Bangalore, April 19th, 2005 ? Just another ordinary day! Did routine, meeting patients, came home, spent some time on EYT, and went to bed around 2 am.
April 20th 2005 – will remain etched in my memory forever! A few crucial hours that seemed like eternity had done the trick!
0530 Hrs: Woke up, feeling a heavy discomfort in my chest. I tossed and turned around in my bed, trying to find that sweet spot, in vain! Gnawing sensation- my throat felt parched, drank water like I hadn?t seen it in ages- No respite. Tiny beads of sweat appeared on my brow, I was perspiring. Dragged my feet out of bed when the shocking realization hit me like a Mack Truck. The floor beneath my feet trembled or was it my knees? A Heart Attack!
0540 Hrs: In a trice, I went into a ‘rewind’ mode as my entire life flashed before me. I remember recollecting my Father’s tragic death. He had succumbed to a heart attack on the very night before my wedding day. My family, my friends, everything and everyone that mattered to me passed before my eyes. I was looking at myself in the mirror, my face was ashen. Opening the balcony doors for fresh morning air, I began to take deep breaths. But the vice like pressure did not abate and my chest felt ‘squeezed’ like a lemon. At this point, I began to feel nauseous. “Cold water will help”, I thought to myself as I darted to the washroom. As I bent down at the faucet, the pressure increased- Mortal fears hit me- I was scared, scared of dying! “Pray”, I told myself and I did.
0545 Hrs: Dressing up, wearing my socks seemed an effort, so I slipped on my sandals. As I walked past the bedroom where my mother and sister were sleeping, I began thinking “Do I wake them up, or go to the hospital by myself?” “I will go myself”, I decided. If I woke them up, panic would surely ensue- Call an ambulance, which hospital, and a host of other worries. So I decided to go on my own. “Did I make the right decision?” That’s debatable. For a dying man, the debate could wait!
0555 Hrs: I tip-toed out of the apartment, and walked out the 300 yards towards the gate, all the time praying that an auto will be available at this early hour. God had heard my prayers, I saw an Auto as I arrived at the gate!! “Bannarghatta Road”, I said telling him the name of the hospital I had in mind. All the while I was pointing to the opposite direction. “Not that way Sir, this way”, he corrected me as he accelerated. Every bump on the road seemed like a hillock, every pothole like a ravine. The cool early morning breeze however was a refresher. The sweat on my forehead played the coolant. “Not much traffic, Thank God for small mercies “, I thought to myself.
0615 Hrs: The auto dropped me off at the main entrance to the hospital. The pressure in my chest worsened with every step. What awaited me at the hospital would be even more shocking.
Reception area- Two men were busy talking. I virtually landed, leaning heavily against the counter, but they ignored me as they continued their conversation. In sheer desperation, I exclaimed “Sir!! I am having terrible chest pain, I need a doctor immediately!!”
One of them turned to me as he responded nonchalantly “Go around the hospital to Emergency ward”. Time was ticking away, I was alone and I needed help fast! Every second was precious. I looked at the other person – A cold ‘do as you are told’ expression stuck on his face. “Save yourself”, an inner voice told me as I headed towards the Emergency Ward.
0630 Hrs: No wheelchairs or stretchers were in sight. I was forced to walk an endless mile. I walked out of the hospital and saw the red Emergency Room sign in the distance. “Can I make it”? I wondered.
Each step was an effort now, and no help in sight. I felt faint, and wanted to sit down. But I trudged along, knowing I would never get up if I sat down. “Please just be with me, I need to see my kids grow, Please God”. I had finally made it to the Emergency Room after what seemed eternity.
….I muttered under my breath. Now I was crying, I was lost, I was in a hospital and yet nobody to help me…..
0645 Hrs: Another reception counter at the ‘Emergency’ room. A line up of people, and before I could utter a word, I was told “stand in line”.
“I am a physician and am having a heart attack and need a doctor right now!! ” I said. “All doctors are busy” was his prompt reply, and looked towards the direction of what is known as the ‘triage’ area. At this point I was gradually but surely, losing my calm. I wanted to scream but I was afraid, that I may do more harm to myself rather than helping!
0655 Hrs: A large room, where a young doctor was talking and laughing with a patient in bed. He looked at me and continued his conversation as if I was just having a stroll in the park! Going up to him, I put my hand firmly on his shoulder and told him, “Doctor, I’m a doctor, am having a heart attack, I need help”. He was cold, as he pointed at a bed and said, “Go and lie down” as he continued his conversation which I had managed to interrupt. “This guy must have been in one of those refugee concentration camps”, I muttered under my breath. Now I was crying, I was lost, I was in a hospital and yet nobody to help me.
