Doctored (20 page)

“But what's the point if this is all there is?” I pressed him.

“Your reputation will live on.”

“But you won't know about it, so what's the point?”

“Still”—my father cleared his throat, a sign he was uncomfortable—“what you do lives on.” I knew the talk wasn't going much further. Dad's intellectualism was secular. He never gave much credence to an inner metaphysical life.

Changing the subject, he asked about my job. Things were getting busier, I told him. However, money was still tight. And Sonia was still pushing me to consider private practice.

“Live within your means,” my father intoned with his usual shopworn wisdom. “And try to be happy.”

“I am happy, Dad,” I replied, forcing myself to sound cheery.

“Okay, that's good,” he said, though he sounded skeptical. “I don't know how long your mom and I will be around. We just want to see you settled.”

*   *   *

That spring the most dreaded announcement from Sonia was “We have to talk about our finances.” It produced an almost instantaneous tightness in my chest, a jackhammer pounding, and for good reason. Our expenses were outpacing my hospital salary, and whatever little savings we had—wedding money, a bit saved up from our residencies—was dwindling rapidly. Sonia's father had offered financial help, but I had turned him down—at least at first—hoping to maintain the semblance of self-reliance. (And once I said no, the refusal assumed its own momentum because I felt that if I relented, he might think I had been insincere all along.) “I just want you guys to be comfortable,” he said on more than one occasion, urging me to consider his tender. “I can explain the way of the world. Maybe you think it is hocus-pocus, but how can you say a song is bad if you don't listen to it?” Eventually I was forced to give in, but I hated to do it. I wanted to show that I had married Sonia despite her father's wealth, not because of it.

The arguments over money took a toll, eroding my peace of mind. I started going to work later and later and holed myself up in my office to call private cardiologists, who (perhaps self-servingly) told me there wasn't much money left in private practice anyway, unless you were willing to do unnecessary testing. My father was adamantly opposed to private practice, too. Apart from the insecurity—medical practices were failing all over the Northeast because of rising expenses and decreasing reimbursements—I'd have to give up my job, an academic title (assistant professor of medicine), and a certain degree of status. Did I really want to become another private practice grunt, overtesting, kissing ass for referrals, fighting insurers to get paid, depressed that medicine wasn't the way I'd envisioned it in medical school?

Things came to a head when my parents visited Long Island in the early summer of 2006. As usual, I drove from Manhattan to see them, this time without Sonia and Mohan. We spent the morning at a Hindu temple in Hicksville, where we attended puja. Priests with shaved heads and powdered faces were clanging bells and chanting fervently. Sanskrit syllables were shooting off their lips like bullets. I knelt on the stone floor and, for the first time in at least a year, whispered a prayer. As with many people, my relationship with God was complicated, ranging from quiet skepticism to outright atheism, with occasional forays into foul-weather faith.

Back at Rajiv's house, the mood was somber. The following day my parents were flying back to Fargo, North Dakota, where my father worked at a government agricultural research station, and we were all waiting on tenterhooks for him to bring up my career plans. In the kitchen, I rinsed out a glass and let the faucet run for a few seconds, checking the temperature of the stream with my finger. Then I filled up the tumbler, gulped down the water, and slammed the empty container on the counter. “You look so much like Dad when you do that,” Rajiv said, watching me. “It's unreal how much you guys are alike.”

In the living room, my parents were sitting together on the plush sofa, their dry heels propped up on the coffee table. The window blinds were closed, though it was midafternoon, and a lamp bathed the room in a depressing glow. My father was looking over some pictures of my brother's children. “What happened? You didn't have color?” he said.

“Black-and-white is prettier,” my mother said scoldingly.

“I don't know,” my father replied, unimpressed. “I prefer color.”

