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Sistla Radhakrishna (1935-2020)

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The last surviving Titan of the Tuberculosis Chemotherapy Centre (TCC, now known as National Institute for Research in Tuberculosis, NIRT), Madras (now Chennai), is no more. Dr S. Radhakrishna breathed his last on September 27, 2020 at Hyderabad, India. Prof Wallace Fox [British Medical Research Council (BMRC) Tuberculosis Research Unit, London], Prof Dennis Mitchison (BMRC Group for Research in Drug Sensitivity in Tuberculosis, London) and Dr Radhakrishna (Chief Statistician) formed a formidable trio at the TCC. Dr Radhakrishna regarded Prof Fox as both a professional and a personal mentor. He stayed in touch with him and Ms Fox throughout his life.

I first met Dr Radhakrishna in 1985 and since then had remained in touch with him. In his last email to me in July 2020, he shared a draft of the history of the TCC. Little did I know that the manuscript would be his swan song. I was part of the team at the Indian Council of Medical Research (ICMR) Headquarters, New Delhi, and had the good fortune of interacting with him regularly in the meetings of scientific advisory committees of various ICMR institutes, scientific advisory groups and the scientific advisory board and the governing body of the ICMR. Always immaculately dressed, he would have meticulously read through all the background documents. He was never without chits of paper and a pen in his pocket to make to-do lists for himself. His conversation, casual or technical, was always punctuated by anecdotes and a touch of subtle wit and humour. He took pride in his Queen's English. It was always an intellectual treat to listen to him. He liberally quoted poets, statesmen and from religious scriptures.

He worked towards bringing about a fundamental change in the relationship between a doctor and a statistician. He maintained that, “No longer can the statistician afford to sit on Mount Olympus and pronounce verdicts, nor can a doctor brush aside his suggestions. The statistician must familiarize himself with medical aspects and the doctor must have a basic grounding in statistical methods”. He walked the talk.

Dr Radhakrishna was a clear role model for how statisticians can make a difference. He had an abiding passion for statistics. He was intensely dedicated to his work and focused on doing things the right way. His clarity of the principles of statistics was exemplary. For him, statistics was crystallized common sense. He was a brilliant scholar and educator - a natural and tireless mentor who was always interested in and successful at helping and training the next generation of biostatisticians. Dr Radhakrishna was a tough task master, and he had mastered the art of criticizing without offending.

He was one of the few Indian staff to join the TCC in 1956, and was its chief statistician. This was a five-year project funded jointly by the Madras Government, the WHO, the BMRC and the ICMR. He played a major role in the analyses and reporting of the findings of all clinical trials of the TCC. The most prominent among those was the randomized controlled clinical trial comparing domiciliary outpatient treatment with treatment in the sanitorium of patients with sputum-positive pulmonary tuberculosis (TB). This Madras Classic made waves, and showed that treatment at home for a year was as effective as at sanitorium with no additional risks to close family contacts. This finding revolutionized the management of TB globally and had a great impact on the global WHO policy. In 1964, the TCC became one of the institutes of ICMR and named Tuberculosis Research Centre (TRC) in 1978. The statistics department became an integral part of TRC.

The department started to collaborate with scientists across ICMR institutes and in other domains such as leprosy, rheumatoid arthritis, health services research, hospital statistics and training programmes in statistics for doctors and statisticians. In his own words, “its outreach would have done octopus proud”. The impact of the statistics department was palpable, and prompted its upgradation into the Madras Chapter of the Institute for Research in Medical Statistics (IRMS) in 1978. Dr Radhakrishna was its founding director till he retired in 1995.

In 1993, he was offered the position of Additional Director-General (DG), ICMR, which required him to move to Delhi. But, he did not. Not that he loved ICMR headquarters less, but his love for TRC/IRMS was more.

