“Dr Shetty is in the OT,” I’m told as I’m led to a waiting room. Later, when I am ushered into Dr Devi Prasad Shetty’s office in Bangalore’s famed Narayana Hrudayalaya Institute of Cardiac Sciences, the tall, smiling 56-year-old surgeon greets me in blue scrubs and cap, a surgical mask dangling from his neck. Cheerful and chatty, he betrays no hint of the hours he’d laboured in the OT, the operating theatre.
His passion is all about making healthcare available to all, especially children. Since he returned from England and opened the B.M. Birla Heart Research Centre in Kolkata in 1989, Dr Shetty pioneered two concepts that he feels are the way forward in reducing healthcare costs. In 2001 he started a telemedicine project that has since helped treat some 53,000 rural patients. Two years later, he conceptualized the Yeshasvini Health Scheme with the Karnataka Milk Federation, providing health insurance to some 17 lakh farmers at an annual cost of just Rs60 per person. The insured farmers are offered everything from consultation to major surgery.
Dr Shetty’s group now does 12 percent of all heart surgeries in India, and he’s known for smartly using these numbers to haggle down the cost of medical equipment—so that patients pay less. Reader’s Digest tried to delve into the mind and heart of the good heart doctor.

Q. Dr Shetty, what made you choose medicine?
Devi Shetty. Growing up in South Canara [in Karnataka], I was the eighth of nine children, so by the time I reached my formative years my parents were old. Mother was once hospitalized for more than six weeks. My father would develop diabetic coma. So doctors were the most important people—they saved my parents’ lives. And there was a kid, a relative, who required operations. But the doctor did them for free. You hero-worship those who do such good things. My older brother became a doctor, and I saw the respect he commanded.

Q. And why did you specialize in cardiology?
DS. Actually, I decided to become a heart surgeon before deciding to become a doctor [Laughs]. When Dr Christiaan Barnard did the first heart transplant in South Africa [in 1967], my teacher announced it in class and I thought, That is what I want to do. It excites me even today.

Q. What was your childhood like?
DS. Ours was a joint family. And being among the smallest, you get bullied, learn to survive, learn the art of living—because children can be very aggressive. But, on the whole, it was happy.

Q. What did you learn there that has deeply influenced you?
DS. I grew up in villages. In every village there is one rich man with a big house and others have smaller homes. But rich or poor, you ate more or less the same type of food. You watched the same entertainment… like folk dancers. The rich sat on chairs, the poor on the floor.
If a major disease struck, both the rich and poor died. There was an equity and dignity in life and in death. But now, if you are rich you can afford the best things. And it is demeaning to be poor. When you lose someone you love because you do not have ten thousand rupees, that is not acceptable. And these deprived people can see what wealth can do. I’m surprised that there hasn’t been a revolt among the have-nots. I think we have managed [peacefully] so far primarily because of our spiritual background.

Q. Were you a brilliant student?
DS. I was not very studious and had great difficulty with mathematics—still a mystery to me. I was educated in a small-town school. But my drawing teacher was so dedicated, he used to teach me maths too at his home.

Q. Unlike most Indians abroad, why did you come back from England?
DS. My brother went there, had his education, worked there and came back. It is a tradition—you go, get experience and come back—that’s understood. I wanted my children to be brought up the way I was brought up. I belong to this country and I have to be where I am supposed to be.

Q. So, you’re a happy man?
DS. See, all of us want to be happy. But the ultimate joy is not in having what you want in life, but seeing people around you also having what they want. Just suppose you love ice cream and you’re enjoying your favourite flavour. Then, suddenly, a hundred hungry children surround you. Would you enjoy it as much? Now imagine every child getting an ice cream and they are all very happy. Then your ice cream would have never tasted as good.

Q. Were you able to spend much time with your children?
DS. I didn’t spend much time with them as kids because in England my job was very hectic. They called me an “operating machine” at London’s Guy’s Hospital. I enjoyed surgery and worked from morning till night, seven days a week. When I’d introduce my wife to my bosses, they’d shake her hand and say, “We feel very sorry for you, honey.” She brought up my three sons and my princess. Today, I take a lot of interest in my daughter’s studies, daily teaching her economics or biology. My sons, who’re older, didn’t have that privilege.

Q. What’s the greatest satisfaction you get from your work?
DS. It may sound like a boast… but this is one profession where we are real-life heroes. A young lady comes to me with her baby who is blue, gasping for breath. We operate and five hours later the mother sees the baby in the ICU and she is so happy and says, “My baby, he is now so pink!” A baby brings lots of joy to a family. The moment he starts turning blue, the joy becomes a nightmare. And they may have financial problems. They come here and we tell them that if they have no money, we can organize it and they can’t believe these things are possible. We are heroes not once or twice a month, but ten to twenty times a day. Who wants to exchange that position for anything else?

Q. But there’s the perception that doctors have become materialistic.
DS. You have to blame the medical education system for that, not the individuals. Under our program, called Udayer Pathey, we’re trying to help children from Bengal’s villages become doctors. Today, most children from poor families, irrespective of how bright or how passionate they are, can never get into medicine. But the world over, some of the brightest doctors, who radically transformed healthcare, came from deprived backgrounds—they are the ones who have the fire in their belly and can work twenty hours a day. You cannot expect a person who’s paid Rs1 crore to get an MD seat to be passionate about caring for the poor.

