Dream To Destiny: The Making of a Heart Surgeon

By Dr Mani

‘Dream to Destiny: The Making of a Heart Surgeon‘ is a story of a heart surgeon’s training – a thrilling journey to an ambitious dream that takes you behind the scenes into a gruelling residency program in heart surgery.

Have you ever dreamed of being a heart surgeon? Or wondered what it must be like to be one? The aura of glamor, romance and mystique attached to a majestic masked figure who wields scalpel to fix broken hearts and save lives is hard to resist.

But...

What does it really take to become a heart surgeon?
How does a surgeon master the rare skills to fix heart defects?
Which traits decide if you’ll be a success in heart surgery?

‘Dream to Destiny: The Making of a Heart Surgeon‘ is an engaging story about the long yet fascinating journey to become a heart surgeon.

In a narrative that often reads more like a thriller novel than a memoir, you’ll experience life alongside a budding heart surgeon - right from when he begins training in the specialty, all through a roller-coaster of soaring highs and crushing lows.

You’ll see how a trainee evolves and grows in confidence, skill and judgment as he manages complex problems under extremely arduous and stressful circumstances... and undergoes a personal transformation not only as a professional, but also as a person.

‘Dream To Destiny‘ includes many a thrilling depiction of dramatic scenes in the heart surgery operating room.

"A fascinating glimpse into a world most of us never see. Told with an exciting passion, it's surprisingly riveting!" - Derek Sivers, author and entrepreneur

"Such a delightful read! Crisp narrative. Kept me riveted,till the very last word." >- Dr.V.Srikala

‘Dream to Destiny: The Making of a Heart Surgeon‘ is a fun, entertaining and informative read that’s sprinkled with anecdotes and stories, mixed with a smattering of history, and replete with biographical footnotes.

A worthy sequel to 'Heart, Guts & Steel – The Making of an Indian Surgeon‘, this book is set to become a must-read... for boys and girls, men and women, of all ages and nationalities who have ever been curious about heart surgeons and their art.

• Language: English
• Publisher: Dr Mani
• Release date: Dec 18, 2020
• ISBN: 9781005837532

Dr Mani

Dr.Mani is a heart surgeon who also works to spread congenital heart disease (CHD) awareness and raises funds for heart surgery in under-privileged Indian children. Dr.Mani has written several ebooks and the popular print book, "47 Hearts - How To Live Your Dreams With Passion, Purpose & Persistence".A share of the profits from all of his book sales go towards helping a child receive life-saving surgery. The Dr.Mani Children Heart Foundation is a non-profit that has funded 152 heart operations in children upto May 2020 - with many more to follow. Dr.Mani hopes that you'll join in this initiative, and order some books from the list.Equally important is your support in spreading word about this mission. Please help spread CHD awareness. And buy a book - or ten. You'll be helping heal a child's heart!

Book preview

Is Born

Alighting from the bus, I turn right.

Then I walk down the busy main road that's already teeming with traffic. A hint of the night's chill lingers, mingling with the sharp tang of diesel smoke from autorickshaws and carts.

I inhale deeply.

Turning my head to the left, I gaze at a crowd hurrying in and out of the warren of by-lanes that once led into the famous Moore Market and now offers access to a suburban terminal of the city's largest rail station, Madras Central. Like busy ants they scurry to their daily toil.

I stride along briskly towards the traffic lights.

As I wait for the signal to change, I gaze across the road at an imposing pale pink structure that soars seven flights into the sky. The historic Cardiology block of Government General Hospital is an impressive sight, one that always makes my heart beat a little faster.

Once more, the thought flashes through my mind.

One day, I'll be there!

It's become a personal mantra, one that I chant to myself every day as a medical student. A self-affirming belief and silent reinforcement of my earnest dream to be a heart surgeon.

The traffic light turns green. I cross the road.

The building that was inaugurated by a pioneering cardiologist Helen B.Taussig and named after her, vanishes behind the looming facade of our out-patient block.I turn right again, entering the gates of the hospital building.

It's another step on the long journey towards my dream.

So it shall be written. So it shall be done.

- Rameses

Dream to Destiny.

What a perfect title for this story!

Nothing could be more appropriate. Because, believe me, this paediatric heart surgeon of today has dreamed, dreamed and dreamed again.

