On being a Patient

Worldwide, an estimated three million coronary angiograms and angioplasties are performed each year. These interventions are used to look for blockages in coronary arteries and to open them with balloons and stents. Global Industry Analysts predict that by the year 2017, the global market of coronary angioplasty products is likely to be close to US$ 1.84 billion (about 10,200 crore Indian rupees).

Big numbers, these. Last Monday, I contributed a tiny drop to the angioplasty ocean. Admittedly, the drop was small but it caught the eyes of those treading along the shore. For, they were unable to fathom what made me land up in a cardiac catheterization lab.

Cardiologists use several risk assessment tools to estimate the person’s 10- year risk of developing cardiovascular disease. Almost all scores placed me in a low risk category. For example, The Framingham Risk Score suggested that 6 of 100 people like me would develop a cardiac problem over a ten-year period. The Interheart Study revealed that nine risk factors explain 90% of the global risk for heart attacks. I lacked all nine factors.

And yet, the Monday noon I developed cardiac pain that led to an angioplasty. I was lucky on several counts, though. I was working in the hospital when my chest pain began; I sought medical help quickly; my physicians swiftly administered me aspirin, clopidogrel and statin- drugs with proven benefits. My electrocardiogram showed no infarction; the echocardiogram showed no damage to the cardiac muscle. My colleagues in the ICU consulted each other and decided to accompany me to a cardiac hospital- 50 miles away.

Six hours following my chest pain, I was wheeled into the cardiac catheterization lab. The angiography began. The cardiologist chose my radial artery to insert a sheath, deftly threaded the catheter to my coronary arteries and injected the dye through the catheter.

As the dye began to fill my coronary arteries, the cardiologist smiled at me: “Good, you have no calcium lining the walls of coronaries.” And, after a few seconds his smiling voice brought music to my ears again, “your left main coronary artery is perfect.” The dye found its way into the left anterior descending artery where it hit a cholesterol-filled plaque that had grown large enough to bulge out of the artery wall and into the bloodstream. Like a rock sitting in a stream, it was causing the dye to move a bit sluggishly into the distal coronary bed. The cause for my cardiac pain was found.

 

Pages: 1 2 3

85 Comments

  1. Dear Dr Kalantri,

    The best way to become a better doctor is to become a patient !

    Your piece is a very useful contribution to pathography. However, I do have a question. You write – ” the cholesterol filled plaque was the cause for your chest pain”. I am not sure how you came to this conclusion ; and I would respectfully disagree with this. This plaque could very well be an incidental red herring

  2. First of all, I am glad that the acute plaque rupture was treated appropriately, successfully and in a timely manner.

    Second, what a wonderful perspective from “a horizontal position” – as only you could have pollinated in your uniquely inimitable style – yes, we practice medicine led by evidence described from “averages”, “means” and “generalities” – but life surprises us more often by the ubiquitous presence of “exceptions” – Why did this plaque develop? How did it suffer from inflammation? Why did the hot edge burst? What was the perfect storm that determined this interface in you that very day? What mental stress contributed to this event? Was there a microbial element that helped destabilize this plaque? We will never know the final answers and in that lies the very beauty of medicine which teaches us to never cease to think and question prevailing norms!

    Thanks so much for sharing this elegant piece and I am most delighted with your outcome – God bless and love to you.

    Mandeep

  3. Aniruddha Nene
    Aug 29, 2012

    Sir, 

    Your blog was great.  And so typical of SP that I know, you would not stop thinking for medicine even when you are a patient.

    I particularly liked :

    “But medicine is an inexact science- it involves nuanced and personalized decision making by both the sufferer as well as the caregiver. When they have to resolve an uncertainty and need to decide what is best for them, their choices are also guided by so many factors: their doctor’s recommendation, pressure from family and loved ones, dissenting expert opinion, confusing numbers, and individual perceptions about health and disease.”

    I could easily co-relate it to my own field. There is a perfect analogy here. When we implement Informatics somewhere it is never our own decision / control all the way. It’s a ‘three legged race’ and the success lies in synchronizing with each other’s pace. And amazing part is that this pace is different if one pairs with a new partner! 

    So in your case you try to understand if the patient is minimalist / maximalist / techno-savvy etc. But who shoulders more responsibility to quickly diagnose THIS nature of patient.. and arrive at best speed for synchronization ?… Many doctors including my relations sometimes grumble about touchy and paranoid patients and throw their hands up saying “I am applying the best of my efforts and look at this fellow going in tantrums!” I almost on every occasion tried to take patient’s side, maintaining that the patient has to go through this as an episode just a few times in life. But Doctors go thru this all along. So who should shoulder more responsibility to ‘manage’ the synchonization with more experience? Logical answer should be the doctor. However it is also important to that to acknowledge the fact that there are always exceptions statistically occurring far away from the standard ‘bell shape’ where the doctors is not expected to stretch his/ her tolerance in the best interest of the patient!    

    I agree that finally it boils down to the ‘pair’ and it becomes very personalized matter. BUT WHERE ARE GUIDELINES FOR THIS?A guideline is something that always helps like a lighthouse. So if we can some how formulate ‘Best practice’ in medicine that includes this process of synchronisation with patient then it becomes  ’appropriate care’. Otherwise it remains ‘medically evidence based’ care.

    Sir, Can we start an attempt to start a forum that will provide medical result ( evidence ) along with patient experience / perception about the care provided and then arrive at ‘appropriate care’ concept ? So while evidence based medicine can be globally / demographically / ethnically generalised and linked to ‘Care Guidelines’ in general, Approrpiate care has to do with much specific segments. Like a patient coming to Sevagram, say!

    Thanks for sharing this with me..

  4. Sudhir Bhave
    Aug 15, 2012

    Extremely well written! Society benefits if intelligent, articulate men (SP, Abhay Bang) get heart attacks!

    Sudhir.

  5. Shubha Phadke
    Aug 15, 2012

    Every experience adds to ones life and helps to grow as a human being and also a doctor.. Hope you back to work.. normal and fit again.

    Shubha

  6. Y Geetadevi
    Aug 14, 2012

    Sir,

    I was on a holiday- so didn’t pick up your post till I was back today. Initially I was shocked, but you chose the right option of getting a stent placed into your coronary atery. I felt good hearing about your speedy recovery; I think you would do very well with good blessing from near and dear.

    Aap sochte bahut hain sir…lekhak jo thehre

    Well, take good rest.

    Geeta (MGIMS, batch of 1994)

  7. Dr Sunil Jayaswal
    Aug 14, 2012

    Dear and Most Respected Sir,

    I happened to open my mail after a long span of time after we returned from our vacation of ten days from abroad and I am shocked to read that you suffered from the acute CAD. By God’s grace everything seems to have gone very well and you are recovering .Our best wishes are for you and your health and I Pray to God with my most sincere humble prays that your health returns back to normalcy soon.

