Dr. Govindappa Venkataswamy popularly known as ‘Dr. V’ was born a hundred years ago, on Oct 1, 1918. He is probably one of the most extraordinary institution builders I know.
While most entrepreneurs build enterprises to maximize profit (short-term or long-term), Dr. V built Aravind Eye Care - a world class exceptionally profitable chain of eye hospitals - to maximize long-term care of his patients. To understand the scale of operations, since 1976, Aravind has treated over 50 million patients and performed over 5.5 million surgeries – more than half of them either free or highly subsidized. And no, the organization does not run on charity; they are entirely self-funded and vigorously profitable. And no, the quality of care is not compromised –the clinical outcomes are among the best in the world. Today, Aravind is the largest eye care system by far in the world with 12 eye care centres, 63 eye care clinics, a manufacturing set-up, a consulting division and a research centre.
To understand why this is so special it might interest the reader to know that Dr. V started the chain as an 11 bed hospital at the age of 58. What is perhaps even more fascinating is the amount of pain he witnessed in his early years. Consider this excerpt from our case study:
Dr. V was not very healthy as a child and developed lifelong psoriasis (chronic skin condition characterized by patches of abnormal skin) early in his childhood. But he made up for his sickly health with hard work and was the first in his village to pursue higher education and enter the medical profession. He graduated in 1944 and was well on his way to becoming an obstetrician.
But this dream was crushed when in 1948 he developed rheumatoid arthritis. He had just turned 30, was engaged to be married and about to begin training as an obstetrician. Instead, in a seemingly cruel twist of fate he was hospitalized and bedridden for two years. His youngest sister, Natchiar, who was less than 10 years old, left her village to take care of him. Dr. V’s psoriasis and arthritis was mistaken for leprosy and at times he wasn’t allowed to enter trains or restaurants. The sight of her brother going through such pain – both physical and emotional- deeply impacted Natchiar as well.
After he finally recovered, Dr. V decided to join the eye department for further specialization – where nimbleness mattered more than physical strength. Despite the distortion in his joints, he persisted, learnt to hold the scalpel and do cataract operations. And thus began his journey into the world of blindness.
For me this early part of his life is quite instructive. One cannot begin to imagine the pain he would have suffered - due to loss of his loved ones, life’s seemingly cruel turns, and the ill-treatment at the hands of ignorant fellow humans. A normal human being might have been lucky to just survive the aftermath. But Dr. V not only survived but found a new calling to which he gave his absolute everything. Despite being shunned cruelly at a time when he was probably suffering the most physically, he found a way to develop an abiding love and sympathy for humanity. It is his deep compassion for the poor who were suffering that led him to set up Aravind. It is his deep affection for humankind and his sense of responsibility that made him devote himself to becoming one of the finest weapons against needless blindness in the world.
Soul in the Game
‘Skin in the game’ as a concept has become popular recently, where the incentives of the top management are aligned with those of the owners. Consider this excerpt from an article written by someone who met Nicholas Taleb to understand the concept better:
The main idea has been to have managers participate in the upside potential of a company to ensure that shareholders’ and top management’s incentives for growth and profitability were aligned. Real ‘skin in the game’, however, means that you also participate in the down side risk. Entrepreneurs have ‘skin in the game’ as they balance upside potential and down side risk, as they manage trade-offs between short term and long term to build a healthy company.
Nicholas Taleb in his most recent book talks about ‘Soul in the Game’. The below is a brief excerpt from his book :
Now there is another dimension of honor: engaging in actions going beyond mere skin in the game to put oneself at risk for others, have your skin in other people’s game; sacrifice something significant for the sake of the collective.
Here is another excerpt from the article referred to above:
Now, think of people that have ‘soul in the game’. They have a purpose, they are on a mission. Their talk is very expensive, in a sense that they often bear hardship to pursue their mission. Think of an innovator, developing an idea against all odds and resistance in an established world that is not awaiting his new idea. ‘Soul in the game’ is usually linked to service of others; you are doing something for the sake of others. ‘Soul in the game’ is another word for having a purpose in life. And when you meet people with ‘soul in the game’, you will hardly hear them talk about work-life-balance because work and life have become one the same as they are pursuing their purpose in life.
Dr. V had considerable soul in the game. He refused to take a salary for years after Aravind was started (similar to FlightSafety’s founder A.L. Ueltschi ), living instead on a modest pension. He convinced his siblings and their husbands, who were comfortably settled with high paying jobs abroad to return to India to join him in his crusade against blindness. He was so obsessed with curing needless blindness that he got inspirations from the unlikeliest of places - McDonald’s.
It is apt to end the article with a few lines from ‘Savitri’, an epic work that inspired Dr. V till the end.
The vast universal suffering feel as thine; Thou must bear the sorrow that thou claimst to heal;
The day-bringer must walk in darkest night. He who would save the world must share its pain;
If he knows not grief, how shall he find grief’s cure?
If far he walks above mortality’s head, how shall the mortal reach that too high path?
If one of theirs they see scale heaven’s peaks, Men then can hope to learn that titan climb.