The Anti Burn out Prescription — Goodbye Nottingham: What I Carried Home.

.The Final Sprint

As my fellowship at Queen's Medical Centre drew to a close, the pace became relentless. 3 major projects demanded completion:

· Sertoli cell culture research on proteomics

· Computer Assisted Semen Analysis (CASA) studies

· GnRH pulsatile therapy for ovulation induction

I completed them successfully & on time—though, they would never become the degrees I had dreamed of.

The Send-Off

The department organized a farewell attended by nearly all faculty, fellows, & staff. Champagne flowed. I true to my lifetime principle, reached for fruit juice instead.

They gifted me—a portrait of the University of Nottingham's Trent Building with the lake in front—still hangs in my study in Chennai, four decades later.

A smaller gift from the domestic staff: a set of coasters. They had seen me making coffee late at night, sometimes for them, working when the hospital was quiet. Small kindnesses, preserved all these years.

The Patient's Card

I had not planned to formally take leave of my patients. It felt too difficult. But one patient learned through a nurse that I was leaving and sent a handwritten card of thanks.

That card, too, remains among my most treasured possessions.

Three Academic Milestones

1. ESHRE Cambridge 1987 — A 15-minute oral presentation on GnRH therapy in PCOS

2. Human Reproduction publication — A large retrospective study of chromosomes in 1210 infertile men

3. Challenging convention — An article questioning 30-year-old practice in post-molar contraception

Through these works, he got to know giants—including Professor Robert G. Edwards, who would later receive the Nobel Prize for IVF.

Friendships That Endured

He made many friends during those two years. 40 years later, the friendships continue. Some bonds are not bound by geography or time.

The Greatest Gift

But Nottingham gave him something beyond research, beyond publications, beyond friendships.

His daughter.

The first girl born on his father's side in three generations. Delivered in the very hospital where he trained—with his consultant's consent & the Registrar standing by. The institution that challenged him also blessed him in the most profound way possible.

The Journey Home

He sent his family ahead—wife and children on a direct flight from London to Chennai. He followed later, his own journey smooth and uneventful, a stark contrast to the locked doors and bureaucratic nightmares of his arrival.

He returned to Chennai in 1987 as the first Indian gynaecologist to be officially trained in all aspects of Andrology and Reproductive Sciences at a British University on a Commonwealth Scholarship.

His dream was clear: establish the country's first academic Department of Andrology and Reproductive Sciences at his alma mater, Madras Medical College.

That dream—despite his best efforts—would become a pipe dream within the government system. He would go on to develop the field in private hospitals across India, but the academic department he envisioned remains unrealized.

That story—the Indian Saga—will be told in a future volume.

A Prescription for Burnout

This episode, like all in this series, carries a message for anyone feeling the weight of burnout:

Tough times do not last forever. Tough people outlast them.

Analyze what is causing your distress. Name it. Face it. And if necessary—walk away. Nothing is more important than your health. Nothing is more precious than your life.

He wishes you a life filled with eustress—the good stress that sharpens performance, that challenges growth, that gives work meaning. And freedom from distress—the kind that drains, that breaks, that burns out.