The Hole in My Heart

by
NINAD JOG

Given that my heart beat loudly and seemed to want to jump out of my chest every once in a while, my parents decided to take me to a ‘heart specialist,’ as cardiologists were commonly known. But where could we find one? We could not pluck one out of thin air. We couldn’t get a referral from our family doctor, because we didn’t have one ever since we moved to Khar two years earlier. We could drive around the neighborhood on my father’s scooter and look for doctors’ signboards, hoping one of them would be a cardiologist, but it was far from certain that we would find one. Even if we did, what was the guarantee that he would be competent and would treat me—a complete stranger who had wandered in without a referral—with the same personal touch that he treated other patients?

Fortunately, my mother knew a woman living in the housing complex in Dadar where she grew up whose husband was a cardiologist. So off we went, my parents and sister and I, in my father’s yellow sidecar scooter, to his office in Dadar T. T. (T. T. being Tram Terminus), near Khodadad Circle, one weekend. It was a good seven kilometers from our home, but not too far from where my grandparents and an aunt lived.

He welcomed us to his office, which I thought was posh because it was air-conditioned and had large black leather sofas and plush chairs. As he listened to my parents tell him about my palpitations, my attention was drawn to a large painting of two tigers on the wall.

“Do you like the painting?” he asked me.

I nodded.

“You too are a tiger, just like them!” he said.

I blushed. I was used to being called a cat because of my green eyes and a skin complexion noticeably fair by Indian standards. But no one had called me a tiger, at least not in a long time. I felt quite powerful! He was surely a nice doctor, a ‘likable chap,’ as the British would say.

He made me lie down on the consulting table and listened to my heartbeat with a stethoscope, moving it all over my chest. Then he asked his technician to get an ECG, which the technician did by taking me to a different room.

“Don’t be scared, Pingo!” my father assured me as the technician applied gel at different spots on my chest. “The gel might feel a little cold, but you won’t feel anything when he takes the ECG.”

I was quite nervous, as it was the first time my electrocardiogram was being taken as far as I knew. Once it was done, the technician asked me to get up and wear my shirt while he went to the doctor’s office and gave him the ECG printout. A few minutes later, my parents and I were back in the doctor’s office, seated at the table across from him.

“I examined your son and looked at his ECG,” the cardiologist said. “He has a murmur, because there is a hole in his heart.”

The words fell on me and my parents like a ton of bricks. I could scarcely believe what I had heard. If I already had a hole in my heart, the doctor’s words cleaved that most vital of my organs wide open. Overcome with fright, I melted into the chair I was sitting in. I started shrinking and shrinking until I was as tiny as an ant. The doctor, his desk, the painting on the wall, the furniture—the entire room, in fact—became as big as an auditorium. Never in my life had I felt so small. Never in my life had I seen my parents so worried.

The doctor was quick to notice our extreme discomfort. “Please don’t worry,” he assured my parents with what I’m sure he thought of as a soothing smile. “Surgery techniques have improved to the point where it can be easily corrected. I can tell you the details when you make up your mind.”

My parents were unnerved, but my father, ever the pragmatist, took it in stride. “We have enrolled him in a technical school,” he told the doctor, “so he can learn some smithy, carpentry, fitting, turning, moulding, and engineering drawing right from eight grade and get a leg up when he attends engineering college. I too did the same when I was growing up.”

It was the cardiologist’s turn to be shocked.

“Your son is simply not strong enough to become an engineer,” he told my father quite matter-of-factly. “He should not attend even a technical school, let alone an engineering college, when he has a weak heart.”

My father heard him out.

To say that my parents and I felt dazed on our way home, as if we had been hit by a truck, would be an understatement. My sister was just six years old, a little too young to comprehend the gravity of the situation. Without warning the world around me had collapsed, leaving me still standing. Why, oh why, had it not been the other way around? I started thinking of myself as a ‘heart patient,’ a term I heard quite frequently since then, always accompanied with pitying looks. I’m not sure whether I was consumed with self-pity, but I do remember being immensely scared. In one fell stroke I had been reduced from a ferocious tiger to a bashful kitten. This cardiologist was not a likable chap after all. My regard for him evaporated as abruptly as it had first manifested.

