I was surprised to know that Dr. Kakarla Subbarao is alive and well at the age of 94 Dr Kakarla Subba Rao was born on 25 January 1925 in a middle class agricultural family at Pedamuttevi, a small village in Krishna District of Andhra Pradesh
although I knew of him by his reputation personally I have never worked with him/
I should say that I was influenced by the ongoing gossip that the only reason he became the director of NIMS only because of his caste and his proximity to the actor turned politician chief minister N T
Ramarao but after reading a few pages of his autobiography I have changed my opinion.
His thoughts are pretty much resonant with my own ideas regarding public health institutions and their role in India.
From
"With Institute back on rails, I started looking into the larger problems of managed healthcare. The technological gains made by the nation need to percolate to the grassroots level of our society leading to enhancement of the basic quality of life. One of the major achievements of the Indian health services system over the last fifty years has been the development of an extensive institutional network in the public sector. This network, despite severe limitations in the delivery of preventive, promotive and rehabilitative healthcare, served as an institutional life support system for the poor in the country. However, the profound infusion of technology in healthcare undermined the approach to primary healthcare and enforced an entirely new paradigm of health services. The paradigm included changes in the conceptualization, planning and delivery, including new ways of health financing. At the same time, epidemiological priorities remained unchanged. This new paradigm not only created confusion but also raised fears among the common man that the days of State-supported healthcare are over. The Western Model for structural adjustment and health reforms, primarily promoted by the private sector, calls for cuts in public spending on health services, including tertiary level medical care. World Bank officials issue statements asking the Government to strengthen population control and shift curative care to the private sector. Newspapers are writing sponsored articles about introduction of cost-recovery mechanisms in public hospitals,care to the private sector. Newspapers are writing sponsored articles about introduction of cost-recovery mechanisms in public hospitals, defining essential clinical and public health packages etc. in the disguise of expert opinions. This kind of talk has already made considerable damage to the State run healthcare system in the country. The emergence of medical insurance is already loaded With unfavorable consequences, as it would shift the responsibility of medical and public healthcare to households or the household micro environment. This would be disastrous as it leads to the State eventually abdicating its responsibility for the provision of healthcare, and a majority of households at the subsistence level in India would be left without any life support system. NIMS held, right since its inception, responsibility to initiate effort to empower the State run healthcare infrastructure With technology and rejuvenate it to effectively support the common man during distress. For various reasons, most health indices remain at unsatisfactory levels. Though so many hospitals mushroomed, the state of preventive medicine and diagnostics is still awry. I knew well that NIMS was expected to not merely function but also to respond to multiple managed care pressures. There were conflicting pressures from the demands of specialized care and its affordability. We had to consolidate as well as upgrade our in-patient operations. When I was working in Baltimore, there were two area healthcare systems—the two hospital Johns Hopkins Health System. and the 500-physician member Kaiser Permanente Group. We also had three Other hospital systems, namely, five-hospital Helix Health System, the academic medical facility, University of Maryland Medicine, and the two-hospital Bon Secours Baltimore Health System. They all worked in tandem as far as the delivery of care to the patient was concerned. There were protocols. parity of tariffs and certain minimal framework of standards that every hospital would adhere to. Here in Hyderabad we had a dozen profit savvy private hospitals all out to capitalize on their investments from patients, two government monoliths settled in their inertia With out-of-order equipment, demoralized physicians and corrupt staffers turned into virtual leaches, and private practitioners running their own queer road shows. The demands for hospital care can be divided into two categories: community induced demands and the demands influenced by the hospital. The hospital has little or no influence on the amount and range of services provided towards the
India is a land of Gods, Avatars and Gurus. More than one billion people live in this vast land of diverse geographic regions and long history. Most of them are believers. But more than allegiants of an almighty supreme power, they fear God as unknown. Everything that is unexplainable is seen as an act of God, every problem that is insurmountable is passed on to God for solution, every wish that is unachievable is presented before God for fulfilment. Most of the buck is passed on to God. Success is enjoyed in His name, failures are attributed to His indifference. There is an almost fatal fascination for the status quo. An inherent inertia can be seen in every walk of life. A lack of drive to come out of the rut is the most common trait among Indians. God has been idolised in hundreds and thousands of forms and is seen as an ombudsman out to bail one out of one's life problems including those related to health. Everything, everyone, has been segregated into the two compartments of good and bad, black and White, zeros and heroes. Everything