Nursing Book Club

Intern: A Doctor's Initiation

Understanding the mindset of doctors

By Sandeep Jauhar; Farrar, Strauss and Giroux, 2008
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Reviewed By Christine Contillo, RN, BSN

Book Review: Intern: A Doctor's InitiationI once worked in the delivery room of a big-city hospital with a doctor who told every patient that they’d just had an extremely difficult delivery. According to him, it was lucky for them that he was their doctor and had saved the baby’s life. I used to wonder if physicians were taught to be that arrogant. Intern: A Doctor’s Initiation by Sandeep Jauhar makes it clear that it could be a learned behavior because he, for one, didn’t begin with that kind of bravado.

Dr. Jauhar has shared his thoughts about patients and the practice of medicine for over a decade. I’ve been following his progress in The New York Times, but he can also be found in The New England Journal of Medicine. Like all good nurses, I would begin to read one of his essays and then try to guess the diagnosis and treatment before he comes to the conclusion. His writing, though, goes beyond the clinical and comes with a great deal of compassion and warmth and brings contemporary issues like DNR, ICU psychosis and advance directives out in the open.

Years ago I decided that he was someone I would have referred patients to, if only he still practiced medicine. I assumed that a doctor who could write about his patients with such empathy would be one who has the ability to see them from a great distance. I was surprised to learn from the book jacket that he is director of the heart failure program at Long Island Medical Center. Now that I know he began as a scientist, I realize it was probably even more of a stretch for him to join a patient-centered field like cardiology over something like radiology or pathology. But on the other hand, cardiologists near me have their faces on billboards and their statistics published in magazine ads. Maybe he has absorbed some of the medical culture along the way.

Dr. Jauhar paints an honest picture of himself as having a conflicted history and long path to medical school, unlike his wife and her family, who seemed born to be doctors. He finds himself the second son of an immigrant family with a father embittered by lack of success as a geneticist, and a younger brother already a successful physician. He begins with a Ph.D. in physics and then contemplates journalism before polishing off medical school. Even with his M.D., he acknowledges that there’s more to being a doctor than what is found in textbooks and wonders if he really has what it takes.

We all know about the difficulties of the intern year. We’ve seen them enter with their labcoat pockets full of notes, unable to find time for a shower, functioning without sleep. Dr. Jauhar lets us know what it feels like to do that when you’re not even sure that becoming a physician is the correct choice for you, when you feel the pressure to succeed from loved ones, when you’re not even sure that what you do is helping anyone at all.

He candidly admits that his first code was, in fact, run by the nurses and that he didn’t know how to deal with terminal patients or their families. In short, through the first two segments of the book, we watch Dr. Jauhar grow into the physician he is now and we root for him to learn the lessons without too many personal blows. Perhaps it’s his own battle with chronic pain during the year and an earlier girlfriend with a serious illness that helps him take the lessons to heart and succeed.

The final section of the book is what the author does so well — he candidly details interactions with his patients and what they mean to him. His reflections are so honest and human that it makes you hope doctors everywhere share his moral code.   

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written extensively for various nursing publications, as well as The New York Times.

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