TRIBUTE DASA --- DISALU

Transcription

1 1 TRIBUTE DASA --- DISALU Dr. B.Dibbala Rao

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3 3 DEDICATED To the Savior Sri Soma Raju

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5 5 INSPIRATION The Heart Beat, the Great Souls, The Path breakers, the Physical Beats, The Distracters, the Inhibitors The Friends and the Back Biters The Pulses and the Impulses

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7 7 CONTENTS ONE TWO THREE FOUR FIVE SIX SEVEN EIGHT NINE TEN Dear Dr. B.Soma Raju Sir, WHAT DOES ALL THIS MEAN IT IS BETTER TO, NOT TO GET WHAT YOU DESERVE ARA CHETI MEEDA BETTAM CHECHINA NATYMA NADUMU MEEDA PIDI GUDDULU MUCHATAGAA MOODO SAARI--CHEMPA CHELLU MANNADI GUNDE PAGILI RAKTAM NEERAI VARADAI.. KAI RAJA KAI REARING UP A JUNIOR CARE BANJARA NEURO SURGERY DEPARTMENT

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9 9 PREFACE A tribute is generally paid to the very important people who played the major role in moulding other s lives and fortunes. Those persons who were greatly benefited and started leading a totally transformed life with significant changes in their attitude always remembered and revered those important people and their help during their entire life time. The tribute could be paid to a real life saving person, a physician like Dr.B.Soma Raju; to persons who contributed for prolonging the bonus life; to the teachers who contributed to the character moulding in the early days of schooling which was responsible for a strong foundation and the super structure, like Sri.Ramaih, Sri.Kola Koteswara Rao and the NCC instructor at the college; to the classmates and fellow students who directly or indirectly contributed for my steady and studious career and finally the lessons learnt from the professional colleagues, was all a learning process. Looking back, what my Telugu teacher often called Simahavalakanam I could reflect all my feelings and emotions in a compact and concise form, to keep all my thoughts close to my heart only and never to reveal to others to begin with. But, those lingering thoughts repeatedly replayed in my mind so frequently that I almost ruminated day in and day out. I also tried to narrate to my very close friends and colleagues on every given taken occasion. So much so, what I wanted to keep in a closed fist has become an open secret. As the time moved on, a day has come where I have no fear or love for expressing my inner feelings in an uninhibited way.

10 10 I have no reservations in my mind to express my happiness, gratefulness, admiration, adoration, love and hate even in the sublime form. I have kept in mind the reflections and repercussions of the other persons involved. Even though I could have used fictitious names to preserve the privacy of the other persons, I decided against such concealment to make my statements more authentic. The tribute is totally a selfish confession. I do not know whether I am a qualified person to offer something in the name of a tribute. The tribute was reserved for very great and important people. Whether I am competent and qualified enough to pay the tributes I leave to the judgment of the unknown reader. If I live long enough, I shall stand the test of time to defend or to deflect my own statements and comments. Ultimately, life is an open book. If I missed out on even more important events it is just that I did not feel they are relevant for the present time. Dasa Disalu is my concept of ten directions incorporated in the ten items I have chosen like Toorupu, Padamara, Uttaram, Dakshanam, Esanyam, Agneyam, Nairuthi, Vayuvyam, Ningi and Nela. All the ten have impacted my life in an immeasurable quantity and quality. That does not mean that all the directions are uniform and give the same information and inference. Sometimes they are contradictory and conflicting, if not self defeating. Some of them work in quite opposite directions. The tribute has come out of my heart, its vessels and the blood. It was there when my heart was hale and healthy, broken, damaged and bled; got repaired and regenerated and finally pumping with all its vigor and energy.

11 11 Om Sai Ram Dear Dr. Soma Raju Sir, As I personally perceive.. You have grown so tall, It is difficult to gaze your height from close quarters, From a distance, even the Himalayas look like ant hills, So keep growing for ever and ever TRIBUTE ONE You are shining so bright It is impossible to see you face to face From a distance even the sun looks like a candle light So, keep shining brighter and still brighter You are working, so hard day in and day out You are the first to come and last to leave Let this trend continue, as It will inspire next generations, you as Torch bearer Sir, your work ethics, limited words, disguised smile, Gives hope on life for those eagerly awaiting your daily visit. You should keep this trend for endurance and fitness You are destined to save many more lives Those too more precious lives. You have already saved many lives and many more should get your Help and golden touch, of your magic, nay, scientific wand. Ultimately, you have saved me a number of times, And I live with the Hope you will save me many more times to come The bonus life looks more valuable than the original Your selfish patient, who wants to live long, Defying the laws of life Hoping God drops catches like before Dr. B.Dibbala Rao

12 12 The Idea of writing the tribute came to my mind when I was recovering from the cardiac arrest for the third time in the ICCU of the CARE Hospital, Banjara Hills. The recovery itself was unexpected and dramatic as very few people gave me any chance of survival. Even Dr.B.Soma Raju commented that my life was very strong for me to recover from such a grave situation. After coming out of the ventilator and the intubation I was still kept in the ICU for the total recovery. I was fully conscious and was totally aware of what went wrong when I was staying at the guest room at Dr.B.Soma Raju s house before the cardiac arrest. Those people who visited me including Prof.S.Balaparameswara Rao, my former teacher and well wisher and also some close friends like Mr.Sivaiah, Income-Tax Officer along with other doctor friends closely observed my recovery step by step. Even with the intubation and the ventilator on, I was conscious and tried to convey through scribbling some words with the help of a paper and pen which was not so legible but an effort was made to communicate what I wanted. First I tried to thank Dr.B.Soma Raju for saving me from a certain irreversible stage and also expressed my gratitude on the New Year day of What I wrote in the tribute was not generated just at that time but the first few lines were at the top my mind and thoughts about Dr.B.Soma Raju whom I have been following closely, admiring and respected him as my senior. He was also a very successful student in MD. General Medicine at the Guntur Medical College, I told a