is either sacred or sinful. I am a physician by profession. More than five decades of working in hospitals has brought me very Close to pain, suffering, and death. Looking around in my domain of healthcare I see more of pain than care. Problems outnumber solutions. There are crises related not only to individual and community health but also in I am a physician by profession. More than five decades of working in hospitals has brought me very Close to pain, suffering, and death. Looking around in my domain of healthcare I see more of pain than care. Problems outnumber solutions. There are crises related not only to individual and community health but also in the deliverance of healthcare. Unlike in Western countries, where medicine is practised as a law monitored, insurance-driven service profession, in India it is a very complex proposition involving handling of human emotions. Disease and pain are seen here as a punishment from God. Patients look at treatment as an exercise in A Doctor's Story of Life and Death atonement and salvation and approach doctors as they would, a priest in a temple—carrying all they have With folded hands and leaving egos outside as shoes. During the course of treatment, they fluctuate between helplessness and idle serenity and turbulence of
restlessness and unsettling anxiety. Doctors often find themselves tangled in the web of these emotional loose ends and their own personal priorities for affluent life. This is a very peculiar situation that needs closer observation and careful analysis. Sometime back I felt a strong desire to undertake such a Study and write down my observations for further examination before they vanish into oblivion With my physical being. I felt that at the least my memories would provide an insight into the pain that a physician undergoes in his chosen profession of combating others' pain. I am no great achiever. There is nothing spectacular that has happened in my life and I certainly do not consider myself belonging to the category of people Who write about their lives or are written about. Nevertheless, when I decided to write my memories, I could not go much farther than the pain and problems of my patients. Lesser mortals always imitate legends. I took the clue from the great Mahatma Gandhi, Who chose to write about his experiments With truth in his autobiography. I have decided to share With my readers about perhaps the only thing that I know—my experiences With my patients—why we suffer With so many sicknesses and What is it like to die. For doipg this I needed
sicknesses and What is it like to die. For doipg this I needed someone Who can hear me With the mind of a scientist and write it in a form that a reader relishes. I had teamed up With Bharat Ratna APJ Abdul Kalam in some of his Societal Missions concerned With making healthcare technologically enriched, affordable and accessible. This interaction had brought me closer to Arun K. Tlwari, his disciple and an outstanding scientist in his own right. The team of Dr. Abdul Kalam and Arun K. Tlwari had already produced the widely acclaimed masterpiece, Wings ofFire. It was, therefore, very natural that Arun and I teamed up to write the book you are about to read. Why should änybody read my Story? With a monotonous regularity my life revolved around the problems of my patients.
All I saw was suffering and people fighting pain. My patients were my all-consuming interest all along. I was talking to them all my years. I was listening to them all my days. Each patient was a book. Each patient was a teacher. Each patient was a personality—an integrated being having mental, emotional, social and physical characteristics. Each one brought to me a unique set of thoughts, fears, hopes, reactions, behaviours, and dreams, wrapped up in the form of diseases. Though suffering from widely known diseases, the problems of no two patients can ever be the same. Just as the physical body has a seemingly unlimited variety, so does the sickness that makes the body suffer. The response of the body to the disease is What makes each patient unique. The latest research in genetics, molecular biology and neuroscience shows that many core physiological traits are inherited at birth, and that many of the differences between individual responses to disease are the result of differences in genes. Each one of us is created from the genes of our two parents. Each one of us is a product of generations of evolution, countless bits of information collected over millions of years, focused, narrowed, and refined until one is pushed out ofthe binh canal into the world. However, in spite of this inborn biological dimension, no one isreally stuck up. There is an amazing built-in flexibility in each one of us that allows us to adapt to life's hurdles and challenges. Growing up means not only learning the ways of the world, but also dealing With one self. There is a body and there is a mind and both disease and healing hover between them. Everyone has the ability to grow and change at every stage in life. People learn from experience, from parents and from friends. Individuals have the option to give in to temperamental weaknesses, or to overcome them. They can take advantage of temperamental gifts or hide them. People can indulge their desires to smoke, drink, or eat too much—or they can resist. They can live an active life or lock themselves in shackles of sedentary schedules and safe familiarity of habits. Sometimes they will do both during the course of their Jives. The environment too plays a part but not as much as is Popularly believed. The most important environmental factors are not reading, education, or social status, they are rather random and uncontrollable experiences such as precise concentration of a particular chemical in the brain, or something apparently minor like a childhood case of the measles. While we like to imagine ourselves