Interviewer: Mohan Bhusal

Crew members: Biswaraj Tharu, Abhishek Thakur, Pragya Acharya

 

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“Born in a small village of Palpa in 2017 B.S, Prof. Dr. Bhagawan Koirala is an eminent cardiac surgeon and a proficient administrator. He has served in the health sector of Nepal for years and is one of the pioneers in establishing Cardio-thoracic surgery in Nepal. We feel honored in presenting ups and downs of his inspiring life. We believe his path to success will be a source of motivation for the novice medicos…”

 

Q. Sir, How would you like to introduce yourself?

Well, I am a professor of the Institute Of Medicine and a cardiac-surgeon.

Q. Would you like to tell us about your childhood days, your upbringing?

I am from a middle class family. We had enough to eat but we weren’t that rich. In short, my upbringing wasn’t that difficult.

Q. Tell us something about your schooling.

Up to grade eight, I did my schooling in my own village in Palpa.  I was among the toppers but in SLC, I got high second division only.

Q. Could you tell us something about your post SLC days?

After my SLC, I got admitted in Health assistant (HA) program at IOM. The first semester was very herculean for me because I was from an ordinary government school .I was fifth among the five students who passed in the first semester. From the second semester, I transformed. I have no explanation how that physiology worked but it happened. I started to become interested in studies and everything became easy for me. What I would like to tell here is, your mindset determines everything: confidence and positive attitude helps you achieve what may seem impossible.

 

Q. What inspired you to be a doctor?

During the third semester, Dr. Govinda Sharma inspired me to pursue medicine as a career and that too in the cardiac field.

Q. Could you please tell us something about your life as an MBBS student?

Being a topper of HA, I should have been selected for Dhaka Scholarship but I was not. I became frustrated and began doubting the system that prevailed in our country. A few months later, I was selected for Soviet Union Scholarship and I went to Ukraine to pursue my MBBS.

During my first one and half years, I had to take regular Latin and Russian language courses. Luckily, despite the political background in the then Soviet Union, my teachers were good enough. They supported good students irrespective of their political views (that doesn’t mean I was in politics). I used to play badminton and represent my college. Once we got terribly beaten by national players (ha ha!!). I was also appointed as a foreign student representative.

From third year onwards, I used to go to hospital regularly. As I had a good command of language, I could communicate with teachers and patients well. During surgery postings, I was so interested that I used to do night duty every alternate day, not because I had to but because I wanted to. I wanted to do some extra work in surgery.

I used to read 2-3 hours everyday (1hour at night and 2 hours in trolley bus while commuting). I was very attentive in class. The teaching-learning activity there was so designed that you had to attend daily seminars and presentations, question and answer sessions. Every few weeks, there used to be Internal Assessment, so learning was spontaneous. You didn’t have to put much effort; few hours of study everyday would suffice.

Q. Could you please share your experiences as a PG student?

After I graduated, I came to Nepal and worked as House-officer in Emergency as well as Surgery at TUTH for two years. Then I went to Dhaka to pursue my post-graduation. PG in Dhaka was considered to be and is still supposed to be one of the tough courses. First semester was the basic science. I enrolled late and the semester exam was just after three months. Despite the high failure rate, I passed the exam. The notion among students was that; in a place like Bangladesh, this guy could pass the exam being there only for three months, so he must be a genius. That was a big boost and that changed the whole scenario. In Bangladesh, I had hard times as well. Students had complexities among themselves; people pulled your legs so that you wouldn’t perform well. If you were inclined to one professor, other will chase you to death. Somehow I could float by striking a balance among students and teachers. By the time I was in third phase, I was pretty settled in the sense that I was considered a good student. One religiously inclined teacher oppressed me by telling that I haven’t learned ICU.  He sent me to ICU back from operation room. I worked so hard there that; when anesthetists had trouble, they used to call me. The same professor used to tell me; could you please help me with this patient?  Interesting thing is: by the end of my MS, he assigned me to take classes for his MS students. Finally I had an easy exit because whichever teacher tried to fail me, he would be pointed out.

Q. What difficulties did you face while pursuing your career?

Not much of difficulty except for lodging, fooding, that also for a transient period.

Q. When and how did your professional life start?

When I returned from Dhaka there was no real set up for Cardiac-surgery in TUTH. But I always thought TUTH as my workplace because I was interested in interacting with people and doing academic activities. It took nearly two years to setup Cardiac-surgery in TUTH. Govinda Sharma (the then HOD), Prakash Sayami, BM Singh were already working in TUTH. We started open heart surgery in TUTH in February 1997. In July 1998, I got accepted for an accredited residency program in US. Shortly, I requested to change it to a non-accredited Cardiac surgery fellowship so that I could get back to my country as soon as possible. I didn’t care about the accreditation in US. I just needed training and experience. From there, I went for fellowship in Children’s heart Surgery in Toronto. I came back to Nepal in 2001.  I tried to strengthen our program in TUTH, I wasn’t in a mood to go to Gangalal Hospital. I just wanted to work as a surgeon not as an administrator. But things didn’t work then.

