Brotherhood Dharma, Destiny and the American Dream (15 page)

Apparently mail had managed to arrive at the front, and this soldier had received a distressing communication that his mother had died. He went to his sergeant to ask for a few days’ leave from the front lines in order to grieve, but before he could finish his sentence, he was angrily dismissed—no shirkers were allowed in the heat of battle. Going over his sergeant’s head, he went to the platoon commander with his request, then to the regimental command. But each
time, as soon as he got out the words “I need leave, sir. My mother has—”, he was abruptly cut short.

A day later he lost the ability to speak.

My father went to the distraught soldier’s tent and sat beside him. He had made a connection between the mother’s death and the symptom of aphasia. It wasn’t due to a stroke. The soldier wasn’t allowed to finish his sentence, and this traumatized him into the belief that speaking was hopeless. Why not stop altogether? My father didn’t reveal his thinking but simply asked the soldier if he wanted to talk about his mother. At that moment the aphasia disappeared in a flood of tearful words.

When he recounted this incident, my father wasn’t trying to evoke pathos. He was fascinated as a diagnostician. I can’t pride myself on being precocious, either. Listening to the story, I didn’t suddenly discover the mind-body connection. The only effect on me was hidden, one of those invisible bricks that build a self. Besides, there was Linnaeus’s system of classification to memorize after high school, and when genera and species got too boring, I’d play tennis for hours on end with a beautiful general’s daughter named Deepika, the female equivalent of my name. (The games went no further. Our names meant light, but we struck no sparks.)

When the autumn of 1963 came, I started taking premed courses in Jabalpur. More rote memorization lay ahead, years of it. I had no awareness of inner turmoil. I saw nothing insidious about learning to block out emotion as I learned to be scientific. Compassion was an unintended casualty, like an innocent bystander in the throes of wartime.

At seventeen I had no idea who Elvis Presley was, or Cassius Clay. They became real, and instantly exciting, thanks to a rich boy who rode his bicycle with me to Robertson College every morning. Sunil Jain knew about events in America because his parents talked about them. He goaded me (unsuccessfully) to bet on whether Clay could beat a hulking bruiser like Sonny Liston, and listening to him discourse on the subject of Elvis was like listening to an Apollo astronaut
describe the feel of moondust under his boots. We usually met to discuss these alien topics in his family’s mansion in an exclusive part of Jabalpur.

The only person I knew who had actually set foot in America was one of the Irish Christian Brothers who taught at school. His main impression of New York City was that he had walked block after block without hearing a bird and that no crows perched overhead. One day he announced to the class that Marilyn Monroe had died. From there he launched into dark warnings about the debauched lifestyle that many Americans led and told us to avoid two curses, fame and alcohol, if we ever went there.

Sunil had many sisters but no brothers. The sisters hovered in the background, giggling and whispering with curiosity about me. Servants drifted in and out of Sunil’s private rooms with spiced tea or garlic and onion soup. But wealth wasn’t nearly as thrilling to me as “Jailhouse Rock.” In retrospect I suspect that Sunil, worldly as he was, didn’t know about the Beatles. They arrived in my world much later, in the luggage of visiting med students from the United States, along with surreptitious tiny packets of LSD. Well into medical school I was invited to parties where
Sgt. Pepper’s Lonely Hearts Club Band
was played incessantly while boys and girls sat on chairs sipping Coke. The girls’ braided hair was glossy and black, the air scented with the jasmine sweetness of a flower called
Raat Ki Rani,
queen of the night.

Sunil was as ambitious as I was to become a doctor. Premed lasted only a year. I lived in the front part of the Raos’ house, in the same compound where Mrs. Rao ran a maternity clinic with fifty beds. This place felt like home but also like the future I was meant for. The leading lights of the town went to her husband for X-rays and to her to have their babies. Sunil’s family was unfamiliar but enticing: They were Jains by religion—the same as their family name—and therefore strict vegetarians. My lasting image is of studying with him late into the night, and of a large swing under the mango trees where birdcalls were mixed with the sound of giggling girls somewhere in
the shrubbery. It was also at their house that a servant ran in gasping with the news that President Kennedy had been assassinated.

