BOOK REVIEW May 2019. Christian Journal for Global Health 6(1) One Step at a Time: The Birth of the Christian Medical College, Vellore, by Reena George. Roli Press, 2018 Gareth David Tuckwella a MB BS, MRCS, LRCP, Dip Pall Med (Univ. of Wales), MRCGP, Chairman of Friends of Vellore, 2009-2013; Chairman of Sanctuary Care, 2013- current, UK Introduction One step at a time was written to mark the centenary of the founding of one of the foremost medical colleges in India. Behind so many remarkable institutions there lies a hidden story relating to its founding, its struggles to become established, and its challenges faced while growing to maturity in our rapidly changing world. As we journey through the second millennium with many well-established organisations, straining at the leash of tradition and seeking fresh vitality and vision, it is important to look back to the founders and reflect on the lives of those who have been pioneers and teachers in the preceding decades. To be radical in moving forward, organisations benefit from drawing from their roots (radix: Latin) and allowing their strategies to be enriched through them. Hence, this amazing book deserves to have a wider readership than just those many thousands who have passed through the Christian Medical College (CMC), Vellore. Today, when time seems at such a premium, it would be easy to decide that giving precious hours to reading over 300 pages centred on the birth and development of CMC would be a poor investment. For those with this mindset, there is very helpful guidance inserted indicating the chapters not to be missed because their content is key to the message of this book. Overview Outline Following a forward by Philip Yancey, the subsequent chapters take the reader chronologically through the events of the last one hundred years that lead up to CMC as it is today. The content of each chapter draws on college minutes, speeches, and personal correspondence, and these are coloured by reminiscences, photographs, and fascinating biographies. Weaving these together, the gifted author’s narrative adds depth, insight, and meaning. Review of content Writing that this book is a comprehensive record of the development of CMC is almost an understatement. The reader is even treated to a copy of Ida Scudder’s 1911 paper on vesico- vaginal fistulae and perineorrhaphy along with a list of the operations performed in 1906. The book concludes with an excellent 8-page bibliography. This is an indication of how thoroughly the contents for this book have been researched. With much of the content drawn from archival material, this book is filled with facts rather than sentiment. This is particularly refreshing because delving into the life and call of someone as remarkable and revered as Dr Ida Scudder could so easily allow sentiment to rule the day. For those who have lived on the residential campus as part of the CMC community, this is an unsurpassed and fascinating record of the development of both the college and the hospital, from minute beginnings to the educational and 92 Tuckwell May 2019. Christian Journal for Global Health 6(1) research institute of today that is of national and international renown. For others who, like myself, were not students at CMC but are ready to learn from history and to integrate that learning into transformational healthcare strategies for their own situations, there is a depth and richness in the material here. The evidence-based, thoroughly researched text is filled with insights that are surprisingly relevant for today despite the technological advances that are currently transforming both medical education and treatment. It is encouraging to read how certain core values and beliefs that were so evident in the life and work of Ida Scudder (such as learning, ever-advancing skills, and a focus on reaching out to poor and marginalised people) remain close to the heart of CMC today. CMC, as is so evident within the text of this book, is refreshingly unashamed of how it holds to its Christian heritage and how this is lived out today despite increasing pressures to dilute this. Obedience to God’s call has consistently been the heartbeat of its success. Those reading this book with no such faith are unlikely to find the Christian thread off-putting as the accounts of people’s lives and the development of training and care are not embellished with words that focus unnecessarily on God’s provision over the past century. Dr Reena George is a gifted writer, such that even potentially lengthy historical text is an easy read peppered with wisdom, insight, and an in- depth understanding along the way. What stands out that makes this book an important and rewarding read? CMC was not born out of ambition but in obedience to a call from God. That ‘call’ was born during a time of great