The Surgeon's Cut (2020) s01e04 Episode Script
Heart & Soul
1
For me, surgery is an art…
And all surgeons are artists.
Whatever we do in the end
should look beautiful.
If it looks beautiful, it always works.
As surgeons,
we would like to be operating machines
without having any emotional attachment
to the patients.
But in reality, it doesn't work like that.
I am under pressure.
But the thing is, as a surgeon,
we need to be supremely confident
about our skill.
How many people in this world
can rip open somebody else's chest
and cut the heart and stitch it back?
For me,
heart is the center of the universe.
No human body can function
without heart.
First half of my life…
Was spent on dreaming about the heart.
And the second half of my life
was spent working on it
and trying to make it happy.
If I have to come back
to this world another hundred times,
I would like to do exactly what I did,
and in every life…
I want to be a heart surgeon.
That's all I want to do.
Nothing else.
This particular patient started
complaining about breathing difficulty
a few years ago, which got worse…
Until he presented to us,
unable to walk
or even do the daily routine.
So I have to get this man right
so that he can go home.
On his life depends
the life of the entire family.
Please take a seat.
This is Paul's wife, Deepa,
and that is my daughter Asam.
Come, come.
We are planning to do the operation
tomorrow early morning.
Yes.
The operation will take us
about 10 to 12 hours
and the main operation may take me
about one to two hours.
He has multiple blockages
in all the blood vessels of the body.
And the blood clots from the legs
come up and go inside the heart,
and when the heart pumps,
it goes to the right lung
and the left lung and block the arteries.
This causes high pressure in the lungs,
which puts a lot of pressure
on the right side of the heart,
and the right side of the heart
eventually fails.
When have you taken your last meal, sir?
- Eleven-thirty, last night.
- Eleven-thirty.
Wide open.
Okay.
- Any loose tooth or missing tooth, sir?
- No.
So, within ten minutes
we are going to push him out.
Okay?
These operations carry much higher risk
than any other operation.
It is very important
that all the family members
understand that there is
a risk to his life
and that's in the range of 10 to 15%.
Without operation,
he's not going to live for a long time.
It's the only choice he has.
To clear all the blood clots
is an extremely complex operation.
There are less than 50 heart surgeons
in the world
who have done more than 100 or 200
of these operations.
I have done more than 600…
Which is considered as one of
the largest experience in the world.
That knowledge,
we get it only after years and years
of passionate work.
I am the eighth of nine children.
I was born and brought up
in a very large family.
That's Okay.
Dada, see my painting.
Oh, it is so beautiful.
My brothers did bully me.
And my only ambition then was to grow up,
have big muscles and bash them up.
And that's exactly what I did.
But when I grew up,
when I had big muscles,
my brothers became my best friends.
Like this, like this.
Like this.
What is this?
- That one?
- The clouds!
Oh, there is clouds as well!
So beautiful.
It was a very happy childhood.
My mother had nothing else
other than pure love for all of us.
But as I was growing up…
My parents were growing old…
And going in and out of the hospital…
Particularly when my mother was sick.
As a little kid
who really didn't understand
what was going on…
All I could understand
is that there is somebody called a doctor…
Who can save my mother's life.
So, in our life…
"Doctor" became like a god.
- Ready?
- Ready to start.
Give me the bullet.
Ready to ventilate, please.
Yes, sir.
Headlamp up, please. Headlamp up.
Is the line clear?
- Aortic line's clear.
- Yep.
Suction on.
When I am operating,
I'm surrounded by hundreds of gadgets
which gives me real-time data
about how the heart is.
But one look at the heart,
I know how exactly the heart
is functioning…
What is a problem,
and what needs to be done.
This is the secret language
between the heart and the heart surgeon.
We open the chest,
connect the heart
to the heart-lung machine…
Then we stop the heart.
Ready to arrest.
And then we take over the circulation.
- The aortic line is clear.
- Yeah.
Suction on.
But when there is blood,
you cannot do this delicate operation.
So we cool the body down
to 18 degrees centigrade.
At that temperature,
we can stop the blood circulation
for 20 to 30 minutes
without really damaging the brain.
- Pump off.
- Pump off, sir.
The moment you stop the circulation,
the clock starts ticking.
So you are racing against time…
And you are doing
one of the most delicate operations.
That is the reason why
it's technically challenging.
How many minutes are we arrested for?
- Nine minutes, sir.
- Okay.
The blood clot,
you have to separate delicately
without damaging
the pulmonary arterial wall.
Because, if you damage,
the lung will get flooded with blood,
and that is the end of the patient's life.
The worst thing is to see
one of your patients you operated on die.
That is the worst experience.
The patient dies once,
but we die a hundred times.
And that particular day,
believe me,
I'm in no mood to do anything.
I cancel the rest of the operations,
I just want to be left alone.
As a kid, I was brought up
in a very spiritual family.
My mother was deeply spiritual.
So, when something goes wrong…
It is my spirituality
which keeps me going.
In India,
we are famous for calling anyone
who makes some difference in our life,
as gods.
But as a heart surgeon,
I operate with metal instruments
in my hand
and I feel I am an instrument
in the hands of God.
And I do what exactly he wants me to do
and nothing more, nothing less.
- The aortic line is clear.
- Yeah.
Back on.
Okay, ventilate, please.
