intern: a doctor's initiation - Dr. Sandeep Jauhar
Posted Oct 03 2008 11:32am
Dr. Sandeep Jauhar (www.sandeepjauhar.com) blazed (or stumbled upon, perhaps) his own personalized path into medicine; a highly non-linear trail (he depicts it elegantly in his memoir, intern ), which, on the surface may seem out of the norm, but, upon further reflection, you may relate rather well with his journey (conceptually, that is).
I sure do.
Dr. Jauhar completed his Ph.D. in physics at UC Berkeley before leaping in a new direction and pursuing a career in medicine. Now, as an accomplished physician, Dr. Jauhar is leading patient care and research in heart failure and continuing to write insightful, reflective essays in The New York Times and in the New England Journal of Medicine, among others. His book, intern: a doctor's initiation, is a memoir of his experiences during his grueling medical training.
At the core of Dr. Jauhar's narrative is an intense desire to share his experiences with others in hopes of illuminating the human elements of medical training, the practice of medicine, and career decision-making; Dr. Jauhar understands the essence of Nassim Taleb's statement (code of conduct), "Above all else, be human." The humble limits of being human are, well, humbling at times. No question, physicians in training experience moments where they glimpse the vast and amazing potential that humans possess to do remarkable things - saving a STEMI patient's life with successful angioplasty, for instance - but, at the same time, interns constantly face the reality that humans can only do so much to relieve suffering and disease.
Dr. Jauhar's sophisticated yet comprehensible and entertaining prose make intern a flowing, engaging read. Here is an intriguing introductory paragraph that frames his book well:
"This book is about my residency at a prominent teaching hospital in New York City. The story goes up to the point when I decided to pursue a fellowship in cardiology, my specialty, and thus covers the most formative period of my education as a doctor. For me it was a disillusioning time; I spent much of it in a state of crisis and doubt. I had trained as a physicist before entering medical school, and ten years of uncertainty about my choice of a profession came out all at once. In his path-integral formulation of quantum mechanics, Richard Feynman hypothesized that when a particle travels from point A to point B, it traverses many different paths to arrive at its destination. This certainly seemed to apply to my journey into medicine. Because I had lived another, more sedate, professional life, the one I had to endure in the hospital was even more difficult to bear" (XIV).
This paragraph captures a similar state that I have experienced for the past five years - and I see it continuing for the foreseeable future: (currently) invisible paths emerge in the future - life is an updating function, iteratively meandering, and then all of the sudden jumping, in a fractal manner, unpredictable in nature while still presenting underlying order and patterns for periods of time. Of course, since Richard Feynman is also one of my heroes, I love Sandeep's analogy relating the stochasticity of life's uncertain unfoldings to particles' varying paths.
In the final chapter, Sandeep reflects perceptively on his initiation into the profession and practice of medicine, commenting on the experimental nature of day-to-day living as a physician:
"What a strange experiment I had conducted! ... I had learned so many lessons these past twenty months, and perhaps the biggest one of all was that medicine was a lot more complex than I had ever imagined. It was a glorious, quirky, inescapably human enterprise, with contentious debates, successes and failures, villains and heroes, oddities, mysteries, absurdities, and profundities. It was a testament to the power of my profession that now I could not imagine a life without it" (290).
Expressing a dose of epistemic humility, Sandeep captures the reality that the practice of medicine challenges the limits of our knowledge continuously; yet, this challenge, when approached correctly, often provides immensely rewarding moments that keep thinker/doers (of the epistemocrat nature) yearning for more, energized to push the frontiers of our medical knowledge into unknown caverns and uncover (shine light on) the unknown, often elusive dynamics that drive the pathophysiology of human illness, disease, and suffering.
Underneath this experiential (Sandeep's stories are enjoyable to read) memoir lies a deeper philosophical quest - the search for human dignity - within the confines of Dr. Jauhar's journey into and through medicine. This search is worthwhile (his book is certainly worth a read); yet it is a search that never ends. Never stop searching for human dignity; we need solution-searchers - we need creative solutions that respect and enhance human dignity.
Dr. Sandeep Jauhar (www.sandeepjauhar.com) blazed (or stumbled upon, perhaps) his own personalized path into medicine; a highly non-linear trail (he depicts it elegantly in his memoir, intern ), which, on the surface may seem out of the norm, but, upon further reflection, you may relate rather well with his journey (conceptually, that is).