DOCTORED

The further education of a doctor.

Cardiologist Jauhar (Intern: A Doctor’s Initiation, 2007) was nearing middle age and finding himself ever more impatient, indifferent, dismissive and paternalistic—everything he had abhorred in his idealistic youth—and his sense of integrity gnawed at him, as did the demands of his job. What will come as a surprise to many readers is that doctors, too, worry about their incomes, which aren’t close to Midas’ pocket change. Granted, it’s far more than many of us earn, but for many doctors, moonlighting helps pay the insurance coverage. When Jauhar had embarked on his medical school training, he had visions of entitlement dancing in his head—“They made more money and earned more respect than just about any other profession”; “Doctors largely set their own hours and determined their own fees”—but that was then; now he finds himself an overworked, underpaid cardiologist at a Long Island hospital. Although income issues come to dominate the book, Jauhar shows flashes of warmth and connection—“At one time, keen observation and the judicious laying on of hands were virtually the only diagnostic tools a doctor had. Today they seem almost obsolete”—and he writes with a nitty-gritty appreciation for hard work as he wrestles with moral quandaries and struggles to keep everything—home and work—intact. At times, the author seems to be arguing with the devil on his shoulder—shady big pharma money, collegial back-scratching, pure fraud in the ordering of excessive testing—as he strives to meet his quota of “Relative Value Units”—i.e., the values insurers place on medical services.

A medical story about the loss of ideals and the corrections to course one makes as midlife and its responsibilities arrive, with insights into the overly complicated and often fraudulent state of health care today.