Brotherhood Dharma, Destiny and the American Dream (16 page)

Sparks flew from the surgeon’s hands. I had stepped on the electrical connection to the special knife used to cauterize blood vessels, shorting it out and giving him a jolt. He put down his instruments and turned to face me.

“You are not a surgery student,” he said in a flat, deadly tone. “You are a bull in my china shop.”

When he told me that I didn’t need to come back, it wasn’t necessary to add “ever, ever again.” We both knew he was right. For the rest of medical school I never participated in another surgery. So it seems ludicrous that I passed the course. But I did, thanks to the constant presence of memorization. I sat with my surgical textbooks and learned by rote a skill I could no more have practiced than an actor pretending to be a surgeon on television. But I became an excellent theoretical surgeon. I learned all the techniques and memorized every surgical instrument and its uses. Since our exams required us
only to answer questions on paper, not to actually operate, I went into the finals without the slightest anxiety about not passing.

Why do so few doctors have a Buddha moment? Being filled with compassion is the essence of Buddha nature, as it is called. Legend has it that when he was a privileged prince named Siddhartha, the future Buddha sneaked out of the palace one night and set eyes on a sick man, an old man, and a corpse. This glimpse of human suffering made him renounce his right to the throne, and the sight of a fourth man, a wandering monk, told Siddhartha how to seek the solution to suffering.

I don’t think I’m being accusatory when I say that modern medical training practically ensures that compassion won’t be unnecessary. The first sight of a massive gunshot wound in the emergency room is a terrible, upsetting experience. The second is slightly better. By the hundredth, however, you are drained of shock and pity for the most part. Repetition dulls your response, but that is only superficial. What really happens is adaptation, one of the wonders of the human nervous system. Anything can be normalized once the brain is trained to accept it. Entering a burning building, riding on the back of a killer whale at Sea World, hauling snow crabs out of the raging Arctic Sea—they all progress with astonishing quickness from “You want me to do what?” to “It’s the job.”

Adaptation is a two-edged sword. It allowed me to fit into the specialized world of medicine by suppressing the parts of myself that weren’t needed. At moments I could still step back and be more human, could hold the hand of a dying woman with real pity or shake my head sorrowfully, after I came to America, at the sight of a ghetto child who had been caught in the gunfire between two gangs in New Jersey. Adaptation doesn’t completely hard wire your brain.

Unless you want it to. In the cold light of day, isn’t compassion a hindrance when you only have ten minutes to save the life of a gunshot victim? This logic is good enough for the practice of emergency medicine. When I was a young doctor, it satisfied me. But there’s a flaw in the logic. What if compassion is a form of healing? If that
seems too far-fetched, say that compassion is a window through which we can see a different world, where a completely different way to heal becomes possible. In that world there are ancient kinds of traditional medicine. There are shamans and healers. There is energy work, herbal remedies, sacred rituals and prayers. In my training, however, no such world existed—or should be condoned. The window must remain sealed, and it was for me for many years.

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Real Doctors

Sanjiv

Deepak and Sanjiv on their first ski trip to Vermont, 1973.

T
WO YEARS AFTER DEEPAK
concluded his medical training, Amita and I did our posting in the village of Kurali. As part of our one-year internship we had to spend three months in a village diagnosing and treating the poor and uninsured. It was called the social-medicine rotation. Kurali was only about forty miles outside Delhi, but it was entirely rural. The town, where the electricity would go off several times a day, had a bicycle shop, a tea store, a few other shops, and a small school with a principal and a teacher. We lived in one room, more of a hut, which was often lit by candles. But that lack of modern amenities did not concern us at all. For the first time we were actually practicing medicine. Being only twenty years old and having the trust of these villagers was a very powerful feeling. At times it made us feel like we were much older, and much wiser, than in fact we were.

It was a challenging situation. We’d spent four years learning how to use the tools of the modern physician, and we were expected to practice medicine without any of them. Deepak had warned us what to expect, so we were not surprised to discover that the dispensary had only a limited number of drugs and almost no medical equipment. We didn’t even have an X-ray machine. It was hands-on medicine at the most basic level.

We did have two registrars in medicine who supervised the interns assigned to the three villages in our area. They were brimming with knowledge and experience. We thought they were so wise. At night we would sit with them over dinner and talk about medicine. We were very busy, seeing as many as one hundred and fifty patients a day. Most of my work was stitching up wounds, setting broken bones, and giving out tetanus shots. Amita treated almost all of our female patients and the majority of the children. In India many women will
not go to a male physician, so she treated the entire range of women’s conditions.

It was hard work, but I loved every minute of it. I was doing what I had wanted to do my whole life. And on occasion I was able to make a real difference in a patient’s life. One gentleman came to see me with very vague symptoms. He had lost some weight, he had a slight fever and a very brassy cough, and he was often tired. Even at that young age I loved the challenge of diagnosing a difficult case, applying the lessons learned in the classroom to a real-life patient. I put my stethoscope on his back and asked him to breathe in and out. His heartbeat seemed unusually loud, so I asked him to count “one, two, three” in a whisper. I could hear it loudly through my stethoscope. This sign is called a whispering pectoriloquy. It often indicates that the patient has a tumor abutting the airway, conducting the sound. I couldn’t be certain, but I suspected he had lymphoma.

