Extending to Jungpura clinic, he fulfilled his initial academic and clinical pursuit.

His dream of an autonomous charitable independent dermatology institution, soon took shape in the Greater Kailash-I, where he established an exclusive skin hospital – Skin Institute and School of Dermatology. Missionary service, free treatment of poor, free medicines, independent histopathology and an advanced scientific research department, along with a 30 bedded Indoor ward all were now under one roof. For teaching post-graduates, he started 2 regular full-time courses- M. Derm (2-year) and (Fellow of Skin Institute [FSI], 1-year). Soon National Board of Examination recognized 4 seats of prestigious DNB course to his Institution. His pioneer work in Skin Surgery attracted lots of patients both from India and abroad. Thus indoor wards were usually full. Besides, a huge outpatient provided a lot of exposure to the postgraduate doctors. Regular lectures, assisting skin surgery, managing difficult and challenging patients, advanced diagnostic, and therapeutic gadgets all fascinated postgraduates from India and abroad.

Patients with chronic skin disorders used to be referred to him unhesitatingly by many dermatologists. He always stressed to put in time and efforts in every case so that no patient should remain undiagnosed. His three-step formula of morphological diagnosis, clinical diagnosis and etiological diagnosis is still indispensable in the management of skin disorders. He used to say that no disease is idiopathic, only some more effort is required to find the cause. Elimination of the cause, treating with minimal medication and guiding the patients about prevention of the disease in future, can give a lasting relief. Irrational use of medicine and unnecessary investigations he always discouraged. He always stressed a holistic approach to life, which he further propagated in his other two ventures, namely, Rural-Cum-Industrial Skin and Health Institute, Dasna, Ghaziabad, and Dr. Behl Wholistic Health Institute, Ashok Vihar, Delhi.

A prolific writer, he wrote a dozen books on the subject. Running for several editions, his books have trained MBBS students, postgraduates and dermatologist for over 5 decades. Being a philanthropist at heart, he opened free dermatologic clinic at Santhal Tribel Belt, Bihar to give free treating to village far and away. He conducted over 30 free dermatology treatment camps in remote areas in Rajasthan, Uttar Pradesh, Haryana, Jammu and Kashmir and Bihar where skin diseases used to be rampant.

He is referred to as “Father of dermatosurgery in India”. For the first time in the world, he introduced skin grafting in stable vitiligo (1964). Excision of Keloids followed by Grenz ray irradiation, Dermabrasion of lichen amyloidosis and smallpox/acne scars, debridement and grafting of chronic non-healing ulcers, leprosy deformity surgery were routinely performed by him and his team. He imparted this surgical, cosmetic, and therapeutic skills to scores of skin specialist through his 4-day annual/biannual workshop conduced every year. Besides, over hundred fifty students have successfully completed DNB (2 years and 3 years) and M. Derm (2-year) full time course in Dermatology and serving the specialty in India and abroad.

He had a special interest in herbs. A lot of scientific research was done by him on irritant and sensitizing plants of India and herbs useful in dermatological therapy. Swertia chirata in chronic bacterial diseases, Andropogon muricatus in chronic urticaria and photodermatitis, Ammi majus in vitiligo, Withania somnifera in neurodermatitis and several other plants were extensively studied and used by him. He was averse to chemical contamination of body either in food or as pollutants in the environment, and believed many skin disorders get precipitated by them. Travelling widely as an invited speaker in international conferences, he used to mesmerize the delegates by his extraordinary grasp of the subject. His scientific advice as to eliminate the cause along with the therapy of skin diseases was always thought-provoking.

Widely travelled over the globe, and always in touch with the stalwarts of dermatology of prominent International Institutions, he always kept his institution with latest gadgets. He was first to install Versa pulse Laser containing four different wave lengths to treat a wide range of laser-responsive dermatoses [Figure 2]. Melanocyte culture – state of art laboratory, PUVA and NBUVB chambers were managed by specially trained staff.

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Figure 2:

Dr. PN Behl doing laser treatment on a patient.

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Like every Wednesday, on December 29, 1993, Dr. Behl went to Dasna to see the skin patients. Around mid-noon, in the presence of a crowd of 50 people, he was kidnapped by armed gangsters, who fired two bullets to scares everyone around. Captive for over 2 weeks in open sugar-cane fields in biting cold and inhumane conditions, he maintained his poise and a die-hard will to survive. After getting free, by the extraordinary efforts of the Government of India, he converted his ordeal in a best-selling book– “The Lord of Darkness” – his dialogue with kidnappers, which imparts invaluable lessons for survival of humanism.

Despite of his failing health, from 1998 onward, he continued to do all academic activities, outpatient and indoor patient care and other philanthropic work including his rural school teaching village children from class 1 to class 8. Often, he had to work 16–18 h daily. When confronted not to work so hard in this selfish world, he used to quote the Nobel Laureate Dr. Albert Schweitzer (1875–1949) – anyone who prepares to do good must not expect people to roll stones out of his way, but must accept his lot calmly if they even roll a few more upon it. A strength which becomes clearer and stronger through its experience of such obstacles is the only strength that can conquer them. Resistance is only waste of strength. Even when he was on dialysis 2 times a week, he discharged his services to his institution uninterrupted. He always used to tell us to keep the flag flying on this temple of service and disseminating knowledge. On October 15, 2002, Dr. P N Behl left peacefully for his heavenly abode. His services to the mankind, his principles and his auspicious foot prints will always guide the future generations.