13 13 number of people that the transformation of the MD. General medicine post graduates at the Guntur Medical College and the General Hospital Guntur was a land mark which I preferred to call as a Soma Raju phenomenon where all the MD. General medicine post graduates flocked together at the M1 ward at nights and studied continuously which attracted many other department post graduates and students to work hard and spend time in the wards totally devoted to the subject. So much so, that Dr.B.Soma Raju was a contender for the gold medal along with Dr.P.Krishnam Raju which ultimately adorned Dr.B.Soma Raju and both of them passed MD. General Medicine in the first attempt and also reached the goal of becoming cardiologists from the PGI, Chandigarh and the AIIMS, Delhi respectively. Long before my illness, during my friendly conversations with some close friends like Dr.(Mrs). Hema Parimi and Dr. S.R.Parimi, I was mentioning my feeling towards Dr.B.Soma Raju while we were travelling to Ongole by car and mentioned to them the great heights and the brightness which Dr.B.Soma Raju achieved during his exemplary career both academically and as a clinician. I told them they were purely my personal perceptions. After I drafted the matter of Tribute in the ICCU, it took a few days for me to get it typed, corrected and also to get it laminated with the help of some hospital staff and also Mrs.A.Vara Lakshmi. Ultimately I decided to show what I wrote, to Dr.B.Soma Raju when

14 14 he made the morning rounds during the Sankranthi festival. He read it and also made some comments to his assistants and the team of nurses who followed his rounds early in the morning hours as if it was some routine matter to him given by his patients almost every day. He was amused and also was hiding his real feelings without any direct comment. I hope, it appealed to him, but as a man of few words he just walked away. I thought I made a sincere effort in penning down my inner feelings as really and truly as they went through my mind. I was also elated to know that I too could write a few lines in English to please myself. Hence I reserved a few copies of the Tribute and showed to the people who visited me for their impressions and comments. The first person whom I showed the Tribute was Professor S.Balaparameswara Rao, when he visited me in the room when I was shifted out of the ICCU. His comment was that the write-up was good and also he commented that I used good English words. Dr.M.A.Saleem and Dr. (Mrs.) Lakshmi Saleem also appreciated what was written about Dr.B.Soma Raju. Dr.V.Krishna Murthi, also a common friend, read the Tribute along with some other written material by me and was very happy that I could write such a tribute. He mentioned that the first half was poetry and the second half was a prose composition. It did not matter for me whether it was poetry or prose as long as it was appealing to read and understand. For many other people who ever came across, I showed them what I

15 15 wrote about Dr.B.Soma Raju. When I showed the copy to Dr.(Mrs).Hema Parimi when she visited me at Dr.B.Soma Raju s residence, after I was discharged from the hospital after a successful stent procedure for the third time, she was very happy and expressed her instantaneous liking for the Tribute and also wanted to keep the copy with her, the only copy available with me at that time. Dr.(Mrs).Jaya Prada Devi also read it and liked it. One Dr.L. Seshadri Rao a long time close friend and former professor of Pharmacology was originally my roommate at the Guntur Medical College Men s hostel during the year 1966 and we both stayed in the room number 66 of the old block. His comment was very much amusing as he himself has got the art of writing some good letters both in English and Telugu. After reading he was smiling and told me that my tribute was very flattering and also asked me whether Dr.B.Soma Raju fell flat after reading my tribute. Many people read the tribute and made their appreciative comments. It was shown to the team of neurosurgeons at the CARE Banjara and many more doctors with whom I had direct friendship like Dr.B.N.Prasad, Dr.K.Rama Raju and Dr.Chakravarthi Rajasekhar. I had one interesting discussion with Dr.P.Krishnam Raju when I showed him the tribute along with other few articles I wrote during my convalescence. He appreciated the tribute and I asked him whether I could read it to the audience of doctors when I was given permission to address the outgoing DNB students in

16 16 January-2010 at a hotel meeting. He asked me to keep the tribute close to my heart and try to get a chance to read it in the hospital auditorium so that many people from other hospitals also would get a chance to listen to the tribute. I did not get the chance and the tribute remained within my mind and my files, safely preserved. I shared the tribute with my two daughters and son-in-law when they called on me when I was recovering from my heart ailment. I also shared the same thing with Dr. (Mrs.) K.Sarada, my colleague house surgeon in neurosurgery when she visited me at Hyderabad. She was also impressed and took the copies for her files. Dr.B.Surya Mohan Reddy a retired orthopedic surgeon and his wife Dr.Aruna Kumari both from the Railway hospital Vijayawada visited me and read the tribute along with the rest of the few writings I completed by that time. They were also very much impressed with the tribute. Incidentally, Dr.Aruna Kumari also had a stent placement for a single vessel disease which was done by Dr.B.Soma Raju and she has been doing well for more than ten years. Finally I shared the tribute with one Mr. Shah of Bombay in whose apartment Indralok ; I stayed for a couple of months. He was much impressed with the write up and took the original laminated copy to Bombay and got it fixed on a good looking photo frame which I presented to Dr.B.Soma Raju to be kept in his clinic room. I thought it was precious to me as a mark of successful treatment given to me on three occasions at the CARE Hospitals Visakhapatnam and Banjara

