HIGH-TECH LIFELINE

Dr ANIL GANDHI

Transforming lives through transplantS

HIGH-TECH LIFELINE

©Inking Innovations, 2014

First Edition : 20 March 2014

Dr. Anil GandhiGandhi Hospital250, C/8, Shaniwar Peth,Pune 411 030Tel.: (020) 2449 8585E-mail : ganilgulab@gmail.com

Published by :Soniya KhareInking Innovations,Ground Floor,India Printing House42, G.D. Ambekar Marg,Wadala, Mumbai 400 031Tel. : (022) 2418 6233E-mail : ipw@vsnl.net

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Price : ` 300/-

ExcEptions apart, continuous research in all sciences has contributed to the upliftment of the human race. The researchers have already extended the scope of their research and focused it on the universe. They have gone beyond self, beyond earth and beyond our galaxy. I indeed thank and salute them.

I dedicate this small book to all these scientists of the past, the present and the future, who devoted their entire life for this noble cause of unending research.

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FOREWORD

in my book Reinventing India, I have a chapter on ‘Economics of Knowledge’. Let me quote a paragraph from this chapter.

‘‘Nations, which do not create knowledge societies, will vanish into oblivion. But those, who do, will have the potential to lead the world. If the Indian society has to become a knowledge society, then it is important that every Indian becomes a knowledge worker. It is not scientists and technologists alone, who will be knowledge workers. Even a farmer can be a knowledge worker, provided he understands the soil that he is sowing his seeds in, he understands the why and how of the micronutrient and pesticide addition that he makes, he lives in an information village, where he has the benefit of short and medium range weather forecasting ...”

However, for a common man to become a knowledge worker, the knowledge itself must be communicated in simple terms without complicated jargon. And this is not an easy task.

Dr Anil Gandhi, in his extraordinary book High-Tech Lifeline, has undertaken the task of communicating developments in medicine to the common man. In his own words, ‘this book is to add to the knowledge of the common man’. And he has succeeded exceptionally well in this noble task. And why just the common man? Even a scientist like me learnt so much while I was going through this wonderful book.

Let us step back and take a view of how the practice in medicine has evolved over centuries. Improvement of healthcare for humankind started with something very fundamental, namely sanitation. Then followed several advances. For instance, we had preventive medicine (e.g. vaccines), curative medicine

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(e.g. antibiotics), predictive medicine (e.g. gene therapy) and now regenerative medicine (e.g. stem cell therapy).

Explosive advances in basic science such as chemistry, physics, biology, etc. have helped in this journey. For example, gene therapy would not have been possible if the structure of the gene was not known. And the structure of gene got elucidated when the structure of the basic building block, namely DNA was discovered by Watson and Crick in their Nobel Prize-winning work almost sixty years ago. And this would not have been possible, if advances in X-ray diffraction, a subject in advanced physics, were not available.

In fact, Dr Gandhi brings out this aspect brilliantly throughout the book. For example, in the chapter ‘Physics in medicine’, he brings out how microscopes, lasers, imaging techniques, etc., all products of physics, have made a huge difference in the evolution of medicine.

The coverage of the topics done by Dr Gandhi is both diverse and impressive. They range from the origin of life to the art of reproduction, from genetic disorders to cancer, from bypass surgeries to robotic surgeries, from organ transplants to legal and ethical issues concerned with donors and recipients …….. One can well imagine the deep and painstaking studies that Dr Gandhi must have undertaken to create the distilled wisdom and then communicate it in a simple language to the common man.

The final chapter ‘Vision 2050’ was something that I found absolutely fascinating. The optimistic dreamer in Dr Gandhi shows up brilliantly in this chapter, where he depicts a happy and healthy world with an ultimate equity in 2050. A world, where there are smiles on the faces of all the 9 billion people, not that of just a few.

I must congratulate Dr Gandhi for gifting this book High-Tech Lifeline to our society. The book demystifies as well as enlightens. I consider this as a significant contribution to the ultimate goal of creating a knowledge society, where decisions and actions will be

taken on the basis of knowledge and not on perceptions or blind faith. I am sure the book will be stored as a treasure on the shelves of thousands of common people, for whom it has been intended, after all.

