Louisville Medicine Volume 67, Issue 9 - Page 12

BOOK REVIEW YOUR HEART, MY HANDS AUTHOR: ARUN K. SINGH, MD WITH JOHN HANC PUBLISHER: CENTER STREET, NEW YORK. 288 PAGES, 16 APRIL, 2019 Reviewed by M. Saleem Seyal, MD, FACC, FACP “ I slept and dreamt that life was joy. D I awoke and and saw that life was service. I acted and behold, service was joy.” - Rabindranath Tagore (Nobel Laureate Literature 1913) r. Arun K. Singh is a highly respected, preeminent and prolific cardiac sur- geon who gave up his scalpel in 2016 after a distinguished career span- ning over 40 years. He performed over 15,000 open heart sugeries on adults and children, encompassing the entire spectrum of cardiac surgery. “Your Heart, My Hands” is a gripping narrative of this remarkable Indian immigrant physician’s life. His absorbing account of being the oldest son of a high school teacher is very well presented as he chronicles a fascinating life. From rural Indian beginnings in a rather impover- ished family, with unbridled optimism, hard work and perseverance, he achieved the pinnacle of his American dream. As an adolescent, he got into all kinds of trouble including academic miseries, wasting time hopping trains for free rides, keeping questionable company and flying kites instead of working. He admits to feeling like a juvenile delinquent and had a rather strained relationship with his father, but he eventually redeemed himself. He was afflicted with serious medical issues, including crippling injuries to both his hands and upper limbs on two occasions. These required multiple surgeries and long, albeit un-conventional, home physical therapy. Yet he improved to the point of caridac surgery prowess. He had dyslexia as well, but it did not stop him from gaining admission to Darbhanga Medical College, located in his birthplace, the northeastern state of Bihar in India. He whole-heartedly delved into his medical studies, though he described the school as medio- cre. He earned accolades from his teachers and classmates. He was determined to come to the US for residency and initially wanted 10 LOUISVILLE MEDICINE to become an orthopedic surgeon after his own treatment. He was content to take a surgical internship in a small hospital in Worcester, Mass. after he passed the requisite ECFMG (Education Council for Foreign Medical Graduates) examination. Money was tight, partic- ularly after his father had a stroke, and Arun had trouble coming up with airfare to America. He eventually borrowed money from his estranged maternal grandfather who was a retired ENT surgeon. In the summer of 1967, after a circuitous journey with the cheap- est airfare available via three different airlines with stops in Calcutta, Karachi, Beirut, Athens, Istanbul, Amsterdam and London, he arrived at JFK Airport, and finally Worcester, Mass. with $5 in his pocket and a rickety disingrating suitcase. Very soon after starting his training, Arun realized that this hospital was a sweatshop— he was working 110 hours a week—admitting everybody, doing required scutwork and holding the retractors. The prospects for actually learning surgery were dismal. He declined the offer to stay for four years for his “surgery residency” in Worcester and, on the urging of a friend, moved to New York to the Harlem Hospital, one of the three Columbia University-affiliated hospitals. On his first night in the emergency department, he was exposed to a variety of interesting and challenging situations including gunshot wounds, stab wound to the heart, drug overdoses and many other surgical and medically emergent clinical situations. He rapidly learned a lot and the teaching and supervisory milieu appealed to him. His chief resident, an Iranian immigrant physician, took him under his wing and explained the treachery of the pyramidal residency system: From 12 residents, the number of residents will go down to four the next year and will further decline in subsequent years. He had to work harder and he most certainly did, particularly practicing