17 17 Hills. As Dr.B.Soma Raju must have saved a number of people like me and will continue to do so forever, the small tributes paid by people like me may not be worth keeping forever at his clinic chest, many more and much more valuable tributes and citations must have come and gone in the long journey of the clinical practice of Dr.B.Soma Raju over the past several decades. Whether my life was precious or not, by saving my life I was given a chance to do service to some more neurosurgical patients and also to help save their precious lives. The feelings are endless and everlasting.

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19 19 WHAT DOES ALL THIS MEAN TWO Strange things happened in six weeks time in succession: I came from Vishakhapatnam on 28th November 2008 accompanied by Dr.V.Krishna Murthi, Regional Director of the CARE Hospitals and Dr.G.S.R.Murthy, Director of the CARE Hospital, Visakhapatnam. I underwent Trans-Radial Coronary Angiography on the same day and was admitted for CABG Surgery. Dr.G.S.R.Murthy left for Vishakapatnam the same day evening and Dr.Krishna Murthi was supposed to leave on 29th evening. Meanwhile Dr.V.Krishna Murthi's mother aged 98 years who has been bed-ridden for the last few years, become serious and so Dr.V.Krishna Murthi rushed to Visakhapatnam by 29 th morning flight itself and within shortly afterwards Dr.V.Krishna Murthi s mother passed away. I wish she lived and completed hundred years of age, but it happened otherwise. On 29th night I developed severe flash Pulmonary edema for which I was put in the ICU, Ventilated and managed with emergency PTCA by Dr. B.S.R. with successful outcome, and I survived a certain death. In the last week of December 2008, Dr.(Mrs).Lakshmi Saleem who has been a classmate and good friend for more than four decades, she was regularly visiting me at the hospital during my recovery stage and suddenly announced that she was going to USA

20 20 within hours notice as her sister s husband passed away at New Jersey. He was having some chronic ailment and could have lived a few more years. I knew him very well too. In the first week of January 2009, I got a call from Vishakapatnam that the Annual CMR-AISTA Tennis Tournament has begun at the Officer s Club. Next day morning, in The Hindu Paper, I saw the results of a match that Mr.Sarangi defeated Maruthi Mohan of Hyderabad. In the news item of inside of the pages I was shocked to read that Mr.Maruthi Mohan of Osmania University passed away while playing Tennis Tournament, the same day with sudden heart attack at the Officer's Club Vishakapatnam and before he could be taken to the hospital. It is a strange co-incidence that I had similar heart attack while playing tennis six months back in the same court and was lucky to have survived by the timely resuscitation by Dr.Raghu Prakash anesthetist and tennis player who was readily available on the spot and treatment at the CARE Hospitals by Dr.G.S.R.Murthy and Dr.V.Krishna Murthi. Mr.Maruthi Mohan is known to me in the Tennis circle. He was also well known to the gynecologist Dr.(Mrs).Manjula of the CARE Hospital Dr.Rajeev Menon, who had been attending and treating me along with the team of doctors headed by Dr.B.Soma Raju suddenly went on leave during the Pongal days i.e. the 2 nd week of January I came to know that his father, a doctor suddenly passed away, might be due to Heart attack. This happened when I was

21 21 recovering in the ICCU from severe pulmonary edema for the 2 nd time and was saved by timely help from Dr.B.S.R. and Dr.M.A Saleem. This time my condition was more serious than the previous one. I am living for the fourth time and came out from the jaws of certain death. My friend Mr.A.Bhaskar Rao from Vishakapatnam who has been assisting me in the CARE hospital at Vishakapatnam and Hyderabad got the information that his mother passed away at Kakinada due to chronic illness in the 3 rd week of January, She was also my old patient. I knew her well. Looking back, this strange sequence had never happened in my life or in my friend s circle. It looks as though my own life is being extended at the expense of known people's life, however short it might be. Is it the God's plan to prepare me and my friends and family members for accepting a shorter life or he is planning to give me a long lease of life borrowing from others? Each time I had a life threatening problem, I also had a timely life saving help from doctors and friends even at odd hours at night. Time only will tell the truth about the future of my life but these feelings are haunting me for good or bad, day in and day out. GOD IS GREAT!!!!

