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'The number of days he spends here will depend on how he responds to treatment'

After confirmation of the prime minister's knee surgery from the PMO in New Delhi, it has been hectic days at the Breach Candy Hospital in south Bombay. The few plants outside the hospital walls are being trimmed and the seventh floor -- which will house the PM during his stay at the hospital -- has got a fresh coat of paint.

Preparations are also on to set up a mini-PMO in the adjoining rooms and chefs are being identified for the pantry. Dr Chittaranjan S Ranawat, the surgeon operating on the PM, is due to arrive from New York on October 8 and intelligence agencies are making regular reckies of the premises.

In the midst of such unprecedented activity for the PM's knee joint replacement surgery -- Dr K G Nair, Director (Medical), Breach Candy hospital, spoke to Features Editor (News) Archana Masih about the ongoing preparations for its honoured patient.

The prime minister's surgery has generated a lot of interest. What alterations in the hospital's routine have you had to make because of this operation?

We do not have to make any alterations. We upgraded our operation theatre two years ago to make it the world's best. We have the latest equipment purchased in the last two years. Knee joint replacement is nothing new to us. We have been doing four knee replacements every week for the last three or four years. Today this has become one of the established centres for modern orthopaedic joint surgery particularly. So it's not that we had to make drastic changes.

Has it hampered your regular work at the hospital?

I wouldn't say hampered. I have to do some of the media coverage, but there is also work that I have to do like patient care, reporting to the trustees. So there is some interference, no doubt.

When did the hospital first hear that the PM was going to have his surgery here?

We heard it about ten days ago in a secret call from the PMO, we got wind that he was going to come here. I got news when the special security force (SPG) came here and Dr C P Thakur, the Union health minister, called me. I came to know about four days ago, but one of our chief physicians received a call -- that this was possible -- ten days back.

Apart from giving the seventh floor a fresh coat of paint and vacating the wards there -- what are the preparations being made for the surgery?

We are checking through all our systems. Our equipment is being checked and re-checked. All safety precautions are being checked and re-checked. We have a special pantry being prepared for his food which will be served on the seventh floor. We are setting up a mini intensive care on the same floor. So we won't have to transfer the PM in case of any emergency.

Will he remain on that floor from the time he steps in to the time he steps out?

Yes.

You are talking about checking and re-checking equipment...

Well... anything that goes wrong generally is as follows, there may be, for example, an electricity failure -- so we'd have a generator.

But wouldn't you have that for any patient?

We have all this anyway. We have our routine checks anyway. But we are just going through our routine checks, our fire drill, equipment check etc. We are just doing the same thing.

You aren't doing anything special because you have a special patient?

No. I don't see anything special. Dr Ranawat may conceivably bring a few instruments. But we have all our latest equipment.

Understandably, the PVC cartilage and the metal base for the replacement is also coming from abroad?

Well, it's called a prosthesis. It is available from several companies. He is bringing this because Ranawat has been using these kind of things for the last 10 years. Every few years he brings something from there and he operates here in November or December for three or four days. So he's bringing his special prosthesis to see which one fits the PM's knee. It's made of a chromium alloy and stainless steel and polyethylene polymer.

The other day you mentioned that the SPG group was visiting the hospital. Is there any arm of the Intelligence Bureau camping here to oversee the security preparations?

Several people are coming and going. It is difficult for me to say because this is a secret business. The special group, the CID, CBI has been moving through the hospital. They are looking at all the avenues. So they are all the time here. They are doing a lot of reckies.

How is this going to affect everyday functioning at the hospital?

This is not going to affect the daily functioning very much because the top-most floor is sealed off. So up to the sixth floor there is no difference in traffic. The entry of the PM and his retinue and doctors will be separate. The main entrance will be used for routine patients. There will be a little shortage of parking space for sure because there will be some restriction for parking.

What about the PM's visitors?

They will have a pass and they will be taken by a special route to meet him. There will be a special camp outside the gate. Pramod Mahajan along with the special police force will look into all this. All those with a valid pass will be escorted by the police or the special force to the seventh floor. The traffic on the road outside will be controlled by the police. There will be certain restrictions on travel on this road. Traffic is bound to be diverted.

Will the other visitors coming to the hospital have to go through any kind of security procedure?

