I can’t imagine how my life would have turned out if I hadn’t made that house call. Surgeons don’t make house calls. I was heading cardiac surgery at BM Birla Hospital in Calcutta. Of course, I declined. I was seeing hundreds of patients, not turning anyone away. But a house call was a different proposition. The man on the other line was persistent. He said, “I can assure you one thing. Your life will never be the same once you meet this person.”
My curiosity got the better of me. I’m glad it did. I immediately recognised the address but I didn’t know who the patient was. The moment I entered Mother Teresa’s Home for Children, these lines caught my attention:
People are often unreasonable, irrational, and self-centered. Forgive them anyway.
If you are kind, people may accuse you of selfish, ulterior motives. Be kind anyway.
If you are successful, you will win some unfaithful friends and some genuine enemies. Succeed anyway.
If you are honest and sincere people may deceive you. Be honest and sincere anyway.
What you spend years creating, others could destroy overnight. Create anyway.
If you find serenity and happiness, some may be jealous. Be happy anyway.
The good you do today, will often be forgotten. Do good anyway.
Give the best you have, and it will never be enough. Give your best anyway.
In the final analysis, it is between you and God. It was never between you and them anyway.
Mother was the living embodiment of those lines…the things she had done for the underprivileged, yet she was so humble. I would go on to look after her for the next five years…the man was right; my life was never the same again…
Mother had a simple solution to the world’s complex problems. She used to say, “There are too many problems in the world today and you possibly can’t solve everything. It is easier to pick one thing and make that your mission.” I knew what my mission was. Just like her, I wanted to touch as many lives as possible. In many ways, she was the driving force behind Narayana Health.
It was from her I learnt to never look for endorsements. If we had, we would have never gotten this far. Other thing is that the future can’t be an extrapolation of the past, it has to be an empty canvas, filled the way you want…16 years I have been filling up the canvas. Today, we have a network of 31 hospitals, with over 5,600 beds under management all over India.
Even as a kid, I never wanted to be boxed in. When you have eight siblings, you automatically learn how to get someone’s attention. Sometimes, it is by getting into trouble. For me, it was often…Ours was a small town. Whenever it would rain, schools would get flooded easily – once the water reached a certain level, they would declare a holiday. There was a tiny passage in school through which water would flow out. I would get there first and put large stones to block the passage, hoping that the water would reach the mark. We had many a rainy day holiday thanks to me!
In college, as the secretary of the student union, I had only one agenda. I wanted to be remembered. The only way to do that was to go on a strike. But KMC was a good college; there was nothing to really pick on. The only issue was that the interns’ stipend was very low and they wanted an increase. I was a first year student, had nothing to do with it, but we went ahead with the strike. The interns got their increase but the management increased our fees to pay the higher stipends! It wasn’t exactly a win-win, but it was mission accomplished.
I was juggling so many things then. Nobody thought I would do anything worthwhile. Drawing, painting, martial arts, I even got into body-building and competed for the title of Mr. KMC! I was never an outstanding student. At times, I would do exceedingly well, other times I would drop down to average. Did it bother me? Not at all…
I wonder why I kept up with martial arts for 8-9 years…maybe, it was because I would get bullied and ordered around at home. Mom never took sides or got involved in our fights. She wanted me to stand up for myself. I didn’t want anyone to think I was weak. It’s funny, a few years into martial arts, when people would hassle me, I would want to give it back. Slowly, I realised to smile and walk away…
It’s important not to get rattled easily. When people made snide remarks that open-heart surgery wasn’t possible at $1,500 and we were adopting “iffy” practices, we didn’t respond. We got the hospitals accredited by the Joint Commission International. When it comes to healthcare models, US is considered the benchmark. So, we set up a hospital in Cayman Islands – people could see for themselves how our model works. The 104-bed tertiary hospital was set up in partnership with US-based private healthcare network, Ascension. I felt vindicated when two hospitals in the US wanted to replicate our system.
I always knew I wanted to be a heart surgeon. I was in fifth standard, when the teacher told us about Christiaan Barnard...how he did the first heart transplant in Cape Town, South Africa. I was so fascinated. I didn’t even know you had to become a doctor first, I was so naïve, but my heart was set.
Dr. Alan Yates at Guy’s Hospital in Leeds, London taught me cardiac surgery, but more importantly he introduced me to the business side of healthcare. Heart surgeries can go on for hours, depending on the complexity. He would constantly say the NHS model couldn’t survive on tax payers’ money for long…predicting many of the problems it faces today. “If a solution is not affordable, then it is no solution” — the impact those words had on me. Charity is not scalable…he taught me that unless you understand the economics of delivering healthcare, you can’t build a sustainable institution. That has stuck with me…that’s why senior management and doctors get a report on the previous day’s revenue and operations. It’s like a diagnostic tool, so we can take corrective measures almost instantly rather wait for month-end reports.
Then, I spent even the weekends at the hospital. This was true of the whole team – the nurses, anaesthesiologist, they were all there. But we wouldn’t operate as it was a holiday – it was such a waste of resources – to have the entire cardiac team at the hospital, hanging around for coffee! One Friday, I picked up two patients who had done the angiography…they had angina. I told them, I would operate on the weekends, they agreed, the waitlist was long otherwise.
With the family away in India, I was in the hospital for all practical purposes. The next year, we did even more surgeries, bringing down the overall costs and got recognised by NHS as being the most efficient hospital. That’s when I realised that healthcare is a volume game. Where others were doing 10-12 surgeries a month, we wanted to do 10-12 surgeries a day! Everyone said it was impossible. Today, we do 35 surgeries a day.
This is the first of a two-part series. You can read the second part here.