Lots of things in my life have come as blessings in disguise. Had they provided me only two OT’s per week, I was never in a mood to go to other place. Unfortunate or fortunate, I don’t know, the institute didn’t support me. I had no choice left, but to accept the directorship of Gangalal. My career was attached to Gangalal’s success. If Gangalal didn’t work, my career would shatter. So, I put on all my efforts and it worked finally but I always continued to support TUTH programs.

Q. How is your daily routine being a professional?

For the last ten years, my routine is pretty similar. I wake up at 6-6:30 am and go for sports for an hour. Even if I operate whole night and finish at 6 am, I go to court and play. That makes me fresh. Then I start my professional life with patients (OPD or OT); I have no window of free time even a single day. I usually finish by 5-6 pm but when I operate in Gangalal, it goes around 7, 8 or even 9 pm. By the time I finish rounds, it’s around 10 pm. I usually return home at around 10-11 pm, anytime before that is an early return for my family.

Q. Sir, could you please tell us what your interests are?

I love sports, mainly badminton, tennis and golf. I play badminton regularly. I love listening to music but I am poor at sense of music and arts.

Books: I don’t read much of stuffs other than my subject. As a student, I used to read novels but now,  I enjoy newspapers.

Movies: In the last 10 years, I have watched only one movie in the theatre; 3 Idiots(a big laugh). I loved the movie.

Novels: I like those that are more socially oriented, reality based or responsible type. I’m not interested in fictions and I haven’t read much Nepali novels.

Q. When was the last time you took vacation for family?

Not usually, but if everything goes fine (condition of patients is stable), on Fridays, I once in a while go for an outing and return by Saturday evening.

Q. How do you spend your holidays and weekends?

Except on weekends I don’t have a window of free time. During weekends, I take rounds in TUTH and Gangalal, and then I go for golf with my son and spend half a day there.

Q. How many members do you have in your family?

We are altogether five, my father, mother, wife, son and myself. We moved to our home in Dhumbarahi last year only. Before that, I used to live in hospital apartment.

 

Q. When did you first met ma’am? Was the marriage arranged or love type?

Well…(smiles) It was an arranged marriage. I was already enrolled in MS, when one of my relatives told me of a girl who was good and blah blah…

I talked to her; liked her and her ideas. No commitments were made at that time. So initially, it was a family organized meeting. We married two years later when I returned from Dhaka. She is a zoology teacher by profession.

 

 Q. What are the qualities you think are needed in a good person?

A: I think you have to get back to basics. For short term success, you can get away with anything. There are some basic human qualities one must possess to become successful in the long run. First and foremost, always be honest. You shouldn’t lie, though it’s difficult to live in this world without lying. But if you agree to suffer for the time being for the sake of being honest, you will be paid.

Secondly, you got to be really professional; meaning professional conduct, ethics, principles which are universal. What a surgeon does in America or Europe or Russia is pretty similar to what we do in Nepal and vice versa. We need to follow that. “You can not change science for the sake of making your practice convenient”.

I choose to be unpopular at the start being straight forward rather than fabricating things and being infamous ultimately. And to have this stance does not mean you have evil intentions within you.

Q: How successful do you take your life?

A: Well I am very happy with what I have done. Indeed I am very happy from the background that I came. I could serve many people. Frankly speaking, to find people trust you is great. That gives you the most satisfaction but it is also very difficult to keep up these expectations.

Q: Any terrible mistakes that you have made; that taught you a lesson?

A: I think I have made a lotttttttt… of mistakes in my life. The only thing I need to say is that I have never ever deliberately or selfishly made one. Sometimes I think, the way I did things were probably not right. Take for example my professional conducts, presentations, communication with my subordinates and seniors. I think I could have better ways to deal with those issues. But how, I don’t know.

Rapid fire

Happiest moment in life

Uhm uhm…A single moment does not stand out but…

–          Well may be for Nepal, starting the 1st open heart surgery successfully made me so happy. I think that stands out more than rest of the things.

Q. A habit that you like the most about yourself

Ahem Ahem…I think I am optimistic and I fulfill what I commit.

Q. A habit that you don’t like about yourself

I react quickly.

Q. The most difficult operation

There used to be instances where we used to start in the day time and then finish up next morning. The patient would not come off by-pass; stood whole night under pump, on the table and the worse thing would be you couldn’t not save the patient. These difficulties you will forget if the patient does well. We have done a number of big operations. If I have to cite one, that would be the one with Ascending Aortic Dissection in an eight-month pregnant woman. The surgery took 14-15 hours.

Q. The longest operation

In a routine time you don’t have to spend more than 7-8 hours.

