A Candle in the Wind: The Corporate Lobbyist

By Markose Abraham

A CANDLE IN THE WIND focuses on the prominence of the new women working for the Corporate India of 2013. Breaking traditions they have learnt the ropes of pushing through tenders/contracts in a nation cursed for its political corruption and bureaucratic red-tape. Contrary to stereotypes, some who have even surprised the West’s perception of women in business, have stormed the male bastion in reading minds with sharp acumen and winning over covert deals for their customers with alacrity and temerity, quite often, at risk to themselves and their family.

The 40-year old corporate lobbyist, US/UK educated, wife to a cardiologist and mother of two teen-aged children, based in New Delhi, JSK as she is popularly known, an adept at multi-tasking, balances her official work with that of her family obligations, amidst the venal business climate of a country turning the corner to become a world leader.

JSK is seen to be always on the move from East to West, in the corridors of power, putting her feminine wiles to best use. Her life has been like the candle in the open space flickering bright to provide light to many, while always at peril to the fluctuating moods of the wind.

• Language: English
• Publisher: Notion Press
• Release date: Jun 25, 2014
• ISBN: 9789384049119

Book preview

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1

The India of today has some striking parallels to the United States of America of the early 1800s to mid-1900s. It was about this time that the US began its journey towards becoming the world’s largest economy. The biggest factors that propelled the country’s growth and transformation were technology, natural resources, manufacturing and private enterprise. A few men who dreamt big became the builders of modern America– Andrew Carnegie, John Rockefeller, Cornelius Vanderbilt, JP Morgan and Henry Ford built businesses on entrepreneurial spirit and innovative approach. They were instrumental in helping America make the transition to the modern industrial era. Thus was laid the foundation for the USA’s natural resources – mining, steel, oil and gas, manufacturing, finance and infrastructure, such as building road, rail and ports.

All these five great men were also philanthropists who donated most of their wealth for the larger benefit of society. These funds were used to set up large universities, hospitals, museums, art and culture centres, libraries and charities. The universities, apart from normal teaching, also performed the role of powerful research centres and acted as think-tanks in areas of technology, material and space research, liberal arts and political science. They also helped develop leaders in political, bureaucratic, academic, business and other areas. This created large employment opportunities and also spawned entrepreneurship.

America’s growth journey has some lessons for India. Both are large vibrant democracies with abundant natural resources. While America benefited from a large flow of immigrants in search of the American dream, India has a large population in the working age group. More importantly, like the USA, the subcontinent has people with the entrepreneurial spirit, who can visualise a new India and unleash its potential.

The year 2013 was celebrated as the 100th year of Indian cinema. Dadasaheb Phalke’s Raja Harishchandra, made in 1913, is taken as the date for the birth of our cinema. It could be argued that the sensibilities and cultural backgrounds of Indian audiences are vastly different from those in the West or East, so Indian cinema runs in a separate, distinct stream. Song and dance, for example, are intrinsic to Indian movies. While an international observer might see this as hindering the narrative, Indians don’t. What has been lacking at the core of Indian cinema is the absence of social or moral significance, and its bane has been an overwhelming emphasis on entertainment and romance.

An English language film is shown in America, the United Kingdom, Europe, Africa, Australia, New Zealand, India and many other countries where English is spoken. Apart from the run-of-the-mill audience, there is the large constituency of the educated and literate ‘elite’ audience that are denied the cinema medium in English. Realising this need, the Government of India is changing its film policies – recently, the Ministry of Information & Broadcasting announced a ‘laissez-faire’ policy for international movie shoots in India. Now, a special cell will expedite ‘clearances’ and reduce cumbersome procedures – in other words, no more super censors. In contrast, over the decades, countries such as the UK, Switzerland and Singapore included have welcomed Bollywood with open arms, and even offered hefty subsidies and conveniences like booking hotels and flights. With Bollywood’s worldwide reach and influence, the host countries have gained incalculable exposure in attracting tourists. Fearing a distortion of the ground reality in India, permission to shoot Hollywood films in the country was denied since 1947; policy wielders of the time in New Delhi, brought cinema projects under a strict scanner. Pakistan and Sri Lanka often stood in for India by offering location sites.