Dr RA Mashelkar, FRSrrr

Foreword 7

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PREFACE

Human bEings arE uniquely blessed with intelligence. They have the ability to think, learn and express themselves. They become wiser with experience and they use their experiences while solving the problems they face in daily life. Humans have curiosity about their surroundings, the universe and certainly about themselves. They wonder about the structure, functions, abilities and limitations of their own body as well as the health they enjoy and the illnesses they face. Though everyone is curious about many things in life, they have some limitations in learning and they cannot know everything. One usually tries to be a master of a single subject. With the tremendous explosion of knowledge on all subjects, it is extremely difficult to keep track of even one subject. In fact, this is a time for specialization. People may learn in depth about a small part of one subject and call it ‘specialization’. However, when they study more and more about their own chosen subject, specialists realize how little they truly know compared to the vast amount of knowledge that is available. In short, we remain a jack of many but not all trades and not the master of even one aspect of knowledge.

There was a time when we knew very little about our body’s architecture, way of functioning, health, diseases and their treatments. With increase in various tools of learning like newspapers, periodicals, books, radios, televisions, computers and the internet, the common educated person has many opportunities for learning. However, gaps will always remain in the knowledge of a common man about any subject other than his own specialization.

As someone who has been practising medicine for more than fifty years, I have had the privilege of watching change in the

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approach of the common man towards his own health problems. In the past, people were almost totally unaware of the body’s structures, functions, health and diseases and they were completely dependent on and had total faith in the family physician. Over time, they started learning and medical specialties became more and more narrow. Patients began going to specialists even without consulting the family physician beforehand. Now this class of patients reads and searches on the internet about their health problems and starts displaying their knowledge about health and disease. They start cross-questioning the doctors to verify how deep in the water the doctor is. Sometimes, this kind of half knowledge can be the basis for lack of trust in the physician.

I have realized that even after fifty years in this profession, there are large gaps in my own knowledge on many subjects. I am trying to update myself to the best possible extent.

There are many diseases which have come to light recently and many new diagnostic tools have been developed along with new treatment modalities that are becoming readily available every moment. In this book, I am making a humble attempt to give glimpses of some of these to the common reader.

I have tried to stress that the body itself tries to find a remedy to the greatest extent possible. When it fails, the physicians have to use their clinical judgement, diagnostic tools and medical or surgical treatments, including the use of stem cells, cellular tissue and organ transplants.

It is aptly said, ‘Health is wealth’. Good health is the conservation of one’s own wealth and ill health is a source of wealth to others at your cost. The beneficiaries will be doctors, hospitals, pharmaceutical companies, equipment manufacturers and insurance companies. It is better to be healthy and wealthy rather than to make others wealthy at our cost.

The progress in science and technology has revolutionized every field of human life. There is a phenomenal contribution of

technology in healthcare as well. Continuous research is adding to improved health and an increased lease of life to mankind.

I have tried to discuss some of the advances. This will add to the health awareness of common readers but cannot in any way bypass the advice of the family physician or medical consultant.

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Preface 11

13

ACKNOWLEDGEMENTS

Writing a book even for giving glimpses of high-tech lifelines was not an easy job. I had to read a lot. Vast sources like books, periodicals and the internet were handy. Still it was not possible to have a one-man show. Dr Suchit Kelkar a dental colleague of mine was always with me. He extended a lot of logistic help and also contributed to the dental section and all the informative appendices given at the end.

My friends from medical specialties were of immense help. Dr KH Sancheti, Dr RL Marathe, Dr Mukul Mutatkar, Dr Yashwant Nankar, Prof. Manjeeri Gharat, and Dr Sunil Shah made invaluable contributions in their fields of speciality and experience.

Col. Madan Deshpande, Dr Ravindra Vora, Dr Sheetal Mahajani, Dr Sudhir Bhate, Dr Deepak Kirpekar, Dr Vandita Shah, Dr Vikram Shah, Dr Mohit Shah and Dr Shashank Shah gave valuable tips.

My teacher Dr HV Sardesai, noted Editor Dr Kumar Ketkar, and my friend Dr Shailesh Gujar have always encouraged me in all my writing endeavours.

Mr Vishwas Purandare has done an excellent job in preparing the drawings and schematic diagrams for this book. There are many whose names have not appeared here but have eagerly helped in my endeavour.

I will be failing in my duties if I do not thank my friends Anil Sardesai and Sunil Sapre.

I am thankful to Anand Limaye and Soniya Khare of ‘Inking Innovations’ for publishing my first book in English. Last but certainly not the least has been the steadfast support and encouragement from my family, especially my son Nitin.

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tHErE is notHing which is as important as our existence in this universe. However, our existence is meaningless without good health. We need to be healthy not only to survive, but also to acquire knowledge, to attain prosperity, to be able to enjoy what we have achieved, to help others and thus make the life worthwhile. This is achieved through the science of medicine and health like all branches of science; these life sciences are continuously progressing, evolving, casting old ideas and developing into newer and newer forms. With this vast expansion, it is difficult to keep pace with its progress. It is branching in to specialities and sub specialities. Even Doctors and specialists would lag behind in being aware of the frontiers of medical science. The common man, the new entrant to the profession and to a specialist who has been concentrating as a perticular aspect will find this book a boon to know development in the medical sciences. This book need to read and re-read by everyone who cares to know where Medicine stands today. You will find here advances from concepts to technologies in treatment, from prevention to management. In all ways this is a unique book to possess and to study.

