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        Dr Henry E Sigerist, MD in his classic work,Great Doctors, A Biographical History of Medicine, wrote these lines about great doctors : Bach and Mozart would be dead for ever, where it not for the living artists who are perpetually reviving their melodies. Pasture and Koch would have lived in vain but for the every day practitioners through whose activities their teachings are made effective. It is not so much the great theoreticians upon whom the health of the community depends, as the huge army of family doctors who succour the ailing from hour to hour. These thoughts came to my mind when I recently interviewed a young, dynamic and innovative cardiac surgeon Dr Mohan Thanikachalam who has recently returned from US to work in the CMC Hospital, Vellore.
 

Dr Mohan  Thanikachalam

What is Cardiovascular surgery? It is the surgical speciality that is concerned with the heart and major blood vessels of the chest. It means surgery or procedure involving the heart or blood vessels. Dr Mohan Thanikachalam is a fully trained Cardiovascular Surgeon in every sense of the word.         Born on 25 February , 1967, Dr Mohan Thanikachalam passed out of Madras Christian College School in 1984. He joined Kasturba Medical College, Manipal, Mangalore University in 1985 to do medicine and took his MBBS degree in 1992. He recalls with special pride his happy days as a medical student at Manipal. He told me that he had very dedicated teachers who were totally involved in teaching without being lured by private practice. There was a very close and living contact between the teachers and the students at Manipal. The academic environment was very congenial to the process of serious learning and research.         He served as Special Trainee in the Department of Surgery, Sri Ramachandra Hospital, Sri Ramachandra University from 1992 to 1993. Dr.Mohan Thanikachalam recalls with nostalgia and affection the instruction and guidance he received from Professor Gnanaprakasam who was the Head of the Department of Surgery in Sri Ramachandra Hospital at that time. Simultaneously during 1993, Dr Mohan Thanikachalam also served as Surgical Research Assistant, Department of Surgery, Madras Medical College, Madras University. During this period, he took a firm decision to stick to the field of surgery in his future medical career.

        Dr Mohan Thanikachalam took the examination conducted by Education Commission For Foreign Medical Graduates (ECFMG) in the United States and qualified himself to serve as a Transitional Intern at Carney Hospital, Boston University School of Medicine in 1993 - 1994. One day when he was writing the case sheet of a patient, Prof Dr Mitchel Carrol who was the Chief Surgeon in Carney Hospital, spoke to him and said, 'Dr Mohan, you should be a surgeon. Don't let anybody else change your mind'.

        Dr Mohan Thanikachalam told me: 'Those words of Dr Mitchel Carrol continue to echo in my mind even today. They continue to serve as my guiding spirit as a cardiac surgeon today. Prof Dr Mitchel Carrol really touched my heart and life. At that time it was practically impossible to do surgery in US as a foreigner. It was because of Prof Dr Mitchel Carrol that I was able to go ahead in the field of surgery—particularly cardiac surgery'.

        Dr Mohan Thanikachalam recalls another incident with great poignancy. When he was working in Carney Hospital in Boston, he contracted TB and he was thrown out of the hospital by the concerned authorities. An old Scottish lady called Millecent Lont , then 70 years old, and with whom he was staying as paying guest, nursed him back to recovery with great dedication and affection. He recalls with gratitude, nostalgia and affection and says, 'she only nursed me back to recovery and normal health and thus saved my life'. Soon after his recovery from TB attack, Prof Dr Mitchel Carrol fought on behalf of Dr Mohan Thanikachalam against the hospital authorities and saw to it that he was reinstated as surgeon. Such man-building leaders in the field of medicine are rare in India.'

        It was Prof Dr Mitchel Carrol who again in 1994 recommended the appointment Dr Mohan Thanikachalam as a Resident Doctor in the Department of Surgery at St Elizabeth's Medical Centre in the famous TUFTS UNIVERSITY SCHOOL OF MEDICINE IN BOSTON. Alongside his surgical work, he also pursued a Post Graduate Course for American Board Certificate of General Surgeon from 1994 to 1998. In 1998-99 he served as Chief Resident in the same hospital. By his tireless exertions and dedicated work as a Surgeon in the St Elizabeth's Medical Centre, Boston, Dr Thanikachalam became an institution there by himself at a very young age.

