Dr. Anuj R. Shah: “Give yourself permission to rest — It’s okay to take time for yourself”

Give yourself permission to rest — It’s okay to take time for yourself, a concept a lot of older doctors/business owners may not agree with. It is important to recharge your batteries so you’re more efficient in being able to handle whatever comes your way. As part of my series about health and wellness leaders, I had […]

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Give yourself permission to rest — It’s okay to take time for yourself, a concept a lot of older doctors/business owners may not agree with. It is important to recharge your batteries so you’re more efficient in being able to handle whatever comes your way.

As part of my series about health and wellness leaders, I had the pleasure of interviewing Dr. Anuj R Shah. Dr. Shah is a Cardiovascular Disease Specialist and the Founder and director of Apex Heart and Vascular Care. He holds seven board certifications in Cardiology and Interventional Cardiology. Dr. Shah graduated from one of the top universities in India, Gujarat University, in 2003 with six gold medals and honors. He completed a residency and fellowship at University of Connecticut and published more than 50 articles and abstracts in peer-reviewed journals. He was trained in complex cardiac and vascular cases at Mount Sinai Medical Center in New York. Dr. Shah won The Young Investigator Award from American Society of Nuclear Cardiology and has spoken at several national cardiology conferences on cardiogenic shock. Dr. Shah has held leadership positions, including Director of Vascular Interventions at Good Samaritan Hospital and Bon Secours Hospital in NY. He also served as the Assistant Professor of Medicine at The Mount Sinai Medical Center. Dr. Shah currently has hospital privileges and performs interventional procedures at The Hackensack University Medical Center, St. Mary’s Medical Center, St. Michaels Medical Center, and Englewood Hospital. He specializes in the treatment of circulatory disease, treatment of varicose veins, swelling of the legs, and venous ulcers. Dr. Shah holds seven board certifications in Coronary and peripheral vascular interventions, Level II Echocardiography, Level II Nuclear Cardiology, Level II Vascular Ultrasound Interpretation, Level II Coronary CT Angiography and ABI/PVR Analysis. Dr. Shah is the President of Bergen Indian Medical Association. Dr. Shah has been named a “Top Physician” in the 2015 edition of Leading Physician of the World and has been among the “Top Doctors of New Jersey” since 2015. He was recently featured on Healthline on Artificial Intelligence and AFIB.

Thank you so much for doing this with us! What is your “backstory”?

I always had a passion for helping the sickest of the sick in a fast-paced, acute setting. As part of my training during my Intern year at University of Connecticut, I did a rotation in the Coronary Care Unit and loved being able to immediately act on situations where life and death decisions were being made in patients with very serious and rapidly deteriorating cardiac conditions. The difference of a split second could often mean the difference of life or death. This led me to pursue a career in Interventional Cardiology. Interventional Cardiologists are the doctors who get called in to intervene whenever someone comes to the hospital with a heart attack or cardiac arrest. A lot of residents would often say that they would never want to get into interventional cardiology because of the lifestyle and the acuity with which you have to respond. Just like a trauma surgeon, you’re dealing with sickest of the sick and are always in life and death situations. But nine years into practice and almost 10,000 cases later, I still get excited with an opportunity to provide care for sick patients with acute cardiac issues whenever my ER colleagues call me, regardless of what hour of the night it is.

Can you share the interesting story that happened to you since you started your career?

