A Conversation After the Debate: A Young Vaidya Asks, A Senior Physician Answers — And Neither of Them Has All the Answers

Dr. Aakash Kembhavi and Vd. Ayudha Kembhavi

This article was developed with the assistance of an AI language model and has been reviewed, verified, and finalised by the authors.

What follows is a conversation that took place over several days following the debate between Dr. Cyriac Abby Philips (TheLiverDoc) and Vaidya Vasundhara Sadineni, streamed live on the Neuronz YouTube channel on 14th March 2026. The questions here are Ayudha’s own — but they are also the questions being asked, privately and without adequate answers, by young Ayurveda graduates across the country. We publish this conversation in the spirit of the transparency we are asking the system to practice. We are also aware of a thoughtful piece published on Medium by Pushya A. Gautama, titled “Who Calls Dibs on Science? Ayurveda, Pseudoscience, and the Debate That Failed Before It Began,” which argues that both sides of the debate were defending caricatures rather than the real things. We engage with that argument in Question 2. This conversation is not finished. It is a beginning.

Question 1: The Patient’s Question

Ayudha: A patient asked me directly — was there not a debate recently about whether Ayurveda is a pseudoscience? I answered them. I kept my composure. But after they left, I sat with the question for a long time. I did not know if what I said was the right answer or just the safe one. What should I have said?

Aakash: The first thing I want to say is that the discomfort you felt after that consultation is not a weakness. It is the beginning of clinical honesty. A practitioner who answers that question too easily — with a reflexive defence or a dismissive counter-attack — is a practitioner who has not yet taken the question seriously. You took it seriously. That is where we start.

What should you have said? Not a defence of Ayurveda as a system. Not an apology for it either. What the moment calls for is transparency — and transparency in clinical communication has a structure. It means telling your patient what you know, what you do not know, and what you are still in the process of finding out. It means saying: Ayurveda is a classical knowledge system built over thousands of years through careful observation of the body and its responses. Some of what it observed has been validated through modern research. Some of it has not yet been adequately studied. Some of it, when studied, has not held up. I practice the parts that have evidence behind them. When the evidence is limited, I tell you. When modern medicine can demonstrably do something better, I will say so and refer you accordingly.

This framework — practising at the intersection of best available research evidence, clinical expertise, patient values, and clinical circumstances — is what evidence-based medicine asks of every clinician, regardless of system. It is not a concession to Ayurveda’s critics. It is a professional standard.

Ayudha: But that framework assumes I have the evidence to work with. What do I say when I don’t? When a patient asks me whether a specific herb or formulation has been proven to work — and honestly, the evidence is thin or absent — what then?

Aakash: Then you say exactly that. “The evidence for this is currently limited. What we have is a long tradition of clinical observation and some preliminary research. I am recommending it because in my clinical assessment it is appropriate for your condition, the safety profile is acceptable, and we will monitor your response carefully.” That is not weakness. That is the most honest thing a clinician can say. And it is far more trustworthy to a patient than false certainty — in any direction.

The hardest thing I can tell you is this: the framework is easier to articulate than to deliver when a patient is sitting in front of you and you feel the weight of representing an entire system. No one in your education fully prepared you for that weight. That is a failure I will return to. But the answer to inadequate preparation is not to perform confidence you do not have. It is to practise transparency until it becomes your natural clinical voice.

Question 2: The Debate Itself

Ayudha: I have been reading the responses to the debate. There is a piece on Medium that argues that both sides were wrong — that the Ayurvedic practitioner defended a pseudo-tradition, a romanticised reconstruction of Ayurveda that never really existed, while TheLiverDoc deployed a pseudo-science — science used as a weapon to dismiss rather than investigate. Is that a fair reading?