    Do take some break from your busy schedule and spend some time on Yoga and de-stressing exercises. Such incidences in our life do make us to do the introspection in ourselves and make our lives more purposeful and worthy of what god THE ALMIGHTY has send us for.

    May this period of recuperation be very peaceful and calm giving you more inner strength and will power to handle it with care and compassion as you have always so delicately been doing with sincerity and in a genuine way for all the patients. Medical fraternity and all your students are with you wishing for a speedy and smooth recovery.

    I am writing you all this while still on duty in the ICU in the night shift as I couldn’t hold myself back when I read your mail and i have not been able to share this news with Maya yet.

    Once again our very best wishes for your recovery. Please do let me know if I can help you in any way…

    Take Care.

    Regards.

    Sunil Jayaswal (MGIMS, batch of 1987)
    Abu Dhabi
    UAE

  8. Dr Michael Galvin
    Aug 13, 2012

    Hi SP

    I only heard about your stent a few days ago when we were having dinner with Agam and Suresh. Sorry to hear you had that problem but it sounds like that is all very much behind you now. I enjoyed your article. It gives a very vivid feel of what it is like being ‘on the other side’. Have you published it? I do look at your ‘facebook’ occassionally and have seen some happy wedding pictures there. We are looking forward to seeing Dr Jajoo next month in the UK.

    Best wishes

    Mike and Hazel

  9. SR Halbe
    Aug 13, 2012

    My Dear S.P.,

    Do you really think that you were an ordinary patient? Why deceive yourself? You were “Doctor – patient” as against “a patient – patient”. You did not suffer even 10% of what a common man goes through. It is like a policeman going to another police station! He will have no idea of what a common citizen goes through in a police station.

    I invite you to go to some other city and approach a cardiologist without he knowing that you are a doctor. They will make you undergo minimum one, if not more, cardiac procedures, till your pockets are empty and your heart is full of stents! But I get some idea after reading your blog. Instead of doctors being sent to rural assignment, we must send them as “patients” in some other hospitals. We may devise a suitable “exchange programme”. This experience of doctors as patient may go a long way in ameliorating patient’s plight at the hands of doctor.

    Regards,

    S. R. Halbe

  10. Dr Abhishek Raut
    Aug 13, 2012

    Respected Sir,

    Its really nice to know that you are fine and we all pray that you remain so.

    As the old adage goes -

    “The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.”

    I am sure you have been a source of inspiration to many and will continue to inspire many more and shall be back soon to the classrooms and patients’ bedside.

    May the almighty bless you with loads of love, happiness and health for the years to come.

    Salubriously,

    Abhishek

  11. Dr P F Kotur
    Aug 13, 2012

    Dear Sir,

    100% truth……Tears rolled down my cheeks……A great narration!!!…….An eye opener for all Physicians.

    Can I forward this post to my colleagues and friends? Need your permission.

    Thank God everything sailed smoothly and smoothly too.

    Regards,

    PF Kotur

  12. Dr Sindu Chandran
    Aug 13, 2012

    Dear Dr. Kalantri,

    Greetings.

    Your post came as surprise in every sense of the word. After reading your post, I first thanked God for saving you and prayed for your speedy recovery and good health. I appreciate your remembering me and sharing your experience (after living here, this is the Americanized version of saying thank you, you must have figured out what I meant by that).

    To be honest, after I plunged myself into the U.S medical world, it is you who I remember the most. Documentation and evidence based medicine – how many times have I heard these words pour out of your mouth during my training at MGIMS. I can now understand what you meant. I feel you are an asset for the department of Internal Medicine in Sevagram – a portal connecting to the world outside Sevagram.

    Would like to have a long chat with you, there are so many things which would be fun talking to you about, hope You recover fast- would love to keep in touch with you.

    Sindu Chandran (MGIMS, batch of 1998)

  13. Dr Kapil Gupta
    Aug 12, 2012

    Dear Sir,

    Ah such a relief to know your instant recovery from acute coronary syndrome. You are the most revered teacher and a brilliant clinician with command on your writings (I still remember how in 1983 during my thesis you would sum up long paragraphs into meaningful passages with so much ease).

    MGIMS, the Medicine department, your students and your patients need you for a long long time. My family joins me in wishing you a speedy recovery. It is difficult to account for your acute coronary syndrome. You are a lovable, adorable non- jealous, thin, veggie, non-smoker with simple diet. I knew great men have something turning up unusual but there are millions of souls to pray and wish for you to continue doing your unfinished task for years together…..

    Kapil Gupta (MGIMS, batch of 1975) and family

  14. Dr Asha Srinivsan
    Aug 12, 2012

    Dear Sir,

    It was a pleasant surprise to hear your voice today. Thanks sir. It is very easy for a student to remember all her teachers, but a very difficult task for a teacher to remember all his students. But nothing seems to be impossible for you sir.

    You have been a great inspiration for many of us. At MGIMS, you have taught us how to speak to the patient, how to make a diagnosis without making a hole in patients’ pocket.

    You have been a very special person for me and my family. My dad respects you a lot and takes the liberty of disturbing you often. I’m grateful and indebted to you for taking good care of them. I pray to almighty to bless you with good health and stress free life.

    Please take care.

    With regards,

    Asha (1989 batch, MGIMS)

  15. Dr Shashi Seshia
    Aug 12, 2012

    Dear SP:

    Your post is beautifully written. You are a good writer, and one with a heart. I guess angina affects even the young, especially South Asians. The last time we met, 9 years ago you were thin and did not smoke. I hope your family is well. I read one of your papers-I believe it may have had to do with one of your children being a medical student-in the Journal of Indian Ethics. Sunil Pandya, who is a classmate from school, gave me a copy when I visited him in 2010.

    I stayed with the Galvins in Yorkshire in March 2012. I was attending a course in EBM at Oxford. They have really cherished their times in India.

    With all good wishes for continuing good health

    Yours sincerely,

    Shashi

  16. Dr.Revathi Aiyer
    Aug 11, 2012

    Thank God for your complete recovery. Had you not been such an excellent doctor and teacher you would have been a great writer the world missed and we gained.

  17. Vivek Poflee
    Aug 11, 2012

    Dear SP, For me this was an unexpected news. Never imagined that you could get CAD. My prayers to almighty for your good health hereafter.

    Take care.

    Vivek Poflee

  18. Dr Naresh Kumar Dhaniwala
    Aug 11, 2012

    Thanks for sharing your experience. I am sure any of us will react as you did.Life is more important than logic or evidence.Wish you a complete and speedy recovery.Best wishes from Sangeeta,Mrigank and Mukund also.

  19. Dr Dipesh Trivedi
    Aug 10, 2012

    Respected Sir,

    After coming back to India, I had written to you and then called you. But now I know why I could not get to you on phone. You were in cath Lab, but for very different reason than usual!!

