"The Bullet Is in Your Heart"

Bharat Sharma of Aligarh did his job even after he was shot. Two months later, a surgeon told him

Bharat Sharma's cellphone buzzed at around 10:15am while he was having breakfast with his newlywed wife Aarti. On the line was Devang Vashishta, a colleague. "I have to carry a lot of money today," Vashishta said. "Can you please come along?""Sorry, I can't," Bharat said. "I have to make my own drops." Both men had the job of transferring cash between some of the city's banks and companies, usually on motorbikes. Today-it was 22 July 2014, a Tuesday-Sharma, 32, a well-built five-foot six cash executive with a private firm, had just finished his morning rounds. He'd dodged Aligarh's peak-hour traffic and pedestrians for over an hour, ever mindful of his cash bag with a few lakhs of rupees in it.

"Come on," urged Vashishta. "The company is sending a car and driver."Sharma checked with their office. He also needed to go near the same location as Vashishta did. So it made sense to join his colleague, who was anxious at the prospect of having to carry `35 lakh alone. A month earlier, his older brother Dushank, also a cash executive, had been assailed by a motorcycle gang, who made away with `32 lakh. The police were now investigating the incident, and since then cash executives were provided a company car with an armed guard whenever large amounts were transferred.

Seated in a Maruti Esteem, Sharma and Vashishta were relaxed and chatting with each other and their young driver, Shiv Kumar. By 10:45, they stopped in a narrow lane near a branch of the Punjab National Bank.

Sharma and the guard, Kripa Shankar, needed to walk about 10 metres from the car to the bank's door. As they alighted, Sharma heard a sharp sound, and saw Shankar draw his gun and drop to the ground.Crack! Crack! Sharma froze in disbelief. Somebody's firing at us!

Sharma gripped his bag and sprinted towards the bank, as bullets whizzed past him. I'm not going to let them steal this money, he decided, when he heard the roar of a motor-cycle engine indicating that his attackers were gaining ground. Crack! A bullet hit Sharma in the right side of his chest. It felt like a sledgehammer.

There were two assailants. Seconds earlier, one of them went to the Esteem and held a gun towards driver Shiv Kumar, who pushed open his door, hitting the man with it. He lost his balance and Kumar fled for his life. Vashishta, on the back seat, sat bewildered. The gunman sprang up and grabbed his bag with the Rs35 lakh.

Another bullet pierced Sharma's waist, knocking the wind out of him. Sharma flailed. He tried to keep running, but fell to the ground, losing his grip on the bag. Although shot twice, Sharma now felt just a dull throbbing ache, which he feared would soon turn to agony.

Get up! Sharma told himself as he picked up the bag and staggered to his feet. His legs were rubbery and uncooperative, his grip on the bag tenuous-and he was still being shot at. Just a little further. He forced himself to move step by step until he finally made it inside the bank."Lut gaye! Lut gaye!" [We've been robbed!] Sharma managed to shout, attracting the attention of everyone inside the busy bank before he dropped the bag to the floor and collapsed.

Sharma was rushed to Aligarh's Jawaharlal Nehru Medical College. Hours later, he awoke to find his wife Aarti, in tears, by his side. The doctor told them they'd managed to remove one bullet from his waist, but not a second one. It was too close to his heart, and they'd risk serious damage if they tried removing it."Will I be okay?" Sharma asked."No problem," the surgeon told him. "That bullet will always remain a part of your body."

Sharma wasn't convinced. Later, however, the doctor changed his mind. The bullet needed to go. So on 2nd August, ten days after the shooting, Sharma underwent a second operation, but they still couldn't remove the bullet. Sharma, very weak, his hands swollen, had trouble breathing.Later that month, his wife, mother and older brother Mukesh took Bharat Sharma to New Delhi and consulted a doctor at a leading government hospital. The doctor there told the family that Bharat needed immediate surgery, and that his life depended on it. Shocked, Bharat asked if he could have a month to recover from the pain and fatigue.

"No," the doctor insisted, "You must be operated at once, or anything could happen." Sharma was upset-he wasn't sure he could survive one more surgery. They were at their wits' end, until Bharat's uncle in Ahmedabad put them in touch with Dr Anil Jain, a cardiologist in that city, where Mukesh too resides. On 13th September, Aarti and Mukesh took Bharat to meet Dr Jain at Ahmedabad's SAL Hospital. Dr Jain, 50, bespectacled, ruddy and round-faced with short hair neatly parted to one side, had been a cardiac surgeon since his early 30s. He had a bedside manner that put Sharma at ease. "Don't worry," the doctor said calmly. All this made Sharma feel he had, at last, come to the right place.