Aakash: It is a philosophically sophisticated reading, and the part about the pseudo-tradition is largely correct. The author, Gautama, makes an important historical observation — that Ayurveda was never a frozen, monolithic, perfectly consistent system. The classical Samhitas themselves contain disagreements, competing theories, and ongoing debates. What modern Ayurvedic education produced, particularly through the BAMS degree, was a peculiar hybrid — graduates superficially conversant with biomedical tools but not fully equipped to think clinically with either framework. That observation is accurate and it aligns with what I have been writing about institutional dysfunction for years. Dr.Vasundhara did exactly what that educational system trained her to do — invoke ancient authority where evidence was demanded, assert civilisational superiority where conceptual clarity was required.

But the “pseudo-science” characterisation of TheLiverDoc is where I think the argument becomes evasive. Gautama argues that he arrived already certain of his conclusions — that he used science as a weapon rather than a method of inquiry. This is a philosophically interesting claim. But it elides a crucial distinction that matters enormously in a clinical context. There is a difference between certainty that refuses evidence and certainty that is derived from evidence. TheLiverDoc asked for consensus guidelines. He asked which cancer turmeric had guideline-level support for. He asked which component of metabolic syndrome curcumin had demonstrated efficacy in. He asked for the location of the mind according to Ayurvedic texts. These are not the questions of someone who has abandoned inquiry. They are the questions of someone who has done the inquiry and is asking whether his opponent has done the same. Demanding evidence before accepting a claim is not pseudo-science. It is the scientific method functioning correctly.

Ayudha: But does it matter who won the debate if the format was wrong? If neither side was actually representing their tradition honestly — does the outcome mean anything?

Aakash: In a philosophy seminar — perhaps not. But this debate was watched by 100,000 people. It was not watched by philosophers. It was watched by patients, by families making healthcare decisions, by students choosing careers, by practitioners deciding how to communicate with their next patient. In that context — the real context in which this debate existed — it matters enormously what was said and what was demonstrated. A debate is not only an epistemological event. It is a public health communication event. And what was communicated on March 14 will influence real decisions made by real people. Gautama’s analysis is intellectually elegant. But elegance is a luxury that the practitioners left explaining the aftermath cannot entirely afford.

Question 3: The Embarrassment and the Betrayal

Ayudha: Many of us felt betrayed. There were people within the fraternity who expressed concern — who felt that proceeding in this format, against this opponent, without adequate preparation, was unwise. Those concerns were not heard. She went ahead anyway. And now we are the ones answering for it in our clinics. Is it fair to hold her responsible?

Aakash: Yes and no — and I want to be precise about why, because the answer matters for how the profession responds going forward.

She bears individual responsibility. She accepted the debate voluntarily. She had time to prepare. She chose to respond to TheLiverDoc’s pre-debate announcement with combative social media posts rather than with rigorous study. She chose to refuse the agreed opening slot twice. She chose to attack the questioner rather than engage the question. These were individual decisions made by an adult professional, and individual responsibility does not dissolve because the system also failed her.

But the system failed her first — and that failure is the more important one to name, because it is the one the profession can actually change. She walked into that debate as a product of an education culture that builds confidence without building competence. She had likely debated this topic many times — in classrooms, on social media, among peers — and she had likely won most of those exchanges, because her opponents were equally unequipped. Nobody in that educational ecosystem ever placed her in a room where the gap between clinical enthusiasm and scientific methodology was made visible. Until March 14.

The deeper problem is structural. There is no mechanism — no fraternal body, no institutional process, no professional standard — by which the readiness of a practitioner to publicly represent a knowledge system can be assessed before they do so. Individual ambition filled a vacuum that institutional accountability should have occupied. When a practitioner steps onto a public platform as a representative of a knowledge system, they carry more than their own reputation. They carry the credibility of every practitioner who shares that system with them. The profession must develop the culture and the mechanisms to ensure that weight is understood before it is assumed.

Ayudha: But the system has never held itself accountable. Every time there is a crisis, it goes quiet, waits for the noise to pass, and continues exactly as before. Why would this be different?

