Authors: Sandeep Jauhar
On the morning the essay was published in the Tuesday science section, I was stopped in the hospital by a medical student I didn't know, who asked me if I had written “that article” in the
Times
. I was astounded that a stranger had recognized me. During the day, I spied the newspaper in the hands of several attending physicians, wondering what they were thinking. Of course I felt proud at being published, but I was anxious nevertheless about the reaction the essay could provoke. When I ran into Dr. Carmen, he cryptically told me he had been hearing my name all over the hospital.
The essay (predictably, in retrospect) caused a firestorm. I was told it was discussed at a meeting of the medical board, which apparently thought that I may have created a liability risk for the hospital. At
Memorial, a top-level administrator reportedly instructed the chief residents to draft a press release defending the night-float system and assuring the public that patients were safe. (As far as I know, the press office never released it.) Even Dr. Bertrand Bell, who headed the original work-hours commission in the mid-1980s, sent a letter to the New York State Department of Health, a copy of which was provided to me by the
Times
:
The continued scheduling by hospitals of sleep deprivation and chronic fatigue as a feature of residency training in hospitals in New York State . . . is disturbing . . . [Dr. Jauhar's article] details the most egregious defiance of the law . . . The article is the sentinel event in demonstrating a problem hazardous to health and in need of corrective action. It is quite clear that the department must cite Dr. Jauhar's hospital for breaking the supervisory requirements of the law.
At one time I might have obsessed about the fallout, but at this point I didn't much care. Most mornings now I was waking up fantasizing an escape. That I had somehow found the energy while on leave to write the piece and get it published in the most important newspaper in the country only heightened my ambivalence about medicine: Wouldn't I be better off switching to journalism? In my diary I wrote: “I hate feeling stupid; I clam up and doubt myself. It's one thing in a field where ignorance is sanctioned, like journalism; quite another in a field where ignorance is vilified, like medicine.”
I confessed these doubts to my parents when they came to visit me a few weeks later. They had come to New York for a special occasion. Sonia and I were getting “pre-engaged.”
The view through my window was of a cold late-autumn day: no snow, but no movement on the streets either. My parents were sitting quietly on the couch, expressionless except for their perpetual look of worry, which faded in impact from overuse. Though impressed that I had gotten an article published in the
Times
, my father was worried about its effects on my medical career. After the battles he had waged
at the university over “racialism,” he had become sensitized to professional conflict and advised me to be more accommodating than he had ever been, especially with senior physicians who were going to judge me and perhaps write letters of recommendation on my behalf. “You must remember that medicine is your goal and writing your hobby,” he had written in a letter. “You must never get obsessed with writing at the cost of your profession. We liked reading your article in
The New York Times
, but
nothing
will make us happier than seeing you as a great doctor alleviating human suffering.”
I was sitting at the dining table, absentmindedly looking out onto the street, my head fixed stiffly in a Miami J-collar. I had just taken more Lodine and was waiting for the analgesic effect to kick in.
“If someone gets sick, I think it's a reflection on their abilities,” my father declared.
“Which abilities?” I asked.
“Abilities as a doctor, as a man. I had neck problems, too. I went to all the bloody doctors. They pumped me with drugsâCelebrex, Vioxx, Fiorinalâbut I stopped them all. Now I do my exercises and I feel better. It's your responsibility to keep yourself healthy. It reflects on your abilities as a doctor. At least that's my opinion.”
I said nothing. There was no point arguing when my father was in one of his moods.
“So what is going on now? We are in the dark.”
“With what?” I asked.
“With your career, your life!” my father cried. He leaned forward like a lawyer about to make a case he had been preparing for months. “First you wanted to do physics; you said that medicine was for mediocres. Then you wanted to do law. Law has nothing to do with physics, right?” (He did not wait for a reply.) “Then you applied to medical school. We didn't tell you to apply. I said, âOkay, he wants to be a physicist.' But you said you wanted to do medicine. I didn't tell you to do it. But I told you, âIf you do it, you have to stick with it.' And I'll tell you, by God, you did the right thing. If you stayed in physics you would be doing post-doc after post-doc: no money, no job security,
struggling at the university, like I struggled. Going to medicine was the best thing that could have happened to you. You had landed in a ditch. Now at least you have some direction.”