to be the carefully crafted products of our upbringing and education, we are actually shaped by the same sort of chaotic events that make each laddu distributed at the Tirupati Balaji temple unique. Just as a laddu has little to say about its shape, we are born With limits on the Shape of our bodies, the color of our skins and type of hair. Try as we might to change our shape, most of us will fail. We will eat the way we've always eaten, and we'll have the same activity level we had as children, or even earlier in the womb There is an obese gene we all inherit that determines our body weight rather than the quantum of food we eat. Genes also control how quickly the body breaks down With age. A similar role is played by the genetics of gender—the biological differences between men and women. Every fetus is created without sex until a single gene switches on and begins a cascade of chemical reactions that turns half of us into males and half into females. The changes affect not only physical characteristics but also mental ones. Men are programmed to seek more partners and sexual The changes affect not only physical characteristics but also mental ones. Men are programmed to seek more partners and sexual novelty; women are serial monogamists seeking mates Who will remain long enough to raise offspring. Behavior like addiction to alcohol, tobacco and dangerous drugs too is determined largely by heredity. It doesn't matter What substance you abuse if you are programmed to get hooked. People are driven to violence by a force within them in the form of certain brain chemicals. Each Child shares personality traits With his or her parents, from talents to predisposition, to certain dreaded diseases. Every grown up man has experienced a shock of realization when he does something exactly like his father before him. Every mother has a similar experience when a Child behaves exactly like her. This is not bad; it's beautiful. This does not mean we are doomed to become our parents; it means we begin our journeys where our parents left off. The book has been conceived With no Other plan in mind than that of conversing With people Who want to know more about pain
and suffering related With the health of their loved ones as well as their own well-being. The text is organised into ten chapters and arranged in three parts—Cognition, Creation and Contemplation. The first part covers my childhood, medical education and initial years in the United States. The second part covers my comeback, retreat, growth and final return. The third part over-views the new emerging medical science based on molecular biology and genetics and records my views on going back to the basics of good living. I have written this book as much for myself as for everyone Who reads it. By writing about health and life, diseases and death I hope to recall the things I have seen and make them familiar to everyone else. If diseases may become just a bit more familiar to you, sickness will be less startling. To me, the view that sees physical disease in isolation from the soul is a blinkered one. Unless negative characteristics such as untruthfulness, malice, concealed aggression, a repressed urge to dominate others, unfocused intellectual energy, suppressed vitality and selfishness are diagnosed and treated, we will remain as condemned prisoners of medical contingency.
. Life is a constant surprise. Life's healthy mode is transition. Life manifests itself in only a never-ending process of dying and becoming. It is a strange fact of human experience that great suffering generates its own remedy. Let's evoke the Life's force by understanding the scriptures transcribed in our genes. If there are imperfections coded so are compensatory powers. The art and science of modern medicine can intervene to deal With the results of nature's imperfections, and to make use of nature's compensatory powers. The story I am going to narrate is that of the triumph of the human body, and of the human spirit. While pain is inevitable, suffering is optional. Kakarla Subbarao Hyderabad June 2001 THIS STORY IS FROM JULY 22, 2004
:"HYDERABAD: The Punjagutta police have registered a cheating case relating to the Balakrishna shooting episode against Dr B Soma Raju of Care Hospital and Nims former director Dr Kakarla Subba Rao.","Police acted on a complaint filed by an advocate alleging that Dr Raju intentionally shielded actor N Balakrishna following the shooting incident instead of handing over the actor to the police after administering him first aid.",:"Balakrishna allegedly shot two persons”film producer Bellamkonda Suresh and astrologer Satyanarayana Choudary”on June 3. He later got himself admitted to Care Hospital citing bleeding injuries suffered in an attack by the two persons.""Complainant Gopalakrishna Kalanidhi said Dr Soma Raju, despite knowing fully well that Balakrishna''s case was a medicolegal one, failed to inform police and shielded the actor for 7 to 10 days.","As for Dr Kakarla Subba Rao, the case alleges that he provided ''protracted pseudo-treatment'' to the actor in the name of treatment for psychiatric and orthopaedic problems. Reacting to the case filed against him, Soma Raju said, "I have nothing to hide. In case of Balakrishna we did the same thing as what we would do for any other patient. I am confident that we have not violated any rules. We only tried to help the patient.,"Dr Subba Rao refused to make any comment about the FIR as he felt it is inappropriate to comment as he is no more associated with Nims."
although I knew of him by his reputation personally I have never worked with him/
I should say that I was influenced by the ongoing gossip that the only reason he became the director of NIMS only because of his caste and his proximity to the actor turned politician chief minister N T
Ramarao but after reading a few pages of his autobiography I have changed my opinion.
