World Famous Comics: Intern: A Doctor's Initiation
Intern: A Doctor's Initiation
By: Sandeep Jauhar Publisher: Farrar, Straus and Giroux Average Rating: Binding: Hardcover Label: Farrar, Straus and Giroux Number of Items: 1 Number of Pages: 320 Publication Date: December 26, 2007 Release Date: December 26, 2007
Intern is Sandeep Jauhar’s story of his days and nights in residency at a busy hospital in New York City, a trial that led him to question our every assumption about medical care today. Residency—and especially the first year, called internship—is legendary for its brutality. Working eighty hours or more per week, most new doctors spend their first year asking themselves why they wanted to be doctors in the first place.
Jauhar’s internship was even more harrowing than most: he switched from physics to medicine in order to follow a more humane calling—only to find that medicine put patients’ concerns last. He struggled to find a place among squadrons of cocky residents and doctors. He challenged the practices of the internship in The New York Times, attracting the suspicions of the medical bureaucracy. Then, suddenly stricken, he became a patient himself—and came to see that today’s high-tech, high-pressure medicine can be a humane science after all.
Now a thriving cardiologist, Jauhar has all the qualities you’d want in your own doctor: expertise, insight, a feel for the human factor, a sense of humor, and a keen awareness of the worries that we all have in common. His beautifully written memoir explains the inner workings of modern medicine with rare candor and insight.
Deceptively Interesting I found this work by Sandeep Jauhar to be quite in insightful description of what the world of internship actually entails. What I find brilliantly done is the keen use of language to constantly push forward a sense of dismissal of patients, yet a odd desire to continue. Throughout the course of this work, Jauhar is incredibly hesitant of the idea of medicine in the first place, yet reluctantly decides to push forward over all odds. There are times when you not only know, but feel, as though Jauhar doesn't want to be in the hospital, don't want to talk to patients, doesn't want anything to do with medicine in the first place. I suppose that's the impact of working in a hospital for more than 24 hours at a time. Occasionally I would find myself reproaching Jauhar for his standoffish manner, which is somewhat of a theme of this novel. It seems as though he occasionally doesn't care for patients, but just wants to get the job done and go home. But then I realized that part of what Jauhar is trying to get across is a taste of what a life as a doctor entails. I had assumed there would be some nights where sleep might be hard to come by, but I never thought it was as intense as is portrayed here. I commend Jauhar for a well-written description and await his future works.
What it's REALLY like to become a doctor XXXXX
"This book is about my residency [apprenticeship in medicine] at a prominent teaching hospital in New York City. The story goes up to the point when I decided to pursue a fellowship in cardiology, my specialty, and thus covers the most formative years of my education as a doctor.
For me it was a disillusioning time: I spent much of it in a state of crisis and doubt. I had trained as a physicist [the author has a Ph.D. in physics] before entering medical school, and ten years of uncertainty about my choice of profession came out all at once...
Because I had lived another, more sedate, professional life [as a physicist], the one I had to endure in the hospital was even more difficult to bear...For much of internship [the first year of residency], I felt buried--in a waking Hell under the weight of my own (and others') expectations...
I am [now] finished with my apprenticeship, and...now work as a cardiologist...For the most part, I am happy...But so much about medicine still troubles me...sometimes I'm still not sure cardiology was the right choice..."
The above is found in the introduction to this well-written book or memoir by Sandeep Jauhar, M.D., Ph.D. who now is the director of the Heart Failure Program at Long Island Jewish Medical Center. He also writes regularly for "The New York Times" (which got him into trouble during his residency).
If you're expecting to find phrases in this memoir such as "Medicine is the greatest profession", etc., you won't find them and are advised to look elsewhere. This is because this book is brutally honest. Jauhar tells it like it is and I got the sense he was not attempting to sugar-coat any of his narrative. As well, I totally believe that others being initiated into medicine go through the same struggles, questions, and observations as Jauhar (but for some reason are afraid to admit them).
Here are a few sentences and phrases that caught my eye:
(1) A lawyer from risk management, the department that defended the hospital against lawsuits, informed us that at some point in our careers every one of us was likely to be sued, and that we could even be sued during residency. (2) "It's strange that all week [this was intern orientation week] they've hardly mentioned the patients...These are the people we're going to be learning on. It's like they're already invisible." (3) But as with most of what I learned during then first two years of medical school, I had forgotten it.
(4) It's almost criminal the callousness with which we [that is, doctors] treat some of our patients. (5) We performed our [medical] interventions [on patients] with such confidence, such arrogance, but most of the time there was no way of predicting whether we were doing the right thing, or even a good thing. (6) What is the point of all this? All the protocols, chemotherapy, the transplants--what is the point of it if, in the end, the sickest patients, the ones we were beholden to help, or at least not harm, were better off without us?
(7) The sentiments I had heard about neurologists seemed close enough to the mark. Master diagnosticians, they had depressingly little to offer their patients. (8) I too was learning that deliberate half-truths are a part of a doctor's armamentarium. (9) Even today, patients continue to be enrolled in experimental drug studies without proper consent, or under tacit intimidation.
(10) In the ICU, sometimes the cure is worse than the disease. (11) Doctors make fun of patients for many reasons. Sometimes as a defence mechanism, and sometimes just because they can. (12) In some ways, I probably ended up becoming the kind of doctor I never thought I'd be: impatient with alternative hypotheses, strongly wedded to the evidence-based paradigm, sometimes indifferent (hard-edged, emotionless), occasionally paternalistic.
Each chapter begins with an interesting quotation. Here's one of my favourites by Lewis Thomas:
"The great secret of doctors, known only to their wives, but still hidden from the public, is that most things get better by themselves; most things, in fact, are better in the morning."
Finally, there are notes in this book that contain very interesting information. Here's an example:
"Doctors are more likely than members of the general public to commit suicide...Only 22 percent of depressed medical students seek help. Only 42 percent of those who are considering suicide seek treatment."
In conclusion, in my opinion, this is the best book on becoming a doctor that I have ever read. There are two things that make it stand-out from the rest: (1) the excellent, intelligent writing and (2) its HONESTY.
(first published 2008; prologue; introduction; 3 parts or 21 chapters; main narrative 290 pages; notes; acknowledgements)
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Review on Intern There are several books I've read that speak along the same lines of this book but there is one things that stands out. The difference in this publication lies in that the author speaks magnitudes about one's natural tendency to feel lost in the environment of medicine. It illuminates the emotions a person experiences with clarity and depth. More importantly, in my opinion Dr. Jauhar displays bravery in undergoing the task of writing his experiences.. I do not know any person who is willing to admit to their weaknesses though we all have them. He goes on to create a lucid picture of the hierarchy in the health system while taking the reader along for a ride down nostolgic paths of how one found his/her purpose in pursuing such a career. There is not much more to say except Dr. Jauhar should be applauded for expressing the truth that much of us are scared to admit we dealt with at one time.
Must read for those thinking about a medical career If you are like me and wondering if the path to being a doctor is the right choice, then you might want to take the time to read through this one. The author gives you a first hand look at what it takes, and he doesn't hold back on details.
Mediocre overall....much better books on similar subjects out there I read this book this past weekend. I think the book was an easy read and the writer has some obvious literary skills. I give the author the credit for being honest about his weakness and fears, but in the end, I never get the sense that the author actually wants to be a doctor. He is almost an "Atul Gawande" wanna be....Good effort, but no where near as insightful as the vast amount of other authors who have written similar titles.
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