Playing Doctor

A parent pushing his child to perform surgery is pushing too hard, experts say.

He'd dressed for the surgery in a dark-blue bow tie, light gray blazer and white-striped shirt, hair perfectly combed, stethoscope dangling from his neck. When the video crew signaled, Akrit Pran Jaswal -- sitting behind a desk cluttered with anatomy textbooks, parents hovering nearby -- gazed into the camera and described the procedure he was about to perform on an eight-year-old girl.

"Today, I am very much happy to have an opportunity to serve the poor community," he stammered, glancing repeatedly at his father. "I feel pleasure that I am conducting a surgery independently: Dupuytren's Contracture."

The girl, Anju, had severely burned her hand as a toddler when she crawled into a cooking fire; her fingers had been closed into a tight fist. Her father had come to Akrit's father, Kulwant Singh Jaswal, seeking help. After requiring the man to sign a waiver, Jaswal agreed. Surgical equipment had been purchased, the laboratory prepared, the video crew hired. All was ready.

Akrit Jaswal, the boy wonder, in Denver.
Akrit Jaswal, the boy wonder, in Denver.
Akrit Jaswal performing surgery in India.
Akrit Jaswal performing surgery in India.

At noon on November 19, 2000, Akrit -- now dressed in surgical garb that was much too large for his tiny frame -- began operating. He administered an intravenous and a local anesthetic, then meticulously sliced away the scarred tissue with a scalpel, separating the fingers, opening the hand. His father and another assistant hovered nearby. At the height of the procedure, the girl groaned, squirmed and cried. Akrit's mask started slipping off his face; his gloves became bunched and wrinkled. But after about forty minutes, it was all over.

Later, the girl sat beside her father, holding her bandaged hand. The father smiled, bowed his head and clasped his hands in a gesture of thanks. Akrit nodded graciously, returning the gesture, then grinned and said, "Good health for all."

Akrit Jaswal was seven years old at the time.

He has had no formal schooling and no medical training, yet his father believes he possesses the mind of a master surgeon. Akrit has memorized medical books, witnessed surgeries, performed experiments, prescribed drugs and developed what he claims is a cure for cancer. But the prodigy cannot share what he knows with the medical community; he cannot learn what he does not know. According to his father, Akrit is the victim of "age discrimination." Medical schools in India will not accept anyone under seventeen; they've told Akrit, who is now eight, that he must wait. This is unacceptable to Jaswal.

"If he is assessed and evaluated, he must be allowed to appear at medical colleges and schools," Jaswal says. "Perhaps he has the cure for cancer. He should be given permission to work on it. He must have a chance."

Jaswal, Akrit and the rest of the family arrived in Denver on a muggy August day. They'd sold some of their land holdings to finance the trip and had no money to visit the sites or go shopping. For the most part, they sat in their motel room, watching movies, making appointments, and hoping that with the help of Linda Silverman and others, they might find enough support to open doors that have been slammed shut in India.

"He is a special case," Jaswal said, sitting in that motel room filled with cigarette smoke. "He should be treated as one."

His parents spotted Akrit's gifts the moment he was born on April 23, 1993. He never crawled. He never wore diapers. He was walking and speaking clearly at ten months. By age three, he was reciting Shakespeare and reading T.S. Eliot. "He never hesitated to learn," added Jaswal, who has a Ph.D. in economics. "He explored and explored and read everything. He was like a mature man."

Akrit's insatiable curiosity focused on medicine. He would ask his father how people died, quiz his friends in academia, and "order my father to bring me biology books," Akrit said.

Jaswal assembled a collection that includes Gray's Anatomy, Textbook of Surgery, Book on Anesthesia, Human Anatomy and Medical Physiology. The boy devoured them by studying an hour a day, focusing completely. What he learns, he retains "like a photographic memory," Akrit explained. "It requires only concentration."

"We are unable to know these things he is studying," Jaswal added. "I consider him a scientist. We cannot teach him. He has his own systems. We can only provide him with books."

