A Grueling Test
There are millions of immigrant stories in the naked city. Intern is one of them—the story of the New York cardiologist and author Sandeep Jauhar. Born in India in 1968, he came to the United States nine years later with his parents and siblings. His father was a plant geneticist who did not get many breaks in American academia and blamed that on racism. His mother was a lab technician; and her family, which settled in southern California after two years in Kentucky, often had to rely on her salary to stay afloat. Given that their background was solidly middle class in its values and expectations—her father was an army doctor before going into private practice in New Delhi—Jauhar’s parents were far from living out their American dream. Yet they never seemed to doubt for a second that their children, their sons in particular, were destined for great things. That at Indian social functions the Jauhar children felt looked down upon by the families of doctors, who had fancy cars and designer clothes, could only have acted as a spur. That the embittered plant geneticist had had childhood dreams of a medical career, which were pushed beyond his reach by the early death of his own father, must have been part of the equation, too.
Jauhar, though, is not very interested in ruminating on family dynamics or psychological motivation. He does concede that his charming and easygoing if less academically gifted brother Rajiv “knew the privileges of being the eldest son in a traditional Indian family and he guarded them closely, like a trust fund.” So it is not a surprise that Rajiv unambiguously and unquestioningly chose a career in medicine. Sandeep, always more interested in subjects like philosophy and ethics, fantasized for a time about being a lawyer just like Atticus Finch. He liked history and he shared his father’s passion for current affairs, and so toyed with journalism, too. The elder Jauhar would dismiss such notions with maxims like “nonscience is nonsense.” In any case, he had envisioned his second son as a Stanford-educated neurosurgeon.
Sandeep nonetheless marched off to college with the humanities still in mind. A persuasive roommate influenced a switch to physics, which he pursued all the way to a Ph.D. at Berkeley. His second U-turn led him to begin medical school at Washington University, in St. Louis, the day after he handed in his thesis on quantum dots on the west coast.
His parents were upset at this rebellion in reverse (“Don’t switch horses in the middle of the stream,” his father said), but he speculates near the book’s end that pleasing them may have been his motivation all along.
The book begins with his arrival on the first day at Manhattan’s New York Hospital for the orientation lecture given by the grouchy residency director. You know the drill—in at the deep end. The formula has worked on the big and the small screen alike, from “Doctor in the House” to a doctor called “House.” The problem is that the author doesn’t stick to it. Once the director’s introductory lecture to new interns is dealt with, the author doubles back and tells the story of his life up to that point.
Finally, on page 45, the new doctor meets his first patient, an eccentric 71-year-old African-American woman named Jimmie Washington. The tone of the scene is pitch perfect. And such episodes, usually lasting three or four pages apiece and occupying much of the book thereafter, are Intern’s great strength.
The trend nowadays favors memoir, but the portrait of a doctor as a boy, a youth and a student in various disciplines is not very compelling. And the description of his personal struggles as an intern, particularly concerning his self-doubt, works best in small doses.
Jauhar’s early biography should have been the back story, using a flashback technique where necessary. Not that there aren’t a few lively moments in the first chapters. The author’s affectionate sketch of the patriarch and his frequently batty opinions provide most of them. “The irony of all this is that my father hated doctors,” he writes at one point. They were moneygrubbers, set apart from shopkeepers only by their higher education.
The episode with Jimmie Washington, un-derlining the doctor’s squeamishness, also shows his light touch. Because she insists on making an appointment for two months later and not three as he suggested, we fully expect her to return, much like one of those Yorkshire farmers in James Herriot’s vet books, each of them defined by his idiosyncrasies.
But there are no recurring characters other than Rajiv, a cardiologist in the same hospital. Meanwhile, the mood becomes gloomy and generally stays that way. The outcome is happy, though, for this is presented as the story of how one reluctant intern, after a horrendous first year, learned to love being a doctor.
If you feel, however, that there is no good reason why a young immigrant can not follow his own dream to be an Atticus Finch or a Carl Bernstein, then an alternative interpretation suggests itself: Intern is the tale of someone who has rebelled often, in his own nerdish way, but who has always knuckled under eventually. In the end, the dutiful son, brother, husband and son-in-law emerges from the “waking hell” that almost broke him to embrace fully the elitist worldview of the top doctor.
“I often worry,” Jauhar writes, “that the current crop of interns, mandated to leave the hospital after a 24-hour shift, is missing out on valuable lessons and is learning a mentality of moderation that is incompatible with the highest ideals of doctoring.”
At its best, though, this insider’s account of life on the ward forces us to contemplate our own mortality. And we emerge from it all with a greater respect for medical professionals and their patients.