When a heart travelled from Thiruvananthapuram to Ernakulam in 35 minutes

(Dr Jose Chacko Periappuram, who made history by performing the first heart transplant in Kerala, shares experiences that touched his heart. Read Part 1, Part 2, Part 3 and Part 4 of the series.)

The next four or five hours were exciting. By midnight a new heart began to beat inside Achadan. Yes, it was the first heart in Kerala to come flying!

He was a person for whom the whole locality had joined in prayers and was involved in activities to help when his heart was in the final stages of failure and who, according to the doctors, needed a heart transplant to continue to live.

The head of an ordinary family of wife and two children worked hard to support them by driving an autorickshaw. The family's greatest wealth was the relatives and local residents who wished them well and cared for their well-being.

Mathew Achadan had occupied the minds of the people of Kerala then and he does even now, and his wife Bindu personifies humility and love.

Achadan was admitted to Lisie Hospital in Ernakulam in mid-2015. After two weeks of medical attention and tests, we realised that his body would not respond to any treatment and that a heart transplant would be the only solution.

What followed was days of waiting after giving his name to the Kerala Network for Organ Sharing (KNOS). During those days, Achadan and Bindu were supported by a medical aid committee formed by Dali Varghese, a member of Pariyaram panchayat near Chalakudy, and PV Shibu, a school teacher. 

During those months of waiting for a heart, Achadan had to be hospitalised several times for pulmonary obstruction, which caused great concern for him and us doctors. Doubts about whether the heart transplant surgery could be performed on time bothered the team members of the cardiology department as much as the family members.

In those days, there were reports in the media about the dangers of long-distance ambulance travel and the need for air ambulances. There were statements made by the then Chief Minister Oommen Chandy and the then Home Minister Ramesh Chennithala in the media about the dilapidated conditions of roads in Kerala and how they were responsible for the delay in patients getting medical attention.

I got an opportunity to talk to my nephew and naval officer Jacob Tom about getting Navy’s help in situations like this. We talked about Navy helicopters and their availability.

A message from 'Mrithasanjeevani' said that family members had signed the consent form to donate the organs of Neelakanta Sharma, a young lawyer who was brain dead following a brain haemorrhage at Sree Chitra Hospital in Thiruvananthapuram.

The time that would be required to transport the heart from Thiruvananthapuram to Ernakulam in an ambulance by road bothered us. The journey would take about four hours. And then we needed time to remove the failed heart and replace it with the functioning one.

When we realised we would lose about 6-7 hours in this, we started worrying about the chances of the surgery being successful. That was when the thought of seeking the help of the Navy struck.

We then contacted Chief Minister Oommen Chandy through MLA Hibi Eden, and Collector Rajamanikyam and Naval Commander helped with the procedures to arrange for a naval helicopter. The chief minister directed that he should be kept informed about the decision taken irrespective of how late it got at night.

The Navy informed us that helicopters with only one engine would be available and only two people could travel in them. There was the weight of the surgical instruments and the special boxes needed for storing the heart also to be considered. The phone calls continued till late after midnight. A decision was postponed to the next day at the end of discussions that was leading nowhere. We wondered if the life of the heart donor could even be sustained till the organ donation happened.

At 11am the next morning, we received a good news from the Navy. It had decided to provide us a Dornier aircraft that could carry up to six people and all of our equipment and boxes.

The ensuing hours were busy as we made preparations for the surgery. A group of doctors mentally prepared Achadan and his family for the surgery; nurses and technicians prepared equipment and other materials under the guidance of theatre sister Soumya Suneesh and assistant surgeon Raji Ramesh. There was another group that prepared to go to Thiruvananthapuram by ambulance immediately. In addition, there were the then director of the hospital Fr Thomas Vaikkathuparambil and PRO Rajesh who were constantly coordinating with the district administration and the police.

We arrived at the naval air station around noon as per the instructions of Navy PRO Commander Sridhar Warrier. There, under the leadership of Commander Sanjay Gopinath, Lieutenant R Kapoor and Lieutenant Commander Titu Joseph, the Navy arranged for all the assistance we required.

Accompanying me on the Dornier flight were Dr Jacob Abraham, head of the anaesthesia department; Dr Jo Joseph, cardiologist; and Dr Jivesh Thomas, cardiac surgeon. In 35 minutes, the Dornier arrived at the Thiruvananthapuram airport and landed on the runway reserved for the Navy.

Since no one had till then done a surgery in Kerala after transporting an organ by air, we wished that not many people should know about it till the surgery we were preparing for was completed successfully. But when we reached the Sree Chitra Hospital, we were greeted by a large crowd of mediapersons at the entrance.

As we had not directly convinced ourselves if the heart was suitable for Achadhan, we did not want to waste time in interacting with the media. But Dr Noble Gracias of KNOS and Dr Mathew Abraham, a neurosurgeon at Sree Chitra, stopped us politely. They said many of the relatives who had agreed to donate the organs of the person were waiting outside and insisted that we should meet them irrespective of whether we take the organs or not. So, we gave in to the demand and thanked the relatives with the media witnessing it.