Here, here.
Suction. Take the suction.
- Stop ventilation.
- Stop ventilation.
Scissors.
- Blue righter.
- Blue righter.
Clean it.
If I get nervous or stressed,
I can take wrong decisions.
Believing that somebody else
is in command,
I'm only an instrument
in the hands of God,
puts me in the right perspective
to take the right decisions
and do the right things
to save the patient's life.
Six-oh.
Give me a thin one.
Right, please.
We go to each and every branch
of the lung arteries
and clear each and every branch…
To release the blockage
and bring down the pressure.
Okay.
Back on bypass.
Back on.
These are the blood clots
which went and blocked the lung arteries.
It is extremely satisfying for us to see
a specimen coming out
of the lung like this.
Now I am optimistic that this patient
should get back to normal life
like anybody else.
You can come this way.
Everything went on fine.
Everything went on fine,
very well by the grace of God,
and lung pressure after the surgery
came to normal level.
Yeah, yeah, yeah.
It's very, very satisfying. Yeah.
Very satisfied
with the way things went on.
Okay?
Now he's stable now.
Okay. Not to worry.
By the grace of God,
everything will be fine.
Okay.
- Thank you, sir.
- Not to worry. No, that's okay.
He will be fine.
Not to worry.
Pulmonary endarterectomy is one operation
where we see magical transformation.
Patients with severe difficulty
in breathing…
Today they are able to go scuba diving
after pulmonary endarterectomy.
I met him for the first time
at his sister's wedding.
And, I mean…
He was very good-looking and tall,
and, well…
How do I say…?
I was happy to meet him. Yes, yes.
There was a lot of excitement.
Devi was famous,
even in those days.
He was a bodybuilder.
He was a brown belt in karate.
I think he did some modeling also,
if I remember correctly
of what he told me.
He wrote letters…
And there was poetry written for me,
and…
You know, he did a perfect job
of courting me and impressing me.
We went out for dinners,
he said the most beautiful things,
and he did a perfect job
for that time, you know.
On our wedding day,
he actually came late for the wedding.
You know,
I was there 45 minutes before him…
All dressed and waiting on stage
for him to come,
and everybody was waiting for the groom.
The…
See, the…
You're very young
and you don't take things very seriously,
you know, at that age,
and I was a bit casual about these things.
My father was fuming…
And I'm saying, "Oh, God."
"I'm really going to kill this man
later on."
And there he comes and you know,
with all his…
Big smile and looking as dashing,
as handsome as ever.
I was so happy to be marrying him
on that day.
You know, it was a very happy moment,
mainly because I was at the age
I wanted to get married
and I wanted to build my life
and I found the right person.
Then, three months after we married,
I went to England,
and life started all over again.
The first time I met Devi
was when he came into my office…
In early 1983,
and introduced himself
and said that "I am your new registrar."
When I was a medical student…
I did everything other than studies.
But once I got into cardiac surgery,
everything changed.
I give up everything else.
I just wanted to spend all my time
with the heart.
He was hard-working,
I never heard him complain,
and he used all his spare time studying.
When his hours of duty were over…
Uh, he was still there.
I used to routinely do weekend duties
to cover cardiac emergencies.
But most of the time
there were no emergencies
and we were sitting there
having endless cups of coffee,
with no work.
And then I decided
to do something different.
On Friday evening,
I used to go to cardiology ward…
And I used to choose two patients
who needed a bypass.
And I used to tell them
that they should complain
about chest pain at night.
And if they complained about chest pain,
the next day I would be able
to do their heart operation.
Devi was so anxious
to get hands-on experience…
That he would take on surgery out of hours
in my name,
but with him hoping to do the surgery.
Do you remember being told off?
Yes.
And when that went on two or three times,
I gave him a rocket
and said, "You don't behave like that."
I knew I was breaking the policy.
I was told off many times…
But they didn't stop me from doing it.
A little bit later on,
I began to trust him sufficiently.
If that happened again,
I'd let him get on with it.
And I became increasingly to trust him
as, if you like, my right-hand man.
And towards the latter part
of his training,
he was carrying out major heart surgery
on his own.
Please sit down.
Hi, sweetie!
Namaste. Namaste.
You sit. Sit.
Tomorrow I shall do the operation.
Do you have any questions?
When I first saw the child,
I could see the distress.
The baby was gasping for breath
because of the defective heart.
This is the model of his heart.
There are two pumps inside the heart.
This is the right heart
and this is the left.
The baby has a large hole in between.
I will do the operation
to close this hole.
Sir, after the operation,
are you sure there won't be
any complications?
By the blessings of God, all will be well.
We came from Kolkata just for you,
so that it'll be all right.
I'll do it.
By God's blessings, it'll be fine.
- Okay?
- Okay, sir.
Okay, sir. We rely on you.
I myself will do it. Don't worry.
He is our first baby.
Okay, okay.
I said to the family,
"This kid will need an operation.
Otherwise, he won't survive."
We had no choice.
I decided to move back to India
because I was given a position
at a new heart hospital in Kolkata.
They gave me the total freedom
to build a center of excellence
in cardiac surgery.
My name is Nimita Prasad.
I'm 29 years old.
When I was very young,
I was seriously ill.
So my father took me to Dr. Shetty.
