Swami had sent Dr. Jeevanandam to Chicago for a reason – “Quality over Quantity.” It was achieved over 23 years; and as Swami would have desired, it happened just in time for the final report with him as the Surgical Director. Swami had performed a miracle. Historically, it was the best transplant program in the world!

My Transformation Begins 

My transformation from ‘Ego and Control’ to ‘Faith and Surrender’ started in 1995 from my first interview with Bhagawan Sri Sathya Sai Baba.  Little did I know that this would be the start of a long journey that will continue through the rest of my life.  I asked permission from Swami to volunteer at the Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS) in Puttaparthi.  Swami held my hand, looked lovingly into my eyes, and said “You don’t need to ask for permission.  This is your home.  You can operate here anytime.” The SSSIHMS is a true miracle.  Not only was it built within one year to the highest world standards with the best equipment, but it is also verily a temple of compassion and caring.  Patients receive completely free medical care and in a setting of peace and tranquility.  I might have volunteered my time and services, but in the final analysis I was the person who got the most benefit from working there.  Take one step towards Swami and He will take a hundred steps towards you.  That could not be truer for me, from my experience there.  It was at SSSIHMS that Swami started to slowly peel away the layers of my ego.  Let me narrate an incident that started the process. 

Lesson of Giving Priority to God 

During the early days at SSSIHMS, the infrastructure and surgical expertise was still being developed so that we would come together as a team and perform surgeries. Currently, the team in SSSIHMS is so well trained that the senior surgeons act more in an educational and advisory role. I had come with my team and the first question people asked is how many surgeries will be done by me during the visit and compare it to the number performed by the surgeon who preceded me.  I was very competitive and was fixated on treating as many patients as possible. 

One day, the nurse informed me that all cases were to be stopped at 2 PM so that the staff could attend Swami’s discourse and possibly also get interviews with Swami. Instead of embracing this great opportunity, I was upset that I might not reach my set quota and fail to do more procedures than the previous surgeon. Despite pleas from the staff, I told them to let my assistant and I show them how to do a procedure so fast that we could maintain our quota, and yet go to see Swami. But that day, there was every possible delay during the surgery, although the patient did come out fine. It took so long to complete the procedure, that unfortunately the team was deprived of the opportunity to listen to the discourse and have darshan of Swami. As was customary in those days, we attended the morning darshan. Swami blessed us with His presence and engaged in a brief conversations and enquired about the patients.  What precious moments and what a blessing! But the sad thing is that I never appreciated the honor and rarity of being able to communicate with the living God.  When Swami came near me, He asked me about the patient. I told Him that we finished the procedure, the surgery went well, and the patient is doing fine. He looked at me mischievously and probed “What happened?” and continued “Not the expected half the time but the procedure took twice as long.”  Swami thus revealed His omnipresence – He knows everything.  Swami’s words struck me like lighting. My ego had gotten in the way of common sense and patient safety, and I had denied the team the opportunity to meet with Swami. That lesson has stuck with me to this day. Whenever I pride myself that I am better than someone else and let my ego raise its ugly head, I can hear Swami’s voice as if I were still in the veranda for His darshan.  

Lesson in Patience – Thy Will be Done 

Our pathway to faith and surrender can take many twists and turns. I am a slow learner, so Swami had to work hard to show me the right path – not only through my own experiences but by living through the experiences of others. Mohan was an IT professional who relocated to Puttaparthi to take care of his mother. She had been diagnosed with a leak in her mitral valve which caused increased amount of fluid in the lungs and shortness of breath. She was advised to have the valve fixed. Due to her advanced age and infirmity, the surgeons at SSSIHMS suggested that she have her surgery at a private hospital in Bangalore. Mohan asked Swami about this during multiple interviews and the reply was always the same – “wait.” But his mother was getting sicker, and the doctors were telling him to get her operated on elsewhere, because she did not meet criteria for surgery at SSSIHMS, and Swami kept telling him to wait. This continued for several months. 

