Abraham Verghese on ‘The Covenant of Water’, which is set in Kerala, the instructive nature of fiction, the influence of Somerset Maugham, and teasing out novels from medicine
It is a story he often narrates in his easy, chatty style. How his passion for literature stemmed from his habit of reading at a young age. How he loved the way it often transported him inside a British frigate or landed him in the midst of a Napoleonic war. But, besides journeying into other universes, celebrated author Abraham Verghese — whose latest novel, The Covenant of Water (Atlantic Books) set around a family in Kerala has resonated with many readers around the world — is quick to reel off examples of how fiction can often be “very instructive” as well.
The professor of medicine in Stanford University School of Medicine in the US often urges his medical students to read Leo Tolstoy’s Death of Ivan Ilyich (1886) to come close to being in the shoes of a patient with a terminal condition. AJ Cronin’s The Citadel (1937), in his view, set off Britain’s National Health Service while John Irving’s delightful The World According To Garp (1978) grapples with man’s quest for meaning and purpose in life.
In an interview to The Federal during his visit to Bengaluru, Verghese shares his love for literature, what books teach, how people are intrinsically good, and about end-of-life care, and how medicine led him to stories and storytelling, in the most engaging and good-natured way. (Good-natured, because he seems terribly tired after signing endless copies of The Covenant of Water at Bangalore Litfest for his fans, which include a stream of CMC Vellore doctors and students).
What it means to be alive: On Maugham
Talking about how one stumbles across mind-altering matters while reading fiction, Verghese first shares that he is writing a foreword for a new Vintage Classics edition of Somerset Maugham’s Of Human Bondage (1915), a book that deeply influenced him. “They asked me to write the foreword since I’ve listed it as an extremely influential book. It is truly one of Maugham’s best books — a coming-of-age tale,” he says.
“What it tells you is that sometimes you can completely lose control of your life. Philip, the young protagonist, is in love with this unworthy woman, which causes him a lot of heartache and hardship. He has the insight but he cannot stop being in love,” says Verghese. He adds, “But that’s how the book teaches you the nature of what it is to be alive. For a young person wanting to know what the world has in store for them, the different kinds of people in this world — this is the book. It is a great book, very autobiographical. For Maugham himself was working out certain things in his own chequered life,” he underlines, warning that this book is not for everybody as it is certainly not “entertainment”.
Strong heroic women
The physician-author who stormed the literary world with his epic 2009 novel Cutting for Stone, after having made a mark with a memoir, My Own Country: A Doctor’s Story (1994), is reluctant to unravel the learnings The Covenant of Water may hold in its 715 pages. “It’s for the reader to say,” he says, evasively.
In his interviews online, too, he shies away from deconstructing his novel and stresses that “his simple goal is to tell a good story, to keep the reader engaged”. Steering clear of deriving constructs like recurring themes or hard truths, which are for the likes of reviewers and critics, he says, waving his hands in the air, “The reader wants a good story well told, if it winds up becoming other things that’s not the intention.”
“Some themes emerge if you are lucky such as that good comes with the bad or that people weather a storm in their lives in different ways. Or, that some people are more resilient and some rely on their faith, my focus truly was to tell the stories of my characters,” says Ethiopian-born Verghese about his multi-generational tale of a family around a matriarch, Big Ammachi, from his own hometown, Kerala.
Relenting a bit, however, he admits to having picked up some common themes in his book from what readers have told him. “I pay attention to what people are saying,” he says, pointedly. “The Covenant of Water is all about strong heroic women whose roles are not acknowledged by a larger world, but who have been the anchor to their entire family. Readers may also find it instructive when they experience a sense of familiarity with some situations in my book where they think, 'I’ve been there,” he points out.
