Caduceus as a symbol of medicine worth noting that hospital stewards were not physicians; they played a supporting role preparing drugs for surgeons, supervising nurses and cooks, maintaining accounting and medical records, and in emergencies sometimes performed minor surgery or provided prescriptions. Later, in 1871, the Surgeon General designated the caduceus as the seal of the Marine Hospital Service (destined to become the U.S. Public Health Service in 1912). Gershen states that the change was for aesthetic reasons, whereas Friedlander states the caduceus was adopted by the Marine Hospital Service "because of its relationship with merchant seamen and the maritime industry". The caduceus was formally adopted
Margarita with a Straw into the narrative. Bose and Maniyar worked for two years on the script as it went through over forty revisions before becoming the final screenplay. Bose originally intended to cast actors with the same disabilities as the characters of Laila and Khanum. Since there were no actresses with cerebral palsy in India, she held auditions for the role in institutions that catered to patients, but could not find a suitable person to play the central role. Bose also had a meeting with a blind actress in her early thirties to discuss the role of Khanum, a character she associated herself