    I guess in spite of what the risk scores suggested, statistically you were part of 6% figure from Framingham Risk Score. 6% in total but for you I imagine it was 100%. I remember when I was working in Mumbai many years back, the slimmest most laid back and sort of care free surgeon was the first to get CAD. Now with my hairs graying, time to look in to Primary prevention and Life Style modification!!

    In my specialty, like any other branch of Medicine, I have deal with lots of numbers and figures for decision making. They are more often required for informed consent. 6% is 6 in 100 but for patient it is 100%. I have used this phrase few times for consenting parents for their loved ones treatments. As you mentioned in your article, they come in all variety. Some want to know all, some none, some brood over the numbers and figures and get unduly fixed to a specific number. I found evidence based practice guide for ourselves. Consenting I thought is what we inferred from that. While working in West, quite a few times I found it unreasonable and too much to ask from the parents by asking them to make decisions by giving them multiple options with lots of figures and numbers. What has worked well is explanation of disease and treatment options their benefits and disadvantages, what to expect after the treatment. More often than not lots of parents at the end of consultation would ask what my recommendation is and tend to go with that. With this scenario, perhaps more common in India, it is our duty and responsibility to practice evidence based medicine.

    The challenge is to incorporate evidence base with patients’ perceptions, expectations, fears and to an extent finances. How does one keep this last point out of equation in our country? Just in few weeks of my work here, I have seen finances seem to be important factor in decision making not only for patients which is understandable but even from the professionals. Treatment Recommendations and decisions due to financial aspect from patients’ side tend to oscillate between ideal practice and best available practice. But what about personal financial importance given by professionals in making treatment recommendations. Many decisions by professionals are driven by that aspect rather than evidence base. Here it seems conflict of interest is on the verge of morality.

    “To err is human”. It would be irrational to expect otherwise. One can learn and improve with that experience. To realize and acknowledge that one needs to know and have open mind. But to err due to personal conflict of interest seems irrational. In these matters Irrational such decisions may appear but it is seems it is More Irrational to Expect Man (Medical Profession) to be Rational!!!!

    With that as you suggested in last paragraph of your article, let me get to the primary prevention. After all in CAD Angioplasty or Surgery is only a palliation of symptoms not a cure in itself.

    With Best wishes.

    Dipesh

  20. Dr Pravin Khairkar
    Aug 10, 2012

    Respected Sir

    Joined you bit late in the spurt of pivotal experience laden with emotions and delicious insight.

    The fragrance and force of your words and wisdom has crossed boundaries of continents…as soon as I reached here from Harvard, all my memories overshadowed by clouds of concerns….and as I asked myself why I am silent when all hearts are pouring, I wonder I was waiting for understanding the virtual truth of this life with my little mind and heart.

    It is difficult to be a psychiatric patient when I see them since last 10 years, but a good doctor can make it less so. But when physician become patient, lot of confusion and fear can be overcome by knowledge and compassion, and resistance to treatment is often, although by no means always, amenable to change by intelligent persuasion. The devil, as the fiery melancholic Byron knew, is in the detail.

    I suppose, it is even more difficult for a mind healer to empathize with someone who develops near death physical complications. But as Krishna says you never die which you realize only when you die is practically the best soothing pearl one can wear to shine!
    Love and regards to your art, science and gentle heart!

    Praveen Khairkar

  21. Dr Vijay Sharma
    Aug 10, 2012

    Dear Sir,

    Your experience and emotions just makes me remember, “The moment you are horizontal in an interventional suite or Operation theater, the world feels different!”

    It took the whole cardiology team at Care Hospital, Hyderabad three-and-half days to decide whether or not to attempt angiography/bypass on my 83- year- old grandfather not medically relieved for his recurring noctural unstable angina. His previous angio showed un-bypassable coronary anatomy. When everbody couldn’t arrive at a consensus, the Almighty intervened and immediate deterioration of his vitals on the 4 th day at Care cardiac ICU forced an urgent angiography followed by a successful life saving bypass surgery. (Touch Wood) till date, almost 2 years now. The four days of dilemma turned into a lightening fast sequence of events- ultimately only for the better outcome.

    No doubt, “The heart has its reasons which the reason knows nothing of.”

    And as its rightly said sometimes when nothing happens as per our will ..the best happens!! (beacause then what happens is the will of God himself).

    Wishing you best of heath ahead…!

    Regards,

    Vijay Sharma

  22. Dr Bhoomi Kumar
    Aug 10, 2012

    Dear SP Kalantri sir,

    What an insightful event!

    All the more so when it touches a learned soul!!

    At the horizon and at critical moments, surrender has its own beauty!!!

    Unlike the rational mind clouded by Descartean/ Newtonian linear causality.

    Surrender you did sir!

    Reminds me of Ramana (Maharishi) who surrendered to surgeon’s scalpel sans anesthesia and Ramakrishna (Bhagwan) who surrendered to his disciples wish, despite advanced states of bodily-suffering!

    Wishing you many more years of reflection, knowledge-sharing and insight into the mystery of human body-mind,

    Bhoomi

  23. Dr Hariom Ahuja
    Aug 10, 2012

    Dear S.P.
    Good to learn about smooth recovery. All the best.
    Hariom

  24. Anupama Gupta
    Aug 10, 2012

    Respected sir,

    It’s been long since I savored not only a write up but also the responses after it. You are really worth all the offered prayers, praise, concern and advice (like keeping stress away, Pranayaam, fish oil and even abandoning ‘doctori’) by the dear ones.
    We doctors consider ourselves logical people and believe in logics of disease incidence, risk factors, prognostic signs and all such things. But you proved this evidence based scientific hopes of mine wrong.

    In the world after your illness, anything can happen to anybody.

    As a cytologist. I have seen many a doctors cringing under my fine needle and always thought that if time comes, I’ll not be such a pain in my doctor’s neck. However I have grown a little wiser after reading your account- actually it is something more than the fear of undergoing an unforeseen event; It is the fear of surrendering the total power of decision making for ourselves to an another human being whom the unknown have chosen our healer at that moment. I could palpate that numbing realization pulsating through your words and I don’t feel sure anymore about me.

    I feel that the heart’s cryptic reasons indeed worked in case of Papa (Dr O P Gupta) and you as I see both of you extremely expert in keeping the unpleasant feelings with yourselves only and sharing smiles with everybody around.

    Reading the post was like attending a counseling session with you, about being ready for ‘no matter what’ in life. And believe me, you proved excellent counselor to all of us around you. A lucid brain (both left and right halves) and a tender (and convalescent) heart is what it is brewed of.

    I sincerely hope that I seem mature enough to you to mean these words ‘may the God bless you’ popping up from the deep of my heart.

    -Anupama Gupta

  25. Didi
    Aug 9, 2012

    Baap re! Tere itne chahane wale hain! Ab main aur kya likhun? Ab doctori chhod kar lekhak ban ja. Itna achha likhta hai!

