In July 2012, I had my first heart attack. I have written about that night separately. This page is about what arrived in my inbox afterward — emails from former students, family friends, and colleagues spread across four continents, all saying versions of the same thing in entirely different ways.
Reading them together, I noticed something that I have been turning over since. Almost nobody wrote about the illness. They wrote about me — what they remembered, what they feared losing, what they wanted me to know while they had the occasion to say it. A heart attack, it turns out, is one of the few events that gives people permission to say what they ordinarily keep to themselves.
I am recording some of these letters here not because they reflect well on me — I am aware of how that reads — but because they reflect well on the people who wrote them. And because they taught me something about the practice of medicine that no textbook had managed to.
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The Family First
My brother-in-law Dr. Vipin Zamvar is a cardiac surgeon in Edinburgh. He wrote with the precision you would expect from a man who operates on hearts for a living. He noted that I would probably be on Clopidogrel for a long time. He expressed surprise — “a bit shocked” — and then relief. Then, in a postscript, he asked me to use my recovery time to answer a clinical question: how long should a patient remain on Clopidogrel?
This is what it means to have a cardiac surgeon in the family. The concern and the clinical quiz arrive in the same email.
His brother Dr. Deoraj Zamvar, also a physician in the UK, wrote about Clopidogrel resistance and platelet aggregation inhibition — useful, precise, and characteristic of a man who cannot help being a doctor even when writing to a relative.
Dr. Uma Zamvar, a physician in California, wrote more simply. She was glad I was doing well. She mentioned lemon-flavoured fish oil capsules — apparently they do not have the smell. She said Raju would be coming to India in December and asked if I needed anything brought from the US.
The fish oil capsule detail is the one I remember. It is exactly how family writes.
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The Alumni — Four Continents, One Anxiety
The letters from former students arrived from Edinburgh, Canberra, Abu Dhabi, Lucknow, Mumbai, California, and Australia. They were written by intensivists, oncologists, rheumatologists, radiotherapists, and pathologists. They had different degrees after their names and different time zones behind their clocks. They were all, in their own way, saying the same thing.
Dr. Manoj Singh, from the class of 1990, now an intensivist in Canberra, wrote: “You have been and will remain a guiding star to a lot of students like me and are always remembered in our daily lives.” He wished that the heart attack was “just one bump on the road.”
Dr. Nitin Chavan, from the 1989 batch, now in Mackay, Australia, said he could have called — but thought I deserved a break from answering what, why, when, how, where, and who. This made me smile. He knows his teacher.
Dr. Arvind Ghongane, from the 1979 batch, wrote to say he was receiving a fellowship from the Geriatric Society of India, that his oration topic was “Adding Life to Years,” and that he owed his achievements to me and to Sevagram. He said this in a postscript, quietly, as if he did not want to make too much of it.
Dr. Ragu Krishnan, an ophthalmologist in Mumbai from the 1985 batch, wrote in Hindi and English together — Ishwar ki icchhaa aur hum sabki shubh-kaamnaayein aapke saath hain — and observed that my students must be missing “the heady cocktail of poetry and art” that I imparted to the teaching of medicine, “almost a taboo in the land of prohibition.” Dr. Rajesh Ingole, from the same batch, remembered the bedside teaching — the murmurs through the stethoscope, the supranuclear and infranuclear facial nerve palsy — “in the same land of prohibition.”
Two letters from the same batch, the same phrase, ten years after they had sat in the same ward. I had not known they remembered.
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The Doctors Who Became Patients — or Nearly
Dr. Nilima Ragavan, a paediatrician at Stanford, wrote something that has stayed with me. She said it must have been “quite educational to be on the other side” — to experience the hospital as a patient. She said she would be very interested to hear how I coped with it.
I have thought about this question since. The honest answer is: not as well as I thought I would. A doctor who becomes a patient discovers very quickly that clinical detachment is a professional habit, not a personal one. When the ECG is yours, the numbers stop being numbers.
Dr. VK Gupta, from the 1976 batch and a pathologist in Allahabad, wrote with characteristic wit. He said I had been “very cold and clinical” about a matter related to the heart, which showed that my brain dominates my heart. “Ha ha!” he added. He had been speaking to a mutual friend who, when asked what caused this in a man with no risk factors, replied in a sufiyana spirit: “Everything created by God has a use by date.”
I found this more comforting than any medical explanation.
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The One Who Wrote From the Night Shift
Dr. Sunil Jayaswal, an intensivist in Abu Dhabi from the 1987 batch, wrote while still on duty in the ICU during the night shift. He said he could not hold himself back when he read my email. He had not yet told his wife Maya the news.
He recommended green pumpkin juice — a glass twice daily — for reducing atheromatous plaques over six months to a year. I have not verified this in the literature. But the image of a former student, sitting in an ICU in Abu Dhabi at some late hour, writing to his old professor about pumpkin juice while the monitors beeped around him — that image I have kept.
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The Non-Medical Letters
Dr. Maureen Morgan was a classmate during my MPH at Berkeley. She is American, not Indian, and did not know me as a teacher. She wrote with the directness that Americans bring to affection: “It’s clear that you are someone who adds so much to this world.” She said she was imagining my stent staying clean and patent and my heart continuing “to beat vigorously with all of the passion that you have for life.”
I have had many cardiologists say reassuring things about my stent. None of them mentioned passion.
Dr. Sadhana Bose, from the 1985 batch, a public health professional in the UK, wrote that she had noticed during her last visit to Sevagram that I looked tired and worn out — “your poor heart was working extra hard without you realising it.” She suggested pranayam. She also noted that angioplasty “is almost like an OPD procedure nowadays,” which is exactly the kind of thing one doctor says to another when they are trying to be comforting and cannot quite stop being clinical.
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What I Learned
Dr. Amit Bhatt, an oncologist from the 1997 batch, pointed me toward two books — one about Dr. Nitu Mandke’s heart attack, and Majha Sakshatkari Hridayrog by Dr. Abhay Bang. He noticed I had posted birthday wishes on Facebook for mutual friends and correctly deduced I was recovering well. “PA is home,” he wrote, using the abbreviation that students use.
Dr. Amulya Kulkarni, a psychiatrist in the UK from the 1982 batch, observed that it is “better to receive a warning from the heart rather than be surprised by a MI.” He was impressed that I had texted Dr. Dilip Gupta at 6 AM about the successful angioplasty and then emailed everyone about the good news.
I did not think about that at the time. But reading it now, I think it says something true: that the first instinct, even after a night in the ICCU, was to tell people. Not because the news was good — though it was — but because the people were waiting.
These letters are why.