No One Is a Born NEET Topper: AIIMS Rank-1 Surgeon Lokesh Agarwal on How Toppers Are Made

Genius Born or Made? — Episode 4 3× AIR-1 Doctor: No One Is a Born NEET Topper Guest: Dr. Lokesh Agarwal · Host: Himanshu Gupta

This is a lightly corrected transcript of the conversation, synced to the published video. Auto-transcription errors (names, proper nouns) have been fixed; the speakers' words have not been rewritten. A few short passages spoken in Hindi appear as captured.

— Medical entrance exam toppers: born or made? So what's your final answer on: are those toppers born or made? No, they are definitely made, because I flunked my Class 3. I was on the verge of flunking Class 7, or not seventh, I think fourth or fifth.

And during medical school, I did not perform well in first year or second year. So there was nothing inherent in me that I can say, yes, I was born with a talent to top a particular exam. That hunger and drive to achieve a particular thing helped me in whatever result I got. To answer this question precisely: no one is born with an inherent talent to do well in a competitive exam.

I'm Himanshu Gupta. I'm a new dad, and now I'm obsessed with one question: Is excellence born or made? I interview world-class performers to extract the decisions and habits behind their success. Welcome to the show, Lokesh.

I'd say good morning, based on my time zone. Well, speaking of good morning — I see you're in Tokyo. What are you up to there? I'm here on a one-month fellowship in hepatobiliary surgery and liver transplantation at the University of Tokyo.

I see. For our audience who may not know you, would you mind introducing yourself? My name is Lokesh Agarwal. I am a hepatobiliary and liver transplant surgeon.

I also perform minimally invasive GI oncology procedures, and I'm currently based in Jodhpur. I work at the All India Institute of Medical Sciences, Jodhpur. That's quite a mouthful, Lokesh. A lot of our audience isn't from the medical space.

So what is GI oncology, and hepato— honestly, that first word is a mouthful for me too. What does it mean? Yes. In simple terms, you can think of it as digestive surgery.

It covers all the body parts involved in digestion — from your food pipe and stomach, to the small and large intestines, liver, pancreas, and spleen. I operate on all of those organs. My specialty is digestive surgery and hepato- pancreato-biliary surgery. In India, we're commonly called GI surgeons — gastrointestinal surgeons.

That's what I do. I'm sure we'll have a lot to discuss about Indian diets, lifestyle, and the medical impact on all of us. But we had to reschedule this podcast yesterday because you had an emergency surgery come up. Whatever details you can share — what was the surgery about?

It was a deceased donor liver transplant. Deceased donor liver transplantation is not very common in Asian countries, but it's very common in the West. What happens is: a person who is brain- stem dead — for example, someone who suffered a road accident and whose brain stem is no longer functioning, but whose organs are still viable. The organs are alive, but the person is not.

When the patient's family consents to organ donation, we harvest those organs and transplant them into someone who needs them. In this case, there was a donor call from a location 250 kilometres from Tokyo. The liver was harvested there. It was transported by Shinkansen bullet train to the University of Tokyo, where we transplanted it into a patient whose liver had failed.

That's remarkable. I hope the surgery was successful. The transplant was successful. Yes, it went well.

I wanted to raise that point, Lokesh. Just to highlight what the life of a surgeon is really like. We had this podcast scheduled, and you had to drop everything and go perform that surgery. The other thing we left out of your introduction: you topped the All-India medical entrance exams at both the undergraduate and postgraduate levels.

You were the all-India topper, and the exam has since been renamed NEET, I believe from around your time. Thinking about your journey from being an all-India entrance exam topper to now being a practicing surgeon — what transformations did you have to make in yourself? What traits did you need to develop as a surgeon that are different from what it took to top an academic exam? From my perspective, I never actually set out to top any entrance exam.

I was never the kind of student who was chasing a rank. I just wanted to become a surgeon. My first inspiration was my father, who is also a pediatric surgeon. So surgery was always the goal.

I knew the difficulties and challenges surgeons face, and that it may not be the most financially rewarding path for young people today — but that was my choice. I just wanted to clear the exam so I could get into the institute of my choice and train in the specialty I wanted. And in the process, I happened to top the exam. But that was never the intent.

Coming back to your question — you were asking about the difference in mindset between preparing for an academic exam and the practical reality of being a surgeon in the operating room. I think the preparation is essentially the same — it all comes down to discipline and planning. Even for an exam, what matters is not just that one day, but the two years of preparation — the discipline and daily routine you built — so you can perform in those three hours. And in surgery it's the same.

It's not just those three, four, or five hours in the OR. It's the preparation built over 20 years of training — not just the night before. The common factor across both domains is discipline, preparation, and dedication. Discipline and preparation — we'll come back to that.

But what's different between the two? The difference is the stakes. In an exam, the stakes are for yourself. In the operating room, the stakes involve someone else — and not just that person, but their entire family and community.

The stakes are far higher. So what makes someone a great surgeon? You are one yourself, and you've been trained by great surgeons. What is it that sets them apart?

First, there is no such thing as a great surgeon. The moment someone believes they are a great surgeon, they stop being one. Any surgeon who does their job in the right manner, with passion — that person becomes a great surgeon. There is no scale to measure it.

If the surgery is done well, the patient is happy, the family is happy — that is a great surgeon. The concept of a great surgeon doesn't really exist. What exists is a surgeon who does their job well. Okay.

So let's say someone has done a hundred surgeries and 95 were successful. I'm not sure what the right metric is for doing the job well. But can anyone who has passion and follows the discipline become a great surgeon? Can someone who puts in the hours and follows the process get there?

Yes, I think so. Within their domain, anyone who puts in the work can become a good surgeon and do their job well. You mentioned passion. Where does yours come from?

When it comes to my passion for surgery, I honestly cannot pinpoint the moment it started or when I first recognised it as my passion. What I notice is that when I'm in the operating room, I forget everything — professional problems, personal problems, anything happening in my life. In the operating room, only those minutes and hours matter. That feeling — I call it passion.

I can't define exactly what passion is. But I feel that if you can be fully present in a moment and forget everything else — your finances, your professional and personal life — that is what it is. That is what we call passion. Being able to live fully in that moment — that is my definition of it.

I'm sure you lead a very hectic life. All surgeons do, and given your specialty, yours would be especially so. That's why passion is so important. Growing up in India, we were told that becoming a doctor was about earning respect in society and financial security.

What has your experience been? Did anything about being a doctor surprise you compared to what you were told growing up? No, because I was fortunate to have a surgeon in my family — my own father. So from the start, I had no misconceptions.

I did not choose this field for social status or money. I knew there were many other branches and professions that offer far better financial returns from a much earlier stage in life. And those were simply not the reasons I chose surgery. My choice was purely driven by interest.

I felt this was what I enjoyed most and that I could build my life around it. Even without the extra perks of reputation or money, I am happy doing it wherever and however I can. I was saying that the reputation and financial perks of being a doctor may not be as special as people think. Because that can happen in any profession.

If you are good at your job and doing it honestly, these rewards are common across all professions — not unique to medicine. So what I'm hearing from you, Lokesh, brings me back to the earlier point we discussed. That achieving rank one requires a preparation and mindset very similar to what it takes to become a truly excellent surgeon. But is there necessarily a correlation?