On the Thursday evening darshan during my visit (I was going to leave on Friday evening), Swami came to Mohan and asked him why he was not taking care of his mother and getting her operated on. Swami told him that I was there for one more day and to get me to do the surgery. Mohan was elated. He could finally get treatment for his sick mother. But this is where Swami allows us to be part of His maya. Mohan ran back to the hospital and told the staff to prepare his mother for surgery. But since she had been denied care there, the staff would not proceed without permission from the Director or from Swami Himself. Unfortunately, darshan was over and Swami had retired to His residence. Mohan was frantic. The Director or senior members of the hospital could not contact Swami. Mohan had to get Swami to directly give permission. Mohan wrote a letter to Swami and rushed to get it to Him before He went up to His bedroom. He wanted to give a picture of his mother to Swami so He could identify his mother but there was no time. Mohan rushed to Swami’s residence and was met by one of the students. To his utter dismay, Swami had just gone up to His bedroom and there was no way to get Him the letter. The student reiterated that Swami never came down after retiring to the bedroom. Mohan was devastated.  He gave the student the letter hoping for a miracle – namely, Swami coming down. Lo and behold, to everyone’s amazement, Swami did come down and asked for the letter. He opened the letter and materialized the photo of Mohan’s mother that Mohan did not have time to include with the letter. Then Swami showed the picture to the student attendant and gave permission to proceed with the surgery. 

Sri Sathya Sai Institute of Higher Medical Sciences in Puttaparthi

Mohan rushed back to the hospital so the staff could prepare for surgery the next day. They called me and asked if I would operate – without seeing the patient or the imaging studies and records, I accepted. Who are we to question or doubt the Divine command? The next day during morning darshan, I asked swami about the case. He blessed me and told me to do whatever I thought was correct professionally. He then held my hand, blessed me and told me to proceed. 

The staff at the hospital were concerned especially since the patient was elderly, malnourished, and weak. They had never operated on or handled such an elderly patient. They were afraid that she would never make it out of the hospital even with successful surgery because of poor chances for recovery.  With Swami’s grace we proceeded. Mitral valve disorders can be either repaired or replaced. It is preferable to repair them which allows for the patient’s native valve to remain in place and not have the complications of a replacement. But repair is much more complicated and sometimes may not be durable. The staff was concerned that repair would take longer time and if the leakage recurred, a second operation could not be done. I was in a quandary – do I replace or repair the valve? Then I could hear Swami’s voice – “Do what is correct?” I proceeded to repair the valve, all the time surrendering to Swami. The repair procedure was successful (should I have ever doubted that it would?) and the patient was stable. 

During darshan, I asked Swami if I had done the correct procedure. With a blissful smile, Swami said that He was with me in the operating room, that I was His instrument, and that He would take care of her. And He did exactly that – the patient made a quick recovery and enjoyed many years of health and joy, blessed by Swami. Mohan and his mother had a lot of faith in Swami and surrendered to His Will – and He rewarded their faith in the best way and in His own timeframe. My takeaway message is that one should work tirelessly and earnestly – but the ultimate outcome is determined by God. For me, that is the true meaning of faith and surrender. 

Implicit Obedience to Divine Command 

Swami often communicates with suggestions, symbolisms and indirect advice. There was only one time in my life that Swami was very direct – and He had to be, so that I could follow it implicitly and surrender to His Will. 

The Temple University Hospital

I was the Director of the Heart Transplant Program at Temple University, Pennsylvania, USA.  Swami would affectionately call me His ‘coconut tree surgeon’ because of my tall stature. At Temple, we had the largest heart transplant program in the USA. We had a talented team and received several prestigious research awards for our innovative work. At least in my mind, we set the standard for a good heart transplant program. In February of 1998 I was to travel to SSSIHMS for performing cardiac surgery. I got a call from the Chairman at the University of Chicago (UC) to come and look at a job opportunity to be the Chief of not only heart transplantation but of Cardiac and Thoracic Surgery. He called me on a Monday and as I was to travel to India on Friday, I told him that a trip to Chicago was out of the question. It just so happened that my cases for Tuesday were cancelled and at the last minute I went to UC for a one-day visit. UC is one of the most prestigious academic centers in the world. But at that time their cardiac surgery program was in disarray. The transplant program barely existed. I had absolutely no desire to move from the largest renowned program at Temple and begin from scratch at Chicago. 

His answer was always the same - Go to Chicago.