22 22 AND MORE. The above thoughts went through my mind when I was still recovering in the wards of CARE Hospital, Banjara Hills, after the successful resuscitation from massive myocardial infraction for the third time. I could not but ruminate that many known persons like Dr.V.Krishna Murthi, Dr.(Mrs.).Lakshmi Saleem, Dr.Rajeev Menon, and Mr.Bhaskara Rao have lost their close relatives when I was still in the hospital. The rapid events made me think that whether those people who were dying unexpectedly were also trying to lend their remaining life to me to prolong my own life to some extent. When I wrote this and showed to Dr.V.Krishna Murthi he felt very happy for the sentiment I expressed and also thought that I should live long even if it was at the expense of his mother s life. Same thing was expressed by Dr. (Mrs.) Lakshmi Saleem who lost her brother-in-law in USA. Having got an extended life through the possible contribution of those known and unknown persons to me, I managed to live long enough to know that a few more people known to me closely also passed away with heart disease about that time. At least three of them were well known to me. One was Mr.V.S.N.Murthy a retired State Bank of India, Manager who had been associated with me from the time he was an accountant at the SBI Branch, Dwarakanagar Visakhapatnam. He was a close friend, looked after my bank accounts and was instrumental in sending money to my mother on

23 23 monthly basis regularly. He and his family members were all my patients and were affectionate throughout. Even when I was recouping at the CARE Hospital, Banjara Hills he visited me for some backache and neck pain and also for a general checkup before he went to USA to visit his daughter. After he returned from USA, within a few days, he suddenly expired may be due to sudden cardiac arrest. I came to know about the incident when his daughter called me from USA and asked me about the possible cause of such a sudden death when he was apparently normal without any cardiac symptoms before. I could not really answer the question but nowadays the heart attacks are more frequent causes of sudden death. When Mr.V.S.N.Murthy expired at an early age he must have contributed to add more years to my own life. Last week I received a phone call from my village that a close friend and a noted person in the village suddenly died of cardiac arrest. His name was Mr.K.Shankara Rao, neighbourer to Mr.Ch. Punna Rao, my erstwhile childhood friend. Actually Mr.K.Shankara Rao visited me at the CARE Hospital, Banjara Hills recently regarding his own cardiac problem and consulted Dr.B.Soma Raju who assured him that the medical treatment was sufficient for him. Actually he brought one CT Coronary Angiogram test done at Guntur by Dr.Raghava Sharma of Lalitha Hospitals. He also died at a very young age and I am sure he had many more years to live but for the

24 24 premature death. I can t but think of his contribution to my own life extension. Last but not the least person who was keen on my survival and existence was my own mother. She always thought about my health and well being even though she was becoming old and surviving on one hope that she would see me with her own eyes when I was still alive. She suffered silently when I had the first heart attack at Visakhapatnam in the year 2008 and most of the doctors there gave no hope of my survival, she must have suffered silently and prayed for my recovery. God must have responded to her prayers and pulled me out of the ventilators, ICU and the hospital, safely. She could not come to Visakhapatnam to see me at the hospital as she herself was disabled with Osteoarthritis of both knee joints and was also short of vision in both the eyes because of the cataract. She could not come to Hyderabad when I was admitted at the CARE Hospital, Banjara Hills twice in November and December 2008 with massive heart attacks. When I was still in the hospital as inpatient I made arrangements to bring my mother to the CARE Hospital, Banjara Hills for her knee joint replacement surgery. Dr.B.N.Prasad successfully did the right knee joint replacement for the knee, which was badly damaged by that time and crippled her from moving even to the day to day needs. At that time and also for the last time we stayed together for nearly one month at the same place in the CARE Hospital, at side by side rooms. After discharge from the hospital, I

25 25 made arrangements for her to undergo cataract surgery at Guntur, which was done by my friend Dr.Venkata Ramaiah. She had both the eyes operated at intervals of six months and also regained her vision to some extent. She travelled to Hyderabad when she was able to walk with a stick and also could see me with her own eyes, once after I was discharged from the hospital and was stable with stents and medication. She did not know the full details about my going to Mumbai to the Asian Heart Institute for the Bypass Surgery as all the six stents placed before at different times that got blocked for reasons not known to anybody. Still she was constantly talking to me by phone to enquire about my well being. I did not allow my mother or sisters or any other family members to visit me, as I did not want to present a weak and sick personality for them. After I recovered mostly and was stable for a few months I myself travelled to Vijayawada called my mother and other family members to meet me at the SALAJA Hospital, which was a common place for all of us to meet for a number of years. At that time my mother looked weak and fragile. I did not realize that could be the last and final meeting for both of us. That was in the month of March In the month of July-2011 she developed sudden ischemic heart disease and was shifted to the private nursing home at Guntur. She passed away on with irreversible cardiac and renal failure. By the time I reached her at the hospital, she was already unconscious and was on a ventilator with renal shutdown. I was helpless at Guntur where

26 26 the facilities were not adequate to treat such a patient. As a last minute effort I tried my best to shift her either to the CARE Hospital, Hyderabad or to the CITI Cardiac center at Vijayawada. But it was too late by then. She was already in the hospital for nearly four days and I felt I should have reached her much before when she was fully conscious and talking. Ultimately her wish to see me physically and also her wish to go home to our native place Varagani alive were not fulfilled. She was very reluctant to stay at the hospital and wanted me to come to her as early as possible to take her home. I also missed a golden opportunity and life time opportunity to serve my mother in the last days of her suffering. In my heart of hearts, I had a feeling my mother passed away a little pre maturely even at the age of 80 years as she wanted to see me leading a hale and health life and I wanted her to live long enough to reap the rewards of her knee joint replacement surgery and the cataract surgery. Till she was hospitalized, she was comfortable and confident and leading a near normal life for a few more years. So I can t but feel that she also planned to add some more years of life to my already extended life by sacrificing her last few years. May her soul rest in peace. Comment: Author s good fortune is due to his own fate. Others have died of their own condition and never wished for their death to prolong author s life. They would not have done it for their own kith and kin.

