Brian has a faulty heart valve and needs a replacement. He has the funds to have the operation done in his native US, but as an engineer he has researched his condition thoroughly and scientifically. As a result of extensive reading on the internet, he has decided that the Narayana Hrudayalaya is the best hospital to perform his operation.

His reasoning is persuasive. The Narayana Hrudayalaya hospital probably performs the most cardiac operations in the world each year. They are, therefore, the best at it. They can afford to specialise, their recovery rates are excellent and their costs are significantly cheaper than in the US. Above all their surgeons, because they operate six days a week, are 'in the zone' - which is what Brian wants.

He is upbeat about being in Bangalore. It is the first time he has visited India and he is shocked by the obvious poverty and sheer numbers.

Tiberius Almasi, his neighbour from the US, has come to assist him and is finding it difficult to come to terms with life in India. Tiberius is even more nervous than the patient.

But Brian is pleased that by having his surgery in Bangalore and paying a premium for it, he is able to help those who cannot afford to pay - so that both categories receive identical medical treatment. As he says, it is an example of "the third world benefitting from the first".

Although the cost is a lot cheaper than in the US, Brian is paying a premium by Indian standards to be here. He has a private room with cable TV, internet access and 24/7 care. He saw Dr Devi Shetty, the hospital's founder, for his initial examination and has been amazed at the speed and thoroughness of the tests. What would take weeks in the States is carried out in just hours here.

As medical costs rise around the world, Brian is just a forerunner of foreigners seeking treatment overseas - but he is a vital part of Shetty's business plan for the hospital.

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Source: Al Jazeera