This piece is part of our first-annual Health Care Heroes series, where we spotlight people doing amazing things in the health care and medical fields. Read the rest of the stories here.
IT WAS JUNE 5, 2020 and the mysterious and deadly coronavirus was spreading across America. Outside Northwestern Memorial Hospital in Chicago, the city was locked down—restaurants shuttered, streets near-empty. Inside a 28-year-old woman named Mayra Ramirez lay in a negative-pressure ICU room, kept alive by a ventilator and a machine called ECMO that was doing the work her lungs could no longer manage. She had been fighting COVID-19 for six weeks, struggling to breathe, heavily sedated. She wasn’t recovering. “It was like her lungs were melting away,” says Ankit Bharat, MD, chief of thoracic surgery at Northwestern Medicine.
Dr. Bharat, 46, had spent six years building the lung transplant program and typically performing surgery on patients suffering from advanced lung diseases, such as chronic obstructive pulmonary disease, cystic fibrosis, sarcoidosis, and others. At the dawn of the pandemic, doctors didn’t know how to treat the virus, but when Dr. Bharat saw patients struggling to breathe he went into detective mode to discover what was happening to their lungs. He put on protective gear and started performing autopsies on patients who had died from the disease. His findings revealed for the first time that COVID—particularly the early strains—was destroying the architectural scaffolding of the lungs.
He uses a stark analogy to describe what he saw: “Imagine a building after an earthquake,” Dr. Bharat says. “If it's a minor earthquake, the structure is intact—you refurbish it. But if the whole building gets leveled, you have to rebuild from the ground up.” In the worst COVID cases like Ramirez, that’s what was happening. Dr. Bharat deduced that the only solution was a double lung transplant. “Without radical intervention, she was going to die.”
That day in June, Dr. Bharat and his team performed the first known double lung transplant ever on a COVID patient in the U.S. Once the lungs are harvested from a donor, the team has approximately six hours to start the transplant. Dr. Bharat has the calm manner of an airline captain who has seen it all, but his passion for science and his work bubble up as he explained the surgery. “First you connect the trachea so you have air. Second connection is the pulmonary artery that brings blood to the lungs from the heart. The third is to connect the pulmonary veins taking oxygenated blood from the lungs back to the heart so it can be pumped to the rest of the body. Lastly, you have to fit the lungs—that feel kind of spongey—into the chest cavity and it’s kind of being like a tailor as you may have to cut or sew or staple the lungs.”
The operation took 10 hours. Ramirez survived and eventually returned to her job as a paralegal at an immigration law firm. The story of how Dr. Bharat gave new breath to Ramirez—and what he's done since—is the story of a surgeon who has spent his entire career doing what many doctors said couldn’t be done.
DR. BHARAT GREW up in northern India, the son of two physicians. But he didn't plan on following them into medicine—he wanted to be a pilot. His father, a pulmonologist, had a pilot's license, and young Ankit grew up with flight simulators and a sky full of ambition. Then, when he was 11, his 9-year-old brother had a tragic fall during some construction on their home and slipped into a coma. He died two days later.
What Dr. Bharat has never forgotten is the gift of those final days. The doctors gave his family a little extra time—enough to sit at his brother's bedside and say the things that a child never thinks to say until it might be too late. “At least,” he says, “that gave us some time to come to terms with that. Just tell him everything I could never tell him.”
That loss redirected his life. He enrolled at Christian Medical College Vellore in India, and set his sights on cardiothoracic surgery. “The most common catastrophic conditions result from heart and lung issues,” he says. “That's where I could make the most profound difference.”
He completed his general and cardiothoracic surgery training at Washington University in St. Louis—one of the first international medical graduates to be accepted there—where he trained under George Alexander (Alec) Patterson, MD, the surgeon who performed the world's first successful double lung transplant in 1986. Dr. Patterson would become a mentor for Dr. Bharat and helped him deal with the stress and challenges when Dr. Bharat was hired to build a new lung transplant program at Northwestern.
