Book Review: Silver Lining - Overcoming Adversity to Build NephroPlus, By Kamal Shah

Take any start-up and the chances are you will find an incident or trigger which caused the entrepreneur to found the start-up, with the noble intention of solving a problem or pain point. Nephroplus, a dialysis service provider, founded by Kamal Shah and Vikram Vuppala, to provide patient-centric dialysis treatment in India, also has a “story” behind it. However, this story is a far-cry from the usual start-up story. In 1997, Kamal Shah, one of the co-founders of Nephroplus, was hit by kidney failure at the age of twenty-one when he was on the verge of departing for the US for his master's degree. After the US Consulate in Chennai approved his student visa, Kamal took his extended family in Chennai for lunch at a restaurant called Dasa on Mount Road, which apparently served the best dosas in Chennai, before returning to Hyderabad. In Hyderabad, a mild fever, which Shah initially put down to the various vaccinations he took before his impending departure to the US, deteriorated into a full-blown emergency. After a kidney biopsy at Hyderabad’s Medwin Hospital, Shah was diagnosed with an atypical hemolytic uremic syndrome (AHUS). Shah started kidney dialysis and further complications ensued. A second doctor at Kamineni Hospitals diagnosed the problem as Acute Tubular Necrosis (ATN). Shah kept hoping that a cure was around the corner and that he would depart for the US pretty soon. He was so wrong.

Shah’s first dialysis session was a nightmare. On his way out of the dialysis centre after his first, Shah met a lady who was having her ninety-fourth one! Ultimately, it was decided that Shah needed a kidney transplant. Shah’s mother generously volunteered to donate a kidney, but the renal transplant was unsuccessful. Shah’s trauma continued.

Soon Shah got used to the frequent dialyses and learned to live with his condition. He later moved to peritoneal dialysis (PD), whereby dialysis happens without an external machine. PD made Shah’s life easier. He even took up a job at Suma Computers and learnt Visual Basic. With PD, it became possible to take holidays. He later moved to a software firm started by Obul Kambham (who had moved back to Hyderabad from the US) that focused on the Apple Platform . In December 2004, Shah and a few colleagues took a holiday at a resort in Mahabalipuram, experienced the Tsunami and lived to tell the story!

Shah mentions the names of many good doctors and technicians who helped him to slowly improve his lifestyle. Jayaram, the lead technician at KIMS is one of them. Thanks to Jayaram’s support, Shah was able to switch to home haemodialysis. His energy levels improved, and he could work for eight to ten hours a day. He started to go for a swim every day. Then, in 2007, inspired by his work colleague Akbar Pasha, Shah started a blog. Initially, his blog was on various topics that caught his fancy, including his journey with his kidney disease. However, his posts about his dialysis experience touched a chord with patients and those involved in nephrology. Shah got questions about various aspects of his disease, which he answered. His readership climbed up steadily. One day in 2009, Vikram Vuppala who had worked for Mckinsey in the US, came across Shah’s blog when he googled for ‘dialysis in India’. The rest is history.

After Shah and Vuppula founded NephroPlus, it slowly grew to become Asia's leading dialysis networks with 320+ centres across 4 countries, including India, Nepal, the Philippines and Uzbekistan. How did Shah and Vuppula achieve overwhelming success with Nephroplus? In addition to implementing many innovations which cut down the risk of infection, they started to treat dialysis patients as guests and also followed a 'guest care comes first' policy. They received VC funding. I am not going to give more on this away, other than to say that towards the end of the book, we see Nephroplus acquire a competing business run by US giant DaVita.

Shah writes in simple, but beautiful English which makes the reader glide over the story, even when it details so much hardship. Shah’s matter-of-fact approach to his ailment is reflected throughout and it is very likely that such calm, unruffled demeanour is one of the reasons for Nephroplus’s success. Silver Lining- Overcoming Adversity to Build NephroPlus is a very unique memoir by an entrepreneur which will not fail to strike a chord in any reader, especially in a reader who appreciates courage amidst adversity, despair and hopelessness. Also, Shah’s tome details so many problems which India’s healthcare industry in general and dialysis patients in particular face and will be a boon to anyone who wants to address these issues.

Go on, get hold of this book and read it. Highly recommended.