27 27 It was a well meant comment made by my colleague and friend Dr.K.V.Janardhan Rao, former Professor and Head of the Department of Pediatric Surgery at the King George Hospital and the Andhra Medical College, Visakhapatnam. He was kind enough to read the manuscript and made the required corrections and comments. Still I feel that something extraordinary happened around that time about my own health and some people whom I knew very well for years together. Miracles do happen. Years after I went through the horrid heart problems that required repeated hospitalization, intubation, ventilation and placement of a total of six stents in a short period of four months of time made me feel the vulnerability of life which was under constant threat. Each time I could come out successfully because of the combined efforts of the doctors, nurses, friends and well-wishers in abundance. Certain strange connected or unconnected events also influenced my thought process to attribute the intervention of some divine forces whether I liked it or not. I had already documented a few such events before hand in this article and also in a different article written in Telugu elsewhere. I have come across two more well known people to me who died of sudden cardiac events that I should document as the events have stirred my conscience. If I am not bluffing, one police head constable from Vijaynagaram had a massive heart attack exactly on the same day if

28 28 not at the same time on ninth of July 2008, the same day when I had the first time heart attack at Visakhapatnam while playing tennis at the officer s club. I was rushed to the CARE Hospital, Visakhapatnam in the 108 ambulance, with the help of so many friends who carried me in their hands literally and also the wholehearted support given by the then Commissioner of Police Mr.Nanduri Samba Siva Rao IPS. The person who had the massive heart attack was regularly visiting me before for nearly three years along with his wife for whom I successfully operated and removed a spinal cord tumor which made her life crippled before surgery. Hence both husband and wife were familiar faces in my newly constructed hospital. That police constable was admitted at a hospital at Vijaynagaram and was alright for about forty eight hours and developed a second time heart attack and succumbed to it. It was a fact that I also developed a second heart attack on twelfth of August 2008, when I was still in the ICCU at the CARE Hospital, Visakhapatnam and was luckily resuscitated by the timely action taken by the attending nurses and doctors. Unfortunately my patient s husband could not be saved even though he was under the care of a doctor at Vijaynagaram. The event was narrated to me when I started visiting Visakhapatnam on a monthly basis after undergoing coronary bypass surgery in the year I felt sad to know the details of that event through my old patient who lost her husband when she started visiting me for her own problems and

29 29 follow up. I could not but relate the dates and time and also the sequence of events that occurred in my condition and the deceased police constable. The name of the lady on whom I operated for her spinal cord tumor was Mrs.Rama Bai and she regularly coming for the follow up. I used to have a close friend by name Mr.V.S.N.Murthy a State Bank Officer whom I used to meet and interact very often and we became really good friends. He used to help me in my bank matters along with Mr.T.Sri Rama Murthi another senior bank officer. Mr.V.S.N.Murthi used to consult me for his health problems and also his family members ailments. After his retirement from the bank service he went to the USA to meet his daughter and spent a few months of time with her. Before going to the USA he consulted me at the CARE Hospital, Banjara Hills for a routine check up and also as a courtesy call to find out my health and well being. I made some routine investigations, advised him a few medicines and wished both his wife and himself a happy bon-voyage. A few months later I got a phone call from USA and I was shocked to learn from his daughter the bad news about her father. She wanted to know from me whether her father had any serious disease before going to USA. I came to know that her father returned to India, to Visakhapatnam precisely and suddenly died at his home within a few days time. It was a sudden death and the cause could not be established. I was literally shocked to know the information and felt that I lost a real

30 30 good friend forever. When I hear such bad news about the known people I always tried to relate with my own disease and felt how unlucky those people were compared to me. Coming back to the comment made by my good friend Dr.K.V.Janardhan Rao about my imaginary attempt to connect the sudden death of some known and close people to me while I was recovering from certain death situations, I thought they could be a remote if not a celestial connection or influence on human life and its existence. Fifty years ago when I was still in my high school studies I did not hear anything about medicine, surgery or the organ replacements. During my MBBS study days I heard the utterance of the word of human spare parts for the first time which became a day to day business and a big industry in the production and replacement of damaged bones joints and blood vessels. Again much later during my post graduation studies the concept of the eye bank and the corneal donations and grafts came in to vogue just like the blood transfusions and bone marrow transplantations. Later came, the organ replacements from a variety of sources like the animals, related and unrelated human donors, retrieval of organs from the still fighting for life, terminally ill accident victims under the brand name of the brain dead patients. If one had seen the Hollywood picture by name Coma one would realize the enormous possibilities of organ donations and transplantations done ethically or unethically around the world. So with the advances in the medical

31 31 science, medical technology, the medical industry, the once noble medical profession has become a flourishing medical business undermining the values once the profession stood for and boasted off. Looking back, at the enormous developments and possibilities in prolonging the life in all the persons, today there are heart-lung machines, stents, valves, face makers and even heart transplantations. There are lung transplantations, tracheal transplantations artificial lungs and ventilators. Kidney dialyses, kidney transplantations which are on the rise proportionate with the incidence of diabetes and kidney failure. The list is endless but the bone and the joint replacement were the sky raisers. With so many possibilities the days may not be far away when one person can donate his life to not only to his kith and kin but also to the deserving recipients. There were umpteen, number of stories and narrations in our mythological scriptures where the life was given or taken away by the Gods at their will and pleasure. There were a number of stories of one person entering into the dead body of another person and make the dead body survive which was described as the parakaya pravesam. It might sound like a fiction but many fictions turned out to be realities as the understanding of the human life and the science progressively improves in the course of the time. At present my attempt to connect known people s death and their contribution to prolong my life may superficially look like a selfish wish, which I never wish but happened without my

32 32 knowledge. If I were to get a chance and if I have the powers I would bring back those people to life and speak to them whether they had any idea or any dream of prolonging somebody s life even after their death. If and when I get a chance to sacrifice my life to prolong somebody else s precious life be it my kith and kin or some strangers in like distress. The debate becoming endless but the next fifty years of human existence would witness more miracles to the astonishment and the imagination of the present generation people including doctors and scientists. What is not possible today, brain transplantation might become realty at any time.

