Keywords

30.1 Aim

The aim of this investigator-led study is to introduce a real-world experience of how a mentor could change the course of one’s life.

30.2 Materials and Methods

Would definitely not survive a thorough scientific appraisal, but evidence was painstakingly reminisced, collated, distilled, and transcribed.

30.3 Results

Results were some wonderful experiences which had the power to challenge, stimulate, and empower one’s heart and mind to the limitless possibilities if the intent is true and consuming.

30.4 Conclusion

It is a life worth having lived, if you touch the lives of many, have inspired someone to be better, to be the leader that is also a ladder for others to climb higher, to be a dreamer who recognizes the potential of other’s dreams and lends them the hand that gives them a gentle support to move ahead continuously.

This might be considered incongruous in such a learned text, but what I do have is a story. And like all stories, I hope it catches your attention, makes you a part of the journey, think a bit and take parts of it for your own life and give it the suitable conclusion that each mind is uniquely capable of conjuring.

We hosted the first ever nuclear medicine congress of the southern chapter of the Society of Nuclear Medicine, India, in Coimbatore in September 2013, where the late Dr Ajit Padhy and his team from World Association of Radiopharmaceutical and Molecular Therapy (WARMTH) helped us set up the Re 188 therapeutic program during the Congress. However, it was also a very saddening affair that he succumbed to a massive heart attack after reaching home in Singapore the day after the Congress. In his memory, I was asked to present the data on Re 188 Lipiodol therapy for liver cancer at the World Congress in Cancun in 2014. I entered the hall and it was packed to the hilt with an international audience, and my eyes immediately rested on the moderators of the session upfront on the stage. It was the talk before mine, and I realized that one of the moderators, this huge bearded giant of a man was expounding and professing with such an impact, that I stood in awe. I was nervous to begin with, as it was my first presentation at an international stage and the work I was presenting was all of 7 months vintage. Anyway, I walked up as serenely as possible and delivered for the next 25 minutes our initial single center experience of treating liver cancers with this new product. I had no idea how this project would be received and looked up as I finished to a silent audience. And then out of nowhere came a thunderous voice on the mike from the very same moderator with a –THAT’S OUSTANDING DATA, please give him a huge round of applause. That was my very first interaction with Prof. Richard Baum and it had already made such a deep impact on me. What it taught me was to be supportive and encouraging of the work that is being done by your colleague, however junior or inexperienced he or she may be. To nurture when it need not be done is a gift.

During the same Congress, I was called for a special meeting with the executive committee of WARMTH, wherein I was asked to summarize the Rhenium project and the potential challenges as well as way forward. Prof. Baum was the then president of WARMTH, and after listening to the synopsis and discussing with the other senior members, decreed that I should be the Chairman of a new task force to propagate Rhenium therapies across the globe on behalf of the Late Dr. Padhy and as a legacy of WARMTH. Indeed, it was such a great boost to my confidence, and it really felt like there was a strong wind under my sail taking me in a new direction. In retrospect, I was astonished by his ability to delegate a project on behalf of an international organization to a newcomer and a relative stranger such as I. It spoke volumes of his ability to trust and motivate and to constantly keep moving forward with a vision that would inspire others around him.

After reaching back to India, with so many thoughts whirling in my brain as to how to take this project forward, I learnt with alarm that the only commercial supplier of the Re 188 generator had stopped its production and distribution due to nonviability of the product and that I do not have the main item, that is, Re 188 to continue this project. I really did not know what to do and that is when I decided to write to Prof. Baum to ask him if he could help in any way. EANM meeting that year was in Gothenburg, and on behalf of me, he organized a round table meeting with the major isotope suppliers of the world and asked me to present my case. In essence, what he had done was to leverage his standing in the professional NM community and to lean on industry personally to try and help me to do what was effectively not going to benefit him in any way. So, mainly due to his persuasiveness and weight behind me, we got one of the companies to agree to actually give on a regular basis a subsidized WARMTH generator with a built-in fee for academic and research development. To those of us who have battled the industry on multiple fronts, you would understand how difficult it would be to convince a business entity to support a commercially nonviable product. It inspired me to think – of what good is your clout and influence, if you cannot use it to develop something or help someone out and to do so with no personal gain, not expecting anything in return.

