Assembly Line

Of all the hospitals in Chennai, the one I frequent is situated in Vadapalani. The main reason for this could be the fact that my good friend who is also my Gynaecologist practices there. I have the liberty to walk into her consultation at any point of time. This is something rarely enjoyed by a common man in India. Since she is there, it helps a lot when it comes to organizing anything at that hospital. Thus going to that particular hospital is not as psychologically stressful as going to any other hospital in Chennai or for that matter in India. Now this Hospital is not the state of the art Hospital, by this I am not referring to their operation theatres and other equipments. What I mean to say is the appearance of the building and the rooms. In fact I could even term it as being not a user friendly hospital as there are winding passages and innumerable staircases and thus a person on his first visit could literally get lost. It is to a large extent like a maze. Even with all these short comings, I swear by this hospital, because in almost all the cases the patient is treated well and the end result is always positive.
I would like to talk about the hospital’s Department of Cardio Vascular Surgery Department which is headed by an eminent doctor and a genuine human being. I have had the good fortune of meeting the said doctor who to his and his team’s credit has done around 10,000 operations in the last 12 years. This is definitely no mean achievement. What makes this feat remarkable is the fact that all this has been achieved without any publicity, propaganda or fanfare. When other hospitals in the city go all out to woo patients with sops and other gimmicks, the team at the said hospital has been going around doing their work in a quiet manner and achieving the best possible results. I write about this with some measure of authority, as I have had an opportunity to be a close spectator to all the proceedings.
The first time I ever got to go into an operation theatre was as a college student. We were interning in the Dietary Department of the Christian Medical College, Vellore and at that point donated blood for the open heart surgery of a 19 year old girl, whose name I vividly remember was Sudha. Those were the days (1976) when such operations were a rarity and as an incentive the senior house surgeon who got us to donate the blood, promised that we could watch the surgery. With lot of apprehension we youngsters watched the surgery. We felt a strong bonding with the patient as she was a girl of our age. The surgery was a success and we followed her progress through the post operative period and until her discharge from the hospital. I have had to go to theatres on very many occasions in the intervening years; however the next tryst with a Cardiac surgery was in 2007, when one of my uncles was unwell and after an Angiogram was asked to undergo a Bypass surgery.
This uncle being a bachelor has no close family who could take the lead and thus it was left to me to take the initiative and organize his hospitalization. Since the above mentioned hospital (not CMC Vellore) had one of the best Cardiology Departments, which also included a couple of renowned physicians we chose to go there. One of the doctors on the team was highly recommended. On meeting him I realized that he lived up to every word that was spoken about him. I was impressed by his attitude towards the patient and the patient’s family. He took that extra time to explain in detail all the complexities and also was more than willing to listen to what the patient or his family had to say – a quality rarely seen in doctors in India. Once it was decided that a Bypass was the only option, he assured us that he would make all the arrangements to get the same done at the earliest. He reconfirmed the credentials of the Surgeon and thus made us feel comfortable. With some juggling he managed to get us a date as it seemed that at any time there was a waiting list. I assumed that the reason for the waiting list could be because only one or two surgeries were performed on a single day. I was corrected on the numbers and was told that 5-7 Bypass surgeries were performed and still a waiting list existed.
Thus on August 6th 2007, I watched the Assembly Line in action at the Department of Cardio Vascular Surgery. On that day six surgeries were scheduled. The patients were prepared by the nursing staff and one by one with a gap of half an hour were taken into the theatre on the gurney. Just as they were ushered into the theatre with a half hour gap, they were also taken to the post operative room in succession with a half hour interval. Thus my Uncle being the third patient for the day, I was called in third to see him in the post op ward. The next day the same procedure followed. My Uncle and those who underwent surgery along with him were taken to the Post Op 2 and those who had their surgery on the 7th occupied Post Op 1. Thus in batches of six and seven, these patients completed their post op care and were sent to the rooms and wards. In the ten days I spent in the hospital the same procedure was repeated and I must gladly say that there were no mishaps what so ever. The assembly line was a well oiled mechanism with all the nuts and bolts in place. This mechanism is time and cost effective too. As a lay person, it is really hard to say as to how the assembly line works inside the theatre. I assume that like in the assembly line the patient is seen and acted on by juniors in the team until the critical part is done by the chief.
I am forced to think of the advances in medical science made in the last 31 years, from my first tryst at CMC Vellore to what I witnessed at the Vadapalani Hospital. During the one month that I spent in Vellore about 5 open heart surgeries were performed and that I believe was considered as being the most major of surgeries to be performed on the campus. The doctors there were said to be the pioneers in India and on any given day of surgery, the theatre was filled with doctors from the faculty as well as from other centres who had come to witness the operation from the gallery. Now, with the assembly line in place, the Bypass seems as simple as a tonsillectomy. Somehow the assembly line seems to have taken away to a large degree the risks otherwise involved. I wonder if this is how it works in other hospitals were more than one team of doctors operate. Since medical treatment is to a large extent the repetition of a successful methodology, I assume that the Assembly line would be in place at all the major health centres the world over especially when it comes to the Heart Bypass surgery.
This to me is bringing treatment to the common man in a manner very similar to how Henry Ford brought the automobile to the masses.