Dr Harvinder Singh Sahota: Mender of Hearts
by KHUSHWANT SINGH
When he drives into his mansion at Laguna Beach, in Orange County (California, U.S.A.) on the Pacific Coast Highway, you have to wonder if the darned trousers are a cover-up.
The loose baggy fit, a mismatched, open collar shirt and tie gives an impression of an absent-minded doctor, who seems to lose his way in his own hospital. The constant pacing up and down, the loud and hurried style of talking to people, makes you wonder how he manages matters of the heart.
Ask Maria, who handles billing at the clinic, if the doctor is a confused man. "No. He's just always on the go", she says. How true!
Spend a little more time with him and he actually emerges as a pocket-sized dynamo, not for the weak-hearted, for sure. No wonder he has defied death twice: once when he was a few days old and later on the eve of his teenage years, when he was eleven.
The irony is evident. Meet Dr Harvinder Singh Sahota, who mends souls - I mean hearts, literally - and has invented the Perfusion Balloon - the "Sahota Perfusion Balloon", to be exact - to right your heart if you have overdone your quota of fast-food or butter chicken.
The Perfusion Balloon is now used in angioplasty surgeries all over the world. A small, hollow and flexible tube with a balloon near its end, this device is placed in the heart arteries to lift partial blood blockage caused by fat or cholesterol.
In 1985, Dr Sahota became the first cardiologist in America from the subcontinent to have a patent under his belt and, over the years, has gathered at least twenty-four more.
Fixing to meet with Dr Sahota was not an easy job. With a poor public transport system in Los Angeles - unlike London, Paris or New York - to reach from Sherman Oaks to Dr Sahota's clinic in the town of Bellflower, was a mammoth task. Internet searches on the Metro link put me on a train from North Hollywood station to 7th Main Street station in downtown LA. From there, after another hour on the road, pulling my luggage on the streets of LA, I reached the town of Norwalk as per Dr Sahota's advice.
To cut a long story short, Diane, who forms part of the all-woman team working at Dr Sahota's office, picked me up from the bus-stop to take me to the clinic. I had finally reached safely from one Sahota house to the other; one from Bada Pind in Jalandhar District in Punjab and the doctor hailing from Gardhiwala in Hoshiarpur, my own home district.
Salutations were exchanged, as Dr Sahota greeted me with a "Sat Sri Akal".
"Let's hurry for lunch", he suggested, as we - a friend of his joined us - moved out of the clinic and got into the car. Dr Sahota drove us to an Indian restaurant in the neighbouring city of Cerritos.
I sat in the back and listened as Dr Sahota tried to explain to his American friend how the name "Singh" and the internet implied the same thing.
"You don't know a thing", he told him. "Guru Gobind Singh, the tenth Guru of the Sikhs, the founder of the Order of the Khalsa, gave us the title 'Singh' to establish a web between Sikhs".
After lunch, the action shifted back to the Sahota clinic. The doctor, after completing his clinical obligations, volunteered to show me his clinic. My first extended conversation with the doctor revealed that he speaks English fluently, but the cadences are those of a Punjabi.
The clinic is split into various segments by an alley, and is equipped with a full-fledged reception, main doctor's room, affiliate doctors' rooms, a diagnosis centre where sophisticated cardiac machinery can be found, a billing section, a record room, lounge, kitchen and a retiring room.
After a satisfying tour, the doctor announced that we must head home.
Orange County, a fifteen-minute drive from the city of Bellflower, is home to the rich and famous of the world. We drove past many a picturesque small town on the Pacific Highway, and our conversation spanned a variety of subjects - our shared home district of Hoshiarpur in Punjab, the Indian media and some common acquaintances.
Apropos of these connections, the doctor asked me if I had heard about him in India. I said no, and that in fact during the course of my travels, someone had recommended his name and further enquires had justified the inclusion of Dr Sahota in my book on the prominent Sikhs of America.
"Where are we headed?" I enquired.
"I have to perform one more daily act before we proceed home", Dr Sahota replied. Bowing before the Guru Granth Sahib every day at the Orange County Gurdwara is a routine that Dr Sahota rarely fails to follow. Perhaps it is his way of expressing gratitude to the Sikh Gurus who gave him courage and conviction to be one of the best in his chosen field.