About saving lives. About fixing diseased or deformed hearts. About wielding my scalpel like a magic wand to heal and cure.

About becoming a heart surgeon.

And now, those dreams are my destiny.

The universe has a destiny. Every country has a destiny. And people like you and me have a destiny.

I am very lucky - because I found mine in a childhood dream.

Dream to Destiny is about how a fond belief transformed into reality.

Was this just a happy coincidence, a stroke of fate and good fortune?

Or was it the inevitable consequence of relentless focus and unwavering determination?

Or a combination of both?

I still don't know.

But of one thing I'm certain... It all began in a special unanticipated moment of delight... when I experienced my first heart operation.

The Magic & The Mystique

Damn!

I almost missed the soft expletive. And the flurry of action beside me.

My eyes were locked on a rapidly rising pool of blood.

I felt unsteady, light-headed. My heart pounded within my chest. A cold trickle of sweat ran down my back.

In horror, I wondered: Is he going to die?

That was the day I realized that the world could change completely... in just five seconds!

Five seconds ago, the man on the operating table was alive. His pulse and blood pressure were normal. The surgery would free his heart from a prison of scar entrapping it.

And now, everything had gone wrong - in just an instant!

Beep. Beep. Beep.

The urgent clanging of the monitor sounded like a fire alarm in the hushed yet strained silence of the cardiac surgery suite.

I turned my head to squint at a flickering screen. A few moments ago, the blood pressure had read a healthy 124/80.

Now, it was 40 - and still sinking.

My eyes flicked over to the tall, commanding figure clad in light green. He looked like an alien. Shrouded in a sterile gown with almost his entire face swathed inside a mask, only the eyes were visible above its rim.

From his forehead, a powerful beam shone through a headlight. It focused on the thick, viscous red fluid spilling out of his patient's body... draining away life.

Tubular extensions projected from his glasses. Powerful magnifiers that multiplied the size of a mess he's now responsible for.

And yet, he was calm and cool.

By my side, his anesthesiologist was scrambling.

A pressure bag was unclamped. Fluid rushed through a tube in the patient's veins. A loaded injection was plunged into another tube. A jolt of adrenaline surged into the patient's blood stream.

Instantly, the body on the table responded.

The monitor's sound changed subtly in tone. Grew louder. Stronger.

BP is at 60 and climbing.

Okay, said the surgeon. Let's move on.

Quiet, measured tones. Not a hint of panic. Barely a quiver in his voice.

His finger had sealed the hole leaking blood. But only temporarily. It still had to be fixed.

Without killing his patient.

For an hour, the operation had proceeded smoothly. Painstakingly, one millimeter at a time, the mystical figure in green had snipped at the mass of scar with a pair of sharp pointed scissors.

Slowly, very slowly, the heart was falling away from the chest wall where it had been firmly stuck, because of a disease - constrictive pericarditis - that was slowly choking him to death.

But one snip went wrong. It cut through the paper-thin wall of a major artery.

And all hell broke loose!

Now, there was a lull in the crisis. But it had to be resolved - one way or the other.

Get me a Fogarty, said the surgeon.

The scrub nurse whispered instructions to her colleague on the floor. Within seconds, a choice of three sizes was offered.

Open the largest, please.

The OR was quiet. I heard a rustle of paper as the cover ripped off. With a soft plop, the sterile tube fell on the operating table.

Do we have blood ready? he asked the anaesthesiologist.

Yes. We're fine.

The Fogarty catheter was tested. It's a thin tube with a balloon on the end. Inflated with saline, the balloon expands to fill space. In this case, it would be deployed to save a life.

Ready? Suction tubes handy, please.

He prepared to remove his finger. I remembered a favorite childhood story. The one about a boy with his finger in the dyke. Who saved a country from being drowned.

Everything happened in a flash.

The surgeon's finger came off. Blood flooded the field, again. And powerful vacuum pumps cleared the area instantly.

Deftly, the surgeon slipped a Fogarty catheter into the rent.

Inflate the balloon, please.

The scrub nurse pushed in three cc of saline. The balloon expanded. Gently, the surgeon tugged the tube back. And the balloon sealed the hole - from within!

Bleeding stops. Blood pressure rises. Tense bodies relax. A wave of relief sweeps over the room.