Dr. H. V. Sardesairrr

PREVIEWS

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tHE sciEntists all over the world are exploring the mystery of consciousness. One cannot “show” consciousness or conduct experiments on it. We know that when consciousness disappears the body is what remains. Lifeless body. But it is not “useless” body. The dead body has its uses. It has some parts which can be used, if immediately after death, they are removed and preserved or transplanted. Eyes of such a dead person can be taken out to provide eyesight to someone who is blind. So also liver. Even some bones. Medical students use the body to understand it from within. Indeed, all living human beings should be grateful to those dead who donated their body for research and examination.

There was a BBC medical science serial “Body in Question: A Brute Machine”. The serial raised several questions about life and death, body and mind, consciousness and soul! They were philosophically loaded questions. But there was also a kind of utilitarian and materialist angle. The body in question has parts which are not necessarily dead. Theymcan be transplanted and given new lease of life in some other body, which unfortunately has lost those parts.

By such transplants, we in fact are giving rebirth to someone who otherwise would be dead. When Christian Bernard performed that historic transplant operation about 50 years ago, the world was stunned. But since then, thousands of heart transplant operations have been successful and also kidney and liver and eyes have been transplanted.

But there has been very little information here as well as abroad, about transplants and their uses. There are some moral and

Previews 17

some medical problems. But now there is global recognition that such operations are necessary. But there are prejudices, and also malpractices. Dr Anil Gandhi has steered clear in this book, and written beautifully about the great advances in the field. Dr Gandhi has explained this controversial issue in such simple words in this book that a reader might feel that he should have been a surgeon or a writer!

Dr Gandhi has worked as a surgeon. But he has also become a wonderful writer. I am sure the readers will feel that he has excelled in both the professions. Let him be both.

Kumar Ketkarrrr

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i tHink EvErybody should read Dr Anil Gandhi’s book High-Tech Lifeline. As the name suggests Dr Gandhi has succeeded in describing all major ailments from cancer, diabetes and equipped the readers with the basic scientific knowledge about them and the high tech remedies on management. The chapters on pain management, organ transplants, foetal surgery, telesurgery and Bio-ink 3D printing of human organs are not only excellent but very reassuring. The best chapter on Vision 2050 is simply fascinating. Congratulations and best wishes to Dr Gandhi for the excellent efforts to spread knowledge and remove fear from the common reader.

Achyut Godbolerrr

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tHErE’s a painful disconnect between experts and common man in India in almost all the fields. Experts hardly read write or talk for the common man. In fact many an experts don’t like common man questioning them. They don’t like to answer the queries by common man. Doctors don’t like to be questioned by patients, advocates don’t like to be questioned by clients, politicians don’t like to be questioned by people. This is indicative of a general lack of concern for and accountability to common man. Experts in various fields hardly explain complex issues for layman, in layman’s terms. Dr Anil Gandhi’s book is a very positive answer to our painful predicament. This book explains many modern most issues in medical science in simple, lucid terms. It makes the book entertaining and enlightening. Dr Anil Gandhi has a half century of selfless service to people behind him. His refreshing perception of latest issues in medical science is bound to deepen our understanding and awareness. Reader will emerge a better person after reading this book. I hope the book becomes a trendsetter so that many more experts in many different fields also write for common man. Our society in general will benefit and will rise to a new, creative level of enlightenment.

Avinash Dharmadhikarirrr

CONTENTS

● Is Man an alien on Earth? .........................................................23 ● Art of Reproduction ..................................................................26 ● Interfering in the duties of Gods ............................................31 ● Egg First .......................................................................................36 ● The Ingenious Genes ................................................................39 ● Cancer ..........................................................................................47 ● Cancer pain and its management .............................................55 ● “I see you” (ICU) .......................................................................68 ● Height and Depth of Medicine ...............................................71 ● Space Medicine ............................................................................74 ● Telepathy or Telemedicine? ........................................................77 ● Smart Medicines .........................................................................81 ● Physics in Medicine ....................................................................87 ● Shadow Plays ................................................................................92 ● Interventional Radiology Demystified .....................................96 ● Evolution of Surgery ...............................................................121 ● Scaling the Everest ...................................................................127 ● Idiot Savants ..............................................................................134 ● Human Spares and Alternatives .............................................137 ● Alternative Paths .......................................................................141 ● Powerhouses ...............................................................................144 ● Humans in the Role of God ..................................................147 ● Angioplasty and Coronary Bypass Surgery ...........................150

