“Sir, I had asked for a gastro opinion for the vomiting, and a nephrology consultation for the low urine output.” With wide eyes and a sense of accomplishment, the young doctor expected me to acknowledge her shrewdness. I gently pointed out to her that both the symptoms are related to the patient’s high sugar levels and dehydration, and once the sugar levels are optimised, everything should fall in place. I gathered the students in a circle, and explained them to identify the root cause of all symptoms in a patient rather than seeking multiple specialist opinions. The present generation are tuned for pithy remarks instead of long-winded stories, and hence I quoted a kural, “Noi-naadi Noi-mudhal naadi adhu-thanikkum Vaai-naadi vaaippa seyal.”It is just a combination of seven Tamil words with a deep meaning, about which one can discuss even for a whole day. To the flabbergasted students, I explained them the context. “Valluvar, the author of this couplet, asks the doctor to not treat the symptoms or order expensive investigations. He coaxes the treating physician to talk to the patient, examine them thoroughly, identify the root cause of the symptoms and treat the disease with expertise. In this modern era of super specialisation, most doctors are seeing the patient as a bundle of ‘symptoms’ rather than as a person with a disease that manifests with symptoms of different organ systems. The patients are subjected to multiple specialist opinions and consultations, and a battery of wide-ranging tests, which can be potentially avoided. I wish we read this couplet often to keep reminding ourselves about the need for a holistic individualised approach to the patients.”Thirukkural is a compilation of 1,330 couplets written by Thiruvalluvar. It was written in the Sangam period of Tamil literature between the third BCE and third CE. Many believe that Thiruvalluvar is not a single person but rather different poets because of the extensive and wide range of topics that has been discussed in the Thirukkural. The unique aspect of Thirukkural is its brevity (seven words in each couplet) and rich content, which provides a wholesome perspective of life. The text has three major divisions — aram which speaks about virtues, porul which discusses wealth, and inbam which talks about love life. In particular, the aram segment is so extensive and laden with unique teachings which holds good across different generations, geography, social strata, gender, profession and age. It discusses many essential virtues one should cultivate and practise such as honesty, self-restraint, education, learning, gratitude, hospitality, kindness, goodness, duty, and donating besides covering a wide range of social and political topics such as rulers, ministers, taxes, justice, agriculture, education, and abstinence from intoxicants. Thirukkural has no regional, ethnic or religious identity, and it has been translated into more than 100 languages across the globe. The government has included this in the school textbooks and it ensures that the children and the common person are regularly exposed to it by displaying important thirukkurals in public transport and government offices.Just like any other moral book, one can revisit Thirukkural at different stages of their life, and understand its wisdom from a newer perspective. As a child, I used to recite more than 100 kurals like a sloka much to the excitement of my parents. In those days, memorising the kurals was a sure-shot method to get full marks in the language exams. Having reached the late forties now, I re-read the kurals from a different vantage point. It helps me to extrapolate it to my profession, how I handle my patients and colleagues and deal with professional hurdles.As a doctor, naturally my interest is towards the subject of medicine and Thirukkural. Despite spending so many couplets on other aspects of life, the poet had offered only one section of 10 couplets for medicine. For Valluvar, medicine is nothing but what we ingest as food. Within these 10 couplets, he has allotted six couplets for eating appropriately. I wonder how relevant it is now in this modern era of fast food, binge eating and obesity epidemic. He repeatedly insists us to check what we eat for every meal. After eating, he warns us to refrain from eating until we feel the next hunger pang. He asks us to be sure whether the food we ate earlier had digested well before thinking about the next meal. We have now been conditioned to eat on a timely manner whether we feel hungry or not. Food has become a source of break for us from our hectic schedules. We look for the coffee and lunch breaks to relieve ourselves from the work monotony rather than as the appropriate time for loading calories to our starving cells. The poet insists that the person who moderates his eating lives comfortably while the glutton suffers.In the other four couplets, he focuses on the doctor. First, he insists the doctor to look for the root cause of the disease. Then, he quickly points out that while diagnosis is the key, the prescription should consider the stage of the disease, the patient’s age and his present health condition. How profound and pertinent it is! In the next couplet, the poet brings the focus back to the patient among the different healthcare stakeholders. The famous Mayo brothers who have contributed immensely to modern medicine, once quoted, “The best interest of the patient is the only interest to be considered.” Valluvar had said the same two millennium ago that any medical treatment should involve these four orders: first comes the patient, then the treating doctor, the medications prescribed and finally the nurse. In the current scenario, one can add the hospital management as the last and least important box in this order. When the focus is on the patient, naturally other things will fall in place.Thirukkural is a masterpiece, and it has influenced scholars and leaders across the ethical, social, political, economic, religious, philosophical, and spiritual spheres of the world. It is one of the most important texts in literature, which should be frequently read and re-read by us.rishiortho@gmail.com