What was the vision you had for your life growing up?

Growing up I knew I wanted to do something decent with my life. My mother has been such a strong independent woman that I knew I have something very cool to aspire to. She came from a very small village in western UP. She didn't have a school in her village beyond grade five. Initially, she would walk 15-20 kilometres to study in another village, until her grandmother insisted that a school be made in her own village. After grade 10, she went to Lucknow all by herself at the age of 14 and then she got into medical school. Similarly, my naani (maternal grandmother) was trained in shooting around the 1910s. So I knew I had to do something good with my life.  I always had reason to believe that I would be able to, but I didn't know what it would be. Initially, I wanted to study history and get into curation and conservation, but somewhere along the line, I realised I like medicine, and that is what I want to do.

How did you discover your passion for becoming a doctor and more recently a medical educator?
My dad is a male fertility specialist. People expected me to become a gynaecologist. However, I was keen to not go in with any set idea. I was even very interested in becoming a brain surgeon at one point. Gynaecology was never something I had to study separately, it was always second nature to me. I knew a lot of stuff in medical school as well, because of the information I imbibed from home. So eventually, I just realised I like it. After finishing medical school, I used to hang out at my parents’ centre, and I used to see a lot of their interactions with their patients. I realised that infertility is such a debilitating condition because there's nothing you can cure as such. A lot of times it's unexplained and it's frustrating. But when families have children after their long battle with infertility, it's a different kind of rewarding experience.  I don't think I can ever put it into words. So that made me interested in the idea of infertility.

I went for my masters and learnt how to manage infertility, how to conduct IVF, and things like that. Over there, I realised that a lot of these infertility issues would never have cropped up if we had better sex-ed—viz. information on what can be bad for our genitals or future sperm or eggs. I realised that we don’t know anything about our genital health at large. So many complications can be prevented by just educating people and not making this a taboo subject. So I think it was an amalgamation of my love for infertility and my love for preventive healthcare, that I sort of got into this line.

Also, I come from a very liberal family. I had a boyfriend at a young age and was also slut-shamed very often during my school life. So I think that's where sex positivity comes from. I understand how important that acceptance is and how much of a more sorted life I would have led as a teenager had somebody been that sex-positive with me or if somebody would have told me that having a boyfriend at that age is alright. So I think it was an amalgamation of all of these experiences that led to what has happened.

After completing your graduation in India, you pursued a relatively unconventional path of pursuing a masters in clinical embryology from the UK. What sparked your interest in clinical embryology?

So embryology is the study of embryos. In a clinical sense, it involves studying embryos even before they are embryos. So one is essentially helping make an embryo in the lab. There's a huge contribution of my parents here, given as they're both fertility specialists. We have an IVF centre in Allahabad. When my dad went for his training in 1999, I was seven years old. He showed me a picture of an egg, and the diameter of an egg is 1/100th that of a single human hair! It blew my mind. My parents had put together a lot of money for my dad to go and study in Australia, leaving his clinical practice aside for a month. Looking at this commitment perhaps had already shaped this direction in my head that this is something that I should care about. Growing up also, I used to watch through a small window the surgeries taking place in the operating theatre. So it's always been a thing that I will go into the field of understanding infertility.

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In one of your interviews, you also discussed how India’s medical education system is aspirational rather than passion-related, due to the rank-based system. Is this one of the reasons you went to the UK?

I always wanted to study science. However, I was not particularly good at physics or chemistry. I barely got passing marks in Chemistry. I felt like I studied science in a very poor manner, but I wanted to go into academics. I was researching how I could get some scientific research experience and took a chance with my application at Oxford. I was waiting for the rejection but somehow got accepted. Up until that point, I knew I was going to study embryology, and then come back and train as a gynaecologist in India. But within a week of me getting my Oxford acceptance, I got to know that I managed to clear my PG entrance exams in India. When I sat and sifted through my rank, I realised I would get an MD physiology in India. Now I'm a people’s person, and I knew that sitting in a lab and performing experiments would not work for me.

So this is where — medicine becoming aspirational as opposed to passion-based — is coming from. So many people in India become specialists because that's the rank they get, not because they want to do that. That's not to say that we don't have brilliant doctors in this country, but it doesn't come from a place of passion. I was very privileged to have a choice in deciding what to do with my life. So it was more of a mix of happenstance and a real desire to study science than anything else that this unconventional thing happened.

