Chapters
Shownotes Transcript
This Is Actually Happening features real experiences that often include traumatic events. Please consult the show notes for specific content warnings on each episode and for more information about support services.
For the past month, we've been diving deep into the stories of four survivors of the tragedies of September 11th, 2001, whose jobs brought them face-to-face with the unthinkable, in a series we've been calling The Long Shadow. Today we present the fourth and final story in The Long Shadow series, featuring Sandeep Jahar, a cardiologist who volunteered at a temporary morgue to help process the remains.
As added bonus content for the series, we're releasing an interview between me and Dan Taberski. Dan is the host of the podcasts Missing Richard Simmons, Running from Cops, and most recently, The Line. His new show is called 912, and the series is about what happened after 9-11.
how 9/11 the day became 9/11 the idea, and how that idea has shaped the world, our culture, and ourselves for the past 20 years. Dan and I had a great conversation about our two very different but complementary series about 9/11: what that day meant to both of us, what the experience means now 20 years later, and what we've learned from creating our respective series on the subject. If you are a Wondery Plus subscriber, you can check out that bonus interview today, as well as other bonus content for the series.
However, we're also making that interview available on the free public feed for everyone this coming Wednesday. So if you have Wondery+, check it out now. If not, look for that interview coming up in a couple days. After wrapping up the long shadow series today, we will resume with our regular weekly This Is Actually Happening episodes starting next week.
It's been an honor sharing these stories of September 11th with you all, and amazing to see the outpouring of love and support from listeners. Thank you all for sharing your own thoughts and experiences, and for your ongoing and continued support for what we do. The surrealism of the experience, just, it was hard to fathom. Like, I thought I was in a movie. This had to be some sort of setup. And here we were, you know, in a clothing store, being asked to do these sort of impossible things.
From Wondery, I'm Witt Misseldein. You're listening to This Is Actually Happening, with our special series honoring the 20th anniversary of 9-11, The Long Shadow. Episode 205, The Long Shadow, Part 4, What If You Processed the Remains?
Today's episode is brought to you by Audible. Listening on Audible helps your imagination soar. Whether you listen to stories, motivation, or expert advice, you can be inspired to new ways of thinking. And there's more to imagine when you listen. As an Audible member, you can choose one title a month to keep from their entire catalog. Currently, I'm listening to Daring Greatly by Brene Brown, a wonderful audio title that challenges us to imagine a new way to lead our lives.
love, work, parent, and educate through the power of vulnerability. New members can try Audible free for 30 days. Visit audible.com slash happening or text happening to 500-500. That's audible.com slash happening or text happening to 500-500. This Is Actually Happening is brought to you by Progressive Insurance. What if comparing car insurance rates was as easy as putting on your favorite podcast? With Progressive...
It is. Just visit the Progressive website to quote with all the coverages you want. You'll see Progressive's direct rate. Then their tool will provide options from other companies so you can compare. All you need to do is choose the rate and coverage you like. Quote today at Progressive.com to join the over 28 million drivers who trust Progressive.
Progressive Casualty Insurance Company and Affiliates. Comparison rates not available in all states or situations. Prices vary based on how you buy. Hello Prime members. Have you heard you can listen to your favorite podcasts like this is actually happening ad-free? It's good news. With Amazon Music, you have access to the largest catalog of ad-free top podcasts included with your Prime membership.
To start listening, download the Amazon Music app for free or go to amazon.com slash ad-free podcasts. That's amazon.com slash ad-free podcasts to catch up on the latest episodes without the ads. Check out our recently completed six-part series, The 82% Modern Stories of Love and Family, ad-free with your Prime membership. I was born in India in 1968.
My father was a research geneticist in India. He was very ambitious. And when I was three years old, we moved to Wales. My brother and I and my mother and my father
He was a plant geneticist and did really some seminal work in wheat genetics as well as in the genetics of certain grasses. And that got him quite a bit of scientific fame. Because of what my father perceived to be sort of racial prejudice against him, and he didn't get a sort of permanent position in Wales, and despite having done really good work
His tenure ended, and we moved back to India in 1975, which happened to be a very turbulent time in Indian politics. Indira Gandhi was prime minister and...