Dr. Shetty said
there was a hole in my heart
and it needed to be operated on.
If Dr. Shetty hadn't done the operation,
I wouldn't have survived.
I am thankful.
Because of him…
I have a family and a happy life.
To me, Dr. Shetty is like a god.
He gave me life.
Thirty years ago in India,
cardiac surgery was still in its infancy.
People didn't think that children
can be born with a heart problem.
Certainly, they didn't know
that a heart operation
can take care of the heart disease.
So I had to go out and connect with them.
Every Sunday, early morning…
I used to drive into the countryside
into deep villages.
Thank you.
Okay.
Thank you.
Every time I arrived,
I could see an ocean of people.
Adults, children,
everyone with a suspected heart problem…
Hundreds and hundreds of them.
And, from morning till evening,
we were examining them and screening them,
doing all kinds of tests
and diagnosing their problem.
Sit down. Turn the baby over.
Lift the hand.
What is her problem?
She has a problem breathing.
She has a little hole in her heart.
It's very common.
A lot of children have them.
His heart has four kinds of problems.
We will correct all four
with one operation.
No one is there to help me.
I will help, don't you worry.
He will recover. Don't worry.
- Thank you, sir.
- Okay? Not to worry.
Okay, yeah.
Thank you. Thank you.
I worked very hard
to reach out to rural India
and develop a relationship
with the people.
And this is how I started my career
as a heart surgeon in India.
Antibiotic in at 7:51 a.m.
Eight, double-nine, three-six-eight.
Age, four months, 23 days.
Children are not
miniature versions of adults.
They are different.
Blood group, AB positive.
Patient confirmed, sir.
We are all set.
Pediatric cardiac surgery
is extremely complex.
So, you want to do it on the low floor?
Beating heart, sir.
We can go on bypass, and then do it.
When a child is born
with a defective heart,
the child can have a combination
of a hundred different varieties.
Until you open the heart and see…
There is no way of confidently predicting
the problem before operation.
Antibody prophylaxis given.
There is no doubt
that the pediatric cardiac surgery
is the most complex surgery
on the human body.
Yeah, here we go. Start.
Once the chest is open,
the baby has been put on bypass…
And the body is cooled,
then we stop the heart
and begin the surgery.
You can just imagine
a baby's heart is slightly bigger
than the size of my thumbnail.
So, in that small heart,
there are two pumps,
two receiving chambers, and four valves,
so it requires extremely dexterous work
because the margin of error
is extremely small.
Scissors. Full flow.
Table towards me.
Double thread, hold it in the center.
This is one hole.
The second hole is here.
For a child of this size…
This is very big.
You need to be extremely gentle…
Check the abdominal pressure.
…because the heart is so small.
We close the hole…
And once the heart looks happy
and everything is stable,
we remove all the tubes
and close the chest,
and we shift the baby to the ICU.
Children's heart bounces back
as if nothing ever happened.
It's the most joyful experience to see
this pink heart…
Jumping with joy when you close a hole
or repair the valve
when the heart starts celebrating.
That is a time you feel you have done
something really, really worthwhile.
Your baby is fine.
There won't be any problems in the future.
Please tell.
Please tell.
Sir, we will be happy when he recovers.
You don't worry, he will recover.
He will definitely recover
in three to six months.
Cardiac surgery on a child's heart
is a major event in the life of the child
and the entire family.
They will never forget you.
The events happening in the family
is always described in the future
as "before that heart operation"
and "after the heart operation."
Thank you, sir.
Okay.
I truly believe
that I'm the privileged one…
To get to become a hero
in the real life of thousands of families.
I'm truly blessed.
When I was in Kolkata…
I was operating one day
and the telephone rang…
And my anesthetist took the call.
And the caller asked
whether I can make a home visit.
And I laughingly told my anesthetist
that I'm a heart surgeon
and I don't make home visits.
But the caller told my anesthetist
that if Dr. Shetty made a home visit,
it may perhaps change his life.
I decided to make the visit.
And when I was approaching the address
I realized it was the house
of Mother Teresa.
I took care of Mother Teresa
during her last four years of her life.
It is better you speak to us,
and we do not want to…
Mother was suffering from heart problems.
She was admitted three or four times
to our hospital.
She has the great desire to fight,
and we're very, very optimistic
that she will recover.
And after she was discharged,
I made a few home visits
to make sure that she was all right.
Mother Teresa,
even though she was born
with flesh and blood like us…
She was different.
In her presence I truly felt
the presence of the divine.
The impact she had on my life…
Completely changed my approach
towards my profession,
my family, and the society.
This is the room
where Mother Teresa was treated.
And whenever she got better…
She used to accompany me
when I was doing the rounds
in the pediatric ICU next door.
And one day when I was examining a kid
with a hole in the heart…
She looked at me and said,
"Dr. Shetty, I know why you're here."
When God created these kids
with the hole in the heart,
he realized there was a problem
and he wanted someone to fix it.
"And that's the reason why he sent you."
And I thought this is the best definition
I've heard of a pediatric cardiac surgeon.
So, today I have a single agenda.
My agenda is to ensure
that everyone on this planet
has access to life-saving surgeries,
whether they can afford it or not.
Because I believe
that the skill of surgery is given by God,
and it should be available to everyone.
I felt pain in my chest.
I couldn't do any heavy tasks.
