Kiran Haresh Kumar Patel

Dr Kiran Haresh Kumar Patel is a Clinical Research Fellow at the National Heart and Lung Institute in the Cardiac Function Section.

Maybe it’s because I’m a Londoner

Becoming a doctor was, as with many people who end up going into medicine, a longstanding interest since I'd say secondary school. This was informed by exposure I had, either through family or just through my own interest, with science. I guess it's a fairly stereotypical kind of answer, but you if have an interest in science, and you want to be able to develop practical skills and put them into practice then medicine is a good choice. Of course, science and medicine are very different, but there is an overlap. And I guess that's what attracted me to clinical medicine - the opportunity to do some science alongside medicine as well. And to develop skills where you feel that you're putting them to good use in the real world. It's nice to be able to see that you can apply skills you’ve learnt and see it make a difference. It gives you satisfaction.

I'm a Londoner born and bred. And I'm a practising Hindu and a doctor. My dad was an electronics engineer. He's been working in that industry since graduating from Newcastle University. He came over to the UK when he was 7 years old from India with my grandparents. So, he was the first generation born in the UK. My mum has mainly worked in administrative roles and clerical work throughout her career, and like dad is retired now. I grew up in North London and then I stayed in London for university, so I've not really moved out of London. But I'm aware there's a world beyond Watford! I wouldn't be averse to moving out of London, maybe for a consultant post.

London's probably the most metropolitan city in the world. I think that you'd struggle to find a city as diverse and as accepting, or forward looking. It's quite unique amongst international cities. And I think that's great for institutions like Imperial as we get such a diverse group of people. It's great to be able to be part of that at the National Heart and Lung Institute (NHLI).

My research investigates how weight reduction reverses obesity-related changes in the heart, to prevent people getting heart rhythm problems"

Everyone needs something that they turn to, to give them respite from work. I think music complements academic learning well"

My spirituality has always been my bedrock and it continues to inspire me. I often fall back on it as a source of comfort and strength"

Object one: stethoscope

My research is looking at the effects of obesity on cardiac arrhythmias. Cardiac arrhythmia is a term that describes an abnormal heart rhythm. Some of these can be fairly well tolerated, but a small fraction, not an insignificant amount, can be life threatening arrhythmias. And we know that with increasing weight and increasing adiposity, that is increasing fat tissue, it is detrimental to health for a number of reasons. But more recently, over the past decade or so, it's come to light that actually the amount of volume of fat that you have, in particular, the amount of fat that you have around your heart, is bad for your heart health. So aside from increasing the risk of things like heart attacks, causing inflammation of the blood vessels that supply your heart muscle, it also increases your risk of common heart rhythm abnormalities, and some of these can be life threatening. What's interesting here is if, and how, weight reduction would mitigate any of that risk in patients who don't have a history of cardiac arrhythmias. In other words, people who have never had heart rhythm problems. We want to ask the question whether weight reduction in these people may help reverse any abnormal changes of the heart, and thereby try to prevent them getting any heart rhythm problems in the future.

This is what we call a primary preventative strategy, what we mean by that is trying to help people prevent something happening before it happens, even when they don't have a disease yet. And that's really important from a public health point of view, because there's been increasing focus on this kind of strategy to help empower people to make changes in their lifestyle, to prevent them getting a disease in the first place, which is obviously better. Because once you've got the disease it often becomes very difficult to make that go away completely. Often we end up treating chronic diseases, for which there isn’t a long term lifelong treatment, and there are many things that we can't actually cure. Because for the majority of people with obesity this is a lifestyle driven disease we figured we’d investigate this to try to show that by losing weight, you can actually remodel your heart, the electrics of your heart, which will be a compelling thing to show. From a public health point of view it could support weight reduction strategies that we already have in place. Then from an academic, clinical, and cardiologist perspective, it would best serve our patients in terms of reducing cardiac arrhythmias.

Object two: saxophone

I've grown up with music from a young age. I think that was partly through the encouragement from my parents for me to learn a skill which has been helpful academically. I think music complements academic learning quite well. And I do enjoy playing music. Admittedly, over the past few years, I've played less with work commitments - and maybe a little bit of laziness! But I do enjoy it. I think it's a good respite doing something you enjoy. I think going back, I probably would have liked to have played more for leisure, instead I was playing to pass exams.

Music gives you a break from the work that you do on a day to day basis, it is this kind of release, and everyone needs something that they turn to, to give them a respite from their work, which can be quite stressful at times.

Object three: prayer beads

My spirituality has always been important to me from a young age. And I think that's partly engendered through my family roots and my cultural background. I think it speaks to what I said about music, everyone has something that they turn to outside of their working lives. Which is where they find their confidence - and that happens to be my religion for me. Some people enjoy sport, or going out perhaps, and my spirituality has always been something that I can fall back on as a source of comfort, but also inspires confidence in me. I think it's quite a personal thing, but it's been my bedrock and continues to be my inspiration.