And because of what she and her governing party perceived to be kind of rogue elements in the government and in Indian society that were undermining the government and the country. And so politicians and academics
were rounded up and put in jail, and there was curbs put on freedom of press. And in that kind of environment, my father decided that we needed to leave India permanently and emigrate to the United States.
My father was one of the first scientists to work on what was called the Green Revolution in India and South Asia. I mean, it was a program of scientific research to essentially produce high-yield crops to help feed the poor.
And he really wanted to continue his work in the Green Revolution, but the resources just weren't there for him to do what he felt he needed to do. So he applied for immigration papers. And, you know, back then it was relatively easier and actually got it in six weeks, which is, you know, today almost unbelievable. He immigrated under the status of scientists of exceptional ability.
We emigrated and we moved to Kentucky in a snowstorm, January 7th, 1977. And we lived in Kentucky for two years until my father decided to move us to California.
And this was kind of a theme of my early childhood. It's kind of a peripatetic existence because my father and other academics, especially from foreign countries, had a very hard time getting permanent academic positions in the US. So my father's experience of scientific research and the difficulties led him to push his two sons into medicine. He wanted us to avoid the struggles that he had experienced doing science.
My brother took that up and embraced it with gusto. He sort of always knew he wanted to become a doctor. I, on the other hand, had many other interests, you know, politics and philosophy and writing. I was very interested in writing. My mother and my father were very different. My mother was essentially a homemaker. She had grown up in affluence. He had grown up in relative poverty. But they both agreed that medicine was the way for their children in this new country.
They encountered a lot of racial prejudice and a lot of instability, and that was all even more difficult to handle in financial struggle. And so the way my mother perceived it, going into medicine was a chance to do well by doing good. That was the way to break out of the limitations that they had encountered.
It was complicated for me because my family history was one that had a lot of heart disease. My father's father died of a heart attack when he was in his early 50s. He died actually suddenly in the presence of my father. They were having lunch together and he collapsed and died. And that experience really traumatized my father and by extension me.
I sort of grew up with this fear of the heart as the executioner of men in their prime. And so I would always worry, you know, what was going to happen to my father? I had this sort of malignant family history. And my other grandfather eventually also died of a heart attack. And I was drawn to medicine because of that family history. But then I was also drawn to what I considered more creative pursuits.
So I told my father I was not going to become a doctor. So I ended up going to Berkeley and I decided to study physics. I became fascinated with it when I went to Berkeley. You know, how things worked, how the universe worked. And that gives you a little bit of an idea of the kind of warped culture in which I grew up where rebellion is saying no to a career in medicine and then going into experimental physics.
But I do remember my father kind of pressing and saying, you're making a mistake. And there was truth to that worry because when I eventually graduated from my physics training, there just were no jobs. It was very hard. I decided to stay at Berkeley and pursue a PhD. It was while I was pursuing my physics research that I started to have second thoughts about
Someone who was very close to me, my girlfriend, was diagnosed with a disease called lupus. I had never heard of lupus. She told me that there was no cure and really no effective treatment. That just totally floored me. That kind of launched me on this journey to learn more about this condition.
And in the course of it, I went to medical libraries. I went to support groups. I spoke to decorated researchers. And I came to appreciate that what was lacking in my own academic pursuits was people. I was working on a very esoteric semiconductor structure called a quantum dot. And it was very interesting, but I knew that quantum dots weren't going to help people necessarily.
So I really wanted to join up with what I perceived as the real world, the world outside of the university. Part of it was going to support group meetings and seeing how patients and their family members were transfixed by what the doctors were saying. The doctors had knowledge that was so highly relevant to the lives of these people.
I started to question, you know, what am I doing? You know, what am I going to do to really make a difference? At the same time, my brother, who I told you had always embraced the idea of becoming a doctor, he was already a doctor by then. Residency is a very difficult time, but he loved it. They just had a sense of purpose. In comparison, what I was doing just seemed selfish, right?
It was right around then that I decided that I was going to start taking pre-med classes. I was in my mid-20s and I started taking freshman biology. I ended up finishing up my PhD, so I do have a PhD in physics, got into Washington University in St. Louis. And so I started there after my PhD in the fall of 1995.