I want to clap my hands and cheer.

But I stop myself.

Because... everyone else is simply carrying on.

To the team, it's just another day at the office. A crisis like many others that pepper life in a heart surgery OR. One to manage effectively... or else, risk losing a life.

Stress of this high order is simply... routine.

Even if, to a young and impressionable third year medical student like me, it's totally magnificent. Almost miraculous.

What follows is almost an anti-climax.

6-0 Prolene, please he orders.

An instrument is handed to him, loaded with a hair-thin suture on a tiny needle. With a few strokes of his wrist, the surgeon places stitches around the hole he nicked in the artery.

The balloon catheter is deflated and pulled out. At the same time, he tightens the suture and ties knots.

One... Two... Three.

Four... Five.

And six.

Firmly. Securely.

These knots seal the hole. Permanently.

The crisis had ended. And I'm trembling all over. In nervousness and anxiety. From the thrill and excitement.

Scissors, please.

And the surgeon gets right back to work. Snipping cautiously at the remaining scar. Releasing the heart from its fibrous prison.

It's the moment of truth.

An instant in time when I know, deep inside my heart, that this is what I want to be.

Someone who can stay cool in a crisis.

And act firmly, effectively - to save a life.

I knew I wanted to be a heart surgeon.

In that moment, a dream was born.

Who Should Read This Book?

It's common practice for a publisher to ask an author who their book is for.

For this book, there are two ways to answer the question.

1. Who will enjoy reading it?

2. Whom did I write it for?

When I was in high school, I read an article in Reader's Digest magazine. It was about the world's most famous heart surgeon Denton A.Cooley of the Texas Heart Institute in Houston.

Princes and presidents flew in from all over the world to be operated by this genius. At the time of its writing, he had operated on almost 40,000 patients. I was stunned!

Recently, I read his biography. It's titled '100,000 Hearts: A Surgeon's Memoir', to reflect the number of patients whose hearts Cooley has touched.

Dr.Cooley's story fired my imagination.

He sparked off a dream deep inside my heart. I, too, wanted to become a heart surgeon and save lives. That led me down a path which eventually carried me towards my dream - and transformed my life.

This is a story about that exciting, exhilarating journey.

Unlike many books written by surgeons, though, this is not a see how great I am, and all that I've accomplished brag-fest. Nor is it a manual or guidebook to getting through a tough residency program in heart surgery.

It's a collection of events, incidents and anecdotes from a period when I trained to become a heart surgeon. It might come as a surprise to see just how long this journey is, and how early it really begins.

Just as with my earlier book 'Heart, Guts & Steel', which is about my training as a General Surgeon, I've chosen to use a narrative storytelling style that will engage and entertain even casual readers with no knowledge about - or even interest in - heart surgery.

If you've ever wondered what it takes to become a heart surgeon, or are curious about how one goes from being a wet-behind-the-ears young doctor to a confident, competent scalpel wielder, ready to take charge and accept responsibility for fixing hearts ravaged by disease, literally taking a patient's life in her hands in the process... then you'll enjoy reading this story.

This is a book you can read for fun and entertainment. Or gift to your kids, friends or family. Or recommend to a book club and your local library.

But that's not why I wrote it!

I wrote it to become that Reader's Digest story - for a young boy or girl somewhere in the world, who is dreaming about being a heart surgeon and wishes there was some way to find out what it takes to get there.

It is for the ambitious high school student, who yearns to operate on that magical organ called the human heart.

It is for the young college freshman, who dreams of entering medical school to become a heart specialist who can perform complex surgeries that will save people's lives.

It is for the doctor in training who is fascinated by what she has learned about the heart's anatomy and physiology, is enamoured by its mystique, and driven to specialize in its diseases.

It is for the newly qualified surgeon seeking to specialize in an arduous, demanding branch of her chosen field - but is uncertain about whether or not she will be capable of handling the hardships of a residency in cardiothoracic surgery.

I wrote this book to tell you, Yes, you can do it.

And to show you just what it takes - and what it will demand of you.

That's all this book will be. A simple, no-frills, yet no-punches-pulled account of going through a training process in heart surgery.