Jaswal quit his job as an economic and business advisor in New Delhi and moved his family back to his hometown of Himachal Pradesh. He devoted himself to the education of his son, who has scored in the very superior range on Indian IQ tests. Because of Akrit's abilities, Jaswal decided not to enroll him in traditional schools. Instead, he and his wife founded their own, called Hamlet, where they and other teachers instructed over 200 children. Akrit started attending classes at age three, immediately surpassing his classmates.

"He was the first to see, the first to raise his hand," Jaswal said. "He called me, 'Sir,' never 'Papa.' He was very serious about his studies."

Within two years, Akrit was teaching courses in math and English, a better teacher than his father, Jaswal says. But although he excelled in other subjects, Akrit has never been interested in anything that doesn't involve "living systems," he said. "For me, medicine only. Nothing else."

His dream is "to be a neurologist and an oncologist," he added. "Cancer is something special. It is my mission. Many scientists have tried, tried, tried, but they cannot cure it. But it is curable. Much curable. One hundred percent curable. And I will make a cure."

Jaswal built his son a small library and makeshift laboratory in their home, stocking shelves with textbooks, anatomy charts, microscopes and dissecting instruments. He introduced his son to doctors, medical administrators and professors, who were so impressed that they allowed Akrit to witness surgeries. Akrit did his own operations, too, experimenting on animals.

"We went to the poultry farm, bought a live chicken, he dissected it, and after, we ate it for dinner," said his mother, Raksha Kumari Jaswal, who has a master's degree in literature.

As word of Akrit's abilities spread, villagers crowded their home, seeking advice or trying to catch a glimpse of a boy they considered a god. A guru proclaimed Akrit the reincarnation of a German doctor. "He hates it," Jaswal said of his son's reaction to such idol notions. "He does not listen to them."

But Akrit did begin to treat some of the people who appeared on their doorstep, moved by a genuine concern for the suffering of the poor, his father says. Akrit consulted his textbooks, discussed the cases with doctors and prescribed medicine for more than a thousand people. He treated a man suffering from a brain disorder. He treated a man suffering from lip cancer and cured him in fourteen days. He treated an elderly woman with a leg injury.

According to Jaswal, Akrit's patients were fully aware of his age, of his self-taught skills and his lack of experience. "Indians are accepting him," he added. "This is their choice. There is never a complaint." And since many of the people who request Akrit's help are poor and desperate, he points out, how can Akrit refuse them?

"Is it wise?" Jaswal asked. "No. It is illegal. But he has met with surgeons. He has watched them. He discusses with them. He has learned. He knows. Whatever happens will happen. I pray to God to help me."

Jaswal flashed snapshots of Akrit with his patients. The boy opened an overnight bag and began tossing out packets of pills. "He knows all medicines," his father said. "National, international."

Although Jaswal acknowledges that the videotaped surgery was an unusual way to promote his son's abilities, Jaswal said he had to provide documentation of Akrit's skills, no matter how difficult it might be to watch. "But he did it, sir," he pointed out. "He is very brave. I was astonished. I was shivering when it happened. As he explained to the media, he turned a plastic surgery into a simple surgery. He proved his abilities, illegal or not."

"The hand is all right," Akrit concurred. "Very, very fine."

Jaswal even took his son's case to India's prime minister, but he found no help in his crusade to get his son into medical school. "He was appreciated by all, but refused admission," he said. "Nobody has time to help us. Everyone is too busy. We cannot fight the law."

Or the media, for that matter. Jaswal has been vilified by the Indian press for isolating his son from other children, living his failed medical dreams through Akrit, parading him before television and news crews "to air his worth" and stealing the childhood of a boy "who has never been taught nursery rhymes."

