Intern (4 page)

I spent most of the shift in a back room, reading a book on quantum philosophy called
Wholeness and the Implicate Order.
At 9:30 p.m., when I was getting ready to leave, a call came in from paramedics. “Stick around,” a doctor told me. “Things are about to get interesting.” Within minutes a young man was wheeled in on a stretcher after crashing his VW Bug into an eighteen-wheeler. As he screamed horribly, the ER staff went to work on him, cutting off his clothes, immobilizing his head, wiping away blood. Someone inserted a catheter through the tip of his penis, which began draining red urine. Someone else prepared to insert a tube into his bleeding chest. That was enough for me. I quickly
packed up and left, vowing never to return. Such excitement, I informed my parents, was not for me.

I STOPPED MY LOADED-UP HONDA
at the traffic light at Bancroft and Telegraph. The food carts were still out; Berkeley would obviously carry on without me. Freshman year, a chemistry professor had told me that some people believed the world begins and ends at this intersection, and in a sense it had for me. Snaking up the hill behind me was Cyclotron Road, where E. O. Lawrence had built the world's first atom smasher and where I had spent the past five years doing my graduate studies on quantum dots. The research had been published in the most important physics journals. But after a while, the research didn't matter to me anymore.

On my right was Sproul Plaza, where I had spent many afternoons sitting on the steps of the student union playing chess with a demented old man who took my pieces with strange exuberance (and sometimes cheated), while the hippies played guitar or the evangelists and other cranks hollered inflammatory oratory in the background. One of the evangelists got kicked off campus for uttering a vulgar epithet—a controversial action on a campus that had given birth to the free speech movement—but he eventually came back. Berkeley had a way of doing that, pulling you back in.

As I waited at the stoplight, my eyes wandered over to the Carlton Hotel, a single-room-occupancy dwelling where my girlfriend Lisa had lived. She was from Los Angeles, and we had met my junior year in the dorms, when she was still a freshman. When I was in graduate school, we had had a standing date for lunch at least once a week at the little Chinese place on the north side of campus. I looked over at the stone bench near the dried-up fountain where she first told me about her illness: lupus. I stared at the spot, reliving the moment; sadness washed over me once again. I pictured her in her white sweater, looking delicate and pale, her skin the color of milk, with me holding her tightly and whispering that one day she was going to be cured and that I
would see her through it. She cried hard that day, and so did I. For her and for myself.

The disease aged her, sapped her of strength, inflamed her joints, sullied her unblemished complexion. Her hair thinned; her fingers became swollen, like sausages. The membranes around her lungs became inflamed and protein started spilling into her urine. For weeks she could hardly get out of bed. And the worst part was that there was no cure! At first I didn't believe it. There were entire libraries devoted to medicine, with hundreds, even thousands, of journals. Surely the answer had to be in one of them.

I brought to my girlfriend's disease the kind of can-do optimism that is typical of graduate students, a belief that if I looked hard enough, I would find a solution. The concept of chronic illness was completely foreign to me. Disease came and went; it killed you or you got better. Perhaps there were better doctors somewhere—with better knowledge, better command of the medical literature—that could help her. I called top researchers. I read medical textbooks. I pored over Lupus Foundation of America newsletters cover to cover. I asked my brother, then a new intern, to inquire about emerging therapies. I spent lonely evenings staring into drugstore windows, wondering if the answer could be found inside the panoply of vitamin bottles. I went to support group meetings, often without Lisa. One night in San Francisco, a scientist from UCSF delivered a lecture on the frontiers of research into lupus. He was a short man with an imperious air, and I found him pompous and a bit pedantic, but when I looked around the dimly lit auditorium, all eyes were fixed unwaveringly on him. The woman with large discolorations on her face sitting next to me was in an almost meditative trance. Clearly everybody there was awaiting a cure, hoping for deliverance.