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34 34 IT IS BETTER TO, NOT TO GET WHAT YOU DESERVE THREE THAN TO GET WHAT YOU DON T DESERVE THINK IT OVER / INDIAN EXPRESS. The above phrase was borrowed from one of the English newspapers which I used to read during my high school days regularly. I was fond of the front page first column item under the heading of think it over. Somehow the caption caught my imagination and I have been ruminating and narrating that line since then. It has always been an endless debate within me and I pondered over whether I deserved what I got; either good or bad. Some points got answers, some got buried in the past, and some are still lingering in the mind, for that elusive answer and I am of the final opinion that many issues will never find the answers, at least in my life time. Why bother about such trivial things, one may think. But these things, some times hurt your feelings very badly and get fixed in your mind, so firmly, they rake up the old wounds. Some events moved you, so much that you can never forget and also never know how to reciprocate, leave alone repaying any, if at all. I will start narrating a few events that took place during my school days onwards.

35 35 What triggered me to write this matter was interesting to analyze. When I started sitting in the outpatient consultation chamber at the CARE Hospital, Banjara Hills a strange thing happened. After, I recovered from the third time heart attack, after getting six stents placement in a matter of six months time in the years , I was not fully fit for doing a full time consultant practice. But I recovered enough strength to take care of my personal needs at home and also started writing some of my old memories and experiences both in Telugu and English. One day, when Dr.V.Krishna Murthi called on me at the Indralok apartments, I mentioned to him about spending some time in the outpatient clinic at the CARE Hospital so that I would have some change of outlook and also interaction with some patients who had been calling me from Visakhapatnam and the nearby places for help and advice. I understood that Dr.V.Krishna Murthi mentioned the same to Dr.B.Soma Raju during his formal discussion with him. The following Sunday, Dr.B.Soma Raju visited me at the Indralok apartment along with Ms.Mamata and Mr.Anand and also brought a book for me to read along with a flask full of coffee to share. He came all the way walking up the stair case for three floors without using the lift. I understand that s what he had been doing every day even at the CARE Hospital climbing all the seven floors. During the personal discussion, he went through some of my written-up papers and read my feeling and expression about starting the clinical work

36 36 to see some friends and patients. He promptly asked Ms.Mamata to make arrangements for my visiting the hospital to spend a few hours at the neurosurgery outpatient consultation chamber. I was allotted some time and room No 154 at the C Block of the ground floor which was also shared earlier by the rest of the neurosurgeons like Dr.T.V.R.K.Murthy and Dr.Ameer Basha. I thought I would happily spend a few hours at the hospital every day. Dr.B.Soma Raju took the precaution of informing Dr.T.V.R.K.Murthy about the arrangements made to accommodate me in the outpatient department. I did not know what was brooding over that arrangement but one day I wanted to admit a patient with a brain tumor who needed immediate surgery and removal of the tumor. Before admitting I talked to Dr.Batta Subramanyam who had been with the team of neurosurgeons from the inception of the department at the CARE Hospital, Nampally and also at Banjara Hills from a later date. After admitting the patient the same was informed to Dr.T.V.R.K.Murthy and Dr.Ameer Basha for further management of the patient. It would be the same procedure if any neurosurgery patient was admitted in the CARE Hospital in any other department; the neurosurgeons would be called to take over the problem for the convenience of the patient and the hospital. But Dr.T.V.R.K.Murthy and Dr.Ameer Basha took exception to my admitting the patient directly into the wards and calling them for the management. I understood that both of them discussed the matter

37 37 with Dr.J.M.K Murthy, the neurologist at the CARE Hospitals who was also my close friend and classmate at Guntur Medical College. For reasons best known to Dr.J.M.K Murthy, he discouraged Dr.T.V.R.K.Murthy and Dr.Ameer Basha to take care of the case and hence both of them refused to come and see the patient and did not operate on a very serious brain tumor patient. Not only that, they took very serious objection to my independent admission of a patient and were instigated by Dr.J.M.K.Murthy to come and fight with me at the neurosurgery OPD so that I would never admit any such case thereafter. Dr.J.M.K.Murthy, thoroughly brain washed both the neurosurgeons who were much younger to him and forced them to attack me at the CARE Banjara. Since I was not aware of any departmental problems or difficulties I was not very happy about the developments. So I thought I would take Dr.B.Soma Raju in to confidence and informed him about the resentment expressed by the senior neurologist and the junior neurosurgeons. Dr.B.Soma Raju arranged for the meeting of Dr.T.V.R.K.Murthy and his team with me at the CARE Banjara to sort out any misunderstandings. I was told there was a heated open debate at the CARE Nampally not to accept me in to the team of neurosurgeons, before the meeting took place, which Mr.Hari Haran had organized and fixed the date, time and place. I understood Dr.J.M.K.Murthy was the mastermind in the debate and also strongly advised the neurosurgeons not to allow me to sit at the CARE Banjara and also to run the OPD or to admit the

