“FIRST IMPRESSIONS CAN point to the most important diagnoses,” said Abraham Verghese, leading the way through a warren of drab hospital corridors in San Antonio this summer. We were hustling toward an appointment with medical students of the University of Texas Health Science Center, and the 49-year-old doctor was explaining his belief that American medicine has become too enamored of its lavish technology. An Indian born in Ethiopia, Verghese was trained in the British tradition, which relies heavily on bedside diagnoses, and he still approaches curing and healing like a detective. “When I’m in a crowded elevator, I feel like I’m not paying attention unless I recognize at least three symptoms in the people around me,” he said. “And if there’s nobody else in the elevator, then I need to be studying the mirror, looking at myself.” We had just emerged from an elevator, and his remark had an unsettling effect on me. I felt scrutinized at a glance, and I was momentarily jolted into an acknowledgment of that ever-lurking shadow—sickness and dying—that we try to whistle past in the alleyways of life.
Verghese has an athletic build and bearing, thinning dark hair, and a rich brown complexion. A woman friend of mine recently exclaimed, “I saw Abraham make a speech, and he made me want to take my clothes off.” The setting of her fantasy did not seem to be a medical examining room. A naturalized U.S. citizen and a specialist in infectious diseases, Verghese exudes a soft-spoken charisma. He is a pioneer in the treatment of rural patients infected with the HIV virus, who came into the profession in the eighties, a time when American doctors felt all but invincible; only cancer was truly feared, and its cure was considered just a matter of time. But the dread plague of our era shattered the illusion that research physicians, laboratories, and pharmaceutical companies had all the answers, and Verghese remains a careful doubter in search of telling clues.
HIS APPROACH TO MEDICINE is also shaped by his other passion: Verghese is one of the most gifted writers ever to live and work in Texas. At nights, after he’s had dinner with his wife and their seven-year-old son has gone to bed, he regathers his energy