When I drove back across the Bay Bridge to Berkeley that night, I gave the idea of going to medical school serious thought for the first time. My physics research had slowed to a crawl. I was spending most of my time in the lab tweaking a malfunctioning laser or trying to fix a broken vacuum pump, not collecting publishable data. Quantum dots,
I feared, were never going to make much of an impact on people's lives. Practical considerations of this kind had never been important, but now, in the shadow of physical illness, only the usefulness of medicine seemed to matter. Physics had been a way to set myself apart. Now, its exclusivity had become its main liability.

My thoughts remained unformed while I tried to muster the courage to discuss them with my family. What would my parents say? Would my father think I was being farsighted or irresolute? Would he think of me as a quitter?

I first talked to my parents about my intentions a few weeks later on a family trip to San Diego, where Rajiv was in his second year of residency at UCSD Medical Center. Rajiv was two and a half years older than I, and as with most brothers of roughly equal age, ours was a complicated relationship. Growing up, he was my playmate, rival, and exemplar. There are faded pictures of us as children, dressed in school uniforms, hugging each other in the smoky air of Old Delhi. In America, we were latchkey kids. When we got home from school, Rajiv would fix me a snack—usually a bowl of cornflakes with a heap of sugar—and we'd sit in front of the TV and watch cartoons. As we got older, we got more competitive, especially in sports. We'd go to public tennis courts in the summer or on weekends and play from morning till night, often evenly splitting our matches. In high school, I edged him out for the final spot on the local team going to the California Interscholastic Federation tennis tournament, but my father forced me to give up my spot because Rajiv was a senior and it was his last opportunity to play CIF. When Rajiv went to college at UC Riverside, only a few blocks from our high school, our relationship changed once again, and he became more of a guardian over me, always inquiring about the minutest details of my life at his old school, closely monitoring and supporting my attempts to break into “the Hill” and other popular social groups. Though I had always done better in school than he, Rajiv possessed an easygoing charm that made people instantly comfortable and won him friends and popularity. If he was a politician, I was a political consultant.

Now I was a graduate student with misgivings and he was a doctor with a degree from the University of Chicago. My parents and I were sitting in Rajiv's sunlit living room, just a stone's throw from Solana Beach, when my father asked me how my research was going. When was I going to start collecting data? I told him that I didn't know.

“But you've been setting up your experiment for over a year,” my father said, leaning forward on the black leather couch, the breast pockets of his short-sleeved cotton shirt thick with pens. Even though he had never really supported my decision to go to graduate school, now that I was there he wanted to see me finish up and get on with my life. “You have to learn to focus. I have done a Ph.D. so I know—”

“All right.”

“You can't stay in graduate school forever. You have to look for a job, start a family—”

“Okay!” I shouted. I got up and went to the bathroom, where I splashed cold water on my face and coughed into a towel. Then I went back to the living room, where my parents were sitting quietly. My father was leafing through papers in his ever-present briefcase, which was resting on his lap. I sat down on the love seat. “I'm thinking about applying to medical school,” I announced.

My mother, dressed in a conventional flower-patterned sari, looked at me quizzically. She turned to my father, who was expressionless. “You can't go to medical school now,” she declared.

“Why not?” I replied. I had it all figured out. Over the next two years I could finish up my thesis and take the prerequisites. By the time I matriculated, I would be only twenty-six.

“And then four years of medical school, then three years of residency, maybe even a fellowship. Look at your brother. Do you think you can work like him?” Judging from her tone, she did not.

“It's only a few years,” I snapped. Unlike in India, life in America wasn't set in stone once you turned twenty-one.

“I always wanted you to be a doctor,” my mother said. “Remember? It was always my dream that both my sons become doctors. But that time has passed.”

Her last remark was particularly cutting. It saddened me to think about how many years and how many opportunities had slipped away. My father appeared deep in thought. “What are you thinking?” I demanded.

After a long pause, he said: “Don't change horses in the middle of the stream. Who knows if you will even like medicine?”

That night, we went to the Old Town district to have dinner with my brother and some of his colleagues from the hospital. We sat outside on a cobblestone square illuminated by gaslights, drinking margaritas out of salt-crusted martini glasses while a mariachi band serenaded my father with “Happy Birthday.” At one point Rajiv's beeper went off. He stood up and went off to answer the page. My father and mother beamed proudly.

