Sunday, November 15, 2009

Lucky escape

‘Can any one have a heart attack and recover with in an hour?’ Ratnakar Shetty asked.
I did the mistake of telling him no.
‘I have’ he said.
This was becoming interesting. I asked Ratnakar who has been a friend and an occasional patient of mine for many years, ‘How do you know?’
This Ratnakar Shetty has a number of close relatives who are doctors and he gets free advice and treatment.
He rarely has to consult a doctor out side this immediate circle. When ever he does so it is for either third or fourth opinion and I am one of these.
‘The doctor told me’ he said.
‘Which doctor, you nephew?’ I asked. I knew one of his nephews who practices close to his house in the other end of the city, to whom Ratnakar usually goes. I thought he would have gone to him.
‘No, No, not my nephew, this happened in the middle of the night and I phoned him [his nephew] and that fool told me to go over to the hospital and see a cardiologist. He said it is a waste of valuable time coming over to see me.
‘So what did you do?’
I drove over to the hospital he said.
‘You drove? I asked him, a bit surprised that a patient who was having a heart attack could drive.
‘Yes, who else will drive and take me at the dead of night’ he said. ‘Why did you not call an ambulance?’ I asked. ‘I wanted to save time’ he said.
This of course was true but I still could not stomach his driving to the hospital in pain.
I asked him, ‘did the pain not bother you’?
‘No, there was no pain, by then Brufen had taken affect and I was pain free’. His wife had given him Brufen, a pain killer, as soon as he complained of pain.
‘So you went to the hospital.Then?’
Then what? One young fellow [young doctor] made me lie down took an ECG [electrocardiograph] and took some blood and told me that I have had a heart attack and wanted to admit me.
‘Did you?’
‘No, Don’t I know you doctors [I did not like him including me] I told him no admission gidmission for me, as I was feeling good’.
What did that doctor do? I asked
He was insisting and wanted to call a cardiologist to put a tube into my leg artery [a procedure called angiogram] he said pointing to his groin. ‘I told him I am going home’ Ratnakar said.
He [the young doctor] would not let me. He wrote a letter, ‘discharged against medical advise’ and made me sign and then he let me go.
‘So, you came home’.
‘Yes I drove back home and slept nicely and next morning I went to office’
.Then why did you come here? I asked
‘All because of that nephew [doctor] of mine’ he said.
‘What did your nephew do’, I asked
‘He took me to a cardiologist after three or four days and that man wanted to again admit me and do this test [putting up a tube into his groin artery]’.
‘And you refused,’ I asked him
‘Yes, I did’
‘Because I felt well and I had played golf the previous day,’ he said.
Now even I began to wonder whether the doctors were right. How can a person who has had a heart attack two days earlier, go and play a full round of golf?
I asked him why he did that.
‘Why not? I already had fixed the fourball and did not want to let down the partners, I am sure you too would have done as I did [again he included me against my wishes]. Knowing how crazy golfers are and the important place this game occupies in their lives, I could understand him going to play but not when you have just had a heart attack.
I told him so.
‘That is why I have come to see you. You look at these reports and tell me what the truth is’.
I had a look at his reports. There was no doubt about his having had a hear attack. A fresh ECG done showed an infarct well on its way to healing. I saw no point in restricting his activities ten days into recovery.
I told him that he was one of the lucky few who did well despite the doctors.
He came four weeks later and the stress ECG showed good effort tolerance and he did not really need any further intervention. He did well and it is nearly ten years since that episode and he has had no heart related problems.

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