This thing is inside me, Sharma kept thinking, but he was resolute. I have faith in God. I know everything will be all right.

A CT scan showed that the bullet was somewhere near the heart, but Dr Jain wanted a precise location. He ordered an echocardiogram-"echo" for short-which uses sound waves to create detailed images. Dr Jain noticed a lot of scar tissue. Much blood had also collected around the pericardium, the sac that contains and protects the heart. Jain then examined a spot on the echo-it took him moments to comprehend what he was seeing. And he couldn't believe his eyes! He'd never have thought it possible that anyone could live for nearly two months with a bullet-or anything solid-in his heart. Jain could imagine the trajectory of the bullet. It had entered from the right-hand side of Sharma's chest, moved across the lungs, somehow missed the sternum-breastbone-and lodged within the heart. A few millimetres to either side meant the bullet would have sliced the atrium, the heart's blood collection chamber, or a great artery, and killed Sharma in seconds.

Dr Jain met Sharma by his bedside. "The bullet is not near the heart," Jain said, sounding as gentle as he could, to keep his patient calm. "It is in your heart." "I don't believe you," Sharma said, his face turning pale as he glanced at Aarti and Mukesh, who were speechless. "You've been very lucky," Dr Jain added, holding up the echo image and pointing to the spot. "The bullet has not totally perforated the heart."

"Could I die at any moment?" Sharma asked.

"We'll just have to take it out," Dr Jain replied with a smile.

Nine days later, on 23rd September, Sharma lay strapped on a SAL Hospital surgical table. "Count backwards from a hundred," Dr Kalpana, the anesthetist told him.

Once Sharma was anesthetized, Dr Jain and his team monitored vital signs so they could put Sharma on a heart-lung machine, which would oxygenate and circulate blood in his body and keep him alive while his heart was stilled and operated upon. Using a saw, Dr Jain took minutes of painstaking work to cut open the sternum and split it precisely down the middle. He had accessed Sharma's heart.

Quite a mess," Jain remarked, observing the scar tissue, debris and blood clots in the pericardium. "Everything's stuck together."Jain's deft hands used scissors, forceps and a suction device-a tiny vacuum cleaner-to clean up and wash the area with saline. He then opened the delicate pericardium.

There it was. Sharma's living, beating heart-with an inch-long bullet lodged in the right ventricle. It's moving back and forth with every beat of his heart! Dr Jain was awestruck. In his 20 years as a surgeon, or as a student before that, he'd seen nothing like this.Dr Jain was relieved that the bullet was exactly where they'd reckoned it would be. Despite hi-tech imaging techniques, pointing precisely to where a foreign object like this is located deep inside the body can be difficult.

Associate cardiac surgeon Dr Rajan Modi used forceps to hold the pericardium in place as Dr Jain cut away and cauterized the tiny blood vessels around it. Finally, Jain connected Bharat to the heart-lung machine. His heart beat for a few seconds before it stilled.Dr Jain then used a bolster-a bundle of swabs-to push Sharma's heart up a little and make it more visible under the operation theatre lights. He then cut through more blood clots and scar tissue until he reached the bullet. Then, clamping a pair of forceps around the bullet, he gently extracted it. He held up the bullet to the light above, sighed, then dropped it into a surgical pan. The sound rang out in the quiet operation theatre.

The surgical team then began the slow process of weaning Sharma off the heart-lung machine. The heart was made to beat again with gentle electric shocks. As the heart-lung machine was disconnected, the team watched carefully as the organ resumed its steady thump, thump, thump… Even the ventricle where the bullet had been lodged was doing its job, delivering blood to Bharat Sharma's lungs! The operation had taken over three hours. The surgical team glanced at the cardiac monitor. All was well.

Today, Dr Jain still reflects on his operation of a lifetime. "I was glad I didn't have to tell Bharat's family how the bullet wasn't where I thought it was," he says, still amazed as he relates the experience, adding, "What destiny!"

Kripa Shankar, the guard who was also shot, survived. As for Bharat Sharma, he has been recovering well at home. He looks forward to changes in his life, like finding a less risky line of work. "I've been given a second life. I have a wife and a family," he says. Since the bullet was removed, Sharma has travelled five times with Aarti to Ahmedabad for check-ups and to thank Dr Jain for saving his life.