0700 Hrs: A nurse came to me and asked, “What happened?” I told her what happened. She went to the doc and I gather, he must have told her to do an EKG (Electro cardiogram).
This hospital is publicized as a ‘modern’ cardiac hospital, and I was aghast at what I saw next. The nurse wheeled in a contraption that I had seen used 25 years ago!! She smeared a gel all over my legs, forearm and chest and she had an EKG printed out! I just cannot compare this to what is now available in Canada and USA!! Most importantly, she had recordings of my heart beats.
The Doctor took a quick glance at it, came to me and said” There is no evidence of a heart attack, it must be hyperacidity. You can go home!!” To many others this would have sounded like relief, but to me it didn?t!
0720 Hrs: I almost died (you read it right), when I heard what he said. I pushed myself up in bed and with a controlled rage, told him, “Get me a cardiologist now”. He picked up a phone and talked to someone.
0735 Hrs: Another doc came. “Are you a Cardio?” I asked him. He said” No, I am a PG student”. He looks at my EKG and tells me “You are having a heart attack; you should be in the ICU”. My bed was wheeled near a bank of elevators and all the 4 elevators seemed to be stuck on the 7th floor. “Not now”, I said aloud asking if there was an emergency key to bring the elevator down. I got a few surprised looks for an answer. Somebody ran upstairs to bring the elevator down.
0745 Hrs: I looked at my feet and remembered, I had left my sandals in the triage area. I asked one of the orderlies, if he could fetch it for me while we are waiting. The elevator finally arrived and I was taken to ICU. The doc checked my pulse and told me everything was Alright!!! I wanted to scream “I AM A DOCTOR, I THINK YOU ARE WRONG”.
Was it possible to check my pulse and tell me I was alright? No…even an EKG can be normal and still a person could die of heart attack! I said, “Doctor, my chest pain is killing me, please do something, I beg you”. He dialed someone, presumably to talk to the Cardiologist on call.
The orderly came back and told me, “Sir, I can’t find your sandals!” It didn?t surprise me that somebody else is enjoying wearing them!
0750 Hrs: I can see the doctor still on the phone and finally he came back and told me the cardiologist is on his way. I asked, if he can give me something to relieve the pain. A few minutes later a nurse came with 2 pills, aspirins! I took them and asked the doctor,
“Doc, what is Aspirin going to do? Can’t you start an IV and give me an anticoagulant? Give me something to break the clots or something to dilate my blood vessels…please!”
He got on the phone again and few minutes later, started an IV and told me Cardiologist was on his way.
0815 Hrs: Nearly 3 hrs since I woke up. Nitroglycerin drip was started but made no difference to my chest pain. Now I was panicking, called the doc and told him, “I still have chest pain” and his reply was “give it some time”. Time! I wish I had time!!
I asked him telephone number for another hospital but he wouldn’t give it to me. Instead he said “everything will be alright”- sounding like Bob Marley.
0900 Hrs: The cardiologist was still on his way! Now even breathing became a conscious effort. I must have dozed off because when I opened my eyes it was 9am.
Cardiologist was no where to be seen, then I heard, I will be taken to the Angio suite! I called my sister ? told her not to worry; that I was at the hospital and to tell mom I was doing fine. Told her where I was and to get the telephone number of a doc friend of mine!
I also called my father-in-law and told him where I was and what had happened and to gently break the news to Bharati, my wife who is in Canada. I also called a dear friend of mine, to tell her where I was. Prayers from nearest and dearest were being solicited!
0930 Hrs: My bed was wheeled to another section of the hospital and fortunately it was on the same floor as ICU. I was transferred to angiogram table, my clothes were taken off and I was being prepped for the angiogram.
Now the Angio suite is supposed to be as sterile a place as there can be. But this one was different. I saw all kinds of people come in and go in street clothes and chappals.
Angio technicians arrived and suddenly everything appeared to be moving. Another nurse was giving me an injection, apparently a tranquilizer; he saw my gold chain and wanted it removed. That’s all I heard as I dozed off. Never saw that chain again.
1005 Hrs: I woke up and the clock in the room showed 5 minutes after 10am. Two doctors wearing greens were there, one of them a senior said “good morning!”. Very good morning indeed! The other one was a known face, the “PG student”.
The Angio suite door opened and my Mom walked in! She was telling the doc “please take care of my son, he is the only son I have” she was grabbing his arm and he was consoling her. She came to me, touched my head and asked why didn’t I tell her and she started crying.
The doctor in me looked at the other doctor and asked how did she come in here? He held her hand, mind you he is already ‘gloved’ for the procedure, talks to her and guides her out of the room and wants to start the procedure!