"I don't think there has been a day in his life when he has not come to the Gurdwara", Bicky Singh, head of the Orange County Gurudwara Foundation, told me. "His timings may vary each day but he doesn't forget his date with the Waheguru".
Home to Asha and Harvinder, the Sahota mansion, in a private locality in Laguna Beach, is a lavish affair overlooking the Pacific Ocean. A private beach within the walled colony is a testament to the long journey called life that began from the humble staff quarters of a railway colony.
Born to a station master on 15 April 1941 in Basti Tankwali, in Ferozepur Cantonment of modern Punjab, the story of Dr Sahota - as it unfolded from the comforts of the formal sitting room - is a tribute to the Sikh diaspora which, through education and hard work, has scripted success stories for others to follow.
"You see, I was as good as dead within two weeks of my birth".
The festive mood in the house on the birth of a son was cruelly dispelled as father Lachman Singh and mother Dhan Kaur mourned the corpse of Iqbal (the original name given to the child), who had been struck by double pneumonia. Preparations to bury the dead child had begun and, as per custom, the infant had been transferred from the mother's lap to the father's.
The doctor's "Wait, he's still alive", suddenly broke the stony silence. "Go get an oxygen cylinder", he ordered the family. The family rushed and luckily one cylinder was available at a local hospital and Iqbal's normal breathing was finally restored.
The revival had coincided with the local Imam's call to end the Ramadan fast. "My mother, who told me the story of my recovery later, always believed it was Allah/God who was responsible - making me believe in destiny, stars and divine power". Lachman Singh, thanking the doctor, had quietly vowed to make his son a doctor, who would help save lives.
Safely out of the grave, Sahota grew up like any child would in a British-India railway colony - local school, lots of friends from the community and four siblings. But he remained a weak child.
At the age of five, his name was also changed from Iqbal to Harvinder, as his parents thought a new name wasn't a bad idea to commemorate a new lease on life.
Harvinder soon became Dr Harvinder - or just "Doctor" - to colony members as his father's vow became public.
As a child of a railway employee, transfers were common. Despite occasional moves and the bloody circumstances of the partition of the subcontinent in 1947, changing of schools had no adverse effect on Harvinder, and he started shaping up as a studious boy, hungry to learn more and more. Besides topping his class year after year, Harvinder developed a reading habit that fed his ever-curious mind.
During this time, Harvinder had his second brush with death, at the age of eleven. His father had been re-transferred to Ferozepur. "Malaria in 1952 was no good news", said Harvinder, recalling struggling for his life and how an Ayurvedic doctor, Prem Nath, came to his rescue.
Life went on, and soon Harvinder's attentions were taken over by pretty Indian filmstars, his favourites being Madhubala and Vijayantimala. The doctor to be, like many youngsters in Punjab, at one time even contemplated escaping to Mumbai to try his luck in movies.
Fortunately, one of his friends, Daya Singh Arora, who was to meet Harvinder at the platform to take the Punjab Mail from Amritsar to Jalandhar, never turned up - as he had landed himself a job.
His father politely reminded his son of the vow he had taken to make a doctor of Harvinder. "Back on track, boy!" he told Harvinder.
Seeking to fulfil his father's pledge, Harvinder was soon on track - enrolling in the pre-medical course (F.Sc.) at the DAV College, Jalandhar. Libraries and laboratories became his second home.
"Reading the extra bit is very important for young aspirants, as additional information cannot be learnt from regular textbooks but science journals, magazines and daily newspapers", advises Dr Sahota.
Keeping up his record of attaining good marks, he passed his F.Sc. with distinction.
1959 was the year of the big challenge - getting admission in a medical college. "It was an easy job . . ." he admitted bashfully.
Harvinder was soon packing a custom-made cot to take to the newly established Government Medical College, Patiala. Strangely, the admission letter from Patiala came with a note that said: "carry your own cot"!
Patiala Medical College was set up in 1954 under the aegis of the erstwhile Maharaja of Patiala, who had chosen Dr Amarjit Singh, a renowned physician, to set up the elite institution.
Once in Patiala, it was not a strenuous syllabus that the tiny and fragile Sahota had to deal with, but the onslaught of ragging. Hardly had he dumped his cot and luggage in his room at the Junior Boy's hostel, the seniors already had a plan chalked out for him. Ragging then, like now, formed an integral part of all professional colleges in India.
