Tree & Leaf

DR MANOEL AGOSTINHO DE HEREDIA (1870-1937) ~ installment # two

Chapter II

THE PHYSICIAN

A dictionary defines ‘physician’ as ‘a doctor of medicine other than a surgeon’. Nowadays, the category of ‘doctors of medicine’ itself is subdivided into specialists in the branches of medicine - paediatrics, gynaecology, psychiatry, and the like. Numerous and ever-proliferating aids to diagnosis are also available, offering the apparent certainty of objective, quantified tests of every part of the human organism, by high technology processes and apparatus. These aids naturally outweigh the unaided judgement of an individual medical practitioner, in the eyes of even those who can ill afford their expense. And so medical treatment today is, worldwide, impersonal and unfeeling for all its efficiency.

Dr Heredia was one of that near-extinct class of physicians known as ‘general practitioners’ (‘GP’s for short) who were able to diagnose and prescribe treatment for most diseases and ailments, referring to specialists only such cases as needed major surgery or specialised medical advice. With few technical aids to assist him in diagnosis, a GP had to have a considerable (and constantly expanded) body of knowledge and experience in order to be a successful diagnostician of a wide range of diseases and ailments. From successful diagnosis to the achieving of his patient’s cure, the GP needed, besides knowledge and experience, ability to inspire a patient with faith in his own recovery, a potent if little understood factor in curative medicine.

That Dr. Heredia commanded all the requisite qualities of a GP is apparent not only from his large practice, but also from his successes in treating cases that other doctors and even recognised specialists had deemed to be hopeless.


In the first few years after qualifying to practise medicine, Dr Heredia served as Medico de Partido (Panel Doctor) to the village communities of his native island Divar and of the neighbouring island of Chorão. That the people of Chorão contributed materials and labour to build him a dwelling on their island is evidence of their desire for his professional services. But he felt drawn to Bombay by his recollections of an earlier visit there, undertaken at the invitation of his co-brother-in-law, Major Caetano Fernandez (‘Tio Caetaninho’, who had married Ángela Mericia’s elder sister Analia) to be locum tenens for the duration of the latter’s travels in Europe. *[This history, as related by Julio da Costa in his memoir, is more full than the one here set down. Tio Julio’s account follows, in a different coloured type to differentiate it.]

IV
ESCAPE FROM PERSECUTION

[interventions by EMRH in italics between square brackets]

Agostinho's friends and well-wishers were many, and from all strata of Goan society. Among his highly-placed friends was Frederico Salvador Ferreira, lord ('Senhor') of an entire island, fertile and extensive in area, called Corjuem. Frederico Ferreira and all his family had great regard for Agostinho's skill as a physician; and personal esteem for him as a friend. This 'Grande Senhor' had three sons Carlito, Octaviano and Heliodoro, and a daughter [Herminia] who was married to a lawyer of Margão [José Felipe Alvares]. In the house of Frederico Ferreira, no party, however intimate, ever took place without an invitation to Agostinho, and invariably the Ferreira's own steam launch or pinnace was sent to fetch him to Corjuem and take him back to Chorão. But Agostinho was not merely invited to dinners and galas; he was also consulted as a medical practitioner, and his advice was sought in financial matters. He was adviser as well as friend of the entire Ferreira family. This friendship came to his rescue in the year 1895, when an incident took place that became a turning point in Agostinho's life.

In that year the President (i.e. Mayor) of the Municipal Chamber of Ilhas was a Portuguese official named Gomes da Costa, - an ambitious man, hungry for power. This official wanted his salary to be increased~ The Municipal Councillors were disinclined to support him, and several, amongst them Agostinho, voted against the proposal. Gomes da Costa was infuriated, and sought an occasion for revenge.

In that same year a mutiny had taken place in army units stationed in Goa, in which both Goan and Portuguese troops participated. In fact Gomes da Costa himself had been responsible for this mutiny. But he accused the Municipal Councillors who had voted against him of having been in league with the ring-leaders of the mutiny, and sought to have them arrested on this false charge. He approached the Governor of Goa for this purpose, and in Agostinho's case he cunningly reminded the Governor that Agostinho's priest brother Antonio José had made a representation to the Portuguese Minister for Colonies against the discriminatory treatment of Goan missionaries vis-a-vis European missionaries in the Patriarchal Mission of Aleppey. By playing on the Governor's feelings in this manner, Gomes da Costa succeeded in obtaining from him a warrant for Agostinho's arrest.

Before the warrant could be executed, Agostinho's well-wishers in Panjim had warned him what was afoot, and advised him to flee Goa. At this very juncture my sister, Ana Conceiçao, was to take her daughter Analia to Bombay, where Analia was to wed Dr. Caetano Fernandes, from Honavar, North Kanara, who had a well-established practice in Bombay. This circumstance decided Agostinho to seek refuge at Bombay until the storm over his head blew over. I determined to keep him company. It was known that henchmen of Gomes da Costa were lying in wait for Agostinho at Panjim, expecting to have him arrested at the ferry wharf itself, in case he attempted to flee Goa by the steamer plying between Panjim and Bombay. Agostinho therefore decided to escape overland by walking over the border to the port of Vengurla (in British India, Ratnagiri District), where he would be able to board the same steamer en route from Panjim to Bombay. As the authorities were presumably watching the road as well as sea and rail routes out of Goa, Agostinho chose to use jungle tracks through Pernem and Neibaga, over the border into Savantwadi.

