"A lot of what makes [memoir] good is what you leave out. You can’t interpret things for the reader."

Dr. Sandeep Jauhar, author of “My Father’s Brain”

Today, on “The Things Not Named,” I speak with Dr. Sandeep Jauhar, a cardiologist and the author of several books, including Intern, Doctored, Heart: A History, and My Father’s Brain: Life in the Shadow of Alzheimer’s.

Below is an edited transcript of our conversation on Substack Live.

Transcript:

Joshua Doležal:

Welcome back to The Things Not Named. I’m Joshua Doležal.

Willa Cather said that the presence of the thing not named gives high quality to literature, and this year I’m applying that idea to medicine, asking how we might be more attentive to what goes unsaid in the clinic, in popular culture, and in the experience of illness on the patient’s side.

I’m excited to have Dr. Sandeep Jauhar here today as my guest. Dr. Jauhar is a cardiologist and the author of four books: Intern, Doctored, and Heart: A History, as well as My Father’s Brain: Life in the Shadow of Alzheimer’s, which we’ll focus on today. My Father’s Brain takes an unflinching look at the toll that caregiving takes on families. It also delves into what happens in the brain as we age, how memory gives meaning to our lives and even changes with time, and how dementia complicates our understanding of what it means to have a self. In addition to his clinical work, Dr. Jauhar is a contributing opinion editor for The New York Times. He’s also appeared frequently on NPR, CNN, and MSNBC to discuss medical issues. And his essays have been published in The Wall Street Journal, Time, and Slate. You can follow him on X at @sjauhar and learn more at his website, sandeepjauhar.com.

Dr. Jauhar, welcome and thanks for joining me today.

Sandeep Jauhar:

Yeah, thanks for having me.

Joshua Doležal:

So this is your latest book. Have you done a book tour? Are you currently making the rounds with it?

Sandeep Jauhar:

Yeah, well, the book came out in twenty twenty-three, so I’m sort of done with that part of it. But yeah, I mean, I sort of miss it. But yeah, no, it was a nice tour. I went to, you know, I don’t know, maybe seven cities and, yeah, it was fun.

Joshua Doležal:

So what’s that like? Do you have to take time off work to make the book launch happen? Is it kind of all-consuming for a bit?

Sandeep Jauhar:

Yeah, I think, you know, the first couple of months tend to be a lot of interviews, and, you know, talks, book talks. It takes some time out of my schedule, but, you know, it can be scheduled. So like I know when the book’s coming out, and I know how much vacation I have, and so it all tends to work out.

Joshua Doležal:

Why do you do it? I’ve asked this question of a lot of people. You know, doctors are busy people, and, you know, I assume there aren’t financial demands that require you to write books, and it’s hard to do with a family, as I know. I have three kids.

Sandeep Jauhar:

Yeah.

Joshua Doležal:

So when you work a job that typically has a high burnout rate already and then you’re writing on top of it, it seems like kind of a lot. So why do you stick with it?

Sandeep Jauhar:

Yeah. That’s a good question. It’s really a miserable hobby. No, writing, you know, as I’m sure you know, is really hard. It’s probably the hardest thing I do day to day. You know, harder than my medical practice really, which can get a little bit algorithmic, whereas writing demands a sort of creative impulse, and that’s why I do it, because I always wanted to make art, you know, in whatever way I could. I had that creative impulse, and I didn’t find really an adequate outlet for it within clinical medicine. And so I found a lot of aspects of medicine were fascinating, troubling, you know, sparked a lot of thought and created a lot of dilemmas in my mind. And I found writing was the way to try to help resolve some of those dilemmas. I mean, I do some writing as just pure advocacy. You know, I’ve written many, many op-eds in The New York Times about aging, ethics in medicine, and, you know, other aspects of public health and clinical medicine that, you know, I just want to bring out some point of view that I would like to be debated or I want to advocate for. But that’s really not my main impulse, especially when it comes to books. With books, you know, it’s just I really focus on creating the best art that I’m able to.