Dr. Bharat started at Northwestern on July 1, 2013. He'd spent months getting regulatory approvals from state and federal authorities, building a team, and enlisting patients. On July 4, 2014, he performed the first lung transplant in Northwestern's history. His first patient was a man in his fourties named Harlan Dorbin who suffered from sarcoidosis, an inflammatory disease characterized by the growth of tiny, abnormal lumps of immune-system cells, which can cause respiratory distress. Dorbin had chosen Dr. Bharat's brand-new program over three already-established programs in Chicago. Dr. Bharat remembers Dorbin’s reasoning. “’Doc,’ he said, ‘You're single. I'm also single. And you understand how difficult it is to go out on a date if I have all this oxygen on me.”
Dorbin, however, developed a post-surgery complication that affects approximately five percent of transplant patients—hyperammonemia, a mysterious and near-universally fatal condition in which the body produces massive amounts of ammonia. Nearly every patient who had ever developed it at Washington University, where Dr. Bharat had trained, had died. Dr. Bharat called Dr. Patterson who told him he'd seen the same thing in his early cases. “Keep your head down and keep going,” he said.
A month after the surgery Dorbin died. “That wasn’t acceptable to us,” says Dr. Bharat, who kept searching for answers in the lab he built at Northwestern. Dr. Bharat’s lab discovered that a specific bacteria, which was being transmitted from donor to recipient, was the cause. The finding was published in several prominent journals. Dr. Bharat determined that a course of the antibiotic levofloxacin, if given to all patients, could prevent it entirely. “If I had one extra week, Harlan would be alive,” Dr. Bharat says quietly. “But after that, no one has ever died from it. We found the cure.” It was a precursor of how Dr. Bharat's career would evolve: a cycle of confronting difficult problems with intense optimism and using his deep understanding of the body to create solutions.
WHEN COVID HIT in 2020, Chicago had the nation's second confirmed case. Dr. Bharat watched the ICUs fill. In the six years since starting the center at Northwestern, he had performed nearly 9,000 procedures, including 600 lung transplants, with a success rate he estimates at above 99 percent. “One of the reasons I chose this field of thoracic surgery is because you can save more patients than you lose despite patients coming to us with some of the toughest problems,” he says. Suddenly, with COVID, that number was reversed. Patients were dying in isolated rooms, their families watching through glass windows, unable to touch them.
“Many of these patients, like Mayra, were healthy young people,” Dr. Bharat explains. “They never even thought about dying. And now they were being pushed into a dark room, completely isolated, never able to see their loved ones again. It was devastating to see that many people die.” The parallel to his brother—also healthy, also young, also taken suddenly—was impossible to ignore. “It was traumatic for me personally, it was like flashbacks.”
Rather than pull back, Dr. Bharat leaned in. His mindset was, “This is my job. This is my duty. I have to get to the forefront.” He set up what he believes was the country's first warm autopsy program for COVID patients, entering rooms alone before the standard decontamination process to examine fresh tissue and understand how the virus killed people. The work was hazardous. It was also essential.
The clinical implication was as bold as it was controversial: These patients needed new lungs. “People were not even wanting to touch a [COVID] patient,” he says. “Now you're talking about bringing a whole team to do a transplant on someone who just went through COVID.” It was a paradigm shift the medical community wasn't ready to accept. Dr. Bharat performed it anyway.
The first transplant on Ramirez was followed a month later on Brian Kuhns, a man in his sixties. Both patients survived. Dr. Bharat published the protocols in The Lancet and then outcomes data in JAMA, where his Northwestern team reported 100 percent one-year survival in patients who would otherwise all have died. Since 2020, Northwestern went on to perform close to 200 COVID-related double lung transplants—more than any program in the world.
To manage the weight of it all—the losses, the stakes, the devastation of the COVID years—Dr. Bharat turns to his team, to exercise, and to baking. He learned to make brownies during the pandemic and found it rewarding and relaxing. He often bakes and shares them with colleagues and patients still. “It's not about taking stress away from life,” he says, borrowing a piece of advice a colleague once gave him. “It's about how you manage stress. Like going to the gym—you have to gradually increase stress on your muscles. If you don’t put your body through stress, you’re not going to grow. It’s about managing stress effectively.”
