As a heart surgeon, I ask my patients,
“If you had to choose between living in fear and misery for the rest of your life or facing your challenges head-on with the possibility of improvement, which path would you opt for?”
Surgeons belong to the discipline of medical professionals who play a pivotal role in preserving and enhancing the lives of countless individuals. While the outcomes of medical treatments can be favorable, the journey to success, especially in heart surgery, is often characterized by challenges that evoke fear. It is a universal truth that every physician harbors a strong desire to assist patients in their journey toward health and recovery. Nevertheless, it is essential to underscore the indispensable role of patient cooperation in achieving these positive outcomes.
In this article, Dr Pradistchai Chaiseri, a seasoned cardiovascular thoracic surgeon, shares his insights and experiences, shedding light on the profound commitment he has dedicated to the field of heart surgery throughout his life.
Fascinated by the inner workings of the operating room, I chose to be a heart surgeon.
When questioned about his journey to becoming a heart surgeon and his experiences in the field, Dr Pradistchai recounted that getting accepted to medical school was often regarded as the pinnacle of academic achievement, held in high esteem by numerous families. At that juncture, Dr Pradistchai did not possess a particular passion or preference. Although he harbored an interest in engineering, he ultimately gained admission to the Faculty of Medicine at Mahidol University, which happened to be his first choice on his university entrance list.
“My fascination with surgery began when I had the opportunity to step into an operating room. The OR was a captivating place, with a bright center surrounded by dimmer surroundings. In this environment, surgeons meticulously followed step-by-step procedures, transforming themselves from professors in regular attire to professionals in green surgical gowns. It felt like entering a whole new world. During one fortunate day as an observer in the OR, I witnessed a real-life heart surgery. I even had the privilege of scrubbing in and closely observing the procedure. As I gazed at the beating heart, I could not help asking my professor if I could touch it. The moment I contacted the heart, I was utterly captivated.”
“During this period, I also had the opportunity to learn from a skilled heart surgeon, Dr M.R. Kalyanakit Kitiyakara, who served as a faculty member in cardiothoracic surgery at Ramathibodi Hospital.”
“One particular case that remains vivid in my memory involved a patient with an aneurysm. In the course of the operation, the surgeon temporarily halted the heart activity and disconnected the heart-lung machine, essentially rendering the patient in a state resembling death. Doctors sustained life through controlled hypothermia for approximately 30-40 minutes until they finished the surgery. However, when restoring normal bodily functions, an unexpected bleeding occurred. In response, the surgeon decided to stop the heart for a second time to address the issue. Miraculously, the patient not only survived but thrived. That surgery left an indelible mark on me, and it was on that day that I resolved to pursue a career as a heart surgeon.”
After his experience as an observer in the operating room, where he witnessed the meticulous control and coordination by the surgeon and the seamless teamwork of all those involved in surgical procedures, Dr Pradistchai resolved to pursue a residency in cardiothoracic surgery. Despite facing numerous challenges, his career began to take shape after completing his internship. Dr Pradistchai's journey led him to the Central Chest Institute of Thailand, where he seized opportunities to receive further training and gain hands-on experience in performing actual heart surgeries. It was a journey that spanned several years; through dedication and hard work, he ultimately emerged as one of the most accomplished and respected heart surgeons in the Thai medical community, marked by his outstanding achievements.
“In my early days as a fledgling heart surgeon, it was customary for me to monitor my patient closely after the surgery. During that period at the Central Chest Institute of Thailand, my patient load was not particularly high, allowing me to devote my full attention and efforts to each of my surgery patients. For patients without postoperative complications, I would occasionally step out to tend to other matters before returning to their rooms. However, for patients who had undergone particularly challenging procedures, I would remain at their bedside. It was not uncommon for patients to comment that upon awakening, I was already there by their side.”
Understanding the role of a cardiothoracic surgeon
Treatment options for individuals with heart disease typically encompass medications, angioplasty, and surgical procedures. The choice of the most appropriate treatment modality hinges on the type of heart disease, its stage, and the accompanying symptoms. The various stages of the disease necessitate different treatment approaches, with surgery being considered a final recourse. Historically, the mortality rate associated with heart surgery was a daunting fifty percent. However, in the present day, this rate has dramatically plummeted to less than 5 percent, signifying a considerably low mortality rate.
“Once, we had a patient arrive with a cardiac arrest, requiring immediate CPR as we rushed the patient into the operating room. In the end, we performed a challenging operation that successfully saved the patient’s life. While it was a formidable undertaking, the patient ultimately emerged from surgery safely.”