Joshua Doležal:

Well, it’s nicely said. I have kind of made a name for myself for being grumpy about the quality of new releases. You know, most of the craft touchstones that I look to for my own memoir writing and for fiction are ten years old now. Tobias Wolff, Mary Karr, some of the authors in your genre, Atul Gawande, Danielle Ofri, they were writing earlier, right? So the latest wave seems to be much more grievance-driven. The craft emphasis seems to be lightened. And so I was so refreshed by your book because I was drawn into it with the questions it raised and, you know, the story it was telling. But there are these touches that really showed a high level of nuance and art, as you’re saying. So how did you learn the craft? Is that something you credit your editors with, or did you study it? How did you become an artist?

Sandeep Jauhar:

Well, I mean, I studied it in the sense that I read a lot of really good memoirs, you know. And, you know, I think to be a good writer, you have to be a good reader. And some of the names that you mentioned, you know, I’ve read their whole oeuvre. Tobias Wolff, you know, This Boy’s Life, one of my favorites. And there’s another book called Stop-Time, which is really one of the great memoirs, I think, in American literature. And I think it was an inspiration for This Boy’s Life. Great book. So I spent a lot of time, you know, before I started writing books. My first book was called Intern. I got the contract for Intern without a proposal, which tells you how much things have changed. But it was just an offer from my publisher, my still publisher, Farrar, Straus and Giroux. And I remember I was a cardiology fellow, and I just threw myself into... I didn’t know I was going to be able to do it, to write a book. I had never even thought of writing a book. And so I just kind of dived into reading great books for several months, you know. And you sort of know what resonates with you and the kind of style that resonates with you. And yeah, that’s how I studied it. I didn’t take a creative writing workshop and I didn’t get an MFA. But it was, I was sort of largely self-taught, I guess.

Joshua Doležal:

Yeah. Well, I think we learn language by imitation when we’re young. We mimic sounds. You know, the term for that is canonical babble. And, you know, it doesn’t mean anything, but it sounds like the things that mean something, and then eventually it becomes coherent. So I feel like with writing, imitation is kind of where we start, and then slowly we find our own voice and it becomes more coherent and meaningful. So we all have to be self-taught in that way, I think. One example real quick, and then I want to shift to some of the bigger claims and troubling questions that the book raises. Just as a kind of example, at the end of chapter three, you’re at a luncheon, or it’s an award banquet for your father. He’s featured and he gets the award, but then he gets anxious and wants to leave. And so in this book about his slow decline and progression through dementia, this is one of those painful examples of how far he’s come from the researcher that he was. But his inability to even, you know, really care about social cues anymore, he just, he got his award, so he wants to leave. And you have this kind of exchange where you’re irritated, you’re kind of embarrassed because it would look bad to everyone else if you left. You’re even a little bit cruel because he wants to take a taxi, and you remind him he doesn’t even know where he is. But then it ends with a kind of exchange that’s more affirming. I’m curious if you could kind of talk us through how you designed the end of that chapter, because it seems like you made some real choices there to put yourself in a certain light to show the reality of that exchange kind of painfully. But then you didn’t want to leave it with the cruelty. You wanted to soften that. So could you talk through some of the choices you made as you were writing chapter three?

Sandeep Jauhar:

Yeah, I mean, it was, I haven’t read the chapter in a long time but it was an awards banquet that my father was invited to, and I knew he wasn’t going to be able to go by himself. It actually happened to be at the university at which I am a professor of cardiology. So, you know, I was a little wary of the whole situation and how things were going to play out. And they played out sort of the way I expected, maybe a little bit worse. You know, at first it was okay, but then my father started making comments to people around the table. It was making them feel a little bit uncomfortable.

And in the chapter, I think I reflected on why I was feeling the way I was, and I think it was because my father and I were very similar in so many ways. I mean, physically, we looked very much the same. The same sort of skin tone, facial features. And then he was also a writer of books. He wrote several. He used to... I don’t know if it was him or someone joked, “How many books have you sold?” And he’d say, “Dozens.” He’s written three books over about twenty years. You know, but they were scientific books, you know, more like textbooks.