It was difficult for me to walk.
After meeting him,
a spiritual feeling came to me.
And I think when other people
meet Devi Shetty,
they will have the same feelings, too.
I think that, instantly after meeting him,
half of their disease is healed.
Mohammed is ready, Varun.
Right length.
Indians are genetically three times
more vulnerable for heart attack.
Third section. Cannula.
The commonest symptom
is chest pain on exercise.
This happens because of the blockages
in the blood vessels of the heart…
Which doesn't supply enough oxygen
to the heart muscle.
No, other loop. The big loop.
So, under the chest wall,
there is an artery
which we carefully dissected
away from the chest wall…
And used that to bypass
the blocked blood vessel of the heart.
Eight-oh.
Eight-oh.
We always like to do
a bypass grafting operation
on a beating heart…
Without using the heart-lung machine…
Because occasionally
the heart-lung machine
can damage the vital organs.
Can I have the light, please?
When the heart is not moving,
it's very easy for surgeons to stitch.
But in beating-heart surgery,
the heart is contracting.
And that is challenging
because we are constantly hitting
a moving target.
Water, please.
Table away.
Did he say that?
First year in Kolkata,
I decided to do
the first 100 heart surgeries
without any mortality…
And I never went home.
And my children
were brought up by my wife…
As a single parent.
Is there something in it?
He didn't come home.
In fact, he wasn't leaving ICU.
I used to take my children there
to visit him.
Even his lunch,
I would take it there and he would eat.
He didn't come home all those days,
and home was not far away.
At that time,
we lived in the same building.
Okay,
now slowly get onto your cycle.
Go!
When I decided to move to Kolkata…
I promised Shaku that we will be
in Kolkata only for two or three years.
Vedu, move fast!
Vedu, move fast!
But life got so exciting,
I forgot my promise.
Move fast, Vedu!
I wanted to be in Bangalore
where my children
could be with the family.
So, I said, "I'm going back to Bangalore."
Come, come, come, Vedu!
I don't know
where I got the guts from.
I was brave enough.
I did take my children and leave.
It was
a very, very tough call for me,
because I worked
extremely, extremely hard
for six years to build a practice
and gain the confidence of the people.
But then I had no choice.
I wanted to be with my wife
and my children.
He came to Bangalore
exactly a year later.
I always knew.
I mean, he has to come.
I had four kids.
But if he hadn't come,
I don't know what would have happened,
but he came, yeah.
And when we were in Bangalore…
Devi and my family decided
to build the hospital.
Patients come from all over India.
Sometimes it takes them
three-and-a-half days
to reach our hospital.
That's how long it takes for them
to get to Bangalore.
I see 50 to 80 heart patients
every day.
Most of them are poor.
They can't afford to undergo
expensive heart operations elsewhere.
In the last 20 years,
we have never refused a single patient
because of the money.
This place is the culmination
of my life's work, dreams, and ambition.
For me, the hospital is a temple
where sick people are taken care of.
This is the operation theater complex.
From that end till this end,
there are five operation theaters.
We have four floors, each having
five to six operation theaters.
This building is created
to do 100 heart surgeries every day.
That is our desire.
I worked in Devi's hospital,
just at the end of my specialist training
in pediatric cardiac surgery.
The setup at Narayana is unique.
You still have surgical theater,
you still have an intensive care unit
and a ward.
But it's faster.
The patients just
flow through the process.
That's why you can do much more…
In the same amount of time,
using the same resources.
The idea of doing
a large number of heart operations
is that, because of the economy of scale,
your cost goes down
so that the poor people
If their children require
heart operations,
we can do it at any price they can afford.
What I take away
from my time working with Devi,
is that he's a man with a vision.
Put one more stitch here to hold it.
Leftover stitch please, Sissy.
What he's doing for India
is outstanding.
And that's why I'm in awe.
When I started my career…
When a patient didn't have the money,
I couldn't do much to help him.
This looks like a happy heart.
It is getting all the blood it requires.
Today, the greatest joy in my life is
whenever I come across a patient
who has no money,
but he needs
a life-saving heart operation,
I'm in a position to tell him
not to worry about the money
and get the operation done
without any payment.
I'm proud of him
for all his achievements.
He's saved so many lives,
and so many children's lives,
and helped so many people.
Maybe I'll use him, you know,
in the future, if he really wants to…
Though it's been tough,
and, you know, there's been so many
ups and downs…
Every achievement of his,
I'm very proud of.
Very, very proud.
I never say it to him, but I am.
Hmm? Somebody has come.
Thank you, my darling.
Thank you so much.
I don't find myself extraordinary…
Other than the passion to cut and stitch.
But what I wanted was to reach out
to as many people as possible.
So I wrote this letter on a beach in Goa…
To the 4,000 children
I operated during my stay in Kolkata.
My dear children…
All I ask of you is:
can you spend a few moments
of your precious time
for someone who needs it…
Without expecting anything back in return?
It's very important
that when good things are done,
it gets documented.
So that one day future generations
will read it
and maybe some of them
will decide to do the same,
or something even better.
My country requires
two million heart surgeries a year.
Today all the heart surgeons in India
put together
perform less than
150,000 heart operations.
What happens to the remaining
1.9 million people?
How long it will go on?
How long we are going to tolerate it?
This is unacceptable.