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How was the health training you received in India different compared to the one you received in the UK— particularly with respect to patient autonomy and non-paternalistic gynaecologists?

I'm a registered doctor in the UK as well, and for that one has to sit a certain set of exams. The first part is a theory-based exam. The second part is an exam where they see your patient interaction and clinical skills. In fact, almost two-thirds of the final exam is based on patient interaction skills. When you start interacting with patients, you have to tell them the diagnosis, details about the treatment and give them a choice of treatment. It is all about patient autonomy.

In India, we are given the power to make the decisions for other people's bodies, and not rightfully. A lot of the time, if you speak about this with other Indian doctors, they will say that patients don't know what is the right decision to make. That genuinely leaves me dumbfounded because it's not like we take a very detailed history of these patients and figure out what their lifestyle is like, or whether a particular treatment protocol will fit in their life! We don't have that kind of time because of the sheer number of patients we have. Having said that, that still doesn't give anybody the right to make a decision for anybody else's life. Whereas in the UK, they have the luxury of not having as many patients and not having a completely overburdened healthcare system. This is an anecdote about when I was doing my internship. In India, in a district referral centre, we used to receive 200 patients between 10 am to 2 pm in the surgery department. In England, when I used to sit in on consultations, maybe in the whole day, the doctors would receive six-seven patients and talk about having a busy OPD day!

Another experience I had in the UK was the first time I met a transgender person at a fertility preservation clinics. So the university I was researching at, were working on preserving testicles and ovary tissue from young children who had been diagnosed with cancer. These were pre-puberty, which means they had not started producing their own eggs and sperm. We had to preserve their fertility before they underwent chemotherapy. So many times, we would also get patients who would be pre-transition and would get their sperm or egg saved for post-transition if they wanted to use it for IVF. That's the first time I met a trans person that I wasn't afraid of due to the conditioning from the kind of culture we have here. So it was a whole rewiring for me. Even though I come from a very sex-positive family, it was still surreal to interact with somebody whose life has been so dramatically different compared to mine. I think it was a combination of this along with how often I've been lectured on my body choices or sexual choices that I felt like I got into a more sex-positive direction in my profession.

What has been your experience with ageism and sexism in the medical field?

I think sexism is prevalent everywhere. It's the same in India and in the UK in my area of work. Ageism has a very weird dichotomy here. On one hand, a lot of patients don't like to interact with me because they think I'm too young. So I always try to take out that single strand of white hair or I put my glasses on the bridge of my nose if I preempt this. On the other hand, there is a very weird sense of Doctor worship in India, which makes me very uncomfortable — when you’re put on a pedestal. In the UK, I don't know if I was there in medicine for long enough to really experience it. In science, I think everybody was at the same level. But in medicine, I don't know if that's the case.

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‍What inspired you to conceptualize Dr. Cuterus and what is the core mission behind your work?

I was originally called Uterosaurus Rex because that's my favourite dinosaur. Rex means king and I think the uterus doesn't get enough credit for how cool it is. I also think we sort of idolise neurosurgeons and cardiologists, but none of us would be here without the uterus. We give the brain and the heart way too much credit. I also remember when I was seven, I was reprimanded and made to sit in a corner for saying that my mom had gone to deliver a baby. It was perceived to be “dirty”. This is the sort of view we have about these organs, these fundamentally critical organs. Whereas, I don't think there's a more important organ in our body than the uterus for humanity at large. I wanted to put a cute and happy spin on it, so that's where Dr. Cuterus comes from.

When I started off, I think I was trying to educate people on common medical conditions. My training in the UK was a lot about how you could explain a diagnosis to a patient. I felt like that was cool and also missing here. So I started off with that with regards to sexual and reproductive health. But somewhere along the line, I realised that not everybody cares about what a fibroid is. But everybody is concerned about pigmentation on their inner thighs or on the vulva or their penis. I thought more than anything else, we need to learn more body literacy. I'm very glad that there are influencers who are doing this, but a lot of times they don't have the right information, because they haven't had that training. I thought that if I have that training, I could use it for creating a little bit more body literacy because that has been the most empowering thing I've had in my life. My main idea now is a lot of body literacy and understanding how our bodies function. In other words, it’s viewing a body through the lens of our bodies, as opposed to viewing it through the lens of diseases and how they happen.

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‍What is your process for creating jargon-free and inclusive content?

