Intern: A Doctor's Initiation

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Intern: A Doctor's Initiation the story of Sandeep Jauhar 's residency at New York Hospital in New York City in the late 1990s, is a story unlike those in other books in the medical-memoir genre. There's the inflexible immigrant father, whom the author never seems to like. There's the older brother, an establishment type, whom he admires. There's the rushed courtship with his now-wife, Sonia, also a doctor. Jauhar brooded and fought with uncertainty, unsure that he had made the right choice in choosing a career in internal medicine. When the internship begins to close around him, he becomes depressed in the middle of the year. Thanks to the author's candid and sympathetic treatment of the dark side of doctoring, many trainees will recognize their own journey in Jauhar 's account. This clarity and honesty make Intern a preeminent contribution to the growing medical training literature. The writing is unflinchingly brutal. The path of Jauhar through medical training is at times so personal that he takes his own patients as his mirror: You can find yourself in your patients, he suggests. It's an idea that might shudder the old guard of the profession: Patients don't exist to serve our personal needs. There is no doubt, however, that this book refers to the contemporary age of medical education and practice. The number of doctors leaving clinical practice is on the rise, even though the push to "teach " professionalism in medical education is increasing.

Plot

Intern: A Doctor's Initiation, the story of Sandeep Jauhar 's residency at New York Hospital in New York, NY in the late nineties. Intern is also a credible story of a boy whose medical career is in contrast to previous books on this topic. Some of the characters of this book are the hard father of immigrants, whom the author never seems to like. There's the older brother–a brisk type of establishment –he still admires. There's the rutted court with his now-wife Sonia, a trained doctor. Jauhar brooded and fought with uncertainty, not convinced that he had chosen internal medicine correctly.

In the introduction to the book, we learn that the author freely talks about self - doubt about career choice, constant anxiety, and feelings of insufficiency, exhaustion, and disappointment. Which he does, indeed. But Jauhar speaks first of his family background: born in India and emigrating with his family to the USA at the age of eight; a father holding a doctorate. Father holding a doctorate in plant genetics, writing academic textbooks now and regretting that he could not afford his dream of becoming a doctor; mother assisting the family as a laboratory technician; older brother, Rajiv, both a mentor and competitor, charming, self - assured and unquestioned in a medical career; Sandeep (the author) does graduate work in theoretical physics but realizes that he probably doesn't have what it takes to be successful in the field as he approaches the completion of his doctoral degree. When his girlfriend Lisa gets seriously ill, Sandeep starts to think about medicine as a career. He applies to the medical school and is accepted against the advice of his parents, who are now convinced that he is a dilettante.

Disillusionment began in the first two years of medical school: " I never learned to memorize. in graduate school, but now I could not depend on logical reasoning; I had to memorize large swaths of material ". He considered that he had ceased to be a journalist, a profession that had always intrigued him but was discouraged: " my father made it clear that journalism and writing should never be considered career options because they offered no security ". However, he was awarded a summer fellowship just before he started medical school, which put him in the office of Time magazine in Washington, DC; his contacts then allowed him to work as a student reporter for St. Louis Post - Dispatch at medical school and eventually led to his escalating and current position as a contributing New York Times medical essayist.

Jauhar 's internship unfolds as a series of anxiety-inducing meetings with patients and humiliating meetings with his physician's superiors. Since he feels incompetent and inadequate, he stumbles and worries that he harms patients. Too many " small things that I find burdensome " can be tracked. " It was bad enough to have so much to do, but I didn't know why you were doing what you were doing, it was terrifying. Patients were in need; their demands were overwhelming. Everyone seemed to know how the place worked, except for me. The ecology in the wards was hostile; the interactions were tough, fast ". He is in continual doubt and confrontation regarding his choice of career. Even his private life is affected-his girlfriend Sonia, who is still a medical student, comes from a medical family, is willing and eager and secure in her career choice, which makes him feel of insecurity more difficult.

