Stress and motivation
Heart disease does not raise eyebrows any more. It is very much part of our reality. Today, heart disease is responsible for 29 per cent of all deaths in India. By 2020, it is expected to be the cause of 40 per cent of all deaths. We already have the dubious distinction of being the diabetes capital of the world and now are also slated to be the cardiovascular disease capital, too. Worse, our genes make us more susceptible to heart disease. Add to all this our new lifestyle with little exercise and smoking and we have an epidemic to counter.
One factor in the whole story are our cardiologists, the heart interventionists. They diagnose the disease, decide if angioplasty and stenting is required or if the patient needs a surgeon. With improvement in technology, cardiologists perform all types of invasive procedures. But the increasing numbers are putting stress on cardiologists as well.
Dr Amitabh Keni, cardiologist, says the new strain of patients doesn't make it easy for the doctors. “The patients have become more demanding and aggressive,” he says. “People keep calling even when it may not be an emergency. They want the primary doctor to answer all the questions.” In other countries, he says, patients do not call doctors, they call 911 and are rushed to the hospital for treatment. “But in India, they want the doctors to rush to their homes. It gets very stressful and we feel it's a race against time,” he says.
What drains them emotionally is when their patient does not make it. Says Dr A.B. Mehta, one of the first cardiologists to perform angioplasty in India, “What is stressful to us is the fact that a patient who came to the hospital walking did not survive the procedure. We feel bad especially if he was the breadwinner in the family. It becomes uncomfortable explaining the situation to relatives.” Also, since angioplasty is seen as a less invasive procedure, they are more angry when things go wrong. However, angioplasty isn't as simple as it is considered. “The vessels are very thin and we are negotiating from a remote place. Surgeries on the other hand are simpler from the point of view that the heart is in front of you. But in these cases, we have to imagine the vessel and you can go wrong as the anatomy is not the same for everyone” says Keni.
The incessantly ringing phones don't help. “I feel mobile phones are a bane rather than a boon. I would like to restrict to emergency calls after working hours,” says Dr Ajit Desai, cardiologist at Jaslok Hospital, Mumbai.
Fame does not make things easy. “As one starts getting more renown, patients seek out the doctor. You can't turn patients away and have to work extra hard. Also, if someone important is admitted in your care, you have to be present there all the time. Along with procedures, we are also taking care of the administration part which adds to our workload,” says Dr Tarun Praharaj, senior consultant, cardiologist at Birla Heart Centre, Kolkata.
But working long hours is not new. “We have been trained by putting in long hours, sometimes not sleeping at all. This schedule is nothing,” says Dr Tilak Suvarna, head of cardiology, Asian Heart Hospital, Mumbai. Most cardiologists are particular about exercise. It is a 30-minute walk for Suvarna, three days of badminton for Desai and half an hour of pranayam and yoga for Praharaj.
They claim they are able to deal with stress, but what about the future? Most medical practit-ioners are restricted to the cities and the doctor to patients ratio is already abysmal. By 2025, India is predicted to have 70 million cardiovascular patients. It may take you months for an appointment with your cardiologist then.
One factor in the whole story are our cardiologists, the heart interventionists. They diagnose the disease, decide if angioplasty and stenting is required or if the patient needs a surgeon. With improvement in technology, cardiologists perform all types of invasive procedures. But the increasing numbers are putting stress on cardiologists as well.
Dr Amitabh Keni, cardiologist, says the new strain of patients doesn't make it easy for the doctors. “The patients have become more demanding and aggressive,” he says. “People keep calling even when it may not be an emergency. They want the primary doctor to answer all the questions.” In other countries, he says, patients do not call doctors, they call 911 and are rushed to the hospital for treatment. “But in India, they want the doctors to rush to their homes. It gets very stressful and we feel it's a race against time,” he says.
What drains them emotionally is when their patient does not make it. Says Dr A.B. Mehta, one of the first cardiologists to perform angioplasty in India, “What is stressful to us is the fact that a patient who came to the hospital walking did not survive the procedure. We feel bad especially if he was the breadwinner in the family. It becomes uncomfortable explaining the situation to relatives.” Also, since angioplasty is seen as a less invasive procedure, they are more angry when things go wrong. However, angioplasty isn't as simple as it is considered. “The vessels are very thin and we are negotiating from a remote place. Surgeries on the other hand are simpler from the point of view that the heart is in front of you. But in these cases, we have to imagine the vessel and you can go wrong as the anatomy is not the same for everyone” says Keni.
The incessantly ringing phones don't help. “I feel mobile phones are a bane rather than a boon. I would like to restrict to emergency calls after working hours,” says Dr Ajit Desai, cardiologist at Jaslok Hospital, Mumbai.
Fame does not make things easy. “As one starts getting more renown, patients seek out the doctor. You can't turn patients away and have to work extra hard. Also, if someone important is admitted in your care, you have to be present there all the time. Along with procedures, we are also taking care of the administration part which adds to our workload,” says Dr Tarun Praharaj, senior consultant, cardiologist at Birla Heart Centre, Kolkata.
But working long hours is not new. “We have been trained by putting in long hours, sometimes not sleeping at all. This schedule is nothing,” says Dr Tilak Suvarna, head of cardiology, Asian Heart Hospital, Mumbai. Most cardiologists are particular about exercise. It is a 30-minute walk for Suvarna, three days of badminton for Desai and half an hour of pranayam and yoga for Praharaj.
They claim they are able to deal with stress, but what about the future? Most medical practit-ioners are restricted to the cities and the doctor to patients ratio is already abysmal. By 2025, India is predicted to have 70 million cardiovascular patients. It may take you months for an appointment with your cardiologist then.
-The Week
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