I'll guide you through a journey with giddying highs and terrifying lows, through thrilling moments mixed with heart-wrenching and gut-twisting experiences, that eventually carried me from a hopeful teenager with stars in his eyes to a heart surgeon... who stands proudly over an open chest, gowned and gloved, ready to go into battle against a foe called heart disease - and fight to defeat it... to save a life.

I promise you'll enjoy this story.

What I cannot promise is what you'll decide about a career in heart surgery after you've finished reading!

Spirit of a Surgeon

The most important thing in the Olympic Games is not to win but to take part, just as the most important thing in life is not the triumph, but the struggle. The essential thing is to have fought well.

- Don Schollander, Olympic swimming champion 1964 and 1968

In Laura Hillenbrand's iconic bestseller 'Unbroken', there's a scene where an American soldier Louis Zamperini is held captive at a Japanese PoW camp. The sadistic commandant, in retaliation for his rebellious behavior, tortures him - by ordering Zamp to hold aloft a tree trunk.

It's a soul-thrilling scene. The frail, half-starved prisoner, his arms trembling under their crushing load, stands strong.

For a minute. Then, two. And then, five.

A slow clapping begins, and wends around the prison yard as fellow soldiers display admiration for the indomitable spirit of their fellow man. It continues even after he collapses to the ground, exhausted... but unbroken!

It's a picture that stays fresh in my mind forever.

Because it's all about the struggle!

The outcome itself was never in doubt. You'll break. That's for sure. Everyone will break.

The question is...

How long can you hold out?

How far can you go?

How much can you take?

It's the universal story. Of every man and woman ever born. Of the human spirit.

Be it George Mallory who attempted to scale the tallest mountain in the world, even if it meant going all alone... and when asked why he did it, famously replied: Because it's there!

Or Sir Edmund Hillary who eventually succeeded in conquering its peak some years later, overcoming all odds and enduring past human comprehension... to transform humanity's sense of what's possible by planting a flag atop Mt.Everest.

Or Olympic swimming sensation Don Schollander who describes breaking through the excruciating pain barrier where everything turns red... because to win the race, you must be willing to suffer agony.

All of them discovered the limit of their endurance - by putting it to the test.

And in a way, that's what training to be a heart surgeon really is.

Exploring your limits.

Finding out how much you can take.

How far you can go.

In that sense, this story will also be about my voyage of self-discovery.

As a medical intern, I had doubts about becoming a surgeon. "Am I really good enough?" The question kept repeating, like an echo inside my head. Like an endless drumbeat that would last all through the period of my training.

Did it matter that I had asthma? Would the tremor, from medicines I took for it, prove disqualifying? Was I strong and tough enough to bear the rigors and stresses of a career in surgery? Could I lead a team? Will my hand skills ever improve? Am I capable of making quick decisions under pressure?

I had oh-so-many doubts, insecurities, and crises of confidence. And little by little, over the period of my training, they disappeared. Three years later, I knew that I was good enough to be a surgeon.

But now, as I dream about being a heart surgeon, I realize the worry isn't entirely gone.

It's still there. Just in a different form.

What happens if I can't manage in a crisis?

Will I be able to deal with the heavier work load?

Can I cope with the greater demands of this specialty?

Am I strong enough to handle the emotional, mental and physical stress of being a heart surgeon?

Or would it break me? Crush me? Even kill me?

I still had a lot left to learn; to discover; to prove. Even if only to myself.

And so my training in heart surgery would become a baptism by fire... to answer these questions, one way or the other.

A Moment of Exhilaration

Show me your hand, said the stern matron in a commanding voice.

Hesitantly, I stuck out my forefinger.

She turned to her tray of instruments, and picked up a huge cruel-looking pair of scissors.

I imagined an unholy grin splitting her face beneath the mask, as she brought the weapon threateningly close to my digit... and prepared to cut!

For a moment, my blood froze. The world turned on its side. Is this how my dream was going to end? With a sudden guillotine chop, blood spattering all over, and a severed finger lying on the OR floor?

The rational part of my brain attempted to reassure me. But I was still terrified.

I was a naive young medical student, inside an operating room for the first time. The OR is an exclusive, forbidding, super-sterile domain where highly trained specialists practice an esoteric, refined kind of medicine.

The rare privilege was granted me because the chief surgeon was my father's friend.

I'd hoped to observe events from a distance. But found myself scrubbed, gowned and right inside the field. With a ringside seat to an operation