I made it through the first two years and then got to the hospital my third year. And that's where I really was happiest when I was actually dealing with patients. And when I was in the hospital, I just felt like I had made the right choice. So I graduated from WashU in 1998 and went to New York and started my internship at New York Hospital. Spent three years there.
The mid-portion of my second year, I decided that I was going to specialize in cardiology. I grew up with this fear of the heart as an executioner. You know, when I was growing up, I used to think about my heartbeat. I used to feel it. I would lie in bed and time my heartbeat with the revolutions of the ceiling fan. You know, I was just interested in this thing in my body that is always beating.
that beats so many millions of times in the course of a human lifetime. That's so powerful that it can push blood through literally miles and miles of blood vessels in the body. So for a lot of different reasons, I decided that I wanted to apply for a cardiology fellowship. And fortunately, I got the fellowship at NYU during the first year, which was 2001.
That first summer, from July to September, we got basic training. So I was still kind of relatively green by the time 9-11 rolled around.
Today's episode is brought to you by Quince. It's been a busy season of events and travel, and my wardrobe has taken a beating. A total overhaul isn't in my budget, but I'm replacing some of those worn-out pieces with affordable, high-quality essentials from Quince. By partnering with Top Factories, Quince cuts out the cost to the middleman and passes the savings on to us.
I love the Italian board shorts. They're made from quick-drying material and offer UPF 50 protection for all-day wear, so I can go from hiking to lounging on the beach without a wardrobe change. And compared to other luxury brands, the prices are well within my reach.
Upgrade your wardrobe with pieces made to last with Quince. Go to quince.com slash happening for free shipping on your order and 365 day returns. That's q-u-i-n-c-e dot com slash happening to get free shipping and 365 day returns. quince.com slash happening
This Is Actually Happening is sponsored by ADT. ADT knows a lot can happen in a second. One second you're happily single, and the next second you catch a glimpse of someone and you don't want to be. Maybe one second you have a business idea that seems like a pipe dream, and the next you have an LLC and a dream come true. And when it comes to your home, one second you feel safe,
And the next, something goes wrong. But with ADT's 24-7 professional monitoring, you still feel safe. Because when every second counts, count on ADT. Visit ADT.com today. The morning of September 11th, my wife and I actually had gone to her obstetrician.
That morning, I actually went into work late because I had to go with her to her obstetrician because we were trying to get pregnant. I was in the waiting room filling out some forms and on the television screen was an image of the Twin Towers and there was a fire.
And someone said that a plane had hit one of the towers. And most people assumed that it was like a small plane. And so I was looking at it and I didn't really make that much of it. We did our appointment and then I got into a taxi cab to go down to Bellevue where I was working for the week.
And in the taxi on the way down, we were on the FDR drive. It came on the radio that a second plane had hit the other tower. And I remember thinking, like, what are the chances of that happening? Like, how bizarre.
But honestly, even at that point, I didn't think it was a deliberate act because it was something just out of my and I think most people's conception that people could actually do this and do a suicide crash into a building. So I got to the hospital and then it very quickly became clear that this had been a deliberate act and that we should expect casualties at Bellevue.
because Bellevue is one of the level one trauma centers in New York and did serve that part of the city. We were told to empty the medical intensive care units, the cardiac care units. When we were clearing out the cardiac care unit, someone said, oh my God, the tower just came down.
And I remember thinking, wow, this person must be really stressed because they're hallucinating. And I remember going over to the window and looking out and seeing only one building and just a massive amount of smoke coming
That's kind of lent urgency to what we were doing. And then at that point, we were told to discharge any patients who didn't need to be in the hospital and that we should report for duty down in the emergency room. So I remember when I went down to the emergency room, there were all these surgeons just waiting in the emergency room for casualties to come in.
And I do remember two episodes in that time I was down there. One was that a cop was brought in and it appeared he was having chest pain. It appeared he had suffered a heart attack. He wasn't injured physically by the falling debris or whatever, but he had been down there when the tower collapsed. And I remember asking him, you know, something like, you know, how are you doing? And he said, doctor, the things I've seen today are,
And then he just couldn't continue. He just like just just started sobbing. The other thing I remember, apparently a firefighter had died and a social worker took the wife of the deceased firefighter into a separate room to break the bad news. And I just remember the wife just screaming, just screaming in disbelief.