His thoughts are pretty much resonant with my own ideas regarding public health institutions and their role in India.
From
A Doctors Story Of Life & Death
By Kakarla Subbarao, Arun K Tiwari"With Institute back on rails, I started looking into the larger problems of managed healthcare. The technological gains made by the nation need to percolate to the grassroots level of our society leading to enhancement of the basic quality of life. One of the major achievements of the Indian health services system over the last fifty years has been the development of an extensive institutional network in the public sector. This network, despite severe limitations in the delivery of preventive, promotive and rehabilitative healthcare, served as an institutional life support system for the poor in the country. However, the profound infusion of technology in healthcare undermined the approach to primary healthcare and enforced an entirely new paradigm of health services. The paradigm included changes in the conceptualization, planning and delivery, including new ways of health financing. At the same time, epidemiological priorities remained unchanged. This new paradigm not only created confusion but also raised fears among the common man that the days of State-supported healthcare are over. The Western Model for structural adjustment and health reforms, primarily promoted by the private sector, calls for cuts in public spending on health services, including tertiary level medical care. World Bank officials issue statements asking the Government to strengthen population control and shift curative care to the private sector. Newspapers are writing sponsored articles about introduction of cost-recovery mechanisms in public hospitals,care to the private sector. Newspapers are writing sponsored articles about introduction of cost-recovery mechanisms in public hospitals, defining essential clinical and public health packages etc. in the disguise of expert opinions. This kind of talk has already made considerable damage to the State run healthcare system in the country. The emergence of medical insurance is already loaded With unfavorable consequences, as it would shift the responsibility of medical and public healthcare to households or the household micro environment. This would be disastrous as it leads to the State eventually abdicating its responsibility for the provision of healthcare, and a majority of households at the subsistence level in India would be left without any life support system. NIMS held, right since its inception, responsibility to initiate effort to empower the State run healthcare infrastructure With technology and rejuvenate it to effectively support the common man during distress. For various reasons, most health indices remain at unsatisfactory levels. Though so many hospitals mushroomed, the state of preventive medicine and diagnostics is still awry. I knew well that NIMS was expected to not merely function but also to respond to multiple managed care pressures. There were conflicting pressures from the demands of specialized care and its affordability. We had to consolidate as well as upgrade our in-patient operations. When I was working in Baltimore, there were two area healthcare systems—the two hospital Johns Hopkins Health System. and the 500-physician member Kaiser Permanente Group. We also had three Other hospital systems, namely, five-hospital Helix Health System, the academic medical facility, University of Maryland Medicine, and the two-hospital Bon Secours Baltimore Health System. They all worked in tandem as far as the delivery of care to the patient was concerned. There were protocols. parity of tariffs and certain minimal framework of standards that every hospital would adhere to. Here in Hyderabad we had a dozen profit savvy private hospitals all out to capitalize on their investments from patients, two government monoliths settled in their inertia With out-of-order equipment, demoralized physicians and corrupt staffers turned into virtual leaches, and private practitioners running their own queer road shows. The demands for hospital care can be divided into two categories: community induced demands and the demands influenced by the hospital. The hospital has little or no influence on the amount and range of services provided towards the
India is a land of Gods, Avatars and Gurus. More than one billion people live in this vast land of diverse geographic regions and long history. Most of them are believers. But more than allegiants of an almighty supreme power, they fear God as unknown. Everything that is unexplainable is seen as an act of God, every problem that is insurmountable is passed on to God for solution, every wish that is unachievable is presented before God for fulfilment. Most of the buck is passed on to God. Success is enjoyed in His name, failures are attributed to His indifference. There is an almost fatal fascination for the status quo. An inherent inertia can be seen in every walk of life. A lack of drive to come out of the rut is the most common trait among Indians. God has been idolised in hundreds and thousands of forms and is seen as an ombudsman out to bail one out of one's life problems including those related to health. Everything, everyone, has been segregated into the two compartments of good and bad, black and White, zeros and heroes. Everything is either sacred or sinful. I am a physician by profession. More than five decades of working in hospitals has brought me very Close to pain, suffering, and death. Looking around in my domain of healthcare I see more of pain than care. Problems outnumber