Eager seniors in their second year of college asked the doctor-to-be to follow them. Once in a hostel room, they ordered him to remove his trousers. Harvinder sheepishly obliged. "Take off your underwear", was the next order. Harvinder could take no more. He simply refused. He was aware that he had to maintain his dignity. If he obeyed their ignominious order, he would have to spend the next five years in humiliation. He decided to run away, unmindful of the wrath he would have to face if nabbed. Pushing one of the seniors away and picking up his clothes, Harvinder sprinted out, taking shelter on the Mall Road till nightfall, when he was fortunate enough to find some seniors to mediate between Harvinder and his tormentors.
"Tea or coffee?" The loud and formidable voice of the doctor was suddenly interrupted by a mellow voice. This was my introduction to Asha, the doctor's wife and a former Captain in the Indian Army, who probably realised the guest needed a breather.
"Chai", I said and soon Asha was in the kitchen, adjacent to the drawing room, brewing tea for us. A calm and a composed lady, Asha was a perfect host for the three days that I spent in the Sahota household. Her polite demeanour at times offers a perfect antidote to the over-energetic Harvinder.
To drive his point home, Harvinder can be very aggressive, especially when it comes to Punjab's issues and Sikhism.
Asha came across as graceful, but not one to take important matters of her life or those of women's liberty lightly.
Years earlier, she had taken her own sweet time to decide whether or not she wanted to marry Harvinder - whereas our doctor sahib had flipped the moment he had met her. Suhani aankhein (beautiful eyes), he explains!
A doctor herself, Punjab-born Asha completed her M.B.B.S. from Bihar, where her father, Niranjan Singh Claire, was a mining engineer and worked with a British company, Bird & Co. After her degree, Asha joined the Indian Army and served as a captain, posted at Delhi.
"I was struck by her beauty", chuckles Sahota as water boiled merrily in the background. On a visit from England, Sahota accompanied Asha's father to meet her at an officers' mess in Delhi. Asha's father had given her no hint of what was brewing. Oblivious to the match-making that was taking place, Asha saw Harvinder as just another acquaintance of her father.
"He later told me about all the plotting that went into this meeting", claimed Asha, who has proved to be the pivot in Sahota's success. In support of Harvinder, Asha quit her promising career so that she could bring up their two sons, Neil and Eric.
"Mind you, such a decision doesn't come easily in western countries, especially when you as a family are up against the wall in an alien country and you have a degree that could fetch you fat money. It's one decision that we agreed on unanimously", said Dr Sahota.
I asked Sahota to tell me more about his Patiala days. Harvinder finally became Dr Harvinder Singh in 1965, after completing his MBBS, followed by a six-month internship at Bhadson near Sangrur in Punjab.
During his years of study he had come in contact with various personalities, including brief meetings with prime ministers Jawaharlal Nehru and Lal Bahadur Shastri, and of course the then Maharaja of Patiala who, contrary to all medical theories, was of the view "Khao peeo mauj karo (Eat, drink and make merry)".
Harvinder also enjoyed politics, an interest that still goes strong. He and his friend Harbhajan Singh Samra - the Okra King - dabble quite a bit in Orange County politics; the latter gaining his experience from Punjab's panchayat politics and the former from college.
After spending one more year in Patiala for his residency, Harvinder was England bound, a dream that he had been nursing for quite a while. On 15 July 1967, with eight pounds in his pocket, he landed where most Punjabis land - in London's Southall, where he initially stayed with his cousin's friend. On 18 August, his registration certificate arrived, thus opening a whole new world for him.
It was about 8.30 p.m. and we had been chatting non-stop. Dr Sahota drove Asha and me to Las Brisas, a reputable Mexican restaurant, right by the ocean. Salmon was ordered for all three of us. And, as we waited for our order, we chatted about issues in Punjab, some of which Dr Sahota was aware of, and some quite distanced from.
Bruised by the events in Punjab in the last couple of decades, Sahota was yet to come to terms with the new Punjab-high in India - virtual Sikh Raj. Apna Manmohan and J.J.
However for Sahota, India's Prime Minister Manmohan Singh and India's Chief of the Armed Forces J.J. Singh, by themselves, don't mean much and he feels that Punjab, Sikhs and minorities deserve their fair share and rights to their fair share of the national pie.