38 38 patients. The eventual meeting took place and I could see the neurosurgeons who were nearly twenty to twenty five years juniors to me raising their voice as if I was working at their mercy. They did not know that I was equally well known to Dr.B.Soma Raju both as a student, house surgeon, post graduate, assistant surgeon, professor of neurosurgery and as a practicing consultant at Visakhapatnam for the last four decades as much as Dr.J.M.K Murthy, though not that close. But the fact was that I came to Hyderabad not as a consultant neurosurgeon but as a patient of cardiology for the treatment of my own cardiac problem under the direct supervision of Dr.B.Soma Raju. Since I had three massive heart attacks in a span of six months time and had emergency placement of six stents at different times which were repeatedly getting blocked, I did not want to leave the CARE Hospital surroundings and risk another attack. Also my desire was not to become a fulltime consultant and compete with the existing neurosurgeons but was only to spend my time to suit my health needs. I was not running the outpatient department on any salary basis or to earn any money out of my practice. I had enough of neurosurgical practice and experience and I also reached a stage of encouraging young neurosurgeons as my assistants so that I did not have to struggle day and night looking after the emergency cases. Ultimately I realized that Dr.J.M.K.Murthy had many issues to settle with and had a grouse against the hospital administration especially

39 39 with the chairman Dr.B.Soma Raju for reasons best known to him. At the end of it, continuing as a consultant clinician, I became very unhappy as Dr.J.M.K and his band of neurosurgeons revolted against me and did not cooperate for my stay at the CARE Hospital, Banjara Hills even though it was purely on my medical grounds. I made it very clear to the young neurosurgeons that my interest was only in the patient s condition and nothing else. At the end of the meeting, again I went and told Dr.B.Soma Raju what had transpired in the neurosurgeons team meeting. He told me to ignore all that had happened and also told me that Dr.J.M.K has got Venom in his tongue and he would handle the matter at a different time and place. Beyond that I had no problems either with Dr.J.M.K Murthy or with the neurosurgeons. Still I did not understand what the real motive behind Dr.J.M.K Murthy s objection to my stay at the CARE Hospital, Banjara Hills. Later on, I came to know that many people like Dr.Manas Panigrahi and Dr.Malla Bhaskara Rao made some futile attempts to join the CARE organization and start an independent neurosurgical centre at the CARE Banjara but failed to do so partly because of the objections raised by Dr.J.M.K Murthy and also his non-cooperation to start a separate unit. Whether he wanted or not, separate neurosurgery and neurology departments were started with independent functioning without the involvement of the neurologists or the neurosurgeons from the CARE Hospital, Nampally branch. The departments have been successfully run by

40 40 the team of neurosurgeons headed by Dr.B.S.Siva Reddy and the neurologist Dr.Chandra Sekhar Reddy for the last one and half years. The departments have been fully equipped and financially stable and sound. As on today the neurosurgery department is doing the maximum number of neurosurgical procedures more than those done at the CARE Nampally every month. Retrospectively what prevented Dr.J.M.K Murthy to start a separate department at the CARE Banjara is not fully known. But what is known is the damage to the neurosurgical practice and the loss of revenue to the department. It was a traumatic experience to the neurosurgery and neurology patients who came to the CARE Banjara when they were asked to be transferred to the CARE Nampally for the last several years on some pretext that the facilities at the CARE Banjara was not adequate. After the starting of the department at the CARE Banjara there was no necessity to shift any patient from the CARE Banjara to the CARE Nampally because of any lack of equipment or facilities. At the end, I still don t know whether I deserved the revolt organized by my friend and classmate for no fault of mine. I hope one day Dr.J.M.K.Murthy would repent for what all he did to me. In fact I discussed the matter with Dr.V.Krishna Murthi who was our classmate during our medical college studies, a common friend for both of us, a well wisher, who was actively involved in the life saving treatment for me at Visakhapatnam CARE Hospital in the year 2008 and finally the man who was responsible in talking to Dr.B.Soma

41 41 Raju to find a place to sit and see my friends and patients at the CARE Banjara Hospital. He promised to talk to Dr.J.M.K.Murthy and also to sort it out. His outlook was very positive and helpful. I also talked to Dr.M.A.Saleem who was actively involved in the administration of the CARE Hospital, Banjara Hills in his capacity as a successful general and Laparoscopic surgeon, as a director of the and chairman of the HR department and many other posts. He was also a good friend of in and Dr.J.M.K.Murthy from our medical college student days onwards. His outlook was totally different from that of Dr.V.Krishna Murthi. He was under the impression that the problem was created solely by Dr.B.Soma Raju who was the chairman of the CARE Hospitals. He thought that Dr.B.Soma Raju should have discussed with Dr.J.M.K.Murthy before giving me the permission to sit as a consultant. I was a little bit surprised by the stance taken by Dr.M.A.Saleem my long time trusted friend and savior of my life. He tried to put the entire blame squarely on Dr.B.Soma Raju only because he did not take the consent of Dr.J.M.K.Murthy initially. It was true that I expressed my desire to work as a non-operating consultant clinician at the CARE Hospital on a number of occasions even before I became a cardiac patient. I was planning to get associated with the CARE Hospital either at Visakhapatnam or at Hyderabad. I, in fact, joined the group of doctors and directors when they were searching for a suitable place to start the Visakhapatnam branch of the CARE Hospital at

