Heart surgery. Surgeons conducting coronary bypass surgery on a fully-conscious patient. Rather than a general anaesthetic, the patient has been given an epidural anaesthetic, delivered through the spinal region, to numb only the upper thoracic region of his chest. This has the advantage of not requiring lung ventilation, so is suitable for patients with lung problems. The surgery is performed while the heart is still beating, using an 'octopus' device to stabilise a portion of the heart. Photographed in 2004 at the Wockhardt Hospital and Heart Institute in Bangalore, India, where awake coronary bypass surgery was conducted for the first time in India in 2002.