  26. Abhimanyu
    Aug 9, 2012

    Dear Sir,

    Thank you for sharing your experience. As Woody Allen pointed out in the classic Midnight in Paris “No subject is terrible if the story is true, if the prose is clean and honest, and if it affirms courage and grace under pressure”.

    Although I’m not good at writing but I do, on occasion enjoy the recreational read. Your blog is always such a treat to go through. I was informed of your ailment by Amrita and was in touch with her throughout. We were praying for your well being and speedy recovery, though secure in the knowledge that as a physician yourself and with so many caring doctors around, you would be provided with the best available care.

    Reading about your experience served to change my perceptions about a doctor on the other side of the bed. It reminds me of that time, exactly a year back when I was operated upon for appendicitis. Initially I opted for ‘no surgery’ considering only 27% of cases showing recurrence and being optimistic I counted myself in the remaining 73%. But, when I did finally decide to go for surgery, I insisted on laparoscopic procedure and waited 2 weeks to ensure I get it done with the best possible intervention. Reminds me of your ‘minimalist-technologist’ seeking the most advanced option mentioned in your blog.

    Again, a perfect read to learn and enjoy!!

    Take care Sir..!!
    Regards,
    Abhimanyu.

  27. Uma Zamvar
    Aug 9, 2012

    Dear Jijaji,

    We are glad you are doing well. This was a shock! Given that you have almost no traditional risk factors for heart disease. This tells us there is so much we do not know about the heart yet! What I usually see in my Indian pateints is low HDL and high triglycerides. I am sure you have looked into that as well.

    They have lemon flavoured fish oil capsules available here. apaprently they do not have the same smell. The omega-3 fatty acids in fish oil are thought to be beneficial in treating high triglycerides, and are possibly beneficial in preventing heart disease.

    Please take care of yourself and keep us posted. I know I am not a good communicator but we always remember you and remember our visit to Sevagram.

    Hope to see you again next time we are in India.

    Regards,

    Uma

  28. Vipin Zamvar
    Aug 9, 2012

    Dear SP Jijaji,

    You would be the last person anybody would think would have coronary artery disease. However, you had the benefit of top class timely diagnosis and treatment, something that would not be available to the vast majority. I suppose you will be on Clopidogrel (plavix) for a long time now, in addition to your other medication.

    I was very surprised (a bit shocked) while I was reading your email, and then very relieved that everything has gone well. Hope everything stays well in the future as well. This must surely be a warning sign to the rest of us, to be on the look out for our cholesterol levels and other risk factors.

    Say hello to Bhavana.

    With all best wishes,

    Vipin

  29. Nilima Ragavan
    Aug 9, 2012

    Dear SP,

    We are all relieved that you had an uneventful recovery. One never wants to be an interesting patient.Although It would have been best if you did not have to go through this ordeal,in retrospect I am sure it must be a relief to know that you were able to diagnose it and get it treated in an expeditious manner and most importantly before it led to an MI.You are so right about the mysteries of the human body. The more we study it ,the more we marvel at what we know, we also puzzle over what we do not yet know about the body’s mysterious workings .

    It must have been quite educational to be on the”other side”and experience the hospital as a patient.I would be very interested to hear your comments on how you coped with it.

    Wishing you a speedy recovery. Take it easy and ease back into your work.

    Say hello to Bhavana from me.I know how tough it can be for the spouse .

    Best,

    Nilu

  30. Sadhana Bose
    Aug 9, 2012

    Dear SP sir,

    It was a total bolt from the blue though I have thought many times in my head since my trip in March about how tired and a bit worn out you looked!!! No doubt- your poor heart was working extra hard without you realising it!!

    Some guts though – to write from you hospital bed soon after surgery!! You are obviously on your way to recovery from the unexpected ‘minor’ diversion especially with that pampering from Bhavana ma’m and everyoen else. Jajoo sir also did not mention anything when I last spoke to him during the weekend.

    Do take care and look after your heart- it may have its reasons but you are intuitive enough to know what they are.

    With love and wishes for a speedy recovery – not just from the angioplasty (which is almost like an OPD procedure nowadays) – but also for the longer term recovery. You should start pranayam.

    Sadhana

  31. Yogesh Jain
    Aug 9, 2012

    Dear SP,

    It is so heartening to hear the neat recovery that you have had, and really wish for all of us that you remain well and resume your calling with the same gusto and energy.

    Yet I am worried why this happened. I think all of us, and you are one good example of someone who burns the candle at both ends and perhaps forget to look after oneself as much one should. It makes me sit up and worry for myself too. The conventional risk factors apart, isn’t work stress and unrelieved stress of dealing with so much misery not also risk factors?

    I will try to take a lesson from this experience of this for myself. And from all of us here wish you good health and joy at each stage of life.

    Zindabad

    Yogesh Rachna

  32. Biswaroop Chatterjee
    Aug 9, 2012

    Dear Sir,

    I am so glad you are doing well. Praise the Lord!

    We need you around for many more years; doesn’t matter whether you go to the bedside or not. Life is beautiful because of friends and mentors like you.

    Switching from the ‘we’ to the ‘I’, I love and respect you; always have, always will.

    Do take care, Sir.

    Hugs!

    Biswaroop

  33. Pravas Mishra
    Aug 9, 2012

    Dear Sir

    Whether these accidents happen to us or to those in our sphere of life, it makes us stop and re-juggle our priorities. Here’s wishing you all the best and a renewed vigour for evermore.

    Yours

    Pravas

  34. Renu Lamba
    Aug 9, 2012

    Dear Dr. Kalantri,

    My best wishes and prayers with you. I have always wondered why it will happen to you and Dr Gupta without any risk factors, healthy life style and all the more when you can monitor your chemistries to prevent. I always felt the guilt when my Dad had angina and I was in US and he was diagnosed with DM and high lipids. There was no concept of prevention in India then, nobody would have done yearly blood chemistries to prevent or early diagnose these. I made arrangements for him to come to Hopkins here, but doctors here told me that when Dr. Seth is in India why come here. I spoke to him, he was in Paris then, he opened his arteries. He is doing well. Thanks to Dr. Seth expertise and drug eluting stents.

    Plan to visit us in US sometime.

    Regards

    Renu

  35. Arvind Ghongane
    Aug 9, 2012

    Respected Sir,

    I was totally taken by surprise to hear it for you. A person with no risk factors nor any stress factor could develop a plaque.

    Still God is so kind to let you alarm you in time to save each muscle.

    In the end, We all pray for your speedy recovery to the fullest.

    Sir, we all need you with us, forever.

    Get well soon.

    Arvind.

  36. Manoj Singh
    Aug 9, 2012

    Respected Sir,

    You really got us all worried. I am happy that there was no myocardial damage and that your echo was normal. I am not surprised by the magnitude of response of well wishers. You have been and will remain a guiding star to a lot of students like me and are always remembered in our daily lives.

