Published: April 15, 2008

Each morning as I head for my morning rounds, I routinely hurry through the hallway alongside the cardiac catheterization lab not noticing what goes on inside. But, this morning it was different. On the table, under the x-ray beams, with a catheter tunneled into the arteries of his heart was my father.

Fourteen years ago he had angioplasty (a ballooning of blockages of his artery), seven year ago he had four coronary bypasses and now a thallium stress test revealed defects in the blood flow to his heart muscle within minutes of exercise.

The intervention cardiologist was a colleague. Draped in X-ray protected body armor, masked and gowned with three assistants by his side, he held the catheter.

I sat in the control room just outside the glass walls, focused on the movement of his gloved hands and the computer screen displaying the x-ray images. The cardiologist threaded the catheter up the artery from my father’s groin. In a snake like movement the catheter found its way to his chest and then spat out dye which dissipated into the heart like black smoke in the wind.

Next, the cardiologist injected the dye into the arteries of the heart. As he took x-ray images – the lights in the lab went on-off in dancing movements. The dye gushed into the artery and then narrowed into a hairline passage. My eyes, though not trained to read cardiac catheterization, spotted a bottleneck in the first artery. Another artery was all mottled, like a road with potholes. Another two were clean.

The cardiologist straightened up, ungloved, unmasked and stepped out into the control room and said to me. “Let’s talk.”

Like a referee in a playoff game under the camera-hood, he viewed the instant replays of the blockages. I watched like a lifelong fan hoping for the right call: “no surgery.”

“The blockages are in difficult places, but we can avoid surgery with two stents.” He said. We agreed. I told my dad, as he lay on the table in a self-hypnotic meditative trance. He was mentally prepared for any option. He had submitted to the cardiologist from the moment he was threading the catheter, and to the son who was overseeing the process.

The cardiologist gingerly poked a wire past the narrowing and then inflated a balloon and lodged drug eluding stents at the site of the bottleneck and the mottle artery. It was surreal to see images on a screen and reconcile them with my father who lay serenely on the table.

The closing X-rays showed good flow through both his arteries.

After settling my father back in his room under the care of my mother, I set out for my rounds. But, now, rounds were different. In the rooms alongside the hallways, I noticed patients more as fathers, sons, daughters, mothers, childhood friends and neighbors.

With my own patients, I listened attentively for a few extra minutes; I held their hand a few seconds longer; I revisited a family in the ICU and gave a much-needed hug to a daughter whose elderly mother was critically ill. In every patient I saw my father. I saw his eyes, his breath, his face, his heart and a catheter blowing soft black dye.

Later, as I recalled my experience, a doctor friend said. “Every doctor needs to be a patient or have a family member as a patient as a prerequisite to practice medicine.” I humbly nodded in agreement.

A patient relinquishes control when he hands over his body to a doctor while lying on the table. A doctor wields responsibility of a life when he accepts care for a patient. We, doctors and patients, often take it all for granted.

A patient once said to me. “Doctor, to you I am just a patient – but to me – you are the world.” Now, I have experienced both ends of the stick.