Patient with 20% heart function who lived for another 20 years

“Doctor, I am living a living death because I can’t breathe. I want you to operate on me whether I live or die because I can’t live like this.”

This is an exchange from 1985, every word of which I remember vividly. I was working at New York University and the patient, 65 years old, had been told by every expert he had consulted before that he could not be operated on.
His aortic valve was completely closed, his coronary arteries were blocked, and his heart function had deteriorated to 20%. He could not move without a wheelchair. And he could barely breathe.

When he came to me, he had just one brief — operate and do what you can. I admitted it was a difficult, risky case but decided to give him my best.

We planned the operation carefully, studying the anatomy of the arteries, using a PET scan to identify viable muscle tissue, and replacing the aortic valve. The team worked with clockwork precision. The patient survived and went home after just eight days. It was a major accomplishment. I followed up with him regularly, and he became absolutely normal. “I can’t handle him anymore. He’s become so energetic!” his wife would complain.

After I returned to India, he sent me Christmas cards. The patient lived for another 20 years.

This experience taught me a valuable lesson — never say no to a patient and let them die without trying. That was, I’d say, the point from which I developed a specialty in operating on patients with severe heart conditions, like low heart function, multiple blocked arteries and valve issues. It reinforced my belief in pursuing and perfecting techniques that can produce remarkable results.

My team has brought down the risk of such surgeries from 30% to 3%, and we can now operate on 99% of patients who were previously considered inoperable.

Yes, there’s stress, but emotional involvement is a good thing. It drives doctors to go the extra mile for their patients. I always encourage doctors working with me to ‘chipko’ (embrace) their patients and not let them slip away, just like villagers in the Chipko movement hugged trees to prevent them from being cut down.

In such high-stress situations, keeping the atmosphere positive is helpful for patients and their families. Doctors can do that by being completely honest but not brutal in their communication.

Years ago, on a Sunday just as I was about to leave with my children for a swim, the landline rang — this was the pre-cellphone era — and my house staff rushed out and said someone urgently needed to speak to me. “There’s a lady on the phone crying,” she told me.

It was a patient’s wife, who had just been told he had passed away. When I answered the call, she said, “I will not believe he has passed away till you say so.” So I apologised to the kids, saying I have to run. When I reached the hospital and checked on the patient, he still had a feeble pulse. I put in an intra-aortic balloon (a device to support the heart). He started reviving. Since his BP had sunk to 50-40 despite all their efforts, the doctor attending to him had told his wife that he’s gone. The next day, I operated on him. And the guy went home.

It was his wife’s belief that brought him back.

It also shows why, as a doctor, you never give up.

Dr Naresh Trehan is CMD, Medanta-The Medicity
As told to Ipsita Pati