Sandeep Jauhar’s “Intern: a Doctor’s Initiation” chronicles the first year of his intense, often sleep-deprived and sometimes harrowing medical residency in a New York hospital.

The memoir gives an inside look at the workings of the American medical internship system, as Jauhar navigates the pitfalls of nights on call, informed consent, treating depressions other than his own, and coping with patients so exhausted and scared, that doctor and patient alike just want to go home.

Some readers may find Jauhar’s brutally honest memoir disturbing. In a graphic account, a 55-year-old patient goes into uncontrollable seizures during one of Jauhar’s on-call times. As doctors struggle to stop the seizures by loading the fast-fading patient with intravenous sedatives, Jauhar realizes to his horror that he may have contributed to the man’s death — by failing to check a simple lab test.

He writes: “I lay down in my call room, fatigued…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?”

Laymen often view doctors as Type A overachievers with little self-doubt but Jauhar’s memoir is full of tortured anxieties and it succeeds as a portrait of an imperfect human being trying to do his best at a tough job.

Jauhar, now a successful cardiologist and the director of the Heart Failure Program at Long Island Jewish Medical Center, was an intern a decade ago but says he still remembers it “the way soldiers remember war.”

At that time, as a new medical school graduate, Jauhar rotated through different hospital settings – outpatient clinic, intensive care unit, cancer ward — to learn how the medical field really works. This introduction to the profession is a brutal year marked by 80-hour weeks and  chronic exhaustion. For those looking to join, don’t say you weren’t warned!

Author Sandeep Jauhar, photo by Maryanne Russell

“Working eighty or more hours per week and staying up every fourth night or so on call, most spend it in a state of perpetual exhaustion, as near ascetics with regard to family, friends, food, sex and other pleasures,” writes Jauhar.

The book portrays internship the way most doctors remember it — a grueling rite of passage. It touches upon the inevitability of mistakesand the fallibility of physicians. When Jauhar points out incompetence, they are almost always his own mistakes as a green intern. He says patients should ask questions and demand more from their physicians.

Jauhar’s father, a plant geneticist from India who felt his own advancement in the U.S. 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.

Jauhar entered medical school in his mid-20s after being a Ph.D. student in physics at the University of California, in Berkeley. A girlfriend’s incurable illness gave him the push to study medicine.

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

Uttara Choudhury is Associate Editor, North America for TV 18’s Firstpost news site. In 1997, she went on the British Chevening Scholarship to study Journalism in the University of Westminster, in London.    

Tags: Sandeep Jauhar, Medicine, Intern a doctors initiation