In the recent past, a clutch of Hollywood and British movies have been shot in India without raising eyebrows – The Darjeeling Limited, Slumdog Millionaire, Life of Pi, The Exotic Marigold Hotel, Trishna, and Heat & Dust. Ironically, A Mighty Heart and Zero Dark Thirty used Indian locations to stand in for Pakistan. Moving away from the scanning of scripts and insisting on a fair and rosy picture of India, the present regime’s resolve to opt for a ‘take-it-easy’ policy has brought cheer to Hollywood filmmakers. Against this backdrop of opening its doors to international film shoots, JSK (Joyce Susan Koshy) an international Indian Corporate Lobbyist was at the office of the Minister of State for Information & Broadcasting to seek permission to shoot a Hollywood film in India. She was well known to Mrs Susheela Pandit, the Kashmiri wife of one of the ministers. Both Susheela and Joyce had business interests in common – one was running business houses and trade in the Middle East and India; the other was fixing deals and customers on an international scale. They had both cultivated a taste for international food and travel; they were good friends and helped one another mutually.

After calling on the I& B minister in South Block, New Delhi (where the central government offices are housed), exchanging pleasantries and obtaining the necessary permissions for film shoots in Kashmir, Kerala and Mumbai, JSK returned to her office in Parliament Street. It was noon on a Monday in June. She called her husband, Dr Joshua Jacob Koshy of AIIMS (All India Institute of Medical Sciences)– who told her that he was about to enter the operation theatre to perform surgery on the heart of one of the Governors of the country. After confirming the time he would be home for lunch, she called the Principal of St Joseph’s school to ensure that the school was functioning for a full day on the opening day after the summer holidays. Next she summoned one of her secretaries, Rachel George, and instructed her to fix up an appointment with the Minister of State, HRD in the South Block for the next day with a given assignment on matters relating to higher education.

Rachel had known the Minister of State from Kerala, through her family contacts in Thrissur –this was the reason why she had been given the job. As India braced itself for greater reforms in higher education, protests and resistance were seen all around the country. While academic activists accused the protagonists of change of caving in to pressure from the World Bank or America, such resistance and dissent is being interpreted as an obscurantist mindset on the part of the academia that is caught in a time warp. In 1991 when the early phase of reforms were carried out in the banking sector, the state-owned State Bank of India resisted change and organised strikes. However negotiations between the Government and a few good banking brains led to a healthy banking industry. When the global market crashed recently because of the faulty lending policies of the American system, Indian banks held their own, thanks to the right balance they had struck between orthodoxy and experiment.

A similar situation seems to have arisen in the field of higher education – calling for the right balance between orthodoxy and radical change. Unfortunately state-run institutions have been notoriously resistant to change. The Indian university system is too rigid and resistant to change. Ironically, the impetus for change does not come from within the system. When experiments or innovations are introduced from outside, they are first resisted, then ritualised when enforced. This inherent resistance may have been engendered by either dearth of able and willing administrators, or the attitude towards education among the political class. Who does not remember the incident involving the Kerala Chief Minister, late EMS Namboodripad, and the Kerala University Vice Chancellor, John Mathai, in the 1950s – wherein Mathai was asked by EMS to meet the VC for any clarification or decisions facing the university? Such a scenario does not exist now.

Over the last few decades, there has been growing apathy on the part of capable academics and politicians towards each another. From the 1970s, local politicians and bureaucrats began to treat institutions of higher learning as extensions of their offices of power. As reforms are being carried out all over the country without paying much attention to infrastructure and pedagogic issues, the semester system at the under-graduate courses, credit-based and credit- transfer systems and stress on communicative English have all geared towards the eventual passage of the Foreign Universities Bill in 2013. The time has come for all stake holders– pupils, teachers, parents, academics and administrators to address the issue with a sense of urgency.

Higher education in India in the 21st century is about to open its doors to foreign universities either to admit its students there, or start centers of education in the country. The US has about 800 accredited universities, Canada has 70 universities, the UK and Australia have 10 universities each, and Germany, France, Denmark, Sweden, Italy and Singapore have world-class universities offering post-graduate programs, research infrastructure in arts/science, medical, technology and management streams.

