Recently, I was shaken by the sudden death of my colleague Dr Prasanna Nyayadish, assistant professor of cardiology, KEM Hospital, Mumbai. He was 44. I knew him as a good human being, a mentor, a teacher and a tutor. Prasanna had no vices—he did not drink or smoke, had no known conventional risk factors for heart disease and was conscious about fitness. At work, he enjoyed teaching and was involved in academic discussions. We often did complex cases together.
A few years ago, my batchmate and colleague Dr Manjeet Juneja, too, succumbed to a heart attack before he could reach the hospital. Also, two acquaintances of mine, both cardiologists in their early forties, died of heart attack. A renowned cardiologist underwent angioplasty and bypass surgery twice in close succession in the last few months.
If a person dies of cancer, prolonged illness or chronic conditions like kidney failure, the family gets enough time to accept the loss. But in the case of heart attacks, the loss is unfathomable.
In addition to the conventional risk factors, stress has added to the burden of heart disease, high blood pressure and diabetes mellitus. People who are constantly stressed out are at an increased risk for heart disease even if they do not have a family history. Studies prove that the life of a doctor is six to eight years shorter than that of the average population. Skilled cardiologists are ever wanted at multiple facilities. The demands and the nature of the job put interventional cardiologists under tremendous stress.
Almost all the procedures we perform are done on patients who are conscious and by a single operator. So, we are responsible for even the natural outcome. Multi-tasking is the key as we are expected to operate, keep the patient's financial situation in mind, be a good counsellor and a good human being, too. After procedures like angioplasty, the patient's progress remains unpredictable even if the procedure was successful. In heart disease, there are just too many variables and it is difficult to gauge what may go wrong.
In other specialities like kidney-liver diseases, oncology, poly trauma orthopaedic interventions, disastrous multi-organ failure owing to infections, surgeries under general anaesthesia, the stress and responsibility is shared between multiple disciplines like a general physician, surgeons, anaesthetist, critical care specialists and a super specialist. But in interventional cardiology, it's a one-man army. We can never do a procedure and forget it. For us, it's a lifetime responsibility.
In the initial stages of their career, super specialists get attached to five to eight different hospitals and keep hopping from one to the other. In metros like Mumbai, where traffic snarls do not permit faster movement, the stress levels go through the roof.
Unreasonable demands of the bystanders of the patient also add to the stress. After performing a complex surgery, patients and their relatives expect the same doctor to provide all the information and facilities, from necessary scientific explanation to cost estimations, concessions, progress, reason for change in treatment and day-to-day general counselling. The patient's caregivers need to understand the importance of second and third-level hierarchy in the organisation that allows division of work.
This brings the junior doctors and nurses into the picture. While the doctor cannot constantly monitor the patient physically, he or she takes constant updates from the staff on duty. To avoid major lapses, the doctor makes sure they see the patient clinically once in 24 hours. When patients are admitted for major or semi-major issues, they keep getting better with treatment, support, nutrition, general nursing care and valuable counselling.
Caretakers and patients must try and understand that the doctor attends to many cases in a day and it is impossible to be available all the time. Keep calls to the doctor to a minimum.
My advice to young cardiologists is this: Earning money is not a sin. But going for quick bucks can be disastrous. Be honest. We require more patience and need to stay composed and deliver our best in every situation. When we advise others on stress-free life, we should try and follow the dictum ourselves.
What can be done to lower stress? Here are my suggestions:
Working under one roof: A specialist should not take up too many attachments and should dedicate maximum working hours at one place or at one major institute.
Establishing qualified hierarchy: Have a proper second and third line-up of people, administrators, counsellors and dieticians, to answer patient queries.
Prioritise: Emergencies should be dealt with first, early morning. Rounds should be taken care of before 10 a.m. or 11 a.m. Distribute and depute duties with instructions and names to ensure smooth functioning.
Divide your time: Give more time at the inception stage and clear out things at the beginning, leaving no room for patients to feel that a particular matter was not touched. Keep time for daily briefing in the evening with a responsible relative.
Consider economy: If asked, admit the patient in the economy class as the patient's relatives might not be aware of cost-cutting facilities.
Take care: Make time for yourself. Stay focussed, happy and healthy.When in trouble, everyone expects the doctor to pick up the call, give the right advice and help the patient feel better. But it becomes ironic when the doctor's heart is in trouble, he does not get help in time, and dies. When cardiologists are the victims, needless to say, it's a worrisome trend.
