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  “Will Sonia be happy if you become a journalist?” my mother sputtered.

  “Sonia has nothing to do with it,” I replied.

  “She wants a doctor!”

  “Leave her out of it!”

  “Your mother has a point,” my father intoned. “Money talks. Believe it or not, money is important.”

  “Khoon sook gya hai,” my mother said, shaking her head, meaning that her blood had dried up with worry over me.

  “You are always wavering, flickering, putting us through hell,” my father said, obviously disgusted. “Thanday doodh noo phook marta hai,” he muttered.

  There he goes again, I thought, always telling me that I was blowing on cold milk.

  “You don’t know what it’s like,” I started.

  “My dear son, did you think it would be a walk through a rose garden? They don’t pay you for nothing.”

  “What about passion?”

  “What is passion?! You can train your mind to find passion.” He accused me of immaturity. I accused him of a bourgeois mentality. Back and forth it went—the recriminations, the anger. Why was I not practical? Why were they not supportive? Why, with all the promise I supposedly possessed, would I consider ruining my life by quitting medicine now?

  “You have to learn to focus,” my father said sadly, getting up to end the conversation. “Then and then only are you going to get somewhere. You cannot succeed by doing something halfheartedly. You cannot always do what you like, but you must like what you do.”

  LATER THAT WEEK—on an auspicious day, according to the gurus Sonia’s parents had consulted—we drove a rental car to New Jersey for dinner and a religious ceremony with Sonia’s family. The ceremony was called roka (meaning “to stop”), and it was supposed to signify that Sonia and I had chosen each other and were going to stop looking for other people. When I told my father about this “pre-engagement,” he responded with his usual gruff practicality. “You like her, so why don’t you just get married?”

  Sonia’s family lived in Edison, population one hundred thousand, an enclave for Indian immigrants unlike anything I had ever seen. As I drove through town, we passed Kar Parts, Patel Cash & Carry, Bombay Chaat House, and Delhi Darbar. Young women in salwar kameez tops and braided ponytails ambled along the road carrying groceries. Old men clad in white dhoti cloth were pumping gas. Signs on office buildings read PATEL, GUPTA, KHANNA. Sonia’s parents had a busy internal medicine practice here—an empire really—with two thousand patients and three different offices. Her father had urged me to join his practice after finishing my medical training. “You must become a cardiologist,” he said on more than one occasion. “Then you can take over the practice.”

  We took a sharp right onto a country road lined with tall oak trees. Suddenly the conventional wood-frame homes on the main road gave way to huge mansions set in landscaped plots lined with luxury cars. We turned onto a gravel-ridden private road covered with leaves. The house was visible about a quarter mile in the distance: a rambling three-story whitewashed colonial with black shutters, long balconies, and four Mercedes-Benzes parked out front. A herd of deer looked up as we drove past. So this, I told myself, feeling awed, is what a doctor’s salary can buy.

  Images of our modest bungalow in Riverside, California, flashed through my mind. Our entire tract-housing block could have fit on the roadway leading up to the house. I looked at my parents’ faces, wondering what they were thinking. Were they impressed? Was this the reason they wanted me to stick with medicine?

  In the car, my father and I had reached an uneasy rapprochement; there was to be no more discussion of my career today. His last words on the subject were in the Lincoln Tunnel: “Your mother and I always think of you as our brilliant son—a source of light for our family. Every morning you wake up, ask yourself: What is the aim of my life? Am I heading in the right direction?”

