Thursday, August 21, 2014

In ‘Doctored,’ Sandeep Jauhar Examines a Broken System - NYTimes.com

In Sandeep Jauhar's arresting memoir about the realities of practicing medicine in America, "Doctored: The Disillusionment of an American Physician," he describes an interaction he has with a patient at Long Island Jewish Medical Center, where he is the director of the heart failure program. The patient has an abdominal mass and has been transferred to the medical center from another hospital for a preoperative evaluation. Dr. Jauhar tells her that there are some things he needs to figure out before sending her to the operating room.

"Like what is this mass," he says. "Is it cancer? Has it spread?" Neither her paperwork nor the doctor from the other hospital had provided answers.

"Do you know if it has?" she asks, wondering if the cancer has metastasized. He does not. "No one knows what is going on," she says, her eyes filling with tears.

And she is right, says Dr. Jauhar, whose writing has appeared in The New York Times and whose first book, "Intern," chronicled that grueling year of his medical career. "It is hard to imagine such a thing happening in the era of 'my doctor,' " he says, referring to the days when patients primarily had one doctor who knew them well.

It's not news, of course, that our medical system has become dysfunctional. But Dr. Jauhar's personal account shows that brokenness on a human scale, starting with the doctor-patient relationship, which is in tatters.

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