I told the registrar my patient needed an X-ray. We had a van that made the trip to Delhi several times a week. He was sent to the All India Institute and, sure enough, he had a mass in his chest. It was biopsied and it came back positive for Hodgkin’s lymphoma. He was treated with radiation and did well for several years.

I had saved a life. It was an extraordinary feeling. I was lauded by the registrar for making that diagnosis based only on a small physical finding. For a few days I was a local hero.

There were conditions we treated in that village that I would never see again in my entire career. A young boy who had been bitten by a dog was brought to the clinic by his mother. In that situation the greatest fear is rabies. One of the symptoms of rabies is hydrophobia. I don’t know why this happens, but if you put water in front of someone with rabies it terrifies them. It always seemed strange to me, but that’s what we had been taught. So I filled a pitcher with water and put it in front of his face—and he started screaming. He jerked violently to get away from it. His face was contorted with fear. It was a remarkable but sad sight, but it made it easy for me to diagnose his illness. The young boy died. His face and expression are indelibly imprinted in my memory.

While there were no Ayurvedic hospitals or clinics in this area, there were practitioners of this ancient medicine who worked from their homes. Most of the people who lived in Kurali respected both forms of medicine. Sometimes patients came to see us after Ayurvedic treatment had failed to cure their problem, and sometimes they went to a local practitioner after our treatment.

Our days were filled with treating patients, but at night we were free to do whatever we wanted. Amita and I were newlyweds living in the country, away from our families. After the pressure of medical school, in some ways this was an idyllic situation. We often got together with our classmates posted in the nearby villages. We didn’t have a car, so Amita would sit on the crossbar on the front of a bicycle and I would pedal the four or five miles through the fields to the next village. We would drink beer and dance to modern Western music like Elvis Presley and the Beatles. Then we’d get back on the bike and ride home under a sky filled with bright stars, bathed in perfect silence.

At this time India was fighting a war against Pakistan and we were used to having blackout drills. There were nights we were riding on those dark roads when air raid sirens went off, followed by the sound of a plane overhead. Those beautiful skies were suddenly threatening. We looked up, afraid that it might be Pakistani bombers. Only later did we learn that my uncle Admiral N. N. Nanand would play a pivotal role in India’s eventual victory.

There was one ride home I remember well. We had been celebrating in another village and our classmates served us pakoras, a popular type of fritter made with chicken, potatoes, or cauliflower. They tasted delicious, but our classmate had neglected to tell us that he’d baked
Bhang,
a product of the hemp plant similar to marijuana, into the fritters. I had never tried any type of drug before and I was powerfully affected. It was not a feeling I liked and I was really angry when I found out what he’d done. I cursed him, vowing to take vengeance, then drank a pot of coffee to get sober as quickly as possible. But then we had to ride bicycles back to our village. There were nights I’d ridden home after drinking a few beers, but this was the
longest ride of my life. That was the last time I ever experienced a recreational drug.

When our posting in the village ended we had changed considerably. Amita and I had arrived in Kurali as young medical school graduates with no practical experience. We left months later having treated thousands of patients, flush with confidence in our abilities and clinical acumen. We were ready to be real doctors, not just kids with a medical degree.

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Godfather Land

Deepak

Chopra family grabbing a moment with Hillary Rodham Clinton, June 2007.

I
RODE TO MY WEDDING
on horseback, with people dancing in the streets. All the relatives on my father’s side wore flower garlands and joyful faces. I was ecstatic, too, and in the back of my mind I uttered a small grateful prayer for having learned to ride a pony growing up; there was only a slim chance the groom would fall off his mount when he arrived at the bride’s house to greet her. The traditional procession of the groom to meet the bride is called a
Baraat.
Sometimes the horse is white; mine was brown, and to tell the truth it was a placid animal, being a veteran of weddings all its life, not races.

We were moving through Defence Colony to a house not far from our own. A hired brass band tooted all the way. Rita must have heard it in the distance as her aunts and cousins finished fussing over the gold and jewels that an Indian bride is decked out with—these are usually heirlooms passed down from both families. I adjusted my turban and straightened up in the saddle as our dancing procession rounded the last corner to her house. The pundits who would perform the ceremony awaited, and a place had been made in the back for the sacred fire.

When you throw in the finery draped over the horse (and me), the flower garlands that the two families put over each other before embracing, and the Christmas lights twinkling in the bride’s house, a Westerner might smirk at the gaudiness of this affair. (Because a close aunt of Rita’s had just died, there were no twinkling lights in the house, actually.) But I was playing maharaja for a day, and Rita, as my maharani, looked radiant. There wasn’t a speck of gaudiness. This was splendor.

We had arrived at this moment in February 1970 after a romance that had lasted two years, during which our physical contact amounted to less than what occurs on many first dates in America.
Our families had known each other for years, since before I was born. Her father’s surname was also Chopra, and both couples were married on the same day, by chance. The two fathers had the armed services in common, since Rita’s father had served in the air force, both British and Indian. Secretly the two mothers had hoped to make a match, but Rita and I weren’t told. Arranged marriages were common—and still are—but we were left to make our own choices. There was no prejudice in our minds against parents deciding that a certain match would be good for both sides. I knew of happy marriages that had been arranged, and so did Rita. Her older sister’s was one. But we fell in love by a sinuous path because, as wildly romantic as Indians can be, practicalities aren’t ignored. The word “suitable” is used a lot.