When Covid-19 came along, in all communities from whichever background, whatever faith or non, everyone pulled together. As we all realised the gravity of the situation going on and unfolding globally, which was unprecedented in anyone’s lifetime. Everyone was willing to see what they can do to help. And so I got a phone call from my local temple president in the week of the first wave saying how the temple would like to help by making a donation. It was just chance that they had my number, and contacted me. So I said I could make some inquiries at the local hospital, Northwick Park Hospital, which I've often worked at. All I did was to provide a hospital contact to the temple, and they facilitated the rest so I can't say that I did a huge amount, but the temple making a donation was gratefully received. I think the money went towards new equipment including ventilators and iPads. Because people weren't able to visit their loved ones then, and at that time the hospitals didn't have the kind of facilities for alternatives like FaceTime.

I was also asked to create a video encouraging people in the Hindu community, who would perhaps go to the temple, and the wider Punjabi community, to engage with Covid-19 vaccinations. So I recorded a short video in Gujarati, which is my native language. Someone from the Harrow council came along and filmed the video, it was a short video just encouraging people to take up the vaccination when they were available.

I quite enjoy helping where I can and doing what I can to volunteer on occasion. I think it's part of being in a community. It is important to me and I do take it quite seriously to give back wherever I can. It was nice to be able to do that.

Better together

We've got a wealth of expertise within NHLI, people who are super talented, really bright individuals, with fresh ideas and a range of skills. For me it's been humbling to be in a group like Dr Fu Siong Ng’s where there is so much wide-ranging expertise from machine learning, and artificial intelligence, to lab based and clinical as well - the whole spectrum of research. And there's always discussions in our lab group, there's always something that we can learn from each other. I've learned a lot. And also it reminds you clinical medicine is interesting, which is great as it can get quite repetitive - it can get algorithmic. Pneumonia is pneumonia, and there's only so many ways you can approach that as a doctor. Whereas in academic medicine we’re often finding new ways to solve a new problem. So that's always quite a refreshing challenge. I think NHLI is at the forefront of all of that. You see the kind of research that has come out from the Department, and we've done incredibly well in the past few years, as a leading research institute, I think it just speaks to the wealth of expertise that we have, and the talented people that we work with. It certainly makes my job very easy because there's so much really cool stuff going on. It's great being able to speak to people and to link with others outside your research expertise even if it’s just to find another viewpoint.

"I think I always had a healthy interest in the academic side of medicine. It complements medicine well, you need to be able to ask the right questions to be able to improve treatments but also to identify areas which need further investigation"

Serendipity strikes

So this role was almost coincidence, as with all good things that happen, there was a degree of luck - a healthy dose of that is always needed! I worked with my supervisor Dr Fu Siong Ng as a junior doctor on a night shift. I remember this quite well, he asked whether I'd be interested in research. At that point I was just applying for the cardiology programme but I was keen to get involved with research, and he put it to me that we should stay in touch. I didn't think too much of it at the time, but then after I started my training and I was on night shift (again!) in my first year and looking for opportunities for research, a clinical fellow happened to be on and I mentioned to him I was looking for something. I didn't know at the time his supervisor was Fu Siong. And then a few months after that, Fu Siong contacted me saying, “I've got this opportunity and we need someone in post fairly quickly as we’ve secured funding, would you be willing to join?” And of course, I said, “Yes”. It was a project that was already there, we knew what we wanted to do and the project was flexible. So, it all happened serendipitously through bumping into people, and my supervisor approached me, as opposed to the other way around - so I remain grateful for that.

I think I always had a healthy interest in the academic side of medicine. It complements medicine well, you need to be able to ask the right questions to be able to improve treatments but also to identify areas which need further investigation - there's always gaps in medicine where we don't know things. So I was always keen to have an input in those aspects of clinical medicine’s academic side.

A little bit of kindness goes a long way

I think the pandemic was a time when people had a lot of time to introspect and think about life in general, it was quite a philosophical moment. I do think that it changed people's perspective. And we might be seeing a kind of sea change in terms of working practices. Certainly working practices have changed and probably will continue to do so. But also, I think it helped people reevaluate their priorities in life. It did for me. I think with all strife that we see in the world today, either politically, economically, socially, or environmentally, if there was one thing that we could change, I’d want people to be more accepting of each other. More understanding. Knowing that there's more to life than work. I think that's quite important. I think if we were living in a more tolerant society we would probably have much less strife in the world.

The pandemic was a great leveller. You can be influential, poor, educated or uneducated, from whatever background, but I think when Covid-19 struck, it probably struck you in a similar way at that point. Or you see similar risks. And I think that's one of the humbling things about working in medicine in general. No matter what your background, if you become ill, it can be quite a humbling experience. Certainly in the UK, because of the NHS, everyone gets treated as equally as possible. If you end up in A&E it doesn't matter what your background is. And I think that's great for this country. I know, in many parts of the world, that may not be true. But we're fortunate in this country that actually that is deployed as far as practically possible. And I think that's testament to the society that we live in. But of course, there's still inequalities and there's so much to do to address those, I recognise that, but at least we're striving in the right direction.

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