But I do remember all these surgeons standing around waiting for all this sort of onslaught of casualties and very few patients were being brought in. And so around mid-afternoon, I went out to the parking lot and there was an ambulance that was getting ready to go down to Ground Zero. And they were looking for volunteers to go down and so I volunteered.
Drove down, they let us off a few hundred yards from where the buildings had collapsed. We were supposed to be working at a makeshift triage type center and when I got there the elevators were stopped and inside the elevators were medical supplies.
The place had been turned into several different departments, you know, trauma and injuries, wounds and fractures, and I went to asthma and chest pain. There weren't that many patients who were in really any department. There were a few firefighters wheezing from, you know, all the smoke, but otherwise there were just very few patients.
And I remember at one point just blurting out, "Where are all the patients?" And someone said, "They're all dead." You know, at that point, it just really hit me, the magnitude of the disaster.
We were there for probably about an hour and a half. And then at some point we had to leave the building because another building, and I believe this was the World Trade Center 7 building, was on fire and they couldn't put out the fire and there was a fear that it was going to collapse also.
We got like these stretchers and we put all these supplies on stretchers and we kind of lifted them, taking these supplies down to Pace University. And we were going to set up shop there. You know, we went outside and started basically running to Pace University. And I mean, it was a disaster zone. It's hard to fathom what had happened. You know, I remember thinking, this isn't New York City, this is Beirut.
Bombed out cars, you know, windshields covered in thick ash. Water mains were broken and there was like water running and mixing with all the ash and turning into mud. You know, up at Bellevue, it was still sunny. You know, it was a sunny day. Down at Ground Zero, where we were, it was like nighttime, like a heavy dusk.
So we ended up going to Pace University and setting up shop there. I stayed for a little while, and then the building that had been burning came down. I just remember getting blanketed by smoke. We were probably, I don't know, maybe two blocks away, but the smoke just hit. At that point, I had been in touch with my wife by cell phone. She was like, I don't feel comfortable with you being down there. You need to come home.
So I hitched a ride with a police officer covered in soot and ash. So I got home probably around 9 o'clock, saw my wife, and we just kind of spent the evening together watching the news, seeing what had happened, and trying to process it all. The morning of September 12th, I was planning on going to work.
I called one of my co-fellows and he said that no one was in the department and that some of the doctors had gone down to the World Trade Center site to work in a unit there. And so he was in my neighborhood and I saw a cop car and I said, you know, I work at Bellevue and a lot of my colleagues are down at Ground Zero. And he said he would take me.
I eventually made my way to this mash unit that had been set up in a firehouse. You know, I could see the twin towers. I could see the base. Sort of the bowels of the buildings were unleashed from the buildings. I mean, there was like all these broken wires and pipes. The street was muddy.
There were police dogs sniffing around the rubble. There was like a line of people sort of removing pieces of rock. At some point, someone yelled that they needed doctors in the Brooks Brothers building. I wasn't sure why they were asking, but I volunteered to go with this policeman.
We went into the lobby and there were German shepherds. There was a lot of broken glass and there were cops and there was a dark curtain. The cops who had brought me started to take me in behind the curtain and someone said, "Only doctors are allowed back there." And he explained that I was a doctor. And so I went in. I remember there were maybe three doctors
a couple of medical students and a nurse. The medical students and the nurse were sitting behind a table. They had tags with them. They were sort of filling out paperwork or getting directions from these doctors. And then I joined that group. They were talking about processing body parts. Turned out this was like a morgue that had been set up. And they were talking about the protocol for what to do when body parts came in.
None of them really knew what they were doing. None of us knew what we were doing. People were just sort of asking questions like, "Are you supposed to put body parts into one bag or put them into separate bags because they could be body parts from different people?" And no one really knew. The nurse and the two medical students were sitting behind this table and they're just sort of waiting for instructions. At some point, maybe a few minutes after I arrived, they brought in part of a human being.