Recently, I was shaken by the sudden death of my colleague Dr Prasanna Nyayadish, assistant professor of cardiology, KEM Hospital, Mumbai. He was 44. I knew him as a good human being, a mentor, a teacher and a tutor. Prasanna had no vices—he did not drink or smoke, had no known conventional risk factors for heart disease and was conscious about fitness. At work, he enjoyed teaching and was involved in academic discussions. We often did complex cases together.
A few years ago, my batchmate and colleague Dr Manjeet Juneja, too, succumbed to a heart attack before he could reach the hospital. Also, two acquaintances of mine, both cardiologists in their early forties, died of heart attack. A renowned cardiologist underwent angioplasty and bypass surgery twice in close succession in the last few months.
If a person dies of cancer, prolonged illness or chronic conditions like kidney failure, the family gets enough time to accept the loss. But in the case of heart attacks, the loss is unfathomable.
In addition to the conventional risk factors, stress has added to the burden of heart disease, high blood pressure and diabetes mellitus. People who are constantly stressed out are at an increased risk for heart disease even if they do not have a family history. Studies prove that the life of a doctor is six to eight years shorter than that of the average population. Skilled cardiologists are ever wanted at multiple facilities. The demands and the nature of the job put interventional cardiologists under tremendous stress.
Almost all the procedures we perform are done on patients who are conscious and by a single operator. So, we are responsible for even the natural outcome. Multi-tasking is the key as we are expected to operate, keep the patient's financial situation in mind, be a good counsellor and a good human being, too. After procedures like angioplasty, the patient's progress remains unpredictable even if the procedure was successful. In heart disease, there are just too many variables and it is difficult to gauge what may go wrong.
In other specialities like kidney-liver diseases, oncology, poly trauma orthopaedic interventions, disastrous multi-organ failure owing to infections, surgeries under general anaesthesia, the stress and responsibility is shared between multiple disciplines like a general physician, surgeons, anaesthetist, critical care specialists and a super specialist. But in interventional cardiology, it's a one-man army. We can never do a procedure and forget it. For us, it's a lifetime responsibility.
In the initial stages of their career, super specialists get attached to five to eight different hospitals and keep hopping from one to the other. In metros like Mumbai, where traffic snarls do not permit faster movement, the stress levels go through the roof.
Unreasonable demands of the bystanders of the patient also add to the stress. After performing a complex surgery, patients and their relatives expect the same doctor to provide all the information and facilities, from necessary scientific explanation to cost estimations, concessions, progress, reason for change in treatment and day-to-day general counselling. The patient's caregivers need to understand the importance of second and third-level hierarchy in the organisation that allows division of work.
This brings the junior doctors and nurses into the picture. While the doctor cannot constantly monitor the patient physically, he or she takes constant updates from the staff on duty. To avoid major lapses, the doctor makes sure they see the patient clinically once in 24 hours. When patients are admitted for major or semi-major issues, they keep getting better with treatment, support, nutrition, general nursing care and valuable counselling.
Caretakers and patients must try and understand that the doctor attends to many cases in a day and it is impossible to be available all the time. Keep calls to the doctor to a minimum.
My advice to young cardiologists is this: Earning money is not a sin. But going for quick bucks can be disastrous. Be honest. We require more patience and need to stay composed and deliver our best in every situation. When we advise others on stress-free life, we should try and follow the dictum ourselves.
What can be done to lower stress? Here are my suggestions:
Working under one roof: A specialist should not take up too many attachments and should dedicate maximum working hours at one place or at one major institute.
Establishing qualified hierarchy: Have a proper second and third line-up of people, administrators, counsellors and dieticians, to answer patient queries.
Prioritise: Emergencies should be dealt with first, early morning. Rounds should be taken care of before 10 a.m. or 11 a.m. Distribute and depute duties with instructions and names to ensure smooth functioning.
Divide your time: Give more time at the inception stage and clear out things at the beginning, leaving no room for patients to feel that a particular matter was not touched. Keep time for daily briefing in the evening with a responsible relative.
Consider economy: If asked, admit the patient in the economy class as the patient's relatives might not be aware of cost-cutting facilities.
Take care: Make time for yourself. Stay focussed, happy and healthy.
When in trouble, everyone expects the doctor to pick up the call, give the right advice and help the patient feel better. But it becomes ironic when the doctor's heart is in trouble, he does not get help in time, and dies. When cardiologists are the victims, needless to say, it's a worrisome trend.
