Doctored (27 page)

“Because we are in his inner circle,” he replied. Then he quickly added, “You must have faith, Doctor. It all depends on faith.”

As a boy I'd had faith. I'd believed there were people who possessed special knowledge that I could not access. When I was in trouble, I prayed. But this all had changed. I no longer believed in prayer. I no longer trusted there was a greater source of truth than the thoughts in my own head. I was now apt to ignore the pronouncements of those in authority. Still, I missed that time when I thought others knew more than I about how to live my life. As much as the need for their approval had once unnerved me, my lack of faith was just as unsettling.

Since Sonia's family was playing host, I was accorded a coveted seat next to Guruji in the living room. He was delivering a mini satsang, saying things like “War cannot exist without peace” and making other such pithy pronouncements. Every once in a while he answered his cell phone or checked it for text messages. Sitting next to me on the floor was a young woman with ash blond hair and purple toenails, wearing yellow sweat pants and a Rutgers sweatshirt. She would cry out every once in a while with the annoying shriek of a true believer.

“This body is the temple of the Lord,” Guruji declared to murmurs of assent. “Our purpose is to use this body for good. Not by going to middle schools and high schools talking religion, but rather spirituality. Spirituality and religion are very different. Spirituality unites; religion divides.” He paused for a moment. “Write that down,” he commanded an assistant.

After Guruji had finished his sermon, we were instructed to prostrate ourselves before him and touch his feet. After doing so, I was handed a metal plate sprinkled with rose petals and red powder. I moved it in a circular fashion in front of him and passed it along. A few of his disciples stared at me, seemingly jealous of my proximity.

Guruji asked us to write down some things we wished for but did not have. On a piece of paper I scribbled: “spontaneity and joy of childhood; peace and harmony in my marriage; self-confidence and centeredness.” Then he asked us what we wanted from the practice of kriya. I wrote, “I hope to get a means to put myself in a confident frame of mind—”

Before I could finish writing, Guruji suddenly spoke up. “What do you say now? Talk!” he commanded.

An elderly woman in a drab yellow and purple sari made an appeal on behalf of her sick mother. “When she takes her medicine, she gets tight in the shoulders and shivers,” she said.

“How old is your mother?” Guruji asked gruffly.

“Ninety-four,” the woman replied.

There was silence, as Guruji appeared to collect his thoughts. “It will go away in due time,” he said. People began to laugh.

“But it is only you, Guruji,” the woman persisted, seemingly oblivious of the morbid joke. “Your powers are keeping her healthy.”

“She is ninety-four!” he cried. “You worry too much about your mother.”

Sonia's father stood up. He was now wearing beige kurta pajamas and had a streak of red powder on his forehead. “Guruji, this is my son-in-law, Sandeep.” All eyes turned to me. “I mentioned him to you before. He is a doctor and a writer. He writes for
The New York Times
.”

I nodded respectfully. My father-in-law's remarks were a bit surprising to me because he had long attributed my problems to identity confusion. “You have to decide what you want to be,” he'd said to me many times. “Doctor, writer, father—you have to make some choices.”

But now, before the group, he evinced only caring and pride. “He is a physicist and a scholar, too,” my father-in-law continued. “But his mind is restless. I would request you to speak with him.”

Guruji regarded me with intense curiosity. No one spoke. “So what is the problem?” he said.

A warm wave washed over me, and my mind started to race:
I don't know. On the surface things seem all right, yet I feel unsettled. I keep thinking there is something to worry about, but I can't remember what it is. I am waking up with a fear that things are going to fall apart. I am dreading it, but it isn't happening, so I keep waiting, almost wishing it would happen and be over with.

Of course, I didn't say any of this. I just stared at him. “I don't know,” I replied.

Guruji smiled sympathetically. “If you have a problem, you must go to the right person,” he said, as though reciting a line he had uttered many times. “A problem with your house, you go to the builder; a problem with e-mail, the engineer. And if you have a problem of spirit, you must take the advice of a guru.”

