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girlfriend’s disease the kind of can-do optimism that is typical of graduate students, a belief that if I looked hard enough, I would find a solution. The concept of chronic illness was completely foreign to me. Disease came and went; it killed you or you got better. Perhaps there were better doctors somewhere—with better knowledge, better command of the medical literature—that could help her. I called top researchers. I read medical textbooks. I pored over Lupus Foundation of America newsletters cover to cover. I asked my brother, then a new intern, to inquire about emerging therapies. I spent lonely evenings staring into drugstore windows, wondering if the answer could be found inside the panoply of vitamin bottles. I went to support group meetings, often without Lisa. One night in San Francisco, a scientist from UCSF delivered a lecture on the frontiers of research into lupus. He was a short man with an imperious air, and I found him pompous and a bit pedantic, but when I looked around the dimly lit auditorium, all eyes were fixed unwaveringly on him. The woman with large discolorations on her face sitting next to me was in an almost meditative trance. Clearly everybody there was awaiting a cure, hoping for deliverance.
    When I drove back across the Bay Bridge to Berkeley that night, I gave the idea of going to medical school serious thought for the first time. My physics research had slowed to a crawl. I was spending most of my time in the lab tweaking a malfunctioning laser or trying to fix a broken vacuum pump, not collecting publishable data. Quantum dots,I feared, were never going to make much of an impact on people’s lives. Practical considerations of this kind had never been important, but now, in the shadow of physical illness, only the usefulness of medicine seemed to matter. Physics had been a way to set myself apart. Now, its exclusivity had become its main liability.
    My thoughts remained unformed while I tried to muster the courage to discuss them with my family. What would my parents say? Would my father think I was being farsighted or irresolute? Would he think of me as a quitter?
    I first talked to my parents about my intentions a few weeks later on a family trip to San Diego, where Rajiv was in his second year of residency at UCSD Medical Center. Rajiv was two and a half years older than I, and as with most brothers of roughly equal age, ours was a complicated relationship. Growing up, he was my playmate, rival, and exemplar. There are faded pictures of us as children, dressed in school uniforms, hugging each other in the smoky air of Old Delhi. In America, we were latchkey kids. When we got home from school, Rajiv would fix me a snack—usually a bowl of cornflakes with a heap of sugar—and we’d sit in front of the TV and watch cartoons. As we got older, we got more competitive, especially in sports. We’d go to public tennis courts in the summer or on weekends and play from morning till night, often evenly splitting our matches. In high school, I edged him out for the final spot on the local team going to the California Interscholastic Federation tennis tournament, but my father forced me to give up my spot because Rajiv was a senior and it was his last opportunity to play CIF. When Rajiv went to college at UC Riverside, only a few blocks from our high school, our relationship changed once again, and he became more of a guardian over me, always inquiring about the minutest details of my life at his old school, closely monitoring and supporting my attempts to break into “the Hill” and other popular social groups. Though I had always done better in school than he, Rajiv possessed an easygoing charm that made people instantly comfortable and won him friends and popularity. If he was a politician, I was a political consultant.
    Now I was a graduate student with misgivings and he was a doctor with a degree from the University of Chicago. My parents and I were