Did the high-rankers from your class and your seniors actually become good surgeons? I think that's a very good point. I also think about this: topping an exam or getting a good rank does not necessarily make you good at your profession. And vice versa.

Nor does performing poorly in an exam mean you won't succeed later in life. On the contrary, I've observed that people who achieve a great deal early in life often don't perform as well later on. Whereas those who are considered mediocre or average early on generally outperform those who started strong. So I think the concept of hunger is very important.

For example, if you achieve a great deal very early in life, that hunger may simply die out. You stop working hard to improve because you already feel you're the best and have achieved everything. And then you stop striving altogether. Any exam is just one limited step toward something greater.

Once you've climbed that step, let go of the result — the journey continues from there. It doesn't matter how well or how poorly you did in the past. What matters is that the exam or event helped you reach a new level. And then you carry on your journey from that point.

I really like the point you made about hunger. I call it drive. The drive should never die. How do you keep fueling that hunger?

Hunger comes from many, many sources. I call it hunger because I mean it in a very literal sense. Why hunger? Suppose you go to a very fancy, expensive restaurant, but you're not hungry.

Would you actually enjoy that food? I don't think so. Because the fundamental ingredient for enjoying food is hunger itself. So how do you create that hunger?

One way: you've been deprived of that food. You haven't eaten for a while, or you've worked hard and your body is demanding nourishment as a reward for the effort. That is hunger. Or you've watched that food being prepared or served, but only from the outside.

You've always wanted to taste it, and now your chance has finally come. The idea is that something you always wanted but couldn't access has now been placed in front of you. And now is your moment to have it. The fourth source is the aroma.

You've heard about that food. You've caught its aroma from somewhere and it has stayed with you. And you've always wanted to try it. And now is your time.

This literal concept of hunger maps directly onto how hunger works in real life. Something you've observed from the outside and have always been intrigued by. You've always felt, yes, I want to live that life. That is hunger.

Something you wanted but couldn't achieve. You simply couldn't get it. And then finally you think: if I work hard enough, if I clear this exam or milestone, I will achieve it. That is hunger.

Or you've worked hard and believe that clearing this exam will finally validate all of that effort. That is hunger. That's how I connect the concept of hunger to the real world. I've never heard hunger articulated so beautifully — both in the literal sense and as an analogy for drive.

What did hunger look like for you as a child? You mentioned it's also about being exposed to something and feeling drawn to it. What did that actually look like for you growing up? By kid, I think you mean my school years — though in a way, we're all kids at every stage of life.

The definition varies. I sometimes ask myself: when did I stop feeling like a kid? In my school years, I watched my father rush to emergency surgeries, perform operations, and manage patient rounds over the phone. I was always fascinated by how completely absorbed he was in his work.

I was fascinated by the terminology he used on calls — so brief and precise, yet it captured the patient's entire situation. I also accompanied him to the operation theatre, just to observe from the outside. I was deeply intrigued — would I ever stand where he stood? Would I get a chance to operate alongside him, with that same focus and concentration?

It got to me from within. That was one component of the hunger. When I entered medical school, you only get to operate once you've proven you're capable. As medical students, we watched surgeries.

We were purely observers. During my internship, I got the chance to assist in certain surgeries. That hunger only grew — would I ever get to actually operate on a patient, rather than just assist and observe? When I entered residency, the complex cases were handled by consultants, and I was deeply drawn to hepatobiliary surgery.

I was drawn to liver and pancreatic surgeries because they are the most complex. And we would perform them robotically or laparoscopically. That is, through small incisions. We would complete an entire cancer surgery.

We would remove a specimen roughly 20 centimeters in size through just four or five millimeter incisions. That fascinated me. I wondered: would I ever be capable of performing those surgeries? So I chose surgical gastroenterology and hepatobiliary surgery as my super- speciality after residency.

I got into that program. I completed the three years of super- speciality training. Then I became a consultant. That hunger, I think, kept building and growing.

When I finally got the chance, I was happy — now I was actually doing those surgeries. But simply doing those surgeries isn't enough. What's important is continuing to improve and innovate. That hunger — or drive, as you call it — keeps the momentum going.

It means you don't stop at any single milestone. Because if you achieve your dream and stop there, that marks the end of your progress. And that shouldn't happen. The drive should keep propelling you forward.

And the hunger should help you achieve that next goal. That's why people call it the drive. I still want to address the fact that everyone has a fear of surgery. For example, if someone has gallstones and their doctor says they need surgery, their gallbladder needs to be removed — the immediate reaction is: 'Oh, surgery?'

'I'm very afraid of surgery.' 'Why surgery?' 'Can't you give me medicine to dissolve the stones?' 'Or can I avoid surgery altogether?'

The fear around surgery comes from the incision and the pain. What we're working on is minimally invasive surgery. Through small 5mm incisions, the surgery is done, the patient goes home next day — no pain, quicker recovery. We attempt all major procedures — pancreatic, liver, large and small bowel cancers — all major abdominal cancers.

We do it minimally invasively so patients have the best chance at recovery — minimal time off work, less post-op pain, faster healing. Hopefully we can offer this to more and more patients. For more and more surgical procedures — so the fear of surgery should eventually disappear. But reading between the lines, Lokesh — forgive me if I'm wrong — this hunger and drive ultimately translates to patient benefit.

You're serving patients. Even minimally invasive surgery is a response to what patients fear and need. That's the passion point I wanted to reach — real passion is about helping patients, not reputation or money. And that's what I want to clarify for our audience: why should you want to become a doctor?

I want to explore that more, but there's something else you mentioned — about medical school at AIIMS, arguably India's and Asia's best. You said surgeries are only handed to you once you're capable. What does that mean? Who becomes capable and who doesn't?

In India, we have a five-and-a-half year MBBS — Bachelor of Medicine and Bachelor of Surgery. After that, there's another entrance exam — more competitive than the pre-medical one. There you choose surgery as your speciality and enroll in the residency program. It's called residency because for those three years, you live within that surgical speciality.

You stay in the ward, available 24/7. That's the three-year residency program. During residency, you're exposed to all kinds of surgeries — general surgery, head to toe. Then, depending on your subspeciality interest, you take one more exam — the super-speciality exam.

It's a similar entrance test, but with far fewer seats. When I sat for my entrance test, there were only 38 seats nationwide for surgical gastroenterology and HPB surgery. You enter that program, complete three more years of training, and become fully capable of performing complex procedures independently. Eventually you become a consultant — performing procedures and training the residents under you.

I see. So it's basically a grind to get there — it requires a lot of patience, and that brings us back to passion. If you don't have passion, you'll eventually give up. I want to go back to your childhood — your school days.

You mentioned being exposed to your father's work and observing him. Many school children watch brilliant surgeons — their parents, relatives, or even on TV. Like House MD — though I don't know if there's an Indian equivalent. There must be.

But what translates passion into action? You talked about discipline. Going back to your childhood — what did discipline look like for you? For me, as a school-going child, discipline meant — Discipline meant completing whatever academic work I was given — completing it all, whether co-curricular or academic.

