Maj. Gen. Dr. Muhammad Zulfiqar Ali Khan

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 Obituary

Maj. Gen. Dr. Muhammad Zulfiqar Ali Khan

August 1932- July 2016

Maj. Gen.  Dr. Muhammad Zulfiqar Ali Khan, an eminent cardiologist of the Armed Forces and Pakistan, a versatile physician, teacher, mentor medical educationist, an excellent medical administrator and creator of institutions was born on 22nd August 1932 and passed away on 6th July 2016. The cause of death was complications of cerebral stroke which he suffered in 1998.


Maj. Gen.  Dr. Muhammad Zulfiqar Ali Khan

General Zulfiqar did his FSc Pre Medical in 1949 – passed MBBS from the King Edward Medical College (KEMC) Lahore in 1954. After doing one year house job at Mayo Hospital Lahore, he left for UK for further professional education. I had association with him since 1947.  

At independence K.E.M.C, MBBS degree (Punjab University) carried the high standards of MBBS London University. The degree was recognized all over the world – jobs were easily available abroad. KEMC had an annual intake of 95 students from the vast area, comprising Punjab (pre-partition United Punjab) NWFP (Now KPK) Bahawalpur, Kashmir and students from foreign countries also. Professional exams were very competitive and fair. In the discipline of medicine, the pass percentage was only about 50%- the rationale was that the MBBS degree should be the strongest to lay solid foundations of medical education and practice.

General Zulfiqar’s life history/career is deeply interwoven with medicine and the Armed Forces Medical Services of Pakistan, therefore without describing the history of medicine and cardiology Gen Zulfiqar’s life history cannot be narrated. In 40s sub-specialties in the discipline of medicine had begun to emerge and grow. Cardiology, pulmonology, neurology, hepato-gastro-enterology were main ones called special interests. Overall the general medicine remained supreme, a concept of holistic medicine and a physician taking care of the whole patient, having biological, psychological and spiritual values. In medicine, a patient presents with a problem like chest pain – it’s cause may be from skin to any tissue like cardiac etc. or psycho-somatic, therefore a physician in order to do problem solving, has to be well-versed in every discipline of medicine. Of course one may develop special interest in any sub specialty, do research and advance the subject.

General Zulfiqar practiced at UK, did training jobs earned MRCP (Edinburg) with cardiology as special subject. In 1940s clinical cardiology was limited to two heart sound, (1st and 2nd) two murmurs, systolic and diastolic, two investigations X-ray chest and ECG, two drugs Digoxin and Mercury diuretic injection. In late 40s legendary world-famous cardiologist Prof. Paul-Wood in the UK and Prof Paul-White in the USA, laid the foundations of the modern cardiology. Both wrote world famous cardiology books.

From Pakistan Dr. G.M.K.Baloch Assistant Professor of Medicine at KEMC who had earned M.D. Punjab with cardiology as a special subject before independence, got six months training slot at the London Institute of Cardiology on the basis of his research publications in cardiology. During his training period he appeared in MRCP London exam and obtained the qualification just four months after landing at UK. He came back and introduced modern concepts of cardiology like 3rd and 4th heart sounds etc. At this time General Zulfiqar was a student at the King Edward Medical College, Lahore.

Maj. Nawab Ali (later Brig) an East Pakistani AMC doctor after obtaining Royal colleges Memberships (all three) got training in cardiology under Prof Paul Wood. Col Ayub (later Lt Gen) the consultant physician established the department of cardiology at Military Hospital Rawalpindi in mid 50s, appointing Maj. Nawab Ali as senior medical specialist at MH and in charge of cardiac department.

Maj. Nawab Ali introduced the concepts of opening snap, clicks, etc., phono-cardiogram to amplify heart sounds to help in diagnosis. During that period Lt. Col. Shaukat Hassan (later Lt Gen) did first closed mitral valvotomy operation. Lt Col Ali Masood Akram (later Maj Gen) joined the center as the cardiac surgeon. Lt. Col. Cheema also joined as a cardiac surgeon, later moved to the Punjab Institute of Cardiology at Lahore.

In early 60s Maj. Malik Ali (East Pakistani later Brig) joined the cardiac center after getting training in UK. He later became the Director of the “National Institute of Cardiac Diseases” of Bangladesh Dacca – is still continuing work in the honorary capacity at the age of 86. East Pakistani doctors had deep devotion to profession- not caring for financial gains.