Dr S.P. Tripathy, a former Director of TRC, Chennai, who later served as the DG, ICMR remembering Dr Radhakrishna (whom he affectionately called 'Radha'), said that, “At TRC he was closely involved in every aspect of each study and vetted every paper going out for publication. Without Radha, many of the clinical trials would not have received global recognition and would not have been quoted as classics. TRC owes its fame to him. I also give him the credit of introducing medical statistics to ICMR. Even after retirement we maintained close contact. In his death I have lost a lifelong friend”.

Dr Radhakrishna became a go-to person for advice on clinical trials including those in traditional medicine, and so deep was his and his team's commitment that a Central Biostatistical Monitoring Unit for Traditional Medicine Research for multicentre was created and housed within the Madras chapter of IRMS.

Paying tribute to Dr Radhakrishna, a former DG, ICMR Dr G.V. Satyavati, who also led the clinical trials of drugs of Traditional Systems of Medicine, said that, “Conducting clinical trials on drugs of traditional systems of medicine so that their results are accepted by the practitioners of modern medicine was to sail an uncharted sea. But for Dr Radhakrishna (Dr S.R.) these clinical trials could not have been conducted with the kind of rigour and excellence required. Meticulously planned and monitored through the Central Biostatistics Monitoring Unit, his guidance was the compass in the journey. In our four decades of association I had come to realize that Dr S.R. as a human being far surpassed Dr S.R. as a scientist. He and his wife were part of my extended family. His demise has shrunk my world and left a wide intellectual vacuum”.

Condoling Dr Radhakrishna's death, Dr Soumya Swaminathan, a former DG, ICMR, and presently a chief scientist at the WHO says, “I was lucky to have known and interacted with him closely for many years and learnt a great deal from him. When discussing tuberculosis and its many challenges, I always forgot he was a statistician by training - he had a better understanding of its clinical and public health dimensions than many doctors!”

Dr Radhakrishna was a long time reviewer and member of the Editorial Board of the Indian Journal of Medical Research (IJMR) with inexhaustible enthusiasm. His was the last word in addressing intricate issues relating to biostatistical analysis in manuscripts submitted to the IJMR.

Dr Radhakrishna was elected the President of the Indian Society for Medical Statistics (ISMS) in 1991. He was conferred the ICMR's M.N. Raju Oration Award for his contributions in the field of medical statistics in 1992. He received ISMS's Prof S.K. Bhattacharya Oration Award in 2006 and Life Time Achievement Award in 2016. He served as a short-term consultant for the WHO in India and abroad on several occasions. He had over 100 publications in national and international peer-reviewed journals.

Dr Radhakrishna was a giant in statistics, but it was his human side that has left a deeper impact on every person's life he touched. He was a warm-hearted and caring human being, humble, kind and full of wit and humour. He was very disciplined and methodical. He had tremendous will power and control over his mind. He always faced challenges with a positive attitude, very much like his blood group - 'B positive'. He was also outgoing, fun-loving, sometimes mischievous and a joy to be around.

Born in the family of an Ayurvedic physician, he was the eldest of the three sons. He studied in probably one of the best convent schools at that time in Madras city. He was a consistent class ranker and excelled in all subjects. He went on to gain a postgraduate degree in statistics from Presidency College, Madras - which was quite a puzzling decision, as it was a newly introduced course and not much was known about its application as a discipline at that time. This is when his courtship with statistics started and blossomed over the years. In the early part of the 1960s, he got his PhD from the London School of Hygiene and Tropical Medicine. Both he and I share our alma mater.

Dr Radhakrishna lived his life fully and enjoyed every bit of what he did. In 1966, he married Indira, an accomplished 'Veena' player. As a father, he adapted well to the diverging interests of his children, he often described them as the two ends of a normal distribution curve!

Dr Radhakrishna was preceded in death by his wife, Indira. In whose memory, he has been sponsoring the 'Indira Memorial Concert' every year at Chennai - though the song had ended he ensured that the melody lingered on. He is survived by his daughter Sumithra, and son Prasad.

Dr Radhakrishna has left an indelible mark on the institution and on the countless faculty and staff who were fortunate to work alongside him. We have lost a dear colleague, one of the champions of medical statistics, whose disarming smile and wonderful influence on all of us will be missed but never forgotten.