JSK was soon home after her visit to Susheela’s. She was an aspiring Indian woman who had succeeded in setting pen to paper, and mind to matter, and getting herself noticed in a male-dominated society. An undercover female Indian specialist in corporate house deals, Joyce Susan Koshy, who held an MBA from the London School of Economics, and another degree from the International Law School in Harvard University, was an intelligent business woman who knew how to win tenders and deals in a rat-race that has been a male bastion – much to the chagrin of rivals and friends. At a time when women faced challenges for growth in their career, Joyce (or JSK as she was referred to in business circles), could switch roles with ease, speak different languages, get close to people who mattered and position herself within striking distance of great deals. Against the background of an economically resurgent and educationally enlightened India in the early 21st century, public perception required a female lobbyist to rely on ‘her good looks and clever talk’ to be successful in her profession.

JSK was the 40 year old wife of a New Delhi-based Cardiologist, and mother of two teenaged school children – David (15) and Twinkle (13). She had broken traditions and conventions, and learnt the art of pushing through intransigent and opaque deals within the paradigm of the political-bureaucratic nexus of the India of 2013. The venal business climate had taught her to circumvent hurdles and unravel intricate situations.

Posing as an American movie Producer, JSK and her team of smart young men and women would find their way into the corridors of power to accost ministers and bureaucrats with bespoke gifts and promises of perks at dinners in 5-star hotels. She exploited the general mentality of the cricket and cinema-crazy nation, where young and old would leave no stone unturned to show their faces before the cameras – and then see themselves over and over again on TV at homes and in cinema halls. She dangled the carrot of casting their kith or kin in Hollywood movies, which she was to produce shortly. Her American accent, together with relevant references and contacts provided the perfect setting for initiating deals in the sordid lobbying drama enacted repeatedly from Ministry to Ministry at the South Block – to which nevertheless all Indian roads lead.

With the lure of a growing middle-class that was increasingly adopting western fashion trends and tastes, business houses were updating their products to match new environments and requirements. Apprehensive of the Government’s sluggishness, corporates were swinging into action through their lobbies; lobbyists like JSK were at the vanguard to usher in a new-look India. Some areas like education, IT (Information Technology), insurance, retail management, automobiles , aviation, tourism and textiles were likely to come up for discussion with regard to the Government opening up foreign direct investment or FDI.

Although she had her residence in New Delhi and lived with her family there, JSK operated from two offices – one in the national capital; the other in the business capital, Mumbai. While seeking appointments and meeting VIPs/high-profile officials, JSK – whose roots were in central Kerala – braced herself for new situations, businesses and deals in 2013. She was always on the move in the corridors of power, wielding her feminine wiles to the best use.

Regardless, she managed to strike a balance between her personal and professional arenas. Once home, she spent time with both her kids – who had wrapped up their first day in school. David had entered Class 10 and Twinkle Class 7. In the Indian education system, Class 10 is of vital importance; a mother would always feed her child a little extra when he reached Class 10; she would give in to his tantrums and tolerate his nonsense for that year; she would try and fulfill all his desires and crown him the ‘King of the House’ for those crucial 12 months. Typically, Class 10 scores determine which college the child will go to, which will further determine his career path. JSK herself had been a very bright student, and her husband, being a doctor, had also been a bright student. Hence, they both had high expectations from David. This put David under intense pressures at times. JSK understood that and tried to go easy on him, but Dr Joshua was a typical stern and strict daddy!

David was more into singing and playing the guitar than gluing himself to jejune (boring) text books. Twinkle on the other hand was studious, and into reading and writing. She loved essay writing, and had a diary in which she had penned down a thousand words on almost everything on earth. The mother understood her children very well. She had the ability to instantly connect to the place and the environment she was in; she would instantly disconnect herself from the place and the ecosystem she had left behind. If she was in office, worries about David faring well in his board exams wouldn’t give her lines on her forehead. When at home, she wouldn’t fret over business deals not materialising. She encouraged her children to do what they liked, but she would often tell them when they were going to bed, ‘You know sweethearts, you should always do what you like. But before doing it, be sure that you like it! Master any one thing in life, but be careful to gain mastery over it in and out – so that none can beat you at it!’

It was customary for Twinkle to write at least a paragraph and read it out before her mother each night before going to bed – JSK would make the necessary corrections and give her suggestions regarding alternative words she could have used. David had to play a tune on his electronic guitar. If either one or both of them pleased JSK at any time with their skills, she would get them a little present the next day. After all, they were Indian children and subject to bribery – where corruption runs in our veins! Once the kids were in bed, JSK would go into her bedroom and lock the door. Her husband would be in bed waiting for his beautiful wife. The couple were actually batchmates at Harvard University. When she was studying International Law, he was specialising in Cardiology and Cardiac Surgery at Harvard Medical School. They got in touch through a common church-going friend and then followed it through dating, a relationship, engagement and finally tied the knot.