Recently, I was shaken by the sudden death of my colleague Dr Prasanna Nyayadish, assistant professor of cardiology, KEM Hospital, Mumbai. He was 44. I knew him as a good human being, a mentor, a teacher and a tutor. Prasanna had no vices—he did not drink or smoke, had no known conventional risk factors for heart disease and was conscious about fitness. At work, he enjoyed teaching and was involved in academic discussions. We often did complex cases together.
A few years ago, my batchmate and colleague Dr Manjeet Juneja, too, succumbed to a heart attack before he could reach the hospital. Also, two acquaintances of mine, both cardiologists in their early forties, died of heart attack. A renowned cardiologist underwent angioplasty and bypass surgery twice in close succession in the last few months.
If a person dies of cancer, prolonged illness or chronic conditions like kidney failure, the family gets enough time to accept the loss. But in the case of heart attacks, the loss is unfathomable.
In addition to the conventional risk factors, stress has added to the burden of heart disease, high blood pressure and diabetes mellitus. People who are constantly stressed out are at an increased risk for heart disease even if they do not have a family history. Studies prove that the life of a doctor is six to eight years shorter than that of the average population. Skilled cardiologists are ever wanted at multiple facilities. The demands and the nature of the job put interventional cardiologists under tremendous stress.
Almost all the procedures we perform are done on patients who are conscious and by a single operator. So, we are responsible for even the natural outcome. Multi-tasking is the key as we are expected to operate, keep the patient's financial situation in mind, be a good counsellor and a good human being, too. After procedures like angioplasty, the patient's progress remains unpredictable even if the procedure was successful. In heart disease, there are just too many variables and it is difficult to gauge what may go wrong.
In other specialities like kidney-liver diseases, oncology, poly trauma orthopaedic interventions, disastrous multi-organ failure owing to infections, surgeries under general anaesthesia, the stress and responsibility is shared between multiple disciplines like a general physician, surgeons, anaesthetist, critical care specialists and a super specialist. But in interventional cardiology, it's a one-man army. We can never do a procedure and forget it. For us, it's a lifetime responsibility.
In the initial stages of their career, super specialists get attached to five to eight different hospitals and keep hopping from one to the other. In metros like Mumbai, where traffic snarls do not permit faster movement, the stress levels go through the roof.
Unreasonable demands of the bystanders of the patient also add to the stress. After performing a complex surgery, patients and their relatives expect the same doctor to provide all the information and facilities, from necessary scientific explanation to cost estimations, concessions, progress, reason for change in treatment and day-to-day general counselling. The patient's caregivers need to understand the importance of second and third-level hierarchy in the organisation that allows division of work.
This brings the junior doctors and nurses into the picture. While the doctor cannot constantly monitor the patient physically, he or she takes constant updates from the staff on duty. To avoid major lapses, the doctor makes sure they see the patient clinically once in 24 hours. When patients are admitted for major or semi-major issues, they keep getting better with treatment, support, nutrition, general nursing care and valuable counselling.
Caretakers and patients must try and understand that the doctor attends to many cases in a day and it is impossible to be available all the time. Keep calls to the doctor to a minimum.
My advice to young cardiologists is this: Earning money is not a sin. But going for quick bucks can be disastrous. Be honest. We require more patience and need to stay composed and deliver our best in every situation. When we advise others on stress-free life, we should try and follow the dictum ourselves.
What can be done to lower stress? Here are my suggestions:
Working under one roof: A specialist should not take up too many attachments and should dedicate maximum working hours at one place or at one major institute.
Establishing qualified hierarchy: Have a proper second and third line-up of people, administrators, counsellors and dieticians, to answer patient queries.
Prioritise: Emergencies should be dealt with first, early morning. Rounds should be taken care of before 10 a.m. or 11 a.m. Distribute and depute duties with instructions and names to ensure smooth functioning.
Divide your time: Give more time at the inception stage and clear out things at the beginning, leaving no room for patients to feel that a particular matter was not touched. Keep time for daily briefing in the evening with a responsible relative.
Consider economy: If asked, admit the patient in the economy class as the patient's relatives might not be aware of cost-cutting facilities.
Take care: Make time for yourself. Stay focussed, happy and healthy.
The author is an interventional cardiologist, Jupiter Hospital, Thane.
the week/manorama