And this is the challenge
for our generation.
For me, surgery is an art…
And all surgeons are artists.
Whatever we do in the end
should look beautiful.
If it looks beautiful, it always works.
As surgeons,
we would like to be operating machines
without having any emotional attachment
to the patients.
But in reality, it doesn't work like that.
I am under pressure.
But the thing is, as a surgeon,
we need to be supremely confident
about our skill.
How many people in this world
can rip open somebody else's chest
and cut the heart and stitch it back?
For me,
heart is the center of the universe.
No human body can function
without heart.
First half of my life…
Was spent on dreaming about the heart.
And the second half of my life
was spent working on it
and trying to make it happy.
If I have to come back
to this world another hundred times,
I would like to do exactly what I did,
and in every life…
I want to be a heart surgeon.
That's all I want to do.
Nothing else.
This particular patient started
complaining about breathing difficulty
a few years ago, which got worse…
Until he presented to us,
unable to walk
or even do the daily routine.
So I have to get this man right
so that he can go home.
On his life depends
the life of the entire family.
Please take a seat.
This is Paul's wife, Deepa,
and that is my daughter Asam.
Come, come.
We are planning to do the operation
tomorrow early morning.
Yes.
The operation will take us
about 10 to 12 hours
and the main operation may take me
about one to two hours.
He has multiple blockages
in all the blood vessels of the body.
And the blood clots from the legs
come up and go inside the heart,
and when the heart pumps,
it goes to the right lung
and the left lung and block the arteries.
This causes high pressure in the lungs,
which puts a lot of pressure
on the right side of the heart,
and the right side of the heart
eventually fails.
When have you taken your last meal, sir?
- Eleven-thirty, last night.
- Eleven-thirty.
Wide open.
Okay.
- Any loose tooth or missing tooth, sir?
- No.
So, within ten minutes
we are going to push him out.
Okay?
These operations carry much higher risk
than any other operation.
It is very important
that all the family members
understand that there is
a risk to his life
and that's in the range of 10 to 15%.
Without operation,
he's not going to live for a long time.
It's the only choice he has.
To clear all the blood clots
is an extremely complex operation.
There are less than 50 heart surgeons
in the world
who have done more than 100 or 200
of these operations.
I have done more than 600…
Which is considered as one of
the largest experience in the world.
That knowledge,
we get it only after years and years
of passionate work.
I am the eighth of nine children.
I was born and brought up
in a very large family.
That's Okay.
Dada, see my painting.
Oh, it is so beautiful.
My brothers did bully me.
And my only ambition then was to grow up,
have big muscles and bash them up.
And that's exactly what I did.
But when I grew up,
when I had big muscles,
my brothers became my best friends.
Like this, like this.
Like this.
What is this?
- That one?
- The clouds!
Oh, there is clouds as well!
So beautiful.
It was a very happy childhood.
My mother had nothing else
other than pure love for all of us.
But as I was growing up…
My parents were growing old…
And going in and out of the hospital…
Particularly when my mother was sick.
As a little kid
who really didn't understand
what was going on…
All I could understand
is that there is somebody called a doctor…
Who can save my mother's life.
So, in our life…
"Doctor" became like a god.
- Ready?
- Ready to start.
Give me the bullet.
Ready to ventilate, please.
Yes, sir.
Headlamp up, please. Headlamp up.
Is the line clear?
- Aortic line's clear.
- Yep.
Suction on.
When I am operating,
I'm surrounded by hundreds of gadgets
which gives me real-time data
about how the heart is.
But one look at the heart,
I know how exactly the heart
is functioning…
What is a problem,
and what needs to be done.
This is the secret language
between the heart and the heart surgeon.
We open the chest,
connect the heart
to the heart-lung machine…
Then we stop the heart.
Ready to arrest.
And then we take over the circulation.
- The aortic line is clear.
- Yeah.
Suction on.
But when there is blood,
you cannot do this delicate operation.
So we cool the body down
to 18 degrees centigrade.
At that temperature,
we can stop the blood circulation
for 20 to 30 minutes
without really damaging the brain.
- Pump off.
- Pump off, sir.
The moment you stop the circulation,
the clock starts ticking.
So you are racing against time…
And you are doing
one of the most delicate operations.
That is the reason why
it's technically challenging.
How many minutes are we arrested for?
- Nine minutes, sir.
- Okay.
The blood clot,
you have to separate delicately
without damaging
the pulmonary arterial wall.
Because, if you damage,
the lung will get flooded with blood,
and that is the end of the patient's life.
The worst thing is to see
one of your patients you operated on die.
That is the worst experience.
The patient dies once,
but we die a hundred times.
And that particular day,
believe me,
I'm in no mood to do anything.
I cancel the rest of the operations,
I just want to be left alone.
As a kid, I was brought up
in a very spiritual family.
My mother was deeply spiritual.
So, when something goes wrong…
It is my spirituality
which keeps me going.
In India,
we are famous for calling anyone
who makes some difference in our life,
as gods.
But as a heart surgeon,
I operate with metal instruments
in my hand
and I feel I am an instrument
in the hands of God.
And I do what exactly he wants me to do
and nothing more, nothing less.
- The aortic line is clear.
- Yeah.
Back on.
Okay, ventilate, please.
Here, here.
Suction. Take the suction.