Every Indian knew that First Lady Jacqueline Kennedy was a great friend of Nehru’s. (Whatever their relationship may have been, she took up yoga seriously enough that, without public notice, she invited a yoga instructor to her house for daily private lessons for many years.) Under Sunil’s influence I had learned to look beyond London—the center of the universe for almost every Indian—across the ocean to America. But even if that hadn’t happened, the Kennedy assassination would have seemed like an event of global importance, a blow that struck at the hearts of the young and hopeful.

I graduated from premed with the right credentials and the grades to apply to a major medical school. I was still seventeen, and since India followed the English model of going very young into medical training, I would barely be eighteen when I began to dissect my first cadaver. None of this seemed daunting to think about, but the process of choosing a medical school was confusing. I was accepted at the highly regarded Maulana Azad Medical College in Delhi, and I’m sure I could have been happy there. A more distant prospect was getting into the All India Institute of Medical Sciences, also in Delhi. Since it had thousands of applicants but accepted only thirty-five new students a year, the Institute ran its own battery of tests, with no weight given to your college grades. Besides a science exam, there was an English test (one of my strengths, fortunately) and a psychological interview that included, no doubt because of the Americans, a Rorschach inkblot test, the only one I have ever encountered.

The Americans came into it because the Institute was supported by the Rockefeller Foundation. It was actually built, however, by New Zealand government money in 1956 after the original plans, drawn up by Prime Minister Nehru for a medical school in Calcutta, were killed by a powerful Bengali minister. (Nehru’s other project in modern education, the Indian Institute of Technology, was also born in 1956, on the site of an abandoned detention camp in Kharagpur. It became more famous than the medical equivalent. Getting into IIT
for training as an engineer turned into a life-and-death matter for upwardly mobile families. When asked what she would do if her son didn’t get in to IIT, one mother sighed and said, “There’s always Harvard and Stanford.”)

To my surprise I was accepted into the All India Institute and went on to receive a first-class medical education, which was highlighted by rotating visits from British and American professors from the top schools in those countries. But I must jump ahead. I said before that I was humiliated and crushed only twice in my life. The first time occurred when I got the yellow report card in Shillong. The second, which was far worse, occurred at the end of medical school.

Besides passing the regular course work, there was an oral exam for new graduates at the very end. This wasn’t a formality; it spelled the difference between passing and failing. Each student was presented with a case to diagnose. The patient would have a rare or exotic disease which we would have to discover through doing a physical examination and asking questions—no blood work or laboratory tests were permitted. If we made the correct diagnosis, we then had to prescribe a course of treatment from memory.

For the sake of impartiality, an examiner from our school was joined by an outside examiner brought in from another medical school. If the aim was fairness, the result was intense rivalry. The outside examiners were sarcastic and belittling in their attempts to make us look bad. Even putting bowls of sweetmeats in front of them, which was supposed to soften their dispositions, didn’t ease tensions. My outside examiner, unfortunately, was a fierce senior professor known for his brutality. But I was good at questioning patients and had confidence in my recall of obscure medical facts.

“What is your diagnosis of this patient?” the outside examiner barked as soon as I entered the room. I was taken aback. The professor from my school intervened.

“Wouldn’t you like to hear his findings first?” This was the usual routine, since it was important to know how we had arrived at our diagnosis. The outside examiner brushed the question aside.

“Your diagnosis,” he demanded.

“Friedreich’s ataxia, sir,” I replied.

The professor from my school broke out in a relieved smile, but the outside examiner laughed harshly.

“Who tipped you off?”

The man stubbornly refused to believe that I hadn’t been coached. My face turned red. I felt dizzy on my feet. Friedreich’s ataxia is a neurological disorder; it is inherited, and typical symptoms like difficulty walking and speaking are shared by other nervous disorders. I managed to find the presence of mind to protest that I hadn’t cheated, but in a loud voice the outside examiner declared that the one thing he couldn’t abide was a liar. I had failed the exam. After considerable begging, not just from me but from my professor, he relented enough to allow me to take the exam over. But the failing mark would stand.