  When we arrived at the house, Sonia came out to greet us. Though I had been to the house once before for dinner, going there with my parents set the differences in our upbringings into sharp relief, and I think Sonia must have sensed my unease. A pandit was waiting for us in the ornately decorated living room. As Sonia and I sat side by side on a silk rug under a painting of Lord Vishnu, he lit a havan—a wisp of cotton soaked in oil—and loudly chanted Sanskrit verses. Syllables were shooting off his lips like bullets, and his brown pate glistened with the effort. Hunched over on the floor, with the pain in my neck nearly unbearable, I regretted leaving my neck brace behind in Manhattan. The pandit asked me to repeat certain phrases—“aana maana gaana . . .”—which I did, oblivious to their meaning. Were these another set of commitments I was destined to break? After each verse, the pandit made an offering of rice grains and flower petals to Lord Ganesh. He smeared tikkas of red paste and crushed seeds on our foreheads and periodically filled our outstretched palms with a parshad of holy water and milk. Sonia and I rubbed vertical streaks of turmeric on each other’s forehead and hung flower garlands around each other’s neck. When the time came, the pandit instructed me to offer a ring. I had bought it the week before at Cartier in midtown. It had three intertwining bands of yellow, white, and pink gold, signifying love, fidelity, and passion.

  Afterward, maids brought out platters of chicken and lamb chops, savory pakoras, and curried vegetables—and bottles of Blue Label and Macallan’s. I sat quietly, picking at the food on my plate. My appetite was poor; in fact, I had lost ten pounds over the past two months. The pit of my stomach burned with acidity, the first sign, I was sure, of a peptic ulcer.

  Gifts were exchanged. Sonia’s grandmother recounted stories from the Ramayan, a religious parable. The lesson seemed to be that the person who lives by his words will be rewarded; he will be king. “Never break your promises; never take the easy way out.” Of course, she was talking about my relationship with her granddaughter, but I could not help but think the words equally applied to other commitments I had made.

  I looked around the room. Everyone was smiling, beaming. I resented their laughter, resented my discontentment. Sonia’s father drunkenly took out a microphone and started performing Bollywood karaoke. He took me aside. “Be happy,” he said. “You are always so serious. When you are stuck in a mud puddle, you cannot expect it to flow like the Ganges.” He offered me a set of golf clubs and told me that I would be made an honorary member of his country club. I thanked him, not having the heart to tell him that I doubted I would ever use them. I couldn’t picture myself like him, a successful doctor riding down rolling fairways in a golf cart.

  Under the influence of liquor and the occasion, my father looked happy, perhaps even a bit inebriated. Seeing him that way, a man who took pride in maintaining control of himself and others at all times, felt almost surreal. The smell of Old Spice on his cotton shirt transported me back to a time when I had been vulnerable to his disapproval. I remembered how he used to exhort the virtues of vitamin C. Growing up, I became obsessed with vitamin C because of my father. I gorged on fruit to prove my love for him. He sometimes reminded me of the father in Vittorio De Sica’s The Bicycle Thief: loving, protective, but somewhat pathetic, too. Right then I felt like the boy in the film, holding his father’s hand, looking at him in awe and fear while he ate a pizza to which he was not entitled.

  Outside, in the backyard, a photographer set up a tripod camera and snapped pictures as Sonia, wearing a red silk salwar kameez, and I, wearing a charcoal gray Brooks Brothers suit, touched the bark of a holy tree. Afterward, she went inside and I sat alone on the stone steps. It was dark now, quiet, apart from a rare cricket, the nearly full moon illuminating the expansive lawn. I looked out at the parched, knolled fields singed by the cold, dotted with what looked like burial mounds, my thoughts as tangled as the skein of brown trees in the distance. How can I quit now? I thought. How do I disappoint everyone, including myself? I’m not strong enough, bold enough, courageous enough, to say, Stop!

  I was flailing in a quagmire of my own making, and yet the q
uagmire was the only place I could imagine being. The constant cogitation was exhausting and seemingly preordained. Perhaps this was the way it had to be; perhaps the way my life had unfolded depended on who I really was, deep inside, not the part that could be changed or molded or beaten out like a pellet of ore. A lyric kept going through my head: You may find yourself in a beautiful house, with a beautiful wife/And you may ask yourself—Well . . . How did I get here?

  In a flash, I thought of Lisa. I wondered how she was doing. At one time, I had ruminated over her illness, too. I had been racked with doubts before. I remembered discussing her with my father, crouched uncomfortably on the living room carpet, the snow packed outside, the house unbearably lonely, crying the both of us, me for my losses, he for me, and perhaps for his losses, too. But that had been a very different problem than the one I was now facing. As a good friend had once remarked, “Some problems are divine.”