IN 2024, A decade after Dr. Bharat performed the first lung transplant in Northwestern's history, the program became the highest-volume lung transplant program in the United States. The year prior, Dr. Bharat’s team also deployed a new innovation: the world's first total artificial lung system, which helped keep a man in his thirties with severe influenza and pneumonia alive without lungs for 48 hours until a transplant was possible.
The external part of the system sits on a cart next to the hospital bed, about the size of a small medical equipment stand, explains Dr. Bharat. The main components are a centrifugal pump (roughly the size of a large coffee can) and a membrane oxygenator that looks like a Nalgene water bottle. “You see clear tubes carrying blood from the patient to this machine and back. Blood goes in looking dark red and comes out bright red after picking up oxygen,” he adds.
The real innovation is what’s inside the chest. Think about a car engine without a radiator, or a computer with no cooling fan, says Dr. Bharat. “That’s essentially what we’re dealing with when you remove both lungs. Your lungs aren’t just for breathing. They also act as a massive reservoir that can temporarily hold or release about 500 milliliters of blood depending on what your body needs. When you stand up quickly, take a deep breath, or your heart rate spikes, your lungs buffer those pressure changes. It’s like a shock absorber for your circulatory system. Remove both lungs and you eliminate that buffer completely.”
But take both lungs out and the right side of the heart has nowhere to send blood except into the external pump. If the heart momentarily pumps more than the external pump can drain, the right ventricle swells dangerously, like a water balloon being overfilled. The solution was creating an adaptive pressure relief system. “I surgically placed a tube inside the chest connecting the pulmonary artery (where the right heart pumps) to the right atrium (where blood returns from the body),” he says. This tube is made of Gore-Tex (yes, the same material in waterproof jackets and hiking boots), but medical-grade vascular graft form. It’s about eight inches long and 14 millimeters in diameter, roughly the width of a nickel. Think of this like the overflow drain in your bathroom sink. Your lungs normally are that overflow system. Without lungs, I built a new one.”
Dr. Bharat is still driven to innovate. With the insights gained from doing surgery on severely sick people during the pandemic, he’s now pioneering lung transplants in patients with late-stage cancers. He started a program that challenges one of oncology's most firmly held beliefs: that stage-four cancer is a death sentence. Using double lung transplantation in carefully selected patients with stage four lung cancer, his team has treated more than 17 patients—removing both diseased lungs entirely, clearing the chest cavity, implanting healthy donor lungs, and helping people live longer.
“Before we find a cure for any disease,” says Dr. Bharat, “we first have to demonstrate that it’s curable.” He points to tuberculosis, hepatitis C, and leprosy—all once considered incurable, all eventually conquered. “Lungs are the most common organ for cancer metastasis,” he says. “There is no cancer in the human body that doesn't eventually involve the lungs. Lung failure is the most common cause of death in cancer patients. That's where I think we can be most impactful.”
Guided by that north star of finding where he can have the most impact, Dr. Bharat continues to save people who other doctors believe are destined to die. A health care hero that’s paving the way for doctors now and in the decades to come.
Describe your job in three words.
Hope. Innovation. Courage.
Favorite medical show?
Grey's Anatomy. I never watched the show, but they once asked me to be the patient in a COVID transplant episode and wanted a general surgeon to perform the procedure. I had to politely decline that creative liberty.
Best career advice you've ever received?
My dad told me, “There's no harm in dying early, as long as you make it count.”
Guilty pleasure after a long shift?
Mint chocolate chip ice cream heated in the microwave for exactly 12 seconds. You have to try it.
Describe the future of AI in health care in one sentence.
AI is going to be an essential part of health care—it's going to make us better and more effective, and we have to embrace it.
Ben Court is the Executive Editor of Men's Health. He has a decade of experience writing and editing stories about peak performance, as it relates to health, nutrition, fitness, weight loss, and sex and relationships. He enjoys yoga, cycling, running, swimming, lifting, grilling, and napping.