    I wish and pray that this was just one bump on the road and that the journey is smooth here on….

    With regards,

    Dr Manoj Singh

  37. Amit Bhatt
    Aug 9, 2012

    Dear SP Sir

    I totally knew I would get this blog updating your health status as soon as I saw u wishing Gayatri and Sumedh birthday notes on FB. Even Amrita was a little late than you on FB in writing, PA is home.

    I admire your attitude during these trying times. I remember reading a book on Dr Nitu Mandke , and his reactions when he had a MI. It would make a good read, try it.

    http://alka-mandke.blogspot.in/2009/05/about-book.html

    Another book my grandpa used to love during his MI times is:
    माझा साक्षात्कारी हृदयरोग by Dr Abhay Bang.

    I am sure they would give u good company for the next one week till u you return to full duty, Jazakallah !!

    Many Prayers for ur Good health,

    Regards

    Amit

  38. Maureen Morgan
    Aug 9, 2012

    SP,

    I’m so sorry you went through this, and thank goodness you’re ok!! It’s clear that you are someone who adds so much to this world, and I know in my heart that you have many many more happy, healthy, and productive years ahead of you!! My thoughts and prayers are with you, and I’m imagining the stent and remainder of your coronaries staying clean and patent, and your heart continue to beat vigorously with all of the passion that you have for life, your family, your friends, and your patients.

    Be well, my friend!!

    Warmly,

    Maureen

  39. Atul Singh Rajput
    Aug 9, 2012

    Dear Sir,

    Indeed a shocking incident for all of us. Who would ever guess that such a balanced personality would ever suffer a cardiac event? But we all felt relieved to hear that your left main coronary artery was normal. Sir, one thing which I can’t resist admiring is your ornamental vocabulary. It is hard to believe that a doctor with such suffixes would be so rich in his word store too. Let me tell you that even after doing an ICU day duty and reading your post at 1:36 am, my eyes didn’t feel tired. Wishing you a swift recovery and also wishing those innocent plaques not to lose their innocence.

    Good bye, Sir.

    Atul

  40. Ram Prakash
    Aug 9, 2012

    Dear Sir,
    As always articulate and thought provoking. You have eloquently described the conflicting emotions, the reality that evidence derived from population studies dont always account for what happens in every individual, and that heatlhcare is but a complex and sensitive negotiation between health care providers and patients, with generous helping of pharmacology and technology. All your students are enormously relieved that you are recovering well, and look forward to many healthy happy years for you to come.

  41. Bhavna Dhingra
    Aug 8, 2012

    Sir,

    A perfect masterpiece written by you, as always. Glad and thankful to God that you are back on your feet. I feel its time that the department of Medicine gets a state of the art Cardiology setup under your able guidance.

    Cheers to your good health and a long healthy life.

    Take care,

    Bhavna

  42. Aditi
    Aug 8, 2012

    Hi Dr. SP,

    Good to know you are feeling better! Wish you a speedy recovery and good health in the future :)

    Very interesting and heartfelt article. Thank you for sharing.

    Cheers,
    Aditi

  43. Farzan Siddiqui
    Aug 8, 2012

    We wish our Technophile Doctor and a Client quick recovery who understands not only medical but Technology importance in the field of Medicine.

    We wish you good health and speedy recovery.

  44. Ilina Sen
    Aug 8, 2012

    Dear SP.

    This was a wonderful piece- you are a great and very humane writer. Thanks for sharing it with us, and please continue to write.

    I missed seeing you as I was leaving wardha, but kept in touch through conversations with Ulhas, Suhas, and Ashwini.
    Greetings and congratulations to You, Bhavna, Ashwini,Shaily and Amrita (and of course zombie 2) on the successful outcome of this episode.

    Ilina

  45. Archana Mintri
    Aug 8, 2012

    Dear Mamu,

    All that matters is the Heart. It reigns as supreme organ inside as well as outside our body.

    Now it comes to mind …You are our Amitabh Bacchan of our family.

    You should have done a press conference, as people came to see you and shower their feelings of love and security towards you.

    Daily we hear about the heart warming words like angiogram,aspirins,ICU, cardiac arrest,LDL and HDLtypes of cholesterol,coronary blocks..etc…as words relating to this organ never end. The day it comes to a person who is very near to your heart the story changes like anything,everything seems to be out of place.The more it effects when this person is a Doctor ..a person who handles a big Hospital like MGIMS Sevagram.

    a person who is a good professor of medicine. A person who sees his patients and issues guidelines for there well being daily, a person who knows the aspects of how and why you get into situations of getting a blocked artery…still we are into such a situations.This is a message to all in the family including me to be on your heels early morning and get a brisk walk…walk for a healthy life. I have seen you mamu you are not at rest ..you walk up and down normally,food habits really good…the only factor may be that now we should and should take up that we are in our 60’s ..so this can happen to all of us one day.

    Although my emotions are beyond words. That shocking news from Ma was really beyond imagination, she could not take it up but she suppressed her feelings and narrated me the incident compassionately.

    Mami must have really gone into a thousand miles seeing your pain….
    Aashu had no words …Its totally different when someone near to you gets into high tides.
    Now that the clouds are over. Please think of a more uncluttered way of life.

    I thought of those days when Hanuman Tekri and Neem ka datooon..were the early morning chores way back in late sixties in Wardha.Today they have been replaced with laptops and Networks.
    Please also make a change if you can at MGIMS or else at Sewagram for a good Cardiology Centre so that others will not face the 50 mile run ….

    Alls well that ends well…
    Enjoy back to work. And take care..
    Love you.

    Archana Mintri

  46. Sushma Agrawal
    Aug 8, 2012

    Dear Sir,

    it was a pleasure going through your excellent English.I can understand your emotional turmoil at this moment and being younger than you I do not want to preach you on what to do and what not to do.I am happy to learn from you the perspective of different kinds of patients and I shall apply it in my decision making from today onwards.

    Also its my desire to listen to your teaching once again in the classroom.Insha Allah!

    With sincere regards,

    Sushama

  47. Vijayshree Deotale
    Aug 8, 2012

    Sir,
    I read your experience on being patient. After reading your experience I kept on remembering your one of the comments in the past- “doctors are at times worst patients”. But you seem to be a very docile guinea pig which doctors would love to handle. A poor guinea pig doesn’t have any option, except to look at faces through the corners of eyes at the people that are standing around him.

    But I never dreamt that a Thinny Minny person who walks so fast throughout the day, who eats just minimal, smiles a lot would have this event.

    I think a chapter on CVS needs to be revised. We must tell Harrison that predisposing factors are just not accurate enough to tell the whole story of getting a heart attack.

    Take Care, Sir.

