CHENNAI: I’m sorry we got delayed. It was a critical case,” says Dr Sanjay Cherian, his forehead wrinkle indicating years of this routine. Dressed in his scrubs, sporting black and brown-hued beads around his wrist, the calm demeanour of the vice president and COO of Frontier Lifeline Hospital betrays the gravity of the situation back in his Operating Theatre. Perhaps, this is life as he knows it, I think while shifting my focus from the tall painting — showing the Divine presence in the life of every medical practitioner — that was gifted to him by a patient.
Born in Australia, raised in the US and subsequently India, Dr Cherian holds over a decade of experience in treating critically ill heart patients. Bringing his experience of practising in the West to Indian soil, in 2021, along with his team, he put India on the world map by designing and developing India’s first 3D printed heart valve. A giant leap in the field of medicine, this Made in India innovation is expected to be the future of cardiac surgery, as it overcomes most of the disadvantages and complications associated with the currently available artificial heart valves that are in use. In a freewheeling chat, Dr Cherian talks about the need for funding for such pathbreaking innovation, the doctor-patient bond in India, and offers sage advice to organisations and young working professionals to not neglect their heart health.
How difficult was it to unlearn, learn and adapt to Indian sensibilities when you moved back here?
I was away for 12 years; I chose to come back to India because of family. It was difficult, but at one stage, it’s not about the money or the position you hold. I wanted my kids to be nurtured in the culture here. I wanted to give back to India.
I worked in Australia, the UK, and Switzerland. In India, the doctor-patient relationship is much stronger than in other countries. When a patient gets operated on, here, the entire family is present offering emotional support. In the West, once the surgery is done, we just have to call and inform the family. Most often, the family is not even present in the hospital. The advantage over there is that it is easier to break the news, especially in complicated cases. However, in India, if something goes wrong, there’s a commotion; I’ve been in both situations. No doctor can say they have a 100 per cent track record; everyone tries their best. I believe in the Hand of God. We are just there, holding instruments, God is the one who actually guides us, makes us think and act on our toes. Also, cardiac surgery, unlike others, is intense. In situations like an accident, the patient has to be operated on immediately. There is no time to plan. It must not be easy to swiftly switch your focus once you are outside the hospital.
Several times I have had to cancel movie and dinner plans. In our field, we can’t plan and have our time. The patient always comes first. The family understands and accepts. It is important to have that support system.
Is every surgery a first day, first show?
Not exactly, it might be the same surgery you are doing every day, but each patient is different. It’s like when you first start driving, you are very conscious about taking turns, steering in the right direction, etc. But with time, you don’t think about it, as it becomes second nature. Similarly, surgery, with time, becomes second nature. In our OT, most often we talk about movies, politics, and sports. I always listen to music when I am operating. I prefer western classical, soft rock or pop. Music makes the place livelier and the team is relaxed. My dad used to listen to music as well. But this happens only in routine surgeries, not if it’s an emergency or crash-related surgery.
How do you process grief and death on a daily basis?
When I initially saw death, it was not easy because, as doctors, we meet the patient before the surgery, talk to them, and the next day, if the surgery is not successful, it becomes difficult to process the patient’s absence. I used to get extremely attached to kids. In the initial days of practice, there is a tendency to feel that we have to correct everything, and save everyone. With time, after talking to colleagues and professors, I learned to let go, stand back and analyse the situation to see if I learned something. I now use every negative outcome as a learning opportunity. Also, we have to accept the fact that we are not God, we can’t change the fate of any patient. I have learned to become detached and not feel guilty.
Do you find yourself in situations where there’s a clash of personal and professional values?
Because my parents are also in the same field, there was never a clash of values. I grew up seeing that being a doctor has its pros and cons. My mother taught us about the importance of sharing. She kept us grounded. She’d go out of her way to give food to patients, pick them up from somewhere or drop them home.
In the last few years, there have been several cases of 30-year-old working professionals dying of cardiac arrest.
During my dad’s time, children used to bring their parents for surgery. Now, parents are bringing their young children for cardiac surgeries. Certain sectors are under a lot of stress and the biggest challenge is that most working professionals have no exercise regimen. They eat junk food and don’t see the daylight sun.
But organisations also don’t take responsibility for the health of their employees.
Most don’t. If you don’t perform, there is a constant sword hanging on your head. Our grandparents were healthy even in their 70s. They ate healthy, homemade food, engaged in a lot of physical labour, and walked a lot, which is unheard of these days. The age of our heart patients is getting younger, which is not a good sign. The health of future India is bleak unless we take a step forward as an individual, company, or government for young Indians. In the next 20 years, most of us would not be able to live to the age of 60. While healthcare and healthcare delivery has improved, and we are on par with what the West can provide, at least in the private sector, we still lack funding for research and pathbreaking innovation. There are too many bureaucratic processes.
How do you spend your time off from the hospital?
On my day off on Sunday, I spend most of the time with friends and family. I am not a wild party person; I like to rest as much as possible. I play the piano. It calms my mind. In my younger days, I was part of a band while studying in school, and then later at Manipal, too. I am still in touch with my band members and we catch up when possible. I love going to the beach, travelling, and cooking. I don’t eat a lot, but I am particular about what I eat.
Given the rigour of your work, how do you take care of your mental health?
One of the biggest issues is that we think we feel we are in control. We need to learn to delegate work. We all have time, but what matters is how we utilise it. Covid taught us that we can’t be in control. That’s why I believe that there’s no point in winning every battle, and no point in fighting every war.