This was a normal day in the life of the Koshys. They had two chefs and three maids at their domestic service. JSK was a good cook herself so the chefs could not fool around with her about the proportion of spices to be used in the dishes. She insisted that each dish be simply spick and span. She would even suggest recipes to her cooks, who in turn were awed by her culinary talents and skills. On Sunday mornings, JSK would enter kitchen and cook for her family – Dr Joshua found her French toast finger-licking good; the children loved all dishes that their mother would prepare with love and affection. This was probably the only activity that JSK undertook that didn’t affect the GDP of the country.

JSK was a stickler for perfection – once she takes up a task, she would remain committed to it till completion. When she decided to start lobbying for corporates, and gain proficiency in the art of clinching deals and tie-ups, she had it all planned and mapped down, crystal clear, in her head. When she decided to marry, she was ready to devote extra time to her husband and home. When she decided to have kids, she was ready to do away with her gym and yoga sessions and spend those hours bringing up her children.

2

Early next morning, JSK was in office. She always arrived on the dot at 9 am and expected her employees to be in office before her arrival. While Rachel was trim and smart, the other secretary in her New Delhi office was a couch potato. Priya Amarnath was in her mid thirties and had immense latent talent and skills, but did not use them to her maximum capacity.

‘Rachel, where is Priya?’ asked the boss. ‘Uhm, Ma’am. You think she can ever be in office before 10! She may be on her way.’ ‘Okay. Once she is in office, please send her to my cabin.’ ‘Ma’am, Priya doesn’t even sit back till late unlike our other team members who may walk in late. I mean she rushes into office in the morning with a million excuses. Then, in the evening…’ ‘Rachel, have I structured the hierarchy in such a way that Priya reports to you, and you in turn report to me?’ ‘Well, no…’ ‘That’s it then. Please carry on with your work. Priya reports to me directly and I am well acquainted with all her habits. It is my look out on how to tackle her. Thank you so much.’ JSK looked at the door indicating it was time for Rachel to leave.

JSK was very curt when it came to handling her employees. Having many female employees under her, and being a woman herself, she could recognise the irresistible craving the women had to crib about their colleagues. Some studies have revealed a gender problem in their professional lives, especially if they happen to be competitors. The boss knew where to draw the line; she never discussed the drawbacks of any employee before others. If at all she had anything to say about someone, it was only words of praise.

She was busy attending to her mails on her laptop. Close to a thousand mails gushed into her inbox on a daily basis. Sophia Stephen was her secretary in Los Angeles, and Rose John in Tokyo. There was a production house in LA that had approached JSK Globals in the US to avail of their corporate consultancy services to plan a shoot in India and Tokyo. JSK mainly helped Hollywood film producers and production houses plan their shoots and get all required permissions in India, Japan and UK. She had set up offices in these countries and had a trustworthy reputation in the US film market. There were many who wanted to hire her services, but she would get her team members to scrutinise each and every detail on the projects that came their way and consider their feasibility before acceptance. She would only commit her time and resources to something that she felt was mutually beneficial and attainable.

There were many reasons as to why she would observe utmost circumspection while working on a project. The sole purpose of lobbying to her was to communicate a group’s desires and preferences to the Government. A government is generally shaped by public voting; installs people with certain ideologies into lawmaking positions. Lobbying is more specific. Here laws and policies of the Government are sought to be influenced, using persuasion as a tool for change. Corporate lobbying addresses industry needs to be protected from economic shocks or foreign competition through subsidies or tariffs. Even appointment to positions in high places are clinched through this route. At a local level, companies can lobby for lawmakers to create infrastructure improvements, such as wider roads for shipping goods or more bus stops for commuting employees. Corporations/ corporate houses often hire consulting firms to do their lobbying. Since a business house’s first priority is running its business, it often doesn’t have the internal expertise or appropriate connections needed to find the right government official or fully examine all issues and concerns that need to be addressed. Lobbyists like JSK spend time studying/researching relevant laws and issues, seeking meetings to attend or lawmakers to meet with, and then presenting their client’s or company’s case. This enables lawmakers, individually or collectively to deliberate on proposals before moving forward with their decisions.