It was the lower part of someone's body. The whole torso had been severed from the rest of their body. And all they had was like a pelvis and one leg just attached. And out of this pelvis were like intestines that had broken, that had been severed. When that portion of torso was brought in, the female doctor who was there said, "Oh, Mother of God,
And we looked and it was so gruesome, so horrific. The person had been wearing jeans and the piece of the body that had been brought in, the leg was covered by like a torn portion of jean, of blue jean. And so they emptied the pocket and there was change in it. And they put that in a separate kind of plastic bag. And then someone said that this was...
The other portion of the body that had been brought in a little bit earlier, I guess before I had arrived, and that portion of the body had a cell phone. So they had the cell phone. So they put this portion of torso and leg into a body bag. And at that point, the older doctor said that he had to take a break. His badge said PGY3, which meant he was a third-year resident.
I was a PGY-4 at the time because I had finished my residency and now I was a cardiology fellow. So it just hit me that of all the doctors in the room, I had the most experience. I was actually the most senior doctor. And that just made me feel incredibly uncomfortable because I had absolutely no clue what to do in that situation.
I had always felt very queasy in medical school, in the anatomy lab, dissecting cadavers. I had never been really interested in pathology and it wasn't what I went into medicine for. And suddenly I developed this almost panic that they were going to ask me to run the show, which is basically what they did.
This doctor said, "I have to leave." Apparently he'd been there for a few hours. And the female doctor also said that she had to get away. And she looked at me and she said, "Are you a doctor?" And I said, "Yes." And she said, "Great, you can take over."
That was it. And they both left. I think there was just me and one other. It's all very vague. I don't quite remember if there was another physician with me. I think there was. And then there were the two medical students and the nurse. We were just, you know, just there. A few minutes later, they brought in more body parts. And it was hard to tell what it was, what the parts were. It looked like it was maybe a liver, part of a spleen.
So I was like, I think this is a spleen. I think this is a liver. These med students and this nurse were just writing that down. And then they were putting those parts into a body bag. They were bringing in portions of bodies. And it wasn't clear whether these basically disembodied organs, whether they were from one person, from several people. And it wasn't clear whether we should put them all together or we should put them separately.
There were piles and piles of unused body bags in the dressing room. And, you know, looking around the store as we're doing this work, there were all these like headless mannequins that they had used to, you know, model their clothing.
And there were piles and piles of neatly folded Brooks Brothers shirts in different colors. I just remember the colors so well. They were muted because there was a lot of ash and dust, but you could still make out that there were blue shirts and pink shirts and yellow shirts and white shirts. And then there were all these unused yellow body bags. The surrealism of the experience just...
It was hard to fathom. Like, I thought I was in a movie. This had to be some sort of setup. We were in a men's clothing emporium. I mean, I'd worn Brooks Brothers clothes in residency, you know, when I wanted to dress up. And here we were, you know, in a clothing store being asked to do these sort of impossible things.
I remember thinking that, you know, I had just finished my residency. In my third year of residency, a lot of my friends had done international electives. They had gone to impoverished areas of Asia to work in public health and infectious disease. And they would talk about how difficult it was to work in areas with so few resources. But we had plenty of resources. It was just, it was netherworld medicine.
We were in some sort of like conception of Dante's Inferno. It was just unbelievable. In that situation, as you can imagine, book knowledge is totally useless. You could never simulate in a medical school or residency training exercise what we were faced with. So it was all about improvising.
But you're improvising with the background of such monumental tragedy that it makes you feel really uncomfortable. Just even a simple thing like, do we put all the body parts into one bag or separate bags? I remember thinking, you know, if you put them in separate bags, what if they end up getting separated? That didn't seem right. But putting the remains of several victims together in a bag just seemed wrong.
And it's like, how do you identify? How do you figure this out? It seemed at the moment incredibly important that we like do the right thing, figure this out.
And then to still have to do it and have to do it rather quickly with people watching, it was so hard. And I'm not surprised that the other two doctors just, they left. They had to leave. They couldn't do it. And after a while, I don't remember how long, I just started to feel physically ill. I just couldn't be there anymore. And I said that I was going to have to leave, which I did.
I left and went out the sort of back entrance and went back to the MASH unit where I had initially been at that firehouse. The whole experience, that kind of wilted me.
