Open Drops To Open Hearts! Open Drops To Open Hearts! Journey of an Anesthesiologist from India to America Shreeniwas Jawalekar Outskirts Press, Inc. Denver, Colorado The opinions expressed in this manuscript are solely the opinions of the author and do not represent the opin- ions or thoughts of the publisher. The author has represented and warranted full ownership and/or legal right to publish all the materials in this book. Open Drops To Open Hearts! Journey of an Anesthesiologist from India to America All Rights Reserved. Copyright © 2010 Shreeniwas Jawalekar v6.0 r1.0 All Interior Photos and Cover Photo © 2010 Shreeniwas Jawalekar. This book may not be reproduced, transmitted, or stored in whole or in part by any means, including graphic, electronic, or mechanical without the express written consent of the publisher except in the case of brief quota- tions embodied in critical articles and reviews. Outskirts Press, Inc. http://www.outskirtspress.com ISBN: 978-1-4327-5269-9 Outskirts Press and the “OP” logo are trademarks belonging to Outskirts Press, Inc. PRINTED IN THE UNITED STATES OF AMERICA To Leela, Maya and Nikhil Yes, you can! N and N DEDICATION This is my Guru Dakshina (repaying to my teachers) who open heartedly taught me the Art and Science of Anesthesia. Their Teachings helped me to realize that my work was my worship and the reward was a successful epidural and a smile on mother’s face! Table of Contents Foreword ...................................................................................................xiii Introduction ...............................................................................................xv The Journey The Spray ...............................................................................................1 Pain Control ..........................................................................................3 Hippocratic Oath .................................................................................5 Viewing Gallery–My Visit to O.R. .....................................................7 Internship–My First Witnessed Cardiac Arrest ...............................9 It’s decision time! ................................................................................11 Dr. Krishnaji Gangadhar Utturkar–Anesthesiologist ...................13 My Anesthesia Textbook...................................................................15 Vigilance! .............................................................................................16 Dr. Utturkar–The person ..................................................................19 Mumbai—on my own! ......................................................................21 Last visit and last request ..................................................................25 Dehradoon Express–For more letters! ...........................................27 All India Institute of Medical Sciences ...........................................29 Back to Maharashtra–Miraj Medical College .................................35 Solapur–Power of Positive Thinking ..............................................37 Solapur–The accident ........................................................................41 Solapur–The Art of Anesthesia Practice ........................................45 The Art of Anesthesia Practice–Part 2 ...........................................53 Some definitions ................................................................................57 American Dream ................................................................................59 Residency in New York .....................................................................67 Dr. Gertie F. Marx Mother of OB. Anesthesia .............................73 Monitoring Then and Now ..............................................................75 The Other Charleston .......................................................................77 CAMC 1981 ........................................................................................79 The Ventilator Case – Kathy Smith.................................................83 The Lighter Side of It .......................................................................85 Epidurals–Post OP Pain Management ...........................................91 Dr. Ramakrishna and Work Ethics ..................................................95 House For Community–Puja Mandir .............................................99 Women and Children’s Hospital ................................................... 101 On Call Memories ........................................................................... 109 A Case of Postpartum Hemorrhage ............................................ 113 Learning New Techniques ............................................................. 117 Anesthesia Versus CAMC Administration .................................. 119 Practice Makes You Perfect ........................................................... 121 Some cases to remember! .............................................................. 125 Part Time Job! And Pranayama ..................................................... 131 Concentration–Key to Success ..................................................... 135 Dream! And It Will Happen! Story of CSE Model ................... 137 Retirement ........................................................................................ 145 Amazing Open Hearts! ................................................................... 147 Anesthesia Mishaps Bob and I: In his words! ................................................................. 155 Anesthesia Mishaps ......................................................................... 159 My First Year of Residency ................................................... 160 Mumbai (Bombay) .................................................................. 162 Cardiopulmonary Bypass ........................................................ 163 A Case of Air Embolism! ...................................................... 165 Cases from Private Practice--Solapur ................................... 166 C.V.P. Line Beware of Guide Wire! ...................................... 168 Correct Cricoid Pressure ........................................................ 172 Locum Anesthesiologists ........................................................ 173 Malignant Hyperthermia ........................................................ 176 Those Amazing, Ever Changing Epidurals! ........................ 180 The words I remember! .................................................................. 187 Tomorrow! ........................................................................................ 189 About the Author ............................................................................ 195 Helping Hands ................................................................................. 197 Foreword Open Drops to Open Hearts is the heartwarming chronicle of Dr. Shreeniwas Jawalekar’s professional odyssey from Wai, a small city in India, to the larger city of Charleston, West Virginia, where he spent 25 years providing obstetric anes- thesia to the women of West Virginia’s capital city before re- tiring from the active practice of his profession. Dr.Gerard M. Bassell M.D. This book is more than that, however. It is the story of Jawalekar’s journey, encompassing almost 50 years, to enlightenment and spiritual- ity. Along the way, we meet his family, his gurus, his patients and his colleagues. We become intimately familiar with his daily life of service, his compassion, his absolute dedication to his patients, and his love for mankind. We first meet Dr. Jawalekar as a young boy who experiences the won- der of anesthesia as a frightened patient. His next experience, again as a boy, was a prolonged, painful hospital stay during which he again felt the miracle of pain relief but, more importantly, he recognized the positive effects that result from the warmth and kindness of caregivers. These lessons helped lay the foundation of the personal and profes- sional character of this man who has spent a lifetime caring for others. S xiii s Throughout the narrative, we meet the individuals who taught the young physician and then the older man. He was always wise enough to recognize the lesson even when the example wasn’t necessarily in- tended to teach. It is easy to recognize the luminaries in Indian and American anesthesiology who influenced him; he pays them unstinting tribute. Read between the lines, however, and one can identify the les- sons learned from patients, hospital staff, and others whose influence might be overlooked by less sensitive a man. It might be difficult to understand how a physician can survive in this modern age without apparent regard for the trappings of his profes- sion. Dr. Jawalekar has lived a life where the joy is in service, the reward is in a job well done and a happy mother and child, and he has been cradled in the certain knowledge that God will provide. This book is the true measure of a unique man. I am proud and hum- bled to know Shreeniwas Jawalekar as a friend. Gerard M. Bassell Clinical Professor of Anesthesiology, University of Kansas School of Medicine, Wichita Kansas Editor Emeritus of the Obstetric Anesthesia Digest Past President of the Society for Obstetric Anesthesia and Perinatology Student of Gertie Marx S xiv s Introduction Journey of an Anesthesiologist: Open drops to open hearts! This is a story of my journey from Wai, India to Westford,