solutions. There are crises related not only to individual and community health but also in I am a physician by profession. More than five decades of working in hospitals has brought me very Close to pain, suffering, and death. Looking around in my domain of healthcare I see more of pain than care. Problems outnumber solutions. There are crises related not only to individual and community health but also in the deliverance of healthcare. Unlike in Western countries, where medicine is practised as a law monitored, insurance-driven service profession, in India it is a very complex proposition involving handling of human emotions. Disease and pain are seen here as a punishment from God. Patients look at treatment as an exercise in A Doctor's Story of Life and Death atonement and salvation and approach doctors as they would, a priest in a temple—carrying all they have With folded hands and leaving egos outside as shoes. During the course of treatment, they fluctuate between helplessness and idle serenity and turbulence of
restlessness and unsettling anxiety. Doctors often find themselves tangled in the web of these emotional loose ends and their own personal priorities for affluent life. This is a very peculiar situation that needs closer observation and careful analysis. Sometime back I felt a strong desire to undertake such a Study and write down my observations for further examination before they vanish into oblivion With my physical being. I felt that at the least my memories would provide an insight into the pain that a physician undergoes in his chosen profession of combating others' pain. I am no great achiever. There is nothing spectacular that has happened in my life and I certainly do not consider myself belonging to the category of people Who write about their lives or are written about. Nevertheless, when I decided to write my memories, I could not go much farther than the pain and problems of my patients. Lesser mortals always imitate legends. I took the clue from the great Mahatma Gandhi, Who chose to write about his experiments With truth in his autobiography. I have decided to share With my readers about perhaps the only thing that I know—my experiences With my patients—why we suffer With so many sicknesses and What is it like to die. For doipg this I needed
sicknesses and What is it like to die. For doipg this I needed someone Who can hear me With the mind of a scientist and write it in a form that a reader relishes. I had teamed up With Bharat Ratna APJ Abdul Kalam in some of his Societal Missions concerned With making healthcare technologically enriched, affordable and accessible. This interaction had brought me closer to Arun K. Tlwari, his disciple and an outstanding scientist in his own right. The team of Dr. Abdul Kalam and Arun K. Tlwari had already produced the widely acclaimed masterpiece, Wings ofFire. It was, therefore, very natural that Arun and I teamed up to write the book you are about to read. Why should änybody read my Story? With a monotonous regularity my life revolved around the problems of my patients.
All I saw was suffering and people fighting pain. My patients were my all-consuming interest all along. I was talking to them all my years. I was listening to them all my days. Each patient was a book. Each patient was a teacher. Each patient was a personality—an integrated being having mental, emotional, social and physical characteristics. Each one brought to me a unique set of thoughts, fears, hopes, reactions, behaviours, and dreams, wrapped up in the form of diseases. Though suffering from widely known diseases, the problems of no two patients can ever be the same. Just as the physical body has a seemingly unlimited variety, so does the sickness that makes the body suffer. The response of the body to the disease is What makes each patient unique. The latest research in genetics, molecular biology and neuroscience shows that many core physiological traits are inherited at birth, and that many of the differences between individual responses to disease are the result of differences in genes. Each one of us is created from the genes of our two parents. Each one of us is a product of generations of evolution, countless bits of information collected over millions of years, focused, narrowed, and refined until one is pushed out ofthe binh canal into the world. However, in spite of this inborn biological dimension, no one isreally stuck up. There is an amazing built-in flexibility in each one of us that allows us to adapt to life's hurdles and challenges. Growing up means not only learning the ways of the world, but also dealing With one self. There is a body and there is a mind and both disease and healing hover between them. Everyone has the ability to grow and change at every stage in life. People learn from experience, from parents and from friends. Individuals have the option to give in to temperamental weaknesses, or to overcome them. They can take advantage of temperamental gifts or hide them. People can indulge their desires to smoke, drink, or eat too much—or they can resist. They can live an active life or lock themselves in shackles of sedentary schedules and safe familiarity of habits. Sometimes they will do both during the course of their Jives. The environment too plays a part but not as much as is Popularly believed. The most important environmental factors are not reading, education, or social status, they are rather random and uncontrollable experiences such as precise concentration of a particular chemical in the brain, or something apparently minor like a childhood case of the measles. While