Jauhar suffers from a herniated disk in the middle of the internship. He tries to make it difficult without taking time off, but his stint as a " night float " at the Memorial Sloan - Kettering Hospital, which specializes in the treatment of cancer patients, proves to be too difficult-all night trying to treat patients who are seriously ill and " take care of patients you knew nothing about ". He takes a short leave with a reduced schedule. He acknowledges that his problems are both emotional and physical. However, gradually, as his neck problem improves because he recognizes that medical professionals can actually help patients feel better-his neurologist and physical therapist " made me hope and comfort at a vulnerable time ". As he calls a dying patient into his house, as his essays are published in the New York Times, and as the season moves to Spring, his depression rises, and he looks forward to his work.

Author

Sandeep Jauhar is a U.S. physician and contributing opinion writer for The New York Times. He is also the author of three books: Intern: A Doctor's Initiation, Doctored: The Disillusionment of an American Physician, and Heart: A History. Jauhar was a Ph.D. student in physics at Berkeley when he decided to switch his career to medicine, eventually going to Washington University School of Medicine in St. Louis, where he received his medical degree in 1998. Subsequently, he did his internship and residency in internal medicine at The New York Hospital on the Upper East Side of Manhattan, the second oldest hospital in the United States. His internship year of uncertainty, indecision, and eventual acceptance was chronicled in his first book, Intern, published by Farrar, Straus, and Giroux in 2008.

Intern was a national bestseller and was optioned by NBC for a dramatic television series. It was praised as "brutally frank... (and) fascinating" by William Grimes in The New York Times. Time magazine said that "Jauhar's wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, takes readers to the heart of every young physician's hardest test: to become a doctor yet remain a human being." The memoir was published in several languages and was a bestseller in India.

Jauhar's second book, Doctored: The Disillusionment of an American Physician, released in August 2014, was a New York Times bestseller and was named a New York Post Best Book of 2014. It was praised as "highly engaging and disarmingly candid" by The Wall Street Journal, "beautifully written and unsparing" by The Boston Globe, and "extraordinary, brave and even shocking" by The New York Times.

"Heart: A History," his third book, tells the story of the doctors who risked their careers and the patients who risked their lives to know and heal the heart. It was praised as "poignant and chattily erudite" by The Wall Street Journal, "fascinating" by The Globe and Mail, and "elegiac" by The American Scholar. The New York Times Book Review called it "gripping" and "strange and captivating." It was on several lists of the best nonfiction books of 2018.

Currently, Jauhar is a cardiologist and Director of the Heart Failure Program at Long Island Jewish Medical Center. He writes regular opinion pieces for The New York Times. He has appeared frequently on National Public Radio, CNN, and MSNBC to discuss issues related to medicine, and his essays have also been published in The Wall Street Journal, Time, and Slate.

Themes and Symbolism

Intern is a key counterpoint to medical tradition, a modern voice from the bottom of the trenches. To his credit, Jauhar refrains from pat answers to the doctor's burnout question. Some parts of the book feel somewhat disconnected from the central narrative of the book. One of these is Jauhar 's description of writing essays on health care for The New York Times, which makes fascinating reading but never ends up being brought back to the main story of his development as a doctor and a human being. Similarly, in the last segment of the book, there are a number of cases illustrating some of the new ethical dilemmas facing the profession, which have been carefully written but perhaps deserve a platform for themselves. Intern is, in any case, a key contribution to the canon of the doctor-writer and a call for doctors to heal themselves. Whether the story of Jauhar moves stodgy medical institutions remains to be seen. However, perhaps change can come through the aspiring physicians who read this book or ought to, and who contemplate and internalize its lessons.

The doubts and anxieties of many young physicians-in training-experience but are afraid to voice, sometimes even to and among themselves. Depression is not uncommon among medical students and residents and one wonders how effective it is recognized and treated. The author's critique of the "night float" system and the reduced hours mandated for resident physicians by state and federal law. Criticizes the new system where patient care is discontinuous, fragmented, and important information gets lost.

Adaptations

• Intern: A Doctor's Initiation was a national bestseller and was optioned by NBC for a dramatic television series.
• It was featured on NPR's Talk of the Nation, The Leonard Lopate Show, Bloomberg News Sunday, and ReachMD, as well as in segments on ABC and Fox News.
• It was published in several languages.