But, you know, he was always a person who was striving to make a name for himself. And in that sense, I understand where he was coming from. We were very similar, I guess, in that way. And so I was watching him decline, I was very afraid that this is going to happen to me one day. And of course, we know that Alzheimer’s is not classically inherited, but there are forms of it that have a genetic predisposition. So that was sort of the context. And then of course, you know, there were people there who were basically like colleagues. And, you know, so he got his award. It was really more of a recognition for the fact that, you know, my father grew up very poor, and he created these scholarships for underprivileged students back in North Dakota, where he was living before he moved to New York. He was a professor there. And so when he came to New York, one of his real goals was to create another set of scholarships. He really wanted to spend his money doing that. And we were very supportive. So we created this endowed scholarship for underprivileged students. And so they wanted to recognize him. And so he went and got his award.

And then, of course, immediately he wanted to leave. And yeah, I mean, I felt angry, I felt embarrassed. And ultimately, I acceded to his demand to leave. We got up sort of as the whole thing was going on. I took him, drove him home. I was very upset and didn’t really say anything to him, other than, like, I think I lost my temper a little bit at the luncheon. You know, it’s just really easy to do that. And, you know, it sounds like as I talk about it now, it just sounds horrifying that a caregiver would, you know, would not have empathy, you know, and especially for your own dad. But when you’re in the moment, it’s just hard. It’s hard because you’re seeing a person who’s clearly declining, and your expectations are colored by the person that they were, not the person that they are. And so when your expectations collide with reality, that’s when there’s this cognitive dissonance, and you just... I just reacted with anger. And yes, I said something like, “How are you going to take a taxi? You don’t even know where you are.” And he kind of looked at me and didn’t really respond, but it dawned on him that I was probably right.

Anyway, we got back to his house in the driveway. And then, you know, like a lot of people with dementia, my dad just quickly forgot. Or maybe he knew and maybe he was trying to make up for it. I don’t know. My sense is he probably just forgot that we had had an argument, and that’s one of the sort of silver linings, if you will, of dementia, is that as your brain, let’s say, shrinks, I mean, physically does shrink, so do your expectations, your resentments, your ambitions. You know, a lot of the things that made my father unhappy, this ambition to be recognized. He didn’t really care anymore, you know? And so in some sense, he was happier when he had dementia than when he was sort of a normal, striving, highly striving individual who wasn’t getting the recognition that he wanted.

Anyway, he sort of forgot about it, and I said, “I’ll come tomorrow to see you.” And he said, “Great.” I said, “Maybe we can go get a coffee.” And he said something like, “I don’t really care to have coffee, but I do care to see you.” And, you know, then my heart kind of melted, you know? Because even as a 50-year-old, or when I was probably in my late 40s, you know, a kind word from your dad still means a lot, you know.

Especially my dad, who was a bit sparing with kind words, you know, when I was growing up. So it was a nice moment, and that’s how I ended it, because I think the chapter sort of encapsulated my experience, which was some bad, but a lot of it was redemptive and good, you know?

Joshua Doležal:

Well, I think what you said earlier about the dissonance that caregiving creates and that these end of life stages bring out in us is really the key. When I’m thinking about this from a craft perspective, what I love about it is that on the page, it’s fairly spare. You let the reader connect the dots. You can just let the words kind of stand there on their own, and it makes you uncomfortable in the best possible way, in ways that I think memoirs have started to shy away from. And there’s a lot packed into just a few paragraphs where one minute you’re kind of hissing at your father in this cruel way in the scene because you’re embarrassed and conflicted. And then in the next moment, you know, it’s not about the coffee, it’s just about seeing you. And all of those things are kind of wrapped up in the scene, but not in a way that’s hectoring or that you interpret or that is sermon-like. It just kind of sits there, and then the reader has to finish it within themselves and complete it emotionally. I think that’s where resonance comes from.

Sandeep Jauhar:

I appreciate that. I think with writing that you’re proud of, a lot of what makes it good is what you leave out. You know, you can’t put too much in there. You can’t interpret things for the reader. You just have to, you know, respect the reader, respect their intelligence, respect their ability to draw interpretations from what you’re putting out there.

