Renowned Cardiologist Dr. P K Hazra talks about his childhood, covid, gender, and cardiac ailments. He also talks about the recent development related to the Guinness Book of World Record of his department – the Cardiology Unit of AMRI Hospitals, Dhakuria, Kolkata for conducting the highest number of surgeries (509) in a single month in July, 2021. Read on for excerpts of the conversation:
On Guinness Book of World Record development
We have been doing a lot of interventions, diagnostic cardiac workup, pacemaker implantations, angioplasties, and heart failure treatments. During COVID times, it was very difficult to cope up with the COVID load in our hospital. In spite of that, we could achieve a huge number of successful angioplasties, heart failure treatment, pacemaker device implants, and medical therapy in people who were admitted with cardiac ailment in our hospital.
In eastern India, we are situated in the southern part of Calcutta which is a highly populated area and very strategically located. Many people who were afraid of coming to the hospital during that COVID peak time came when they could not hold their symptoms back any more at home and when there was withdrawal or partial withdrawal of government restrictions last month. We have only one cardiac cath lab because of some logistic issues and some government restrictions. Also, most of the hospital’s beds were dedicated to the COVID patients. Under such restrictions we have been able to take care of 509 cases, with a huge number of ECMO cases as well.
As far as the Guinness World Book of record is concerned, we have applied and they have accepted our application. Formal certificate is awaited once the COVID is over, and they complete inspections. But to elaborate on that – in one month, with one cath lab, in one centre, that too in COVID times, more than 500 surgeries is almost an impossible task, and we could achieve that. Apart from my role in it, it speaks about the dedication of the whole team. There is a team of almost six – seven cardiologists. We have worked almost 24 hours; 3 shifts a day – morning, evening and night shifts, and we could accommodate as many patients in ICU as possible. We are happy with our efforts! Our hospital could achieve that record in a restricted environment, that’s an achievement!
Call of Humanity – Supreme
As you know, a longer stay in the hospital also incurs a lot of expenditure. So that’s why our motto was to finish the treatment and send the patients home as early as possible, so that they save costs and also do not acquire COVID from other patients in the hospital. It was the duty to restrict the spread of pandemic from one patient to another during the hospital stay.
It was a full-fledged endeavour to put patients first and the hospital first, forgetting our own risks, forgetting personal time as cardiac patients cannot wait for months and years like fractures or gallstones or hernia patients. I’m happy that we could achieve such a large number of cases. We’ll be doing more and more and serving more and more lives in future as we work with this aim.
Glimpse of humble childhood
I come from a remote village. We were confined to a mud-house during our childhood. I am the fourth son of my parents. We are six brothers, and two sisters. My father was a humble primary school teacher. My mother was not that literate. She was a homemaker. From the very beginning of my childhood, I had my mother as a motivator. She had gained less education from books, but she was much more educated and much more intelligent, I would say, to push us for education and to aim higher and higher in life.
I went to Ramakrishna Mission, Belur Math. I did my plus two studies from there, and stood 13th in the West Bengal entrance examination. It was quite a significant achievement coming from a remote village. As a result, I joined CMC Medical College in 1982. After passing out, I went to Delhi and from there to Chandigarh, PGI to do my MD course from there.
In Chandigarh PGI, it is a very challenging entry. Not only entry, but staying tuned to the trends, a completely different community, the northern food culture, and cold weather was a challenge for me. Added to this, out of 1000s of candidates competing for 10 seats in all over India, I was able to get my candidature for MD. I was the first and youngest DM from PGI Chandigarh in Cardiology at the age of 27. Immediately after completing my MD the next morning, I joined DM. Once again, it was the competition of thousands of medical postgraduates and only two seats. That was also kind of a breakthrough and it's basically a once in a lifetime event in PGI history. Nobody could believe it!
Later, I wanted to go abroad but thought that I already learned from experts in my homeland whatever I had to learn and it is best to stay and work in my own country instead of moving away from it.
Love for Calcutta
I wanted to bring Calcutta and the eastern India on the world map or at least to the national map. There was a time, when Calcutta was on the top from medical perspective and other perspectives as well. It was on the top in education, culture, literature, films and so on. We lost the supremacy, I would say. So, in the field of medicine many people started moving from Calcutta to southern India for their treatment and they were exhausted monetarily because of the movement, but wanted to stay there. I wanted to bring West Bengal back into the national map from the perspective of treatments. It is difficult for a single person, but then I became a proctor for new things like wireless pacemaker, wireless ICD. Then I went to different countries like Bangladesh, Nepal, Bhutan, Malaysia, Bangkok, for education and to increase knowledge and learn new things. I travelled to other parts of India, trained many people, and learned new things.