The woman next to me let out another piercing shriek.

“Disease occurs when one of the five elements of the body is off,” Guruji went on. “If a patient has loose motions, what does the doctor give? Saline through an IV. He treats dehydration with water. When it is cold, he gives you a blanket. For lack of soil in the body, you eat. When you are suffocating, he administers oxygen.”

He stopped, waiting for a response, but no one said anything.

“The fifth element is peace of mind,” he continued. “And what does the doctor do? He gives shock therapy. He treats stress with more stress!”

People murmured appreciatively. The woman beside me was now rocking back and forth and moaning.

“Yogis have a different way,” Guruji continued. “Your mind is the most wonderful computer. Man has made powerful computers, but nothing compares with the brain, which is natural. Scientists have allowed us to send e-mails, but before there were computers, the old yogis were sending e-mails back and forth only through their minds.”

I glanced at Guruji's buzzing cell phone and nodded.

“My mission is to convey to the world the ancient scientific wisdom of the yogis,” Guruji went on. “The yogis knew that elements could be transformed into others just by changing the number of electrons. You go from four to six electrons, and you can change iron into gold! The yogis have known this for thousands of years.”

He was talking like one of those crackpots who attended the Berkeley physics colloquiums on Wednesday afternoons, spewing theories about things they did not understand. And yet even though I was skeptical and knew his reasoning was faulty, I needed help. I still wanted to hear what he had to tell me.

“The universe is three things: water, matter, and vapor. And these things when you get to a small enough scale all look the same. What is the smallest unit of matter?” he demanded. I hesitated. “Atoms,” he said. “And what is the makeup of the atom?” My mind was blank. “The universe itself,” he answered. “The whole universe is in the tiny atom. The power is all there.” He touched his forehead. “We just need to tap into it.”

People sounded exclamations of agreement.

“There is no question that you will find happiness,” Guruji said, quieting the group. “Just utter this mantra.” He whispered a few words. “If you say this several times a day, you will enter my magnetic field. The physicists have explained that a big magnet can make smaller magnets. Magnets are everywhere: earth, stars, moons, even atoms. If you do this, you will become a magnet, too.”

I nodded, feeling exhausted. Guruji stood up and announced that he was going upstairs to rest. The crowd parted to let him through.

The woman next to me remained on the floor, quietly sobbing. Tissues were wadded up into a ball on the rug. She was unable to speak. Someone said there was a remedy and dashed off to get it. He returned promptly, holding a banana.

Getting ready to leave Edison that night, I still felt the same sense of foreboding. My chest was still tight, a reminder that things weren't right. Overall, the whole experience seemed to have been a wash. In the expansive foyer, as people were milling around in small groups, chatting, one of Guruji's disciples came up to me. He was a stocky man in his fifties with a scruffy beard and a short graying ponytail, wearing a khadi jacket, leather sandals, and blue jeans that looked as if they needed washing. “Once you know and accept you are going to die,” he told me with a pleasant glint in his eye, “the future will not haunt you.” It was a line out of one of Guruji's pamphlets, and he said it had given him succor in difficult times. I turned the dictum around in my head. More than anything else I'd heard that evening, the words had a ring of truth. I thanked him for the advice. Then I went to find Sonia to say goodbye. Shortly afterward I got into my father-in-law's Mercedes for the ride back to the train station.

 

TWELVE

Denial

Private practice today is like surfing. If you don't stay on top of it, you could go under real quick.

—Comment overheard in doctors' lounge

Sonia had gone to a board review course in Cleveland. When she returned, on a staid, languid Sunday afternoon, Mohan and I went to pick her up at the airport.

In the Lincoln Tunnel on the way there, Mohan, strapped into the child seat in the back of the car, complained, “We're going so long, Dadda. I can't see the clouds or the trees or the sky.”

I said it was because we were stuck in a tunnel.

“What? We're stuck?”

“No, we're not
stuck
,” I said quickly. “We're just going very slow.” I discerned some relief in his face.

