Bypass Thanjavur for Bypass Surgery or Not? - Part 1

Early this year, I was visiting India on an official trip. I was visiting the offshore teams that I closely work with. The teams are in Bangalore and Delhi. I also was trying to squeeze in some personal work trying to kill two birds in one stone. 

After my New Delhi visit, I was flying back to Bangalore. My flight was delayed by a couple of hours. Instead of landing at Bengaluru International airport at 10 PM, it landed at about mid night. After landing and turning on my phone, the first message I received was "Dad hospitalized. Heart attack, Call Sister". Couple of frantic phone calls later, I learnt that, My dad had a mild heart attack and is now at Meenakshi Hospital, Thanjavur. My Mom was very calm and said that he is under observation and nothing to worry. 

The first decision was - do I leave for Thanjavur immediately or in the Morning ? To make life a little more interesting than what it was already, some of the political parties had called for a strike to protest against the new dam being built by Karnataka. It was supposed to be from 6 am to 6 PM the next day, and the epi center of it was around Thanjavur. Great!

I decided to take a cab and went straight to Thanjavur and reached the hospital at around 7 AM. I have never heard about Meeakshi hospital before now. I had no idea how it would be, and I expected it to be one of those private hospital that is typically a big house converted into a hospital. I was pleasantly surprised by what I found there. It was a new, well maintained proper hospital.

The security guard did not permit me into the ICU since it was not visiting hours, and after explaining to him that I am the son of the patient admitted, he reluctantly let me in. I was relieved to find my dad in good spirits. I was impressed to notice the facilities. It was clean, and almost each patient had a nurse attending them. I am neither a medical expert nor a hospital management expert, but I could see that the equipment and the facilities were state of the art.

The waiting game began. Every other hour I was asked to buy some medicine or the other or pay for a test or the other. In the mean time, I was constantly on the phone with friends, family and well wishers. One of our relatives is a Doctor by profession and he was suggesting the things to check with the care providers and making sure my dad was getting the right treatment. He did not know much about the hospital either and was trying to get feedback from his circles. 

Some of my friends, my class mates are practicing Doctors. I was checking with them in terms of how the hospital was and the Doctors etc. We were all expecting some sort of angioplasty would fix him up and the specialist Dr Kesava Moorthy's name cropped up in my discussions with my mates and all were talking highly of him. As expected angiogram was performed on my dad but, what we did not expect was the extent of the blocks. Dr Kesava Moorthy explained that 2 out of 3 vessels are 100% blocked and the remaining one was estimated to be 70% blocked. Bypass was the option for him and a Dr Suresh Babu would be the right person to advice us and there is nothing that he could do.

We were a bit disappointed to know that he has to undergo a full blown surgery. There were several questions burning in our minds and we knew that we have to make some decisions. 

The facts were:

1. We are looking at a major surgical procedure. 

2. We don't know much about the hospital.

3. We don't know if the hospital had the facilities to perform such a procedure.

4. We didn't know about the surgeon - we could not get any feedback from any known sources.

The most important question now was to do the Bypass operation in Thanjavur or Bypass Thanjavur and go to a place where we get good feedback from dependable sources.

Part 2.

Government officials & Service mindedness

By now you may have read my earlier posts and figured that my dad had a heart attack and underwent a bypass surgery. He did, and the events and interactions during the last fortnight were quite interesting and made me realize many things about the people and organizations and most of all about myself.

My dad is a retired professor of chemistry, receiving a government pension. Since I have been away from India and Tamil Nadu for better part of last decade, I did not realize that government of Tamil Nadu has introduced a medical insurance scheme along with its pension scheme and people who enroll get a decent medical cover. Since his condition was eligible to be covered under the medical insurance scheme, the hospital guys gave me a form and asked me to get it stamped and signed by the Treasury office.

I have never been to the Treasury office and frankly speaking had no clue as to what the process was. Whom should I meet, what documents do I need to produce, how many steps before I can get the required approvals and so on. One of our family friends had some friends in the Treasury and was able to find out the process and also get the required forms and requested me to meet the Treasury officer in person and get the signature.