"The Ex-child," a 1998 article in The Pioneer, quoted psychologist Dr. Jitendra Nagpal: "All this will take a toll on Akrit's life. He has no friends to call his own except his parents, has never been to a school and has no social interaction. Though he may score above average on the memorizing ability scale, he may be just average in analytical ability. The child's psychological and social development has been neglected at the expense of his intellectual development, which is harmful in the long run. A fast budding of intellectual faculties at a young age usually leads to burnout."

An article in the Indian Expressquoted Dr. Vishwajeet Rohil, of the Maulana Azad Medical College: "Most of what he has studied is from books and by rote. He needs to study in a systematic manner. Personally, I feel the parental pressure put on this child is tremendous."

Those who met with the Jaswals in Denver echo that fear. They worry that father and son are feeding each other's fantasies. At best, Jaswal's single-minded desire to see his son become the world's youngest doctor could lead to Akrit being barred from practicing medicine altogether. And at worst? You have an eight-year-old boy playing doctor -- on live patients.

"I'm deeply concerned," Silverman says. "The relationship between father and son is different than anything I've come across before. All the other parents I have worked with have realized that these are children with adult minds, but with children's bodies and children's level of experience. They make room for the children to be children. They allow them to play with other children. They do whatever they can do to develop their social skills. They make sure they are involved in age-appropriate activities. They are very concerned and aware of the whole child. In my career, I haven't run across a parent who has made the decision of what his child was going to be and then pushed them into that mold. It feels to me like the son is doing what he thinks his father wants from him. He's expected to be a little adult most of the time. There's some question as to who is playing doctor here. Is it Akrit who is practicing medicine without a license, or is it Jaswal?"

Silverman tested Akrit. Because of client confidentiality, she cannot reveal what is in her report -- but Jaswal was bitterly disappointed with its contents. "She has criticized everything," Jaswal said. "But we know his knowledge and we know his activities. It is just somebody's report." Although experts have recommended enrolling Akrit in gifted programs, Jaswal said his son is intent on going to medical school.

Sitting in the motel room, Jaswal produced another report, an evaluation from New Delhi psychologist Dr. O. C. Kashyap, who concluded that Akrit "is so full of confidence and may at times have an inflated view on future outlooks," but shows "no signs of psychiatric abnormalities."

"He shows superior IQ," Kashyap wrote in his July 13 evaluation. "This child is unique in displaying much higher level abilities and if more opportunities are extended, he could perform exceptionally at a much higher level."

Jaswal dismissed the critics in India as "fools," insisting that he held a press conference for his son only because news outlets were constantly pestering them. He displayed snapshots of Akrit playing with other school children, and ordered the boy to recite nursery rhymes, which he did. Akrit also listed his favorite movies -- The Mummy Returns and Exit Wounds, then described his favorite sports, such as volleyball and football. He rolled his eyes, rubbed his hands and fumbled to name a favorite toy, jokingly offering "dissection instruments" and then, finally, "toy pistols."

"I will build a dinosaur," he asserted." And a dragon, also. A realdinosaur. I will! I can do it! I will!"

"In other things, he is a boy," his mother said. "The kids are always calling to him, `Come play with us." But in studies, he is special."

Jaswal insisted that he and his wife are not forcing Akrit into anything. "He is forcing us," he said. "I am not in this, sir. He decides himself. He discusses what he wants to do with us. I never push him. Whatever he wants to do, he does. This is his desire. How can I exploit him? He is my son. I love him too much."

Again and again, Jaswal said that raising someone of Akrit's abilities is a bewildering challenge that, at times, has left the family financially and emotionally drained. But the sacrifices are worth it, he added.

"It is my duty as a father to take care of his talent," Jaswal concluded. "But I don't know, because of the systems and the laws, whether we will be able to do something for him. We must try. I pray to God, `Help me to come out of the problem.'"

Despite the setback he encountered in Denver, Jaswal is determined to continue fighting for his son. The family is now back in India, where Jaswal will again try to enroll his son in medical school.

"No one can kill his knowledge," Jaswal declared before they left Denver. "No one will stop him. My job will continue. Life is struggle."

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