The second time around was ridiculously easy by comparison. My patient showed all the common signs of rheumatic fever. I passed without honors when I had gone into that room the first time expecting to receive the highest honors. My blood runs cold at the memory, which proves the power of humiliation even when it isn’t deserved. Another invisible brick hidden away for the future.

In medical school you cut up bodies. Everyone knows this, and some people are in awe, because they imagine that a wave of sick revulsion would keep them from slicing through a person’s skin to reach in and lift out the liver or gallbladder. Actually there is very little revulsion. In the first place you aren’t dissecting a person. All the juice—blood, saliva, spinal fluid, semen, mucous secretions, and the rest—have been drained out, replaced with preservative. The standard one is formalin, a solution of formaldehyde and water, and its smell is very difficult to remove once it has gotten on you. I understand this intimately because we didn’t wear gloves while working with cadavers.

My dissecting partner was named Aruna, an attractive girl who was also a quick study. We were too focused on following the wandering course of the vagus nerve or peeling back the cornea after popping an eyeball out of its socket to behave like two normal eighteen-year-olds. But the smell of formalin on our hands, which we
neurotically spent hours trying to scrub away, made us unfit to date anyone else, now that I consider it.

Medicine has been called a priesthood, and most of that initiation takes place in the dissecting room, because even without revulsion, cutting open a body is a momentous event. Everything sacred is violated. The heart is no longer the seat of the soul but a bundle of tough, fibrous muscle. If Pallas Athena sprang fully grown from the brow of Zeus, her feet must have been mired in the oatmeal-textured gray mush of the brain. A cold wave of objectivity settles over you, as it must.

For Aruna and me, our whole intent was on gross anatomy, a mechanical process of slicing, sawing, and peeling away. We didn’t follow pictures but rather the detailed written descriptions in our textbook. These were amazingly lucid, and once you reached your desired goal, that part of the body would never be forgotten, even if it was one of the three tiny bones in the middle ear, which are one-tenth of an inch long and so flexible that they quiver at the sound of a mosquito’s wings. Surgery is an act of deliberate violence that becomes moral because the surgeon is doing good. Chopping up a cadaver is just as violent, and it becomes moral because there’s no one home. The ghost has fled the machine.

Morality is half of it, which no one even mentions when it comes down to wielding a scalpel. More critical is to make the violence normal. I didn’t completely succeed at this. On my first day in surgery three of us were assigned to assist a tall, bearded Sikh performing kidney surgery. He was an imposing figure wearing a turban crisscrossed with green surgical tape. My assigned task consisted of holding a retractor in position, without moving throughout the entire procedure—this could have been as long as three hours. I don’t actually know, because I was booted out of the operating room.

My troubles began as I moved closer to the patient to take one of the retractors that were holding back skin and connective tissue so that the surgeon could see what he was doing. He was leaning over the exposed kidney, and I came too close, accidentally brushing the
sleeve of his gown with a gloved finger. Without saying a word or even looking in my direction, he walked out. Through a small window in the door we watched as he removed his gown, scrubbed his arms and hands, and put on a new pair of sterile gloves. This took five agonizing minutes. Then he returned, still without saying a word, and carefully retraced the steps to get back to where he had left off.

Somehow, in another attempt to get close enough to watch, my hand brushed the sleeve of his gown again.

“You, stand over there,” he snapped, pointing to a spot well away from the table. “Don’t touch me again.” Glaring at me, he stalked out of the room and repeated the entire cleaning procedure a second time, for what seemed like half an hour. I was terribly embarrassed, standing silently and all but motionless behind him when he returned. Clearly I couldn’t be trusted to do anything except observe. But even that proved to be too much. I focused for a few minutes on the surgeon’s back—the only thing I could really see—but then my eyes began to wander. I noticed a black rubber disk on the floor. I couldn’t guess what its purpose was, and without thinking I moved my foot and stepped on it.