For a single case, I have been stuck for 24 hours. Recently I was there operating non-stop for 30 hours in Sahid Gangalal. On Saturday  around 2 pm, I had an emergency call and an operation. Right after I finished the case, I was getting out of the ICU when I received a call that there was a young man with Ascending Aortic Dissection, about to rupture. We were quickly back to the theatre, started the case at 10 pm and then by the time we finished, it was 8 o’clock in the morning. The same day, there were five big regular OT cases and I had to do all cases myself. I didn’t want them cancelled because in cancelling, it would be a big hassle. So we had to go on till 9-10 pm Sunday. That was really exhausting.

Your source of energy

Two sources: One is the drive, the urge that you have to do it right, then you would think about the outcome that changes not only an individual’s lives but also of family’s.

Secondly, now it becomes your habit to make sure that what you do gets right. You can’t take it casually because if you don’t get it right; people die. For all of this, you need to be physically fit.

How long do you usually sleep?

Sometimes I don’t sleep; sometimes an hour or two but then in a normal comfortable night I would like to sleep 6 hours.

Inspiring personality

I had asked myself this question too many times but unfortunately I have no single role model. I have lot of inspiring teachers. I tried to copy best aspects of them; best qualities of them. I also don’t think myself having perfect qualities in all sense. But there are few good things in me. What we have to do is try to take the best of everyone and learn from them. I have lots of teachers who I envy and love to copy but they had some difficulty in their personal life. So I think it is unwise to exemplify them as role model.

Best politician

I can’t name that because as soon as I name, that sticks a political label on me. Though I like one personality each from the three major political parties, I can’t reveal here in public (hee hee!!)

Music

I used to listen to old songs only. As I grew old, I have developed variety of tastes, even dyangg dyangg- dungg dungg (laughs)

Favorite singer

Shakira, Shania Twain, Celine Dion, Narayan Gopal. In Nepal, these new upcoming singers are great. I like their songs; Rajesh Payal, Satya and Swaroop Raj Acharaya, Amrit gurung, Anju Panta and others.

Favorite place

I like Pokhara. I don’t particularly like Kathmandu because it’s crowded and polluted.

 

Being a doctor, what do you think you achieved the most?

Respect, Trust

 

What is medicine to you- passion or profession?

Both

Have you ever thought of getting involved in Politics?

Yes. After 65 (ha ha!!)

VIEWS

Q. Have you heard/known of Readers’ Club (RC)?

Yes. I have seen its posters and pamphlets

Q. What do you say about students getting involved in this sort of activities?

I always say that our students are a bit lacking in extra-curricular activities. So I think this is really important and you people are doing a great job.

Q. What do you say about student politics in IOM?

I have seen three generations of politics in IOM. And from my observation, most activists here have personal motives and vested interests. If these are removed, I would be very comfortable with politics.

Q. What would be your priorities for the institute if you were the Dean of IOM?

Either I will fix it or get out within six months. I would firstly enforce discipline; secondly inject professionalism, provide better working environment, better infrastructure. I will increase indirect incentives. Overall, I will try to increase the quality of service, research and teaching.

Q. How would you see IOM 10 years down the line?

Let’s say at present we are at the cross-roads. If rightly handled, it has a great potential to be one of the finest institutes in South-Asia. If not, it will just be a mediocre public institute of the country.

Q. How do you compare IOM with the institutions you have studied?

Ours is better than Bangladesh. We have good faculties, finest students and good infrastructures. This combination here is somehow not working to the optimum. In Ukraine, we had 59 departments, thousands of beds and it was established in 1805 AD so it’s not that easy for us to reach there very soon. The institutes in the US and Canada were one of the finest in the world, so I can’t compare but from them we can learn a lot of things for ourselves.

Q. In your opinion, how should our health policy be like?

Our new health policy should focus on both essential health care and specialized care; work on both communicable and non-communicable diseases.

Q. Is politics the only obstacle for Nepal not progressing in this 21st century?

Yes, but not only. Professionals and bureaucrats have not lived up to public expectations. A topographically challenging country like ours will remain in this state for the time being, it’s not that easy to make a leaping progress…

 

Q. What do you say about the Increasing USMLE trend after MBBS, whilst there is lack of doctors in the periphery?

There should be a clear-cut policy prior to enrollment in MBBS. Policy like 1or 2 years work in the periphery after MBBS would be a significant contribution to the nation.

Q. In recent times, there has been upsurge of instances where doctors have been assaulted by patient parties. How do you take that?

Yes, I agree with the fact that there are incidences of anarchy and violent activities prevailing in our society but it is at such situations where your honesty and dedication pay, where your professional conduct and communication skills matter.

Q. What do you want to see your child become- a doctor or something else?

You see my son is in grade 10 and he is very mature for his age. I have never ever talked about his career but he says, “I would be anything but doctor”. Lately I have developed a selfish feeling that one day my son would recognize   my work and would follow me. But I will always support him in whatever (good) he wants to do.

 

Q. Message to young generation

  • Those who think are weak, be it in study, be it in any field, you don’t have to worry. It is all in your mindset; you just have to be confident and believe in yourself.  Everything will be fine then.
  • Get back to basics; this is how country is going to progress and so will we.
  • Always be honest to yourself.
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