        It is not therefore surprising that he was one among the five outstanding heart surgeons selected by the American Heart Foundation in 1999 to work as Research Fellow in the Department of Surgery, University of Miami. Dr Mohan Thanikachalam served as a Research Fellow for three years from 1999 to 2002. He told me : 'I was inspired by Jeffery Isner, the famous cardiologist who was the first person in the world to do Gene Therapy. I did research on the subject 'The Role of p53 in Vascular Proliferative Disease'. In 2002 he became a full fledged Resident Surgeon in the Division of Cardiothoracic Surgery, Department of Surgery, University of Miami.

        During this tenure in Miami, he worked under Dr Thomas Salerno, Chief Cardiac Surgeon and Dr Si Pham. Under their guidance, Dr Thanikachalam gained unmatched expertise in the field of Off-Pump By-pass Surgery. Together they performed 500 operations in two years. Dr Salerno taught him how to feel through his head and think through his heart while treating any patient by way of clinical examination or any surgical procedure. Dr Salerno, apart from being an outstanding heart surgeon, was also a great humanist.

        After having worked for almost 11 years in United States from 1993 to 2004, Dr Mohan Thanikachalam went to England in 2004 with the determined objective of learning what he calls 'Different medical systems'. He served as a Senior Fellow, Heart and Lung Transpalntation at the Cambridge University Heart Hospital (Papworth Hospital) in England from 2004 to 2005. He worked under the chief cardiologist Dr Steven Tsui and cardiologist Dr Wallwork. Under their guidance and supervision, he mastered the technique of heart and lung transplants. Dr Mohan Thanikachalam did more than 500 heart and lung transplants during his tenure in Cambridge University. During his stay in UK, he also participated in the International Fellowship Programme of the Royal College of Surgeons of England. He told me that in terms of surgical treatment, there is not much of a difference between US and England in the field of heart medicine. But there are vast differences in the systems of total health care between England and America. 'In England you have a National Health System and it is more holistic than in America. However, in terms of total resources, power, technology, innovation etc in the field of cardiac care America is far ahead of England.'

In 2005, THE AMERICAN BOARD OF THORACIC SURGERY awarded its Certification to Dr Mohan Thanikachalam. After studying, learning and serving in America and England from 1993 to 2005, he returned to Tamil Nadu to serve as a Lead Surgeon and Consultant Cardiothoracic Surgeon, Division of Heart Transplantation, Christian Medical College at Vellore.         Dr Mohan Thanikachalam is associated with leading professional bodies in the field Cardio Thoracic Surgery in the United States like American College of Surgeons, and other parallel organisations. He has contributed many research papers and articles of outstanding merit to professional journals like Journal of Cardiac Surgery, Journal of Surgical Research etc. Apart from being an outstanding surgeon, he is also currently working as PRINCIPAL INVESTIGATOR in the following two major research projects fully funded by The Thoracic Surgery Foundation For Research and Education in USA :         A. The Role of p53 in the Nitric Oxide Synthase-Mediated Inhibition of Cardiac Allograft Vasculopathy (CAV)         B. The Role of p53 in Allograft Vasculopathy

Millecent Lont

        Dr.Mohan Thanikachalam is of the view that Government in India should concern itself more with providing basic preventive and curative medical care to the poor millions of India. As regards specialist services, government should subsidise the private institutions in the field of specialist care when they treat patients below the poverty line.

        Dr Mohan Thanikachalam is very quiet and unassuming. He talks more about his favourite subject than about himself. He passionately believes in professionalism in his chosen field of Cardiothoracic Surgery. He is a man of deep conviction which he holds with clarity and a kind of tranquil passion. He has a boyish sweetness of disposition and a genuine hatred of all forms sentimentality and humbug. His attitude towards the great world of thoracic surgery is indeed balanced and harmonious.

        To conclude, Dr Mohan Thanikachalam seems to tell all of us on behalf of all his fellow surgeons, 'we are only entitled to operate when there are reasonable chances of success. To use the knife when these chances are lacking is to prostitute the splendid art and science if cardiac surgery, and to render it suspect among the common people and even among one's colleagues in the same profession. We have to ask ourselves, then, by what standard we can measure the chances of success. We shall learn them through the indefatigable study of our science, through shrewd criticism of our own and others' observations, through careful consideration of individual cases, and through the meticulous appraisement of our results. Operative surgery should not be solely affective only in the hands of a small number of experts, but should also be teachable to and learnable by the average general surgeon'.