That was what discipline meant to me as a child — nothing more complicated. Playing cricket at a fixed time in the evening, coming home, having dinner, sleeping, waking up at a set time, waiting for the school bus. That's what discipline meant to me as a child. Nothing else.

I see. So in school, did you ever realize you were different from other kids — excelling in one area versus another? No, there wasn't anything in particular. Maybe from class 9th onwards, I became serious — serious about my studies.

Before that — and honestly even after that — I was no different from any other kid. In my school. From 9th grade, I got serious because my parents told me, 'We don't have the funds to support your further education.' If you want to get into the kind of medical college you dream of, these are the only few options.

And you'll need to work hard to get into them. We can't send you abroad or to a private university. We can't fund your education. So I became serious — okay, this is the reality.

I want to pursue this further in my life. So I needed to get serious and start preparing for a competitive exam. I'm grateful to my parents for showing me the real picture. Had they told me, 'I have a certain amount reserved for you, just choose—' Any college, any university abroad, any private university — we'll get you there.

Maybe then I would have lost that hunger, because the food would have been served on my plate. I see. But any audience would ask — you're the son of a pediatric surgeon. Your father is a pediatric surgeon himself.

So why did your father say that — 'We don't have funds for you'? What was going on in his mind? What was his objective? What I understand now is that the objective was very clear.

I'd do the same with my own children. In India, we have a saying — let me translate it to English. The saying means: if your child is capable, there's no point accumulating funds for them. And if your child is not capable, there's no point accumulating funds for them either.

Okay. Right. So, yeah. Every parent wants what's best for their child.

But in that process, parents shouldn't forget what's actually best for their child. We want our child to excel academically and professionally, but we're forgetting what the prerequisite for that excellence actually is. Is it something we should give our child, or something that must come from within the child? We want our child's stomach filled with food, but we forget that it's hunger that determines how much they'll eat.

We shouldn't spoon-feed or overfeed the child. Very well articulated, Lokesh. So what does that interest— So how do parents figure out if their child has an intrinsic hunger to become a doctor? I mean, as I said, a lot of kids want to become doctors in India.

But how do parents figure out if this dream is genuine? So parents don't need to figure that out. This is the fundamental problem — the torture we as parents put ourselves through. How do we figure out what our child wants to become?

That's not our job. It's not something we need to figure out. It's for the child to figure out. What we need to do is provide nutrition so all the child's body systems develop well.

We need to provide a good environment for brain development, physical development — all of that. We need to provide basic education. After that, what the child wants to become is for the child to figure out. If we put in a lot of effort trying to figure out what our child's talent is— And try to over-nurture it, as I call it— I don't think we're doing justice to that child — or to ourselves.

We need to sit back and relax. Give what it's our duty as parents to give — and let the child grow. For example, when you plant a sapling, how do you figure out how tall that mango tree will grow? It's not for us to figure out.

Our job is simply to water it daily, provide basic fertilizers and nutrition. And it's for that sapling to grow into a tree of whatever height it was meant to be. Yeah, so you talked about capable versus incapable children, right? Children.

A lot of parents would say, 'I refuse to believe my child is incapable.' What does capability mean for school-age children in the context of becoming doctors, engineers, or whatever? I think capability means you're able to enjoy time with your family. You enjoy going to school — and it's not just about school.

You can enjoy a talent or hobby you engage with daily. You can communicate with others — not just verbally, but emotionally as well. That's what defines capability in a child. So if your child converses well with you, if you can spend time with your child— and the child enjoys and reciprocates that time with you — then your child is capable.

I see. But are they capable enough to become successful? A lot of parents ask that. And in India, becoming successful usually means clearing engineering or medical entrance exams.

So how do we connect the dots here? So I would disagree with that. In India, the definition of success meant much more. I think it was from the West and other countries that doctors, engineers, the definition of capability came.

And I think being capable means you can have a family and enjoy time with them. Anyone who can do that is capable and successful, and anyone who cannot is not successful. For example, a doctor working 18 hours a day and unhappy is probably not successful. But someone in any other profession who can spend time with family and feel happy — that person is successful.

The definition of success varies. And if a person feels happy, I think that is success. We see so many rich people, so many capable people who are unhappy and miserable in their lives. So I don't think they are truly successful.

So talking about passion — there are millions of families from tier three cities or villages in India listening to you, right? And they have no medical background, nor do they know any relative from the medical field. How would they go about exposing their kids to this field? To the medical field?

Yes. I think exposure is important. What I liked about what you said is 'exposure.' Someone has to be exposed to it and realize, 'this is something I can see myself doing in the future.'

How would they expose their kids to it? So this is for someone from the social strata you mentioned. So if you feel your child is interested in medical science, what do you need to do during their basic school education? I think that's the real question.

First of all, I feel that in India, if your child gets a decent school education — meaning up to class 12th, if your child attends school and has the books recommended by the central board, and if your child studies those books properly, then your child is capable of getting into a medical college. Government medical colleges in India have a minimal fee structure. The fee structure at AIIMS when I joined — for the full five and a half years of medical graduation, the total fees my parents paid was around ₹5,500, of which ₹2,000 was a security deposit and ₹3,500 covered gymkhana and library fees. Wow.

That's basically less than the cost of a meal at a fancy restaurant in Delhi these days. Yes. So families and parents shouldn't worry about the cost of medical education. I still remember — the first entrance exam I gave was for a private medical college, Manipal.

I secured eighth rank in that exam. That was the first entrance exam I ever gave, while I was in class 12th. And I secured eighth rank. I excitedly told my parents that I'd gotten eighth rank, and that the university had emailed saying 50% of the fees would be waived for achieving a top 10 rank.

My father said, yes, okay, but the cost of education would still be upwards of 50 lakhs over five years. Even after that waiver. So I won't be able to afford it. You can be happy about what you've achieved.

And that is fine. This should motivate you to do well going forward, but I don't think I can handle this expense. So I thought, okay, that was no help. So I decided I should start preparing for the AIPMT — which in my time was called the All India Pre-Medical Test.

I started preparing for it and forgot that I had gotten eighth rank in a private college entrance exam. I think that was actually helpful — because had I been given assurance that I'd done a great job, secured a seat, and had a bright future ahead, then I might not have worked hard enough to get into AIIMS. So I think, as parents, we should not try to overthink the future, of a child. We should just ask, okay, am I providing my child the basic necessities they need to nurture their potential.

That potential belongs to the child. Don't measure your parenting by your child's success — that is their life and their future. Focus on the present: are you able to provide the basic necessities or not? As parents, we shouldn't overthink whether our child will do well or achieve the best.

There's no such thing as 'the best.' My story is quite trivial compared to some of the doyens of medical science who started their journey at 40 from a village. I have seniors and colleagues who weren't even exposed to basic amenities. They studied in Hindi medium schools, gave the entrance exam in English, and still cracked AIIMS — and are doing very well in life.

My belief from this journey is that a child's future is determined by their inherent potential, not by what their parents do. Yeah. And is that potential something a child is born with, or can it be molded? Definitely, it can be molded.

No one is born with a fixed potential. I think the concept of hunger comes into play here. Somehow a child experiences the world around them, sees it through their own perspective, and then frames a particular vision for the future — what we call dreams. They dream specific dreams for themselves and then try and try to achieve them.