Critical reception

"Jauhar's stories are timeless."
—Barron Lerner, The Washington Post

"An unusually transparent portrait of an imperfect human being trying to do his best at a tough job... A vivid portrait of the culture of a New York City hospital, with its demanding hierarchy and sometimes indifferent cruelty."
—Vincent Lam, The New York Times Book Review

"Excellent, well-written... Jauhar captures vividly the uncertainty, fear, and extreme exhaustion that dominates the (residency) experience... As one reads this emotionally powerful story, it becomes clear that the culture in which the interns work is profoundly important to their experience."
—Katharine Treadway, The New England Journal of Medicine

"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."
—Peter McDermott, America

"An exceptional accomplishment... beautifully written and incredibly insightful... by far the best memoir of a medical student or resident days yet published."
—Kenneth Ludmerer, author of Learning to Heal: The Development of American Medical Education

"Those who enjoy good writing for its own sake will savor the crafted texture of this narrative. ... Jauhar captures the essence of how it feels to be a present-day physician in residency training. ...Certainly, there are no easy answers, and few writers have conveyed this truth more forcefully than Jauhar."
—S. Ryan Gregory, MD, The Journal of the American Medical Association

"As (Jauhar) flinches from the gauntlet run, the grace of his prose allows us to feel every blow. To this young physician, it brought back visceral feelings, and I hope this is not the last literary gut punch we receive from Jauhar."
—Noah Raizman, Lancet

"Intense."
—New York

"This is no made-for-TV sitcom: Dr. House wouldn't last a night in Dr. Jauhar's world."
—San Diego Union-Tribune

"Following in the path paved by doctor-writers like Lewis Thomas and Richard Selzer, Jauhar writes with grace, precision, and passion. What makes him such a stimulating companion is his willingness to couple candid insights into the state of modern American medicine with equally revealing glimpses into the soul of a young doctor."
—Shelf Awareness

"Jauhar's candid account of his stressful journey is enlightening, educational and eye-opening. After ten successful years in the profession, the author dolefully admits that he is unfazed by the 'small injustices' in hospitals today. Required reading for anyone seriously considering a career in medicine."
—Kirkus Reviews

"Honest and vivid... A well-written medical memoir."
—Library Journal

Not since Samuel Shem's classic House of God has there been such an insightful real-world look at the life of the first-year resident. From the hospital floor to the family at home, Intern is a powerful dead-on take of postgraduate medical training. Jauhar's descriptions of physician politicking, patient care, and personal relationships make for fascinating reading for those on either side of the stethoscope.
-Dr. Lee Burnett, founder of The Student Doctor Network

Told of here is a time of travail and testing—a doctor's initiation into the trials of a demanding yet hauntingly affirming profession—all conveyed by a skilled, knowing writer whose words summon memories of his two great predecessors, Dr. Anton Chekhov and Dr. William Carlos Williams: a noble lineage to which this young doctor's mind, heart, and soul entitle him to belong."
—Robert Coles

"Very few books can make you laugh and cry at the same time. (Intern) is one of them. Jauhar reveals himself in this book as he takes us on a wondrous journey through one of the most difficult years of his life. It is mandatory reading for anyone who has been even the slightest bit curious about how a doctor gets trained, and for physicians, it is a valuable record of our initiation.
—Sanjay Gupta, CNN medical correspondent and author of Chasing Life

"Intern is not just a gripping tale of becoming a doctor. It's also a courageous critique, a saga of an immigrant family living (at times a little uneasily) the American dream, and even a love story. A great read and a valuable addition to the literature—and I use the word advisedly—of medical training."
—Dr. Melvin Konner, author of Becoming a Doctor

"Intern will resonate not only with doctors but with anyone who has struggled with the grand question 'What should I do with my life?' In a voice of profound honesty and intelligence, Sandeep Jauhar gives us an insider's look at the medical profession and also a dramatic account of the psychological challenges of early adulthood."
—Akhil Sharma, author of An Obedient Father and Family Life

"In this era when medical shows abound on TV, Jauhar demonstrates the power of the written word in the hands of a sensitive, thoughtful observer and an experienced, gifted writer. Intern is a compelling, accurate, and heartfelt chronicle of what internship is really like. It will be the standard by which future such memoirs will be judged."
—Abraham Verghese, author of My Own Country and Cutting for Stone

References

Category:Books about health care

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