There was a knock at JSK’s cabin door. ‘Come in!’ In walked a tiny lady; Priya was all wet and unkempt. ‘Sit!’ She sat down and tidied her dress and moved her fingers through her hair. ‘Delhi rains you see! Horrendous!’ ‘The Almighty seems to be blessing you and only you with his showers it seems!’ Priya could sense the sarcasm in JSK’s tone and looked down. ‘Look, I don’t believe in rebuking my staff every now and then. Since I don’t rebuke people in public, everybody else in the office feels I am partial towards you – as you are allowed to walk in at any time and also leave sooner than all the others. Priya, I understand you have issues making it to office at sharp 9 in the morning. Accepted! But then what is the problem in the evening?’ ‘Ma’am I have additional responsibilities at home, and moreover I finish all my work in a short span of time. Then what is the use sitting back!’ ‘Priya, work is never less. If you check our office store rooms, there are loads of pending files. So, please don’t give me the excuse of you not having work. If that is the case, where is the report on FireUp Production House’s Contract? Then getting exact quotations from Sophia and Rose? What about your weekly MIS (Management Information System) report? I can’t see any of these done. How can you now say that you finish all your work before time and therefore leave?’ ‘I am sorry Ma’am. I will get all of these done today itself.’ ‘I don’t really want to depend on you Priya… I have already emailed both our LA and Tokyo offices. The report has already been given to Rachel, and you don’t need to submit your MIS for this week as I am sure you have practically nothing productive to put on it!’ Priya’s eyes were wet. The boss was curt and blunt this time; she had warned Priya politely several times before. It was almost two-and-a-half years since Priya was working with her. When it came to meeting clients and coming to terms with them, Priya had the best marketing pitches– but to handle her was a task! ‘Look Priya, we all are women and Indian women at that. We all have additional family responsibilities as men in our society aren’t all that supportive on the domestic front as their counterparts in the West. I do empathise with you but that doesn’t mean my work suffers. If you cannot accomplish my targets and cope up with work in office along with abiding by the time restraints, please let me know in advance. I assure you I will myself help you find another job with lesser responsibilities.’

‘No Ma’am, after working with you, I can’t even think of such a thing! Please don’t say that. I will try my level best to match your suppositions. Please give me a week’s time and I will clear all the mess!’ ‘Okay, but please Priya, this is my last warning to you. Do not compel me to take harsh actions against you. You are such a talented girl, all you need to do is get rid of your work shyness.’ ‘Thank you Ma’am you are someone who always understands me!’ ‘Well, and you are someone who always exploits my understanding!’

JSK handed over a few files to Priya, forwarded certain mails to her and allocated some new work to her. Having received her weekly dose Priya was on her toes at least for the rest of the day. She was just a sample out of an expanse of diverse human beings JSK had to deal with in her organisation. Being a leader and the head of the whole company meant more of human resource handling than working. One tool that each leader at the corporate level should have in abundance is patience. Patience is the state of endurance under difficult circumstances, which can mean persevering in the face of delay or provocation without acting in a negative way; or exhibiting forbearance when under strain, especially when faced with longer-term difficulties. Patience is the level of endurance one can take before negativity. It is also used to refer to the character trait of being steadfast.

The benefits we gain from patience are unique. For one, patience makes us better listeners. Try listening when you’re in a hurry or your mind is filled with thoughts of things you need to do– it is nearly impossible. Good leaders are good listeners. Similarly, patience makes us empathize with fellow human beings. When you’re impatient, who are you focusing on? Most likely it’s you. You’re thinking about where you need to be or what you need to be doing? In those moments, the situation that you’re in – whether it’s a conversation you’re having, a long meeting or an unexpected crisis at work – is an obstacle that needs to be surmounted. When you’re in that frame of mind, you aren’t thinking about the people you’re with or their needs.