Over the next few days I continued to experience the palpitation episodes at the same frequency as I did before, typically in the afternoons when I was home alone. But palpitations or no palpitations, the prospect of undergoing terrifying open-heart surgery always weighed heavily on my mind. It was the silent sword of Damocles, itching to fall, the elephant in the room eager to trumpet its presence.

***

Luckily, my father had a bright idea. He decided to seek a second opinion, even though some of the people around him advised him against doing it. In those days the doctor’s word was final, for the doctor was the human avatar of God. The very notion of seeking a second opinion amounted to dissing him, sending the message that you didn’t trust his judgment, that you questioned his very competence.

But my father put his foot down. “There’s no harm in seeking a second opinion,” he told the naysayers quite firmly. “Who knows? He might confirm the cardiologist’s diagnosis, or he might refute it and recommend a completely different course of action.”

I had a sinking feeling that the second cardiologist would confirm the original diagnosis and give the go-ahead for the surgery, but I was nonetheless heartened that my father was seeking a second opinion. At the very least it would delay the surgery by a few weeks. The lack of a need for surgery was too much to hope for, but the longer the inevitable was postponed, the more time it would give me to build up the courage to face it.

We were back to square one, as we had to start the search for another cardiologist all over again. As luck would have it, my father and his colleagues had contacts at Jaslok Hospital, the swanky hospital that had recently opened on Cumballa Hill in South Bombay. It helped that the air-conditioning company my father worked for had air conditioned it from top to bottom, all twenty or so floors of it, and my father had played a prominent role in the process, at least in his telling.

My father obtained a referral to a cardiologist named Dr. Anil Mehta at that hospital and got an appointment for a consultation. We made the ten-mile trip from our home to the hospital on my father’s scooter. I cannot say I took an immediate liking to the new cardiologist, perhaps because he spoke to me in English rather than Marathi, a language I was nowhere near fluent in despite having studied it since an early age. Besides, it was best to withhold judgment about the new cardiologist until he offered the final verdict. Scratch the tiger once, and it turns into a shy kitten.

Dr. Mehta too took an ECG and advised us to get a 2-dimensional echocardiogram. The 2-d echo was a cutting-edge technology in those days, in the early 1980s, at least in India. Few hospitals in Mumbai provided it. Sion Hospital and Bombay Port Trust Hospital had the machines, but they were not in operation, as they had not been ‘commissioned,’—either for a lack of knowledge of how to operate them, or a lack of money, or both. Only one hospital in Mumbai had a functioning machine and, luckily for us, that hospital was Jaslok.

We made a separate appointment to get the 2-d echo scan, and yet another one for Dr. Mehta to evaluate the results.

“Let me tell you something,” the technician told my parents after he took my 2-d echo scan. “But please don’t quote me on it. There’s nothing wrong with your son. His scan is perfectly normal.”

The words were music to our ears, but it would have been premature to celebrate. Technicians aren’t always right.

When we next met Dr. Mehta, he echoed the technician. “Ninad’s heart looks normal. All the chambers have normal sizes. I don’t see any holes. I can’t find anything wrong with it.”

But he did not unequivocally rule out all possible maladies. My parents and I were nonetheless immensely relieved. The unthinkable had happened. My surgery had been postponed, perhaps indefinitely. Maybe I would never have to undergo it. I could hardly believe my good fortune.

But I still had to confront a horrible truth. My palpitations continued unabated. They happened just once or twice a week, but they had not gone away. The rapid heartbeats, the panic and the confusion that set in, the need to read the Brer Rabbit book to stop them, were all steadfast. How was I supposed to face the unpredictable thud-thudding of my heart? Accept it as the shape of things to come? Grin and bear it? Understand it as an inviolable part of my manifest destiny?

My parents were in a quandary. Whose diagnosis should they trust? Dr. Mehta’s or the earlier cardiologist’s? One said he couldn’t detect anything wrong with my heart; the other was eager to put me under the knife. Much as my parents wanted to go with Dr. Mehta’s advice, what if the other cardiologist was right? What if they decided to forgo the surgery, only to see my condition get worse and possibly cost me my life? The decision would haunt them for the rest of their lives; they would never be able to forgive themselves.