- Stop ventilation.
- Stop ventilation.
Scissors.
- Blue righter.
- Blue righter.
Clean it.
If I get nervous or stressed,
I can take wrong decisions.
Believing that somebody else
is in command,
I'm only an instrument
in the hands of God,
puts me in the right perspective
to take the right decisions
and do the right things
to save the patient's life.
Six-oh.
Give me a thin one.
Right, please.
We go to each and every branch
of the lung arteries
and clear each and every branch…
To release the blockage
and bring down the pressure.
Okay.
Back on bypass.
Back on.
These are the blood clots
which went and blocked the lung arteries.
It is extremely satisfying for us to see
a specimen coming out
of the lung like this.
Now I am optimistic that this patient
should get back to normal life
like anybody else.
You can come this way.
Everything went on fine.
Everything went on fine,
very well by the grace of God,
and lung pressure after the surgery
came to normal level.
Yeah, yeah, yeah.
It's very, very satisfying. Yeah.
Very satisfied
with the way things went on.
Okay?
Now he's stable now.
Okay. Not to worry.
By the grace of God,
everything will be fine.
Okay.
- Thank you, sir.
- Not to worry. No, that's okay.
He will be fine.
Not to worry.
Pulmonary endarterectomy is one operation
where we see magical transformation.
Patients with severe difficulty
in breathing…
Today they are able to go scuba diving
after pulmonary endarterectomy.
I met him for the first time
at his sister's wedding.
And, I mean…
He was very good-looking and tall,
and, well…
How do I say…?
I was happy to meet him. Yes, yes.
There was a lot of excitement.
Devi was famous,
even in those days.
He was a bodybuilder.
He was a brown belt in karate.
I think he did some modeling also,
if I remember correctly
of what he told me.
He wrote letters…
And there was poetry written for me,
and…
You know, he did a perfect job
of courting me and impressing me.
We went out for dinners,
he said the most beautiful things,
and he did a perfect job
for that time, you know.
On our wedding day,
he actually came late for the wedding.
You know,
I was there 45 minutes before him…
All dressed and waiting on stage
for him to come,
and everybody was waiting for the groom.
The…
See, the…
You're very young
and you don't take things very seriously,
you know, at that age,
and I was a bit casual about these things.
My father was fuming…
And I'm saying, "Oh, God."
"I'm really going to kill this man
later on."
And there he comes and you know,
with all his…
Big smile and looking as dashing,
as handsome as ever.
I was so happy to be marrying him
on that day.
You know, it was a very happy moment,
mainly because I was at the age
I wanted to get married
and I wanted to build my life
and I found the right person.
Then, three months after we married,
I went to England,
and life started all over again.
The first time I met Devi
was when he came into my office…
In early 1983,
and introduced himself
and said that "I am your new registrar."
When I was a medical student…
I did everything other than studies.
But once I got into cardiac surgery,
everything changed.
I give up everything else.
I just wanted to spend all my time
with the heart.
He was hard-working,
I never heard him complain,
and he used all his spare time studying.
When his hours of duty were over…
Uh, he was still there.
I used to routinely do weekend duties
to cover cardiac emergencies.
But most of the time
there were no emergencies
and we were sitting there
having endless cups of coffee,
with no work.
And then I decided
to do something different.
On Friday evening,
I used to go to cardiology ward…
And I used to choose two patients
who needed a bypass.
And I used to tell them
that they should complain
about chest pain at night.
And if they complained about chest pain,
the next day I would be able
to do their heart operation.
Devi was so anxious
to get hands-on experience…
That he would take on surgery out of hours
in my name,
but with him hoping to do the surgery.
Do you remember being told off?
Yes.
And when that went on two or three times,
I gave him a rocket
and said, "You don't behave like that."
I knew I was breaking the policy.
I was told off many times…
But they didn't stop me from doing it.
A little bit later on,
I began to trust him sufficiently.
If that happened again,
I'd let him get on with it.
And I became increasingly to trust him
as, if you like, my right-hand man.
And towards the latter part
of his training,
he was carrying out major heart surgery
on his own.
Please sit down.
Hi, sweetie!
Namaste. Namaste.
You sit. Sit.
Tomorrow I shall do the operation.
Do you have any questions?
When I first saw the child,
I could see the distress.
The baby was gasping for breath
because of the defective heart.
This is the model of his heart.
There are two pumps inside the heart.
This is the right heart
and this is the left.
The baby has a large hole in between.
I will do the operation
to close this hole.
Sir, after the operation,
are you sure there won't be
any complications?
By the blessings of God, all will be well.
We came from Kolkata just for you,
so that it'll be all right.
I'll do it.
By God's blessings, it'll be fine.
- Okay?
- Okay, sir.
Okay, sir. We rely on you.
I myself will do it. Don't worry.
He is our first baby.
Okay, okay.
I said to the family,
"This kid will need an operation.
Otherwise, he won't survive."
We had no choice.
I decided to move back to India
because I was given a position
at a new heart hospital in Kolkata.
They gave me the total freedom
to build a center of excellence
in cardiac surgery.
My name is Nimita Prasad.
I'm 29 years old.
When I was very young,
I was seriously ill.
So my father took me to Dr. Shetty.
Dr. Shetty said
there was a hole in my heart
and it needed to be operated on.