I was kind of upset and asked the doctor to change his gloves at least, if not the gown. He reluctantly complied, mumbling something.
1055 Hrs: He gave me a local anesthetic injection to my right groin and inserted a catheter to my right femoral artery and threaded it all the way to my heart. I could see the progression on the monitor. As he manipulated the catheter to one of the blood vessel supplying my heart, my pain almost doubled and I yelled out. Immediately he withdrew the catheter and pain subsided. He asked for a drug, a very potent anticoagulant and was given to me. (This is the drug I was hoping they would give me when I was in ICU).
He re-manipulated the catheter to that blood vessel and the pain was bearable. He injected a dye and I could clearly see the blood vessel almost completely blocked, probably 99% was occluded. He similarly looked at other vessels and I knew he was being guided by my doc friend, coz he was on the phone every now and then. Finally a decision was made to perform angioplasty and stenting.
As he chose a stent and the catheter, I continued to have my chest pain may be little less than before. He rethreaded the new catheter with the stent and as he reached the blood vessel that was affected, he warned me my pain will get worse as he inflated the balloon.
I braced my self and when he tried to dilate the balloon, my pain not only got worse, my blood pressure dropped from normal 110/78 to 45 and I was so sleepy, I thought I was going to die. I said, “Doc what’s happening, Am I going to die?” He said, “Please don’t talk like that” almost reprimanding and asked for a drug to bring my pressure up. He waited for almost 30 minutes for my vital signs to stabilize.
There was an error in the procedure, am sure of it!
Anyway, finally I was out of the Angio suite and I had no chest pain. I had a new lease on life…
1205 Hrs: I was transferred back to ICU and for the first time in almost 7 hrs, I had a smile! I was told to keep my right leg straight all the time and I could eat something.
1600 Hrs: another patient was admitted to ICU, he was next door to me. All I could hear was his uncontrollable cough and wheezing. He clearly was hungry for air and couldn’t complete a sentence. No nurses or the doctors attended him for more than an hour. Finally a nurse took his vital signs and went away. No IV was started that evening. No medication was given.
2100 Hrs: I told my mom to go to nurse’s station and tell the nurse that the next door patient is going to die. My mom was told to go back and they knew what was happening. May be they did. At 6 am
21st April 2005
0600 Hrs: The other patient died of cardiac arrest. I knew because his coughing stopped. He was pronounced dead by a doctor and the family was notified. All of them cried but none that I could see asked the doctor what happened, or how come nobody saw him. He must have been in his 40’s and probably younger than I was.
0800 Hrs: My vital signs were taken, an echocardiogram was done. Readings were normal and this time they sounded real!
1100 Hrs: My cardiologist came and I told him, “I want to go home”. He opined that it would be better if I stayed one more day. But I had seen enough and I wanted to be home. I was discharged. Time to settle the payments.
As I was about to write a check, I was informed, if I am paying by check, I have to be in the hospital until the check cleared! They wanted cash. I called my bank manager and sent my sister to get the money.
1800Hrs: I was out of the hospital…..glad to smell the air and thanked God again for being with me.
Regardless of what transpired at the hospital, I am grateful to all the staff at the hospital. However, I will never recommend that hospital to anyone nor will I go there again willingly! I am lucky to be alive!
Thank you one and all for your good wishes and prayers during my hospitalization. I am indebted to you. A few things still haunt me:
1. Did the pain wake me up or SOMEBODY woke me up? People die in their sleep!
2. Was the Auto there just for me or was it a coincidence? Never seen an auto waiting at that hour!
3. If I was not a physician, I would have walked out of that hospital and died. After the ER doctor told me it was hyperacidity and not heart attack!
4. For almost 4 hrs, no treatment was given to me. Am I lucky to be alive?
5. It took the cardiologist more than 4 hours to come to the hospital. In USA and Canada…..its gross malpractice!
6. It’s outright dangerous and bordering on criminal to have a doctor n the ER that too at a cardiac hospital, who can’t interpret a straight forward EKG.
7. If this is the way they treat a fellow physician, imagine if you are not!!! I realize everyone should be treated equally but from what I saw, anybody else would have died waiting.
8. Why did the next door patient die? Because no doctor saw him. Even the nurse who took his vital signs, didn’t give him the minimum- Oxygen.
9. What if something had seriously gone wrong during the angiogram? My blood pressure dropped precipitously and what if I had a cardiac arrest? Was there a cardiac surgeon available? NO!
10. My bill was for Rs 2 Lakhs….what if somebody couldn’t afford it? Will he/she get the same treatment? NO!
Author: Dr. K.B. Mallya- Canada