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● Lesser known Bypass Surgeries ...............................................152 ● Heavyweight Champs ..............................................................155 ● New Technologies in Orthopaedic Surgery .........................158 ● Dental Implants ........................................................................174 ● Eligibility of Donor and Recipient .........................................183 ● Clear Vision ...............................................................................186 ● Banking for Health ....................................................................191 ● Regenerative Medicine .............................................................196 ● Human Genesis Stem Cell ......................................................200 ● Bone Marrow Transplantation ................................................204 ● Hair-Raising Experience ..........................................................213 ● Live Chemistry ...........................................................................217 ● Sweet Revenge ...........................................................................223 ● ‘The Purifying Angels’ ..............................................................226 ● ‘Donor and Recipient’ .............................................................231 ● ‘Heart to Heart Talk’ ................................................................237 ● ‘Breathing Free’ ..........................................................................240 ● Breathing Obstructed ..............................................................244 ● Face off ......................................................................................246 ● Taming the Soldiers .................................................................249 ● ‘Vision 2050’ Health Scenario ................................................251 ● Organ Donation and Transplant .............................................256 ● Appendix – A : Hospitals Associated ...................................272 ● Appendix – B : From Hell to Heaven with Gratitude .........276 ● Appendix – C : The Supreme Sacrifice .................................287 ● Appendix – D : Eye Bank ........................................................290 ● Appendix – E : Eye Donation Centres ..................................292 ● Appendix – F : Cornea Transplantation Centres .................294 ● Contributors ...............................................................................296

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THE FANTASTIC MACHINE

if you ask an engineer “Which machine in the world is most near perfect, has the most precision, requires the least amount of maintenance, and works round the clock ?”, the answers may vary. However, if we think about the human body as a machine, the answer would be unanimous.

No one can produce a perfect machine like the human body, however intelligent, innovative, or hardworking he may be. This machine can, however, be produced by only the natural way—reproduction. It is perfectly built, the precision is extraordinary, it works non-stop for a number of years, and very infrequently needs maintenance. Any other manmade machine of the same size and shape cannot adapt to its surroundings and cannot learn new things, nor can it be innovative on its own.

However, the human machine needs some maintenance while working. The body parts do get old and are subject to wear and tear. The body (nature) certainly tries to overcome these problems on its own up to a certain limit. Major problems result in disease, trauma, and wear and tear, and they usually need repairs and maintenance. At times, if the damage is beyond the limit of self-correction by the human body, medical aid, surgical aid or even replacements of human parts may be needed, and they are a reality with the advances in technology and medical science. Because of the advances in the health awareness of the patients and availability of better medical care (at a cost), the quality of life and life expectancy have grown profoundly and will continue to do so.

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‘VISION 2050’ HEALTH SCENARIO

Human bEings arE intelligent, they can think, see dreams for the future. They can envision future events. This led to writing stories or making movies with ideas which were thought to be fantasies. In such stories man had dreamt of flying in the sky, landing on the moon, exploring the deep sea-beds and distant planets. All these dreams have come true.

On the health front we had a movie ‘The Fantastic Voyage’. A scientist had a brain haemorrhage. The other scientists got a brilliant idea of miniaturizing the doctors, nurses and a boat along with all the tools necessary to remove the clot. All the team was injected into a vein of the scientist after miniaturization. They did the job and came out. Till date this has remained a fantasy. With advances in physics Einstein postulated the theory of relativity and time has been added as the fourth dimension. If we can travel at the speed of light, stay out in space for a couple of years and then return to earth, then life on earth would have moved a couple of hundred years in future (our time). The space travellers returning thus will find a sea change or with our broadened vision shall we call it space and time change. Nothing would be the same compared to what they had left behind on earth at the beginning of their space travel. There will be a lot of changes in the healthcare scenario as well.

They may find that the average life expectancy of man has gone to 150 years. All people look healthy, and everybody has enough resources to live with contentment. Poverty has been eradicated completely not by politicians but by scientific advancements. Everybody respects each other. There is no corruption, there are no crimes. The police and the military are non-existent. All the vehicles

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are running on hydrogen. All are breathing in air free of pollution, water is in plenty and non-polluted. The food is fresh and plenty without any contamination, grown organically with no trace of pesticides and insecticides. The industries manufacturing pesticides and insecticides have been closed long back. The pharmaceutical industry is gasping for survival. There is no gender discrimination. The ladies are at the forefront in most of the fields but they treat the male counterparts courteously and with sympathy. They are fully aware that the little difference in the intelligence, tender feelings, the physical grit and tenacity are because of the higher number of chromosomes and genes that a female naturally carries. The male is not to be blamed for these in-built minor deficiencies. Instead he is treated with compassion and love.

