Republic Day Redux

Friday, 26 January 2024—Republic Day.

Sevagram in January wakes up slowly. The air stays crisp even after sunrise, and the mornings feel quieter than they should. I woke at five, more out of habit than necessity, and sat down at my desk. Ashwini had reached Nagpur barely an hour earlier. His late-night flight from Pune had been delayed and finally landed at 3:30 a.m. By the time he got home, dawn was already softening the darkness.

I opened the news on my desktop, scrolling through the headlines with the calm attention of a man who had no reason to hurry. The Padma awards had been announced. I read the list casually until one name made me pause—Dr Chandrashekhar Meshram, neurologist from Nagpur, and my classmate from GMC. The Padma Shri felt perfectly placed. It gave me the quiet satisfaction one feels when a good man is recognised without noise.

I called him immediately. The hour did not matter.

“SP!” he exclaimed, startled, as if the phone itself had delivered the award.

“Congratulations, Chandrashekhar,” I said. “The Padma Shri—well deserved.”

He laughed, still trying to make sense of it. We spoke for a few minutes, drifting into old teachers, old wards, and the long, uneven roads we had all travelled since 1973. When I hung up, I opened WhatsApp to share the news with our GMC Class of 1973 group.

That was when I felt it.

It did not arrive like a thunderclap. There was no cinematic clutching of the chest, no dramatic collapse, no warning siren. It came as a deep, dull discomfort that settled in the centre of my chest and stayed there, firm and unmoving. I stood up, walked a little, took a breath, lay down. The sensation remained. It was not sharp, but it was unyielding. It had the unmistakable stubbornness of something serious.

I woke Bhavana gently and told her we needed to go to the hospital.

She looked at me closely, reading my face the way only a spouse can. “Do you want to change into a formal shirt?” she asked, as if clothing could restore order to an unruly heart.

I shook my head. “Just get the car,” I said. “We need to move quickly.”

She did not ask again. Ashwini was downstairs within moments. There was no panic in the house, only a brisk efficiency that felt like muscle memory. Soon we were driving towards Sevagram Hospital, the familiar road suddenly sharper, as if the tyres were cutting through a different kind of air.

I had felt something like this once before, eleven years ago. That episode too had begun subtly, easy to dismiss, easy to rationalise. The angiogram then had revealed a severe blockage, and a stent had been placed in my left anterior descending artery. This time, there was no ambiguity. The body was speaking a language I understood too well.

At the hospital gate there was no wheelchair. I did not wait. I walked up the ramp and straight into the ICU on the first floor. The residents looked up, momentarily confused. They assumed I had come to review a patient, perhaps to ask for an ABG, perhaps to scold someone gently about a delayed antibiotic.

I sat down at the nursing counter and said, calmly, that I was having chest pain and needed an ECG.

There was a brief hesitation. No beds were available. Someone suggested waiting. I shook my head and asked them to take me to the preparatory beds outside the cath lab and do the ECG there. When your own heart is misbehaving, you stop being polite about logistics.

The ECG confirmed what I already knew. Early changes of an acute myocardial infarction. My coronary artery was blocked; my heart muscle was starving for blood. The resident holding the paper seemed to freeze for a second. She had seen heart attacks before. She had treated them. But she had never treated this one.

This patient was her professor.

The pain intensified. Sweat began to pour down my forehead and soak through my shirt. Bhavana held my hand and stared at me with a mixture of worry and irritation, the irritation reserved for situations where fear has no other outlet.

“Why are you sweating so much?” she asked. “It’s January, and the ICU is air-conditioned.”

I knew the answer, but I had no strength to explain it. The body had turned into a furnace, and the mind had narrowed to a single point: endure.

For a few moments, uncertainty hung in the air. The residents hesitated, caught between protocol and urgency. Then the ICU male nurse stepped forward. He did not look confused. He looked calm, almost stern, as if he had decided that the heart could misbehave but the team would not.

He gave aspirin, statins, anticoagulants—swiftly, without fuss. The room found its rhythm again.

