The Heart Specialist

The esteemed Dr Maharaj was the only cardiologist at St Agatha’s Hospital. Although I met him many years after he first arrived from Kashmir, the nurses told me everyone had taken to him right away. How could they not? There was a sincerity in the way he spoke; a strength in the hand he put on your shoulder. And when a patient’s heart was beyond repair - because there was no way he could save them all - he held their hand and promised to help them through until the very end. Dr Maharaj was the doctor that patients would kneel next to their children and point to, saying "that doctor there - he’s the kind one”. Yet it was quite something to find a heart specialist who knew so little about the heart.

Yes, when I first met Ravi, he was still in the industrious, clueless vigour of his forties. He used to bustle through the wards like a portly bowling ball; white-coated junior doctors would scatter in his wake with murmured apologies. His evenings were spent at the hospital seeing extra patients and writing clinical letters. It was ingrained in him from his medical training in India and the challenges he’d endured to become a cardiologist - there was no time to pause, no time for life - and in the process he had become a physician of surpassing quality. Though, as I remarked to him years later, if someone spent that much time at work, you’d expect them to be pretty damn good at their job.

Sometimes the mind keeps itself busy to forget what hides underneath, and I’m sure that was the case in Ravi’s middle years. In all the photos from that time, he cycles between two or three different work shirts, and his moustache is bushy and untrimmed. He was never tall and his waistline grew slowly but steadily. If he did look in the mirror, I doubt he liked what he saw - so it was no wonder his romantic confidence lay down in his boots. I was told it was shameful in his culture to reach his age unmarried. 

Our first encounter was when we were sharing the care of Mr Patel. Oh, Mr Patel was delightful. An elderly gentleman who had survived two heart attacks and three stents and was now taking a bucketload of heart pills each morning. He had come into hospital for shortness of breath and leg swelling, and I brought my medical team to see him on the ward round - only to find Ravi already at the bedside. They were deep in conversation in Hindi. 

“Hiren’s shop sells the best chicken korma I’ve ever had. Just another reason why we need to get him back on his feet as soon as possible,” Ravi said when he saw us, flashing a smile. I felt his eyes linger on me a little longer before he excused himself and left.

I remember asking myself who this man thought he was, seeing my patient before he’d even been referred. But I quickly realised that this wasn’t a power move or a way to get ahead of the game. This man truly seemed to care about the community and his patients. And, appealingly, he wasn’t afraid to show it.

“I’ve been seeing Dr Maharaj through the private system,” Mr Patel said. “He knew this would happen eventually - that my heart would fail. Is there any hope for me, doctor? My granddaughter is expecting later this year, and I have another granddaughter graduating from dentistry school, and I do want to see the Eagles when they tour the world next year. There’s so much more I want to do. I just want more time.”

“You do have time,” I said simply. “Much more than you think.”

That Christmas, I saw Ravi again at the annual work function. Somehow - and I still believe this was the hand of fate - we were assigned to sit side-by-side at the dinner table. We spoke into the night about Medicine, about the limitations of healthcare, about the failings of the system we would pass down to our children. And then something unspoken passed between us, childless as we were, a warning that time was running out. I saw it in his eyes that night: a deep-rooted longing to be himself. A willingness to take a chance. And a promise that I could be the one.

Our love was charmingly bradycardic; the rhythm steady, the beats slow. I was surprised to learn he had never kissed anyone, let alone had sex. The first time I tried to hold his hand, he recoiled as if my hand was a viper, then embarrassed himself further by claiming that hand-holding was for teenagers. But I wore him down. By six months he was leaning into me as we walked down the cobblestones, planting hairbrush-like kisses on my cheek when he thought no-one was looking. I wasn’t afraid to tell him he was sexy; the strands of grey in his moustache were a turn-on and I didn’t care about how round his belly got. The only flaw was how clandestine he insisted on being. 

We used to go to work separately to avoid suspicion - everyone knew the gynaecologists were awful gossips. In clinical meetings we exchanged sordid glances at the back of the room where no-one could see. But the luxury of our stage in life was that we wanted for nothing: candlelight dinners where puffs of lavender-scented candles wafted in the rooftop breeze; a memorable getaway to the States, when we perched on a float at Pride and waved giant rainbow flags - all whilst wearing sunglasses to remain incognito, of course. We couldn’t have Mr Patel accidentally recognising his cardiologist on BBC News. 

One day, he sat me down and said his parents were coming to visit. I was overjoyed - maybe this was our chance, an opportunity to share our love with the world. The closet door beckoned. Who better to start with than his parents?

“I can’t tell them,” he said. He shook his head. “I can’t. In my culture, this is shameful.”

“Shameful?” I repeated. 

He just looked at me in defeat.

“You’re a grown man,” I said. “You’re allowed to do this.”

“I was hoping you would understand,” he replied. “If we just don’t see each other while they’re here…” He took my hand. “I’ll make it up to you once they leave.”