The quest for redemption
His characters seem to be on a quest for redemption, he admits, referring particularly to Philipose, Big Ammachi’s son. “None of us are perfect. We all make mistakes," he says. And stirs up curiosity by saying that he identifies most with Philipose in his book for that reason. “It is Philipose who is the most flawed in the book. He makes a bad mistake and spends the rest of his life trying to redeem himself. I identify with that aspect of him, particularly,” he says.
How people are intrinsically good
The subject of redemption, however, seems to be close to his heart. While talking about how a New York Times book reviewer pointed out not so nicely that The Covenant of Water seems to have only good people in it, Verghese points out that’s in sync with his philosophy in life.
“I believe that most people are inherently good. It’s just that some of us make horrible mistakes and we spend all our lives trying to redeem ourselves,” he says, citing the example of Hollywood actor James Coburn, who was once asked why he plays bad guys all the time.
To which, the actor is supposed to have replied, ‘I have never played a bad guy in my life’. For he believed his character felt he was in the right and the evil stems from how others perceive his actions, explains Verghese. On an incredulous stare about people not being evil, he quickly adds, “There may be evil people but the majority of us are deeply flawed beings trying our best to get along.”
On medical jargon
When asked about weaving in medical jargon in his book, Verghese says, “Writers should write what they know. Tom Clancy writes about submarines and tanks, readers like procedures, a story set in a world. A story set in a police station or submarine, if you are well-versed with that specialised world, adds colour to the story. When I write my medical stuff, I rely on my editor to tell me if it is too much or not. Personally, I enjoy writing it as long as it serves the story.”
On the rare medical affliction of ‘familial drowning’ in The Covenant…, Verghese shares that as a teacher of medicine, he keeps “a lot of rare diseases in my pocket, so to speak”. “I had this condition tucked away in my mind. It is, however, very rare but not as dramatic as my characters suffer from intense fear of water. That part is fictional. But when I was setting the story in Kerala, it seemed natural to weave in that condition,” he explains.
On end-of-life care
In his talks on different forums, Verghese often talks about the importance of bedside medicine and physical examination, like the family doctor of yore. He often contends that the patient gets less attention than patient data in the computer. In his opening address at the litfest, he narrated a passage from a book (he seems to have a great memory for anecdotes and dishes them out as often as he can) on an end-of-life episode involving his hero, the Russian short story writer and doctor, Anton Chekov. The physician who is tending to the dying Chekov realises that there is not much he can do to save his life. So, he brings out a glass of champagne which Chekov sips, and his life slips away.
End-of-life care for patients doesn’t get the attention it deserves today in India and the US, says Verghese. “Yet, there's a growing awareness and acceptance in society today. There are many suffering terminally ill patients who want to end their lives for good reasons. It is a mark of an advanced society to create a mechanism where two or three physicians concur to ensure the patient’s suffering is minimal. It is possible in the Netherlands. Some states in America allow it, but it involves a lot of rigmarole. Right now, a lot of people do it quietly. It is a very complicated subject.”
However, Verghese also conversely points out that he is always amazed by the fact that people have an incredible will to live even if they are in immense pain and dying. “All they know is that there is this one life, so they want to cling to it. After all, it is one more day…,” he says. But that’s when palliative medicine comes into play to help patients pass on without much suffering in their homes, he says.
A robust speciality in America, he says, palliative care is what he tried to do for his young patients dying of AIDS back in Johnson City in the 80s as an assistant professor of medicine. In fact, his poignant experiences then changed his life forever. It is medicine that led him to stories and storytelling, he stresses.
Juggling a busy medical career and his writing, Verghese says, makes him a slow writer. It took him eight years to write Cutting for Stone, and another 14 years for The Covenant of Water. With no fixed schedule for his writing, he writes whenever he can. “I write on weekends, nights and here and there and try to be disciplined about it. It’s not easy but I’m not in a big hurry. I take my time. My writing anyway does not pay my bills. A book from me comes along once in a while and it happens purely for the love of writing,” he says. Writing is a passion he cannot get enough of, it seems.
