The Hindu Business Line : Matters of the heart

At 62, Mithilesh Prasad of Abhimanyupur can jog up a flight of stairs or catch a running bus that has shifted to second gear. Not a big deal really because many in the last quartile of their lives do amazing things these days such as sky diving and learning martial arts, a portal believed to be an exclusive domain of the very young at heart and body.

But eight years ago, Mithilesh wondered if his heart would jump out of his ribcage. Forget about jogging, even if he walked to the dining room, his heart went berserk. Despite a heart that was always ready to help the distressed, he wondered why it reneged. A strict vegetarian and a teetotaller, Prasad couldn't figure out why his heart was failing when many routinely overate, drank like fish and smoked like a diesel loco.

Eight years ago

Dr Murthy: Mr Mithilesh, your racing heart, known as tachycardia, doesn't seem to respond to drugs for long. I advise you complete rest.

Mithilesh: Yes doctor, I faint frequently near the bathroom. Lucky I never fainted inside.

Dr Murthy: Go home, lie down, and don't even think about work. If you feel unwell, or have nausea, or suddenly begin sweating profusely, call me. You must see Dr Siva in Pandai.

Mithilesh: What exactly is my problem, doctor?

Dr Murthy: I have told you... (pauses) Your heart muscles, myocardium, cannot do what they are supposed to. Looks (shows Mithilesh the ultrasonogram) ... Do you see the bulge? (Prasad nods his head) Because of this, your heart is unable to do its work well. Now could you sit outside and send in your son?

(Naveen Prasad, son of Mithilesh Prasad enters)

Naveen: Morning doctor...

Dr Murthy: Mr Naveen, your father is seriously ill and needs complete rest. His heart is badly damaged and we can't intervene anymore. Only a transplant may help, if at all ... Your father's future is unpredictable now and his condition may worsen. I asked him to see a doctor in Pandai.

Naveen: But how? He has no addictions, he is highly principled, and a diehard vegetarian.

Dr Murthy: It can happen. Though statistically some lifestyles — like smoking — are more likely to lead to cardiac disease there is never a one-to-one correspondence. Not every smoker has a heart disease just as not every teetotaller is free of cancer or cardiac ailment ...

Naveen: Thanks. You have done your best. Now it is in God's hands. (leaves)

Mithilesh (sitting outside the chamber): What did the cardiologist say?

Naveen: Nothing more than what he told you. Complete rest.

Mithilesh: But how can I be dependent on you? I am just 54 years old!

Naveen: Remember that I almost died when I was four? Mom told me. So illness is a matter of chance. (pauses) I am taking you to Pandai tomorrow. Early morning flight.

Mithilesh: Why look so disturbed? And why are you sweating on a November night? You are hiding something, are you?

Naveen: Nothing, appa. Just relax. We go to Pandai tomorrow to see the doctors.

Mithilesh: You are afraid I will die, isn't it? (pats Naveen on the shoulder) Son, everyone has to someday, so why panic?

Naveen: We must do our best, shouldn't we? Just because you say that everyone who is born must die one day, do we sit inert, waiting for the "inevitable"?

Mithilesh: Naveen, I know I am dying. I have difficulty sleeping. Lying on the bed helplessly, expecting you and your wife to do everything for me, including cleaning the bedpan, doesn't make me happy. I have become useless. But I must hold Parvathi's child before bidding everyone my final goodbye. I have held your son Avinash. I must also clear the bank debts.

Naveen: Stop talking rubbish. We won't let you go so early.

Mithilesh: That's neither in your hands, nor in mine, nor in the doctor's.

Naveen: All your life you have been a fatalist. Always saying, "What was predicted after my birth will happen... " Forget it pa. We are in the 21st century...

Later in Pandai

Dr Siva: I discussed your dad's medical history with cardiologists. We agreed he needs the operation.

Naveen: But our Abhimanyupur cardiologists said his heart cannot be operated on...

Dr Siva: He can be, but there is a 10 per cent risk while reshaping his left ventricle. Are you willing to take it?

Naveen: What are the benefits?

Dr Siva: Data show that patients have responded well. Many still survive years after the surgery. But he has to be on drugs lifelong. We need your written consent for the operation.

After eight years

Dr Siva: How are you, Mr Mithilesh?

Mithilesh: Never better. You have done what I believed God alone could do.

Dr Siva: We believe that research breakthroughs must reach the patients. Now tell me about your US trip and you daughter and grandchild there.

Mithilesh: Parvathi has a daughter. Antara is beautiful... (pauses) Doctor, My heart raced once and my daughter rushed me to hospital where she showed my medical reports, surgical reports, and insurance papers. The doctors refused to file an insurance claim, saying my problem would fall under the "pre-existing condition" clause. As I had surgery in India, the treatment would cost thousands of dollars that my daughter would need years to repay. The doctors were genuinely worried about me, and suggested that I leave immediately and see my doctors in India. So here I am after 45 days in the US — my first ever journey in eight years after the surgery, that too out of India.

Dr Siva (checks Mithilesh): You are fine. Next time make your foreign visits short. Very short. At your age, you may not get medical insurance. Take the prescriptions and enough stock of medicines when you go abroad again.

Mithilesh: Sure doctor. But can I ...

Racy@TheHindu.co.in

http://RacyCases.blogspot.com