(Dr Jose Chacko Periappuram, who made history by performing the first heart transplant in Kerala, shares experiences that touched his heart. Read Part 1, Part 2 and Part 3 of the series.)
Complex surgeries such as heart transplants are often a mixture of sadness, happiness, loss and gain.
On the one hand, there are family members shocked and finding it difficult to come to terms with the fact that an untimely, unexpected death has robbed a loved one from them, and, on the other, are those experiencing the unspeakable joy of seeing someone who probably had just a few days or a few hours left, getting a news lease of life. Amid all these are doctors and their colleagues who keep themselves busy by putting a shield on their emotions.
I still remember a mother who, through her action, showed the glory of sacrifice and giving.
About five years ago, Krishnaveni, 20, was waiting for a matching heart while lying in a room in the cardiology department of Lisie Hospital in Ernakulam, going through the last phase of heart failure and with death getting closer.
Weeks had passed waiting for a heart donor with A-positive blood. The functioning of her heart was getting worse by the day. Her heart failure had slowly started affecting the kidneys and other organs.
Every day, when I would visit her in the ward, she would look at my face from her bed lying without talking much, and I would understand her unspoken question: Doctor, when will I get a heart?
Then, after the ward visit, while walking to the operation theatre for the daily surgeries, I would find her mother waiting for me in the dark corridors and she would ask: Doctor, is there any possibility of saving my daughter’s life? Those were days when I could not give an answer to her except to comfort her by patting her on the shoulder.
One day, I got a call from transplant coordinator Rajesh at 4pm: “There is a message from 'Mrithasanjeevani' (a network for organ donation in Kerala). There is a 22-year-old man with A-positive blood, weighing 62 kg, who has been on a ventilator for four days after meeting with a road accident. Early-stage examinations have confirmed brain death and his relatives are willing to donate his organs, including the heart.”
All this, including the blood group, matched with Krishnaveni’s requirements.
Everything after that happened very fast. Krishnaveni was shifted to the intensive care unit of our hospital, and the preparations for the surgery began.
The head of the anaesthesia department, Dr Jacob Abraham, and cardiologist Dr Joe Joseph went to the donor's hospital to check if the heart matched with Krishnaveni's or if there were any other problems. An hour-and-a-half later, I received a phone message from them. Everything was fine.
Our second group of doctors, nurses and technicians went in an ambulance from Lisie Hospital at 8pm.
A team consisting of Dr Ronnie Mathew, Dr Bhaskar Ranganathan, Dr Jeevesh Thomas, and anaesthesiologists Dr Job Wilson and Grace Maria was also stationed at Lisie Hospital to prepare for Krishnaveni's surgery.
It usually takes two to three hours to surgically remove the heart and other organs for donation from the donor. Then there is a fast ride with the organs to the recipients.
The critical factor for the success of a heart transplant surgery is ensuring that the heart removed from the donor starts beating in the recipient within four hours. Therefore, it is important not to waste even a single minute on organ transplant procedures.
On the way out of the ambulance and to the ICU of the heart donor’s hospital, the transplant coordinator there stopped me and slowly whispered, “Abhimanyu's mother wants to see you, Dr Jose.”
Abhimanyu was the name of the young man whose organs were being donated after his brain death was confirmed.
I pointed out that the transplant surgery could possibly get delayed if I took the time to talk to his mother and relatives and I promised to see the mother at her home after the surgery.
A little later, the transplant coordinator again came near the operation theatre and said Abhimanyu’s mother was insisting that she had to see me.
When Abhimanyu was two years old, his father died of cancer and she raised him alone. Before dying, her husband called her to his side and told her to take good care of their son. He wanted Abhimanyu to be a good engineer and told her to ensure he doesn’t face any fall.
The woman, who was widowed at a young age, did not succumb to the pressures and suggestions of her relatives and refused to remarry. She lived alone, just for her only son. She gave him a good education and made him an engineer. They lived together by sharing their joys and successes with each other.
Before the final semester exams in engineering, Abhimanyu came home to seek his mother's blessings. After taking her blessings, he asked her, “Mother, if I pass the exam, will you give me a present?”
"Even my life is yours. Everything I have belongs only to you. Ask me whatever you want, I will give you," she told him.
After passing the exam, like all young people, he wanted a bike used by the new generation. After his glorious success in the exams, the mother had to keep her word and she gave her son but with the instruction that he should ride it safely.
Three months later, the mother was overjoyed when he was admitted to a prestigious university in Chennai for higher studies.
On the eve of his journey to the neighbouring state, Abhimanyu went out to spend some time with his friends. His mother next saw him in the emergency unit of the Alappuzha Medical College Hospital.
While riding the bike, a dog cut across suddenly. He swerved his bike so as not to hit it and fell from the bike.
She saw her unconscious son on the ventilator. He was then taken from there to another hospital. A few days later, he was confirmed as being brain dead.
A wife who had lost her husband at a young age, a mother who chased a single dream since then and lived only for her son... a mother whose contentment that she had fulfilled her husband's last wish lay shattered... a mother who had lost everything in her life. There could not have been a greater sacrifice than coming forward to give her son's heart even amid such grief. And here someone was holding my wrist and telling me, “Dr Jose, you should see that mother.”
I could not say no again.
When I went to meet her, tears were streaming down her cheeks. I saw a face filled with the expressions of grief and loss. I approached her not knowing what to say. I took her hand in mine and held it.
After a few moments of silence, the mother raised her face a little and asked me, “You have come to take my son’s heart, isn’t it?”
I stood there motionless; my heart, too, was still. I froze not knowing what to say.
I then gathered my courage and said, “No, mother, we have come to keep your son alive. His heart will beat in another person as it did in him, for his mother, for a long time.”
As she slowly lay down on her bed grief-stricken, we handed her over to the care of the nurses. All of us were heartbroken as we returned to Lisie Hospital with Abhimanyu's heart
I later called a journalist who was very close to me over the phone and asked her if there is any better word than goodness that can describe a person’s deed of giving away the last savings for the benefit of another person even when left with nothing.
What else can you call the feeling of being ready to give what you love the most to someone else even when you have lost everything?