For this plan, a guide familiar with the ways through the jungle was required. It was Frederico Ferreira who came to Agostinho's rescue; he provided a trustworthy guide, and provisions for the travellers (whose number had by this time swelled to four, by the addition of the guide and a friend, one Francisco Paulo Gomes). We set out from Corjuem and reached the border the same night. After an overnight rest, we resumed our journey and reached the ferry wharf at Vengurla late at night, just in time to board the steamer from Panjim. Among the passengers who had embarked at Panjim were my sister Ana Conceiçao and her daughter; also Frederico Ferreira's youngest son Heliodoro, who was to seek specialist medical treatment for his ailment at Bombay, under Agostinho's supervision.

We attended the wedding of my niece Analia which took place soon after we arrived in Bombay. Her newly-wed husband, Dr. Fernandes, was a shrewd judge of men: he had a flourishing practice, and discerned in Agostinho one with sound knowledge and much experience of medical science. He invited Agostinho to work as his assistant during his stay in Bombay, and Agostinho accepted. We remained at Bombay, in the house of my brother- in law Jujut Simoes at Mazagaon. After the Goa Government's suspicions regarding Agostinho were dispelled, Agostinho and I returned to Goa, where he resumed his duties at Chorão.

V
SUCCESSFUL CAREER IN BOMBAY

Dr. Caetano Fernandes had not forgotten how ably his co-brother-in-law Agostinho had performed as his assistant during his enforced stay at Bombay. Dr. Fernandes' practice had grown, and he planned to travel in Europe. He offered Agostinho attractive terms to look after his practice during his absence from Bombay, and thereafter to work as his assistant on a permanent basis. Agostinho accepted the offer, and moved to Bombay in the year 1900. After settling down in his new assignment, he secured accommodation for his family and brought his wife to Bombay, along with their two infant daughters. In order to raise funds for furnishing his new house-hold, he sold his Chorão dwelling and all its contents.

By the time Dr. Fernandes returned from foreign travel Agostinho's reputation as a skilful physician had spread, attracting more patients than before to Dr. Fernandes' consulting rooms. His co-brother-in-law was not entirely pleased with Agostinho's success as locum tenens. It was not long before Agostinho found it expedient to set up in practice on his own.
etc. [A romantic detail omitted by Tio Julio is that there were some small creeks and brackish streams requiring the use of a tona (a sort of canoe made from bark); and the crossings were made possible by the ready cooperation of fishermen and hamlet-dwellers.]

Tio Caetaninho readily agreed to transfer to Manoel Agostinho that sector of his huge practice that was based at a dispensary on Kalbadevi Road. According to a cousin, a sum of Rs.13,000 was the consideration paid, the equivalent of not less than five lakhs of rupees today [1987!]. Manoel Agostinho could not have raised even a fraction of this sum from his savings from a few years of community service, nor from his wife’s dowry, for he had foregone it. He could only have raised this amount by borrowings.

However, it was an investment that repaid itself many times over. Kalbadevi was then the hub of a greater business centre than the Fort. The great merchant houses – predominantly Gujarati-speaking Vaishnavas, Jains, Bohras, Khojas and Kutchi Memons - were clustered in the three or four city wards adjoining Kalbadevi. The Goan community, too, was settled within the same wards in the parishes of Cavel, Dhobitalao, Sonapur and Dabul. The Cathedral, founded when Bombay was Portuguese, was in Bhuleshwar, scarcely four furlongs from what had become Dr. Heredia’s dispensary.

His practice soon grew, encompassing at the high end, rich merchant families, who rewarded his services with business insights worth far more than his fees, and Goan seamen, waiters and domestic servants, at the other end poor patients whom h treated at nominal or no cost. From his wealthy patients he derived inspiration, ideas and collaboration for subsequent ventures into business. From his poor patients the returns were hardly less rewarding: enduring respect, regard and esteem for him, and for every descendant of his name.

It was not merely his professional skill and the high percentage of patients cured, that won him such rewards. His bedside manner, comprising the courtesy, consideration and sympathy that every patient received from him, not only hastened recovery, but won their grateful affection.

Many were the "hopeless cases" that recovered under his tender care. When the only son of his former tutor contracted tetanus, (for which there was no known cure) it was Dr. Heredia who undertook to treat him, and saved his life. His son-in-law, C.M. Correa’s first-born infant son, William Raymond, went down with pneumonia, and the leading physician of the time, Dr .Judah, had told the anxious parents that he had no hope of saving their child. Refusing to acquiesce in this expert’s opinion, Manoel Agostinho took charge of the case, and the boy recovered.

Manoel Agostinho’s professional integrity ensured timely referral to specialist consultants of cases in which a second opinion seemed to him expedient in the patient’s interest. Thereby, he came to know every one of Bombay’s many specialist consultants in every branch of medicine and surgery. With many of them, acquaintance ripened into enduring relationships of mutual esteem, even of friendship. Soon, his reputation attracted patients from Goa to Bombay in search of better facilities for treatment than those available in Goa or in the many Indian mofussil towns that had sizeable Goan communities.

Again, it was his reputation for integrity that led to his appointment as Medical Examiner to the Government of Iraq by Mr. E.W. Perry, an ICS officer, who acted in the capacity of Agent to the Government of Iraq (then under the aegis of the British Crown.) Once again, it was the reliability of his opinions on the medical examinations of life insurance prospects that inspired confidence in the quality of business underwritten by the Asian Assurance Company Limited, which he helped to found in the year 1910.

There is no doubt that Manoel Agostinho’s professional abilities were the foundation of the thriving practice that he built up within a decade of arriving in Bombay, and that relationships which grew out of his practice in turn provided the bases for his subsequent successes as an entrepreneur.