I kept quiet. My father was nothing if not persistent. He always believed that one more warning could avert disaster, and right then I was kind of hoping it was true.
“You can fix this,” my father went on. “Nothing is lost. It is not falling into water but staying there that drowns a man.”
“What do you want to do?” my mother asked quietly.
“I don't know, maybe journalism.”
“Journalism?” My father's face filled up with fury. He had barely tolerated this interest when it was an avocation. “What guarantee do you have that you will get a job in journalism?” he demanded. “Do you think they are going to make you an anchorman or hire you at
The New York Times
?”
“Will Sonia be happy if you become a journalist?” my mother sputtered.
“Sonia has nothing to do with it,” I replied.
“She wants a doctor!”
“Leave her out of it!”
“Your mother has a point,” my father intoned. “Money talks. Believe it or not, money is important.”
“Khoon sook gya hai,”
my mother said, shaking her head, meaning that her blood had dried up with worry over me.
“You are always wavering, flickering, putting us through hell,” my father said, obviously disgusted.
“Thanday doodh noo phook marta hai,”
he muttered.
There he goes again, I thought, always telling me that I was blowing on cold milk.
“You don't know what it's like,” I started.
“My dear son, did you think it would be a walk through a rose garden? They don't pay you for nothing.”
“What about passion?”
“What is passion?! You can train your mind to find passion.” He
accused me of immaturity. I accused him of a bourgeois mentality. Back and forth it wentâthe recriminations, the anger. Why was I not practical? Why were they not supportive? Why, with all the promise I supposedly possessed, would I consider ruining my life by quitting medicine now?
“You have to learn to focus,” my father said sadly, getting up to end the conversation. “Then and then only are you going to get somewhere. You cannot succeed by doing something halfheartedly. You cannot always do what you like, but you must like what you do.”
LATER THAT WEEK
âon an auspicious day, according to the gurus Sonia's parents had consultedâwe drove a rental car to New Jersey for dinner and a religious ceremony with Sonia's family. The ceremony was called
roka
(meaning “to stop”), and it was supposed to signify that Sonia and I had chosen each other and were going to stop looking for other people. When I told my father about this “pre-engagement,” he responded with his usual gruff practicality. “You like her, so why don't you just get married?”
Sonia's family lived in Edison, population one hundred thousand, an enclave for Indian immigrants unlike anything I had ever seen. As I drove through town, we passed Kar Parts, Patel Cash & Carry, Bombay Chaat House, and Delhi Darbar. Young women in
salwar kameez
tops and braided ponytails ambled along the road carrying groceries. Old men clad in white dhoti cloth were pumping gas. Signs on office buildings read
PATEL
,
GUPTA
,
KHANNA
. Sonia's parents had a busy internal medicine practice hereâan empire reallyâwith two thousand patients and three different offices. Her father had urged me to join his practice after finishing my medical training. “You must become a cardiologist,” he said on more than one occasion. “Then you can take over the practice.”
We took a sharp right onto a country road lined with tall oak trees. Suddenly the conventional wood-frame homes on the main road gave way to huge mansions set in landscaped plots lined with luxury cars.
We turned onto a gravel-ridden private road covered with leaves. The house was visible about a quarter mile in the distance: a rambling three-story whitewashed colonial with black shutters, long balconies, and four Mercedes-Benzes parked out front. A herd of deer looked up as we drove past.
So this
, I told myself, feeling awed,
is what a doctor's salary can buy.
Images of our modest bungalow in Riverside, California, flashed through my mind. Our entire tract-housing block could have fit on the roadway leading up to the house. I looked at my parents' faces, wondering what they were thinking. Were they impressed? Was this the reason they wanted me to stick with medicine?