I flew to India and got fully engaged in working at the SSSIHMS. The big difference was that my trip was a little later in the year, and Swami had already left for Brindavan, and so I missed my precious daily darshan of Swami. I was wondering if I would ever be able to see Swami during the trip. Swami knows your innermost thoughts. He sent word for me to come to Brindavan and that He would see me on Saturday morning. With much excitement and anxiety, I went to Brindavan and entered the interview room. Swami was holding a group interview with several families and motioned for us to have a private family interview. On the way to the adjoining room, He held my hand and said “You are going to Chicago. I set up a job for you there.”  I was stunned since I had no desire to pursue that position. My mother and father who were with me asked Swami many questions. I must have asked Swami multiple times about the Chicago job and no matter how hard I tried to change His mind, His answer was the same: Go to Chicago. I pleaded with Swami, explaining that the program in Temple was the best. He gently corrected me – quantity does not mean quality. 

They offered me more money and a promotion to stay at Temple. But, in the end, putting faith in Swami’s words, I went to Chicago despite getting less salary and joining a far underdeveloped program.  My stay at UC posed many challenges. The program was good but not spectacular. Every time I would get job opportunities elsewhere, I would ask Swami and His answer was always the same – “who told you to go to Chicago?” I often felt however, that the move to Chicago was better for my family although it certainly did not appear to be better professionally, for me. I accepted the situation as Swami’s Will. 

The situation at UC stated to change only after fourteen long years. The Cardiology Head of Transplant left the position to join our main competitor. Then the program was placed on probation since our volume and results deteriorated. We had always accepted very high risk cases and also accepted a certain number of poor outcomes to help a larger population of patients who did not have any alternatives. I began to change my philosophy on how to lead the program. We had been very focused on surgery and did not interact as much with other disciplines of medicine. The hospital invested in medical components to augment surgery and also invested in advanced practice nurses and coordinators, and an entirely new infrastructure. We wrote and developed protocols, so that patient care was better standardized. We had to accept less complicated cases until the foundation was solidified. Then slowly we were able once again to do surgery on high-risk patients considered inoperable by other major medical centers. We became the leaders in helping Jehovah’s Witnesses who due to their religious beliefs do not accept any blood transfusions. We became the leaders in the incredibly complex triple organ transplant procedures (heart-liver-kidney) done in a single operation from the same donor. Our volumes increased. Much of this happened because I set aside my ego and allowed a magnificent team of professionals to blossom. In September of 2021, I finally handed the Surgical Directorship of the program to a very senior highly talented surgeon.  

The Eternal Companion

The Best Heart Transplant Program 

I compared our program to others in the country, at the end of my leadership. Data from all transplants is reported by the SRTR (Scientific Registry of Transplant Recipients) which is a database of all organs transplanted in the USA and supported by the U.S. Department of Health and Human Services.  When we looked at the July 2021 report, to our amazement, the UC Heart Transplant program had the best survival rate of any program in the country. In a historic first, we also had the shortest wait times and the highest percentage of underserved minority community patients in the country – truly a miracle!  Never could anyone conceive of that combination being achieved. We were the best program in the country – de facto, the world, since such comprehensive databases only exists in the USA. Swami had sent me to Chicago for a reason – “Quality over Quantity.” It was achieved over 23 years; and as Swami would have desired, it happened just in time for the final report with me as the Surgical Director. My faith in Swami had kept me in Chicago. With hard work and more importantly, change in personal behavior and respect towards others, Swami had performed a miracle. Historically, it was the best transplant program in the world. It is really Swami’s program, where He challenged me to face obstacles – and showed me the way to overcome challenges and conquer them.   

Swami is Eternal and Omnipresent 

The experiences I have narrated happened during the blessed physical presence of Swami. Without that close and personal guidance, I might have never found the strength to surrender and place my life in His hands. My faith in His words never wavered in the ensuing years after He left the physical form. We can all communicate with Swami – during prayers, through dreams, through signs or incidences that we must pay attention to. Swami might not be physically present, but He is omnipresent and as pervasive as ever. Let us be patient with Swami, for patience with the Divine is faith. Let us listen to Him and follow His teachings and guidance with conviction. When we surrender to Him, we will realize that nothing will happen without His Divine Will. Our journey may not be as planned – but He will give us what we need to progress towards the goal of Self-realization.  

 

- Dr. Valluvan Jeevanandam