A surgeon’s journey through precision and faith

Ever wondered how highly skilled and trained people go about making choices in difficult situations. A window into one such professional’s life was provided by my friend Dr. Tameem, heart surgeon, who has his hospital in Bangalore. When I first met Dr. Tameem, he didn’t look like the kind who spends his days cutting open people’s rib cages and holds their heart in his hands. With his athletic built and fitness, he could pass off as a martial art trainer or even a poet. A poet would not be a farfetched description of Dr. Tameem, as he handles the physical heart as adroitly as a poet would while referring to the metaphorical heart.

In my discussions with Dr. Tameem, I was trying to understand what goes on in the mind of this martial art practicing heart surgeon. I was trying to correlate how surgeons make life saving decisions and what is at stake for them.

“To understand that you have to come on an imaginary journey with me, Captain”. Said Dr. Tameem. (He never refers to me by my name, to my chagrin). I agreed. Let’s go on this journey, he said.

Imagine you are a heart surgeon, visited by many patients throughout the week in your hospital.

One such patient is this famous music director. You go through all the reports and conclude the patient requires immediate surgery and he has three arteries blocked. You schedule surgery, and you are quite confident about dealing with this case. As the surgery date approaches you start receiving calls from politicians and well-known personalities, adding unnecessary pressure. You don’t allow the pressure to bother you too much, in any case you have a good feeling about this case.

In the operation theater you carry out a beating heart surgery. You graft bypasses on three heavily clogged arteries. Everything goes as per plan. Patient goes home after a few days. If only every case was as simple as that.

Three weeks later, you have another patient with a similar condition and blockages. This is a poor patient, a person who cannot afford the treatment. That is not a very big problem, by god’s grace you are able to treat poor patients as well. You deem surgery is required and schedule one. For your level of experience it’s not a very difficult case, after all three weeks back you carried out a similar surgery on that music director. Everything had worked like clockwork.

This time there were no calls from politicians or rich relatives. Something is still bothering you. Your body shivers when you think about this surgery. Intuition tells you it’s not going to be an easy case to handle.

Day of surgery

You come in early, relax in your favorite chair and put yourself in a positive frame of mind. As the patient is wheeled in, you see your team completing their pre-op checklist. You talk to them about flying airplanes just to keep the mood light. That niggling thought is still bothering you, feels like a fine worry line on your forehead. You drive those negative thoughts out of your mind, Afterall there is no place for these kind of unnamed feelings for a professional like you.

Your team of anesthetists and others get the patient ready, and you start the surgery. The ribcage is opened, and you access the heart. You find the first artery and graft it with a bypass even as the heart continues to beat. All parameters are normal. Two more to go. You think maybe all those feelings of despair were just negative thoughts, and you make a mental note to guard against them in future.

You relax a little bit and then lift the heart to gain access to the other two strained arteries. As you lift the heart all hell breaks loose. All the parameters suddenly go haywire, monitors start beeping relentlessly, your team is frantically reading out parameters that are either too high or dangerously below the normal range. The once-sterile air is now suffocating, heavy with the unspoken dread- so thick, even a scalpel would struggle to cut through the tension. You let the heart gently descend back into its cavity, your own chest tightening in response. The weight of your intuition, the warning your body tried to deliver, now presses down with undeniable force. All your fears were true.

The dilemma…

If you continue with the two grafts, with these parameters, you will lose the patient on the table. If you don’t put those two grafts, the patient will not survive for long. Both the options are dead ends, figuratively and literally. Still struggling with the options, you ask your assistant,” What do you think, will this patient go home?”

“Yes, patient will go home sir”, she replies.

You look at her wondering whether she means it.

At least this gives you clarity, you resolve that the patient must go home. You think of God or the higher power, then it strikes you.

You immediately ask your team to get the heart-lung machine ready. The heart must be stopped and cannot be stressed anymore. Once connected, the Heart-lung machine does a great job of keeping the parameters within range. You manage to graft two more bypasses in no time.

After placing the graft, it’s now time to remove the heart-lung machine and revive the heart again. The next few seconds feel like a long pause, the internet of the universe trying to download the patients remaining life. Then the heart starts beating, in the sweetest possible rhythm. You and your team are delighted. The patient will go home, after all.

On your rounds a few days later, the patient greets you with a Namaste representing gratitude and blessings. That is the best compensation for your efforts.

As I sit back replaying this nail-biting OT saga, I see similarities with how pilots operate in challenging situations with precision and skill while dealing with intuition and doubts simultaneously. With an undeviating commitment to safety. As I came back humbled from this meeting. Dr. Tameem’s final words still rings in my years, he said- Remember Captain,

Doctor’s treat, God heals.