DOCTOR OF THE MONTH
Running on Heart
When not fixing hearts, cardiologist Kishor Avasarala, MD, tests the limits of his own
Google Kishor Avasarala, MD, and you discover two things. He’s a cardiologist at Children’s Hospital & Research Institute Oakland, an “extraordinarily kind one,” according to a Berkeley Parents Network posting, and he’s a competitive ultra-long distance runner.
The paths to both began long ago on the dusty streets of his hometown, Bangalore, India.
Barely 5 years old, Dr. Avasarala was already helping his physician grandfather, Tata Rao, on house calls. Young Kishor carried Tata Rao’s bag, sterilized his syringes, and even helped him mix medications.
“There was no doubt in my mind at 5 that I wanted to be a physician,” said Dr. Avasarala. He also had five aunts and many older cousins who were already doctors. Doctoring was in his blood.
So was running.
As a young teen, Dr. Avasarala, his brother Madhu encouraged him to take up long-distance running. The brothers ran together, armed with “a couple of stones and a stick” to ward off wild dogs that roamed the dusty streets.
Their ritual of running together continues. Every year the brothers celebrate their shared birthday (three years apart) at the Quicksilver 50Mile/50K Endurance Run.
The joys of cardiology
Dr. Avasarala, director of Pediatric Electrophysiology in the Cardiology department at Children’s Hospital Oakland, explains the case of a 14-year-old girl as he spreads out her echocardiogram on his office floor.
“Any time she gets any kind of fear or anger response, she suddenly goes into cardiac arrest, her heart rate goes over 300 beats a minute,” he said. “Without this device (a defibrillator he implanted) she’d be dead in two minutes. I see this on a daily basis, that’s the kind of feel-good sensation that all us physicians get; to be able to make changes in people’s lives or impact them directly, it’s worth all the training, all the trouble.”
After a troubling start to his education, Dr. Avasarala was in 7th grade when he discovered a love of math and science. Eventually he completed medical school and a pediatric residency in India.
In 1990 he came to the United States to do another pediatric residency, at New York Medical College. He’d planned to study neonatology, but after a few months he found his true calling — cardiology.
After 15 years intensive training in medical school, residencies and fellowships, Dr. Avasarala took his first job at Children’s, where he has now practiced for eight years.
Dr. Avasarala’s subspecialty is electrophysiology, which examines the heart’s electrical problems.
If a heart beats too slowly or too fast, its speed must be adjusted. Depending on the condition — medication, pacemakers or defibrillators may be used. If there’s an abnormal electrical pathway causing odd rhythms, a catheter ablation is performed. About half the cases Dr. Avasarala sees involve this delicate procedure.
“You find out where the abnormal pathways and abnormal ‘wires’ are, then move the catheter to the exact spot,” said Dr. Avasarala, holding up a catheter and manipulating its caterpillar-like end to demonstrate. The tissue is then either heated or frozen with the catheter. The resulting scarring interrupts the undesired electrical circuit. The cure rate for catheter ablation is about 95 percent.
“In what field of medicine can you say we can cure your problem most of the time?” said Dr. Avasarala. “Controlling stuff with medication or palliating stuff, partially controlling symptoms patients still have to live with, is a lot of what medicine does.”
It took discipline to become a specialist in one of pediatrics’ most technical subspecialties, and so does running. By 5:30 a.m., Dr. Avasarala is usually well into his two-hour morning jog. He starts early so running won’t take away from time spent with his son, Rahul, 14, and daughter, Shalini, 9.
“I don’t feel its right to preach if I can’t practice it myself,” said Dr. Avasarala. “I can’t tell a 16-year-old who is overweight that he has to run daily unless I can do it myself. I feel more conviction in what I say if I practice it in my own daily life.
“I think I’m a far better physician because of my running,” he said. “I can take a lot more stress, both physical and mental, and it helps my ability to concentrate, to work long hours. It’s mind over body and you are training yourself to do that.”
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