To bust pressure, docs considered Indian PM too as a patient

Abhishek Shukla
New Delhi, Feb 1 (PTI) What is it like for a doctor when
he performs a major surgery on the Prime Minister?

For Dr P K Rath, one of the cardiac surgeon who carried
out the coronary bypass on Indian Prime Minister Manmohan
Singh, the challenge was to perform under pressure like top
Indian cricketers such as Sachin Tendulkar and Yuvraj Singh.

"For us the Prime Minister is also a patient and we try
to treat him as such. But there is a certain amount of
pressure. A doctor cannot allow pressure to prevail. So the
key is to perform well under pressure like Sachin Tendulkar
and Yuvraj Singh," said Dr Rath of Mumbai's Asian Heart
Institute.

Dr Rath, who was a part of the team of surgeons who
operated upon the Prime Minister in the All India Institute of
Medical Sciences (AIIMS) on January 24, was responding to a
query whether they were tensed because of the fact that the
Prime Minister was their patient and there was so much media
attention.

Prime Minister Manmohan Singh was brought to AIIMS after
he complaint of chest pain. The angiography performed last
Wednesday revealed multiple blockages and collapse of stents
which were placed in 2004 to dilate the vessels and ensure
smooth blood supply to heart muscles.

"I was informed about the surgery only on Friday. I could
not inform my brother and sister but I told my wife," says
Rath adding that Dr Ramakant Panda may have been informed
about it by the Prime Minister's office.

When asked about the most complicated part of the
surgery, Rath said, "It is always the dissection of the
heart."

He said since the surgery was a redo one it carried
higher risk. Besides a beating-heart surgery was also a
challenge.

"Because it was the second bypass for the Prime Minister,
everything right from the opening of the sternum (bone which
protects the heart from injuries) ...to opening the heart from
chest tissues" was crucial.

Redos are done when the grafts placed in the previous
bypass surgery get obstructed and fresh grafts are placed to
smoothen the blood flow.

"We had to maintain the blood sugar level by
administering insulin. We have also to ensure that heart does
not get injured during the opening up of chest and then the
grafting," he said.

During the operation surgeons ensured that there was no
bleeding which always remains a risk during a repeat bypass
surgery. They had planned four grafts initially but found that
one more blood vessel was needing a graft, so finally five
grafts were placed on Singh.

Rath, a passout from Beherampur Medical College in
Orissa, has been with Dr Ramakant Panda, head of surgery team,
for last 14 years and specialises in beating heart coronary
artery bypass surgery.

So far he has performed more than 1000 bypass surgeries.
The surgery of a serving Prime Minister came as a recognition
of his talent.

"I felt very honoured when I was informed about the
surgery," he said. PTI