“You know what this is called?” I said.

“Lincoln Tunnel.”

“What does the Lincoln Tunnel mean?”

“It goes underwater, under the Hudson River.”

“That's right!” I smiled proudly, amazed that in three and a half short years my son had already developed into a thinking person.

When we met Sonia at the curb, she cried, “Mohan, I missed you so much, my darling. Did you miss me?”

“Guess what?” he said. “A big blue rocket goes up really fast.”

Sonia smiled. “Does he seem bigger to you? I can see he's grown, he's more verbal.”

She'd been away only a few days, but she was probably right. I said, “Mohan, Mama is going back to being a doctor soon. She is going to start working.”

He didn't respond.

“Mohan, do you want to be a doctor?” I asked.

“No, a nurse.”

“Not a doctor?” Sonia said.

“No, I like nurses. They take care of people.”

*   *   *

I had been taking most of Chaudhry's doc-of-the-day calls. Over a twenty-four-hour period, several times a month, I admitted cardiac patients from the ER who did not already have cardiologists. However, insurance companies were denying the necessity of (and therefore payments for) about 30 percent of these admissions, meaning a lot of lost revenue for Chaudhry's practice. Chaudhry had been grousing that I wasn't bringing in enough money to cover the salary he was paying me, so I became more aggressive about appealing the rejections, which until then I had been ignoring.

“Yes, this is the CareAllies medical director.”

“This is Dr. Jauhar. I called a couple of times yesterday. I know you're aware of it; but you didn't call me back, and this is the second time I'm calling today.”

“I apologize for that. What can I do for you, Dr. Jauhar?”

“It is clearly stated in the appeals document that I've read and shown to people in my department that you are supposed to take my phone calls.”

“Dr. Jauhar, I'm … there's nothing I can say. I am sorry we didn't get back to you in a more timely manner.”

“As you probably know from my messages, I want to discuss the denial on James Castle.”

“I am not able to approve this admission, Doctor. As our nurse informed you yesterday, this chest pain workup did not have to be done in the hospital. I understand you may disagree with this judgment, and you do have the option of an appeal. The best thing is to have your hospital send us a copy of the chart.”

“To whom?”

“To CareAllies, along with the denial.”

“I don't understand. This was a fifty-four-year-old smoker who was having palpitations and chest pain. Why do you feel he didn't need to be admitted to the hospital?”

“Doctor, I am not in any way questioning the services that you rendered in an extremely timely manner. But those services could have been done under an observation level of care.”

“But we don't have an observation unit at my hospital!”

“I am sorry, Doctor, but that does not oblige us to pay for a level of care that was not warranted.”

Whatever the case, it meant Chaudhry and I weren't getting paid. I sent in the required paperwork, filled out the appropriate appeal forms, and followed up to make sure they were received. But we never did get reimbursed for that admission.

When I checked with Liam, a billing clerk in my department, he told me that payment denials by managed care companies had become routine. “You have to take out the shovel and dig hard to get paid what's rightfully yours,” he said. “By the time I'm done digging, we probably get paid about eighty percent of the time. But it isn't easy. They have all sorts of excuses: ‘didn't get billed right,' ‘didn't get it on time.' Come on, ‘didn't get it on time'? I have three confirmations, and you're going to tell me you didn't get it on time? Please. Sometimes they won't release the funds; then you ask them and they say, ‘Oh, yeah, now I see. Don't know why that wasn't paid. I'll release the funds.' My boss hears me saying on the phone, ‘How's the baby, Alice?' and there's a reason for that. You have to get the insurance company on your side. I can't say, ‘Hey, I want to get paid.' I have to say, ‘How are you?' That works better than anything else.”

As the months wore on, Chaudhry was beginning to sound irritated whenever we spoke. “I thought I was making money on you,” he said on the phone one morning. “But when Jean, the biller, sent me this report, I had no choice but to talk to you and say, ‘Sandeep, this is ridiculous.'”