And I wasn't a stranger to emergencies, right? I mean, in cardiology, we dealt with emergencies all the time. Patients go into cardiogenic shock, go into acute heart failure, go into life-threatening arrhythmia, having a heart attack. So I was used to dealing with emergencies, but this seemed of a different scale.
You know, it seems kind of trivial, but my wife was very upset that I was down there. She kept saying that she really wanted me to get out of there, that if I wasn't going to be in the hospital, then I needed to be at home with her.
And all along, we'd been trying to get pregnant, and we were actually pursuing in vitro fertilization. And so at the end of the day, when I was getting ready to leave, I said, I'm coming home now. And she said, fine, can you just stop by the Apthorp pharmacy and pick up our IVF materials? And I remember thinking like, oh my God, like, no, I can't do that.
Life was still going on. We still had our plans to have a baby. That didn't stop. She had no idea of what I had gone through that day.
Eventually, it's probably like the next day, if I remember correctly, we went back to the hospital and we just went back to our training routine. You know, I believe I was in the echocardiography lab and was learning how to read echocardiograms and how to scan patients and went back to taking call therapy.
In the midst of all that, bodies were removed from the rubble and they were processed in these sort of mobile morgues that were parked just off First Avenue between Bellevue and Tisch Hospital. And so you could kind of smell that work.
In between my work at Bellevue and then we'd have lunch conference at Tisch, I'd have to run in between the two hospitals and pass these trucks and smell the decaying body. It was very stark.
This season, Instacart has your back-to-school. As in, they've got your back-to-school lunch favorites, like snack packs and fresh fruit. And they've got your back-to-school supplies, like backpacks, binders, and pencils. And they've got your back when your kid casually tells you they have a huge school project due tomorrow.
Let's face it, we were all that kid. So first call your parents to say I'm sorry, and then download the Instacart app to get delivery in as fast as 30 minutes all school year long. Get a $0 delivery fee for your first three orders while supplies last. Minimum $10 per order. Additional terms apply. So much of my life in my first couple of years after 9-11 was spent in the hospital, taking care of patients, you know, in a very busy training program.
Like I said earlier, life goes on. Your married life goes on. The kinds of things that you're planning to do goes on. Your professional development, specifically, like, we still had to make a baby. You know, I still had to do my training. And then longer term, worries came up about my exposure to, you know, all the dust and all the dangerous chemicals that I had been exposed to.
I think for a portion of the time I was down there, I don't even remember having a mask. For a while, I developed what I thought were pulmonary problems I'd never had in my whole life, like asthma. And so all these things are going on, right? But no one can really see what you've suffered in your heart. No one can erase those images forever.
And so you have to continue to function with this almost terrible secret. Like you can talk about it, but no one can really appreciate it. So I remember those months afterwards just resenting these things I had to do. Like there was no time to like recoup, you know, recover, rehabilitate.
And I was relatively newly married too, so there was that whole thing to negotiate. I mean, it was a wonderful time, don't get me wrong, but at the same time, it was a stressful time. There's kind of like your feet are in these concrete boots, like you don't want to get up sometimes in the morning to do what you have to do. You have nightmares, like...
I had this recurring nightmare that I was actually in the building and I was plummeting down the various floors that were collapsing and I was collapsing, I was going down. I couldn't stop having that. I mean, that eventually, fortunately stopped, but I had it for quite some time. And so the hardest part was continuing to live your life and kind of continue to follow the script that had been laid out for yourself by yourself and then feeling like everything had changed.
But not everyone could really understand why it had changed or how it had changed. Yes, they knew you were down there. They knew you had seen some very terrible things, but they'd never really understand it because they weren't there. I successfully finished my training, became a cardiologist, wrote the books I wanted to write. I did those things. Maybe I had a little guilt afterwards. I was still able to do those things and so many people had perished.
But I still never really talked about 9-11. I didn't want to talk about it. When 9-11 came around, I never posted anything on social media. I kind of ignored it for years, years and years and years. After the 9-11 memorial, I never went. Eventually I went. I took my kids. It sent shivers up my spine. The way they did it was, I think, really incredible.