***

Luckily for me, my father had another bright idea. He decided to consult yet another cardiologist and get a third opinion. The people around him—family and friends and colleagues—were incredulous. Second opinions were rare but not unheard of, but third opinions were simply beyond the pale. Then, as before, my father paid no heed to the naysayers. I’m not sure how he found the third cardiologist, but I remember we made two trips, both to a hospital different from Jaslok—the government-run Bombay Port Trust Hospital, located in a seedy neighborhood not too far from the comparatively pristine neighborhood of Matunga, where my mother worked as a college professor.

The first visit was to get some type of a test (perhaps another ECG), and the second was to meet the cardiologist, Dr. Arun Chaukar. What would his verdict be? we wondered with bated breath. Would I be proven guilty of having a hole in my heart, and sentenced to the knife as a punishment for my crime? Or—dare I even contemplate it—would I be fully exonerated?

We met Dr. Chaukar in his office, which was just as dark and dingy as the entire hospital. He appeared to be a few years older than my father but was just as jovial as him. He greeted me with a big grin and immediately put me at ease. He got straight to the point.

“Do you get tired, do you start panting, when you climb one flight of stairs?” he asked me.

“No, I do not.”

“How about two flights of stairs? Three?”

I thought the questions were so ridiculous, so besides the point, that I started laughing. What did climbing stairs have to do with panic attacks and palpitations? I had the attacks mostly when I was home alone; never while climbing up stairs.

“No!” I cried. “I can easily run up the stairs without getting tired.”

“He climbs three flights of stairs several times a day when we go to Pune during the summer and Diwali vacations,” my father explained. “Our flat in Pune is on the third floor.”

“He even climbs Chaturshringi Hill without panting,” my mother added.

Dr. Chaukar burst out laughing. “I have looked at his ECG and his 2-d echo,” he said. “There’s absolutely nothing wrong with him. There is no hole in his heart. He just needs to eat more and gain some weight.”

With that, he prescribed me a B-complex vitamin tablet. The prescription was superfluous, as the pill was available over the counter at any chemist. I knew because my parents took one capsule of the same vitamin every day. But the very sight of a paper prescription made the requirement all the more real. In my mind, it was the pill that would save my life. Absent the prescription, who knows whether I would have taken it regularly.

My parents and I were thrilled. The score was now 2 to 1 against the hole-in-the-heart hypothesis and the need for immediate surgery. We felt relieved that Dr. Chaukar had told us so unequivocally, so confidently, that nothing was wrong with me. From that day onwards I started taking the B-complex capsule. It was no mean task, as it was a large pill to swallow, and I always had trouble swallowing pills. But my appetite improved by leaps and bounds, probably because of the pill and, slowly but surely, I started eating better. I remained almost as skinny I was, but the extra layer of meat on my bones, no matter how thin it was, kept the palpitations in check. Before long, the palpitation attacks tapered away, although it would take another five to eight years for them to fully go away.

As it so happened, I continued to attend the technical school, and attended it all the way up to twelfth grade, getting my feet wet with many of the skills my father mentioned. Carpentry was my favorite, especially the tenon and mortise joints, followed by fitting. I was wary of turning, as I was a little scared of working with lathes. Moulding I absolutely hated, mainly because our teacher had a bit of a temper. Smithy was the toughest, as I wasn’t strong enough to wield the sledgehammer. Engineering drawing was a delight, while the electrical circuit assembly was largely a mystery. But I must have done okay, for I joined engineering college afterwards. I might not have been particularly strong, but neither was my heart particularly weak. I might not roared like a tiger, but neither was I a bashful kitten.

Pardon me for engineering the above digression, but all I can say is that three-and-a-half decades later, it feels good to be still alive. Someday I will surely tell you how my palpitations ultimately ended and what the underlying causes might have been. I would have told you the whole truth right now, but I simply do not have the heart.

February 2018