Munnabhai MBBS (2003) and the Germination of Medical Humanities in India

Shrishti Dey, Anandita Saraswat and Aratrika Das reflect upon the need to assimilate a humanistic understanding of medicine into the landscape of Indian healthcare through Rajkumar Hirani’s 2003 film, Munnabhai MBBS.

Munnabhai MBBS and the modern hospital setup

Munnabhai MBBS (2003), a Hindi-language dramatic comedy, written and directed by Rajkumar Hirani, attempts to understand the commercialised functioning of medicine and the institutionalisation of the hospital space. The film, set in Grant Medical College, Mumbai (Maharashtra, India), critiques the transformation of medicine into a “service rendered” under the Consumer Protection Act (1986; see Bhat 1996). Hirani employs the character of Munna, played by Sanjay Dutt, to present a possible anomaly to the medical system in India. Munna is an illiterate goon, turned doctor, who uses unethical means to pass the medical exam in order to win over Chinki, played by Gracy Singh, daughter of the Dean of Grant Medical College, Dr Asthana, played by Boman Irani.

Over the course of the film, Munna becomes an insider, examining the internal machinations of the hospital through a closer lens and finding himself regularly appalled by them. He wears a white coat and plays the role of a doctor, only to discover many deficiencies in the profession. As much a misfit as he could be, Munna wishes to reform the norms of the medical space and transform it into a rehabilitative sanctuary, by sharing his Jadoo ki Jhappi (magical hug) with the patients.

Munna’s idea of a hug bridging the chasm between the doctor and patient is contrasted with Dr Asthana’s attitude, which is based on the practice of cornering the patient into “the non-hygienic, non-rational, disordered other” (Gordon 2005, 5). The film constitutes a microcosm to depict the medical situation in India, with Dr Asthana reflecting a recurrent attitude among doctors, nationwide. This highlights why a humanistic understanding of disease and caregiving practices is needed in the subcontinent: a need that could be met by the discourse of medical humanities.

Care vs cure

Modern medicine often relies on the biomedical model of disease (see Jecker and Self 1991).  This model, which banks upon objective indices of cure and the ethics of the medical profession, ignores the emotional and psychological needs of the patient. The concept of cure is now intertwined with the legalities of the profession. In one scene, the doctors are clearly reluctant to admit a patient, following an attempt to take his own life. As his mother wails in sorrow, they consider the legal repercussions that might envelop the hospital in the wake of admitting a patient who had attempted suicide. Owing to the absence of formal medical training, Munna, who lets emotion drive his advances towards his patients, is shocked to hear a doctor say, “Casualty mein le ja, I’m off duty now” (Take him to Casualty, I’m off duty now). Nobody, apart from Munna, extends compassion to the mother in distress. Likewise, the doctors treat the young boy as just another case who need not be attended to, if their duty hours are over. Filling out forms to ensure no legal sword falls on the hospital when a treatment becomes unsuccessful is a practical, yet sad, state of medicine today. The film, through Munna, voices the concerns of the common man in India: how necessary is it to fill up a form when a dying patient enters the corridors of the hospital?

Foucault, the medical gaze and “anatomo-clinical perception”

It is through defamiliarising the clinical space that the film emphasises the idea of the medical gaze, conceptualised by French philosopher and historian Michel Foucault in The Birth of the Clinic ([1963] 2003). Foucault examines the clinic as a space marked by the increased prominence of a gaze that emphasises an empirical understanding of disease in terms of visible symptoms; the gaze makes the diseased body the source of knowledge. This notion of the medical gaze as fundamental to clinical spaces runs throughout the film, serving to emphasise the symptoms and disease of the patient, over their experience of them. This is visible in Dr Asthana’s treatment of a colleague, Rustom’s father. He first examines the patient, prescribes a sugar test and asks the nurse to give him a glucose drip while the camera zooms in on the needle and the hand of the patient, focusing on the empirical evidence of the disease and, in turn, dehumanising the patient.


Source: Unsplash

In contrast, the film defamiliarises this clinical space by making Munna and his friends play carrom in the hospital, which draws the viewer’s attention away from the disease and symptoms and onto the patient experiencing the disease. R. S. Khare (1996, 838), in “Dava, Daktar and Dua: An Anthropology of Practised Medicine in India”, notes how Indians “ground their medical reasoning and practice within their distinct religious/moral conceptions of the body, self, personal well-being, soul, society and cosmos.” The inclusion of a carrom board, set up in the morose environment of the hospital, upholds this notion of ideal medical practice in India but, sadly, is seen as unreal and utopian when expressed through the movie. This key deficiency of health care in India is foregrounded when the essence of medical practice, as highlighted by Khare (1996), comes across as an anomaly in the current scenario, making Munna an object of ridicule and turning the film into a comedy.