Dr Sumedh Jajoo arrived soon after and took charge instantly. The atmosphere changed the way it changes when a senior clinician walks in—less talking, more action. He ordered that I be shifted to the main cardiac ICU. The hesitation vanished. Decisions became crisp. The chaos, if there was any, moved out of the room.

I said, “Give reteplase.”

It was not a command from a professor. It was the desperate clarity of a patient who knew what minutes meant.

IV lines were secured, monitors began their steady beeping, and the clot-busting drug went in—one dose, then another ten minutes later. I glanced at the clock. Barely thirty minutes had passed since the onset of pain. The speed startled me even in that moment. Nowhere else could I have received treatment faster—not because of privilege, but because of proximity and familiarity. The hospital was two minutes away. The team knew me. There were no formalities to slow us down.

Yet the pain did not subside immediately. My blood pressure rose. Sweat pooled on my back. A resident listened to my chest and paused briefly, then continued as if her stethoscope was also trying to stay calm. Later she told me she had closed her eyes for a second and prayed.

I asked Ashwini to call Diti and Nivi. They arrived with Shaily—eleven and eight years old—standing quietly at the foot of the bed. Their faces held questions they did not ask. Children, when frightened, become suddenly adult in their silence. They looked at the wires, the monitors, the unfamiliar stillness of their grandfather, and tried to make sense of it.

Then, without warning, the pain vanished.

Not gradually. Not in steps. It disappeared completely, as if someone had switched it off. The clot-buster had worked. The artery had opened. Blood flowed back into the heart muscle, and relief spread through the room like a soft exhale.

I smiled. Bhavana squeezed my hand. The nurses exchanged glances that said, Yes, it has happened. We have crossed the worst part. The air felt lighter. I had made it through the first gate.

The rest of the day passed under vigilant care. Gini, the senior ICU nurse, took charge the way experienced nurses do—quietly, firmly, without drama. She had spent more than two decades in the ICU and shared a special bond with me. She kept visitors at bay, protected my rest, and ensured that the vigilance around me stayed unbroken.

My residents sat by my bedside, watching the monitors with an intensity that reflected both concern and familiarity. They were used to seeing me on the other side—walking, teaching, questioning. Now they watched my heart rate the way students watch a difficult viva: afraid of missing a sign, afraid of being wrong.

Amrita, seven months pregnant, was in Chandigarh when she received the news. She asked for my ECG to be sent to her father-in-law, Dr Rajiv Rathi, a cardiologist at Max Hospital in Delhi. His response came quickly: the treatment was appropriate and timely. By midnight, to everyone’s surprise, he arrived in Sevagram. Some people show love not through words but through the sheer refusal to stay away.

The next morning, Ashwini drove Bhavana, Dr Rathi, Dr Sumedh, and me to Dr Pramod Mundra’s cardiac hospital in Nagpur. The ninety-minute drive passed quietly. The road was familiar, but the silence inside the car felt different, as if all of us were listening for something that might go wrong again.

Dr Mundra was ready. A decade earlier, he had placed my first stent and knew my heart well. The timing could not have been worse—his daughter’s wedding reception was scheduled the next day—yet he stepped away without hesitation. In medicine, the best people often disappoint their families to keep someone else’s family intact.

In the cath lab, the angiogram revealed a total occlusion of the LAD just above the previous stent, and significant disease in the circumflex artery. The images were stark, almost insulting. The heart had been quietly building its own problem while I was busy reading newspapers and making congratulatory calls.

Two new stents were placed. The procedure went smoothly. When it was over, Dr Mundra smiled and said simply that my heart was pumping beautifully. It was not a poetic sentence, but it felt like poetry to me.

Two days later, I walked out of the hospital and returned home—alive, and quietly grateful in a way that did not need to be announced.

A week later, I walked back into the ICU, this time as a physician. My residents looked up, startled, as if they were seeing a ghost who had come back with a stethoscope. I told them I had resumed my routine, including cycling. One of them smiled, visibly relieved, as if my return restored a sense of normalcy in their world too.

That night, I wrote thank-you emails to Dr Mundra and the ICU team. Some experiences leave you with no choice but gratitude—and the responsibility to acknowledge it.

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