Desi doctor chronicles his trial-by-fire as a green intern

Jauhar describes 80-hour weeks and chronic exhaustion — trademark of first-year doctors completing their residencies

NEW YORK: Well-known Indian American cardiologist Sandeep Jauhar’s candid memoir of his training in a New York City hospital is not for the faint hearted. The National Public Radio network posted a brilliant chapter from Jauhar’s Intern: A Doctor’s Initiation on its Web site with a warning that some readers may find the excerpt “disturbing.”

In the characteristically graphic account, Jauhar describes his horror at realising that he had failed to check a routine lab test on a 55-year-old patient who developed seizures, which may have contributed to the man’s death.  Jauhar beats himself up and writes: “I lay down in my call room, fatigued behind words, listening beyond anything I had ever experienced before. I had stayed up all night only a few times in my life: once in college before a history final, a couple times in graduate school when I was collecting data and now seven times over the past three weeks. The thoughts began to flood in, even as I tried hard to hold them back. Why didn’t you check the sodium earlier? Aren’t you responsible for what happened?”

Jauhar’s memoir is full of tortured self-doubt. The New York Times said Intern actually succeeds as an “unusually transparent portrait of an imperfect human being trying to do his best at a tough job.”

Jauhar, who is now the director of the Heart Failure Program at Long Island Jewish Medical Centre, said at a South Asian Journalists Association (SAJA), radio talk; “I wanted to present medicine the way it is; the reality of it. Portray doctors in their glory, and also their fallibility.”

Jauhar describes 80-hour weeks and the chronic exhaustion that is the trademark of first-year doctors completing their residencies. “The book portrays internship as the way most doctors remember it — which is a gruelling, brutal rite of passage. It touches upon the mistakes that can happen and the fallibility of physicians.”

“In the book when I do point out incompetencies they are almost always my own as a green intern. Patients should ask questions and really demand more from their physicians,” he said at the talk. 
 
Jauhar’s father, a plant geneticist from India who felt his own advancement was stifled by racism, had derided medicine as intellectually inferior to pure science even as he encouraged both his sons to become doctors for the sake of income and prestige in the Indian American community. “My parents pushed me and my brother and my sister to some degree to become doctors. It never struck my fancy,” said Jauhar who finally came round. He entered medical school in his mid-20s after being a Ph.D. student in physics at Berkeley. A girlfriend’s illness gave him the final push.

Jauhar moved from Delhi to the US when he was seven and a half and remembers that growing up in Kentucky was tough; “When I moved to Kentucky I had a very odd mixture of a British and Indian accent which didn’t go overwell in Kentucky in the late 1970s, especially in elementary school. I guess I had some odd ways of expressing myself which made it difficult to make friends.”

Roughly 12 per cent of all medical school students in the US are Indians, according to the 45,000-member American Association of Physicians of Indian Origin.