In Sickness and in Health
The misty skies and hesitant drizzle make Chennai look alluring and mysterious, quite unlike the bustling, rapacious city of ten million people it has become. I walk in from the drenched streets to the fluorescent lit foyer of Apollo hospital. There is no chance to notice the structure, setting or décor, as I am swept right away into a clamoring mass of humanity. Slowly, this moving, flailing, mass of persons parts to reveal the individuals, the people who have come from everywhere, hoping for everything.
Almost unfailingly they clutch a plastic bag crammed with a record of their lives, the secrets of their bodies. Some of these bags are cheerfully emblazoned with names of popular silk sari shops, x-rays, ECGs and blood reports poking out between the handles. Some of them, these patients, shuffle along, others rush purposefully, determinedly chasing a cure for their ailments. There are those who look fearful. Some are hopeful, others happy. Most look exhausted... and some seem to have started the process of grieving. Almost everyone is accompanied by a family member and there are uniformed custodians of the hospital everywhere, directing the flow, moving everyone along, and preventing chaos. Almost 25 years ago I stood with my sister holding a silk cushion with a pair of scissors, ready for the President of India, Zail Singh to cut the ribbon inaugurating the opening of this hospital. The brainchild of our family doctor and dear friend Dr. P. C. Reddy, the hospital has grown and now is a chain, taking care of people everywhere. They have all walked these corridors to be treated or visit friends, family or colleagues; Indira Gandhi, MGR, Karunanidhi, Rajiv Gandhi, film stars, the middle class, rich and poor, the forgotten and cast off. Apollo is now a behemoth corporate structure with hospitals, clinics and pharmacies across India, South East Asia, the Middle East and Africa.
Right after graduating from Madras Medical College I worked briefly in the ICU of Apollo hospital. Dr. P. C. Reddy would make his lightening rounds and fix each doctor with his penetrating gaze and ask the one most pertinent question about each patient. I learned to cut through the red herrings, to distinguish the trees from the forest, and get to the core of the patient's problem. Later I went away to many gleaming hospitals abroad but I missed that... the frail patient lifting folded hands in a Namaste. A Namaste of thanks, of blessing or of supplication. Apollo has often been criticized for being elitist, for catering to the rich. What I have seen is often different. Doctors and administrators trying to discount prices, surgeons foregoing their fees, and everywhere around me the common man, the patient, gets the benefit of cutting edge technology at a tenth of the cost as a developed country.
Twenty years ago I watched through the glass, paralyzed with fear, and it seemed that Dr. Reddy was waving his arms, and directing an opera of tragic proportions. Instead, he was saving the life of my father, his friend. The pain had my father in its vice like grip as drug after drug did not work and his heart attack marched relentlessly on. Dr. Reddy did not give up, rock steady, a General with his troops, trying everything for endless hours. Finally he made the decision which was ahead of its times, to go into my Dad's arteries, even in the middle of the heart attack, with a balloon to open up the choked blood vessels. Many years later the New England Journal of Medicine would report trials and success of balloon angioplasty in patients during an acute heart attack. This time I am here again and my father once again is the patient. He has had a state of art surgery, coronary artery bypass on a beating heart and a pacemaker implantation. They could not have done better at Cleveland clinic or any leading center around the world. I am grateful for my father's life. More than that I am proud of the advancements and strides our hospital, my city, our country has taken. Patients routinely travel to India for joint replacements, heart transplants, and cosmetic surgery. The old guard of cardiothoracic surgeons, cardiologists, urologists, surgeons and Gynecologists still anchor the hospital, their compassion a guidepost for their newer upcoming colleagues. And they are everywhere, the young Turks, some my former college mates, the young world renowned Surgeons and doctors to whom patients are coming from across the globe drawn with the power of the internet and Google research.
Where does Apollo go next? Obviously the main goal would be to strengthen clinical excellence, expand teaching and clinical research and trials. There is however another great unmet need: India's large rural and underserved population. In Tamil Nadu alone there are only 3989 Government doctors in rural areas and approximately 12,000 in urban areas. All teaching and district headquarter hospitals are located in Urban areas. The Private health care in villages is at best sketchy. There are many health service delivery questions the world grapples with. How to deliver optimum care to an ageing population and harness technology while controlling spiraling costs? How to deliver medical care by utilizing telemedicine and the internet to far flung areas of our world? How to control sanitation and infectious diseases? We hope Apollo's growth and renaissance will lead to the answers to this and so many more questions for a better India and a healthier world.