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Staying ahead
I wanted to stay ahead of time whether it is medical therapy, whether it is angioplasty or anything else. Recently it’s the first time that we have made use of impella technology in India. It is a medical support device and the cost is almost over twenty- two lakhs. I have many other firsts in the list like the first LAA closure for stroke in eastern India, first double chamber wireless pacemaker in eastern India and so on. Other than that, there are several procedures done in a single centre like AMRI. I have been lucky in the sense that patients have done very well, with almost 0% mortality with new and innovative devices.
I have been seeing 75% of my patients free of cost for the last 25 to 26 years. During this pandemic under a government program (Sastha Sathi), we have seen several patients free of cost and not rejected any of the patients who came to us. I believe that if you want a good eulogy when you are dead, work for the best eulogy when alive and that will only come from your good work.
Thoughts on keeping pace with the times
I learned English not from my teacher, not from books, but from various media, by reading novels, newspapers and listening to the radio. So, the media has contributed a lot in my life. I use social media greatly to stay tuned with the times. I have moved with the modern thinking and modern way of education. I have transferred my thought process to some extent to my daughter, but then I realize that I may be inferior to this generation. They are far ahead than the book teaching or the pencil and pen teaching. There is no pen and pencil teaching anymore. The teaching is basically visual, audio and digital in nature now.
In the field of medicine, things have changed and I have stayed tuned to the newer way of learning things. There is no end to learning new things. In the last 25 years, I have dedicated myself to earn, to enjoy and to help people in spite of doing free of cost up treatments. I have a decent life and have taken care of my parents and siblings. At the end of the day, I am happy!
Covid and cardiac complications
People who had COVID related deaths, have been more of the elderly, and immunocompromised people. Our centre was one of the best centres to tackle Covid. There were many heart patients who were initially prone to COVID related issues. There could be two reasons, one is due to comorbidity or hypertension. If you compare an 18- and 80-year-old. The younger person would not suffer from diabetes, hypertension, heart failure, angioplasty, cancer, rheumatoid arthritis etc. These are more frequent if you grow older. So that is the natural spectrum of risk factors.
Men and women equally got affected by COVID. The virus affects patients from mainly two angles. One is lungs and the other is the heart – clots get formed in the two. Now, the heart ailments patients developed heart failure or sudden death. In many patients we could not do anything initially. Gradually with time, we learned the tips and tricks.
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Outlook of people towards medical fraternity during the pandemic
The government was so supportive this time. And next were the people of the country who started respecting doctors, not hurting them when the patient died. So, we got the confidence back from the society itself, which was quite diverse to non-COVID times. During non-COVID times the doctors’ community suffered from a lot of apprehensions and physical attacks from the community. But this time, the Prime Minister Narendra Modi, and our chief minister have given us confidence and courage to go ahead whatever may be the consequence. There are some very few incidents, attacking doctors and nurses. It was a collective effort, of the society as whole and everybody participated for the cause to tackle the pandemic.
The nation and doctors’ community stood in unity. Social media played a great role in the unity. We as a country have helped internationally to people by donating vaccines. So, it’s a proud moment I would say in times of sadness. The society is still vibrant in spite of challenges.
Gender and diseases
In medical jargon, sex difference or gender difference are there. So, there are many diseases which are more prevalent in women and there are other sets of diseases which are more prevalent in men. Though men and women are born equal, their longevity and their life cycle have a different start and end. Reproductive and hormonal release starts late and finishes late in men. There are hormonal differences in both the genders. Secondly, there is a difference in the body surface area; the basic frame of people. Due to body surface area, women have a smaller heart and men have larger hearts as usually they are taller.
So, in our society, there's a clear distinction between the risk factor between men and women, smaller and bigger hearts, smaller and larger arteries, menopausal issues, childbirth, hormonal differences, stress related issues, comorbidities like diabetes, lack of exercise in women as they are more homebound, more air pollution related ailments in men, drinking and smoking more in men etc. These are the factors which predisposes women for some diseases, and men from some other diseases. The death threat due to cardiac ailments is more in men. Cholesterol related issues are also much more in them, and sudden death is higher in men than women.
So, incidence wise, prevalence wise, complication wise, there is a spectrum of difference all over the globe between the genders. However, despite the differences between men and women, the care or the medical therapy are not different but equal.
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