  I felt the urge to cry, but I told myself to wait until a more appropriate time. I cleared my throat, tightened up my face, anything to keep myself from sobbing, but the tears came anyway, hot and quick, salting my face. Images were shooting in from the fringes of my memory. I had seen them before, perhaps in my childhood, perhaps in a movie. I was six years old again, running across the road into oncoming traffic, only to be whisked up into my father’s arms. He was forcing me to eat an overripe banana on the way to the school bus stop, dragging me along in my starched public-school uniform. I was back in middle school, preparing to defend my title in the Math Field Day competition. After the competition, in the school parking lot near the petting farm with the one goat and a few chickens, my father took one long disappointed look at my fourth-place certificate and ordered my mother to kiss it.

  I don’t feel like being bold. I just want to be solemn and brooding. Being courageous takes too much effort. What’s the point? When the going gets tough, the smart get out! That’s what the preacher used to say on the steps of Sproul Hall. Get out, get out. I can’t get out!

  At one time, I had been so optimistic about my future, and so had my parents. I had invested it with so much hope, comfort, profundity—and here it was, and I had become a doctor, and it was all so muted and colorless. Everything was gray, in tone and shade. What would happen if I broke myself down again and rebuilt? I was afraid that all that would remain would be fragments of shell and dust. Everything else would evaporate.

  CHAPTER FOURTEEN

  winter blues

  O Wind,

  If winter comes, can Spring be far behind?

  —SHELLEY, “ODE TO THE WEST WIND”

  When I was a boy, I used to ponder the following question: Should a person stop doing something if there is a chance that thing could lead to disaster? For example, would I stop driving altogether if I knew that at some point in my life I was destined to crash into a brick wall? Would I consign myself to a life of immobility (especially true in Southern California) to avoid such a calamity? During the winter of my internship, I often asked myself this question in relation to medicine: Should I go on? Though I was still working in the hospital, I was just barely functioning. And I wasn’t sure that disaster did not lie ahead.

  In December, with the pain in my neck starting to subside, I was sent back to Memorial—to substitute for an intern who had just returned from a leave of absence for major depression. Even though she was back on the wards, the chief residents thought it best that she perform her Memorial service in the spring, so I ended up spending New Year’s Eve once again on call on the leukemia ward.

  That night, I saw Kayvan Patel for the last time. A middle-aged man, he had been diagnosed with acute lymphocytic leukemia two years earlier. At first his disease responded to chemotherapy and he went into remission. But the cancer returned and eventually proved resistant to all treatments. He knew he was going to die. But first, he wanted to spend a little more time with his two sons, eight and eleven, to impart lessons they could carry with them when he was gone.

  He could not escape the hospital, though. The leukemia had ravaged his immune system, so every time he got a new fever—which happened every few weeks—he would be hospitalized and placed in virtual isolation. His sons were discouraged from visiting him because they were going to school and posed an infectious risk. He was given antibiotics—antibacterial, antiviral, antifungal—for weeks at a time, often becoming violently nauseated and short of breath during his daily infusions. With each passing day his frustration and sadness grew as he realized the fever was consuming the precious little time he had left.

  One day, he decided he had had enough. The months of hospitalizations and the endless, mysterious fevers had taken their toll on his mind as much as his body. When he told his doctors that he wanted to go home, they discouraged him, telling him he could rapidly succumb to an infection, but he would not be dissuaded. On New Year’s Eve, shortly before midnight, he called me into the small room that had become his home. Lying on sheets wet with perspiration, his face dark and flushed, he spoke to me with a resoluteness I had not seen in the three weeks I had known him. “They say I will die if I leave the hospital,” he whispered. “I will take that chance because here I am already dead.”

