Building India’s Medical Future: Sneh Bhargava and the First Four Decades of AIIMS.

In 1956, the All India Institutes of Medical Science, or AIIMS, was established thanks to the efforts of Health Minister Amrit Kaur to create a center that would serve a crucial triple purpose - not only to heal the sick, but to allow research to be carried out on the diseases unique to the Indian subcontinent, and most importantly, to train the medical personnel needed to bring a high standard of medical care to those remote regions of the nation that had effectively no modern health services. 

Today, that institution is a global center of medical research and care, but to get to that state required pushing against a mountain of tradition and institutional inertia, and for the first four decades of its existence, one of the most persistent voices contributing to that grand push was Dr. Sneh Bhargava (b. 1930), who began her career in one of the Institute’s most disrespected and undersung branches, which she raised by pure force of will to a global level of recognition, before assuming the directorship of the entire organization, steering it into a new era of modernization and esteem.

Bhargava was born to a loving, somewhat untraditional family. Her mother did not have a higher education, but wanted to keep learning after marriage, and so her father brought in a series of private tutors to allow his wife to learn whatever she wanted. Sneh was their first child, and came under the intense observation that often falls to the first born, her mother in particular noticing Sneh’s predilection for turning her dolls into doctors and patients, and then, when her younger sister Pushp arrived, she in turn became Sneh’s regular patient, suffering from all manner of pretend illnesses it was Bhargava’s job to conquer.

At the age of five, her parents sent her to boarding school, at the Sacred Heart Convent in Dalhousie, as her father’s job required constant moving, and the family reasoned that a boarding school would provide her with some continuity of friends and mentors that she otherwise wouldn’t have. Though her experience at the school was mixed, with some of the nuns seemingly making her their favorite target for discipline, she did establish for herself there a self-conception as an individual with a gifted mind that was worth developing, a sentiment echoed by her father, who believed that the best use of his money was in the educating of his children.

The easy progress of family life was interrupted suddenly in 1947 with the partition of India. Her family was Hindu, and found themselves suddenly located in a region under Muslim governance. The days that followed were ones of carnage and panic on both sides of the haphazardly drawn border, as stories spread of entire railcars getting stopped by religious zealots, their inhabitants gruesomely murdered as they attempted to flee the country. That fate was nearly Bhargava’s - in her memoirs she describes her train pulling up to a station and witnessing the dead bodies of Hindus from the previous train who had been pulled from their cars and killed. Fortunately, her train made it to safety, and her father was able to find a new position without too much difficulty, though all of the family land now lay across the border, its future uncertain. 

Bhargava, for her part, overcame the trauma of partition and found her feet, attending Lady Hardinge Medical College, Delhi’s first medical institution, founded in 1916. Here, students were already in the mad scramble to define their likely future specialties, weighing chances for advancement against salaries against likely vacancies against prestige. The field that precisely no one was talking about, however, was radiology. At the time, radiologists were treated as mere technicians, laborers who mechanically took and developed x-rays, a dead-end career to be distinctly avoided if at all possible. 

Bhargava saw the job differently, and took the time to discuss its potential with its most skilled practitioners. What, after all, could be of greater use than the ability to probe the contents of the human body without having to open it up? And what might the technology be able to do as it improved? Perhaps an era would come when you could take images of soft tissues without needing to inject potentially dangerous contrast fluids. Bhargava signed up for a six month posting with Dr. Gadekar at Irwin Hospital, specializing in radiology, much to the chagrin of her colleagues, who felt she was squandering her potential. She pressed on and, after learning all she could in India, where the low esteem that radiologists were held in had prevented the profession from flourishing and developing, she decided to travel to Europe in 1955, and learn all she could from the most advanced radiological practices there. 

She was 25, and though she didn’t know it yet, this excursion would set the stage for the next three decades of her professional life. Here she learned about B lines from their discoverer, Dr. Peter Kerley, and how to use them to detect congestive heart failure. This was a distinctive step forward in what X-Rays could reveal non-invasively, and it was far from all Bhargava would learn abroad. During her 18 months at Westminster Hospital, she took every opportunity to look through the X-ray libraries of nearby hospitals, where images were accompanied by detailed histories that allowed her to build up what would become her legendary mental Rolodex of how different medical conditions manifest themselves on X-Ray film. 

She returned to India, where she worked at Irwin Hospital to build up experience before her ultimate goal of working at the newly established AIIMS. Arriving at AIIMS in 1961 (articles about her career assert 1958 but her memoirs say 1961), she found a radiology department in dire straits, with minimal equipment, and no esteem from the other departments. It was all she could do to get doctors to include histories with their requests so that she could better advise them on what she was noticing in the images. Most doctors simply wanted an image snapped and to have it sent on up to them, completely neglecting the specialist knowledge of the radiologists. 

