On January 26, 2023, I was admitted to the MGIMS ICCU with a heart attack. The details of that night — the ECG, the thrombolysis, the second dose of reteplase, the moment the pain finally lifted — I have written about separately, in “The Republic Day, Redux.” This page is about what came after.
When you survive something like that, people write to you. Not the polite, obligatory letters that institutions produce for retirements and farewells. Something rawer. Something that people normally keep to themselves because there is no occasion to say it — until suddenly there is.
I received dozens of emails. From former students in Liverpool and Memphis. From a Harvard professor who once sat in my ward. From a staff nurse who said the news was “indigestible.” From a medicine resident who told me she had closed her eyes and prayed while I lay on the table, and that within a minute, my pain had subsided.
I did not know what to do with these letters at first. I still do not, entirely. But I know they deserve a page.
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The Resident Who Prayed
Dr. Shifa Guhagarkar was the resident on duty when I walked into the ICCU complaining of chest pain on the morning of January 26. She later wrote to me with an honesty that I found remarkable in someone she described as “the smallest right now in the profession.”
She wrote that she had a mind block when I told her I had chest pain. That she acted mechanically, by impulse, reaching for the ECG without thinking. That she regretted making me walk to the bed for it.
She described the moment when my blood pressure shot to 180/100 and my heart rate dropped to 60. “A chill went down my spine,” she wrote. “I was scared for the worst.”
And then: “I closed my eyes and silently prayed. Within a minute after that, sir, your pain subsided.”
I have taught medicine for forty years. I have taught residents to examine evidence, to trust data, to follow the science. Dr. Shifa did all of that with calm efficiency on a morning when her teacher was the patient. And then, when the science had done what it could, she prayed.
I do not think those two things are in conflict. I have lived long enough to know they are not.
***
The Staff Nurse at the Counter
Ms. Nandini Patil works in the registration OPD of the Medicine department. She is not an alumnus. She has no publications. She wrote to me in the simplest English I received, and it was the most direct.
“The news is really indigestible that you are leaving.”
She was not writing about the heart attack specifically. She was writing about the years before it — the times she had come to me with a sad face and left with a smile. “You will never leave our hearts,” she wrote. “Hats off to your work sir you have another level of potential in you.”
I have received letters from professors at Harvard and consultants in London. None of them landed quite the way Nandini’s did.
***
The Alumni
The emails from former students followed a pattern I had not anticipated. Most of them did not dwell on the illness. They wrote instead about what they remembered — which told me more about what had mattered than anything I could have concluded myself.
Dr. Iada, from the 2001 batch, now at NEIGRIHMS Shillong, wrote that she still proudly tells people that her institute — the first rural medical college in India — has had a Hospital Information System since 2005 and went paperless in 2012. She remembers the clinical lectures. “Making the lectures so simple and putting everyone’s brains into action in a very calm atmosphere.”
Dr. Rishi Adhikary, from the 2006 batch, wrote something that I have read more than once. He said that if he were to make a slide deck of his life story, the introductory slide would carry the quote “It’s not the destination, it’s the journey” — with Ralph Waldo Emerson’s name crossed out and mine written in its place.
I do not know what to do with a sentence like that either. I am recording it here because it happened.
Dr. Amulya Nadkarni, from the 1982 batch, had visited MGIMS recently and written with the eye of someone seeing the place after years away. He said the Institute was lucky to have me at the helm for twelve years. Then he added, almost as an afterthought: “The most controversial may have been the management of the pharmacy, but I hope that the Institute has the sense to persist with it, even if it isn’t exactly beneficial for the bottom line.”
That sentence pleased me more than the praise. He understood what the pharmacy policy was about — and why it mattered.
***
From Across the World
Dr. Mandeep Mehra holds the William Harvey Distinguished Chair in Advanced Cardiovascular Medicine at Harvard. He was once a student in Sevagram. He wrote that my legacy is “forever etched in the institutional fabric” of MGIMS — which is the kind of sentence that Harvard produces with ease.
But then he wrote something simpler: “You will now bring the talent of your experiences woven into the cloth of your exquisite expression to us all.”
Dr. Thillainayagam Muthukumar, from the 1985 batch, a radiologist in the UK who told me he has no social media presence, wrote that he remembers me as a teacher who showed him that the role of a doctor is “a role of love and service.” He said fresh vistas await. “Get the boots mended and ready for new adventures.”
Dr. Ram Prakash, from the 1987 batch, now a consultant endocrinologist near Liverpool, wrote warmly and mentioned his nine-year-old son Rishi who loves art and writing, and his three-year-old daughter Reva who ensures every ounce of attention is directed at her. He invited me to visit. These are the details that stay.
Dr. Sanjay Pai, pathologist and head of department at Manipal Hospital Bangalore, wrote in the register I appreciated most: brief, precise, and ending with a PS about Ramanujam and cricket analogies that made me smile. “You are a test cricketer, not a T20 tamasha man.”
He is right. I have always preferred the long game.
***
Sister Gini
Sister Gini is an ICCU staff nurse. She wrote after the heart attack with a warmth that carried no professional distance at all.
“God is great,” she wrote. “You reached ICCU on the 26th morning at the right time. So, you were able to get the right treatment at the right time by the right people. It made a great difference in your recovery. It was a miracle of God’s love lavished on you through a competent team spirit of compassionate care.”
I spent thirty years teaching my residents to be precise about causation. Sister Gini attributed my recovery to God, to competent teamwork, and to the right time — in the same sentence, without contradiction.
She may be right about all three.
***
What These Letters Taught Me
Dr. Yogesh Kolkande, a former student, wrote the most philosophical letter. He read my farewell note multiple times, he said, “to understand how a wise man like you navigates life.” He wrote about the rate of change of change, and the question of when to hang up one’s boots, and the need to rediscover oneself every second of life.
I am not sure I am the wise man he describes. But I know what these letters, taken together, told me.
They told me that people remember the small things — a calm lecture, a sad face made to smile, a corridor conversation about a child’s chest pain. They told me that the pharmacy policy mattered to people who understood what it was trying to do. They told me that a resident prayed at my bedside, and that a nurse in the OPD found the news indigestible, and that a pathologist in Bangalore compared me to a test cricketer — and meant it as the highest compliment.
I received these letters because I had a heart attack on Republic Day and survived it.
I am glad I survived it. Partly because of the ECG, the reteplase, and the angioplasty the next morning. Partly, perhaps, because Dr. Shifa closed her eyes for a moment and asked for help.
And partly because I had not yet written any of this down.