A doctor talks about his 'initiation'

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

In his newly released memoir, Intern: A Doctor's Initiation, New York cardiologist Sandeep Jauhar writes about the infamously arduous year of training that follows medical school. I invited Dr. Jauhar -- a fellow writer and friend -- to speak at HMS last Thursday.

The passages he read, before an attentive assembly of first- through fourth-year medical students, documented the loneliness of his experience at New York Hospital -- despite the hustle and bustle on the floors -- in harrowing detail. He described his first solo "road trip" taking an elderly woman for a routine MRI in the bowels of the hospital, a trip that left her in near-cardiac arrest and the young intern feeling helpless.

My own thoughts turned to the times I've been alone with a patient and worried about Doing No Harm. We have scores of brilliant doctors to teach us, but ultimately (and especially in this formative year) I'll have to navigate my own transition from primarily learning from patients to primarily treating them. Jauhar captures this passage with precision. A physicist in a past life as well as a gifted writer, he flavors his prose with unlikely connections between disciplines and surprises the reader with moments of unguarded clarity.

Following the reading, Jauhar discussed pragmatic issues with the audience (Q: I’m about to start my internship. What can I do to prepare myself psychologically? A: Nothing), as well as the growing presence of medical writing as a genre. Firsthand accounts like this one provide much-needed windows into a training process that affects the lives of many. (It's a goal of this blog as well.) Most people have complaints about their medical care (Harvard’s Robert Blendon finds that no more than 20 percent are satisfied in any given country) and by extension, a vested interest in how doctors are trained.

The overdramatic, hormone-driven portrayal of internship year on prime-time television underscores the need for accurate commentary, Jauhar argued.

The soft-spoken doctor-journalist (he writes for The New York Times, among other publications) talked about the importance of showing medicine as it really is -- with all of its uncertainties and missteps. In this sensitively written account, Jauhar offers himself up as a compelling case study, one that will resonate with anyone who has stepped into a doctor’s office or has ever felt unsure about a life choice.