  Not long ago, his words could have described my feelings, too. It had been a bleak autumn. Trying to make it through each day was like pedaling a bicycle up a steep hill, straining to keep my balance as my calves burned with heat and pain. The constant pressure to perform, to satisfy the expectations of my family, my colleagues, and myself, was too much to bear, and eventually I cracked. And once I cracked, the crisis of confidence became self-sustaining, as I began to flagellate myself over my state of mind. Why wasn’t I stronger? Why couldn’t I handle the stress? Why me? Why now? The lower I felt, the worse it got, as my mood seemed to feed on itself. But fortunately, even in the midst of this crisis, I knew that my dark mood was pathological. I had enough insight to know that I was clinically depressed.

  Because I was miserable, I succeeded at making the people close to me miserable, too. A nugget of anger was always wedged deep in my brain, ready to explode at the slightest provocation. At times I lashed out at Sonia, dumping my frustrations on her even though we were supposed to be in the prime of our courtship, a honeymoon phase. Post-call, I’d snap if I didn’t get enough sleep. One afternoon, exhausted after a difficult night on call, stress ulcers stinging the inside of my mouth, I told Sonia I wasn’t going to be able to make it to a social function at her parents’ house that evening.

  “My parents had it a lot worse than us,” she said, clearly annoyed by the change of plans. “Those were the days of the giants. My father used to be on call every night. You and I have it comparatively—”

  “Stop it!” I roared, rage surging through me, momentarily clearing my mind of its cobwebs. I always hated it when Sonia compared me to her father. I was having a hard enough time in medicine without being reminded of how he had succeeded.

  “Why are you yelling?” Sonia shouted.

  “I don’t want to hear about your father or your family! I have my own way.”

  Before long we were angrily circling each other in the foyer. We were in our volcanic phase, and in the volcanic phase, you didn’t know where the lava would flow.

  “Have you no concept of what I’m going through?” I barked.

  “You act like you’re the only one!” Sonia said. “I’ve got my own stuff to deal with.”

  “You don’t know the pressure I’m under!”

  “Don’t dump it on me,” Sonia retorted. “It isn’t fair.”

  “You see how I’m working. Why don’t you understand—”

  “I understand, but honey, you need help. You’re depressed. Remember how things were last summer—?”

  “Stop it, just stop! I can’t deal with this right now.” And with that I stormed out of the apartment.

  As was typical in those days, Sonia called me a few minutes later, and we quickly made up. That was the nature of our fights during internship: explosiv
e eruptions rapidly followed by amends and calm. After a long nap, I apologized for my outburst, and we went to her parents’. But I still felt like a razor precariously balanced on its edge.

  IN JANUARY, I rotated back to the outpatient clinic at New York Hospital. After what I had been through the past couple of months, I was glad for an easy rotation, and it was good to see some of my regular patients. Perry Richardson showed up for his normal psychotherapy session. A lumbering black man with a flirtatious manner, he had fallen on hard times after being laid off as a sales representative at a pharmaceutical company, losing his apartment and his boyfriend, even living for a while in a homeless shelter on Ninety-sixth Street. But he had started taking night classes in graphic design and was planning on starting a glossy-brochures business. Jimmie Washington came in, too, still loudly announcing in the waiting room that she was a busy obstetrician. She had a few surprises for me, like the stroke she had suffered in 1984. “Did I know about that?” I asked. “You would if you’d been listening,” she admonished. “Okay, so tell me about the stroke,” I said. “It was after my brain surgery,” she replied. Brain surgery! I didn’t know what she was talking about. It turned out that she had had a brain aneurysm resection fifteen years earlier, which I thought probably explained her eccentric personality.

  That month, I made my first house call. In truth, it wasn’t entirely my idea. The patient, Roberto Gonzalez, had prostate cancer that had spread to the bones. He had been coming to see me with his wife at least once a month throughout the fall and winter, but he had missed his last couple of clinic appointments. One afternoon I got a call from his visiting nurse. I had never spoken with her before. (Admittedly, I had even been a bit lax about filling out the home-care order forms that were periodically put into my mailbox.) “He’s getting sicker,” the nurse told me. “He would love to see you.”