I had to unlearn a lot of my language so I could become a little bit more inclusive. I think the way I teach myself concepts helps with jargon-free content. If I have to learn about a fibroid, instead of thinking of a fibroid as a leiomyoma tissue, I will think of overgrown muscle tissue. This concept called “Explain Like I’m five” by Richard Feynman, says that you understand the subject truly once you can explain it to a five-year-old. So I started using that to understand for my own benefit and that's where I think the jargon-free stuff comes from. The creative process is quite bizarre. It’s mostly based on questions I tend to get from my audience more than anything else. I will think about something, check the latest scientific resources on it and then use Canva on my phone or any other application to finish the post.

As a legit social media influencer, do likes/comments and the kind of engagement you get on a particular post affect you?

I care about engagement. More than likes or comments, whether people are finding my posts useful matters. If I'm getting no response in a post that means it's useless and I could be focusing on other things that people want to know. So it's not like I freak out. For example, I put out a really nice post that I was really proud of, on Lysol. It was about how Lysol was meant to be launched as a feminine hygiene product. I was really excited to talk about this to encourage more conversation about how women have been conditioned for so long that their smell is bad and they should put Lysol down there. But it didn’t perform really well. So I was upset since this would have given more people an idea of why historically, we've been told we smell bad or whatever. That is frustrating.

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What advice would you like to give younger folks who may want to start having sexual health-related conversations with their parents?

Just start! You will feel awkward for the first 15 days, on the 16th day your parents will be like, “hmm since we're talking about this, here's my two cents”. Maybe don’t start with, “that menstrual cup that I put inside my vagina”.  Go with something like, “why are bra straps showing such a bad thing?”. What worked for me very well in my household was the fact that I never had a talk with my parents. It was always free knowledge in the house. Never have my parents told me this is not appropriate age reading.

So one shouldn't have to build up to a talk. It should be common knowledge. Just as we're told, “this is how you wash your hands, this is how you brush your teeth”. We should be told, “this is what your bits are instead of saying these are your private parts.”. We should be told that “using these organs, you eventually make a baby just the way you know your heart pumps the blood around your body. These organs make a baby when you grow older”. I feel like that's the best way though it may be a bit radical for certain households. Sex is such a taboo subject. Our bodies are so taboo. We're quite lucky that we're born in the information age. There are good books, we can get children-level books that can encourage conversations. This is a very difficult conversation to have. So the first thing is one must brace themselves for the tasks they're going to pick up. It won't happen that one day you’re visiting and discussing buying pads with your dad. In a lot of households, that's not going to happen, realistically. But having said that, even in those households, you can get to a level where you can say that, okay, I'm on my period, so I need some rest, and I'm gonna go lie down. I feel like the best way is just to talk about it, asking those uncomfortable questions. Like in Bridgerton, Eloise asks, “How does a woman come to me with a child?”  and the mama freaks out.

In your experience, how should one go about challenging deeply ingrained but problematic norms about women’s sexual health?

In India, over 70% of male children who are born with congenital heart disease get surgery for it. Just a little over 20% of female children with congenital heart diseases get surgery. There is a massive disparity between who gets surgery and that's because if a woman will have those scars on her body from surgery, that means she is defective. This will make her less marriageable and that's why women's healthcare is so inherently political. That's why we need to challenge the notions that exist around it. Again, it's all about questioning. You have to have science-based facts to counter the answers that come to those questions. A lot of times these questions are answered with “we’re telling you because we’re older”. No doubt, traditions are cool and they're a nice way of keeping family nostalgia alive. But tradition shouldn't dictate how people access healthcare. Education and questioning are definitely the answer.

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‍What advice would you like to give younger folks who may want to start having sexual health-related conversations with their parents?‍

Just start! You will feel awkward for the first 15 days, on the 16th day your parents will be like, “hmm since we're talking about this, here's my two cents”. Maybe don’t start with, “that menstrual cup that I put inside my vagina”.  Go with something like, “why are bra straps showing such a bad thing?”. What worked for me very well in my household was the fact that I never had a talk with my parents. It was always free knowledge in the house. Never have my parents told me this is not appropriate age reading.
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So one shouldn't have to build up to a talk. It should be common knowledge. Just as we're told, “this is how you wash your hands, this is how you brush your teeth”. We should be told, “this is what your bits are instead of saying these are your private parts.”. We should be told that “using these organs, you eventually make a baby just the way you know your heart pumps the blood around your body. These organs make a baby when you grow older”. I feel like that's the best way though it may be a bit radical for certain households. Sex is such a taboo subject. Our bodies are so taboo. We're quite lucky that we're born in the information age. There are good books, we can get children-level books that can encourage conversations. This is a very difficult conversation to have. So the first thing is one must brace themselves for the tasks they're going to pick up. It won't happen that one day you’re visiting and discussing buying pads with your dad. In a lot of households, that's not going to happen, realistically. But having said that, even in those households, you can get to a level where you can say that, okay, I'm on my period, so I need some rest, and I'm gonna go lie down. I feel like the best way is just to talk about it, asking those uncomfortable questions. Like in Bridgerton, Eloise asks, “How does a woman come to me with a child?”  and the mama freaks out.