So potential is actually the result of the hard work put into achieving that dream. Potential by itself is nothing. I am capable of doing complex surgical procedures because I dreamed of it and worked to build those skills within myself. I was never capable of operating when I was born, or at age two, three, or ten.

I have that potential now. But I want to go back — let's say parents of five to ten year olds are listening right now, especially from tier three towns. In India or villages of India. And they're listening, thinking — okay, Lokesh is talking about understanding your child's potential and what they dream about.

But in those towns and cities in India, children don't get many exposures. So what are three or four things parents — or even children — listening to you can do? To figure out if they're genuinely interested in medical science or not. What are two or three things they can do — in the coming week or year — to figure out if they're interested in medical science?

First, it wouldn't be right for me to speak in English if I'm addressing tier three cities in India, because our language isn't English. I'm here in Japan and I'm very deeply impressed by their culture. They have their own language — Japanese — and everyone speaks Japanese. They have their own literature in Japanese.

They speak Japanese and respect their own language. So if I'm addressing my fellow countrymen, especially — you can say that in Hindi. It's all right. Yeah.

Absolutely. What I'm saying should reach them and be understood — that's what matters. First of all, we shouldn't fixate on making our child only a doctor or an engineer. We need to give our children time and truly understand them.

We need to understand what our children feel and what they want from their lives. They find their path and love it — because parents want nothing but happiness for their children's lives. Children don't need to decide right now whether they want to be a doctor or an engineer. If someone in school sees a person fall sick and has to travel to the city for treatment — that person thinks — if only there were a doctor here.

And they decide they want to become one themselves. They want to become a doctor because they've seen real suffering in their own village. That's real motivation — they want to solve a genuine problem. Not just for marks or rank — but for a real purpose.

And that person will be the better doctor. Society needs such doctors. The ones who became doctors out of genuine care, not just career planning. So — I'm not pointing at anyone — this is just what I've understood over time.

An engineer — whether building software or a dam — fundamentally wants to solve a problem. Whatever your dream is, it eventually evolves. In 90% of cases the dream matures. Because when you get exposure, the original dream shifts.

Once they get into IITs, into engineering or medical colleges, and get exposed to the wider world. Exposure works both ways — it can kill dreams and it can build new ones. So understanding how much exposure is the right amount is also important. I think that in today's time, in our country, children from villages and small towns already have sufficient exposure.

Instagram, TikTok, YouTube — there's already too much exposure. And today we talk about how to save our children from endless scrolling. We want to save children from YouTube, but all the information is on YouTube too. That's the real challenge.

Completely blocking YouTube isn't the answer — we need to guide them on what to watch. On one hand YouTube has harmful content, but on the other hand it has incredibly valuable content too. So finding that balance is what matters. So first of all, I wouldn't want to say that.

So maybe we need to sit back and relax a little, and figure out what content is genuinely important for children to watch — those are the things that truly matter for children. Allow children to watch those. Good content on YouTube — like podcasts — is genuinely important. Don't just police what they watch.

Share with your children what you yourself have lived through and experienced. And wherever you are, I would recommend that you don't stress too much about your life — whatever you have achieved, you have worked hard for it. Live your life alongside your children. Don't stress too much.

Your child will eventually do well if the environment at home is good. If you have cultivated a good environment at home — your child will eventually do well. Whether it's in medicine or engineering — the field doesn't matter. I think that's exactly what I wanted to hear.

I think I've got my answer, which is — if you can help your child see a dream — and give them a good home environment — the child will find their own path. You won't need to force anything. Trust your children. Give them your time.

Give them your love. And trust the process. Your child will build a good future for themselves. You said the environment should be good.

So what does a good environment actually mean? I think it means — time with your parents, time with your family, and teaching them what's truly important in life. That it's okay — we may not have much money, we may not have certain things. But we sit together and eat.

We eat good food together. We play with you. That is a good environment. It's not necessary that money can buy a good environment.

Money can buy you good gadgets. Money can buy you many other things. But I don't think that is a good environment. Because then those children start to develop other problems.

And I have numerous examples of it. Then around class 8 or 9, they start seeking psychiatric counselling for their child. Saying, 'okay, my child has a problem.' I think getting into the best school is not what matters.

If you can't afford that school, don't stretch to send your child there. That will kill your child's future. Because school means peer group. Your peer group should match the socio- economic status you come from.

If you're earning ₹10,000 a month, don't put your child in a school that costs more than 10% of your salary. Because that will kill your child's future. It will not help your child achieve their potential. This is entirely my viewpoint.

See, when he goes to that school, that child's peer group will have a pencil box that might cost ₹500. And because of that school — meaning he comes home and his dream becomes: yes, I want that pencil box — the ₹500 one. So when that very dream becomes faulty, then maybe that thing is not right. We're exposed in India to the idea that sushi is very good.

Because when people eat out in India, sushi looks very beautiful. But as an Indian, when I ate sushi, I found it disgusting. For my own taste buds. What a bland thing this is!

I love chole bhature. I just cannot eat this sushi. But still, we were shown the sushi version of things. Because that is how we are exposed in the system.

How you eat sushi — sushi is very beautiful, very elegant, you eat it with chopsticks. No yaar, I am a person who eats dal-roti with my hands. That is how I was raised, and that is what brings me happiness. Now in some places in the U.

S. and even Japan, they call eating with your hands 'mindful eating'. That when you eat with your hands, those thermoreceptors activate and you enjoy your food more. So you see how the transition is happening.

Yeah, yeah. Western to eastern, eastern to western mindset — and back to eastern philosophy. So I think we are hitting some very key points here. Like, what is a good environment — within the family, right?

And it doesn't matter whether you're in a village, a tier-3 city, or Delhi. Because both under-exposure and over- exposure are bad. Like you said — but once the child has seen it, right? After that, what?

So parents should help that child — guide them in the right direction. What should a parent do to help and support that child so he or she can be on the right track? Okay, so what we follow in India — in our society — is, for example, if my child dreams of getting into an IIT, and I have no exposure to engineering — I have no engineering background; I can only support my child from a medical background or perspective. So if my child wants to become an engineer, the next possible option for me is any friend, any neighbor, anyone from my city who is an engineer — I would approach that person: okay, my child wants to achieve this — what is the next step, which exam he or she needs to clear, when do they need to appear for that exam?

So if your child wants to pursue a particular dream, approach any person near you — in your neighborhood, family, or city — to ask what the way ahead looks like. So usually after class 10 there are streams like Physics-Chemistry-Maths or Physics-Chemistry-Bio, Commerce, Arts — so that person will help you choose the right subjects and will tell you that after class 12 there's an entrance exam for that particular specialty — be it any engineering, medical, arts, commerce, CA — anything. And for medicine there's some unique advice from you. For medicine, after class 10 you need to choose Biology as your subject in class 11 or 12.

My subjects were Physics, Chemistry, Biology. Some people choose Physics, Chemistry, Biology and Mathematics. But I was not — and I am not — in favor of this. Because if you keep one foot in two boats, there's a much higher chance you'll drown.

