Medical Dialogues Team interviewed Pioneer Cardiologist Dr M Khalilullah on changes in the field of Cardiology as well as Medicine in general in his nearly 50 years of experience.
MDT: Sir, you are one of the senior-most cardiologists in the country. Tell us about your journey in these past decades.
DR K:I started my journey in the field from medicine from Government Medical college, Nagpur in 1956 where i did my M.B.B.S, internship and house job. I did my MD at GMC, Nagpur and joined as a registrar there.I still had a craving there to learn more, hence I applied to AIIMS for the course of DM Cardiology. I think that at that time, the course was just in its nascent stage with we being the third batch. At that time there were only two posts and 13 candidates. One was from AIIMS itself so he got selected, and they somehow selected me, gave me a scholarship and told me to join immediately. This was the year 1966. I finished my DM (Cardiology) in 1969.
During my DM cum residency in Cardiology at the college, I did some innovations. I made India’s First pacemaker. It was developed in an animal lab and then human experiment was done. And it became the first pacemaker in India. This event really inspired me and suddenly wanted to do more and more work.
Post DM I got a job offer from Pune Chest hospital to set up a cardiology center at a salary of Rs 50 per month. I remember, I was probably the only D.M in the state of Maharashtra. I remember reviving a few patients from Sudden Cardiac Death and you know, suddenly that became a rage, that a man who had been declared dead has been revived. You know I am telling you this, because the modern concept of Cardiology is completely different from what I saw and practiced in those days. The awareness is different; the protocols are different and so on.
While in Pune, I still had a craving for academia, so i came to G.B Pant in Delhi and joined as an ad-hoc lecturer in 1971 on a salary of Rs 1150 a month. So you know from 50 rupees to 1150 rupees was a big jump for me. So I joined G.B. Pant Hospital and then began my journey towards an assistant professor, associate professor, professor, and then became director of the hospital. Since I was involved in the institution, I have seen the whole training program at GB Pant being beautifully upgraded. I remember all the young residents of cardiology, we all used to inspire each other, we used to work together day and night and slowly the department grew to become the leading Cardiology centre in the country.
I can proudly say that 80-90% of modern cardiology in India has come from the G.B. Pant Hospital, now G.B Pant Institute of Postgraduate Medical Education and Research. We had necessary drives, enormous support from Dr. Padmawati with the requisite equipment being given to us. More importantly, we wished to grow, to paint something new on Indian horizon.
MDT: In the last fifty years of your working what has been change in the cardiology mainly on two grounds, the sudden rise of CVD in the country as well as the changing techniques in the technology?
Dr K: I think it’s both. Cardiology has become a real challenging area. People who can burn their blood join cardiology. It’s quite hard. It’s dramatic; you do this and patient immediately becomes alright. You put a pace maker and the patient becomes normal; you open an artery and the patient’s angina goes off. So these are all the new things, which started, and there is now a prospect that cardiologists have become a therapy agents. Earlier,we used to be diagnosticians, we diagnosed and the surgeon took over. But then therapy came in hand. From1984, I started first cath-ablation and first balloon valveplasty in 1985. So all this becamea bignews that you can now treat lots of patients without surgery.
Plus when private sector started, the whole heavens opened up with big financial gain for cardiologists. Patients also started realizing the facilities are there in the country to get treatment here only. Patients earlier used to go abroad and now they stopped.
The training went off from there onwards and it produced some of the best cardiologist in the world. I must say, we now have some very good talented people in the country. This new generation of young cardiologists has changed the whole method of treatment.
MDT: Sir, Ethics have become a important issue in medicine and also in cardiology now. Do you think ethics have changed in the past years?
Dr K: You know all this has got something with role models. You see we had different role models.My professor, could not afford a car, so he travel in a taxi, but today people go in a Mercedes and BMWs. Things are changed. It’s all about role models. I had a role model one could see and get inspired and when Prof Sujoy B. Roy stood and talked, the whole country used to listen to him. Today its very different, people look at what car you are travelling, what suits you are putting etc, etc. But things have changed overall for the society as a whole. You can’t just blame the medical profession. The whole society has changed. You can look at the teachers, at one time the teachers used to be the most respected people on earth. They bring you to a level where parents can’t take upto. But today it’s become the commerce. So things have changed in all branches. Look at the legal profession also. You can’t only blame medicine and cardiology. It’s been a global change and some people get swayed away by that. So it’s a different story. It all depends on how strong you are on your feet, how strong your base is. If you base is strong, nothing can’t shake you.
MDT: There are a number of articles today about unnecessary procedures including stenting and pacemaker in cardiology. What’s your opinion on that?
Dr K: It’s unfortunate but it may not be fully correct. There are indications for procedures to be carried out. The indications can vary in interpretation and opinions. Somebody says a procedure may not be required, somebody says it is. But in all fairness a doctor will not do anything, which is unjust to a patient.
MDT: Sir, The costs of stents are now becoming unreasonable, making cardiology procedures out of the reach of a common man. What’s your opinion on that?
Dr K:Ok, understand it this way. This country has produces so many variety of cars. Why didn’t you produce medical devices?Tell me, how many pacemakers and valves does this country produce now?We all import it. Why were we sleeping all these years? What is the quality of products that is being imported from the country outside? Whose problem is that? It’s the country’s problem as a whole. We the whole country, including the government, the industry, the society, need to look into this.
MDT: Sir, it is alleged that with corporatization, cardiologists are working more like Sales employees having targets. Do you fell in your opinion it is right or it is true?
Dr K: Again it is the problem of the country. Why don’t we have many more government institutions to capture the potential of the young ones, teach them the values available and channelize the talents of cardiologists? There should be an opportunity to grow. How many government medical colleges do you have? We set a department of cardiology. How many institutes do you have with good departments of cardiology?
In absence of such things, they are forced to go to private sector. And all run by commercial organization. So they can’t do charity there. They have to earn money. The only way to earn money is marketing, etc. So this is our problem. Why don’t you create jobs? Every district hospital should have atleast have a cardiologist. Do you have one here? How many cath-labs do you have in the government sector? Very few. The waiting period in institute goes months together. So does in G.B.Pant/ AIIMS. So neither the patients nor the doctors have any alternative than to go to the private sector.
MDT: Also one more thing Sir, What would be your message to the young students who want to become cardiologist in the young future.
Dr K: I think they have to make up their mind that they have taken up medicine. It’s a professional service, requiring total commitment and dedication. Material does not enjoy high priority. I am sure these things will come as a product of time. They have to wait some time to take their own popularity, their own reputation and status. And it’s a vice versa. Society should also appreciate all this. I am going to extent to tell you this that as the society does not appreciate doctors, the number of applications of M.B.B.S. is now coming down. People will not take medicine as a career. Because they are see difficulty in long time to come. It’s important that a relation of mutual trust between medical profession and the society develops. Only then will we be able to survive and flourish.