Being a cardiac surgeon…
for those who want to experience a cardiac surgeon’s life.
The life of being a cardiac surgeon is nothing short of a Roller coaster ride. Practicing cardiac science is a serious business handling life and death every day. Every patient teaches us something as they leave which is worth sharing. Being in a busy transplant unit, saving a patient near cardiac arrest needs quick meticulous planning and also flawless execution. As this is cardiac surgery there is no room for error, else it costs human life. Like anywhere else, people who work behind the screen are many times comfortably forgotten.
One such case worth sharing is how we handled a patient referred to us with just a few breaths left.
Being a renowned Transplant team in India , on a Saturday evening we got an urgent referral from Erode through a known cardiologist. We came to know that there is an 11-year-old girl in his ICU rescued after two cardiac arrests and her heart was hardly contracting. The girl’s heart was dependent on multiple drugs and on high doses to do its minimal work. We were here in Chennai 500 Km away from the patient. With the expertise and infrastructure we have, we were confident about saving the child but the child is beyond our physical reach. By the time we got the first call, it was 10 pm. Spoke to the cardiologist there, but he had done all he can do. The plan was to consider shifting the child from Erode to Chennai on the road which was the only possible way that was extremely dangerous as her heart was not stable enough. It’s nearly 7 hours travel on road. The team here in Chennai and the medical team in Erode were in detailed discussions until midnight. The other hurdle was that she needed a cardiologist or Intensivist to accompany her to handle any crisis during transit. It was in the middle of the COVID-19 lockdown and many physicians were in quarantine after their COVID duties. It was 1 am when we dropped the plan to shift her to Chennai. What next ???
Only thing running in our mind was we shouldn’t loose the girl.
There was an ongoing talk for collaboration of MGM Healthcare, Chennai with PSG institution, Coimbatore for setting up a Heart and Lung Failure program. We decided to seek their help (Coimbatore is nearly one hour drive from Erode). We straight away called Dr.J.S.Bhuvaneshwaran, the director of the institution. It was around 1.30 am by then. When we gave him the case details, he immediately initiated the protocol to shift the patient to PSG hospitals, Coimbatore. Dr.Vinod, pediatric cardiologist in Coimbatore interacted with the cardiologist in Erode and stabilized her electrolytes and started on drugs to control her heart rhythm. Now the next hurdle was getting an ambulance. It was 3 am and as the institution was handling a heavy load of COVID patients, there was no in-house ambulance available at the time. Dr.Vinod, cardiologist through his contacts he arranged a private ambulance. He loaded the ambulance with all the essential things to shift the child from Erode to Coimbatore. As all his juniors were busy managing Covid patients, he himself got into the ambulance and started to Erode by 5 am.
The whole night, myself, Dr.Ganapathy (my senior colleague and mentor) and the medical team in Erode and Coimbatore were on the phone tracking the child’s clinical status and the process of transit. By 6.15 am team from PSG hospital reached Erode .The patient was stabilised and shifted back to PSG hospitals by 8.30 am. Once we confirmed her safe transit to Coimbatore , we had sigh of relief. The transit was unnerving for all of us, as there was high chance of another cardiac arrest. The child had quaternary care in coimbatore and the heart was stabilised.
I travelled along with Dr.Ganapathy to Coimbatore for assessing the child the very next day. Her heart was in a very bad shape and she needed urgernt heart transplant. Once she was optimised for Heart transplant she was shifted to Chennai and she underwent the same in a month. The child was discharged in 10 days.
Nearly 50 people have joined force and worked in tandem on that Saturday night with all their adrenaline levels at the peak with a common goal. From the Director of an institution to a housekeeping staff next to the patient has an equal share in saving the girl.
The momentum and driving force for us is the smile when the patient leaves us as they go home well.