If Dr. Shetty hadn't done the operation,
I wouldn't have survived.
I am thankful.
Because of him…
I have a family and a happy life.
To me, Dr. Shetty is like a god.
He gave me life.
Thirty years ago in India,
cardiac surgery was still in its infancy.
People didn't think that children
can be born with a heart problem.
Certainly, they didn't know
that a heart operation
can take care of the heart disease.
So I had to go out and connect with them.
Every Sunday, early morning…
I used to drive into the countryside
into deep villages.
Thank you.
Okay.
Thank you.
Every time I arrived,
I could see an ocean of people.
Adults, children,
everyone with a suspected heart problem…
Hundreds and hundreds of them.
And, from morning till evening,
we were examining them and screening them,
doing all kinds of tests
and diagnosing their problem.
Sit down. Turn the baby over.
Lift the hand.
What is her problem?
She has a problem breathing.
She has a little hole in her heart.
It's very common.
A lot of children have them.
His heart has four kinds of problems.
We will correct all four
with one operation.
No one is there to help me.
I will help, don't you worry.
He will recover. Don't worry.
- Thank you, sir.
- Okay? Not to worry.
Okay, yeah.
Thank you. Thank you.
I worked very hard
to reach out to rural India
and develop a relationship
with the people.
And this is how I started my career
as a heart surgeon in India.
Antibiotic in at 7:51 a.m.
Eight, double-nine, three-six-eight.
Age, four months, 23 days.
Children are not
miniature versions of adults.
They are different.
Blood group, AB positive.
Patient confirmed, sir.
We are all set.
Pediatric cardiac surgery
is extremely complex.
So, you want to do it on the low floor?
Beating heart, sir.
We can go on bypass, and then do it.
When a child is born
with a defective heart,
the child can have a combination
of a hundred different varieties.
Until you open the heart and see…
There is no way of confidently predicting
the problem before operation.
Antibody prophylaxis given.
There is no doubt
that the pediatric cardiac surgery
is the most complex surgery
on the human body.
Yeah, here we go. Start.
Once the chest is open,
the baby has been put on bypass…
And the body is cooled,
then we stop the heart
and begin the surgery.
You can just imagine
a baby's heart is slightly bigger
than the size of my thumbnail.
So, in that small heart,
there are two pumps,
two receiving chambers, and four valves,
so it requires extremely dexterous work
because the margin of error
is extremely small.
Scissors. Full flow.
Table towards me.
Double thread, hold it in the center.
This is one hole.
The second hole is here.
For a child of this size…
This is very big.
You need to be extremely gentle…
Check the abdominal pressure.
…because the heart is so small.
We close the hole…
And once the heart looks happy
and everything is stable,
we remove all the tubes
and close the chest,
and we shift the baby to the ICU.
Children's heart bounces back
as if nothing ever happened.
It's the most joyful experience to see
this pink heart…
Jumping with joy when you close a hole
or repair the valve
when the heart starts celebrating.
That is a time you feel you have done
something really, really worthwhile.
Your baby is fine.
There won't be any problems in the future.
Please tell.
Please tell.
Sir, we will be happy when he recovers.
You don't worry, he will recover.
He will definitely recover
in three to six months.
Cardiac surgery on a child's heart
is a major event in the life of the child
and the entire family.
They will never forget you.
The events happening in the family
is always described in the future
as "before that heart operation"
and "after the heart operation."
Thank you, sir.
Okay.
I truly believe
that I'm the privileged one…
To get to become a hero
in the real life of thousands of families.
I'm truly blessed.
When I was in Kolkata…
I was operating one day
and the telephone rang…
And my anesthetist took the call.
And the caller asked
whether I can make a home visit.
And I laughingly told my anesthetist
that I'm a heart surgeon
and I don't make home visits.
But the caller told my anesthetist
that if Dr. Shetty made a home visit,
it may perhaps change his life.
I decided to make the visit.
And when I was approaching the address
I realized it was the house
of Mother Teresa.
I took care of Mother Teresa
during her last four years of her life.
It is better you speak to us,
and we do not want to…
Mother was suffering from heart problems.
She was admitted three or four times
to our hospital.
She has the great desire to fight,
and we're very, very optimistic
that she will recover.
And after she was discharged,
I made a few home visits
to make sure that she was all right.
Mother Teresa,
even though she was born
with flesh and blood like us…
She was different.
In her presence I truly felt
the presence of the divine.
The impact she had on my life…
Completely changed my approach
towards my profession,
my family, and the society.
This is the room
where Mother Teresa was treated.
And whenever she got better…
She used to accompany me
when I was doing the rounds
in the pediatric ICU next door.
And one day when I was examining a kid
with a hole in the heart…
She looked at me and said,
"Dr. Shetty, I know why you're here."
When God created these kids
with the hole in the heart,
he realized there was a problem
and he wanted someone to fix it.
"And that's the reason why he sent you."
And I thought this is the best definition
I've heard of a pediatric cardiac surgeon.
So, today I have a single agenda.
My agenda is to ensure
that everyone on this planet
has access to life-saving surgeries,
whether they can afford it or not.
Because I believe
that the skill of surgery is given by God,
and it should be available to everyone.
I felt pain in my chest.
I couldn't do any heavy tasks.
It was difficult for me to walk.