Aakash: I cannot tell you with certainty that it will be different. What I can tell you is that this time, something is different about the scale and the permanence of what happened. A debate with 100,000 views does not disappear. The clips circulate. The patient who asked you that question in your clinic did not read a journal. They watched a YouTube stream. Social media is not a fringe channel any more — it is the primary source of healthcare information for a substantial and growing proportion of the population. The profession can choose silence again. But silence in 2026 is not neutral. It is a communication choice with consequences that compound over time.

Question 4: The Safety Question

Ayudha: My patients ask me whether the medicines I prescribe are safe. And honestly — I prescribe them, I believe in the classical formulations, but how do I actually know? There are over 7,000 licensed pharmacies manufacturing Ayurvedic medicines in India. I learn about half the newer formulations from company representatives. No one in my training ever taught me to critically evaluate a pharmaceutical representative’s claims. What is the honest answer to my patient’s safety question?

Aakash: The honest answer is that the safety net you assumed existed does not exist consistently. And saying that is not a betrayal of Ayurveda. It is the precondition of fixing it.

Let me be precise about the safety concern, because it deserves precision rather than either dismissal or panic. Herb-induced liver injury from Ayurvedic preparations is documented in peer-reviewed clinical literature. TheLiverDoc has published research on this. The findings are not fabricated. Heavy metal toxicity from certain classical formulations — particularly Rasa preparations and Bhasmas — is a legitimate and unresolved concern when those preparations are manufactured without rigorous quality controls or consumed outside the therapeutic doses and durations the classical texts specify. The argument that these preparations are safe because they have been used for centuries is a historical argument, not a toxicological one. History is not pharmacovigilance.

But here is the distinction that almost never gets made clearly in public discourse — and the absence of which costs Ayurveda enormous credibility in debates like the one on March 14. The hepatotoxicity concerns raised about turmeric are directed almost entirely at high-dose standardised curcumin extract supplements — not at traditional turmeric used in therapeutic whole-herb doses. This is a difference of enormous clinical significance. Classical Ayurvedic formulations were designed around whole herbs, processed according to strict ratios and methods specified in the classical texts. The Acharyas who formulated these preparations understood, through centuries of careful clinical observation, that a formula is not simply the sum of its ingredients. Individual constituents within a whole-herb preparation may modulate or counteract each other’s effects. The ratio is not decorative. It is functional.

What the modern Ayurvedic market is increasingly doing is departing from this principle — manufacturing formulations using standardised herbal extracts, concentrated isolates stripped of the broader phytochemical matrix in which they were originally embedded. These extracts are pharmacologically stronger, which makes them commercially attractive. But strength without buffering is not safety. And when practitioners learn about these formulations from company representatives rather than from critical pharmacognostic study, they are making prescribing decisions on a foundation that is neither classically grounded nor evidence-based. It is the worst of both worlds.

Ayudha: So what do I do? I cannot run laboratory tests on every formulation I prescribe.

Aakash: No — and you should not have to. That is the regulatory system’s job. The Drugs and Cosmetics Act and the ASU Drug Rules require GMP compliance and licensing. The Pharmacovigilance Programme of India has a dedicated stream for ASU drugs. The infrastructure exists on paper. What does not exist in adequate measure is enforcement, transparency, and a culture of adverse drug reaction reporting among practitioners. When a patient develops a reaction to an Ayurvedic formulation, the professional and ethical responsibility is to document and report it — not to suppress it out of fear that reporting is an admission of culpability or ammunition for critics. No fear is more important than the patient who is harmed.

What you can do, today, is prescribe preferentially from manufacturers with verifiable GMP certification. Ask your suppliers for batch testing documentation. Be deeply sceptical of extract-based proprietary formulations promoted by representatives without peer-reviewed evidence for the specific formulation. And never accept a representative’s claim about safety or efficacy without asking what evidence it is based on.