    Vijayshree Deotale
    Professor Microbiology
    MGIMS, Sevagram

  48. Christine Ho
    Aug 8, 2012

    Dear SP,

    I was so surprised to read your email yesterday – I am so glad you are alright! I’m still digesting how this must be for you to have a mortality-encountering event. Although your MI was picked up and acted upon quickly before there was cardiac muscle damage (thank goodness) I’m sure that it was a sobering event that reminds us that we are all not immortal. So what matters in the end – a life well lived I think. And what that means to everyone is different…Some other time I will share with you my experience of being a patient – when I was 24! Definitely a life changing event. Time flies by quickly doesn’t it? Your son is married (!) and in medical school and daughter Mika is in Ireland for the summer and Lee at MIT for graduate school. I realize that a life can really pass so quickly and we’ll be both silver haired in not so long, with us feeling like it was not so long ago that we walked the halls of Berkeley together!

    It’s funny, I have a small windowless interior office and it has been a busy place of late. I have had numerous spontaneous meetings with people crammed in there, including my branch chief and team lead. And last week I actually thought of you, and how you would always have people in your apartment in Berkeley, where there was always something getting worked on, and how we knew we were welcome to come anytime.

    Anyhow my friend, I hope your recovery is smooth, and that you will take some time to relax. Perhaps with your new duties as an administrator on top of everything else, you just needed a break and a reminder to take time for life. If you and Bhavana ever come to visit U.S. again (or come to CDC for a meeting) please know that my house is open to both of you. We have a beautiful house here in Atlanta, with a saltwater pool, and the weather is tropical much like India! I’m actually interviewing for a CDC/WHO position based in Delhi on Thursday. I’m not the lead candidate and it would be too soon for me to leave Atlanta, but I could be there in a few years! Anyhow, it’s been a bit too busy with readjusting to new family etc. to visit you in Sevagram, but I have not given up on it yet – one of these years!

    Take good care and wishing you a speedy and effortless recovery,

    Christine

  49. Shivika Chandra
    Aug 8, 2012

    Dear Sir,

    There are some days (like today) when I realize why I love medicine. I had the chance to work up a couple of interesting patient histories today (Cortical visual impairment, Capgras syndrome masquerading as dementia) and this blogpost was a perfect way to unwind after a day at work – thank you so much for sharing it!

    Written in your inimitable style, it’s a case in point for narrative medicine and reflective practice. I particularly loved the lucidity of the post. The evidence incorporated is not numeric jargon, it’s simply put as “nine risk factors” and “6 out of 100 people”. Angioplasty is similarly outlined in a simple manner which would allow even a non-medical reader to get the gist of the procedure.

    It’s rare to find a post which captures one’s interest both professionally and personally – for now, I have a lot of new additions to my reading list

    1. Your Medical Mind – the blurb sounds interesting, and I’d love to read more on the individual subtypes (just realized my mom’s a naturalist, dad a passivist) .
    2. The complete Lancet paper on the INTERHEART study (an attempt to explore beyond Framhingham)
    3. The ACCF/AHA/SCAI practice guideline (a long read, ergo I’m going to selectively start with the clinical factors which influence the choice of revascularization)

    I confess, when I initially heard the news of your being in hospital my first reaction of disbelief was followed by a evidence-imbalanced “But how? Oh God, please don’t tell me we ” . In so many ways, this blog post was a reassuring read and you intuitively anticipated and addressed so many of the queries one might ask in such a situation.

    I’m glad that you were surrounded by a great team (both care-givers and care-takers) and had a speedy recovery – It’s fantastic to have you back Sir! :)

    Warm regards,

    Shivika

  50. Anshu
    Aug 8, 2012

    Dear Sir,

    Really beautifully written. I love the way you play around with words and finally coerce them to say exactly what you mean.

    Yes, I have experienced what you have said first hand on several occasions. You know what the right thing to do is as a doctor, but then you give in to patients, circumstances and your professional colleagues. All that you studied as correct suddenly disappears when an actual patient appears… especially if that person is close to you.

    I remember someone I know was having severe candidiasis and the dermatologist ordered an HIV. I knew what he was doing was the right thing, but I remember breaking into a sweat until the time the report turned out to be negative. What you study and what you practice are completely different things.

    Yes, your illness has given others more of a scare. But seriously I was glad to see you hale and hearty! Now, you seriously need to vent out all the stress and not be such an introvert!

    Take care,

    Anshu

  51. Dr Nikki Pant Pai
    Aug 8, 2012

    I am just pleased to know and relieved to read the write up. Got scared a little when i read your email.

    Good souls like you have lots of patients to heal.

    Your heart will heal with its inherent goodness and purity of your soul.

    No risk prediction tool is perfect, it is always under assumptions. Personalized medicine is here to stay…
    6% is ?high ( courtesy Framingham~) …doesnt predict individual risk for persons of south Asian ethnicity where baseline risk is high!

    Please take care of yourself. And take a good vacation!!

    Hugs from us all.

    Nitika

  52. Vinay Kumar
    Aug 8, 2012

    Dear Dr Kalantri: Thanks to this connected world, I just learned of your illness and prompt treatment. The blog you wrote is exceedingly honest and hence beautiful. All doctors should sometime be on the other side. You have done great service to your students, your colleagues including those sitting 10,000 mile away by penning your thoughts.
    I wish you speedy recovery and hope to read more of your writing.
    Regards
    Vinay Kumar
    University of Chicago

  53. Surendra Kalantri
    Aug 7, 2012

    Dear Chachaji,

    I think you are slowly inching towards writing your own biography in future. Your write up is a classic example of your own account of your heart. You wrote your heart story in a very pen friendly manner. I love one of your paragraph:

    “The doctors join hands with patients to make choices that combine the best of art and science of medicine. Unfortunately, medical professionals do not use data as often as they should, and instead, base their decisions on prevailing practice patterns, individual perceptions and experiences. This must change.”

    Also, I liked this advice:

    “Indeed four out of five coronary events can be avoided by just four simple behaviors: not smoking, exercising for 30 minutes daily, eating healthily, and maintaining normal body weight.”

    Please add stress to this list. Isn’t in today’s stressful world stress also contributing to the heart problems?

    Maintain good health and keep writing.

    Regards
    SAK

  54. Dr. Meera Kulkarni
    Aug 7, 2012

    डॉ एस पी
    तुम्ही सुखरूप आहात ही तर देवाची कृपा
    तुमचा कॅथ मधला डोळ्याने पाहिलेला आणि मनाने जाणलेला अनुभव वाचला
    अनुभव मोठा कडक शिक्षक असतो तो आधी परीक्षा घेतो मग धडा शिकवतो
    म्हणून डॉ अभय बंग म्हणतात हृदय रोग साक्षात्कारी असतो
    आपल्या जवळ च्या लोकांसाठी आपल आयुष्य खूप महत्वाच असत हे लक्षात ठेऊन काळजी घ्या
    मीरा

  55. Preeti Bajaj
    Aug 7, 2012

    Respected Uncle

    Good evening. Thank you for sharing blog. The way you write, express your thoughts is amazing. Thank you very much for the warm welcome, you were so normal to the extent that you discussed my health problems ….simply great…. only you can do this.