I sat down to watch television. “Did I tell you that your mom went for blood tests?” my father said as I flipped through channels. “They were normal.” Though my father's blood pressure was now better controlled since his stroke scare two years prior, my mother's pressure had become labile, and the medications for it were making her fatigued and her joints achy. My father had been asking why doctors couldn't fix the problem. He kept telling me and Rajiv to arrange a conference call. I had told him it wasn't that simple.

“All the tests were normal,” my father repeated.

My eyes stayed glued to the television. “So what does that mean?” I said.

“The X-ray was normal, too,” he added.

“So what did Dr. Williams say?”

“She said she doesn't know what's wrong. She suggested taking that medication you suggested.”

“Ibuprofen.”

“And she said if it doesn't get better, to go to a rheumatologist.” He said the last part with a flourish, as if he had just made his point. “These doctors will shunt you back and forth. They don't have a clue what's going on. Still, she sent us a bill—”

“So what do you expect, Dad, that a doctor shouldn't get paid for seeing you?”

“That's not what I said. I just don't think that should be her primary consideration.”

“What makes you think it is?”

“Many doctors are more interested in money than health! Remember that doctor who wanted to cut my foot? By God, I would have lost my foot! Now I do exercise, and I am completely cured.” He looked at my mother, who stared at him blankly. “Dr. Williams gave your mom the results but didn't even write a report! She doesn't want to write anything down. She will protect herself first.”

“Whatever, Dad.” I was in no mood to argue against his paranoia.

“She kept us waiting for forty-five minutes.”

“So?”

“That means she is an irresponsible doctor!”

“Not necessarily. I am always running late.”

“She never once addressed me as Dr. Jauhar.”

“So what?” I cried.

“She saw your mom for two minutes and said she needs an antidepressant. Talk to the patient first! If I had listened to her doctors, she would have been on an antidepressant ten years ago.”

“How do you know you made the right choice?” I shot back angrily. “Maybe she would have had a happier ten years.”

“Antidepressants will make you happy?” he said incredulously. “You think a medication will change her basic nature? Like you, she is not a happy person.”

The wrangling elicited a half smile from my mother. She almost always deferred to my father in such conversations unless she felt he had crossed a line. We remained seated in silence while I seethed. My brother popped in and out. He could never sit still when my parents were around.

My father leaned forward, arms crossed. The veins in his hands were prominent. “So what is going on?” he finally said.

“With what?” I replied, feigning ignorance.

“With what? With your job!” As the patriarch of a traditional Indian family, he took it as his right to speak out about our problems, no matter how uncomfortable it made us.

“I already told you, I'm trying to figure things out.”

My father leaned forward, hiking his fraying trouser bottoms over his hairy shins. “Don't do private practice,” he whispered ominously. “We know so many doctors in Fargo who are having a rough time. Vijay Malhotra joined an oncology group that cheated him out of so much money. Now he is doing shiftwork in Boise on the weekends. His wife was crying to your mom.”

My father's horror stories didn't carry much weight because I had heard enough of my own, about senior practitioners taking on young associates, exploiting them for cheap labor, and then firing them when they were up for partnership. I remembered a private cardiologist at a medical school mixer bragging about hiring fresh graduates, running them into the ground for two years, then letting them go and enforcing a no-compete clause in their contracts if they tried to set up offices nearby. He had done this many times.

“I have to pay my bills,” I said quietly.

My father turned to my mother with a disbelieving look. “I think he is obsessed! He never used to be so money-minded.”

“What is he supposed to do?” my mother cried in Hindi, rising to my defense. “He can't cover his expenses!”

My father opened his briefcase, took out a notepad, and with my input wrote down a list of outlays: rent, nursery tuition, car, insurance, parking, gas, tolls, taxi, cable, cell phone, groceries, credit card, and miscellaneous. Then he wrote down my monthly take-home pay. I was about $2,000 short a month, a deficit that Sonia's father had been covering.

“What did I tell you?” I said angrily as my father studied the paper. He shook his head in disbelief.

