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| Intern: A Doctor's Initiation | 
 enlarge | Author: Sandeep Jauhar
Publisher: Farrar, Straus and Giroux
Category: Book
List Price: $25.00
Buy New: $11.95
You Save: $13.05 (52%)
New (37) Used (16) Collectible (1) from $8.88
Avg. Customer Rating:  26 reviews
Sales Rank: 8519
Media: Hardcover
Number Of Items: 1
Pages: 320
Shipping Weight (lbs): 1.2
Dimensions (in): 9.1 x 6.3 x 1.5
ISBN: 0374146594
Dewey Decimal Number: 610.92
EAN: 9780374146597
ASIN: 0374146594
Publication Date: December 26, 2007
Availability: Usually ships in 1-2 business days
Condition: brand new hardcover with dust jacket!
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Product Description
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.
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| Customer Reviews: Read 21 more reviews...
 Couldn't put the book down. December 28, 2007
19 out of 23 found this review helpful
As a physician, I don't have much time to read a book for leisure, but I couldn't put this book down.
You don't have to be in the medical profession, or have gone through internship to appreciate this book, but it definitely brought back memories from my own training. I wish I had kept a journal during my internship and residency.
Will this book be our generation's version of House Of God?- I'm not sure, but one thing is for sure, it is a great read, well written, and a lot better than the sweater I got for christmas!
 RICK "SHAQ" GOLDSTEIN SAYS: "ONE DOCTOR'S STORY: BUT ALL PATIENTS SHOULD STILL BE VERY CONCERNED!" January 10, 2008
17 out of 24 found this review helpful
The story of Dr. Sandeep Jauhar's journey from college to medical school through internship, up to the decision to become a cardiologist is written by Dr Jauhar (Sandeep) himself. After reading this book I feel it's my responsibility to describe the impact of this book through two totally different perspectives. The first perspective is through a medical professional's eyes. I am not a medical professional but after reading some early reviews by medical professionals their synopsis is basically "it definitely brought back memories from my own training" or a night charge nurse stating: "I can vividly picture the new house staff in Jauhar's writings of his CCU experience." The other perspective, which I feel in the long run will provide the much larger reading audience and undoubtedly will prove to have the strongest and most enduring affect is that of "THE PATIENT!" I was a patient! On February 13, 2003 I almost died during brain tumor surgery. I am blessed to have made it through, recovered fully, and am thankful for every day I have on earth. If you think of it, everyone out there has either been a patient, will be a patient, or have had their loved ones in the hospital as a patient. The details provided by Sandeep regarding medical mindsets are absolutely frightening for any patient or his loved ones.
Sandeep's story starts at Cal Berkeley continues to St. Louis for medical school and finally to his internship at New York Hospital. Sandeep was never totally sure that he wanted to be a Doctor, and throughout the book he fields an internal battle as to whether he made the right choice. He had in fact, majored in physics with his thesis involving "quantum dots". His older brother Rajiv was already a cardiologist and Sandeep went to him numerous times during this story seeking guidance, council and direction, and many times Sandeep came away with answers and attitudes that deeply troubled him. An early example of such dismay was when Rajiv took him to the hospital for his first visit to an ICU. "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 the beginning of residency a lawyer from risk management informed them that at some point in their careers every one of them was likely to be sued, and that we could even be sued during residency. During medical school impressionable young Sandeep was surprised by the dark humor in the anatomy lab, "when they were dissecting the heart, and his partner took the organ, rested it precariously on our embalmed cadaver's forearm and said, "This guy really likes to wear his heart on his sleeve."
One of the many times that the author doubted whether he had the internal fortitude to become a medical doctor he considered switching to psychiatry, one of his mentors said "that psychiatry residents came in two types: those from the bottom of the class who could not compete for more prestigious residencies, and those from the top of the class who were mentally ill." The honesty that is dealt to the reader from the author is refreshing. He tells of almost fainting and throwing up with a tear rolling down his cheek when he gave his first rectal exam, even though he tried to think of something, anything, even dead kittens. Where the story really gets frightening from a patients point of view is during his internship and the long continuous hours that the interns have to put in. It was stated quite clearly that as shifts changed and "LIFE AND DEATH DECISIONS" had to be made that Doctor's wouldn't even read the patients complete chart! In many instances the patients were treated with no respect or dignity, as stated in Sandeep's own journal: "Do doctors care? I don't know. I don't see a lot of caring. Maybe I myself don't care, or care selectively, which is hypocrisy, which I despise. No I don't see much attention to the psychosocial aspects of medicine. There is lip service, by and large, no one seems to pay it much mind. It's almost criminal the callousness with which we treat some of our patients. Remember Mr. Fellini. Poor man; it was almost comical how he cried out for us to leave him alone, to not hurt him, punish him for his HELPLESSNESS. This was a man loved by his family, a businessman or banker, perhaps, one who asserted his will on others, and now he is a helpless child." Halfway through the book he says: "By this point in my internship, I had already come to appreciate that there was a fundamental disconnect in the hospital. Good relations with patients weren't rewarded." One morning at shift change one intern said: "I was kind of hoping he would die. One less note for me to write." "That's how I felt. Is that wrong?" "But you know what?" she went on, not waiting for a reply. "I had to write a note anyway, and fill out a death certificate, and deal with the morgue, and call the attending and the family. So it didn't really save me any time at all." One last warning from someone WHO HAS BEEN THERE. Make sure you make your feelings known to a VERY STRONG person you trust with your life and the QUALITY of your life to represent and defend you while in the hospital. Many of the Doctors portrayed in this book will fight you tooth and nail, and coerce you or your loved ones, in your most dire moment of life regarding DNR's and what ongoing medical procedures to attempt. One such Doctor (pseudonym) Klein after leaving a patients room having "victoriously" got the patient to change their mind regarding "INFORMED CONSENT", chuckled. "WE CAN MAKE THEM DO WHATEVER WE WANT," he said. "AS LONG AS THEY AGREE WITH US, THEY'RE NOT CRAZY."
What it's REALLY like to become a doctor July 31, 2008
8 out of 10 found this review helpful
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"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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Brilliant, honest account of internship December 29, 2007
7 out of 8 found this review helpful
Intern
This book is a brilliant, honest and touching memoir of one man's journey through his medical internship at New York Hospital. I could not put it down. I had no idea how grueling the process was. He has shared intimate details of his daily life on the wards, the stresses as well as the rewards. Yes, I give it as many stars as there are in the sky! DWD
A must read! December 31, 2007
7 out of 10 found this review helpful
"Intern" is brilliantly written in the classical story telling style known to Dr. Jauhar. Being a night charge nurse for over 20 years in the CCU of a large teaching hospital in New York I can vividly picture the new house staff in Jauhar's writings of his CCU experience. His frankness and truthfulness is applauded. A must read!
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