I had just started my career as an interventional cardiologist. I received training at Mount Sinai, one of the best centers in the world for interventional cardiology. I started working as an attending at Mt. Sinai, but would also go to a smaller Satellite hospital outside of the city. It was my first week as an attending and I was trying to get my name out to the local doctors. On Saturday night around 2 am, I got a phone call that there was a very sick patient who went into cardiac arrest and required multiple shocks to bring him out of it. We immediately activated the cardiac cath lab. Upon arrival, all the senior doctors from the hospital, the chief medical officer and the mayor of the town were all there. This particular patient was the senior most cardiologist of that hospital who unfortunately got sick. He had worked there for 42 years and was a community leader. When I scrubbed in and started the case, his blood pressure was very low and his pulse was very rapid but barely palpable — consistent with a severe cardiogenic shock state (when the heart stops pumping blood) and his main coronary artery (left main artery) was occluded. I had to remind myself of all the training I had over all these years, calm myself down and remove myself from any performance pressure in front of peers. I approached him with a calm mind. He was too sick to go for open heart surgery and needed a very special device called Impella (Artificial Heart). This was the first time they had seen the use of this device in this hospital, but fortunately, I had done a number of cases with Impella and was very confident that it could be successful. I placed the device and could open his arteries. I am a strong believer that once you’ve had robust medical training, you can always go back to the basics, like a seasoned pilot flying an airplane in stormy weather. If you follow the basics, you will be able to land safely and successfully.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Working in a cardiac cath lab is like any other complex work (like flying a plane or launching a rocket!) — there are protocols and steps that have to be followed and you have to be prepared. Usually, an entire team is involved. When I first started working in the cardiac cath lab, I was not aware of the role and responsibilities of various team members. As a trainee, I assumed I had to be part of everything, from getting the consent of the patient for the procedure to bringing them in the cath lab/procedure room, scrubbing the patient and draping them and making the field sterile, all the way to preparing the surgical table for the procedure. There are a number of instruments that every Interventional Cardiologist likes in a particular way and each cardiologist can have a completely different preference as to how their surgical table is prepared. In the beginning, I did all of that on my own and it would often times take an additional 30–40 minutes in each case (the cases can last anywhere from 30 minutes all the way to 4 hours). This eliminated any available time for me to even take a breath in between cases (we would do on average 8–10 cases a day as a trainee). Later on, I realized that my role was not to do everything on my own. We have scrub technicians, cardiovascular technicians (CVT) and OR nurses to help out.

During fellowship, the scrub techs wouldn’t tell me to stop and were laughing at my eager enthusiasm. One day, a kind scrub tech said to me, “Doc, you do realize that you don’t have to do this preparation work, right?” I was embarrassed at my ignorance! It took me a while to get comfortable at asking for help from others on the team, but once I learned to do that, I realized I could focus on the true aspects of the case that I should be paying attention to! I learned the lesson of teamwork. There is no shame in asking for help, especially when you’re first starting out. Since then, I have always been a great proponent of discussing every aspect of a case with my cath lab team, from the initial planning to decompression to make sure there were no issues in the case. The scrub technicians and CVT’s are some of my best friends and the biggest source of help during any case! Team work = Dream work!

Are you working on any new or exciting projects now?

I am working on a very exciting non-profit organization to bring advanced healthcare to underdeveloped nations. It’s basically like Doctors without Borders but provides more cutting-edge cardiac procedures. Organizations like UNICEF and Doctors Without Borders do an excellent job and provide tremendous basic healthcare facilities, but cardiac procedures requires a relationship with local doctors at the grassroots level. We are in the very initial phases of talking to local doctors, healthcare organizations and local governments in a few developing countries.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I owe all my achievements to a number of very kind and helpful individuals and mentors who have truly shaped my career. As an immigrant from India, I came to the USA with a one-way ticket, 2 suitcases and a heart full of dreams and ambitions. I’d like to particularly mention my mentor — Dr. Gary Heller, my program director at Hartford Hospital, UConn and the ex-president of American Society of Nuclear Cardiology (named ASNC). I was in my intern year and interested in working with him, but his secretary at the time would not grant me a meeting with him because it was known he wouldn’t work with interns. One day, I timed walking on the same corridor as him, so I’d get a moment with him in the elevator. I got all of one minute and I immediately told him that I was a big fan of his research work and would love an opportunity to work with him. I still don’t know to this day if he was impressed with my honesty or took pity on me, but he decided to give me a shot and allowed me to come to his research meetings. Under his mentorship, what started as one research meeting, turned into multiple research projects over the years with more than 20 publications and getting selected as the ‘Young Investigator Award’ at the International Society of Nuclear Cardiology. I became one of his favorite fellows and we ended up forming a genuine friendship and a deep bond of respect and camaraderie. I got a chance to visit his place in Cape Cod and traveled with him to multiple international conferences to speak on the latest technologies to detect blockages (PET scan). To this day, he still says I am the most bold elevator talker he has ever met! Moral of the story- Go for it!

Can you share your top three “lifestyle tweaks” that will help people feel great?

  1. Proper Sleep. A lot of people ignore the importance of sleeping adequate hours and treat their bodies like a ‘machine.’ Proper emphasis on sound sleep does wonders for mind and body and health.
  2. Plant-Based Diet — There is a substantial amount of data that supports a plant-based diet for lowering cholesterol.
  3. Meditation and Mindfulness. We know that there are definite advantages of calming the mind for blood pressure, cholesterol, arrhythmias and overall cardiovascular health.

And of course, exercise is critical for cardiovascular health!

Is there a particular book that made an impact on you? Can you share a story?