At the same time, the doctor could not be cornered, for his arguments, I must confess, were based on facts and thorough information. I was at a loss for words with him, because I was not adequately informed of the history preceding the phase of human rights violations by the Indian Government.
"Where were we . . ?" he asked as we sat on the dining table. "In England", I replied, as I was keen to move further from the point when the doctor had procured a registration certificate.
"The journey is long but it was the spirit of travelling and exploring the new world that kept me going. I took each challenge head-on. It's because of this never-say-die spirit - perhaps a Sikh trade-mark - that I am where I am".
Bromsgrove hospital at Kidderminster became the first hospital where Dr Sahota worked as a resident. And how could the first day be uneventful?
The nurses dispatched a patient to him and, based on the case history of fever for the past seven days, Sahota announced the patient was down with typhoid. "Administer him with Chloromycetin", he ordered, causing a panic in the hospital.
"Doctor, there is no typhoid in England,",said the consultant, who had been hurriedly summoned by the nurses after they heard Sahota utter the forbidden word- "typhoid'". '"And Chloromycetin is banned in England", he whispered in Sahota's ears.
A major lesson had been learnt, of not jumping the gun. From Bromsgrove, Sahota moved to Clayton hospital in Wakefield near Leeds.
Working in the casualties department, Sahota learnt his second lesson. On the first day, treating a patient with a dog bite, he caused a commotion when he asked the nurse to administer an anti-rabies injection. Embarrassed, the nurse took the doctor aside to tell him, "Doctor, there is no rabies in England".
"It was not all that bad", he laughs, as there were moments of glory too. For example, during his six-month stint, he treated a five-year-old girl who was brought to the hospital absolutely sozzled.
In the absence of her parents, the little girl had drank vodka, thinking it was water. Dr Sahota emptied her stomach, and the girl had recovered remarkably, leading to local newspapers going gaga over Sahota's medical skills.
His third job was as a house officer at Llangwyfan Hospital in Denbigh, North Wales, in chest medicine. Promoted soon as a registrar, Dr Sahota worked at Llangwyfan for four years, quitting in 1972. During his stay, Harvinder had the opportunity to complete a postgraduate course in tropical medicine from Liverpool School of Tropical Medicine and in 1971 he completed a post-graduation in chest medicine from the University of Cardiff.
A drive from Cardiff to Llangwyfan reminded him that he was ready for marriage, and geared up to take the responsibility. And, back home in Punjab, the search was already on for an appropriate girl to match up with Harvinder - who, besides being a doctor, had a "phoren" tag. However, Harvinder had to wait.
India and Pakistan had just broken into a second war over East Pakistan, soon to become Bangladesh, on 16 December 1971.
Harvinder decided not to risk the travel.
It was in February 1972 that Harvinder finally had the chance to go to India and meet Asha. They were married on December 16, the first anniversary of the Indo-Pak war, at Wrexham in England, where Sahota worked after returning from India in April.
But, as usual, the event was not without action. Asha's uncle, who was scheduled to pick her up and bring her to the office of the marriage registrar, coolly forgot to pick up the bride-to-be!
Time passed quickly, as we sipped one cup of tea after another during our conversation. "So did your wife work in England?" I questioned. "Certainly", he replied. "I think she started her residency a day after we got married. No time for honeymoon too, or that kind of a thing. Our first holiday was only in 1973, when we went for a sightseeing trip to Paris and Rome".
"We reached the U.S.A. in 1974", adds Harvinder. His ambition to see the world and unearth opportunities had kept him on a look-out for openings in the U.S.A. or Canada. And sure enough, a telegram from Rochester, New York, with a pre-paid reply card, said "Position available from July 1".
He immediately initiated the paper work. "See, my heart is still in England, but in England I was only doing temporary jobs. It was time to use my experience for a better opportunity", is the way Sahota justifies his exit from England. With two suitcases and 3,000 pounds worth of savings, the Sahotas landed at JFK airport, New York on June 30, 1974.
A green card was issued to them instantly and out marched the couple - America, here we come.