I think they would. The norms are being worked out by the director, administration (of the hospital) along with the police. What cards/visitors passes to be given out etc. They are at it.

In terms of availability of doctors and staff to the remaining patients, is there going be any difference?

We have no shortage of doctors and staff. The prime minister will have one young intensivist every eight hours and one nurse every eight hours. Then we have this special team of physicians. Then he (the PM) is bringing his anaesthetist.

Is he being accompanied by just one doctor?

He may bring another one. I don't know yet. We don't have details.

How many people are expected to accompany the PM?

I have no knowledge from the PMO yet. We have not received a list. I think that will be available on October 8, 9.

How many rooms are you keeping ready for the PM and his entourage?

The entire floor. All ten rooms.

I understand a substitute for the PMO is also going to established on the floor.

Yes. We are prepared to do whatever he wants, including an office. Once he recovers from the operation and becomes conscious, he will be able to dictate notes at least for the five, six days I expect him to be here. By October 4, we should be ready with all our preparations.

Has the seventh floor already been cordoned off?

Not yet. There are still some patients there. Every day we discharge a few patients and don't admit any more. We can't drive them out, that will be bad. We are phasing them out.

What is that floor usually used for?

That floor takes private patients. We also use it for difficult cases. That has been so for years. Because it is the top-most floor, for security purposes it was best suited.

Has there been any concern from the patients who are already here about the likely inconvenience they could face while the PM is treated here?

Nobody has spoken to me so far. Except for some consultants who ask us would there be difficulty in admitting their patients. I think for 3, 4 days there will be some difficulty till the new ward is ready. So for the next few days while the patients are being discharged and the new ward is not yet ready, there could be some problem. While he is here there will be no admission problem. The new ward will be ready then.

Do you think the patients are likely to be put off at the sight of so many security personnel on the premises? Especially because the middle class harbours an aversion for such disruptions caused by political bigwigs.

They should not forget that the PM is an honoured guest and to sacrifice a bit is not something that they should frown upon. We get educated people, they should be tolerant. Our public relations department is trying to explain all this to them. After all, the PM is an important dignitary.

When will the PM arrive here? When is the surgery going to take place?

He is coming on October 9. Surgery is possibly on October 10. Unless the doctors say his condition is frail and they want to wait one or two days. Post operative care will need another five days. The number of days he spends here will depend on how he responds to treatment etc. We can't speculate on this.

Apart from Dr Ranawat and Dr N Laud from Sion Hospital, who are the doctors from within Breach Candy who will assist on the surgery?

Our cardiologist, senior intensivist, our chief physician. There could be one or two doctors from Delhi. There will a team of 6, 7 doctors.

Since when has Dr Ranawat been conducting surgery at Breach Candy?

I think for the last 8, 10 years.

Is Dr Ranawat going to bring any assistant from the US?

He is bringing his intensivist.

You have earlier said that you will not charge the PM.

There is a convention that doctors don't charge heads of state or religious heads. I don't think there will be a problem from the doctor's point of view. The central government health service will surely pay for the rooms and other expenses. We will be paid by the central government, but we are not going to make this an issue. The convention is to treat him with respect and say 'It's an honour to treat you sir.'

How much does a surgery like this, inclusive of all expenses, usually cost?

About one lakh sixty, but it is a variable figure because the surgeon's charge is not always fixed. He may charge Rs 10,000 or one lakh or even two lakhs.

Who are the important personalities who have undergone treatment at Breach Candy recently?

Sunil Dutt. V P Singh who comes and goes very frequently. The governor of the Reserve Bank recently. In the old days, we had Neelam Sanjeeva Reddy.

But these kind of arrangements must be unprecedented.

I agree. But we have been prepared for some serious events. Supposing President Clinton was ill during his visit. We are prepared even for (Russian President) Vladimir Putin (who is coming to Bombay next week). In these cases, the consulates and the government inform us in advance.

What arrangements have been made for the PM's culinary requirements?

He will have a special pantry on the seventh floor. The food will be according to his needs and the special security will look into all this. The chefs are from within the hospital. We have exceedingly talented chefs. They will prepare what is medically required and what he likes.

Photographs: Jewella C Miranda

The PM's surgery: The full coverage

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