Maybe you're so stable or skillful that you can navigate both — but there is a higher possibility that you'll drown. So I would say — if you want to become a doctor, if you want to get into medical science, do not keep a backup option. Because if you have a backup option in mind, most likely you will fall back on that backup option — because the journey is tough. So if you have a backup option of 'okay I didn't become a doctor, I'll do biotechnology, I'll do something else' — don't keep that.

have a backup option in mind, because if you keep a backup option, that option is always easier to fall back on because this journey is very long. After five and a half years, you're still struggling for another competitive exam. You don't know whether you'll be able to crack it or not. Then you get into residency — three more years.

Then another competitive exam. Overall, it takes at least 15 years of commitment before you're actually capable of doing anything meaningful. Commitment and hard work. That's a good point, Lokesh — why commitment is actually so important.

And it's very difficult to stay on something for 15 years if you're not committed to it. But at the end of the day, exams are competitive. Medical entrance exams are very competitive in India. So, you mentioned that when your father told you there wouldn't be any financial savings reserved for you...

So, you had to figure things out on your own. You were in 9th standard at the time. So did that change anything about how you spent your day? And if someone were to observe you preparing for medical entrance exams...

When you were in 10th or 11th class, what would have surprised them? Yeah. I think from the day I realized I needed to crack a competitive exam — and that it was important for my dream — I became most sincere in my studies. So what do I mean by 'most sincere'?

My sitting time increased. So, one thing that... What exactly is sitting time? So, when I was preparing...

I topped the All India Pre-Medical Exam, so a lot of youngsters, they came to me and asked, 'Did you study 6 hours? 8 hours? 10 hours?' So the truth is that I had no particular number of hours in mind, like 'I'll study for 8 hours.'

So if you study by the clock, then maybe you're not doing justice to your studies. You should study according to your capability. So for example, say you want to run. I like to run.

So, Do you run 3 kilometers every day? Or 5 kilometers every day? No — I run until I'm out of breath. That can be 2 kilometers one day.

It can be 10 kilometers another day. Or even 21 kilometers. I just run until I'm out of breath. So I think you should also...

My advice to people who are preparing for a medical entrance exam would be: Study until you're exhausted. And do it every single day. Your exhaustion threshold will vary from day to day. Some days you'll get exhausted in 2 hours.

Other days you might be able to go for 10 hours. But make sure you push to exhaustion every single day. That is your true capability. So, something...

I didn't achieve anything great. I got a particular score and did better than the rest. Younger people will do much better than me. Their exhaustion threshold might be much higher than mine.

So that was my limit. Maybe if I took the same entrance exam today, I'd end up with a rank of 1,000 or 10,000. Because there are people much better than me. The approach I followed was to work right up to the limit of my exhaustion.

And I left no stone unturned. This is a phrase that I... I don't know. I came across this phrase.

I think I read it somewhere or heard it somewhere. But it worked very well for me. So even in the last few weeks before my exam, people are afraid to open new books. They say, 'Okay, we'll just revise what we know.'

Just revise, revise, revise. But my philosophy was to leave no stone unturned. I would go through everything possible before my exam, right up to the limit of my exhaustion. And that's how I ended up getting rank 1.

But that is not what I aimed at. My aim was I will work to the limit of my exhaustion And I will leave no stone unturned. So, these were the two basic principles That I followed and I got a result. So, I think the result will vary for everyone.

But this is the basic philosophy that I work with. So, exhaustion and no stone left unturned. But what does learning look like for you back then? Study for eight hours, study for eight hours.

So, what is your... Like, how do you learn about any new things? So, I... So, my study strategy, as you would call it, was I used to break a book into multiple small sub-segments.

Like, for example, day 1, my intent was I just saw the cover of that book. I just saw the contents. Then I analyzed, okay, what is this book about? For example, class 12th biology book.

So, contents will be genetics, human system, human physiology, animals, animal farming, other things, many things. So, first, I would just see the cover of that book. I would just see the contents. Then I would just see the first page of every chapter.

I would just... So, my target is to cover all the pages of that book in that one particular day. Then second day, since I've already seen the cover of the first page, I would go ahead and try and understand the subsections of every particular chapter. By the third day, I'd actually dig into the content of each segment, so every day you're simultaneously reinforcing what you covered before and absorbing the new material on top of it.

Once I've internalized a concept, it stops being rote. People say biology is about rote learning, that you have to mug things up. But it really isn't like that. Biology is just as conceptual as physics or mathematics.

If you understand a particular concept of human physiology, then it will be consistent across all textbooks. You don't need to re-read all the books. Just go through it. You will realize, okay, this section, this paragraph is trying to explain this concept, and I already understand this concept.

This is my favorite part of the show, Lokesh. You're talking about how we learn, right? Okay, yes. In medicine, we assume that it's all about rote learning, right?

It's not, it's conceptual learning. So let's say, when biology is introduced in more depth in schools, I remember in my time, that's how it was. If someone is reading about the digestive system for the first time, being introduced to it, what does conceptual learning look like for that topic? So I feel like, for example, the topic you gave me, the digestive system.

First of all, it is equally important for teachers to instill this thought process in children, because it is very difficult for a child to understand how to learn. So, this is how learning begins. I feel very lucky to have had teachers who taught in this way. For example, the digestive system.

We need to understand why we are learning something. We need to understand the entire process. We need to understand the entire process. Until you know what you don't know, you won't know what you don't know.

Correct. That gap in knowledge is important. So you ate a laddoo, right? You need to understand the taste of it.

So you ate the laddoo, and now a question arises in my mind. I need to find an answer to that question. How does that taste register in my mind? My mind asks: I ate the laddoo, what happened?

So you ate the laddoo. So I ate the laddoo. Let's begin there. So how does it get digested?

Because saliva is involved. Because saliva is present. Where does the saliva come from? From the salivary glands.

Why do they secrete saliva? Then you dig into the details until you reach the limit of your exhaustion. So we still don't have answers to all aspects of the digestive system. If you and I sit here and try to answer every question, we will get stuck at some point.

For example, we eat the laddoo. The glands have secreted saliva. Why did they secrete saliva? Because a signal traveled from the nerve to that gland.

The nerve signal told the gland to secrete. So how did the signal travel through the nerve? Because it traveled via electrical stimulation. How did it become electrical?

Because ions were exchanged. How did the ions exchange? Because one concentration increased and another concentration decreased. So what happened?

What happened? Every concept leads to another concept. Every concept leads to another concept. So sometimes the brain gets exhausted.

Oh, wow. I haven't thought about it. It's not covered in my textbooks. And that is your point of exhaustion.

It's curiosity-based learning. As you're explaining to me, it's curiosity-based learning. So if all these questions arise in someone, okay? I mean, I remember back in my time, when I was in sixth standard, I had to ask my biology teacher: if our stomach can digest everything, why can't it digest itself?

Exactly. That's a very good question. That is actually a very good question. And that is a key area of research nowadays.

Because we have seen that in peptic ulcer disease, the stomach lining has been eroded. So the stomach is essentially digesting itself. So we have to understand why the stomach has not completely digested itself. Then we can develop medicines to repair the damage that has occurred in the stomach.

So the medicine works by replenishing the mucosal barrier. I think that is a very good question. And we are still working on it. We have still not fully answered that question.

