The visionary speaks

The visionary speaks

POORNIMA KAVLEKAR

Dr. K.M.Cherian, a pioneer in pediatric cardiac surgery in India, has performed more than 39,300 operations in the last 38 years of his career. An honorary surgeon to the President of India from 1990 to 1993, he now runs Dr.K.M.Cherian’s Frontier Lifeline Hospital, a cardiac hospital in Chennai, which he started in 2004. And he has big dreams for his hospital – he wants it to become the best research institute in the country. The surgeon’s current passion is Frontier Mediville, a medical village, where he wants to build the first and the only platinum medical science park in the nation.

He has many firsts to his credit – the first heart transplant in India after the legislation of brain death, the first bilateral lung transplant, the first pediatric heart transplant, the first auto transplant and the first heart and lung transplant. However, he believes that these are not his achievements but are opportunities, which once identified and acted upon, become an achievement. In this interview, Dr. K M Cherian reminisces about his journey as a surgeon, his various achievements and some important lessons that he has learnt along the way.

You have founded hospitals and pioneered treatments like coronary artery bypass surgery, the first bilateral lung transplant, the first pediatric heart transplant and so on. What according to you is your biggest achievement and why?

There is a saying by the Greek philosopher Epictetus that god chooses his servants at birth, perhaps even before.  I believe that it happened to me because even before I was born, when my mother was three or four months pregnant with me, somebody told her that she is carrying a boy who will have a mole on his right wrist and he will become a doctor, a surgeon who operates on the heart. In 1940 there was no heart surgery. So I believe that this is not my achievement, it is fate. I have not achieved anything except that I had the fortune to understand that this is an opportunity and I worked on the opportunity. I became a cardiac surgeon. I trained in Australia initially where I never knew anyone.

After I came back to India from Australia and New Zealand, where I went as a migrant, I joined Railway Hospital, which was a non-descript hospital. And within a week of my coming back to India, I did the first coronary artery bypass surgery in the country. But the funniest thing is that I never realised that it was a first of its kind in the country. So that is not an achievement. Achievement is something for which you prepare and go and do it. This is something, which happened without my knowledge because of the opportunity that presented itself.

I have not achieved anything except that I had the fortune to understand that this is an opportunity and I worked on the opportunity.

What weightage do you give to fate and destiny? And why?

When I did the first transplant, there were other hospitals in India that were looking to perform transplants. They were preparing recipients and looking for donors. I was not looking for it even though I had the experience for it. I was working in a couple of transplant units in Australia and the U.S. And when I was in Vijaya Hospital, I was asked by the then health secretary, Dr. Srinivasan, to be a part of the committee that was legalising brain death.  After this, I had a donor but didn’t have a recipient. The donor happened to be related to people in the railways service and I happened to work in the railways. So they were keen that I do the transplant and agreed to it only if I would do the transplant. This is fate. I subsequently found a recipient in Government General Hospital, Chennai.

We had an infant – one year and 10 months old from Noida. At the right time, we had a one-year-old donor from Bengaluru. And that was the first interstate infant transplant.

The most striking thing is that in one night we had two young fellows with two blood groups – A and O who needed a transplant and the same night we had two donors with A and O blood groups. So we did two transplants in one night. This proves Epictetus right. You try to achieve a lot of things, but if you do not have something else, you cannot achieve it.

How much of your personal and professional decisions do you base on intuition?

I am interested in pediatric cardiac surgery. Christiaan Barnard, a South African cardiac surgeon, said that if you are destined to do certain things, it will happen. (Of course, you have to work hard for it). Pediatric cardiac surgery is difficult as the decisions are immediate and you should have a strong intuition because it is the correction of congenital defects. While intuition does come with training, there are certain times where intuition is also instinctive and you have to be a little street smart to recognise that. It needs a fair amount of guts too as these surgeries are high-risk.

You are known to have a wonderful memory. Can you take us down your memory lane and share with us two most memorable incidents in your professional life?

I always remember failures and bad outcomes. I operated on a patient, Ahalya, in 1975, who was six months pregnant with a heart problem. She had a previous operation when she was four or five-years-old. She had a recurrence of that problem and her main valve was critically blocked. She had pulmonary enema and her lungs were full of water. She needed an operation, but, it was a high-risk surgery as the recurrence of the previous operation was huge. So you have to get control on that before you are on heart lung machine. After struggling for almost seven to eight hours, I lost her on the table. This I will never forget. The whole responsibility was mine.

At the same time, if you talk about a memorable incident, it was when I did the first transplant and brought the patient back to ICU at 3:30 a.m. in the morning.

Who is your idol? And what have you learnt from him or her?

I happened to work with the best cardiac surgeons during my early days. The most important thing in my life has been that I grew up with the history of cardiac surgery. Knowing all those pioneers personally has been the biggest achievement for me and they are all my idols.