Patience puts us in the right frame of mind to put ourselves in the other person’s shoes. As leaders, there are times when customers, project deadlines and cash flow demand quick action. At times like these, it’s incumbent on us to prompt people to move quickly where needed and ensure that deadlines are met. It’s a tightrope, though, because even in these moments, if you lose your cool or act too hastily, the work and your relationships can suffer. People, relationships, organisations– they all require patience if they’re going to grow and reach their full potential. It’s easy to make quick judgments about the value of employees or projects, but in most cases it’s only by being patient that we know if our judgments are accurate. As leaders, patience isn’t only about being focused, centered, even-tempered and persevering. It’s also about fostering growth: watering, feeding and tending to those aspects of the business where we want growth. It’s by demonstrating that patient care and attention that we see real results. Otherwise, we run the risk of pulling out roots before they have time to blossom.

In the meanwhile, Dr Joshua was in AIIMS, at work. He was already treating the governor, whose body was responding well to the treatment. Almost all top notch political leaders with heart ailments would come to Dr Joshua. The Chairman of the famous BKP (Bhartiya Krantikari Party) in Delhi was suffering from restlessness that morning and was immediately rushed to the hospital. On being kept under observation until noon, Dr Joshua concluded that Mr Somnath Singh, the Chairperson of BKP had suffered a mild heart attack. Several tests were performed, and the reports indicated that he further needed rest and had to spend few more days in the hospital. The parliamentary leader of the party along with Mr Singh’s family members went over to speak to Dr Joshua in his cabin. ‘We need to take good care of him. Just keep him away from work and politics for about a month’s time. He needs some mental repose. He will be fine if all my instructions are followed well.’

The news about such politicians, particularly party leaders, being ill usually spreads like wild fire in the country; so did it this time also. The rival party of BKP was DBP (Desh Bhakt Party). It had some serious issues with the leaders of BKP and could resort to any means to win an upper hand over them. The leader of the Youth wing of the DBP, Vimal Saxena, was an acquaintance of Dr Joshua. He sought an appointment from Dr Joshua’s secretary and went over to meet him in the evening.

‘Good evening doctor!’ Vimal greeted the cardiologist with a funny smile on his face. The doctor was running through a few cardiograms and ECG reports when his glance turned towards the door where Vimal was standing. ‘Oh Vimal, come in! How are you? Come, sit!’ ‘I am doing absolutely fine Dr Joshua!’ ‘So, how come you are here today?’ The surgeon drew his chair closer to the table and to Vimal. Vimal looked around the cabin and cleared his throat. He went on to say, ‘Well, doctor, we all know that Singh is lying in the hospital since morning, and none but an adept like you will be treating him. So, how is he now by the way?’ ‘He is doing good.’ Dr Joshua was not able to conjecture the objective of Vimal’s conversation thereby he chose to keep his answers concise and crisp. ‘Well, so what exactly had happened to him?’ ‘Vimal, if you are genuinely concerned about Mr Singh you can talk to his family or party members. I may not be the right person to answer all your questions.’ ‘Okay, listen doctor I don’t want to beat around the bush any more. How is Singh?– good or bad – is my question. I am not looking for diplomatic replies. I basically want to know if he is going to live any longer or shall we just wait for a short while before natural death would kiss his feet?’

Dr Joshua was stunned at such a brusque and terse question. He took a while to think over what and how could he answer Vimal. ‘Vimal, as I told you earlier you better talk about his health to some of his well wishers. From my end I can only tell you that I am not God, that I can give you a fixed time line of Mr Singh that he will die on a particular date and at such and such time! And I understand your intentions behind asking me these questions. But I sincerely advise you not to worry over Mr Singh and focus on your own party matters more! What makes you wish ill about Mr Singh? The mere fact that he is the Leader of your rival party! And if he is no more your party may have a better say in the present Indian political scenario.’

‘Yes! You got me right doctor. Look, I don’t care whether he is doing good or no, just don’t let him live for long and treat him in such a way that he is shown the path to heaven within a week! I assure you Dr Joshua, if they pay you Rs 25 lakhs for his treatment, I and our party will pay you a crore to get rid of him! It is going to benefit both of us, so what say?’

Dr Joshua looked at Vimal with disdain. ‘Vimal, I am a doctor and I am bound by the Hippocratic Oath to do good and only good to all my patients. I know terms like oath, pledge, affirmation and troth are insignificant to you people in politics but they bear a high-octane importance in my life. I cannot and will not take the burden of the guilt of actually murdering somebody on my shoulders. I am too weak a material for all these tasks, which involve a lot of bravery and courage. I will do only my duty, whether he lives longer or dies sooner is the wish of the Almighty and his destiny. Vimal, even if you pay me 10 crores, I will not dirty my hands and soul with something like this. I am not saying you are wrong, or what you are asking me to do is wrong. But it is just that it is not the right thing for me to do!’