Joshua Doležal:

Well, I’m nerding out about craft here, and one of the more, I think, universal facts and themes that you get out in the book is how pervasive dementia’s becoming. This really was chilling, I thought. Right now, currently, one in 10 Americans over 65 already have some form of dementia, and then in 30 years when I’m 80, that number will be one in five, so it’s going to double. And at that point, dementia will be the second leading cause of death behind heart disease, even greater than cancer. And polls, I think you say, show that people fear dementia even more than they fear death. So, ugh, that’s a lot. What do we do with all that?

Sandeep Jauhar:

Well, one of the reasons why dementia prevalence is increasing is that we have more vascular disease. And one of the things I point out in the book is that some of the ways to prevent dementia, some of those risk factors are the same as for cardiovascular disease. So move more, exercise, eat right, get enough sleep, all things that we know about heart disease we can apply to dementia.

The difference between heart disease and dementia is that heart disease has a lot of good treatments, and dementia does not. And dementia is unique in the sense that you’re still the same person when you have coronary blockages. But when you have a deteriorating brain, your self can get effaced in various ways. I do make the point that self never goes away, that there are certain habits and predispositions that are, let’s call them subcortical, that are not affected by Alzheimer’s. So my father, for example, may have forgotten a lot about who he was, but he still knew what music he liked. He still knew what foods he liked to eat. He was still the same man. It’s just that he was a different man.

So people often say that dementia can change the self. And in that sense, it’s very, very scary to have a disease where you find yourself changing, but you find your memories getting erased. And also you find yourself socially isolated, especially in America, where people just don’t really have the patience for people who have a deteriorating brain.

There are other parts of the world that probably have a little more patience, a little more reverence for the elderly, than we do in America. But even those parts of the world are changing. I think in China, the term for dementia is something like elderly retardation disease. And in Colombia, people who have dementia are thought to have had hexes placed on them. In America, it’s just very striking because in America and especially overall in the West, the things that we prioritize tend to get compromised in dementia, economic productivity, the ability to process information. We are in an age where we are constantly being inundated with information and putting our own information out there, and the information traffic is just so incredibly dense, and people with dementia cannot participate, and so they end up getting isolated, and that isolation feeds the disease. And so the disease is no longer just one of plaques and tangles in the brain, but it’s also one of social isolation.

I think that’s why people are more afraid of dementia than they are of death. Because my mother was so afraid of the word Alzheimer’s that we never mentioned it, even when we knew in our hearts that my dad had it. But she finally was the one who advocated to take him to a neurologist. But we never mentioned the word because in her mind, Alzheimer’s meant institutionalization and isolation and physical dependency. And all those things are true, in many ways. So it’s tough. We as a society are completely unprepared for the tidal wave of dementia cases that are going to be hitting us in the next couple of decades. And we have some medications, but they don’t really work very well. And so we spend a fraction of research dollars on dementia as we do, a fraction of the dollars we spend on heart disease and cancer.

Joshua Doležal:

Yeah. Well, it is a wake-up call. I was reading some of this as a kind of indictment of American culture, which isolates people even without dementia. Bowling alone has been the case for a while. But your parents left India, left an India that seemed at that time to represent these traditional values of community. And so I think America is often seen as the soulless place where people don’t have that, or they lose the sense of belonging to a neighborhood, or they just spend their whole lives moving around. But I think you said somewhere in the book that’s also true in India more. There are no stay-at-home parents necessarily or fewer than there used to be.

Sandeep Jauhar:

Mm-hmm.

Joshua Doležal:

And so I wonder, do you think there would have been a better life for your father back in India, or is his story playing out more or less the same way for aging people in India today?

Sandeep Jauhar:

No, I think it’s different still. I think Indian culture is still... There are a couple factors, and there are cultural factors. The Indian culture still preaches reverence for your elders. And, of course, things are changing as the world generally is getting more, let’s say, Westernized and developed. But I think that in India still, multi-generational families are the norm. And the problem in America is that, well, so 100 years ago, America, maybe a little bit more, maybe 150 years ago, most Americans did live in multigenerational family units, often on farms. And there was always someone around to help when someone got sick, especially an elder. And then because of different factors, industrialization, and other cultural and social changes, the American family unit became more nuclear and smaller and more urbanized.

