A Neurosurgery In Delhi-A Tale of Two Hospitals

A couple of weeks ago an old friend of mine called from Indore. His father in law, who was visiting his family in the US has had a seizure. His wife had rushed him to a local hospital, where they found a large tumour in his brain. The tumour measuring more than 5 cms was likely to be benign. The patient, a sprightly 68 years old has never had any illness, has never seen the inside of a hospital and the family was very concerned about this sudden turn of events.

Now I have known Asit for a long time. We went to school together. After the school got over we drifted apart. Asit migrated to the US, while I settled down in Delhi. We lost touch with each other till we found ourselves connected over the wired world of e-mails and the ubiquitous Facebook. Asit subsequently started a yahoo group and many of us got in touch with each other after almost 20 years.

Asit over the phone sounded very worried. He was in India on work, his in-laws were in the US with his wife (their daughter) and a medical crisis was facing them. His father in law has been recommended surgery and Asit wanted to know everything about the tumour, the treatment options, the hospitals in India, where the surgery could be done, the prognosis post surgery, the mortality rates and who were the best neurosurgeon whom he could get an opinion from. I recall I was in Mumbai when Asit spoke with me first and I promised all possible help.

Asit, soon had his wife send me the patient’s scans and reports from the US. On Asit’s request I met a neuro-surgeon in the Lilavati hospital in Mumbai. The surgeon gave me time in the evening and explained about the surgery. However, this surgeon for some reason did not inspire trust. He seemed almost bored through out our interactions, it was as if I was a smart alecky patient attendant and he the big reluctant surgeon, doing me a great favour by discussing the impending surgery.

On my return to Delhi, I set up a meeting with Dr. Ajeya Jha, the chief of neuro surgery at the newly opened Medanta Medicity in Gurgaon. I have known Dr. Jha from my days at Max Healthcare,where he was the chairperson of the Institute of Neuro Surgery. Dr. Jha, went through the reports and the scans, confirmed that the patient had no choice except surgery and answered all my questions patiently. He was happy to speak with Asit over the phone and allay his apprehensions as well. He also assured Asit that the surgery in India at Medicity was as safe as any where else in the world.

In the meanwhile Asit’s wife Sudha sought a medical opinion at Stanford in the US. She met with the doctors in the US, and discussed the option of surgery in India. They were reassured that surgery in India was a safe option and the outcome was expected to be just as good as any centre in the US.

Now that we were making progress I requested Asit to travel to Delhi to meet Dr. Jha. I also told him that, while in Delhi he must also meet at least one more neuro-surgeon so that he can exercise choice. I made enquiries and was referred to Dr. Rana Patir, the chief of neurosurgery at Max Healthcare.

On March 31st, the patient landed in Delhi. Asit too arrived from Indore and in the afternoon we met Dr. Jha at the Medicity. Asit was very impressed with the hospital. It looked almost as good as any hospital that he had seen in the US. Dr. Jha spent an hour with Asit and his close relatives who had also arrived in Delhi for the surgery. They bombarded Dr. Jha with questions, which he answered patiently, explained in great detail about the surgery, the odds of complete recover (95%), partial recovery (99%) and mortality 1%. He drew diagrams to explain the situation. Not once did he sound either overconfident or tentative. Dr. Jha laid it out as it was, yet inspired confidence in his and his team’s skills.

After our meeting with Dr. Jha, we drove to Max for an appointment with Dr. Patir, which was fixed for 6 in the evening. On reaching the hospital we were informed that Dr. Patir was in surgery and would see us in 15 mins. We waited outside his OPD amongst a bunch of patients, apparently all waiting for him. Our wait grew from 15 mins to almost 2 hours, and there was no sign of Dr. Patir. I called up the hospital administrator, who is a friend of mine from our days together at Max. He too was acutely embarrassed and advised me to write a complaint and promised to raise the matter internally.

Finally as we were about to leave in disgust, Dr Patir sauntered in. A wild rush amongst those waiting outside his office to meet him ensued. After about 2.5 hours of waiting we were ushered in to meet Dr. Patir. He too went through all the reports, answered all our questions, gave us time and the same kind of odds that Dr. Jha had given. Since, I had to return to work and I had been delayed waiting for Dr. Patir, I left Asit, while they were still Dr. Patir.

The next day Asit called me up. They had decided to have the surgery at the Medicity. He felt more comfortable with Dr. Jha, who had given them more time and treated them with great courtesy (not that Dr. Patir was rude, he just felt Dr. Patir was too busy). Asit also felt that Dr. Jha appeared more keen on treating his father in law, had given them personalised attention and had been very honest and forthright with them.

Mr. Jain underwent successful surgery at Medicity two days later and made a quick recovery. The cost of surgery in the US was approx. USD 160000 after the factoring in all the discounts that Asit was entitled to. At Medicity the cost was less than USD 15000.

As far as Max is concerned, they lost a patient to a newly opened rival because Asit did not have enough patience to put up with Dr. Patir (who by all accounts is a very good surgeon) and Medicity honestly tried a lot harder.

I have the changed the names of the patient and his relatives to protect their privacy