“Many patients who undergo heart surgery have previously endured severe fatigue. However, after the surgery, their conditions and quality of life remarkably improved. I distinctly recall one patient who, 20 years later, attested that his heart was still in excellent condition. He candidly shared that, without my assistance, he might not have survived. His condition had been so dire that it had rendered him incapable of leading a typical life. Such experiences reinforce my realization that the work I do is truly life-changing, and I take immense pride in it.”
Dr Pradistchai's approach to handling complex and challenging cases involves providing patients with a comprehensive explanation. He ensures that patients understand the reasons for the necessity of surgery, imparts accurate information about what to anticipate during the surgical procedure, discusses potential risks, and outlines possible complications. This open and informative communication is a fundamental part of his patient care philosophy.
“You are facing a challenging cliff, and I understand it is not something you would willingly choose to climb. But if you are currently at the bottom and aspire to reach the top, then climbing that cliff becomes a necessary step. The choice is between overcoming fear and temporary hardship for the possibility of an improved condition or living with fear and suffering for the rest of your life.”
Teamwork is another crucial element in the success of heart surgery. A robust, well-coordinated team can streamline the process and enhance overall performance. Dr Pradistchai takes a proactive approach by thoroughly explaining the procedure to his team members, enabling them to become proficient and work harmoniously together.
“In the case of an elderly patient with chronic illness and a high risk of mortality, the role of the surgeon is to prepare both the patient and our medical staff as thoroughly as possible. This preparation includes caution to minimize the potential for errors, ensuring that everyone involved is as prepared as they could be.”
The heart, if abnormal even in the slightest way, should receive prompt attention.
Heart surgeons frequently stress that once the symptoms of heart disease emerge, they indicate the disease has already progressed to an advanced stage. Many may underestimate the significance of symptoms such as fatigue and mild chest pain. However, these can serve as a canary in the coal mine of underlying heart issues. Consultation with specialists can lead to a prompt diagnosis and straightforward treatment.
“Some individuals present with abdominal pain, but an ECG test reveals abnormalities, leading to a diagnosis of heart disease or coronary artery disease, which may require angioplasty or surgery. Some individuals may initially be unconvinced and refuse to accept, believing their symptoms to be related to a stomach ailment. At times, symptoms of heart disease manifest in unexpected ways, such as back pain, abdominal discomfort, or abdominal distention. Some may have initially thought they had acid reflux and pursued treatment along that line, only to find no improvement. Subsequent comprehensive physical examinations reveal instead a diagnosis of ischemic heart disease.”
Today, various methods are available for heart screenings, each serving specific purposes. These methods encompass a standard ECG test, chest X-ray, blood tests, echocardiography for detecting heart and heart valve abnormalities, a stress test involving treadmill walking to assess heart function, and CT coronary calcium scoring to evaluate calcium deposits in the heart arteries. In cases requiring more detailed information, angiography may become necessary. After a screening test, the doctor will assess whether the most suitable treatment involves medications, angioplasty, or surgery.
A surgeon dedicated to heart surgery
Dr Pradistchai's leisure activities are refreshingly straightforward, in contrast to his lifelong dedication to heart surgery and patient care. Amidst his demanding schedule, his relaxation ritual revolves around watching sports.
“I enjoy watching various sports, including American football, rugby, soccer, badminton, table tennis, and volleyball. I not only appreciate the games but also relish analyzing them. Even with something as specific as ice skating, continued watching allows you to grasp the compulsory poses and discern whether a skater executes them correctly.”
In essence, Dr Pradistchai gravitates toward pursuits he can scrutinize, delve into, and comprehend deeply.
“I am deeply committed to giving my best in whatever task is at hand because I hold a strong regard for precision. When I am suturing a wound, perfection is at the forefront of my mind. I persist until I am content with the result, always mindful of how to improve the next time.”
Dr Pradistchai's penchant for delving deeply into his work and employing a range of techniques right from the outset likely contributes to his proficiency in surgery.
“For those who sense bodily irregularities, especially if you readily experience fatigue, it is unwise to assume you are fine. Even if you are as fit as an athlete or possess robust muscle strength, you could be oblivious to plaque accumulation in your coronary arteries or whether the heart valves are functioning properly. Neglecting these signs until they worsen and impact your daily life is ill-advised. You should get a comprehensive heart checkup. It is crucial to recognize that the disease exists and will manifest itself sooner or later.”
To mitigate the risk of heart disease, Dr Pradistchai advises regular exercise, avoiding the consumption of fatty foods, refraining from smoking, managing stress, and maintaining healthy levels of blood sugar, blood pressure, and cholesterol. Above all, he underscores the importance of routine health checkups and self-monitoring. If you notice any unusual symptoms, consultation with a specialist is paramount.