I pulled away. “No. How much longer can we do this? I’m tired of creeping around like we’re doing something wrong, like our relationship doesn’t mean anything. And do you think people at work haven’t noticed already? Cat’s out of the bag, Ravi. Let’s tell your parents and enjoy this the way we deserve to.”

Then he said those awful words again: “I can’t.”

For the next ten years I saw Ravi mostly from a distance. We did our best to remain professional at work, since we shared patients all the time, and I tried not to dwell on what he was thinking when we were forced to discuss our cases. Such is the curse of working in a small hospital like St Agatha’s. I knew he saw my eyes straying down to his moustache on occasion, where I noticed the grey hairs multiplying. I said nothing when he lost a significant amount of weight over several months (though of course I pondered which exercise regimen he followed, or indeed if he was sick and hadn’t thought to tell me). I even went to Pride by myself one year - sans sunglasses - and hoped that he saw me on the BBC. 

I saw less of him over time. He was promoted to Chief Medical Officer for the entire hospital and shifted his cardiology practice to purely private clinics. When we did encounter each other at St Agatha’s, it was always brief and professional. We became strangers for a time, but I was sure he never married, never even dated anyone else; he knew that year of his life with me was perhaps the only time when he had been himself, and that it was the closest he’d ever been to the happiness he deserved. He knew this, and that was why he waited. 

For reasons known only to fate, Dr Maharaj once again came into my life at Christmastime. It wasn’t at a Christmas party - I’d stopped attending those long ago - but somewhere altogether more poignant. Holding a bag of Indian takeaway, I pushed open the door to leave and came face to face with him. He was holding his umbrella stiffly against the rain. He looked down at the bag.

“Chicken korma,” he said.

I nodded, unable to get any words out.

“You heard about Mr Patel?” he said. 

I nodded again. “A shame. Made it into his nineties, though. Entresto, eh? Wonder drug.”

“You’ve fallen behind. There are better cardioprotective therapies now,” he said, smiling.

I bit back a retort about therapy. “How… how have you been?”

“I made a mistake,” he said. “I’ve regretted it every day for ten years. I understand if you never want to see me again, if you’ve moved on. But if there’s still a chance for us… if there’s a chance for me to be myself again, I have to try. Better late than never.”

“And your parents?” I said. My heart pounded in my throat.

“They’re dead,” he replied.

I don’t know how a relationship blooms again after years of neglect. Once, we’d grown something pure and full of life, carefully watered and treasured like the most precious thing we owned. When it was cut down at the stem, its gentle, tentative growth faltered. But I knew the roots remained. And I quickly began to feel - more fervently than before - that this was the man I loved, the man I needed most. I was even willing to forget that he’d waited for his parents to die before coming back to me. 

Yet love in our fifties felt different than it had in the previous decade. We quickly settled back into old, familiar patterns, yes - but Ravi’s duties as Chief Medical Officer took up much of his time. Where I had started to shed responsibility as an aging physician, he took it upon himself to bear more duties. Many a night was interrupted by a hospital emergency, or some matter that needed his urgent attention, and the grey in his whiskers started to outnumber the black. He began to tell me that he missed working with patients. He was tired of this distant bird’s eye view of the hospital.

Nevertheless, times were good, and we basked in the sunny freedom of a normal relationship. The days of cautious hand-holding were gone. Ravi’s wealth had ballooned with his dual salaries from both the public and private sectors, and on the rare occasions he took time away from work, we jetted off to every corner of the world with first-class seats and the most extravagant hotels. We decided we were too old to attend Pride - instead watching it on the BBC - but quickly changed our minds when we saw geriatric couples (much more decrepit than us) gallivanting with the best of them. All was well, until the call came. 

“Ravi?” I saw his face fall as he put the phone down.

“I’ve been offered a job,” he said. “Director of Cardiology at Headwin Hospital in Kashmir.”

“Kashmir?” I said. 

“Yes,” he replied. 

“I’ll come with you. We’ll keep going. We’ll live the same life.”

“We can’t. It’s Kashmir. We’d have to go back to hiding it all.”

A silence stretched for eternity.

“I’d do that for you,” I said.

I waited for him to pull it out, roots, stem and all. I waited for the rhythm to end.

“No,” he said. “I can’t do it again. We’re not hiding who we are to fit society because we’re afraid of what people think, or what they might do. This is it. I want to hold your hand in public. I want to kiss you without being stared at. I want to get married, and adopt a child, and raise them with you so that when we’re gone, there’s someone else who shares our kindness and spreads it the way we do. I don’t care where we go. That’s all I want.”

I must have looked at him with the most incredulous expression, because he burst out laughing and pulled me into an embrace. His breath was warm against my neck. His moustache tickled my cheek.

“I won’t let you go this time,” he said. “I can’t.” 

For all of his expertise in cardiology, the esteemed Dr Maharaj took fifty-six years to qualify as a specialist in the heart.