I love the book “The Heart Healers: The Misfits, Mavericks, and Rebels Who Created the Greatest Medical Breakthrough of Our Lives.”

This is a great book highlighting some of the champions in the history of cardiovascular disease who changed the field. Historically, heart disease has always been considered an absolute death sentence, and by the middle of the twentieth century, it was killing millions and many physicians stood helpless. The visionaries had begun working on it with the very first case of a German surgeon Ludwig successfully suturing the heart of a living man with a knife wound to the chest for the first time.

There have been instances of doctors inserting catheters in their own arms and forcing X-ray technicians on duty to take photos as he successfully threaded the catheter down his own vein. There are so many interesting stories that show the truly innovative and daring mavericks who acted not only with courage but also compassion. These are the visionary leaders who shaped the field of cardiology.

My personal favorite story is of Dr. Andreas Gruentzig, the ‘father of coronary angioplasty’ — who had the vision and courage to insert a balloon inside a coronary artery when no one else dared to do it. This Emory emeritus professor not only did this innovation, he was visionary enough to publish his research and teach the rest of the world how to perform this incredible technology. The very first patient who underwent this procedure ended up outliving the famous doctor himself. Reading about these hero’s has inspired me to be courageous and innovative in my own private practice.

If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?

If I could start a movement it would be teaching people how to make habits that last forever. If you know the science of forming a habit — it’s easy to form healthy habits. It’s not that most people want to eat unhealthy or not exercise, they just don’t know to form a habit of living a healthy lifestyle and how to sustain that lifestyle. Mind over body is always the key! You have to learn to hack the mind to be able to turn the body! Everyone knows they should exercise and eat healthy, but most people can’t do that or can’t keep doing it because they don’t know how to have their mind get over their bodies. This would enable people to form new healthy habits and stick to them. It is more beneficial to exercise only ten minutes daily than 45 minutes one day and not working out for another month. The key is to form healthy habits slowly and stick to them.

How have you used your success to bring goodness to the world?

As an interventional cardiologist, you take an oath of service. What this means is that whenever a patient is having a cardiac emergency, whether it’s cardiac arrest or a heart attack or any other such situation, we respond right away. We are available for any procedures patients need for 24/7. We have to be within a very close radius (usually five miles for most hospitals) and respond immediately when/if needed. I take the call of cardiology very seriously. Not many people understand what “taking call” really means. Interventional Cardiologists and Trauma Surgeons take call as an act of service by doing emergency, life-saving procedures. I believe that this brings goodness to the world because we provide the ‘safety blanket,’ the line of defense that people need and deserve! When you wake up in the middle of the night and rush to the cath lab to save someone’s life, you are using all your medical training to make an impact in patients’ lives in the most direct way and in turn help them and their entire families. I am very proud and humbled to do this work.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. Life is a marathon and not a sprint — As a medical professional, you keep learning and running and get used to hoping for ‘light at the end of the tunnel’ but it’s the marathon and the compound interest that matters. After all, learning is a never-ending pursuit!
  2. Sometimes you have to be the ‘bad’ guy — More often than not, patients and family members don’t like what you have to say, but at the end of the day, that’s’ the right thing for them. Trying to be the ‘nice’ person and changing therapy per their wishes could lead to very bad results.
  3. Fall in love with all parts of your practice — Oftentimes, doctors fall in love with the ‘surgical skills’ and sometimes other doctors fall in love with the ‘pathology’ that they’re most comfortable treating. It the end, none of that matters as much as taking care of your patients and focusing on whatever it takes to help them.
  4. Give yourself permission to rest — It’s okay to take time for yourself, a concept a lot of older doctors/business owners may not agree with. It is important to recharge your batteries so you’re more efficient in being able to handle whatever comes your way.
  5. Medicine is a Team Sport — and you have to trust your Teammates. Even the smartest doctors need a great team working with them. A bad team could mean bad outcomes for your patients, your practice, and your personal life.

Can you please give us your favorite “Life Lesson Quote”?

My favorite quote that applies to cardiology:

“An Ounce of Prevention is worth a pound of cure.” -Benjamin Franklin

My favorite life quote:

“In the end, only three things matter: how much you loved, how gently you lived, and how gracefully you let go of the things not meant for you.” -Buddha

Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

Dr. Eric Toprol — he’s the superstar cardiologist, geneticist, and digital medicine researcher who is very in tune with the future of healthcare. He is paving the path for the future of cardiology, which will have an influence on digital technology. In his book, The Patient Will See You Now, he has explored how smartphones, big data, and technology are changing healthcare and giving patients the power they deserve.

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