"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