In your experience, how should one go about challenging deeply ingrained but problematic norms about women’s sexual health?

In India, over 70% of male children who are born with congenital heart disease get surgery for it. Just a little over 20% of female children with congenital heart diseases get surgery. There is a massive disparity between who gets surgery and that's because if a woman will have those scars on her body from surgery, that means she is defective. This will make her less marriageable and that's why women's healthcare is so inherently political. That's why we need to challenge the notions that exist around it. Again, it's all about questioning. You have to have science-based facts to counter the answers that come to those questions. A lot of times these questions are answered with “we’re telling you because we’re older”. No doubt, traditions are cool and they're a nice way of keeping family nostalgia alive. But tradition shouldn't dictate how people access healthcare. Education and questioning are definitely the answer.

What kind of investment is needed in India’s healthcare industry for it to be more inclusive and accessible to people?

We need a lot more paramedical staff. We don't have trained paramedics in the country. In most centres, we will have one qualified nurse and other people who just learnt how to do things by staying in those centres. We don't have enough ambulances either. Most of our doctors are so highly qualified that they're redundant in a normal setting. If somebody breaks an arm, I will freak out. I will know how to settle it for them, but I will not know how to put it back in place. I think the best generation of doctors in our country — the youngest and most updated doctors — are not sitting and working at hospitals. They're sitting in coaching centres. Then they get into a PG degree and after that, they sit at home for another two years to do a super specialisation. So the average time to become a doctor is easily over 15 years. Nobody wants to come out with less than a super specialisation. So we need a lot more investment in primary health care. At basic levels, we should encourage MBBS doctors. A lot of people give me flack for just being an MBBS. Whereas I do everything that has to be done and I'm legally allowed to do everything that I'm doing. So I don’t understand why is this such a problem? Of course, we don't also have the infrastructure in terms of support staff. So primary healthcare and paramedical staff would be the two biggest investments that can change the face of healthcare in this country.

We wonder whether you feel bogged down occasionally? How do you deal with the lows of life?

Who I am on screen is generally who I am as a person. I'm very chirpy. Yes, of course, I have my days when I'm not as chirpy. In that case, I just don't go on social media. It's very simple. Also, I have a very good support system. So even if that happens, I'll tell my friends, I'm having a bad day and they'll come over and fix me within three hours. I'm very lucky that the general makeup of my mind is very chill.

How do you deal with personal body image issues, if you do struggle with them?

I'm human, so I have those same personal body image issues as well. But I think they come more from an angle of what is a very eurocentric beauty standard as opposed to just being confused about my body. I think it's more of a societal thing. Sometimes I wish I had smaller boobs. But I understand that it happens because of genetics. If I didn't have this knowledge, I would have tried breast reduction creams or pills to reduce the size of my breast and been left feeling not just insecure but also frustrated having lost money.

Do you think therapy should be mandatory and free for doctors in India?

100%!

I went to medical school at the age of 17. I was not prepared to see the stuff that I saw. I've lost friends to suicide and substance abuse, and this is all before the age of 24. Kabir Singh is obviously an exaggeration, but alcohol and drug abuse are very common in the medical fraternity. That's because we get to see really messed up situations. For example, we have no guidelines on how to care for a rape victim. More often than not, people get so involved, that the boundary between personal and professional blurs. We have no idea how to handle cases of domestic violence. I know for a fact, about 30% of my patients with pregnancy have experienced domestic violence on a regular basis. That's where it becomes very difficult. You wonder how you can provide them with the best care without losing your sanity about what is really happening? It's a very high-pressure environment. I think because I'm a second-generation doctor, I have had a very chill life that way. But I know for most people that's not how it is. Therapy is looked down upon very much even in the medical fraternity. First, we need to make it widely accessible, and then we can work on changing the way we look at it.