There is no rush to join the medical profession. The hospitals are few but all of them very well-equipped. Every hospital has a store of its own backed by a fully funded research laboratory.

Any person has an easy access to these stores run by the research labs. If you want a child, you can give your specifications – a baby girl or a baby boy. You have a choice of giving the design for your baby. Choose the features, colour of the skin, iris, straightness or curliness of the hair, dimples on the cheek while smiling or no dimples. Single chin or double, height and built, intelligence, and industriousness. You can choose the sports, performing arts and multilingual proficiencies. Last but not the least the mental framework of your baby. You can also request to delete any or all of the disease-producing genes. All that you have to do while placing your order for the baby is to give the unique id numbers of the intended parents along with an ovum and a sperm or an embryonic stem cell and of course a fee proportionate to your specifications and demands. You have an option of placing the order online if you have a complete plan. Alternatively, you can visit the store. Discuss the plan with the scientists in the lab of the store and place an order over the counter.

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Your unique id numbers when fed to the super computer will give the scientists all the information about your genetic mappings, health and ailments at a single click of the mouse. Your life story of health and disease will be displayed in a fraction of a second.

In case you have to go to the store for a health problem, again you need to give your unique id number. All the screening tests of blood and all images of various modalities will be done and processed in ultra short time and a printout of the consolidated health report along with the pinpoint diagnosis will be in hand. Now the choice is yours whether to opt for medicines, surgery or change the organs or part of the organ system. In case you have come for a preventive check-up, your stem cells will be harvested and the organ or tissue will be used for you when the need arises at an estimated time in future. In case you need the organ or tissue urgently because of loss of the organ because of trauma or an acute problem, you can opt for a readymade tissue or organ harvested from some donor cells. This may be used along with little immunosuppressive medications to avoid rejection of the alien tissue. Simultaneously, your stem cells taken will be processed to build the tissue or organ for future use. Once it is ready it can replace the old organ used as a stop gap. This will give you the liberty of stopping the immunosuppressive medications taken during the interim period.

There would be no need for the use of artificial joints (for replacement), the prosthesis used for loss of teeth or the loss of limbs. All the problems of wear and tear can be taken care of by injecting embryonic stem cells at the sites of damage at an early stage. In short, all sorts of alternatives will be available.

When the astronaut who returns from the space journey will look into the field of MEDITRONICS and computers he will not believe his senses. Before leaving he had seen large-sized computers and robots. He was aware that the British researcher Alan Turing born in 1912 had established the mathematical principles for computers in 1937 and had predicted that the artificial intelligence of the machines will grow. By 2050 they will have cognitive abilities,

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in fact a mind like human beings. Just as the machines built by human beings have much larger muscle power, speed and precision, these computers are ranging from a nano size to a palm size but have a wide range of applications with a thinking mind. They have become 15 million times more powerful than the computers he had left on the earth.

Human brain cells seem to communicate using off and on electrical spikes. The new generation of the nano computers are even faster than the brain cells. They can be injected through the vein, reach the site of disease or damage, pinpoint the problem, rectify it and come out through the urine or sweat. Remote areas of brain hematomas can be treated successfully without causing collateral damage to the brain.

All these intelligent computers from nano size to the relatively larger ones are used in robots. The world of robots with a thinking mind has outnumbered the human population. In spite of their superiority over the human beings in almost all fields, they are treating and serving the human beings with courtesy and integrity. This is because they feel the human beings are their creators, they are to be respected as the fathers and forefathers. They are not hostile to each other and the human race because they have not inherited the human brain in toto. The human brain is adaptive. This makes the human race greedy and greed is the basic cause of all the sins that man is committing. The robots and computers know this well and they are determined that they will keep away from the greed and all the sins associated with it.

These robots are peace-loving and intelligent. They preach and practice ‘peace’ in the real sense.

I am reminded of a story. Lord Rama as a baby was fascinated by the full moon in the sky and asked for it. The maid did not know what to do. The baby Ram started crying. The maid took a shiny silver plate and showed the reflection of the moon in it. The child took the plate in his hand, saw the reflection of the moon in it and was satisfied that he had the moon in his hand. Now give small

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Higgs Boson Particles in the hands of the scientists. They will give you a moon. It is possible that you could ask for and own a moon in the near future.

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