In the operating room, we detected excessive levels of calcium in the arteries of the heart to be donated, prompting us to reconsider whether we should take it. But, as per the suggestion of Dr Matthew Abraham, a newly purchased fluoroscopy machine was brought to the operation theatre with the permission of the superintendent and an angiogram was performed on the heart on the spot. We decided to take the heart for Achadan after confirming thus that there was no obstruction in the arteries.

I believe that Dr Mathew's timely intervention may have been the most crucial thing in this event that was to become historic.

We reached the Thiruvananthapuram Airport from Sree Chitra in 13 minutes. From there, the Dornier flight took us to the Kochi naval airport in 35 minutes. As the plane landed, we were able to see a great deal of light and flashes there. There was a long line of journalists there, too.

Along with happiness, we also faced a lot of mental stress. Thinking about how the mission that the people of Kerala were praying for would end made us uneasy.

From the Naval Airport, Lisie Hospital’s ambulance drivers Balachandran and Hanson took us to the hospital in just eight minutes after the MG Road, the busiest road in Kerala, was tuned into a green corridor with the help of the police.

As we passed by, people waved at us and saluted us from the sides of the road, which we felt was a warm welcome being given to us. In those hours, we were in the thoughts and prayers of the people of Kerala.

The next 4-5 hours were exciting — the hours everyone was waiting for. By midnight, a new heart began to beat inside Achadan. A new life that had sprouted spread all over his body through the bloodstream. After a few days in the hospital, Achadan returned home completely healthy.

The state government paid Rs 6 lakh for the use of the Dornier aircraft, as per the decision taken by the then Chief Minister Oommen Chandy.

Eram Group owner Siddique Ahmed had come forward to bear the expenses on Dornier. But as the government paid for the use of the aircraft, Siddique later decided to give the money to Achadan's family.

Achadan’s life that had only a few days left has now entered the sixth year thanks to a sacrifice. He now supports his family by driving auto taxi.

In this case, the organ transplant was made possible by a great show of amity. Neelakanta Sharma's relatives took prayers of lord Ayyappan when his heart left from Sree Chitra. In front of the operating theatre of Lisie Hospital, the prayer that greeted the heart was ‘Heavenly Father’. The one who came forward with financial help for the air ambulance was a Muslim brother. Where else can a greater model of religious harmony be found?

Goodness of many pulsating in Achadan’s heart

“The sight of Dr Jose Chacko Periyappuram rushing into the hospital with the heart that was delivered through the airport by an air ambulance still lingers in my eyes,” said P V Shibu of Chalakudy Pariyarath. “We had strived a lot for that moment. We waited in front of the hospital with bated breath. A lot of patience was involved in getting to that point — from Matthew, the doctor and from us,” Shibu, a neighbour of Matthew Achaton and who was the chairman of the Medical Aid Committee that was formed to help sponsor his medical cost, said.

Shibu said Raising Rs 25 lakh for the transplant was not easy. “There were days when we ran around for it from morning till 10 at night. Some who thought the heart transplant would not succeed discouraged us. But the majority came together to help,” said Shibu, who works as a teacher at St Sebastian's Higher Secondary School in Kuttikkad.

“When we found out that the heart of a man who was brain dead in Thiruvananthapuram would be a match for Mathew, we had only Rs 10-15 lakh in our hands. Besides the Rs 25 lakh required for the treatment, we also had to arrange for the Rs 6 lakh that was required to bring the heart in an air ambulance. And we had to arrange the whole amount in a few hours,” he said. “We called Dr Siddique Ahmed of Eram Group directly. He came forward to pay that amount.”

The next day, the then chief minister Oommen Chandy came to visit Achadan. His announcement that the government would bear the cost of the air ambulance came as a big relief, Shibu said. The money received from Eram was also then used for Achadan’s treatment.

“There were anxious moments even after the surgery. During those days, my wife and I would go to Matthew's house and talk to him to give him courage,” he said.

The untiring work of 30 good men of Pariyaram and the goodness of the doctor is what is pulsating in the form of Mathew Achadan's heart, he said.

The whole place was with him

Mathew Achadan's heart surgery was a result of the goodness of Pariyaram also, said Daly Varghese, former member of 15th ward of Pariyaram panchayat.

After we realised the treatment would cost a lot of money, the first meeting of the aid committee was held at my house. Thirty people attended the meeting. Despite the discussion being on a topic like heart transplant, Rs 50,000 was collected in that single meeting itself. When we went to Dr Jose Chacko Periappuram, he was amazed to hear how much the locals cared for Achadan.

The doctor told us as a warning that it would cost Rs 6 lakh to bring the heart in an air ambulance and that the amount would go waste if the surgery was not successful. We were unanimous in saying that the doctor should proceed with the treatment. It was a testament to the fact that people are always willing to stand by a good cause.