Incredible how the water flows into that sort of like bottomless pit. It really, really just floored me. I think it really encapsulated how I felt. The water was flowing down into this cavern that seems bottomless, like it's actually leading into hell. That was the experience for me at that Brooks Brothers morgue, that I had kind of entered a sort of hell. That was very powerful to me.
There was a young woman who survived, who was removed from the rubble with a crushed leg but nothing else. She was admitted to Bellevue and she was being seen by the arrhythmia service. And I remember hearing about her at conferences that she had developed these arrhythmias that were very difficult to manage.
It was very clear to me even then, and even more so now as a cardiologist, that the stress and the trauma of what she had gone through was almost certainly precipitating these incessant and essentially life-threatening arrhythmias.
So this is something that caused me to revisit that experience down at Ground Zero those two days, really for weeks afterward, because we'd talk about this patient or we'd talk about other people who had been retrieved and survived.
So, you know, I've always been fascinated by the heart both as a biomechanical pump, which is how modern medicine conceives of the heart, but also by the cultural and metaphorical meanings of the heart, especially the emotional meanings. Something that has engaged the cultural imagination for millennia, really.
The heart is like the only organ in the body that sort of palpably moves. You can feel moving. The heart has been thought throughout history as the container, the vessel of human emotions. Bravery, fear, love are all thought to be contained within the heart.
And when I heard about this patient who had survived and had developed these incestuous arrhythmias, it just drove home to me the point that the emotions have a profound effect on the heart and on heart rhythms and so on. And that led me to think more deeply about the heart as not just a mechanical pump, but as an emotional canvas.
how important the emotions are in leading to cardiac pathology, both in an acute sense, like in this young woman who developed these life-threatening arrhythmias, but also in a chronic sense, how emotional stress over long periods of time can lead to worsening heart disease.
Through the course of my training, I came across the paradigm of this emotional heart intersecting with the biological heart.
The sort of archetype of this paradigm is the broken heart syndrome, where patients who suffer severe emotional upset, like from a breakup of a relationship or the death of a loved one, can actually have physical effects, can suffer physical effects on the heart. The heart can actually acutely change shape. I mean, just to give you one small example, I mean, the patients we had who had defibrillators, they were getting shocked more and more after 9/11, probably because of post-traumatic stress.
That was just striking to me. The Greeks were onto something. The ancient philosophers were onto something. It was clear that there was an overlap between this emotional object that the Greeks thought was sort of this purely metaphorical object, or the way we conceive it today as a purely metaphorical object, the heart as the container, the vessel of human emotions, and this biomechanical pump that
The concept of which evolved from 18th, 19th, 20th centuries to the point where we started to think of the heart as being just a entity that had pipes that got clogged and had wires that sometimes crossed and caused arrhythmias. And we sort of conceptualized the heart as this purely mechanical object. But it was so clear to me that it's both. And these two types of hearts overlap.
And so I would say that this experience led me as a cardiologist to think more deeply about the effects of the emotions on the heart. And it was an uphill struggle because, you know, throughout my entire fellowship, no one really talked about the emotions. You know, that just seemed like a fuzzy concept.
We talked about the resistance of coronary arteries. We talked about the capacitance of cardiac chambers. We talked about all these sort of physics concepts that I was very familiar with and comfortable with, but no one really talked about how emotional stress can affect heart health.
Even today, the American Heart Association doesn't recognize emotional stress as a key modifiable risk factor for heart disease. They're coming around to it, but they still don't officially recognize it like they do cholesterol or high blood pressure or so on. Part of that is because we can lower cholesterol and we can lower blood pressure with medications.
it's much harder to treat emotional disruption, emotional stress like what happened on the scale of, or what happened on 9/11. So I think that experience really had lingering effects on my career. It eventually motivated me to write my last book, which is Heart of History, which really explored this theme much more deeply.
Anyone who lived in New York City during those weeks and months after 9-11 remembers how the city came together. I remember outside Bellevue, there were all these posters of people who were missing, and it was just heart-wrenching.
People lent a helping hand. Even in the hospital, I feel like things changed for some time. People were just a little gentler, a little nicer, a sense of we're all in this together.