That was a wonderful thing, because a lot of good things came out of that. Kids were able to leave the homestead, go out and blaze their own paths. Women were able to leave home and go work and achieve their own goals. Those are great things. The problem is that when someone gets sick you see the deficiencies of that model. And today, when families, there are 15 to 20 million unpaid family caregivers, most of them are women. Most of them are daughters or daughters-in-law. And so the brunt of the work still falls on the family, but it’s not as diffused as it once was, and it falls on one or two people and can make them very miserable and sick physically and emotionally.

I would say that India has changed. There are nursing homes that are cropping up wherever, but there’s still the multi-generational family unit is still generally the norm. So I think from the perspective of social acceptance and integration into society and the family unit, I think my parents probably would’ve been better off in India. I think they certainly would’ve been less lonely. But of course, India doesn’t have some of the amenities that one has in America. So it’s hard to say.

I know if I had asked my parents, they would’ve said, “We’re way better off here than being at home.” But in India, in a lot of communities, a lot of cities, there’s a cousin down the street. A brother living next door. There are people around who can help out. Everyone is so spread out in America. My brother and I live in New York. My sister lives in Minneapolis. And my parents were living in Fargo, North Dakota, where my father was a professor. And we would see them once or twice a year. We didn’t even know until later when they moved to—we brought them to New York to help take care of them. We didn’t even know until their friend came to move them, she told us that my parents were eating cereal for dinner.

Joshua Doležal:

Yeah.

Sandeep Jauhar:

We didn’t know that. So you see the deficiencies of the model when people get sick. Until that point, it’s all hunky dory. But it allows you to chase your ambitions.

Joshua Doležal:

Well, it’s the paradox of the American dream, and your father chased that dream, right? To opportunity that he wouldn’t have had elsewhere. But it left him isolated, so it seems like that’s the trade-off. Be all you can be. The American dream is, the price that you pay is isolation and this kind of sobering experience that your father had and others like him. So I don’t know if it’s a fair question or even possible to answer, but do you think that trade-off is worth it? Because you and your siblings have done the same thing, chased careers. Is it worth it then to have all of that and a lonely final chapter? Is that what you think will be your story too?

Sandeep Jauhar:

I hope it’s not my story, but it likely will be, right? Look, life is a guaranteed tragedy in the end. We all die. And for most of us, the final chapter is a difficult one. It can be lonely. It can be physically uncomfortable. You’re faced with pain. So does that make the rest of it not worthwhile? No. But how you end an experience always sort of has an outsized importance. So how we end our lives is very important. That’s one of the lessons I took from Gawande’s Being Mortal. And it’s super important. But you can never know.

Joshua Doležal:

So it’s an illusion to think that we have choices about those things.

Sandeep Jauhar:

Well, we have choices about chasing our ambitions and living a fulfilling life. If you have resources, yeah. We have choices, but how we end our lives, some of it depends on the choices we make. If you buy long-term care insurance, then you’re likely to have a way of living in a decent place near the end of your life, if you can’t live at home. If you maintain good close relations with your children, then chances are that they’ll be around to help you, as they should. As my brother and I and my sister helped our parents. They were good parents, and we tried to be good kids, up till the very end. But some of it is out of our control. How we get sick, how our bodies, our families respond to that sickness, some of it is beyond our control. And so look, that’s just the nature of life.

Joshua Doležal:

Well, tell us a little bit about Harvinder, who was a family friend who did the bulk of caring for your father. So you and your siblings were doing your best but you’re also working full time. You can’t provide twenty-four/seven care. So she lived with him. How did she meet the family? And tell us a little bit about her story.

Sandeep Jauhar:

Yeah. No, we found her services in... I think it was an ad in an Indian grocery store maybe. Or she might have been recommended by someone. I don’t remember all the details, but she was a godsend. She was just a wonderful caretaker. She came from South Asian culture where respect for the elderly is very important. And so she approached the caregiving with that mindset. She was very patient with my dad, even when he would lose his temper. She knew his likes and dislikes, some of which were culturally based, so she just had an intuition for it. She made him Indian food. She was wonderful. And even with her helping us, I would still say the care for my father in that last couple of years was one of the most difficult experiences I’ve ever been through. So one can only imagine, one hates to imagine what families go through who don’t have resources to hire help.

