At last!

After more than 2 years, I have a contributor for the blog!!

Dr Ritesh Sukharamwala, who trained in our team at Narayana Hrudayalaya from Nov 2006 to July 2009 has shared his experiences as independent Pediatric Cardiologist. Please go through and let us know your opinions:

Following is the complete transcript of his experiences in first person. I have not edited a single word; there was no need for any editing. Everything seems right from heart!

Over to Dr Ritesh:

Where am I standing at the end of 1 year? A freshly passed out pediatric cardiologist

I would life to share my 1 year experience as a pediatric cardiologist in my home town Surat.

After completing my fellowship in Pediatric Cardiology at Narayana Hrudayalaya it was very clear in my mind to settle down in my home town Surat. There were lot of comments and suggestion by senior colleagues stating difficulties of establishing new subspeciality of pediatric cardiology in small town. As a pediatrician during my residency days I have faced lot of problem in treating pediatric cardiac problem. So with a vision of providing tertiary level of pediatric cardiac care in my city I started my journey at CARE hospital Surat. CARE hospital is basically cardiac hospital providing services for adult patients. To begin with, this hospital provided me basic infrastructure in the form of echocardiography machine & OPD.

I started meeting pediatrician in my city and near by areas. To begin with there was lot of apprehension - whether this small city will accept this new subspeciality? Will I get patients? Will I be able to provide quality work? Whether I am capable? Will I be able to do interventions independently?

I started getting 1 or 2 patients a day in my OPD who were primarily referred by pediatricians. There were days where I had not seen a single patient in a day. I also started doing bedside ECHO in outside hospital ICUs.

Everyday was like a new day, learning and applying something new. This was for the first time when I have no backing of my senior. There was always a check echo by senior colleague even in my last days of fellowship. I was making my all patients rely on my reports and there was no second check. I remembered my teacher said” though you have cleared your exam, your exam starts from today”. In my initial few months of my services I got out of inferiority complex and started believing in myself. By this time I was in the second month of my journey. I had a plan to focus more on outdoor work for first six months and then to think of interventional work.

But in second month itself a patient knocked the door for PDA device closure. The time to use other infrastructure i.e. cath lab had come. The patient was admitted for the procedure. My night before procedure was sleepless. At every step I wanted to be double sure. Confirming the diagnosis more and more times and checking the hardware many times. Procedure was done successfully and that was for the first time when I felt that feeling of eternity and happiness of saving somebody’s life. I realized the meaning of job satisfaction. After that I had many diagnostic cath which went uneventfully.

Second challenge came when I had a 2 kg 2 day old preterm with critical aortic stenosis but my confidence level boosted up after its success. It was a true life saving procedure. I mean it is a life saving procedure but I realized it in true sense on that day.

Pediatric cardiology program is incomplete with out a team. I inspired my surgeon to take challenging pediatric cases. I use to go to operating room, gross anatomy was confirmed on table and surgery was done as per plan. We got away with cases like ASD, VSD, PDA & TOF. I also had to play a major role in post operative care especially when my ICU staff was not trained for pediatric critical care. It was now 6 months of my journey and the time have come when I have to think in terms of treating more complex cases which needs trained surgical expertise like arterial switch operation and single ventricle pathway surgery. One of the trained pediatric cardiac surgeons was called for arterial switch operation. Everything went smoothly & child was discharged on 11th POD and doing well on follow up. That day was new landmark in the history of my town Surat when arterial switch operation succeeded. All pediatric procedures were done for the first time in entire South Gujarat and I feel proud of enjoying honour of being the first interventional pediatric cardiologist of South Gujarat.

At the end of one year I am realizing that my journey has in fact started. Today I am seeing around 150 patients in month out of which 2-3 patient gets ready intervention and 3-4 children for surgery. I still have same feeling of apprehension when I do intervention today as every case is a new case and I don’t want to take a chance.

My majority of above said statement depicts my immaturity which I have already realized. However I firmly believe that there is no other way to success when you are alone and not backed up by your senior colleagues. I consider myself lucky to go through this phase which you will never face when you are protected by your seniors. I am trying for progress of pediatric Cardiology branch as a whole rather than individual progress. I am still learning daily and there are lots of things coming forward to learn, I mean life ends but process of learning never ends.

I am looking forward for valuable suggestion and guidance from my senior colleagues and teachers.

Sincerely,

Dr Ritesh Sukharamwala
Pediatric Cardiologist
CARE Hospital –The Heart Institute
Surat.
email: sukharamwalaritesh@yahoo.com

Please reply to the blog comments, or to Dr Ritesh or to drkiranvs@gmail.com

Regards

Kiran