Abraham Verghese & Writing

 A doctor by profession working for HIV victims, wrote a scientific paper describing that, but then felt that the language of science didn’t begin to capture the heartache of the families, the tragedy of that whole journey. That was the moment he became a writer. (His first book―My Own Country: A Doctor’s Story―came out in 1994.) And then  just sort of have kept going,  have kept writing ever since then partly because he love to read. He came to medicine because of certain books, certain novels that inspired him. And so once he published that first book, he had this ambition to write the kind of novel that would inspire another generation of readers to go into medicine.

And he did at his own pace. He worry that when your attention span is confined to Instagram and short bursts like that, and when it is all visual and when you don’t have the experience of taking words and making pictures in your head, then a part of your brain just doesn’t get exercised and we lose something.

He had his medical education in two places―in Ethiopia to begin with and then when the civil war broke out there, eventually finished in India [Madras Medical College]. But in both cases, there was a British system of education that put great emphasis on learning to read the body as a text. It is an art that is dying, that is not done very well anymore. But he loved it. And he had the most wonderful teachers, unforgettable people who were incredibly skilled at reading the body. And so he sort of really fell in love with that. And it is ironic that his reputation in America in academic medicine has a lot to do with bedside medicine  yet it is not as though he learned some special skills in his postgraduate years. 

He is an outsider looking in, wherever he had lived his life. This is a great perspective to have as a writer.  Nonfiction, at least in America, outsells fiction five to one, ten to one. For some reason, if something really happened, readers are more interested in it than if you make it up. So in general, even though novels make a lot of splash, nonfiction makes money for publishers. So there was a lot of pressure for  to write another nonfiction story. And he had just lived through another experience with the death of a friend.

But he was really keen to write fiction because he think it is very liberating.  Fiction though it draws on things he know, it draws on  experience, he don’t think it is autobiographical in the sort of broadest sense. But he do write about what he know. So the first novel was set in Ethiopia and the character goes to medical school. But that’s about the only resemblance―he had a twin,  mother was  a nun.

According to him the most important decision is geography―where you locate the book. 

He is a  big believer in the quote “Geography is destiny.”  heard this as a medical school, and it was taught  as something that Freud said, speaking about the proximity of the birth canal to the interesting organs nearby. —he was paraphrasing Napoleon. Napoleon, in saying “Geography is destiny,”.

Every change of geography change destiny.

He has a whiteboard where he doodles, it is the  artefacts of the creative process. They weren’t the causative agents that made me write in a certain way. They were just part of the process.

To keep the readers engaged, You want them to forget all personal problems and enter this world in two or three pages. And then you have to work very, very hard to keep them in this fictional dream with their disbelief suspended. So he think it is much harder to write fiction than nonfiction because when something really happens, we have an inherent interest in it. But when you write fiction, I think you just have to work very hard.

There is a famous saying in writing that you have to kill your darlings. But when they say kill your darlings, it doesn’t mean killing your favourite characters, by the way. What it means is, as you know, if you think a piece of writing is very, very cute, you have written 10 pages, but you love this one paragraph, that’s the paragraph your editor and you, if you have some wisdom, are going to realise that it is just not working.

He think of myself as all-physician. And is looking out at the world through the lens of a physician. A very famous American physician who died in 1919 used to say, ‘It is much more important to know what patient has the disease than what disease the patient has.’ I think that remains true. I think it is much less about specific diagnosis than it is about getting to know this person in front of you and the illness that they have and sometimes the outcome depends much less on the nature of the illness than on the nature of the patient.

We raise our children with stories. We use stories from the very earliest stage. If you think about your own childhood, it is a succession of small stories that impacted you. And it is always puzzling to me why people stop reading fiction, to their great detriment. At least in America, the majority of readers are women. One could argue that they have perhaps more time. That’s not a really good argument, but it’s being made. Fiction, time and time again, has the ability to change societies. You think about Uncle Tom’s Cabin in America. That novel ended slavery in America. One book captured the public’s imagination and made slavery unpalatable. Similarly, in the UK, one book―The Citadel by A.J. Cronin―depicting medicine and health care in a small Welsh mining town created the National Health Service. It caused such a public sentiment.

When fiction sweeps through society, it has a particular role in shaping us. And, a part of the reason that to me medicine feels very unimaginative at times in terms of the way people seem to understand it is because we have become so left-brained in our orientation. And we are not tapping into the right brain and all its wonderful mystical associations. All the stuff that Freud and everyone else would tell us is terribly important in driving us.

One of the common things is that when you have done something, then it is assumed that you are going to keep doing it. You are going to create another one, another one. And with every book, you have always felt that you have nothing more to say, that you have put everything you know into it. When you do something that’s worked well, there is immediately the sense of, ‘Oh, what’s next? You’re gonna do this again. When will you do it again?’ He feel free of that pressure. So that’s probably why it took 14 years between the last book and this book.

It is not easy for him to do that. And he can’t just do it on demand. It has to sort of come organically, because he feel he has something to say, and there is a story that’s compelling. So he is not in any rush to write another one right away. He probably will write. He enjoy writing. But he don’t feel compelled to churn out another bestseller, first of all, because it is impossible to do. It is incredibly lucky to have had one novel do well, and then to have a second one do even better. There is no formula. With every book, you start from zero. And it is long, tortuous. 

Art gives meaning to our lives. If we were mechanical creatures, then we wouldn’t need art. But art is in a way tapping into our subconscious and tapping into our complex motivations. I mentioned Proust talking about novels being an optical instrument that allows you to look into yourself. Similarly, I like a lot of modern art, but it is very subjective. The artist presents you something and you bring your life history and your biography and your eyes and you look at this thing and you tell yourself a certain story. My belief is that we need art to make meaning of our lives. We need technology to boil our coffee and to allow us to talk on Zoom, but it doesn’t necessarily give us meaning.

AI is going to do a lot of things (laughs). But there is a big misconception about AI; it is neither artificial, nor is it intelligent. It is actually parasitising material already existing in the world by writers like me. In fact, there is a movement afoot to try and make sure that AI pays us for poring through our novels and coming up with ways to imitate us. So I think it is an interesting phenomenon, it will generate a lot of interesting quasi art. But ultimately, we respond to human beings, individuals making art. I am not sure whether we are moved by, except in the abstracts, technology creating art even if it has some similitude where it feels real. Even so, I don’t think it is quite the same thing.

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It was during her time as a nurse that she met Abraham Verghese, a young medical student whose passion for medicine matched her own dedication to patient care. Their shared values and love for their work brought them closer, and they soon realized that they were meant to be together. After a whirlwind romance, Sylvia and Abraham tied the knot and began their journey as a couple. Sylvia's unwavering support for Abraham throughout his career has been pivotal in his success. They had two children. 

Abraham Verghese and Cari Costanzo Kapur, Ph.D Anthropology work together now.