The following is a conversation edited by Emily F. Peters with Sandeep Jauhar, MD, PhD, practicing cardiologist and New York Times best-selling author.
So much of what makes us human is tied with what we remember.
You are the person you are today because you’re connected to the person you were in the past. When that connection gets broken, who are you? You are unmoored in some deep way. I didn’t really appreciate how key memory is to what makes us who we are until my father lost his memory.
I also think that we suffer from a kind of hypercognitivism in the Western world where you’re nothing unless you can think, unless you have intact cognition, unless you can be a productive member of society, unless you can remember things, unless you can add to the conversation. When you can’t do these things, when you lose your memories or develop dementia, then you are treated like less of a person. Other cultures, particularly in the East, don’t emphasize this cognitivism in the same way. Elderhood and memory loss are afforded respect, not ridicule.
Of course, memories change just like stories change. We think of memories as a reflection of how things actually happened, as correspondence, yet our memories change as we evolve; they become more a reflection of who we are today. What you remember isn’t exactly what happened. You remember what you must to support the person you have become. That same thing happens with stories as you reflect on the events to create a narrative.
That’s one of the reasons why I enjoy writing. Writing clarifies. It helps you understand your experience. What did this mean to me? I love telling stories: stories about myself and stories that people haven’t heard about in medicine and medical history.
I found it incredibly rewarding to write about Daniel Hill Williams in my book Heart: A History. He was a Black man who lived in Chicago and used to work as a guitar player on river boats. He had no formal medical training until he decided he wanted to become a doctor and was employed by barber surgeons, professionals who cut hair as well as pulled teeth and performed bloodletting. He eventually went to medical school and became the first documented surgeon to operate on the human heart.
Then there were surgeons like Clarence Walton Lillehei, who literally created a human heart-lung machine by anesthetizing parents and having their blood perfuse the brain of their child undergoing open-heart surgery. I don’t think courage is the right word. It’s brazenness. He was also a womanizer and prosecuted in his later years for tax fraud. A real human, weak and extreme.
The first cardiac catheterization was done by Werner Forssmann on himself. The first studies of arrhythmias were done by a young Englishman who was experimenting, eventually learned the substrate for what causes rhythms in the heart, electrocuted himself, and died. There’s something deeply moral about what some of these pioneering physicians and surgeons did on behalf of medical innovation and discovery. They didn’t want to take on the moral responsibility to experiment and maybe harm other people, so they worked on themselves.
Those stories are amazing. They make me feel like I’m in this wonderful and intellectual tradition of storytelling. One of the reasons I was attracted to medicine in the first place was that it has such a long and rich history. In going to medical school, I was consciously joining into this historical tradition, these stories going back millennia.
Why do so many physicians write? Why do some physicians make really great writers? A lot of it has to do with how we’re trained to be interested in people.
To be observant of things outside of ourselves. A large subset of physicians are very introspective people.
Your first patient, your first patient death, your first prescription, your first altercation with another colleague. Those experiences are very vivid. My experience with my father and having to remember for him also impacted my writing and storytelling. Remembering the things my father did. He grew up in poverty in rural India, doing his homework under streetlamps with borrowed books. He was an accomplished scientist who genetically modified crop plants to increase food production. Never forgetting where he came from, he devoted a large portion of his savings to creating five endowed scholarships for underprivileged undergraduate and graduate students in Fargo and on Long Island. When he could no longer do basic things, my dad didn’t want to admit it. With memory loss, what’s happening conflicts with how you view yourself. It creates dissonance.
My dad was still the person he was in part because I remembered what he was. I still thought of him as my father, and I still remembered the things he enjoyed. The continuity in my own mind helped him to continue to be himself. Sometimes memory becomes a burden that has to be carried by your loved ones.
My father always said, “It’s not what you remember, but what others remember about you.” In medicine, what we remember about our history and our own stories integrates into our views of who we are and who we want to be. What will others remember about us.
Emily F. Peters is the author of Artists Remaking Medicine: The practice of imagination and the power to create a better healthcare future. Sandeep Jauhar is a cardiologist.