Heart has its problems

DR NARESH TREHAN arrived at the studio in a big, white limousine with another equally fancy but smaller car following close to its rear bumper. He was half-an-hour late for his appointment. "Emergency case", he explained by way of apology. "Every heart ailment calls for emergency treatment: a few minutes make a difference between life and death, or leave a patient impaired for life". That explains Trehan’s second car; he can’t afford to be delayed by a flat tyre; he has to save a life.

Dr Trehan is Delhi’s (perhaps India’s) leading heart surgeon and has performed thousands of operations making it to the Guinness Book of World Records. Every day starting from 7 a.m. to late in the afternoon, he and his team of surgeons operate on people with a variety of heart problems in his massive Escorts Hospital with its own research and training centre. Anyone who has visited Escorts knows the rigorous discipline imposed on patients and their well-wishers. The reception room is usually crammed with people who want to see their relatives or friends in the wards. Their requests are firmly turned down. Even the liftmen check permits before they let anyone in the elevators. Those allowed are sternly warned not to stay beyond time allotted to them, I experienced this when I went to call on Giani Zail Singh who was there for a simple check-up, following his surgery in America. After five minutes, the nurse ordered me out of the room.

Dr Trehan told me that time was vital in his profession. As soon as a person feels pain in his chest or arms, he must put everything aside and rush to the hospital. "If you don’t make it in ‘the golden hour’, you may suffer a stroke which may reduce you to a vegetable." To ensure quick treatment, Dr Trehan has introduced a tele-medicine, a portable telephone on which the press of a button signals a fully equipped ambulance van to go to the patient’s home, administer restorative medicine and rush him or her to the hospital. Many lives have been saved in the nick of time. Quite a few who did not respond to the symptoms with alacrity died on the way to the hospital.

Dr Trehan was born in Karachi in 1946. He did his M.B.B.S. and specialised in heart surgery. He became the favourite pupil of his guru, Dr Frank Spencer, who persuaded him to stay in America. Dr Trehan and his wife Madhu (sister of Aroon Purie, owner of India Today) set up home in New York. He acquired a large practice and a clinic of his own. Amongst the thousands of patients who came to him for surgery was Dr Shanti Lal Mehta, head of Mumbai’s Jaslok Hospital. Dr Mehta persuaded him to return to India. Dr Trehan accepted his advice and first came on a reconnaissance expedition to study medical facilities available in the country. For a while he worked in Jaslok. Then he decided to set up a heart hospital and research centre of his own. He sent blue-prints of his project to several industrial houses. Only one, H.P. Nanda, agreed to invest money in it. So came up Escorts near Okhla. And soon acquired the reputation of the best heart hospital in the country.

I asked Dr Trehan about the crass commercialisation of Indian hospitals, nursing homes and clinics. All demanded full payment in advance; many are known not to issue a death-certificate or allow the dead person’s body to be taken away till all the bills are cleared. He agreed that it was true of many privately-owned medical institutions, but not of Escorts. Although it does ask for cash payment in advance, it has never refused to hand over a body of a patient who died in the hospital.

"Your charges are exorbitant," I protested. "You can’t get an open-heart surgery for less than Rs 1.5 lakh. How many Indians can afford to pay that kind of money?" He replied: ‘We have the best equipment you can find anywhere in the world. Some machines cost over Rs 1 crore. For similar operations anywhere in Europe or America, you would have to pay ten times as much or more. And we have never turned down a patient because he or she did not have the money to pay for it. Almost half the operations are performed by me."

I asked him about his successes and failures. "Very few failures," he replied. "If people with heart problems get to me in time, I can guarantee them a long life. My guru Frank Spencer used to say, your patients will begin to look upon you as God because you give them a second lease of life. But let me tell you, the hardest thing for me is to tell a patient’s relatives that I did my best but it was not good enough. They take it very well but it keeps bothering me for several days and nights. I keep asking myself: ‘Did I go wrong anywhere? Was there something more I could have done to save his life?’"

We finished our half-hour interview talk for Doordarshan and were relaxing over an over-sweetened glass of tea in the make-up room when his mobile phone began to ring. He heard the message and replied, " I am leaving immediately. I’ll be there in 15 minutes." He stepped into his limousine and sped out of the studio gates with the second one following hot on its heels.

Nudity as way of life

We Indians have a very ambivalent attitude towards nudity. On the one hand we do not see anything wrong in bare-bosomed sculptures of our goddesses, tribal girls and women. But if foreign women expose themselves on the beaches of Goa, local puritans kick up such a shindig that the police has to order them to cover themselves or march to the police station. Many beaches now have notices warning people against exposing themselves. In the western world, Australia, and New Zealand, nudity is becoming increasingly acceptable. Near Stockholm there are sea-fronts when on any sunny day you can see thousands of holiday-makers of all ages going about stark naked. In the heart of Berlin, there is a large park where young people lie on lawns without a stich on them. It is much the same on a beach not far from Sydney: a veritable concourse of naked men, women and children frolicking on sunlit sands.

The subject of nudity as a way of life occurred to me as I read a novel by David Sedaris called Naked sent to me from New York by my Rakhi sister Prema Subramaniam. I had never heard of Sedaris. He is the son of a Greek father and American mother. He has made quite a name for himself as a novelist and his Naked has been widely acclaimed as a masterpiece of wit combined with incisive analysis of young America; bumming around, drugs, heterosexual encounters—all within a close-knit family observing Greek orthodoxy in an ever-changing chaotic milieu. The main character of the novel, now nearing middle-age takes a holiday in an affordable nudist colony.

Hard evidence

Inspector: Did you catch the thief?

Constable: No sir. But I have his finger print.

Inspector: Where?

Constable: On my cheeks.

(Courtesy: Ujagar Singh, Chandigarh)

Diagnosis

Banta: "You know, Banto, a disease always attacks the weakest part of the body."

Banto: "Thats why you always have headache."

(Contributed by S.P. Singh Kaka, Bhopal)