On the appointed day, I turned up at around 10:30 AM at the Treasury office, Thanjavur. It happened to be the first day of the current financial year, and at this time of the year the pensioners are required to appear in person so that, proof of life can be provided and continue collecting the monthly pension. The scene could not have been any more pathetic.

The Treasury building is already an old and almost ancient building, I am surprised that it is not yet classified as a national monument of historical significance. On a hot, summer day when the mercury is boiling and threatening to break the thermometer and burst out, in a room with is very badly ventilated, measuring not more than 250 sq ft, about 20 odd government officials and clerks are trying to help about 50 odd 65+ pensioners who have formed a classic Indian queue, i.e stand where ever you could place your feet. The room was hotter than the outside by at least 4 degrees. 

There were couple of ceiling fans making more noise than a steam engine and about three desk fans.

I truly understood the meaning of appalling working conditions. One of the clerks had put a couple of card boards on their chair because the seat of the chair was broken.

Finally when I reached the counter where I was supposed to submit the forms, the lady behind the desk explained the process, and gave me directions to couple of desks in different buildings where I need to get the required signatures. She was in a hurry and did not have the time to explain things more than once. 

For once, I did not feel angry at what appeared to be less tolerance on the Govt official's side and what would normally be considered as bad customer service. That they turn up to work every day in those conditions, is itself a service.

I am sure the government departments have enough money and budgets to set up a decent, air conditioned offices. But then I guess its reserved for "Senior" officers and "higher ranking" officials. The "Raj" mentality has not gone even after 60 odd years of Independence. While all are equal under the law and in general, its bloody obvious that some are more equal than others.

PS: The officials were very helpful sorted out the documents, and in about a day's time we got the relevant insurance approvals and availed cashless treatment facility. We did cover the shortfall.

Accidents - it happens only to others. Not me.

My dad had a myocardial infraction, in lay mans terms heart attack. We admitted him and he was in ICU for a couple of days before his bypass operation.

In the 2 days I was waiting at the doors of ICU, I observed atleast 3 cases of serious head injuries - all of them men between 25 to 30 ish years. All of them riding a two wheeler. A basic helmet might cost probably in the region of Rs 1000. I am sure that the injuries could have been less severe.

One particular scene still fresh in my memory, a young lady not more than 25 years old was a state of utter despair, tears flooding her eyes, holding on to what I thought was her mangalsutra, and looking down at her badly injured husband, he was in a coma. The nurse attending the victim, advice her that he can still hear and and probably see her, and she needs to stay positive and radiate hope. This girl immediately wiped her tears and tried to put up a brave face. All this was happening when they were taking the injured man for an MRI scan.

I later learned that the man was riding a motorbike and was hit by a bus and thrown off. 

That scene will stay with me for the rest of my life. That moment was a stark reminder of the fragile nature of life. Everything that we think is a long term and important and the things we take for granted, our dreams, our wishes, our achievements, our great success stories - all of it, is just one blow away from tragic consequences.

It is one thing where my dad who is 72 years old, who has completed his duty towards his parents, family, has had the pleasure of playing with his grand children and has experienced a relatively good & long life, ending up in the ICU with a life threatening condition. It is a completely different thing where a 30 something chap, ending up in a life threatening condition leaving behind a devastated wife, desperate parents, god only knows if the couple had any kids or not. 

And to think that this was completely avoidable, by a simple act of wearing a helmet, made me wonder why? Why people don't value their lives? In Thanjavur, I saw 3 people wearing a helmet out of possibly several thousand two wheelers. The attitude among riders seems to be "Accidents are something that happens to others, not me". It is true that out of a hundred thousand riders, only a few hundred end up in an accident and end up with nasty head injuries. However, when you are the victim of an accident, 100% of you gets into trouble and guess which body part gets knocked about the most? 

Its easy to blame governments and law enforcing agencies and say, they have not made helmets mandatory or police is not penalizing offenders who wouldn't wear helmets. I respectably point out that that's utter bullshit. Its your life, you don't need a frickin government to tell you that.

I think that people who respect and love their spouses, parents, children and most of all themselves wear helmets, others are just waiting to become an accident statistic.

PS: At the time of writing this article the Girl is still waiting for her husband to regain his consciousness . He was moving in and out of consciousness,  and she has not lost hope. Its been 15 days since the accident. She and her husband are in my prayers.