And for me, the long-term change was that I pivoted from wanting to do kind of hardcore cardiology, the way that my professors had done it, the way that some of my co-fellows were doing it, into a sort of a more human-based cardiology, which is sort of in keeping with why I went into medicine in the first place, because I really wanted to make a difference in people's lives.
And so pretty soon after 9/11, I decided to specialize in congestive heart failure, which I believe is the most humanistic of all the cardiology disciplines. You know, it's not purely imaging like cardiac ultrasound. It's not just doing procedures like putting in stents. It's looking at the whole person, the person who has a rhythm, who might need a stent, who needs imaging, but is also a real person who's suffering with an incurable disease.
And I just realized that that's the kind of cardiologist I wanted to be. The average amount of time that a doctor gives to a patient to speak freely, uninterrupted, is about 16 seconds. That's not enough time because so much of what's ailing the patient isn't necessarily the chest pain, but it's like what's going on in their lives.
I don't know if I would have been a different doctor if I hadn't gone through this, but I do believe that the experience and the paths that have led me down, those paths made me a better doctor. The experience of 9-11 and all the sort of emotional overtones, all the sort of emotional repercussions in the months afterwards...
It's hard not to think about the finiteness of life when you're as young as I was when, or at least how I remember how young I was, and you're in a morgue, in a clothing store, processing body parts on a day that you thought you'd be doing something completely different. It's hard for that not to have a profound effect.
Today's episode featured Sandeep Johar. Sandeep has written three books, including his latest book, A History, which tells the colorful and little-known history of the doctors who risked their careers and the patients who risked their lives to know and heal our most vital organ.
A practicing cardiologist, Jahar is currently a contributing opinion writer for the New York Times, has been published in the Wall Street Journal, Time, and Slate, and has appeared on NPR, CNN, and MSNBC to discuss issues related to medicine. To learn more about him and his work, visit the website sandeepjahar.com or follow him on Twitter at sjahar. That's S-J-A-U-H-A-R. ♪
From Wondery, you're listening to This Is Actually Happening. With our special series honoring the 20th anniversary of 9/11, The Long Shadow. If you love what we do, please rate and review the show. You can subscribe on Apple Podcasts, Spotify, the Wondery app, or wherever you're listening right now. You can also join Wondery Plus in the Wondery app to listen ad-free. In the episode notes, you'll find some links and offers from our sponsors. By supporting them, you help us bring you our shows for free.
I'm your host, Witt Misseldein. Today's episode was co-produced by me. A special thanks to all who helped out with this series to make it happen. Ellen Westberg, Andrew Waits, Marcelino Villalpando, Gabriela Quintana, Emily Caldwell, and Jason Blaylock. The intro music features the song Illabi by Tipper. You can join the This Is Actually Happening community on the discussion group on Facebook or at Actually Happening on Instagram.
On the show's website, thisisactuallyhappening.com, you can find out more about the podcast, contact us with any questions, submit your own story, or visit the store, where you can find This Is Actually Happening designs on stickers, t-shirts, wall art, hoodies, and more. That's thisisactuallyhappening.com.
And finally, if you'd like to become an ongoing supporter of what we do, go to patreon.com slash happening. Even two to five dollars a month goes a long way to support our vision. Thank you for listening. Wondering.
If you like This Is Actually Happening, you can listen to every episode ad-free right now by joining Wondery Plus in the Wondery app or on Apple Podcasts. Prime members can listen ad-free on Amazon Music. Before you go, tell us about yourself by filling out a short survey at wondery.com slash survey.
Hey, it's Guy Raz here, host of How I Built This, a podcast that gives you a front row seat to how some of the best known companies in the world were built.
In a new weekly series we've launched called Advice Line, I'm joined by some legendary founders and together we talk to entrepreneurs in every industry to help tackle their roadblocks in real time. Everybody buys on feeling, Guy, like everybody. So if you don't give them the feeling that they're looking for, they're not going to buy. A lot of times founders will go outside of themselves to build a story. And
And you can't replicate heart. You know, I think we all have a little bit of imposter syndrome, which isn't the worst thing in the world because it doesn't allow you to get overconfident and think that you're invincible. Check out the advice line by following How I Built This on the Wondery app or wherever you get your podcasts. You can listen to How I Built This early and ad-free right now on Wondery Plus.