Vimal stared at Dr Joshua. ‘Doctor! Think over again… I can give you a day or two’s time to think. You will be losing out on a golden opportunity!’

‘Oh, that is really kind of you! But my verdict is irrevocable.’ Vimal soon left the doctor’s cabin. He left the cardiologist thinking over the whole situation. Dr Joshua was very much resolute over not supporting Vimal in even the minutest manner, but he thought about how insensitive people can be. Even if Singh was dead, there was no guarantee given to Vimal that DBP would rule over the country and would overtake BKP in all spheres. Why couldn’t people simply adopt the straight path in life instead of meandering here and there and looking for short cuts which mostly are futile and lead you nowhere?

It was past dinner-time and Dr Joshua had messaged JSK that he would be late that day. He was a workaholic and just couldn’t leave the hospital before being done with his quota of work for a day. If he did, even when his body was at home resting, his mind would be at the hospital – all anxious and strung out. He was going through the report of a patient who had a very rare heart disorder. He was referring to certain Medicine Bibles and some websites to figure out what course of treatment could be recommended. The rare heart condition in a 29-year-old female patient, who had consulted him for the past eight weeks, was called atrial flutter.

Atrial flutter (AFL) is an abnormal heart rhythm that occurs in the atria of the heart. When it first occurs, it is usually associated with a fast heart rate or tachycardia (beats over 100 per minute), and falls into the category of supra-ventricular tachycardia. While this rhythm occurs most often in individuals with cardiovascular disease (such as hypertension, coronary artery disease, and cardiomyopathy) and diabetes, it may occur spontaneously in people with otherwise normal hearts. It is typically not a stable rhythm, and frequently degenerates into atrial fibrillation. Symptoms can arise suddenly. Stress, exercise, and emotion can all result in a normal or physiological increase in heart rate. Episodes can last from a few minutes to one or two days, sometimes persisting until treated. The rapid heart rate reduces the opportunity for the ‘pump’ to fill between beats decreasing cardiac output and consequently blood pressure. While atrial flutter can sometimes go unnoticed, its onset is often marked by characteristic sensations of regular palpitations. Such sensations usually last until the episode resolves, or until the heart rate is controlled.

Atrial flutter is usually well tolerated initially (a high heart rate is for most people just a normal response to exercise). However, people with other underlying heart disease or poor exercise tolerance may rapidly develop symptoms that could include shortness of breath, chest pains, light-headedness or dizziness, nausea and, in, some patients, nervousness and feelings of impending doom. Prolonged fast flutter may lead to decompensating with loss of normal heart function (heart failure). This may manifest as effort intolerance (exertion breathlessness), nocturnal breathlessness, or swelling of the legs or abdomen. Atrial flutter is recognised on an electrocardiogram by the presence of characteristic flutter waves at a regular rate of 240 to 440 beats per minute. Individual flutter waves may be symmetrical, resembling p-waves, or may be asymmetrical with a ‘saw tooth’ shape, rising gradually and falling abruptly or vice versa. If atrial flutter is suspected clinically but is not clearly evident on ECG, acquiring a Lewis lead ECG may be helpful in revealing flutter waves. Dr Joshua penned down the course of the treatment after a thorough scrutiny of the case in hand and the reports of all required tests.

3

JSK was home relatively early that evening. ‘Hello my babies… How was your day at school? David, how was your quiz?’

‘It was great mom! We were the runner- up team this week!’

She went over to David and patted him on the back. ‘Wow! So, next time you have bright chances of coming first and winning the quiz, eh!’

She then smiled and looked at Twinkle who seemed to be lost in thought. ‘Twinky! What’s the matter? Wasn’t school good for you today?’

‘It was great!’ Twinkle said as she forced a smile upon her face.

‘Dad is coming home late today.’

‘Why so?’ asked David anxiously.

‘From the time he has been anointed Head of Cardiology at AIIMS he has assumed a lot of responsibility. He will stay back in the hospital for a simple diagnosis of a case or even determining the course of treatment for a patient. You know your dad – he was a workaholic from the very beginning and being the Head of Department has just boosted the workaholism! So, let us just go for dinner without any further delay