    Thats SP uncle for which we all ….respect him. This time I could see in this blog, your feelings truly as patient and you have related this phase also as learning platform for decoding relation between dr and patient, understanding their mental state….simply uncomparable.

  56. Anshu
    Aug 7, 2012

    Dear Sir,

    You certainly have a way with words, and I love how you nudge them, cajole them and finally convince them to say exactly what you feel!

    Glad the scare has passed over. I often wondered how someone with impeccable bedside manners like you do, would react when having to deal with another of the physician breed who wasn’t all that perfect! And didn’t you cringe when they went for the stent bypassing all the informed consent rules that you have stood by? But then, that is life! Some one else decides what is best for you, and surely, that person means well.

    One learns when one goes through this…. and then textbooks, lectures, and the cardinal rules… they all appear hazy! I was amused to read Akshay’s comments about the drug tasting exercise. Doctor, taste thy own bitter medicine, indeed! Thank God, doctors of other specialties are not forced to apply their scalpels or procedures on themselves… else this would be a more sensitive world!

    Take care of your health.

    BTW, I thought this deserved a place in the NMJI instead of a blog… do consider it for formal publication.

    Regards

    Anshu

  57. Parvin Ansari
    Aug 7, 2012

    Dear Dr Kalantri,
    Nice to see you back. Very good write up. I could not stop reading one started. It is a very interesting article. The best thing was the end of the article.
    I also enjoyed reading about type of patients and started thinking about myself, when I had my hysterectomy. My very little interference made me stay in the hospital for five days instead of 3 days. I was loaded with IV fluids by resident doctor because I asked if the urine color seems to be dark, and I need more fluid. This was under heavy sedation.

    Take care of yourself

    Parvin ,71

  58. Anurag Bhargava
    Aug 7, 2012

    Dear SP,

    A wonderful post, wise, luminous,measured, and full of insights, written under extra-ordinary circumstances.

    Thanks for sharing it with me.

    Take care,

    Anurag

  59. Chasanal
    Aug 7, 2012

    Resp sir,

    Sorry to know that you had to go through these events. But at the same time glad to know about ur recovery.
    I always had a feeling that doctors are worst patients, reading ur blog has changed my perspective and also it’s an eye opener towards better lifestyle and wellness.
    The concluding line is awesome.

  60. Vasumathi Sriganesh
    Aug 7, 2012

    I heard about your “being out of good health” (I simply cannot imagine you as ill!) – when Amrita mentioned that you are “back home” in Facebook and I later made inquiries.
    As everyone above has mentioned – your blog is as usual a superb account. Much as I wish it did not have to be about your health issues, I guess nature/destiny has its ways with our health.
    Others who have responded are all health professionals who have also been patients. Just today I was sharing with a colleague as to how I had an “almost emergency” surgery soon after I left my job at Hinduja Hospital. I was telling her that if I – someone so familiar with the medical environment could feel so unsure, about several decisions, how would other patients feel….

    And here – each one of you shares how you felt as a patient. I read Dr Sunil Pandya’s excellent account too in the NMJI. I have heard an oral version from DR KG Nair, the Cardiologist who had a heart attack… and more.

    I guess all our experiences show us that we are human beings first and professionals next. And it is important we remember that when we deal with humans we are helping.

    I wish you excellent health and I hope maintain it for long!

  61. Akshay Sharma
    Aug 7, 2012

    Dear Sir

    Good to know about your healthy recovery and as always, a pleasure to read your blog. Thanks for sharing.

    Just following up on what Manu started, a few days ago our pediatrics team, including the interns, residents, pharmacists and nurses all had a “drug tasting seminar”. We brought about 20 commonly used medicines on the pediatrics floor and all tasted them one by one. With the recent advancements and progress, we have flavored and made all these more palatable, but I guess having a first hand knowledge of what and how exactly they tasted would have helped. Even though we are expert and knowledgeable doctors, our knowledge of more of the procedures and simple things such as the taste of these oral medicines is limited to literature of the medical representatives. No wonder kids hate us when we prescribe them all these so called ‘orange and banana’ flavoured colored liquids which we are told they apparently ‘like’!

    Akshay

  62. Manu Mathew
    Aug 7, 2012

    Hello Sir,

    Good to know that you are back on your feet and fully active. I got to know when I inquired around why Amrita wasnt responding to calls. I guess all of us were praying for a speedy recovery from the time we heard the news.

    Your blog post, as usual is splendid. I would like to comment that as doctors, we often dont realize the trouble, pain and anguish that we put our patients through. Our perspective and practice will change quite drastically if we ourselves were to undergo a treatment or diagnostic procedure that we prescribe everyday.

    I was recently required to undergo a abdominal CT scan. They asked me to drink a particular liquid(a glycol) to increase the visibility in addition to the contrast. I had difficulty in drinking even a spoonful and was required to drink 2L. At the end I managed to drink about 1.3 L and told them that I couldnt simply drink anymore. I also never thought that the temperature increases quite significantly in the body during the exposure. The total process took an entire day of mine even though the CT per say took around less than 5minutes. I wouldnt undergo another CT scan unless there was no other alternative.

    I am pretty sure that the doctor who prescribed the procedure has never undergone the similar procedure. If he thinks about the procedure all that will come to his mind is the 5 minute exposure to X-rays in a machine and the result he expects to get.The elements of the foul drink, injections, time wasted etc. would have probably skipped his mind entirely…

    Is it important for doctors to know this? Why? will it reduce unnecessary prescription and intervention? or will it result in the doctor being more conservative? Probably a good research question?…

    Manu

  63. Rohit Sharma
    Aug 7, 2012

    Dear Sir!……As usual….a brilliant write up…we all are glad for the successful intervention and the fact that now you are hail and hearty……. ‘ the 9 risk factors and the interheart study’ was bit ‘scary’!……
    With Warm Regards!
    Rohit

  64. Anne Slater
    Aug 7, 2012

    This blog gave me more information about my own angioplasty and surrounding medical experience than I received 15 years ago in a big-deal hospital in Philadelphia (USA) under a big-deal cardiologist .

    I wish you the best of health and continued success in your writing.

