A change of heart leads to endless possibilities!
My wife and I moved to England during the gorgeous summer of 2005. We moved from Bahrain where I had helped to set up the anaesthetic and intensive care service at
Bahrain Specialist Hospital. It had been an excellent three years, but I was looking for new challenges, including the opportunity to sit the infamous FRCA. My wife was also looking for new horizons, and the opportunity to further her career in microbiology in England.
I started as an anaesthetic SHO in Harlow, Essex, and we settled
in really well. The weather was at times a challenge, but I thought
we managed our first cold winter well! However, in May 2006
I became ill and was diagnosed with severe heart failure and
dilated cardiomyopathy secondary to viral myocarditis. Of course,
I was shocked. My initial ejection fraction was 10-12%. At first
there was denial, then a process of acceptance, a consideration of
my life priorities, and the best way to move forward.
My life was in complete upheaval. I was unable to work, and
reliant on my wife, family and friends for support. I received only
one month’s full pay and two months’ half pay as I had been in
the job for less than a year. We moved in with a friend to enable
my wife to get back to her training job. I focused on how I could
improve my health and wellbeing, but I knew that my heart failure
was worsening. This was my nadir, my rock bottom.
I referred myself to Dr Jayan Parmeshwar, the transplant
cardiologist at Papworth. He and the transplant team took
me into their care. I was asked to attend urgently, when they
explained the various treatment options and I had the workup for
transplantation. They encouraged me and gave me tremendous
hope, confidence and optimism for the future. The initial plan
was medical optimisation and follow-up every three months. I will
remember this as the most important phone call of my life.
My confidence began to grow. I wanted to return to work so
long as I could do so safely for myself and my patients, and
began a phased return to work in March 2007, 10 months after
my diagnosis. Work was hard with heart failure, interrupted by
the insertion of an Implantable Cardioverter Defibrillator for
non-sustained VT in June 2007, but I was very happy to be back
working as an anaesthetist. In February 2008, I had built up
my hours and restarted night shifts. I passed the Primary FRCA
MCQ in January 2009, but failed the Primary Structured Oral
Examination for the fourth time in October 2010. I had struggled
with my memory and stamina, and kept falling just short. I
suppose my awful cardiac output was not helping either. To add
to my struggles, I was informed I could make no further attempts.
I was so disappointed.
I gained great solace from the fact I had some control over my destiny.
Shortly after the exam, in November 2010, I decompensated. I returned to Papworth and was deemed non-transplantable
because of pulmonary hypertension. I was offered a Left
Ventricular Assist Device, but knew that this would not be
compatible with the life I wanted to live, and I would be unable to
give anaesthetics and help other people anymore.
I had a cunning plan! Stop work, relax, socialise, and prioritise my
health and wellbeing. We bought and moved into our beautiful
new home. In March 2011, I was feeling much better and was deemed in the transplantable range and therefore listed for
an urgent heart transplant.
I gained great solace from the
fact I had some control over my destiny. I returned to work
while on the waiting list, doing some daytime elective work at
reduced hours with agreement from the transplant team, my
department and the Occupational Health Department. I have
always felt happy to be at work, meeting and interacting with
patients, colleagues and friends - this is part of who I am. It kept
me occupied and fit.
My transplant went ahead on the second attempt on 31 May
2012. I had put my affairs in order, my family were there to
support me, and I was ready. I was transferred to the operating
theatre at 14:00 and extubated at 20:00. I had made it. I was
pain free and discharged from ICU the following morning,
physically exhausted. As a small gesture of our immense
gratitude, we bought pizzas for the staff in theatres, ICU, the
transplant team and the ward.
On this journey I have lost my fear of failure, which has enabled me to step out of my comfort zone and believe in myself.
I returned to work on 1 September 2012, 12 weeks after my
heart transplant. I started slowly, which was crucial. I re-sat and
passed the Primary theory and viva sections after a change of
regulations allowed me another attempt. I continued as a Staff
Grade until August 2016, when I started an ST3 post in the East
Midlands. I continue to work 80% less-than-full-time through
choice. In December 2017 I passed the Final, and became
a Fellow of the RCoA! This summer, I commence my final
academic year of UK anaesthetic training.
Organ donation
Organ donation changes lives. It is a tremendous gift. I try to
encourage people to talk about, and document, their wishes
regarding organ donation while they are in good health. I have
spoken at various forums, undertaken numerous awareness
campaigns, and conducted fund raising activities to promote
organ donation in BAME communities.
I would like to be a regular, real-life reminder of what
transplantation can do. I hope to stimulate people within
the medical community to champion transplantation as the
life-changing and life-saving gift that it is. It has given me
the opportunity to continue to be a contributing member of
society, to be the best I can be, and to continue to help others
along the way.
On this journey I have lost my fear of failure, which has enabled
me to step out of my comfort zone and believe in myself. After
years of uncertainty and little progress, I would like to finish
with a quotation from Winston Churchill:
“Success is not final, failure is not fatal. It is the courage to continue that counts.”
Snehashish Guha
ST6 in Anaesthesia
East Midlands School of Anaesthesia
Read the new special collection on organ donation from Anaesthesia.