Dr. Smooth, the Velvet Catheter
When I reflect on the journey I've taken since my stroke and subsequent AVM diagnosis, two doctors stand out as heroes in my story: Mr. Jarnaill Bal, my neurosurgeon who quite literally gave me a second chance at life, and Mr. Levansri Makalanda; or as I affectionately call him, Dr. Smooth, the Velvet Catheter.
Before this ordeal, I didn’t know that cerebral angiograms even existed. I’d heard of angiograms in the context of heart health as my grandfather had heart issues and spent much of his later years in and out of hospital. But I never imagined that the same process could be used to map the brain.
I’ve now had three cerebral angiograms. It’s not a walk in the park. The procedure involves threading a catheter through your femoral artery in the groin (or less commonly, the arm), injecting dye to visualise the vessels in the brain. Dr. Smooth explained that going through the groin remains the preferred route as it offers better control and access though it comes with the added bonus of lying flat for hours afterwards to avoid re-bleeding at the entry site.
The procedure is deeply uncomfortable. I have to hold my breath as the dye is injected where a warm flush races through my body, sparkles dance in my eyes and I feel a wave of nausea not unlike seasickness. It lingers. Flickers of black dot my vision until the dye clears.
Strangely, I found the angiogram more nerve-wracking than brain surgery itself. During the operation, I was under anaesthetic. With the angiogram, I was wide awake and talking to Mr. Makalanda and his team while a catheter navigated its way to my brain.
But here’s what sets Dr. Smooth apart.
He’s an expert in endovascular intervention. He has the ability to perform embolisation, a technique where an AVM can be closed off by injecting a type of medical glue to stop the blood flow. It could’ve been a pathway for him to take the lead in my treatment and yet, after carefully reviewing my case, he advised against it. My AVM was too close to my motor cortex, and embolisation posed too great a risk. Instead, he referred me to Mr. Bal because was the safer and more effective option.
To me, that’s integrity.
He could have followed the recommendation and handled the case himself. But he didn’t. He chose what was best for me, not what was convenient or beneficial for his own practice. In a system that often feels overrun and stretched, that kind of patient-centred decision-making is rare and remarkable.
Looking back, I’ve realised that the procedure itself is only a fraction of what matters in recovery. Yes, the surgery was critical. But the things that have brought me the most comfort? Clarity, kindness, and timely follow-up. The way a doctor speaks to you. How they listen. Whether they see you as a person and not just a case file.
That’s why Dr. Smooth holds such a special place in my journey.
He’s precise, measured, calm, and effortlessly kind. The way he handles a catheter is, dare I say, elegant. I’ve got one more angiogram left before I can hopefully declare myself free of this AVM for good. And I wouldn’t want anyone else threading a wire through my body and into my brain.
The Velvet Catheter. What a man.