It is not a complete solution. But it is where individual clinical responsibility begins — within a system that has not yet fully discharged its institutional responsibility to you or to your patients.

Question 5: The Future

Ayudha: Should I keep practising Ayurveda? I chose this profession. I believed in it. I still do, in some way I cannot fully articulate. But after this debate, after these conversations, after sitting with all of these uncomfortable questions — is there a future for practitioners like me? People who want to practise honestly, who ask questions, who are not comfortable with the way things are?

Aakash: Yes. But I want to be honest about what I am saying yes to — because it is not the Ayurveda that produced the March 14 debacle.

The Ayurveda that is worth practising — worth defending, worth building a career on — is not the one that responds to hard questions with civilisational pride. It is not the one that invokes 5,000 years of tradition as a substitute for evidence. It is not the one that teaches research methodology as an examination subject and then produces graduates who cannot tell a subjective outcome measure from an objective one. That version of Ayurveda has been in the room for decades and it has done enormous damage — to patients, to credibility, to the practitioners who were trained within it and then left to answer for its failures in front of patients and cameras.

The Ayurveda worth practising is the one that is honest about its evidence. That says clearly: here is what we have demonstrated, here is what we have not yet studied adequately, and here is what we have studied and found wanting. It is transparent with its patients — not secretive about diagnoses, not proprietary about prescriptions, not paternalistic about clinical decisions. It is rigorous in its research culture — not producing dissertations to satisfy regulatory requirements, but producing knowledge to advance clinical understanding. And it is humble enough to know that humility is not defeat. It is the precondition of being trusted.

That version of Ayurveda does not fully exist yet as an institutional reality. The guidelines have not been written. The pharmacovigilance culture has not been built. The faculty who model epistemic humility in front of their students are the exception rather than the rule.

Ayudha: Then what am I practising towards, exactly?

Aakash: You are practising towards it. Every consultation in which you are transparent with a patient about the limits of your evidence is a data point in a different kind of Ayurvedic practice. Every time you ask a company representative for the evidence behind their formulation rather than accepting their claim, you are building a different kind of professional culture. Every time you report an adverse reaction rather than suppressing it, you are contributing to the pharmacovigilance infrastructure the system needs but does not yet have. Every uncomfortable question you ask — including the ones you have asked in this conversation — is the kind of question that, multiplied across a generation of practitioners who refuse to be comfortable with the status quo, eventually becomes institutional pressure for change.

The system will not reform itself. It never has, and there is no reason to believe it will without external and internal pressure simultaneously. You — and the practitioners like you, the ones who are embarrassed and frustrated and uncomfortable, the ones who sat with their patient’s question after the consultation rather than brushing it away — you are the internal pressure. That is not a small thing.

A Note at the End — From Both of Us

This conversation is unfinished. The questions Ayudha asked do not have complete answers — not because the answers do not exist somewhere, but because the institutions that should be generating them have not yet been compelled to do so with sufficient urgency.

We publish this not because we have resolved anything, but because the culture of private silence has already cost the profession too much. The debate of March 14 will be followed by others. The patients asking questions in consultation rooms across the country will keep asking them. The 100,000 people who watched a live stream will tell others what they saw. The social media conversation will continue with or without the Ayurvedic establishment’s participation.

What Ayurveda’s practitioners — particularly its youngest ones — deserve is not reassurance. It is honesty. Honest acknowledgement of what the system has failed to build. Honest engagement with the questions its critics are raising. And honest commitment to the work of becoming the profession it has always claimed to be.

We are a father and daughter who have chosen the same profession — one at the beginning of a career, one in the middle of one. We do not agree on everything. This conversation is evidence of that. But we agree on this: the discomfort is not the problem. The discomfort is the work.

If you are a young Ayurveda practitioner reading this and recognising your own questions in Ayudha’s — you are not alone. And your discomfort matters. Add your voice. The conversation needs it.

Share your thoughts in the comments below.