After meeting him,
a spiritual feeling came to me.
And I think when other people
meet Devi Shetty,
they will have the same feelings, too.
I think that, instantly after meeting him,
half of their disease is healed.
Mohammed is ready, Varun.
Right length.
Indians are genetically three times
more vulnerable for heart attack.
Third section. Cannula.
The commonest symptom
is chest pain on exercise.
This happens because of the blockages
in the blood vessels of the heart…
Which doesn't supply enough oxygen
to the heart muscle.
No, other loop. The big loop.
So, under the chest wall,
there is an artery
which we carefully dissected
away from the chest wall…
And used that to bypass
the blocked blood vessel of the heart.
Eight-oh.
Eight-oh.
We always like to do
a bypass grafting operation
on a beating heart…
Without using the heart-lung machine…
Because occasionally
the heart-lung machine
can damage the vital organs.
Can I have the light, please?
When the heart is not moving,
it's very easy for surgeons to stitch.
But in beating-heart surgery,
the heart is contracting.
And that is challenging
because we are constantly hitting
a moving target.
Water, please.
Table away.
Did he say that?
First year in Kolkata,
I decided to do
the first 100 heart surgeries
without any mortality…
And I never went home.
And my children
were brought up by my wife…
As a single parent.
Is there something in it?
He didn't come home.
In fact, he wasn't leaving ICU.
I used to take my children there
to visit him.
Even his lunch,
I would take it there and he would eat.
He didn't come home all those days,
and home was not far away.
At that time,
we lived in the same building.
Okay,
now slowly get onto your cycle.
Go!
When I decided to move to Kolkata…
I promised Shaku that we will be
in Kolkata only for two or three years.
Vedu, move fast!
Vedu, move fast!
But life got so exciting,
I forgot my promise.
Move fast, Vedu!
I wanted to be in Bangalore
where my children
could be with the family.
So, I said, "I'm going back to Bangalore."
Come, come, come, Vedu!
I don't know
where I got the guts from.
I was brave enough.
I did take my children and leave.
It was
a very, very tough call for me,
because I worked
extremely, extremely hard
for six years to build a practice
and gain the confidence of the people.
But then I had no choice.
I wanted to be with my wife
and my children.
He came to Bangalore
exactly a year later.
I always knew.
I mean, he has to come.
I had four kids.
But if he hadn't come,
I don't know what would have happened,
but he came, yeah.
And when we were in Bangalore…
Devi and my family decided
to build the hospital.
Patients come from all over India.
Sometimes it takes them
three-and-a-half days
to reach our hospital.
That's how long it takes for them
to get to Bangalore.
I see 50 to 80 heart patients
every day.
Most of them are poor.
They can't afford to undergo
expensive heart operations elsewhere.
In the last 20 years,
we have never refused a single patient
because of the money.
This place is the culmination
of my life's work, dreams, and ambition.
For me, the hospital is a temple
where sick people are taken care of.
This is the operation theater complex.
From that end till this end,
there are five operation theaters.
We have four floors, each having
five to six operation theaters.
This building is created
to do 100 heart surgeries every day.
That is our desire.
I worked in Devi's hospital,
just at the end of my specialist training
in pediatric cardiac surgery.
The setup at Narayana is unique.
You still have surgical theater,
you still have an intensive care unit
and a ward.
But it's faster.
The patients just
flow through the process.
That's why you can do much more…
In the same amount of time,
using the same resources.
The idea of doing
a large number of heart operations
is that, because of the economy of scale,
your cost goes down
so that the poor people
If their children require
heart operations,
we can do it at any price they can afford.
What I take away
from my time working with Devi,
is that he's a man with a vision.
Put one more stitch here to hold it.
Leftover stitch please, Sissy.
What he's doing for India
is outstanding.
And that's why I'm in awe.
When I started my career…
When a patient didn't have the money,
I couldn't do much to help him.
This looks like a happy heart.
It is getting all the blood it requires.
Today, the greatest joy in my life is
whenever I come across a patient
who has no money,
but he needs
a life-saving heart operation,
I'm in a position to tell him
not to worry about the money
and get the operation done
without any payment.
I'm proud of him
for all his achievements.
He's saved so many lives,
and so many children's lives,
and helped so many people.
Maybe I'll use him, you know,
in the future, if he really wants to…
Though it's been tough,
and, you know, there's been so many
ups and downs…
Every achievement of his,
I'm very proud of.
Very, very proud.
I never say it to him, but I am.
Hmm? Somebody has come.
Thank you, my darling.
Thank you so much.
I don't find myself extraordinary…
Other than the passion to cut and stitch.
But what I wanted was to reach out
to as many people as possible.
So I wrote this letter on a beach in Goa…
To the 4,000 children
I operated during my stay in Kolkata.
My dear children…
All I ask of you is:
can you spend a few moments
of your precious time
for someone who needs it…
Without expecting anything back in return?
It's very important
that when good things are done,
it gets documented.
So that one day future generations
will read it
and maybe some of them
will decide to do the same,
or something even better.
My country requires
two million heart surgeries a year.
Today all the heart surgeons in India
put together
perform less than
150,000 heart operations.
What happens to the remaining
1.9 million people?
How long it will go on?
How long we are going to tolerate it?
This is unacceptable.
And this is the challenge
for our generation.