Joshua Doležal:

Well, it was kind of abusive for her, wasn’t it? He kicked her out of the house multiple times.

Sandeep Jauhar:

Yeah, yeah. No, she was incredibly patient. And, yeah, he, as people with deteriorating brain cortex and deteriorating amygdala do, he became emotionally violent and sometimes physically violent. And didn’t believe that she needed to be there to take... He didn’t think he needed her. One of the problems with dementia, as is with, let’s say, schizophrenia and maybe some anxiety disorders like OCD, is you develop something called anosognosia, which is that inability to recognize your own deficits. And with dementia, it’s an inability to know that you have a disease because of the disease, and that’s what my father had. He was unable to recognize that he couldn’t take care of himself. And so you’d point out, “Well, you don’t know how to use the microwave. How are you going to make tea in the morning?” Or, “You left the stove on. I came into your house, and the stove was on.” Do you realize that... But he couldn’t process it. So yeah, he would kick her out constantly and, God bless her, she would sneak back into the house through the garage and call us, and she didn’t want to leave him alone. And she stuck by him till the end.

Joshua Doležal:

But as I was reading that, I was struck by... I mean, she is a wonderful character and speaks truth to all of you as well about the limited role that you’re able to play at certain times. But it was heartbreaking to read that her own husband died while she was caring for your father. And that’s one of these... Why did she stay? Her own family back home was in need of her. So what kept her with your family?

Sandeep Jauhar:

A lot of, some of her children had already left India. And, yeah, no, she just was very loyal to my father and really to my sister, who had a very close relationship with her and they became really, really good friends. And so we needed her and she stuck by us, till the end. So yeah, it was tragic that she stayed. She couldn’t go back and be with her own family. But that was a decision that she made. But we couldn’t have done what we did, and my father would have had a much worse ending to his life without her. Absolutely.

Joshua Doležal:

Well, I thought she was an important character and added some nuance definitely to the story of caregiving.

Sandeep Jauhar:

Yeah.

Joshua Doležal:

So one of the tough questions I want to ask you is about writing about others, and it’s a kind of perennial question for memoirs. How much of stories that involve other people are ours to tell? And in a certain way, our reputation or our legacy is how people remember us. And your father was like you, or you’re like him in that regard, that you care a lot about how people think of you. So this wasn’t a choice that he got to make. If he’d had editorial sway, he probably would have not wanted certain scenes to be told publicly. So I’m curious how you wrestled with that. I know that you’re hard on yourself too. You have a scene where you briefly imagine, you don’t actually imagine suffocating him, but you imagine that it could be quick, right? So the finger is kind of pointing both ways in that regard. But how did you work through that ethical question of how much of your father’s story of illness was yours to tell publicly and how it helped serve a larger need?

Sandeep Jauhar:

Well, my father was a very giving man. And I had written about him in many of my books. Intern especially, he was a major character, and not always in a flattering way, but in a realistic way. He read Intern and he didn’t object. My brother also was a major character in Intern, didn’t object to the way that I interpreted my experience with them. You’re right. When there are problems and mistakes that are made in my memoirs, most often they’re made by me, and so I don’t flinch in pointing the finger at myself. But knowing what I knew about my father, I don’t think that he would have strongly objected to my writing a book that would help hopefully thousands if not millions of people cope with this most difficult journey. So yes, I did see that whole story as being part of my own story. And I didn’t... I mean, I didn’t deliberately try to make it as garish and baroque as possible. I presented the way things unfolded. I don’t know if he would have had major objections. If he had, yes, that would have affected how I viewed things. But given our history together and what I knew about him and what I knew about his social consciousness, I thought it was fine to write.

Joshua Doležal:

Mm-hmm. Well, one of the ways that you try to serve that larger need is in talking about memory. And so you have some portions that are more scientific about just what happens to the brain when it ages and how erosion of memory affects self and some of those things. But I saw it as a subtle thread throughout the book where it was your father’s memory that was slipping, and often you were either correcting him or you just silently knew that whatever he was remembering was not true. He was making things up. As Mark Twain says, “Sometimes you reach the age where the things you remember best never happened at all.” It’s an exaggerated version of that in places. But then I saw toward the end of the book, you start doing the same thing yourself, or you’re at least more aware of how the way you see things is more of an interpretation than just the reality.