So you see, as a sixth standard child, you were able to ask a question that 60 years of medical science has still not been able to fully answer. My biology teacher would be very happy to hear that. But let's talk about the role of teachers here, right? In curiosity-based learning.

I mean, the reason I'm starting from fifth or sixth standard is that's when biology is first introduced, in depth to us. And eventually, it will translate into how you learn about competitive exams too, right? And how to prepare for those too. What is the role of teachers?

How do they need to guide children? So I think the problem that We have a... I would not start with a problem. I would start with a positive note that how to study.

So I think this why is very important. You should always try and create a lacuna in a student's mind. So the teacher should try and create a question. And then in that class or in that particular period, in that time, they should try and find answer to that question.

If not completely, then to some extent. And then maybe they can start building on that particular platform and eventually go further. So this is how it should be. Then the second part on a negative connotation that why is this not the scenario in most of the education systems is because we have a particular syllabus that we need to complete.

And we have an exam that is gauged by certain metrics in a specified period of time. So this is often not possible. So I think the balance would be to generate some questions pertinent to that syllabus, try and answer the questions, and then it depends on the child based on his or her curiosity, how further that child wants to go after completing the syllabus. And we should not, I think this grading system or this anything, I think it should be just a pass or fail system anywhere, because the metrics, the grading that I used, the marking pattern, they curve down the why.

Because it happened with me also. Sometimes I used to get deeply engrossed in a particular question, but then a sudden realization hits me that, okay, don't waste your time in this. Even if you answer this, why, you will not achieve what you want to achieve. You need to understand these things more and answer those questions.

So the time, the constraints of a syllabus, they often curb this question, why. So maybe the question that came to you in SIC standard, you gave up on that question, because you felt it is no longer relevant. And if he didn't digest your stomach, then what's the difference between me, or you have to get a name from me, or you have to get a name from me, or the parents who are happy from me, so I will leave that question. But still, that question remains unanswered, in your mind.

So, see, a very important idea that got curbed down in SIC standard, just because of certain constraints of time and syllabus. Maybe I would have been a doctor myself, if the teacher has promoted it a little bit. But I think, you know, we talked about when learning becomes fun, keep on discovering and answering these questions. What is this?

What will I have to do with you? I won't get an entrance exam clear, right? And I won't get good marks, right? So let's talk about the expectation versus pressure balance as well.

So, what I feel is that parents should not stress themselves now, I think it's required at the same time, it becomes too much as well, right? So how do you think about parents balance expectation versus pressure? So, I also feel like maybe my thought process would evolve, would change over time, because this thought process or this viewpoint is a dynamic thing. So, what I feel is, parents should not stress themselves.

See, as kids, we never thought that our goal in life is to become parents. As kids, our thought process was different. We wanted to achieve certain things for ourselves. Then when we become parents, we think that maybe this is the way to happiness.

If our child achieves this thing, then we'll be happy in life. And when there comes another time, when our child achieves that thing, and we become unhappy again. Maybe they'll not say this thing to you or to us, but they'll feel this way. So, as parents, we need to understand that we are still kids.

So, therefore, I raised the question mark that when you were a kid, I don't know when I stopped being a kid or when I'm not a kid. So, we are all kids. We now have our kids, but we are still kids. So, we should focus on ourselves.

We should relish our time with our children. And we should not stress that, okay, and maybe that is not the best thing for them. If you would have become a doctor, maybe you would not have been that happy as happy you are now. Or maybe if I became a doctor, had I became something else, I would have been much more happier, much more content.

So, it is all, I think, this concept of destiny also comes. So, we must not forget that, okay, we are mere human beings. In this ecosystem. And let's not stress ourselves.

As children, we stressed ourselves into satisfying our parents. And then as parents, we are stressing ourselves for our kids. And later, we'll stress for something else. Let us enjoy our life and let us be happy with whatever present moment we have.

So this is my, I think, viewpoint as a parent and my viewpoint as a kid. That's a beautiful viewpoint. Expectations and stresses actually steal your childhood and your parenthood as well in a lot of ways. If that's the right term to use.

And I completely agree. No, one thing is, you know, we all need to prepare our kids for failures. I'm sure like there must be a few surgeries that won't have gone well. Right.

Or even when you were preparing for mock exams, intrinsic time play, then there must be a few mocks where you would have not scored well at all. Right. So how do we think about like, how was your, like, go back to your present and past as well. Like, how do you deal with setback?

So my first official failure was in class third standard. When I needed to repeat my class third standard, because I was not fit enough to get promoted to fourth standard. And the reason was because my father was doing his residency. He got selected in super specialization.

So he switched cities. So four months I studied in a different school in Lucknow. Then I went to Banaras. So that was not, so the school did not feel I was fit enough to be promoted.

So I repeated class third. So I repeated class third. So I never felt at that time, maybe that it was a failure because my parents never made me feel that I failed. They just said that it was your new school.

These are children of your age. So maybe you continue with them. So I continued. Maybe when I was in class, maybe 10th, they told me in a friendly atmosphere at home that, okay, this happened with you and you flunked the class third.

So then, okay, I was also happy. Oh, and now it becomes a story that I can tell you or I can tell the public that, okay, I flunked class third. So maybe failure, the stigma of failure should be removed from the word failure. So failure should be, uh, should be maybe taken in a very lighter note that, okay, you failed, but yes, things should be analyzed that why you failed.

You failed because of these particular circumstances. And if those circumstances, for example, say family circumstances, personal circumstances, then maybe it is not failure. It is, you needed some extra time for yourself. You gave time to your family.

You gave time to those circumstances and then you are back in. That is not exactly a failure because the race is very big and we try and age the race in a very small. So it is not a hundred meter race. It is not a 10 kilometers race.

So for parents, let's say, I mean, how many people are sitting for need? 6 lakhs, 7 lakhs in India every year? Yeah, I think so. I think so.

6-7 lakhs, right? And how many get selected eventually? I'm not sure of the exact seats now, but maybe, uh, 5,000, I would say, would get a MBBS seat. So less than like 2-3% overall.

So those kids were preparing and they could not get selected anywhere. Right? Medical, dental, or whatever. What should the conversation be with their parents?

If a child doesn't have a phone call for their parents, what will they say? So that is a very tough question for me because, and I may not be able to give the right answer to it. But yes, if I would visualize myself in that position, so I will just ask that you don't forget it, why did it happen? If it happened or not, you think about it, why did it happen?

Because you were not well prepared for it. You want to be better prepared for it next time. Or were you not interested in doing this? You were just doing it out of some pressure or some, uh, thing that you feel that maybe you'll be able to achieve later in life just by clearing this exam.

So I would, my response would be that you thought that why didn't happen? If you were not full of preparation, you feel you need more time or what was the reason that these, like, two years or one year was not sufficient for you? If you can introspect this and you feel you want more time, then sure, continue with your journey. You have a long life ahead.

Some people live for 15 years, some people live for 40 years, some people live for 90 years. So this one, two, three years won't make any difference. I'll be able to feed you for these two, three years. I have sufficient funds to feed you for two, three years.