42 42 Visakhapatnam. I almost succeed in striking a deal with the St.Joseph s Hospital management to spare one of the floors in their hospital for starting the CARE Hospital facility. The St.Joseph s Hospital was the place where I had been working earlier for several years and also established my own department of neurosurgery which was running successfully. It was so nice of the sisters of the St.Joseph s Hospital who readily acceded to my request and processed the agreement. For some reason known to only a few people that agreement got fizzled out in the last minute just before the formality of the signing. As my attempt to bring the CARE Hospital to the St.Joseph s Hospital was nullified by some unknown forces working behind the scenes I was helplessly watching when the CARE Hospital was shifted to a building in the next road, The Pallavi Nursing Home. With that jolt my chances of working at the CARE Hospital were also ruined and my interest got slowly evaporated and dwindled slowly. The gap and distance increased day by day. Even though the hospital building was very close to my working place at the St.Joseph s Hospital, my interest in joining the newly established CARE Hospital, waned off. The initial priority of the CARE Hospital was cardiology and cardiothoracic surgery in addition to the nephrology specialty and not the other surgical specialties. My junior associate Dr.P.V.Ramana who worked with me for nearly three years deserted me and decided to go to different places before he ultimately landed in the CARE Hospital as the consultant

43 43 neurosurgeon with the help of the local director of the CARE Hospital, Dr.V.Krishna Murthi. That was not the end or the beginning of my attempts to positively enter the CARE organization or to get associated with the team of Dr.B.Soma Raju. Going back in my memory lane way back in the year 1991, when I left the Seven Hills Hospital at Visakhapatnam for good, I was looking for other avenues to change my working place to anywhere else other than Visakhapatnam. There were two reasons for making that decision. One was the medical practice started shifting from the government general hospitals and the government medical colleges to the private sector. Even in private sector the corporate concept had crept in fast and almost engulfed the existing pattern of medical practice. In those days before the corporate concept had come in, the consultants were the supreme and the corporate hospitals lured and hired the upcoming and established specialists and blunted the name and fame of the individual consultants. The transformation of the type of the patient management from the purely clinical examination to technical examination demanded huge investments which only the corporate sector could provide. Even from the very established autonomous institutions the specialists migrated to full time practice because of the vast difference in the earnings and the emoluments. In that transition phase, I tried to go to other countries like Libya and Saudi Arabia but changed my mind as I always

44 44 refrained from my going to the foreign countries. Even in the years I had an opportunity to go to Japan to work with the famous neurosurgeon Dr.Jero Suzuki who was the leading vascular surgeon and who did thousands of aneurismal clipping under naked eye. I declined the offer in those days. Some of my friends suggested and sent me the papers required to register myself for UK employment. Anyhow, I was totally against going to USA/UK even from house surgeon days. I decided to work in one of the premier teaching institutions in India itself. My first attempt was to go to NIMHANS at Bangalore but somehow it did not materialize. Even in the year 1979 I appeared for an interview at the NIMHANS along with Dr.A.Raja my colleague post graduate at the Institute of Neurology at Madras. Dr.A.Raja was working as the assistant professor of neurosurgery at the Kasturiba Medical College at Manipal under Dr.M.V.Subrahmanian, my former professor at the Guntur Medical College. In fact I should have been in the place of Dr.A.Raja at Manipal. I decided to join the AP Government service declining the offer given by Dr.M.V.Subrahmanian. That was a big mistake I made immediately after my completing the MS neurosurgery examination. Coming back to the matter of NIMHANS, both Dr.A.Raja and I were not selected for the assistant neurosurgeon s post as the local candidate who was appearing for the final examination was preferred over both of us with enough experience. I revived my intension in applying for the post at the NIMHANS again in the year

45 At that time Professor B.Ramamurthi was with me at NIMHANS when we attended an International Workshop on the Skull Base Surgery. Professor B.Ramamuthi talked to the Director of the NIMHANS Dr.Narayana Reddy and did not get a positive response for my appointment there. Then I broached the subject of my futile attempts made earlier to join the NIMHANS or to go to Japan to work under Dr.Jero Suzuki. Then Professor B.Ramamurthi told me that he would have helped me to join either at the NIMHANS or to go to Japan if only I approached him for his help and guidance. I was a little bit foolish and did not want to trouble Professor B.Ramamurthi even after his out of the way training and teaching me but also help me to get the selection for the government job in the state of Andhra Pradesh. Even before I joined at Visakhapatnam, Professor B.Ramamurthi made all out efforts to put me under Dr.S.Balaparameswara Rao at Hyderabad but could not succeed. That was a different story altogether. When he failed to convince Dr.Narayana Reddy to get a posting at the NIMHANS Professor B.Ramamurthi immediately asked Dr.D.Raja Reddy to take me to the NIMS Hospital at Hyderabad to which he agreed readily. But Dr.D.Raja Reddy called me aside and told me privately and politely that he himself was unhappy to work at the NIMS Hospital as the salary was very meager and he was planning to perform his daughter s marriage very soon by borrowing money towards the expenses. Thus, he indirectly, suggested to me that my choice of