Heart-felt observations

US-based cardiologist Dr. Johnson K. Zacharias talks about the latest trends in the field, as well as the impact of medical tourism in India

By Shevlin Sebastian

One day, US-based cardiologist Dr. Johnson K. Zacharias, who lives in Port Huron, near Detroit, received a call from his nephew in Florida. The youngster said, “My dad is having gas pains, so I am going to the drug store to get some medicines.”

Zacharias said, “Please turn around immediately and take your father to the hospital. What is gas pains could be the symptoms of a heart attack.” At the hospital, a cardiogram showed evidence of blockage. Timely medications saved the life of his brother-in-law.

On his way to India, last month, Zacharias stopped over at Dubai. There he came across another case, Ranjan (name changed), who had been suffering from gas pains. Unfortunately, the family, unaware that he had a heart attack, did not take him to the hospital. Two days later Ranjan collapsed and died at home.

“When you think you are having a gas pain, which may be in the lower end of the sternum or upper stomach, always have it checked,” he says. “It could be a heart attack.”

Zacharias says Indians are predisposed towards heart attacks. “Indians have low levels of High Density Lipoprotein, which is regarded as a good cholesterol,” he says. “They have smaller blood vessels in the heart, as compared to Westerners.”

Indians also tend to suffer from diabetes, obesity, and stress. “All these factors raise the chances of a heart attack,” he says.

Zacharias has been running a successful heart clinic staffed with Indian doctors for several years. “Indian physicians are well respected in the United States,” he says.

This is one reason why medical tourism in India is booming. More and more Americans are coming to the country to do open-heart, knee, cosmetic, and dental surgery.

According to a study conducted by the Confederation of Indian Industry and McKinsey consultants, 1,50,000 foreigners visited India for treatment, last year, with the growth pegged at 15 per cent a year. India could earn more than $1 billion annually.

“Private hospitals in India have some of the most up-to-date facilities,” says Zacharias. But the biggest plus is the cheaper costs of surgery.

“An open-heart surgery in the US costs anywhere between $30,000 and $50,000,” he says. “In India it can be done for as low as $10,000.”

But there are inconveniences. “If I have chest pain and need a bypass surgery I will be scared to travel 15 hours in a plane,” he says. “Travel, itself, is a big strain.”

The other drawback is that when you go through a major operation abroad, you cannot have the family with you. “After surgery, a patient needs the support of friends and relatives,” says Zacharias. “But when you come to India, it is just a business transaction.”

Zacharias has been taken aback by the ‘big business’ attitude of most hospitals. “In India the authorities first check whether the patient can pay the bills,” he says. “This is a disappointing attitude. There should be a social conscience.”

In the West there is no discrimination between a millionaire and a poor person. “They get the same treatment,” he says. The hospital authorities worry about the payment much later. Their first and immediate priority is to save the human life. Whatever needs to be done, will be done.

“Indians have to learn to keep the balance between ethics and profits,” says Zacharias.

Asked about the new trends in cardiology, he says, “Research has been done to develop medications to thin the blood.” When the clogged blood vessels are dilated and a stent is put, there is a tendency for that area to get blocked again.

“To prevent that happening patients are given blood thinners,” he says. Zacharias usually prescribes a tablet called Plavix, along with aspirin.

Meanwhile, thanks to international seminars and information available on the Internet, cardiologists in Kerala are also up to date, says Zacharias, who was on a brief visit to the state.

Belonging to the Kuttanperoor family, of Chanagancherry, he did his MBBS from Trivandrum Medical College and worked briefly as a teacher of physiology at Kottayam Medical College.

After further stints in different parts of Kerala, he got an opening as an intern in the Detroit General Hospital in 1968. Later, he did a two-year cardiology fellowship, and settled down in the US. This 42-year-long stay has made Zacharias unprepared for life in India.

On a recent holiday to Munnar, this expert of the heart suffered from palpitations. “I was sitting in the front, near the driver,” says Zacharias. “But our car was barely missing other cars and buses on the road. My heart started beating fast. I had no option but to go to the back seat and avoid seeing these narrow misses. At times, Kerala can be hard on the heart.”

(The New Indian Express, Kochi)