So, uh, I think you can continue with your journey. If you feel, ki, "Main is me interested in tham, ma falto, ma fuzz gaya, maine us time pe galet decision liya." To, okay, we still have other options we can re-discuss. So I think it is important to delve into your child's brain ki what he or she thinks.

Kya, woh, is me odd time chaata hai? Matlab, woh, is race mein nahi jeet pa hai hai? Because he was not prepared for preparation time, or he wasn't interested in history. Between a child, let's say, you know, setbacks would come in various forms, right?

Maybe you flunked in the school or maybe like you didn't clear the entrance exam at all, right? So, in your experience, what have you seen a difference between a child who says, like, okay, let me analyze and as to why I didn't get in and then start working on those versus who get into depression, which is something not much talked about in India, right? What, in your view, happens in the mind of those two children? So, what I recollect from my experience and what I feel is, this concept of depression or this concept of anxiety comes from the peer group.

By peer group, I mean not just friends or the peers with which a student or child is exposed to, but also the family. The immediate family and the near family that the child is exposed. So, I think we should be very cautious in the environment in which our child is. Most of the depression, or that fear, comes from the thought of 'what will people say.'

So we need to understand that all these things will eventually fade away. What stays with you is your parents — everything else is very transient. So try to protect your child from this external atmosphere, and your child will eventually come through and do well. So, as parents, this is what I mean by environment.

So, you should try and protect our child from external influences. So we need to understand that all these things will eventually fade away. What stays with you is your parents — everything else is very transient. So, you should try and protect your child from this external atmosphere and your child will eventually come out of it and he will do well.

So, as parents, this is what I mean by environment. Environment, we mean that we should try and protect our child from the external influences. So, if your child is exposed to that environment, then automatically your child's brain will also start functioning the same way. So, parents will start thinking this is my failure as a parent that I am not able to give my child the best education and then the whole vicious cycle will continue.

So, what do you say is that the most important thing is the most important thing. So, I think these Indian proverbs, these Indian sentences make a lot of meaning and I over time have started to understand these sentences more and more now. You know, Lokesh, I think I promised you one hour but because the discussion is going so well, I think it's something that I would a lot of parents and kids would find useful. So, I want to continue for the next 10 minutes as well, if that's okay with you.

Yeah, sure. Today is Sunday. I have no commitments. Okay.

I want to be careful about the doctor and surgeon's time, right? I mean, you have more important things to do as well. I mean, I have no commitments today. I'm okay.

I am also enjoying the discussion because see, the best part about it is it was not pre-planned. So, whatever is coming to my mind is maybe I am able to root it out from something deep within me. So, I am equally enjoying the conversation. That's great.

So, I want to go back to you said 5000 seats. Is India producing enough doctors? So, that is a risky statement for me to make. So, because it is a conversation that will be streamed.

Correct? So, I'll try and simplify it. So, I am no administrative expert. I don't know the grassroots situation of our country so well as the administrative experts would know it.

But from my mind, medical profession. See, there are many controversies to this statement. So, maybe I will not be able to put in… Let's clarify here, Lokesh. This is less about what any government is doing, right?

I am talking about the last 30 years, like 35 years since we have grown up or the Indian population is growing up. I don't think it has anything to do with what government is doing or not doing it. We are just thinking about that if you want to make a doctor with a 5-6-6-6 selection. And then, you have also seen that your past patient growth was in Ames and so on.

So, India is a good thing. Why are you producing more doctors? So yes, India needs good amount of doctors for its population. But what is equally important to note is it needs good doctors.

So it is not right that just to increase the number of doctors, you compromise on the quality of doctors. So it needs. I think I cannot pinpoint a particular amount in INR or US dollars, how much is invested by the country to make a doctor a super specialist, because the contribution of our government of our Indian government is immense to make a particular doctor. So if we are just increasing volumes, then are we doing justice to our society just by increasing the number of doctors?

So for example, if I feel I fell ill, or if any one of us fell ill, what are we looking at? Are we looking the quality of care? Or are we just wanting to go to any doctor? Well, you see that in India, we have lots of doctors in tier two, tier three cities now, and even tier one cities have lots of doctors, lots of corporate hospitals.

Now the confusion is whom to choose? Because they are all doctors. So I think this question is tough is it's a very tough question to answer. But because the debate around quantity and quality will continue.

And someone or the other has to pay the price between quality and quantity. So, you know, I want to, I think, it's a separate discussion itself. And let's leave it at that for now. I want to come back to what you practice right now.

And also one of my favorite subject to research, which is gut health. And I live in Silicon Valley, though, the most popular case of gut health is, of course, Steve Jobs, he unfortunately died of pancreatic cancer. When we were talking about it last time, you know, casually, you gave me some very concerning insights about what's the, you know, the, the trend in, in gut health in India, and especially in cancers associated with it. Like, do you want to talk about what you observe in your practice, especially recently, what is happening in India?

So the incidence of malignancies of cancers in India is rising, or, and there's a second component to it, that we are able to diagnose more cancers now. But the problem, and this is not just in India, this is across the globe, as I know of, like countries that I know of, it is a common problem across the globe. So I do not exactly know the reason. It is a multifactorial cause, the environment, the food, the water that we are exposed to.

But as a medical practitioner, what I understand now is, it is also important to generate awareness in our society, regarding early detection of cancers, and to remove the fear of the world of the word cancer. For example, it still happens in our society that if, if a person feels a lump or some problem in his body, then that person is afraid to go to a medical practitioner, Because he or she feels that the medical practitioner would diagnose something, and then he's all stressed out. The financial stresses, the personal stress, the stress of future, prevents that person to approach a medical practitioner. But what we forget is that in this battle against cancer, malignancy, it is important that we need to diagnose these conditions early.

The earlier we diagnose, the more complete would be the cure. If we diagnose these conditions early, now we are capable enough to remove or to treat that condition completely, if not completely, to a great extent, So that that person can have a good quality of life and a long enough life. So what are the most common symptoms that family should not, early symptoms that families should not ignore? It's a, it's a broad question coming to my speciality.

So I am a gastro-intestinal and HPB surgeon. So the common symptoms that we encounter in our patients is one is jaundice. If someone's eyes turn yellow, urine turn yellow. So we should not neglect this symptom.

That okay, it's going to be hepatitis, it's going to get water or food. We should try and, Go to a medical practitioner and try and diagnose, get the diagnosis made. That is why this pillia, this jaundice, why? We should not miss these symptoms.

That is very important. That is very important. The elderly population, more than 60 years, Has no sleep. They say, "I don't sleep at all."

The younger population feels that they have been aged, And they don't sleep at all. That is a very important early sign, early symptom, That if you don't sleep at all, It is a symptom that our body is not good at all. Because again, this is different from that hunger, But this hunger is very important. The hunger that we discussed, That was also very important, And this hunger is also very important.

So, sleep at all is very important. So, Think these are the early symptoms. If someone feels like they must approach a Medical practitioner And try and get themselves diagnosed. They should not fear the medical Treatment now.

It is safe. It is increasingly becoming more safe and coming to the surgical Speciality That I am in. If you have any surgery in early stage cancers, you are able to Completely Cure it almost. So you should not be afraid of surgery.