Sandeep Jauhar:

Hmm.

Joshua Doležal:

And I thought that was a really nice touch in the final scene. So I wonder maybe as we wrap up, if you’d be willing to read that final scene, and we can talk about why you ended it that way.

Sandeep Jauhar:

Sure. So memory and deconstructing memory, examining what it means, it was a big part of the book. And one thing that we know about memory is that it’s active and vital. It’s not just simply a reproduction of what happened in the past. That concept where memory is a reproduction of some event is known as correspondence. And that’s how we think of memory. But there’s another competing concept in memory called coherence, which is that memories change as one changes, and memories can be constructed to conform with the values and person that you are today. And so there’s a tension, right, between correspondence and coherence, and that really exists throughout the book and in many different scenes. But the final scene, and I guess this is the last two paragraphs of the book, after my father died, he had stopped eating and it was a Friday morning, and I hadn’t made it home to his home. And my siblings called me frantically. I was on my way, and they said, “You need to come now.” And I got there and my brother said, “Dad, Sandeep is here.” And not long after that, probably a matter of a few minutes, he took a long breath, and then he went silent.

So I wrote,

As he drifted away and people began to wail, I experienced a strange remembrance. It was from our second year in America. I was nine years old and learning to ride a bike on the sloping dirt hill behind our house in Kentucky. It was a cheap girl’s bike that my father had bought on sale from Kmart. Built for a paved street, it made creaky metallic sounds as I coasted precariously down the furrowed trail. As I used to remember it, when my father quickly realized that I could make it down the hill on my own, he lost interest and went inside. But that sunny March morning, as I gripped his lifeless body, for some reason I saw him running beside me. I was pedaling furiously down the rutted path, flying over sticks and weeds as my father kept pace to make sure I did not fall. I know it didn’t happen this way. I can’t imagine that it did. But it is my memory now. I’ll keep it.

Joshua Doležal:

It’s a lovely scene, and it’s a shift because earlier your siblings were willing to lie to your father to keep the peace. Validation therapy, I think, is a term for that, that advocates for that. Don’t contradict or cause conflict, but just agree. Go along.

Sandeep Jauhar:

Yeah.

Joshua Doležal:

And you had held the line that you wouldn’t lie to your father. You’d always tell the truth. But here it seems like you’re almost lying to yourself and accepting it.

Sandeep Jauhar:

Yeah.

Joshua Doležal:

Why did you want to end on that note?

Sandeep Jauhar:

I think it’s just a recognition that we do what we can to cope with our lives and difficult experiences. And it also points to the fact that memory is such a big theme in the book, and I wanted to end it on that note. That all the false memories that my father had or his inability to maintain memories of reality. For example, that my mother had died, he kept forgetting. That in some sense, we all do that. It’s just that in his case, it was just more obvious. But in some sense, we all sort of lie to ourselves. And that was the reason.

Joshua Doležal:

Well, thanks for sharing your father’s story with us. It made me think about my own life and my relationship with my kids and lots of important things. So it’s definitely provided a service for me, and I know for anyone who reads it.

Sandeep Jauhar:

Thank you.

Joshua Doležal:

And I appreciate you being here. So that’s all the time we have for today.

The Recovering Academic is made possible by the support of readers and listeners like you. So as always, thank you.

Next time I’ll speak with Rachel Weaver, author of Dizzy, which is part memoir and part medical mystery. Weaver recounts waking up dizzy one morning, unable to function, and how it took ten years and more than thirty doctors to diagnose her and eight more years to find some relief. So after hearing from doctors and other healthcare practitioners for the last few episodes, we’ll go back to look at illness from the patient’s side.

That’s the thing not named for today. Thanks again to Dr. Jauhar for joining me, and see you next week. Take care.

The Recovering Academic explores the messy intersections of medicine, culture, and storytelling. I write three new essays a month, hold live interviews, and produce a podcast about the things medicine leaves unnamed. It's all free to read, and it stays free because readers choose to support it. I also give 5% of what I earn here to local charities.

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