  65. A M Tarnekar
    Aug 7, 2012

    Resp. Sir,
    A breath holding moment till I finished the bottom line. Thanks for giving guidelines from your own terrible experiences. Hope you guide us about other such inevitable but quite likely untoward situations without being part of them. Wish you a long healthy life..
    sincerely
    A M Tarnekar

  66. Pravin Wankhede
    Aug 7, 2012

    Sir,that was a Tendulkar’s (SPK) brave batting, nice batting sir, me tumcha dirgh ayushaa sathi prathana karto………… Pravin Wankhede

  67. Art Reingold
    Aug 7, 2012

    SP
    Greetings from Brazil. Sounds like you had a lucky escape and a good outcome. My best wishes on a speedy and full recovery. You may not have heard that Warren Winkelstein died last week at age 90. A great loss for us, personally and professionally. Best wishes. Art

    Sent from my iPhone

  68. Vinchurkar
    Aug 7, 2012

    Hi Sir ! As always a well written article !It was indeed shocking to read about your chest pain-block etc since you are otherwise so fit! Hope you are in best of health again and your ticker keeps ticking happily always! All the best !
    Regards,
    Vinchurkar

  69. Dr S Chhabra
    Aug 7, 2012

    Thanks dear SP. As always pearls with their own shine.
    Wish you a long, healthy and happy life.
    Lot of affection.

  70. Surekha Tayade
    Aug 7, 2012

    Respected Sir,

    I am extremely glad to find you fighting fit again. It was rude shock to see you in the hospital ICU bed and the question in the subconscious was if Kalantri Sir with his healthy life style can land into this then what else can happen?

    Let me tell you Sir, that at home, we have suddenly become cautious, with less oil in the food ( almost nil) and exercising consistently. In your ill health too you have succeeded in motivating people.
    I have gone through a similar ordeal when I was bedridden for almost 2 years because of polytrauma caused by vehicular accident, when I was a young postgraduate. Dr Tayade actually nursed me back to health. I can vouch that since then, I find every day very precious and want to live life to the fullest.

    My best wishes for your continued good health in the future. I am sure your zeal for life would have increased tenfold with this experience.

    Regards,

    Surekha

  71. Rishi Adhikary
    Aug 7, 2012

    Respected Sir,
    I have been expecting this blog to come up from the day I heard the shocking news. The connection to the blog was temporarily unavailable. It was a delight to find the link in my inbox.

    What I feel is that most doctors are themselves made in the “waiting rooms” or the “hospitals”. What it implies is the basic fact that most of us decided to become doctors in the long queues of clinics or the hospitals which hold role model doctors. Life after a Med School and with a 2- alphabet prefix does not remain the same. The naive mind is filled with sophistication as a part if medical training and that makes the concept of disease and health much more complicated. What is easily accepted by others remains open to reason for the medical mind. This could be sometimes the most troubling both to the healer and the healed.
    I have been at the receiving end of a similar situation when my ma got operated. Being in the OR and watching each step has a whole lot of issues when we actually know what can go wrong in each of them. In this regard perhaps, “Ignorance seems to be a bliss.”

    Seeing the other side of the coin is the VIP treatment that we give to the brethren, helps us get many of the standard medical care. The paper we did at Sewagram, gave a symptom to door delay of nearly 5 hours. Doctors seldom have to calculate this time for themselves as if we see the philosophy, doctors are already at the door (as you were minutes away from the Medicine ICU). So, what concerns us are the times after we reach the door. Your door to balloon time itself was a couple of hours which is a luxury that very few common men get, irrespective of the social status they enjoy.

    All in all, we are all thankful to the Almighty that it saved every corner of one of the most precious things that we ever got a feel of- The Heart of Kalantri sir!!! Hope you have a speedy recovery and a wonderful life ahead.

    Yours Sincerely,
    Rishi

  72. Ashish Goel
    Aug 7, 2012

    Words that come from the chambers of the heart often sound more forceful and have greater impact than those that come from the folds of the mind. QED

  73. Sunil Pandya
    Aug 7, 2012

    Dear Dr. Kalantri,

    Many thanks for sending me this essay – thought-provoking and very humane – as always from your pen.

    I am glad that you were left with no cardiac damage and that your cardiologist successfully opened out the narrowed branch of the coronary artery in good time.

    I have made a note of your very well-designed web site and look forward to returning to it again and again to browse past and future essays.

    Sunil

  74. Rakesh Khera
    Aug 7, 2012

    Sir

    I am happy that you have recovered well.
    Take care of yourself.

    Rakesh

  75. Renu Khanna
    Aug 7, 2012

    Dear Dr. Kalantri,

    Chinu forwarded me your mail with the link.

    Really sorry to learn that you had to go thru this episode. And also very grateful that you wrote about it and shared it so lucidly…. I think that we are all in the stage of life when we have to reflect on and learn from experiences like yours… even the most professional of professionals are humbled by these life experiences and they contribute to helping us to be even better as professionals, add a new dimension and perspective to how we approach our work….

    Thanks once again and keep well…

    Renu Khanna

  76. MVR Reddy
    Aug 7, 2012

    Dear SP,
    Thanks for sharing your feelings and for passing on useful take home messages to us, which reflect your continuing strong faith on medicine supported by evidence and science.
    - Reddy

  77. Dilip Gupta
    Aug 7, 2012

    Dear Sir
    Read the article. Well written.
    I saw many of our faculties running for treadmill test and EKGs after your getting angina. many of us have started exercising too!!!!

    Dilip Gupta

  78. Dr Ravin Das
    Aug 7, 2012

    Dear SP Sir,

    Enjoyed going through your well-written article. I too experienced what it is like to be a patient for a hernia surgery that I underwent a few years ago. It has changed the way I treat my intra-op patients.

    Ravin

    • Vijai Kumar Gupta
      Aug 7, 2012

      Dear SP,
      I enjoyed your view-point.I have been reading lot of articles on utility/futility of evidence based medicine by eminent professors.You have very honestly narrated the whole episode and the decisions taken .I would also have reacted in same manner.The objectivity comes only as an afterthought.
      The debate will continue………………
      Picture abhi baki hai dost……………….
      VK

  79. Nitin Chavan
    Aug 7, 2012

    Respected Sir
    Good to know that you are back and fine.
    This was a kind of “live commentary” of the cath lab events – not only for non medicos but for medicos as well .
    Of course not to mention its an “update on cardiology” for people like me.

  80. Kishore Shah
    Aug 7, 2012

    I can see that the process of introspection has begun in real earnest.
    Invariably, the first question after a cardiac event, which the patient asks himself, is, “Why me?”

    Everyone has to decide his own answer. Right or wrong, the answer that we get to that question can be life changing. Best of luck with your quest.

  81. Ganesh Srinivasan
    Aug 7, 2012

    Dear Dr.SPK, your heart , your head , science,poetry, art, vulnerability and tremendous strength and insight shine so brightly in this piece. I cried and I smiled and I thought and I wondered. Thank you dear Teacher, take care , so glad to read your work and waiting for you to write the book which I am sure has to be written!
    With warm regards,
    Ganesh

  82. Ragu Krishnan
    Aug 7, 2012

    Lucid.

    Dr. SPK, you have woven a masterpiece out of emoton, objectivity and science.
    A great example of spirituality and detachment this, to recount one’s own experience.

    In the end, some great ‘take homes’.

    Glad, I read this!

    Take care.

    Warm regards,

    Ragu Krishnan

Submit a Comment

Seo blog