distress when 20-year-old Ida Scudder was caught up in the grief surrounding the deaths of three women in childbirth because there were no female doctors to attend to their obstructed labours. It was the anger in her compassion that became a compelling force for a complete change of course for her life as Dr George has described in Calling and Consecration.2 She was subsequently shown the way forward ‘one step at a time’. Similarly, many see the birth of the modern hospice movement in the UK as being born out of an anger within compassion that became a powerful force for change.3 Until fifty years ago, many people were dying in pain and distress with clinicians and carers watching helplessly at their bedsides. Today selfish ambition, greed, and the desire for power are too often the motivators for change, a change that rarely benefits the wider community that often remains in great need. A ‘call’ that determines the choice of a career is rare today. It is fascinating to read the story behind how the training of women to become doctors became established—the impossible became possible and eventually normative. Today, in the UK and India, a little over 50% of those in medical training are women, something inconceivable just fifty years ago.4 Ida Scudder’s exhaustion and probable “burn out” in 1913, from overwork and enhanced by unmet need led to fresh vision and the realisation that there just had to be a medical school founded to enable more women to access medical training. Yes, this took a decade to come about due to a long gestation and a protracted labour exacerbated by the First World War, but there was no giving up; determination won through. There are interesting insights into student life that would be hard to recreate today. Training as an undergraduate at CMC offered an experience that “nourished the heart and soul.” Students, whatever their faith position, said how they felt loved and cared for despite their founder’s expectation of good results. Any significant success was celebrated, and this spurred them on to further achievements. For many, Dr Ida Scudder’s compassion for and overflowing love of humanity was caught rather than taught. In this context, her address to the first college graduates (pp 110-115) makes for such an inspiring read that, if lived out today, still has the potential to transform healthcare across the globe. This address deserves reading and reflecting on time and again. 93 Tuckwell May 2019. Christian Journal for Global Health 6(1) Conclusion Reading this book will be time well spent whether you are part of the worldwide CMC community or someone keen to learn from history and see breakthroughs today that lead to the transformation of treatment and care in their situation. Even if you are involved in fundraising, and wondering how a one-bedded clinic-come- dispensary in 1900 has become an educational and research institute of national and international fame, including a network of primary, secondary, tertiary, and quaternary care hospitals with over 3000 inpatient beds across six campuses (with the seventh under construction), there is real learning embedded here. Having a compelling cause and building key relationships with the energy of a committed community alongside wins through. References 1. George RM. One step at a time: The birth of the Christian Medical College Vellore. Roli Press, ISBN: 978-81-937501-7-9. Available from: http://cmykbookstore.com/one-step-at-a-time.html 2. George, RM. Calling, conflict and consecration: The testament of Ida Scudder of Vellore. Christian Journal for Global Health. August 2014;1(1):26-33. https://doi.org/10.15566/cjgh.v1i1.10 3. Clark D. Religion, medicine, and community in the early origins of St Christopher’s Hospice. Journal of Palliative Medicine. 2001;4(3):353-360. https://doi.org/10.1089/109662101753123977 4. Jefferson L, Bloor K, Maynard A. Women in medicine: historical perspectives and recent trends. British Medical Bulletin. June 2015;114(1):5–15. https://doi.org/10.1093/bmb/ldv007 Peer Reviewed: Submitted 19 Dec 2018, accepted 25 Dec 2018, published 31 May 2019 Competing Interests: None declared. Correspondence: Gareth David Tuckwell, Chairman of Friends of Vellore, 2009-2013; Chairman of Sanctuary Care, 2013-current, UK. garethdtuckwell@yahoo.co.uk Cite this article as: Tuckwell GD. One Step at a Time: The Birth of the Christian Medical College, Vellore, by Reena George. Roli Press, 2018. Christian Journal for Global Health. May 2019; 6(1):91-93. https://doi.org/10.15566/cjgh.v6i1.271 © Author. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/ www.cjgh.org http://cmykbookstore.com/one-step-at-a-time.html https://doi.org/10.15566/cjgh.v1i1.10 https://doi.org/10.1089/109662101753123977 https://doi.org/10.1093/bmb/ldv007 http://creativecommons.org/licenses/by/4.0/