Books
The Doctor Is In
Can El Paso physician Abraham Verghese build a healthy career as a writer by chronicling life and death? The prognosis is good.
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Soon Verghese was publishing sharply observed, emotionally wrenching short stories, most of them drawing on his experiences as a doctor. Perhaps the strongest is “Lilacs,” which appeared in The New Yorker in 1991; it recounts the last hours of a young man named Bobby, addled and wandering the streets of Boston, still shaking his fist at an old foe, the implacable AIDS virus. His most disturbing story, “The Agent of His Death Is a White Woman,” ran in The Black Warrior Review the same year and is also set in Boston, among a group of homeless drug addicts. One is a pimply-faced white woman who is desperate to shoot up but can’t because “everything has been hit so many times, the veins are hard as cement and clotted.” A black man named Ndongo takes the dirty needle and assists: “The needle slides into the center of a fat hemorrhoid, and she grunts. Blood spurts out and runs down her leg, but blood also comes rushing back into the syringe, transforming the white fluid to red-black.”
Verghese enjoyed the life of a writer among writers in Iowa and considered staying longer, but he needed what he calls “the workaday world of medicine.” He started looking for a position in academia, and though he had received offers from several major teaching hospitals around the country, he chose El Paso. “I feel my services are needed here,” he says. “Coming back from India or Africa, where I have worked at times, I came to realize that it’s not me they need but money.” By contrast, he sees El Paso as “a First World setting where I can deal with Third World diseases,” a place where patients seem to require his soothing presence and his writer’s willingness to listen almost as much as they need the hospital’s expensive high-tech equipment.
It was his New Yorker editor who urged him to begin work on My Own Country. Newly arrived in El Paso, Verghese would get up each morning at four-thirty to write before going off to his job at the hospital. The result, which took three years to complete, showcases Verghese’s keen powers of perception as well as his fully drawn, real-life characters and finely tuned sense of place. Verghese found that the impoverished trailer dwellers, the uneducated country people, even the fundamentalist preachers in his little niche of Appalachia were often more accepting of the plague victims among them than his professional colleagues were.
After the success of My Own Country, Verghese planned to resume his fiction writing; he says he likes the control over outcome that often eludes him in the world of medicine. But so far, it hasn’t worked out that way. His second book, The Tennis Partner, grew out of a proposal he wrote for The New Yorker. It’s the true story of a young doctor—a former student of Verghese’s and his best friend—who got hooked on cocaine; after checking into an Atlanta clinic devoted to treating doctors addicted to drugs, he went home, relapsed, and shot himself to death. “It takes place in the world of medical schools and hospitals and medicine,” Verghese says, “but it’s really about male heterosexual friendship. It’s amazing how important male friendships are, but we’re silent about them.”
The Tennis Partner is nearly finished—HarperCollins will publish it in December—but Verghese still has to elbow out time for his writing. His duties as a faculty member can easily overwhelm everything else, so his output isn’t as steady as that of a Rick DeMarinis. It also doesn’t help that Texas Tech bosses aren’t particularly supportive. “The mind-set here is too provincial,” he says. “By and large, I’ve found them pretty unimaginative in the way they’ve used me. I have yet to even give a talk here at Texas Tech. I’m taking a forty percent pay cut to write. My writing just seems to be something they tolerate.”
At least his students seem to appreciate his accomplishments. “He’s so eloquent,” a young woman tells me as we walk down the hall of the hospital. A bearded young man striding along ahead of us overheard our conversation and waited for us to catch up. “Verghese is the reason I’m going to be a doctor,” he says. “I want to be like him.”
It’s easy to see why, as the slender, dark-haired Verghese leads three students on rounds. In one small room a 22-year-old man in blue-and-white pajamas lies in bed on his side, a pillow between his knees. A former dancer at a gay bar in Juárez, he is strikingly handsome, HIV positive, and suffering from testicular cancer that has spread throughout his body. Verghese asks whether he is in any pain, and the patient murmurs no. With a reassuring hand on the young man’s knee, the doctor tells him about chemotherapy and the cocktail of medications he will prescribe to battle the AIDS virus. He answers the young man’s questions, then gently grasps his left hand. “We’re going to fight this thing,” Verghese assures him.
Outside the room the man’s middle-aged mother stares into a mirror, trying to stop crying before she walks in to see her son. When she sees Verghese, she starts crying again. He puts his arm around her and, in Spanish, softly explains the treatment he is prescribing. Her husband doesn’t know their son is sick, the woman says, doesn’t know their son is gay. Verghese and his students answer the mother’s desperate, imploring questions as best they can.
After the morning rounds, Verghese sits at his cluttered desk eating lunch, Batman figures standing guard on the windowsill ramparts. “What’s amazing to me,” he says, “is that there are not more doctor-writers, given the fact that we are privy to the kind of drama we witnessed this morning.” He mentions two doctor-writers he admires, Oliver Sacks and Robert Coles, and his hero, doctor-poet William Carlos Williams, whose patients were mostly working-class people from New Jersey. Verghese believes that, like them, his strength as a physician lies not so much in his medical acumen as in his ability to listen carefully to his patients. “God is in the details,” he says, “in both writing and medicine. When I’m called onto a case, it’s not because I’m better equipped. It’s because I listen to their stories better.”
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