Rajiv, looking bored, urged us to come out with him to the backyard. My father and I followed him out the sliding glass door, up the sloping lawn, past the swimming pool, to a stone patio behind the tennis court abutting the neighboring horse farm, where we watched him shoot baskets.

“Your job is critically important,” my father intoned as my brother threw up bricks. “Go to work on time, get more patients, and secure your job.” His advice was essentially the opposite of what I had been planning. Instead of quitting, he thought I should work even harder and ask for a raise.

“I need more money now,” I said. I felt pathetic talking about my financial troubles in front of my brother—and at his palatial home, no less—but part of me wanted him to feel sorry for me, too.

“All he does is talk about money!” my father shouted.

“I have bills to pay!”

“So send Mohan to public school!”

“That is not an option. It's one of the worst in the city.”

My father shook his head in disgust. “As far as I am concerned, you can come home from work and start worrying. Worry the whole night if you want to, but in the morning go to work and do your job. If you lose your job, then it's over. It's over for you; it's over for us. Apart from the financial problem, won't you feel embarrassed? Your colleagues, your in-laws, everybody will know you were fired!”

Rajiv dribbled in for a layup.

“This is a utilitarian society,” my father said. “If they need you, they will beg you. If they don't need you, they will kick you. At my job, they keep track of when I come and go.”

“It's a government job! You have to clock in and out.”

“Well, yes, I have to swipe my ID badge, but that is not the point. If you lose your job, we are finished. I will be the first to have a heart attack!” He hollered to a phantom audience, “He is my son! I cannot see him out on the street.”

I couldn't help faintly smiling. My father was nothing if not persistent. “I'm—I don't know…”

“What? Tell me.”

“I'm depressed.”

“If you lose your job, you'll be more depressed! Things are going well—”

“Things are never going well!”

“Things are going well, and if they aren't, so what? Worrying won't help.”

He was right, of course. I had made my own choices, yet I was wallowing in self-pity. What I wanted most of all was for my father to simply commiserate. But Dad never gave you what you wanted, only what he thought you needed.

“I don't enjoy—”

“If you get busy, you will enjoy. What's not to enjoy? You are a doctor!” he hollered. “You have the respect of the world!”

We walked back to the house. Head bowed, my father was deep in thought. I couldn't help thinking of the way he looked when I was ten years old, similarly stooped over his desk in our garage in Riverside, California, reeking of rubber cement, painstakingly preparing a table for one of his research papers while exhorting me to become a doctor and never take the purely academic path he had taken. At the university, he explained, people were jealous. They stabbed you in the back. There was no job security. You might not get rewarded for your hard work. In medicine, he promised, I would have respect, wealth, and influence—all things that had eluded my talented father.

At the pool, my niece and nephew were splashing around in the water. We sat down with my sister-in-law, Vandana, who was watching them. “Why don't you and Rajiv come up with a plan?” my father implored.

“I told him I could set him up with my friend Amir Chaudhry,” Rajiv said suddenly. “He is a cardiologist in private practice. Sandeep could moonlight at his office on weekends. [Many academic physicians he knew were moonlighting in private practice to supplement their salaries.] Amir told me he talked to Sandeep, but he didn't show any interest.”

“Well, that seems like a good idea!” my father said, his face brightening. “Try out private practice and see if you like it.”

“He will hate it,” Rajiv said dismissively. “He doesn't have the mind-set for private practice.”

Rajiv's operating philosophy was that doctors didn't really care how competent you were, or at least that wasn't the overriding concern when they referred patients to you. It was all about personal relationships. Rajiv understood this as well as anyone. When Dr. Singh's sister was hospitalized, Rajiv went to the CCU at 2:00 a.m. to put in a basic IV line that could have been inserted by an intern. When Dr. Kohli's father had chest pain after stepping off a plane from India, Rajiv left his family at the movie theater watching
Shrek
and went to meet him in the emergency room. “You have to learn how to play the game,” Rajiv said. “Every doctor I know says I'm his best friend.”