Scoping out the future

If Dr. Love Dalal had followed his father’s advice, he’d not be Oroville Hospital’s newest gastroenterologist. In fact, he wouldn’t have been a doctor at all. He might have followed his twin brother’s path into chemical engineering, or some other line of work.

It’s not that his father has something against physicians. He, too, became a Dr. Dalal and had a busy practice in India. He just knew the sacrifices involved in a medical career.

“My father was a very successful physician in his days,” Dalal explained, “but he thought this particular profession is not an ideal profession with the calls, the late nights and the lifestyle.”

Dalal was undeterred.

“I told him I was interested only in medicine,” Dalal said. “He said, ‘If that’s what you want to do, go ahead.’”

Dalal studied in India, then began practicing in his home country. It was only when he was 43, with a wife and two teenage children, that he decided to come to the United States to complete a gastroenterology fellowship at Rhode Island’s Brown University.

He can tell you the exact date of his trip: Sept. 11, 2001.

“The first stop on the flight was the Middle East,” Dalal recalled, “and they said, ‘U.S. airspace is closed; you cannot go farther.’ So I went back to India, spent 10 more days, then took another flight.”

He had no hesitation. Dalal viewed the 9/11 attacks as “an isolated incident” and wasn’t dissuaded from following through on his plans. He and his family moved to Rhode Island, and he completed his fellowship in 2004.

Next stop: Bakersfield.

Why Bakersfield, of all places? Partly he made the decision to join a private practice he liked, at the Bakersfield Digestive Disease and Endoscopy Center. Partly he made the decision because of the warm temperatures, after enduring several Northeast winters.

“I interviewed at a lot of places—I interviewed in Michigan, I interviewed in Oregon, I interviewed in Florida,” he said. “This was a good opportunity, and in India we come from a tropical climate, so that probably made me decide not to go to the colder areas of the country.”

Dalal spent nine years in Bakersfield. But as the health-care landscape changed, he began looking for hospital-based employment, which he thought would be more stable than private practice. He also believed he’d have more room for advancement in a larger organization.

Once more, he interviewed at multiple places before deciding Oroville was the place for him. He started working at Oroville Hospital in late March.

“Obviously I like the area,” Dalal said. “I’ve always loved to be in smaller towns and smaller areas. If someone asked me to go to Los Angeles or some other city, I would never go there. I don’t like commuting. I’m looking for a small place with nice people, and I think this fits.”

During his interview, Dalal learned that Oroville Hospital had recently purchased a piece of technology called the Endo Capsule. No one had been using it, however; Dalal was excited by the opportunity to be the first.

The Endo Capsule is a miniature image recorder used to locate abnormalities in the small intestine. It’s about the size of a vitamin capsule, and it transmits a signal to a receiver worn on the patient’s belt. The patient swallows the capsule, and the capsule’s camera shoots two pictures per second as it works its way through the digestive tract.

Dalal has been using the Endo Capsule since 2004. It’s helpful because it goes where standard upper and lower endoscopies can’t reach.

“When you put a scope through the mouth, you can only go to the beginning of the small intestine, and when you put the scope through the rectum, you can see the colon/large intestine—but in between there’s about 17 feet that’s not easily visible,” Dalal said. “There are endoscopes that can lead you through the area, but they take three to four hours, they need anesthesia, and it’s more of a research tool and not in regular community practice.

“This capsule, I think, is a very powerful tool.”

With a battery life of eight hours, the Endo Capsule shoots more than 55,000 images. That’s a lot for the doctor to review, but Dalal explained that the technology includes software that deletes duplicate images, so it takes him only around 45 minutes to read the stream of images.

The GI doctor looks for any abnormalities. Even with time stamps and physical landmarks as guides, he cannot exactly map where an abnormality lies. Instead, he’ll identify the general area for a follow-up scan with an MRI or more specialized endoscope.

It was the opportunity to work with such technology that attracted Dalal to gastroenterology. He sees further advances thanks to high-definition imaging, multidirectional cameras and new techniques. He’s heading off to a convention next week and is excited about what he’ll see.

“I’m a lifelong learner,” he said. “I always like to learn, and through the years my scoping techniques have improved remarkably, just by looking at how [other] people are doing it.”

He has a busy practice in Oroville—performing endoscopies in the morning, seeing patients in the office in the afternoon, then making rounds in the hospital. His father was certainly correct about the workload.

“I think [medicine] is my hobby, and I’m enjoying my life,” Dalal said. “I’m not tired of what I’m doing. But none of my children are doctors!”