They had always favored my brother, their firstborn, and Rajiv demanded it, too. He knew the privileges of being the eldest son in a traditional Indian family and guarded them closely, like a trust fund. Watching him that night, I thought of all those times I had pitied him studying organic chemistry or preparing for the MCAT while I read novels or blasted Rush records on our turntable.
Why do you begrudge him his happiness?
I asked myself.
He earned it.
I remembered the summer I visited him in Chicago. He was a third-year medical student and would usually leave the apartment for the hospital before six in the morning. I'd sleep till noon, get up, eat lunch, read the newspaper, do some sightseeing if it wasn't too hot, and usually end up roaming through bookstores in Hyde Park. Rajiv would trudge in at 6:00 or 6:30 p.m., always looking a mess but claiming he felt great. Now where was he, and where was I?

His colleagues asked me about my research, but I couldn't bring myself to say much about it. Now that I had lost my enthusiasm, I couldn't imagine anyone else finding it interesting. So I asked them about residency, hospital life. They were working hard but it was obvious that no one had any regrets. Like my brother, they seemed to have embraced their training as a sort of boot camp, a necessary hardship on the way to a fulfilling career. One of them boasted that he had recently
diagnosed a case of malaria by examining a smear of a patient's blood under a microscope. Someone else told me that he was in the process of applying for a hematology-oncology fellowship. Listening to them, I felt envious. They possessed everything that I was lacking: passion, confidence, a sense of purpose. Graduate school had left me feeling lonely, marginalized, like an interloper in the real world.

Riding home that night, I was surer than ever that I wanted to become a doctor. Choosing to do so now was as much of a rebellion as dismissing it had been years ago.

The next day Rajiv took me to the hospital. Walking through the teal double doors of the intensive care unit was like entering a sanctuary, scrubbed and sanitized. I had never been in an ICU before. Residents were moving quickly, purposefully, dressed in light blue scrub uniforms and fanny packs. Rajiv took me from room to room, telling me about each case. We passed a young man on a ventilator. A middle-aged couple was sitting quietly at his bedside. “He'll be gone by the afternoon,” Rajiv whispered casually. We walked on as he continued talking. After a few paces, I stopped. “What did you mean back there?”

“Where?” Rajiv said.

“Back there. You said that guy was going somewhere. Where is he going?”

“To the morgue!” Rajiv replied. “He has AIDS. He's circling the drain.”

I searched his face, bewildered by his lack of feeling. At one time he had been so sentimental. He had wept when I left for college, and again when he went off to medical school. Now he seemed so different, so hardened, like the sort of person who might pick up a ringing phone and shout, “Talk to me!”

“You've changed,” I said, not even trying to hide my disappointment.

“So you'll be a different kind of doctor,” he shrugged. “Once you get out of the ivory tower.” We continued walking while I seethed quietly.

When I got back to Berkeley, I met with a campus psychologist, a balding, bespectacled man who specialized in career counseling. He asked me to take a career interest inventory test. A few days later I went back to discuss the results with him.

“Well, Mr. Jauhar, the test indicates that you have little interest in medical science.” The occupations I seemed best suited for were lawyer, college professor, human resources director, and flight attendant.

When I told him I had already decided to apply to medical school, he asked me why. Judging from his tone, he didn't think it was a good idea. If I wanted to do biomedical research, had I considered seeking a postdoctoral fellowship after I finished my physics Ph.D.? If my reasons were primarily pragmatic (the hope of a high salary), what about options requiring less training, like management consulting, investment banking, or business school?

I was yearning for something I couldn't quite put my finger on. “I just want to get out of the ivory tower,” I blurted out, and of all the possible reasons that had gone through my mind, that one probably best explained my motivation. I had begun to despise academia. I had been enmeshed in the world of esoteric ideas, and where had it gotten me? The lupus support group meetings had reinforced my belief that the work I was doing was going to have little impact on people's lives. Physics was an enterprise of reflection, ideas. Medicine was an endeavor of prescription, of action. Becoming a doctor, I hoped, would bring me back into the real world. It would make me into a man.