In the car, my father and I had reached an uneasy rapprochement; there was to be no more discussion of my career today. His last words on the subject were in the Lincoln Tunnel: “Your mother and I always think of you as our brilliant sonâa source of light for our family. Every morning you wake up, ask yourself: What is the aim of my life? Am I heading in the right direction?”
When we arrived at the house, Sonia came out to greet us. Though I had been to the house once before for dinner, going there with my parents set the differences in our upbringings into sharp relief, and I think Sonia must have sensed my unease. A pandit was waiting for us in the ornately decorated living room. As Sonia and I sat side by side on a silk rug under a painting of Lord Vishnu, he lit a
havan
âa wisp of cotton soaked in oilâand loudly chanted Sanskrit verses. Syllables were shooting off his lips like bullets, and his brown pate glistened with the effort. Hunched over on the floor, with the pain in my neck nearly unbearable, I regretted leaving my neck brace behind in Manhattan. The pandit asked me to repeat certain phrasesâ
“aana maana gaana . . .”
âwhich I did, oblivious to their meaning. Were these another set of commitments I was destined to break? After each verse, the pandit made an offering of rice grains and flower petals to Lord Ganesh. He smeared
tikkas
of red paste and crushed seeds on our foreheads and periodically filled our outstretched palms with a
parshad
of holy water and milk. Sonia and I rubbed vertical streaks of turmeric on
each other's forehead and hung flower garlands around each other's neck. When the time came, the pandit instructed me to offer a ring. I had bought it the week before at Cartier in midtown. It had three intertwining bands of yellow, white, and pink gold, signifying love, fidelity, and passion.
Afterward, maids brought out platters of chicken and lamb chops, savory
pakoras
, and curried vegetablesâand bottles of Blue Label and Macallan's. I sat quietly, picking at the food on my plate. My appetite was poor; in fact, I had lost ten pounds over the past two months. The pit of my stomach burned with acidity, the first sign, I was sure, of a peptic ulcer.
Gifts were exchanged. Sonia's grandmother recounted stories from the
Ramayan
, a religious parable. The lesson seemed to be that the person who lives by his words will be rewarded; he will be king. “Never break your promises; never take the easy way out.” Of course, she was talking about my relationship with her granddaughter, but I could not help but think the words equally applied to other commitments I had made.
I looked around the room. Everyone was smiling, beaming. I resented their laughter, resented my discontentment. Sonia's father drunkenly took out a microphone and started performing Bollywood karaoke. He took me aside. “Be happy,” he said. “You are always so serious. When you are stuck in a mud puddle, you cannot expect it to flow like the Ganges.” He offered me a set of golf clubs and told me that I would be made an honorary member of his country club. I thanked him, not having the heart to tell him that I doubted I would ever use them. I couldn't picture myself like him, a successful doctor riding down rolling fairways in a golf cart.
Under the influence of liquor and the occasion, my father looked happy, perhaps even a bit inebriated. Seeing him that way, a man who took pride in maintaining control of himself and others at all times, felt almost surreal. The smell of Old Spice on his cotton shirt transported me back to a time when I had been vulnerable to his disapproval. I remembered how he used to exhort the virtues of vitamin C. Growing
up, I became obsessed with vitamin C because of my father. I gorged on fruit to prove my love for him. He sometimes reminded me of the father in Vittorio De Sica's
The Bicycle Thief
: loving, protective, but somewhat pathetic, too. Right then I felt like the boy in the film, holding his father's hand, looking at him in awe and fear while he ate a pizza to which he was not entitled.
Outside, in the backyard, a photographer set up a tripod camera and snapped pictures as Sonia, wearing a red silk
salwar kameez
, and I, wearing a charcoal gray Brooks Brothers suit, touched the bark of a holy tree. Afterward, she went inside and I sat alone on the stone steps. It was dark now, quiet, apart from a rare cricket, the nearly full moon illuminating the expansive lawn. I looked out at the parched, knolled fields singed by the cold, dotted with what looked like burial mounds, my thoughts as tangled as the skein of brown trees in the distance.
How can I quit now?
I thought.
How do I disappoint everyone, including myself? I'm not strong enough, bold enough, courageous enough, to say, Stop!