The cardiac department at MH became the Cardiac Center- a referral center of the Armed Forces Medical Services. Maj Zulfiqar joined the AMC as a classified medical specialist in 1967 and cardiologist in charge, Cardiac Center. Maj Gen Ayub Khan later Lt Gen) was the Director of Medicine. Lt General Ayub Khan encouraged the development of specialties – he also initiated FCPS courses in AMC after becoming the AMC Chief. FCPS Medicine and Cardiology students were trained at the cardiology units. General Zulfiqar always encouraged and helped doctors in specialty training. Sadly Gen Zulfiqar’s legacy of holistic medicine has faded way at the AFIC – many practicing as mono-organists –missing many diagnosis involving other organs/mind resulting in poor patient care. At UK all medical consultants are called consultant physicians irrespective of their special interests. They continue doing general medicine. Maj Gen Zulfiqar was a strict disciplinarian, intolerant of any lapse in the patient care. He stressed on students to also diagnose and treat emotional disorders of patients.

I was posted at Military Hospital Rawalpindi  in 1970. I had the subspecialty of hepato-gastro-enterology and was entrusted with clinical pharmacology/clinical therapeutics as a 2nd interest. I was made instructor in pharmacology for the FCPS Part-I course which at that period had the mandatory nine months attendance, to take FCPS Part I examination. Although the College of Physicians and Surgeons Pakistan launched FCPS qualification in 1962 but in the Army due to lack of basic sciences courses, FCPS qualification did not start in the Army until 1970. Lt. Gen. Ayub Khan on becoming Head of Army Medical Corps started FCPS courses. These courses opened the door for doctors in the Armed Forces to develop their careers as specialists otherwise it was very difficult to go abroad for higher qualifications.  With the retirement of Gen. Ayub Khan in 1972, sub specialties had a setback including the cardiac center.

During 1970 and later due to East Pakistan National Emergency, general duty medical officers and junior (graded) specialists moved out to the field units. Specialist had to run units alone without any assistance – to write histories etc.

 Later Gen Zia ul Haq became the Army Chief – the situation changed whatever may be his political leanings – he did enormous welfare work – he was like Sher Shah Suri not Shahi Mughals. He started paediatric specialty in the Armed Forces – laid the foundation of Armed Forces Institute of Cardiology / National Institute of Cardiovascular Disease, Armed Forces Institute of Dentistry, Urology etc., provided many senior ranks to the doctors in the Armed Forces and also in the Civil. He also provided higher ranks to the academic civil institutions. Many of these ranks have been taken away by General Musharaf- who believed only in regimentation- opposite of Zia ul Haq.

At that period, there was no worthwhile medical facility in the civil sector in Northern Punjab, NWFP (New KPK) AK and Northern areas. I had deep interest in clinical cardiology, used to work at the cardiac center with Gen Zulfiqar Khan to clear the enormous cardiac work load. Maj Gen Zulfiqar also used to work in my medical outdoor- we shared the clinical work. Maj Gen Zulfiqar went abroad with Gen Zia Ul Haq’s family for cardiac treatment. I was officially deputed to run the Cardiac Center – many times in 70s. Prof Zulfiqar was always very polite and courteous with the patients. To him the patient’s interest was supreme-he practiced patient centric medicine. About the administration in the medical units he used to profess that in the AMC, there is only professional administration. The other administrative matters like finances were with the military accounts department, recruitment, selections, disciplinary matters with the AGs Branch, food, rations, building, etc with the QMG Branch, ordinance matters with Ordinance while purchase with the DGP department. Therefore doctors should be well versed with professional administration and can only be done efficiently if there is deep knowledge of profession and also an aptitude for administration. He proved it to the hilt by running the units efficiently. He would check care of each patient in details.

Ultimately Gen Zulfiqar succeeded in making AFIC the state of the art cardiac institute with his persistent passionate hard work, perseverance, deep commitment, employing his immense leadership administrative qualities and professional acumen. As soon as the institute came into existence, conspiracies and intrigues erupted to remove the professionals and install mediocres at the helm of affairs.

Gen Zulfiqar had deep interest in preventive medicine, developed PANAH, an organization to carry nation-wide campaign for prevention of cardio vascular disease – the campaign is continuing. Academic activities like weekly journal clubs, joint clinical sessions, grand ward rounds, research projects were features of academic activities, involving clinical units, pathology, radiology depts. etc.

It would be unfair not to mention the immense contribution of his wife, Begum Fauzia Zulfiqar who during the difficult periods stood beside Maj Gen Zulfiqar to provide support to him for achieving his mission and goals. It is well known phraseology that behind every successful man there is a wife – that was proved.

After retirement, Gen Zulfiqar continued his creative work-developed Hearts International Medical Center, Islamic International Medical and Dental College and Riphah University. His son, Hassan Muhammad Khan carried the legacy forward, becoming pro-Vice Chancellor of the Riphah University, expanding the projects in the country and abroad. Younger son Dr Shoaib Muhammad Khan is a consultant in geriatric medicine working abroad. His married daughter is living in Islamabad.

May Allah rest his soul in peace and grant patience to his family to bear this irreparable loss.

Lt. Gen. Prof Emeritus Mahmud Ahmad Akhtar
Former Surgeon General/DGMS (IS), Pakistan Army.

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