Thirty years ago a young anaesthetist, newly appointed as head of department at Calicut Medical College Hospital in the Indian state of Kerala, encountered a case that would change his life.

A college professor aged 42 with cancer of the tongue had been referred to him by an oncologist. The man was in severe pain and the anaesthetist, Dr. M R Rajagopal, was asked if he could help. He injected the mandibular nerve in the jaw in a procedure known as a nerve block and told the patient to return in 24 hours. Next day, the pain had almost completely gone and Dr. Raj, as he is known, was pleased with his work.