In Her Own Words: Dr. Ruchira Garg
Dec 16, 2021 Carrie St Michel
Meet Dr. Ruchira Garg, expert cardiologist and amateur soap maker. Dr. Garg, director of Congenital Noninvasive Cardiology and associate director of the Guerin Family Congenital Heart Program at the Smidt Heart Institute, shared her thoughts about the challenges of caring for patients still snuggly nestled in their mothers' wombs, as well as the demands of caring for adults nearing the end of their life journey. As Dr. Garg observes, "My patients span the spectrum from cradle to grave, literally."
"I just love that I can build a bond with patients and families, and I'm honored that they share with me the challenges they're facing."
Ever since childhood, I've been called Ruchi. It turns out that in Hindi, Ruchi means interest. I think that's apropos, because I love to be busy, and I'm interested in so many things!
Congenital heart disease is fascinating. There are no rules by which the heart lives. Where the heart is located in the chest, where the chambers are and how they connect to each other can all be abnormal. As an imaging specialist in pediatric cardiology, I have to put all the pieces together using two-dimensional images to create a three-dimensional understanding of the heart to guide surgery or other interventions.
Every day in the clinic is a little bit different. Most of my time is devoted to clinical care of patients with congenital heart conditions. When I'm in my cardiology clinic, I'm seeing expectant moms whose babies may have a congenital heart issue; I'm seeing pediatric patients with whom I have longstanding relationships; and I'm seeing adult congenital heart patients who may not have recognized that they have a congenital heart condition or who have a history of valve repair or other childhood heart surgeries.
One day per week is dedicated to cardiac MRIs. These are lengthy studies that can take upwards of three hours to scan and interpret. We look at heart function. We look at the blood vessels that enter and leave the heart. And we can measure how much blood flow goes through the various chambers in the heart and the vessels in the chest. There have been significant advances in MRI technology that allow us to visualize three-dimensional flow patterns in the heart. We also can create three-dimensional digital models from MRI scans to help plan surgeries and other interventions. It's a very comprehensive tool that I had the good fortune to learn during its early days, and that we still use routinely.
I've been in pediatric cardiology since 2000, and I've seen a lot of advances. A major advancement was pioneered at Cedars-Sinai just a few years ago. Up until then, when premature infants were sick with a patent ductus arteriosus—a persistent opening between the two major blood vessels leading from the heart, also referred to as a "hole" in the heart—surgery was performed on these fragile babies. I worked closely with Dr. Evan Zahn who developed a minimally invasive procedure to fix this problem. I provide the imaging with echocardiography (ultrasound of the heart) to guide the procedure, which consists of passing a catheter through a vein in the leg to the heart to close the connection with a specially designed device.
I'm in somebody’s life during a very challenging time: Telling a mother that her unborn child has a heart problem is an incredible responsibility—explaining that heart surgery is needed, is a shock that most new parents are not expecting to hear. I regard this aspect of my work as a privilege—to build a bond with a patient and his or her family. I'm honored that my patients and their families share their challenges with me, and look to me for guidance at a pivotal moment in their lives.
I wanted to be a doctor since I was 8. My mom was a physical medicine doctor in Toronto where we emigrated when I was 2. I saw how happy she was every day after work, and how much she loved being with her patients. I thank her for modeling for me that you can be a woman who loves her family very much, but who also loves her job.
I have a rather unusual hobby. It started about 10 years ago when I made my own shea butter lotion. Then I started making soap. I make a 10-pound batch of soap every month. I make a solid shampoo bar that I use for my hair. I make a lavender soap, cucumber French clay soap, Himalayan salt soap and a charcoal soap my sons really like. It makes me happy knowing that my family is using natural products, and we cut down so much on plastics and other waste. For the past several years, my holiday gift to coworkers has been an assortment of my soaps, facial oil, lip balm and whatever other new concoctions I have created. People seem to really like their little gift baskets of Ruchi goodies!