"Life was not easy in big America. This house, this life, has come after years of toil and hard work", remarked Dr Sahota, an indication of the fact that life is not all golden in the USA, as perceived back in India. "You see, there people think that the moment you land in the U.S.A, you are made. They are highly mistaken. I have seen qualified doctors, engineers and M.B.A.s toil at Seven-Elevens, Subways, gas stations, departmental stores . . ."
The job at Rochester fetched him a meagre $800 a month, just enough to make both ends meet. The savings in England had been spent in buying a car - a life-line in America. Life was tough as everything was topsy-turvy as compared to England: beginning with the change in driving patterns, from left to right.
However Harvinder was strong-willed. Slowly, the two started getting their bearings. And, in the struggle, good news was on the horizon - Asha soon gave birth to her first child, a baby boy, whom they named Neil, meaning "champion" in Scottish.
Harvinder soon became "Harry" to friends and acquaintances. In July 1976, it was switch-over time again - it was Canada calling. After spending almost a year in the small town of Regina, Saskatchewan, Harvinder wanted to be back in the USA. He knew where the opportunities lay!
Moreover, the lovely Californian weather was more than a respite from cold Canada. California was the place to be.
Through a contact - a professor - he quickly picked up a job in LA at St Vincent's Hospital where he was to create his first invention in 1977 - the Haemostat.
Though still a fellow, Harvinder's haemostat started being used for general surgeries to stop blood spillage. It helped doctors plug the blood without using their thumb or hands.
Hopping from one job to another for fourteen years, mostly as a "fellow", Sahota was to get his first big professional opportunity when he joined a group of cardiologists who were looking for a partner in Bellflower. His income doubled from $1,500 to $3,000, but so did his family.
On June 8, 1978, their second son was born, who they named Eric, meaning "royal" in Scandinavian.
And with the advent of this new soul, Sahota did what all sensible people would do. Buy a house for himself worth $130,000. "I had savings of $10,000 which was used as down-payment", explains Harvinder.
Nevertheless, with a busy medical practice, life was on a roll.
"OK, get ready", Harvinder suddenly announced, "let me drive you around and show you beautiful California", I must admit I had started liking California, after my visit to San Diego. And it only made me miss my son Adiraj and wife Harmala more.
"You see, after the Swiss Dr Gruentzig's angioplasty operation, a question arose in my mind that the inflated balloon would stop blood to the heart, which amounted to causing a heart attack!"
On September 16, 1977, Dr Gruentzig became the first doctor to perform an angioplasty operation in Zurich. His feat had a bearing on Sahota's inquisitive mind.
"The same question kept coming back to me again and again and I kept thinking of the perfusion balloon and started working on a catheter, a thin tube made of plastic with a polythene balloon at one end. The balloon is then pushed into the blocked heart artery and then inflated by pumping water with a syringe through the catheter from near the groin. The balloon inflates and opens the artery. The Sahota Perfusion Balloon takes care of this problem by drilling holes in the catheter before and after the balloon. The balloon is then taken out from the groin after the angioplasty is done.
"The idea takes its origin from common sense, which we Punjabis have in plenty",asserted Sahota. "Oh! You mean the juggad (ingenious and indigenous solutions) we Punjabis are so famous for?"
Was perfusion balloon just a juggad, I wondered?
"What I did was take a needle and puncture two holes at either end of the balloon in catheters. The punctures did the trick as blood began to flow through these holes". The experiment was carried out in 1978 and Sahota applied for the patent in 1980.
Not worth it, said medical companies when Sahota showed them his invention.
One company based in Boston said it in as many words, while another company politely turned him down saying the invention was too advanced for the equipment available.
Disheartened, Sahota forgot he had ever made a perfusion balloon till a phone call activated him again. The president of the same Boston-based company, United States Catheter Inc. (USCI), John Civinar, called Sahota to tell him that his company was now keen to manufacture Sahota's catheter. They were all set to market the product and approached Sahota because he had acquired a patent.
A deal was signed. But subsequently, San Francisco-based Advanced Cardiovascular Systems (ACS) inquired if Dr Sahota had signed an agreement. Sahota said yes, and stuck to his commitment with USCI. As luck would have it, ACS also tested and manufactured a similar balloon and went ahead with their project minus Sahota, seeking approval from the Food and Drug Administration (FDA) in 1988. USCI ran into problems and could not market the catheter.