You should go to a Qualified surgeon. I don't think-- I think, any qualified surgeon who has given you your 15-20 year speciality in Training, He will give you the wrong advice. So, the wrong advice concept is that we get the wrong advice, money minting. I think they are all market driven and no experience, No super specialized surgeon or practitioner would ever give you a wrong advice.

Because I can tell you from my experience, after 15-20 years of rigorous Training, It is no longer about money maintenance. We don't need that money now and we have sufficient money to take care of our Needs. So what we need is our patient's well- being, their happiness. So yes, private sector demands certain amount of funds from the patients to Deliver that patient care.

That is okay. But I think the advice would be right from almost all the medical Practitioners. So we should not be afraid of this thing and we should try and get our Diagnosis. And treated early as early as possible.

Especially you said like now the kind of surgeries you do minimally invasive Surgeries Are five millimeter incision, right? So five millimeter would be like one third? Correct. So wow, things have progressed for good.

That's crazy. So a lot of these gut health issues and eventually of course malignant issues Are also about a lifestyle, right? Then, And food habits. Any advice for everyone?

I think this applies to anyone, not just kids or parents, but everyone out there. What should we watch out for, and what things are good for gut health? I think a few things. One is, we should stay away from processed foods.

Processed food is a by-product of our lifestyle, because we are so busy. We have pre-packaged foods. Just warm it in the microwave, ready in 5 minutes. See, there is a natural element to everything.

If something heats up in 2 minutes, that is not natural. So processed foods and a sedentary lifestyle. A sedentary lifestyle means we are not active. Obesity is a risk factor for many cancers and numerous diseases.

I am in Rajasthan currently. I am in Jodhpur, so there are a lot of... Obesity is very widely prevalent there, so I perform bariatric surgeries as well. Bariatric surgery is a procedure for patients with a BMI above 35.

They are unable to lose weight through lifestyle changes alone. We operate on them to help them lose weight. So the question that is often raised is, we do eat food. This is our traditional food.

We eat our food. That is why we are fine. So that is a myth. Because eating food is good.

But obesity is a different matter. Obesity is a risk factor for multiple diseases. It is akin to having cancer, or similar to having a heart condition, because we never know when the problem will strike. And the clock is ticking.

Every year you carry extra fat, you are inviting more and more disease. And once that vicious cycle sets in, India is now the diabetic capital of the world. India has the highest number of diabetics anywhere on the globe. So this is a serious concern.

To answer your question, I would say two things: one is processed foods, and the second is a sedentary lifestyle and obesity. We grew up in the Maggi generation, right? And then the next generation grew up on McDonald's and KFC, basically. I mean, we ourselves haven't touched Maggi in five years, and we cut it out completely.

But what mindset shift is required to actually change those food habits? There are many patients. There are many patients, people are on Instagram, they don't want to do this, they don't want to do this. But what have you seen in the mindset of patients who are able to change that lifestyle versus who are not?

I think give time to yourself. I am here in Tokyo, here for one month and I have one more week remaining. So during this three week stay, I have myself opened five packets of processed foods. Those pre-packed dal makhani and pre- packed that have a shelf life of maybe one year or one and a half years.

So the reason is that I am in a hurry that I have to make food after the evening or after the evening I have to make food and warm it up. I have to sleep quickly so that I will go to the operating room in the morning because I have to commute. So we need to understand that what are we here for or what are we doing to get a better life. And in that race to get a better life, we are actually compromising our life.

So it is not something that I can just preach and I can continue doing it myself. So I also tried that I will soak it and soak it. Then I add some spices and make chole and rice for myself. It is tough.

It needs time because they also get some water. I need to wash those dishes myself. So you need to give that time to yourself. And you need to sideline yourself from that race.

I would say. And we need to understand that life is big. And this is what our achievement is that what we are living at present. So we should not try and that we have so much work that we forget that what our life actually is.

So this is what is actually happening. It is no one's fault. And it is very easy for me to say that don't eat processed food, exercise two hours daily. But actually, am I fulfilling that 100%?

The answer is no. Maybe to the extent 60 to 70%. But yes, I know that it is important. And I will try my best to increase this percentage upwards of 60-70%.

But yes, this is important. I think what you also said is we should not strive for perfection in any goal as well, right? Correct. Perfection doesn't exist.

There will always be days when you still eat processed food. But it is like incremental improvement that you are talking about. Correct. I think I would like to end the show with the last question, which is the topic of this show.

Which is, are geniuses born or made? Which is, I think I know the answer from our discussion so far. What answers are you going to give? But I want you to explain an answer to our audience, which is, are good doctors born or made?

So I think this was the only question that I prepared for in my mind. Because I knew that this question will be coming. And I expected this question at the start of the interview, maybe, of the podcast, maybe. So I looked up for the definition of genius on the dictionary, Oxford dictionary.

So to my mind, I think this word genius should be replaced by talent. Is talent born or is talent made? Because there is no one who can be called a genius. When I thought of the answer to this question in my mind, only maybe two or three names came to my mind whom I could say that they are genius.

Maybe Albert Einstein, Shakuntala Devi, and Ramanujan. I think these were the people whom I can call that they are genius. And there is no other name that came to my mind. And the reason is so, why so?

Because I feel that these were the people who were not exposed to anything. Still they did something that we can still not even think of. So that is genius. And rest everything else is talent that a person acquires during one's own life and from one's own experience.

So I think if you rephrase this question as, is talent a person born with a particular talent or is the person gains a particular talent through his or her experience? So I think the answer is very clear. That person, no one is born with a particular talent. Everyone gains it.

And regarding this genius is made or born. So I think there are very few and only the geniuses will be able to get, give those answers, give the answer to these questions. So I am no genius to answer this question. No, I think that's a fair point.

But if I were to rephrase this question is, are medical entrance exam toppers born or made? Because this is a question I am sure like so many students will be having. Yeah, this is a rank one. So it will be different.

Right? So what's your final answer on are those toppers born or made? No, they are definitely made. Because I was, I flunked my class third.

I was on the verge of flunking my class seventh. And not seventh, I think fourth or fifth. But during my medical school, I did not perform well in first year or second year of my medical school. And then when I got serious, I maybe dropped my post-graduation entrance exam.

So there was nothing inherent in me that I can say that, yes, I was born with a talent or I had that inherent talent to top a particular exam. So I think that hunger and that my drive to achieve a particular thing helped me in whatever result I got. So to answer this question precisely, yes, no one is born or no one has an inherent talent to do good in a competitive exam. And as a final point, I would say that the result is not actually important.

The result is not the rank that you get. The result is what is the actual result of that result that you enter into a training program which you dreamt of. That is the final result. And that rank becomes meaningless.

If I achieve rank one in my PMT, post graduation, super speciality, they are all meaningless now. Because what all were the fruits of those rank or result, I've actually read those fruits. So now what is important is what I will do from now on and not what I have already done. So I think this rank thing should go away now.

And what is important is that what a person wants to do and what is important to achieve or to be capable of doing something what he or she dreams of. Yeah, I think you articulated it really well. It's more about the dreams and how those dreams convert into process and then to the purpose which is serving patients versus getting a rank. So on this positive note, Lokesh, thank you so much and appreciate you taking out your time.

Lokesh, thank you so much.