Along with the medical gaze, anatomical practices also become important for understanding clinical spaces, an idea foregrounded by Foucault’s ([1963] 2003, 139) use of the term, “anatomo-clinical perception.” This anatomical perspective treats the modern body as a source of  knowledge, which marks a shift from the process of healing to the process of acquiring new knowledge and, in doing so, effaces the subjectivities of the body. The film projects this through a doctor who is dissecting a corpse, as a means of teaching medical students. The objective lens granted by medicine and its “anatomo-clinical perception” is critiqued by Munna when he raises questions regarding the names and identities of the dead bodies. The film provides a template for realising the currency of dead bodies and lays the foundational argument for necessitating the inclusion of medical humanities in medical syllabi, by foregrounding the dehumanised inclination of medicine and the requirement for empathy and subjectivity that should punctuate the medical discussion in India.

Towards a medical humanities narrative

The hospital in Munnabhai MBSS fails to live up to the concept of Indian medicine advanced by Khare (1996, 841), which gives precedence to “patient-oriented,” effective care and “psychologically supportive expressions,” initiated from the doctor’s side. The case of a brain-dead patient, Anand, played by Yatin Karyekar, is handled with the utmost detachment. Doctors claim that sound reaches his ears but never his brain and they thus refuse to communicate with or support him. The other doctors rebuke Munna for getting “emotional” over this case. The element of empathy in medicine has been dethroned by the objective gaze, which empowers the doctor with “the power of decision and intervention” (Foucault [1963] 2003, 89), exercised by the doctors in the film who refuse to administer medicine to Anand, labelling it as futile.

Foucault’s ([1963] 2003, 101) medical gaze emphasises the “affliction and not the afflicted person.” The traditional concepts of compassion, attachment and comprehensive care, which underpinned the Indian medical system (Khare 1996), are effaced by the doctors in the film. However, the importance of a patient-centred approach in medicine, and a respectable space that would honour patients’ experience of illness, enters the medical vocabulary through the work of physician and literary scholar, Rita Charon (2006). Charon’s idea of understanding the words, phrases, silences and pauses that accompany the patient’s narrative of the self and the illness is advocated in the film through Munna, who encourages the doctors to read the silence of the comatose patient (Anand) and empathise with the tears of the mother of a suicidal son.

Analysing the film through a medical humanities lens becomes a useful vantage point from which to unpack the commercialisation of medicine in India. The film denaturalises the representation of the hospital as a space marked by science and objectivity by laying bare the political and economic underpinnings of medical discourse. This raises questions regarding the effacement of the subjectivities of the bodies used as a source of medical knowledge and highlights the dehumanisation of medicine. The film, through the character of Munna, provides an alternative to the commodification of medicine by aiming to incorporate both the aspects of care and cure.


About the authors

Shrishti Dey is a second-year doctoral candidate (English) in the School of Humanities and Social Sciences, Indian Institute of Technology, Indore. Her areas of research are Medical Humanities and Gerontology.

Anandita Saraswat is a first-year doctoral candidate (English) in the School of Humanities and Social Sciences, Indian Institute of Technology, Indore. Her research area is Environmental Humanities.

Aratrika Das is Assistant Professor (English) in the School of Humanities and Social Sciences, Indian Institute of Technology, Indore. Her research interests include nineteenth-century British literature, the Gothic, Medical Humanities and writing pedagogy. She received the Young Researcher Seed Grant 2022-2024 from IIT Indore. She is currently working on projects including “Teesta and Siliguri in Maps, Memories and Music”, funded by the India Foundation for the Arts, which focuses on methods of archiving the social, ecological and cultural practices of South Asia; and “Critical Thinking and Writing Lab IIT Indore”, funded by the JP Narayan Center for Excellence in the Humanities 2023-25, which seeks to create pedagogical tools and theoretical vocabulary from South Asia.


References

Bhat, Ramesh. 1996. “Regulating the Private Health Care Sector: The Case of the Indian Consumer Protection Act.” Health Policy and Planning 11 (3): 265–279.

Charon, Rita. Narrative Medicine: Honouring the Stories of Illness. New York: Oxford University Press.

Foucault, Michel. (1963) 2003. The Birth of The Clinic. London: Routledge.

Gordon, Jill. 2005. “Medical Humanities: To Cure Sometimes, To Relieve Often, To Comfort Always.” Medical Journal of Australia 182 (1): 5–8. https://doi.org/10.5694/j.1326-5377.2005.tb06543.x.

Hirani, Rajkumar, dir. 2003. Munnabhai MBBS. Mumbai: Vinod Chopra Films.

Jecker, Nancy S., and Donnie J. Self. 1991. “Separating Care and Cure: An Analysis of Historical and Contemporary Images of Nursing and Medicine.” The Journal of Medicine and Philosophy 16 (3): 285–306.

Khare, R. S. 1996. “Dava, Daktar, and Dua: Anthropology of Practised Medicine in India.” Social Science and Medicine 43 (5): 837–848.

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