"No problem", said Sahota, who had relentlessly worked hard to achieve high standards of cardiac diagnosis and held twenty four patents at one point of time.
The multi-lobe balloon is another one. Sometimes blockages occur at the bend in the artery. The balloon will straighten the artery on inflation. But many times, the artery breaks.
"To enable angioplasty at the bend, I attached many balloons on the catheter".
After the multi-lobe, it was time for the red laser balloon in 1993. The device, used to stop blockages from coming back, is yet to be introduced in the market. Another of Sahota's inventions: "Two wires and one balloon which means that the balloon is attached to a wire instead of a catheter in cases where the catheter becomes difficult to reach.
"Blockages in small arteries were difficult to remove, you see", said Dr Sahota as if seeking approval of his invention from me. Some balloon man, our Dr Sahota, except he didn't make mega bucks selling balloons.
The house at Laguna is a result of his hard work at his practice. On June 8, 1986, Sahota's decision to break away from the group with whom he had worked seven years proved to be a bonus and he set up his own medical practice. Srinatha joined Dr Sahota and both established a flourishing practice with two other doctors. Dr Vinod Singhi and Dr Narinder Batra joined them later.
A place on Park Street in Bellflower became their permanent clinic as it remains till today.
The invention of the perfusion balloon had made Sahota a name to reckon with in the cardio fraternity. By the turn of the decade, he was an important guest at various lectures and seminars and was being invited to perform the angioplasty at hospitals in different countries.
In 1989, Dr Inder Singh Anand, head of cardiology at the Post Graduate Institute of Sciences (PGI), Chandigarh, Punjab, invited Harvinder to start their Angioplasty Program. Harvinder put together a team of seven that included three cardiologists - Dr Jose Fainha, Dr M. Choi and himself - two laboratory technicians, Nicole and Steve Bellows, and two nurses, Annal Hall and Denise, and reached Chandigarh.
The team performed the first angioplasty in North India on January 17 and nine more followed in the week that the team spent in Chandigarh.
It was five in the evening when we reached home, where Asha waited for us with tea. Time quickly passed as Dr Sahota shared his views on the rapid changes in the medical field. He talked about how, during his student days, there were only four prominent areas in clinical medicine that included Eye and ENT, medicine, surgery and Ob-Gyn. The pacemaker was unheard of and terms like open-heart surgery, angiogram, angioplasty, echo-cardiograph and electro-cardiology were alien. The world, according to Sahota, was stunned when Dr Chris Barnard performed the first heart transplant on December 3, 1967 at Cape Town in South Africa.
Harvinder, who had the opportunity to meet Dr Barnard during his visit to St Vincent Hospital, was thrilled shaking hands with the pioneer. In the 1970's, Dr Barnard achieved another feat when he transplanted a monkey's heart into a human.
The discussion was followed by a dinner at an Italian joint where Harvinder shared his personal accomplishments - that included his keen interest in the welfare of the community, dabbling in politics and meeting the high and mighty.
Very Sikh-like, isn't it?
"I've just been appointed Commissioner of Emergency Medicine (presently Chairman) unanimously by the County Board of Supervisors", he informed me over dinner. "The term is for two years, unlike India where people sit on posts till they die. We have a system of retiring. Holding elections every five years is not democracy but free debate and free press is democracy".
"We have a free press in India", I asserted.
"OK, will your so-called free press allow me to write an article on how the Sikhs in the USA felt when the 1984 riots took place?"
"Maybe not", I conceded.
"Forget it", he said and talked about how Sikhs, including him, had worked hard towards the establishment of the Sikh museum in the world-famous Smithsonian Institute in Washington, DC.
Sahota, who serves as one of the board trustees, feels that the Sikh museum gained more significance post-9/11 and was one of the good things to happen for the community.
September 11, 2005
It was the fourth anniversary of the terrorist attack on the World Trade Center in New York. Sahota was watching television when I got up and stepped outside the room. "Tea is on the table", he said as he remained glued to a programme on the dreadful event.
August 21, 2008
[With input from A Hero of American Hearts (Rupa and Co., 2004) by Gurmukh Singh. The book in which this article forms a chapter - Sikhs Unlimited, by Khushwant Singh - has undergone three reprints and is available on www.amazon.com and easternbookcorporation.com .]