we like to imagine ourselves to be the carefully crafted products of our upbringing and education, we are actually shaped by the same sort of chaotic events that make each laddu distributed at the Tirupati Balaji temple unique. Just as a laddu has little to say about its shape, we are born With limits on the Shape of our bodies, the color of our skins and type of hair. Try as we might to change our shape, most of us will fail. We will eat the way we've always eaten, and we'll have the same activity level we had as children, or even earlier in the womb There is an obese gene we all inherit that determines our body weight rather than the quantum of food we eat. Genes also control how quickly the body breaks down With age. A similar role is played by the genetics of gender—the biological differences between men and women. Every fetus is created without sex until a single gene switches on and begins a cascade of chemical reactions that turns half of us into males and half into females. The changes affect not only physical characteristics but also mental ones. Men are programmed to seek more partners and sexual The changes affect not only physical characteristics but also mental ones. Men are programmed to seek more partners and sexual novelty; women are serial monogamists seeking mates Who will remain long enough to raise offspring. Behavior like addiction to alcohol, tobacco and dangerous drugs too is determined largely by heredity. It doesn't matter What substance you abuse if you are programmed to get hooked. People are driven to violence by a force within them in the form of certain brain chemicals. Each Child shares personality traits With his or her parents, from talents to predisposition, to certain dreaded diseases. Every grown up man has experienced a shock of realization when he does something exactly like his father before him. Every mother has a similar experience when a Child behaves exactly like her. This is not bad; it's beautiful. This does not mean we are doomed to become our parents; it means we begin our journeys where our parents left off. The book has been conceived With no Other plan in mind than that of conversing With people Who want to know more about pain
and suffering related With the health of their loved ones as well as their own well-being. The text is organised into ten chapters and arranged in three parts—Cognition, Creation and Contemplation. The first part covers my childhood, medical education and initial years in the United States. The second part covers my comeback, retreat, growth and final return. The third part over-views the new emerging medical science based on molecular biology and genetics and records my views on going back to the basics of good living. I have written this book as much for myself as for everyone Who reads it. By writing about health and life, diseases and death I hope to recall the things I have seen and make them familiar to everyone else. If diseases may become just a bit more familiar to you, sickness will be less startling. To me, the view that sees physical disease in isolation from the soul is a blinkered one. Unless negative characteristics such as untruthfulness, malice, concealed aggression, a repressed urge to dominate others, unfocused intellectual energy, suppressed vitality and selfishness are diagnosed and treated, we will remain as condemned prisoners of medical contingency.
. Life is a constant surprise. Life's healthy mode is transition. Life manifests itself in only a never-ending process of dying and becoming. It is a strange fact of human experience that great suffering generates its own remedy. Let's evoke the Life's force by understanding the scriptures transcribed in our genes. If there are imperfections coded so are compensatory powers. The art and science of modern medicine can intervene to deal With the results of nature's imperfections, and to make use of nature's compensatory powers. The story I am going to narrate is that of the triumph of the human body, and of the human spirit. While pain is inevitable, suffering is optional. Kakarla Subbarao Hyderabad June 2001 THIS STORY IS FROM JULY 22, 2004
:"HYDERABAD: The Punjagutta police have registered a cheating case relating to the Balakrishna shooting episode against Dr B Soma Raju of Care Hospital and Nims former director Dr Kakarla Subba Rao.","Police acted on a complaint filed by an advocate alleging that Dr Raju intentionally shielded actor N Balakrishna following the shooting incident instead of handing over the actor to the police after administering him first aid.",:"Balakrishna allegedly shot two persons”film producer Bellamkonda Suresh and astrologer Satyanarayana Choudary”on June 3. He later got himself admitted to Care Hospital citing bleeding injuries suffered in an attack by the two persons.""Complainant Gopalakrishna Kalanidhi said Dr Soma Raju, despite knowing fully well that Balakrishna''s case was a medicolegal one, failed to inform police and shielded the actor for 7 to 10 days.","As for Dr Kakarla Subba Rao, the case alleges that he provided ''protracted pseudo-treatment'' to the actor in the name of treatment for psychiatric and orthopaedic problems. Reacting to the case filed against him, Soma Raju said, "I have nothing to hide. In case of Balakrishna we did the same thing as what we would do for any other patient. I am confident that we have not violated any rules. We only tried to help the patient.,"Dr Subba Rao refused to make any comment about the FIR as he felt it is inappropriate to comment as he is no more associated with Nims."
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