The Good Doctor
(Page 3 of 3)
“Because he quit smoking,” said one.
Verghese nodded and coaxed more with motions of his hands. “Sure seems sudden, though. Why?”
“Where he was,” theorized another, “he wasn’t allowed to smoke.”
Verghese was nodding. “Or he couldn’t smoke,” realized the third student. “He had lost the ability.”
Just like that, the apprentice clinicians had begun to unravel the poor man’s mystery. Verghese reminded them that fingernails grow out at a rate of about one millimeter a week. If they measured how many millimeters of normal nail had grown from the line of demarcation, they could calculate with certainty when the man had suffered his stroke, and with that knowledge, they could begin to know how to help him.
Later, when we were back in his office, I look at the bookshelves and walls and found myself staring at the photograph of the man’s fingernail. The puzzle had a missing piece. I asked Verghese, “But why would you know nothing about the man who had the stroke?”
The doctor smiled sadly. The fleeting moments of transcendence always come paired with tragedy. “Members of his family brought the man to an emergency room,” he said, remembering that evening in Tennessee. “They said they were going out to park the car, and they never came back.”
WHEN HE AND HIS FAMILY arrived in Iowa City, Verghese worked part-time in an AIDS clinic, but the real reason for his move was to enroll in the prestigious University of Iowa Writers’ Workshop. Verghese dressed for class in doctor’s corduroys and tweeds and worried that he hadn’t read enough to write well; other students sauntered into class in jeans and T-shirts, spouting their knowledge of postmodernism and other critical theories. Verghese’s good friend at the University of Iowa, Tom Grimes, is a novelist and playwright who has since helped launch the thriving writing program at Texas State University. “Abe was a little tentative at first,” he tells me, “but he had such tremendous subject matter in his grasp that he soon lost his anxiety. He always said, ‘I can’t just be a doctor, and I can’t just be a writer. I want to do both.’”
One night there was a big reading in Iowa City by John Irving, the author of The Cider House Rules and The World According to Garp. The famous novelist’s real purpose in town was to watch an NCAA wrestling tournament. But Irving went to a student party, where the apprentice writers put out some chips and beer in a dirty apartment and, out of intimidation, were slow to approach him. Verghese introduced himself to the author, who, as it happened, was researching a novel called A Son of the Circus, a story about a doctor trying to find his way in India. Verghese had found a mentor, and a friendship took root.
Verghese wrote some dark and self-conscious stories about junkies in that period, but the story that struck a match to his talent and career was “Lilacs.” An agent who had passed through Iowa City discovered the manuscript and sold it, to Verghese’s amazement, to the New Yorker. The story portrays an AIDS victim in Boston who tries to prepare and counsel another with a personalized shock treatment: “It’s not illegal to hold hands—is it, Clovis? O.K., I’m going to let go of your hand. I want you to answer a series of questions for me. I’ll write down your answers on paper, and then you put that paper in your pocket and carry it with you. Then—trust me—you will have conquered death. It worked for me. O.K.? First of all, where do you want to die?’”
Verghese left Iowa City in 1991 with a master’s degree in fine arts and a desperate need to earn a living again. He moved his family to El Paso, where he taught medical students and residents of its Texas Tech Health Sciences Center and worked in a county hospital. He fell in love with the isolation, scruffiness, and spunk of El Paso, though it was during those years that his first marriage failed. The AIDS epidemic had become a permanent part of his life. At the El Paso clinic, he treated a Hispanic man who later died from the disease; the man’s lover also became Verghese’s patient and one of his closest friends—years later, he died as well. A woman named Sylvia, a cousin of the first AIDS victim and a friend of the other, worked as a volunteer at the clinic. She and the doctor of her loved ones married in 1996 and now have a small son.
Editors at the New Yorker, meanwhile, urged Verghese to write a long nonfiction piece about the coming of HIV and AIDS to rural Tennessee. He submitted a proposal, but the magazine rejected it—actually a piece of luck, for he salvaged it and made it the proposal for My Own Country. He worked on the memoir for four years, and it came out to extraordinary acclaim. Showtime made a fine movie of it. During the time between marriages, Verghese had first lived in a barely furnished apartment and, when he wasn’t working or trying to entertain his two children, he had played obsessive tennis with a young medical student named David Smith, an Australian who had come to America on a tennis scholarship and had played briefly as a pro. But the friendship was not enough to save the young man from an addiction to cocaine. In The Tennis Partner, which Verghese wrote several years afterward, he last sees David snarling in an alley, like a cornered rottweiler. “Leave me alone,” the best friend shouts, then crashes between garbage cans and runs off to his doom.
“I sometimes think I don’t learn anything from an experience until I write about it,” Verghese tells me. “From My Own Country I learned that relationship and family almost always win out. I don’t care how bigoted and rednecked people might seem; when AIDS happens to their families, the overwhelming response is to show courage and caring. Gay men also taught me a great deal about maleness. They’re free of so much posturing that heterosexual men think they have to do to impress women. The Tennis Partner delivered me from the guilt of a terrible experience in my life. People who were close to others who’ve committed suicide are always thinking, ‘What could I have done? How could I have stopped it?’ Writing that book, telling that story, enabled me to learn that the addiction was David’s illness. It was his responsibility.”
With the books have come numerous requests from editors to write pieces for magazines: British Esquire, the Atlantic, Granta. Verghese smiles and says that despite the time constraints and the urge to finish his novel, he seldom turns the magazine editors down—he doesn’t want to take their calls for granted. His experience is so broad that he can draw a convincing personal essay from life on three continents. A year behind Verghese at the medical school in Addis Ababa was a brilliant young student named Meles Zenawi. He took to the harsh countryside in a guerilla army, and they fought the dictatorship’s troops in running battles for seventeen years. The victorious rebels wore long hair, khaki shorts, and sandals when they took the capital, in 1991. Zenawi is now Ethiopia’s prime minister. Amazed that he could have known such a man, Verghese returned to Addis Ababa to interview Zenawi for Talk in 1999. The leader of the country greeted his onetime colleague: “Welcome back.”
THOUGH HE’S STILL hard at work on his novel, Verghese spends much time these days making speeches, raising money, and building support for the new center in San Antonio. And since his curriculum is only two years old, he is constantly tweaking it, trying to find new ways to shake up his students’ perspectives.
In one of the school’s first sessions, a lecture he gives to the incoming class, Verghese describes the course objectives in broad terms and talks again about the importance of story—not just patients’ stories but the students’ stories as well. Then he introduces Patti Wetzel. She is a polished, attractive, self-assured physician—everything the medical students hope to become. “I tell them that as they learn about disease, they’ll start thinking they have every one,” she tells me. “If the subject is breast cancer, and you’re a woman, you will start feeling lumps. That can’t continue, of course, because if you’re constantly frightened, you can’t treat your patients. So you construct this wall that protects you, but the problem is that it divides you from your patients.”
Then, as Verghese observes, Wetzel will tell the students her story. She was a practitioner in Fort Worth who had dedicated herself to the care of HIV and AIDS patients. In 1991 she had an accident that happens all the time in hospitals and doctor’s offices. “I was drawing blood from a patient and pricked myself with the needle. For thirteen years, I’ve been living with the HIV virus. Dr. Verghese is my physician.” Verghese will watch his students as a total hush grips the room. Divisions of rank between doctor and patient are eliminated. Any psychological and judgmental barriers that his students may have constructed against AIDS and its victims will have just come crashing down.