One of the key areas lacking with the propagation of the Re 188 project was the general lack of awareness of the product. To address this challenge, I envisaged the first world Rhenium Congress in 2015 with an idea to bring all the stakeholders, industry, reactor companies, pharmacy, dosimetry specialists,clinicians, and researchers working with Re 188 from around the globe together to Coimbatore, a tier 2 city in South India; which again was a stupendous step forward and was never imagined on such a large or an international scale. Of course my main inspiration was Prof. Baum who had conceptualized and organized the First World Gallium Congress in 2011, which was very successful. When I reached out to him for support as the incumbent president of WARMTH, he immediately warmed up to the idea and was enthusiastic with his suggestions. Not only was he prompt in responding to calls of help, but he also went out of his way to get us the major funding for the Congress, called up favors owed from his colleagues to help get me support and even flew down on his own expense as well as sponsored researchers who could not afford to come down due to financial constraints. Learning point: No idea is your own, go out on a limb to help someone who wants to do something new or useful when you can and always propagate knowledge. We had delegates and faculties from over 35 countries who flew in on their own expense to attend this novel meeting. In fact, when many of them applied for their visa to India to attend the meeting and said they wanted to go to Coimbatore, the officials of the Indian embassy had very less idea of where this city was or why would anyone from say Colombia or Russia go there.

I remember wanting to ask his support on multiple things during a meeting in South Africa wherein, he was to leave early and the only time that we had left was actually the bus ride to the conference venue. I had my pen and paper as it was a short ride and I did not want to forget something. I said I wanted to host the second Rhenium Congress and also wanted to combine it with some other international agency such as IAEA, SRS, ISCORN, WTA, WARMTH or SNMI. Typical of Richard, he said great, let us do this with all of them .The 2017 Congress had all of the above agencies supporting us and it was due to the indefatigable effort from him personally many a time that made it possible. For me, it was amazing how he would take the time out, to discuss and encourage and not just promise, but to actually act on that discussion and enable its fruition. He was unfazed by enormity, the bigger the better.

I was ecstatic that Prof Baum had landed in Coimbatore for the Rhenium Congress, and I visited him on the same day in his hotel room to check on him as well as to invite him for a private dinner. He politely refused to come out that evening saying he had to prepare for his lectures that he was due to give the next day and he also said that he never uses the same presentation twice. He always believed that you should respect the audience and the platform and put in your best when up there. Indeed it was an inspiration for me, that how much ever you grow, always do your job to the best of your ability and never take a podium or the ability to educate and influence other minds for granted. Due diligence matters.

During many an interaction with my clinical colleagues who had trained with him or were working with him, when asked what is the secret of his success; the answer consistently revolved around three things. Hard work (he came most days in the wee hours of the morning 3–5 am), a great clinician (an attribute which many of us NM physicians are distancing ourselves from), and ability to believe in yourself and take that risk, provided you have the patient’s good as your endpoint. I have kept these guiding mantras in my pursuit of success in the professional arena, and still have a long way to go.

His ability to remember even the most elusive and what you would consider the most minute or inconsequential detail has always amazed me, and in part, I feel it is because of his inherent curiosity. I remember many a times, even across the dinner plate, when he hears something new, he would always ask it to be sent to him so that he could read it and understand better. He would take great pride in pronouncing words and names the exact correct way and would remember fondly the details of a particular wine at a dinner or even the entertainment on an evening way back in time. The abiding lesson learnt was that the tiny details matter and it embellishes the ability to live life to the fullest.

It was after great difficulty that I had convinced a journal to come out with an entire issue based on Re 188, covering all relevant topics from bench to clinical and research avenues. However, the stumbling block was to find financial support for this issue. It took a 2 min call for help to Dr. Baum, who asked me to go ahead and decided to fund it himself. Not only did he do that, he handed over the money personally to me when he saw me next, in a cover marked with the current euro exchange rate and was exact to the last cent. If in a position to give, give freely and easily, do not make the recipient ask many times and most importantly do not give like it does not mean anything to you – be accountable even when you are beneficent.

In all my series of conversations with him, the one thing that I always admired was his ability to cut through the molasses and reach to the core of the person. He had a way of knowing who would stand up to their pitch, who could walk the talk and pick the winning horse or even the one that would not give up. He always respected the hustle, knowing that opportunities are everywhere and the person who did the hard yards to reach wherever they were now, needed to be respected.

Some enduring images are of professor with the traditional white “veshti” and a cigar in his mouth at the Rhenium Congress, to shouting out: “someone give this German a beer,” to pulling me aside to a restaurant in the lunch break of a conference saying “I can’t be eating these box lunches anymore if I have a choice.” Make things count, a meal, an evening to cherish, a ready quip, a hearty laugh, a good beer, and time well spent: celebrate the small things.

Some of the small things the Re 188 taskforce has achieved over the past few years that need to be celebrated have been summarized. We have been able to stabilize the Re 188 generator availability and also convince agencies to produce commercially available cold kits for labeling in a cost-effective manner. Multipronged training has been imparted to multiple centers in different countries to use this technology, conducted two world congresses, had editorials and journal issues dedicated to Re 188, sparked bench chemistry and dosimetric research in various universities across the globe and even have ongoing collaborative multicentric trials.

With support from so many unbelievable people that I have met in my journey with Re 188, the chief among them being key members of WARMTH and Prof Baum, I continue to walk feeling stronger with every step; maybe that is what happens when you journey with Hercules.