Q. You were a surgeon to Mother Teresa. What did you learn there?
DS. I learnt from Mother that love is more powerful than any lethal weapon. One day when I was doing the rounds in the paediatric ICU, she said, “I know why you are here.”
I asked, “Why Mother?” She said, “When God created children with heart problems, He was probably preoccupied. Then He realized there is a problem and He wanted somebody to fix it, so He made you people.” That is the best definition of a paediatric heart surgeon.

Q. Where did you get the idea of farmers’ insurance?
DS. The idea came from a bank program called “pygmy deposits” that worked when I was a kid. They’d go around villages and collect 10, 20, 50 paisa from every household, and at the end of the year they’d have a tidy sum. People didn’t mind paying such small amounts. When the Karnataka Milk Federation came out with low-fat milk, they wanted me to endorse it as being heart-friendly. I said I’d do it provided they give an affordable health insurance to the farmers producing the milk. They agreed.

Q. Have other state governments shown interest in the scheme?
DS. Three or four years ago, the Andhra Pradesh government wanted to emulate our model. They were in a hurry because elections were coming up, so instead of collecting premiums from the farmers, they paid the whole amount themselves. Politicians everywhere do the right thing for the wrong reasons! It covers 80 percent of the population. All below the poverty line cardholders of Andhra have it. The Tamil Nadu government had an election coming up, so they launched their Kalaignar insurance scheme. The Delhi government, too, is starting a similar insurance scheme. Eventually all state governments will offer it. The government will stop being a healthcare provider and become a health insurance provider.

Q. Does the government listen to you?
DS. Twenty years ago, government attitude was totally different. Today, they are the best partners to have. They listen and are very proactive.

Q. What is the one medical reform you are rooting for?
DS. Medical education should be made inclusive. Any young doctor who wants to become a heart surgeon or neurosurgeon should be able to become one. What he makes of it is left to him. If we create the infrastructure, we can train ten thousand heart surgeons a year. Why put an artificial barrier? It is exactly like a licence raj, when we only had Ambassador cars. Once we liberalized, we got the world’s best cars. Why not do the same with medical education?

Q. How did the idea of telemedicine come about?
DS. If somebody is unwell, he does not require an operation 99 percent of the time. He requires consultation, some investigation and advice. If I don’t need to operate, I don’t need to touch the patient, so I don’t need to be there. I can see the patient through video-conferences and offer advice. There are very few countries in the world that can put a satellite in space and India is one of them. How we use that satellite is up to us. With it, we could offer heart care to remote areas, to government hospitals. Now we treat diabetics, even psychiatric patients, in remote areas and we are linked to 56 cities in Africa. Telemedicine will be the way healthcare can reach difficult terrain.

Q. How will medical tourism impact India?
DS. Healthcare is going to drive the world’s economy. Right now it’s a $4.5 trillion industry. It will create the maximum number of jobs, machines, accessories. In the US, the major debate after Obama came into power is about healthcare. In the UK, elections are fought over healthcare issues. But more than medical tourism, I strongly feel that Indian doctors and hospitals will start running medical establishments in those countries.

Q. Over the years, is there any change in the profile of your patients?
DS. There has been a major shift. We see a lot more poor people. When I started my career, only the rich could afford surgery. I strongly believe that in, say, five to ten years, millions of very poor Indians too will have access to hi-tech healthcare. India is going to prove that it’s possible to give people quality healthcare regardless of their levels of affluence.

Q. What makes Indians so vulnerable to ‘expensive’ diseases like cancer and heart attacks?
DS. We are three times more vulnerable to heart attacks than Europeans and we have one of the highest incidences of cancer. And there will be a cancer epidemic among young people because of smoking, gutka and paan chewing. The Indian diet today is very fattening. It’s ideal for developing diabetes at a young age. As kids we ate healthier food, without so much oil and there weren’t this many pastries and cakes. But now for a modest price, you can get very rich food.

Q. What are your own habits here?
DS. I am an exercise freak; fanati-cal about fitness. In medical college I used to teach karate. I hold a senior brown belt. I’ve never smoked. I am a teetotaller. I love fruits. I believe in eating nutritious food. I believe the human body is made for eating vegetables and fruits, not non-vegetarian food but, having said that, I do eat non-veg food in moderation.

Q. Have you recognized any common patterns in your patients?
DS. People always attribute heart disease to rich people, or obese people, but in our experience that is not the reality. Some of the slimmest people develop massive heart attacks. And heart disease is not a prerogative of the rich. Stress definitely adds to hypertension and diabetes, and being poor doesn’t make you stress free.

Q. What about women?
DS. Women are protected till the age of 45 by their hormones. But past 45, nature drops them like a hot potato. They become as vulnerable as men. There is a disturbing trend—more women are smoking now. That will have an impact in the future.

Q. What is your average day like?
DS. I get up at 5am, exercise and come to work very early. Mobile phones have really improved our productivity, so I do most of my dictation and communication in the car. I reach here, then spend about an hour with management. Then I start with the outpatients. I see at least 50 to 60 patients a day either personally or through video-conferencing. Then I do at least one or two heart operations. I work for at least 15 to 16 hours.

Q. Is it stressful?
DS. Never. I really enjoy it.

Callout: I learnt from Mother Teresa that love is more powerful than any lethal weapon.