She formed alliances with the departments that used her services the most, building up trust levels as she dazzled her colleagues with her diagnostic skill, and began arranging inter-departmental meetings where information about cases could be shared, radiology having its own distinct seat at the table. Her skill and professionalism gained notice, and with notice came the ability to call on more funding for her department. She was a great believer in pushing the technological edge, and recognized the importance of CT scanning and Ultrasound techniques from her first acquaintance with them, lobbying hard to purchase machines for AIIMS in the face of traditionalists who held such imaging to be a waste of money, and an insult to the expertise of physicians. 

As ever, she got what she wanted, and once again, her results won over skeptics as AIIMS became a sought-after center the nation over for the variety of non-invasive options it offered for diagnosis. By 1970 she was head of the Radiology Department and a Professor, and when, in 1984, a new Director of AIIMS had to be found, Bhargava stood top of the list in terms of seniority and contributions. Not only had she made AIIMS Radiology a nationally recognized department sporting the most up to date equipment, but she had also carried out extensive research on the use of radiological methods to non-invasively spot a variety of otherwise difficult to diagnose conditions, include tuberculosis of the central nervous system, rheumatic heart disease hypertension, neurocysticercosis, and liver disease, along with the discovery of regional variations of global diseases that have their own distinct markers. She had not spent her career fostering political connections as other doctors did, but her track record spoke for itself, and Indira Gandhi, who had returned to the Prime Minister chair in 1980, was fully in support of a woman finally assuming the directorship of AIIMS, and so it was that in 1984 Bhargava made history in assuming that office.

Her first day was hardly one of celebration, however, as it coincided with the assassination of Indira Gandhi, who was brought into AIIMS at virtually the same moment as Bhargava arrived to assume her new role, and so the history-making appointment was overshadowed by the national tragedy, as Bhargava’s first official duty ended up being crowd and narrative control over Gandhi’s death. Over the next six years, however, Bhargava continued to apply her characteristic no-nonsense energy (colleagues once said that, to get doctors to behave, all they would need was a scarecrow with Bhargava’s head to place in the hallway, so generally feared was her strict attention to detail and patient service) to reworking the institution, creating new departments to keep up with global medical trends, including centers devoted to biotechnology, medical education, and epidemiology, while also going through the delicate political dance of finding more housing to meet the exploding demand from the hospital’s growing staff.

By her retirement in 1990 from AIIMS, then, Bhargava had every reason to sit back and enjoy an old age, secure in the knowledge that she had made a profound difference on medical care in India. But of course that’s not what she did. Instead, she threw herself into a new six-day-a-week schedule split between service at Sitaram Bhartia, a non-commercial hospital where she was made medical director in 2008 at the age of 78, and oversaw all of the minutiae, from nurse training to equipment repair schedules to security, and her role as a guiding force behind the foundation of the Dharamshila Cancer Foundation and Research Centre, which opened its doors in 1994 as the only cancer research institute operational in northern India. Bhargava’s iron constitution, aided by a life of constant activity and social interaction, gave her the ability to continue doing the work that gave her days meaning into her 70s.

And 80s.

She only resigned her formal positions in 2020 at others’ urging that she not subject herself to COVID at the age of 90 by doing her normal hospital rounds. The break gave her the time to recall her life and record it in a memoir, The Woman Who Ran AIMS, which was published in 2025 around the time of her 95th birthday, and some seventy years after she first went to England to discover all she could about the promising world of radiology. In an age when many doctors put their prestige and salaries first and foremost in their career calculations, she devoted herself to the field that she thought had the most promise of doing good, and she kept that devotion to patient service foremost in her thoughts throughout all her decisions of the ensuing six decades, ruffling feathers by holding those around her to the same patient-centered ethos that drove her, while inspiring three generations of doctors with her willingness to give the last shred of her time to improving medical care in her native country, resisting at every turn remunerative temptations to travel West and take up a position there. Her parents raised her, as she described it, as a girl of “Eastern values and Western education” and her long life of service has done honor to both those halves, and demonstrated to the fullest what happens when medical traditions share the best of each other’s worlds.

FURTHER READING:

Bhargava’s memoirs are a wonderful source of information about the history of medicine in modern India, and the tangle of political and professional expectations that a doctor must overcome in order to institute change, as well as being a sort of love-song to the power of radiology as it has developed over the course of the last century, a reminder to all of the remarkable power of this technology that has become so ubiquitous as to seem banal, but which has saved us as patients from so many diagnostic torments. It’s not an easy book to track down, but worth it when you do!