6.3 Abraham Verghese: A Saga Through Kerala's Backwaters

Picture this: Kerala, a family that suffers a strange hereditary affliction- and everywhere they look is the very thing that could kill them.

In this episode Tara talks to Abraham Verghese about his bestselling book 'The Covenant of Water'. The book is set in the Malabar Coast of Kerala and follows three generations of a family where, in every generation, at least one person dies by drowning. 

Abraham talks about how his book was loosely inspired by his mother's 120-paged, illustrated depiction of her childhood, his experience in medicine, and how he always carries a pocketful of knowledge about rare diseases!

Join us as we find out why this was Oprah's book club pick and why she simply did not want the book to end!

Books and authors mentioned in this episode:
God of Small Things - Arundhati Roy
The Better Man - Anita Nair
The Brothers Karamazov - Fyodor Dostoevsky
The Love Songs of W. E. B. Du Bois - Honorée Fanonne Jeffers
Master and Commander - Patrick O’Brian

‘Books and Beyond with Bound’ is the podcast where Tara Khandelwal and Michelle D’costa uncover how their books reflect the realities of our lives and society today. Find out what drives India’s finest authors: from personal experiences to jugaad research methods, insecurities to publishing journeys. Created by Bound, a storytelling company that helps you grow through stories. Follow us @boundindia on all social media platforms.

Transcript

Tara Khandelwal  00:00

Hi, everyone. Welcome back to Books and Beyond. And today I am very, very excited because I am interviewing the author of one of my favorite novels of the year, and possibly over the last few years. Dr. Abraham Verghese. He's written an amazing book called the covenant of water, and he is one of the most talented surgeons and writers we know of. So his first book cutting for stone came out in 2009. And I remember reading that as well. And absolutely loving it. It followed the journey of two twin brothers, born of a secret union between a beautiful Indian nun and a brash British surgeon in Addis Ababa. But today we are here to unpack Dr. Berg, his latest 700 Page family saga, which is the covenant of water and it spans the years 1900 to 1977. It's a beautiful book, it's set in Kerala. And it follows three generations of a family that suffers with a very strange affliction. So in every generation, one person drowns dies by drowning. And the family also belongs to a Christian community that traces itself to the time of the apostles. And we enter the story with the story of beggar mochi, who lives that means big mother, and she is a young teenage girl and she is married off to a 40 year old man and that is how the story begins. And then we see this story evolved over you know, this this time period, and we have a myriad of characters. Matar is a very big part of this novel. It's also been recommended New York Times 100 Vice books of 2023. And Oprah has recommended I've never seen OPRAH You know, gush about a book as much as seen. Oh, gosh, about this one. So let's dive into this podcast. And, you know, find out from Dr. Verghese himself about the writing process about medicine, Madison, Kerala, this family saga and I'll place and history have come together in this epic book. Welcome. Dr. Varghese,

Abraham Verghese  02:34

thank you so much. It's so nice to be with you. A couple of corrections if you don't mind, the surgeon, although most people think I am, I'm actually an internal medicine, infectious disease. Probably a probably someone who wanted to be a surgeon, but never could. The other thing is that I wrote two nonfiction books before this. Yes, my own country. The second was the Telus partner. But the last two word novels, as you said, yes. Thank you so much for having me on your podcast and looking forward to this. Thank

Tara Khandelwal  03:06

you. Okay. So what I found really interesting is, you know, even in bound, very interested in chronicling people's family histories, and I found the origin story of the covenant of water very interesting, because you've written, you know, in the foreword, that your that your niece actually had asked her grandmother that is your mother. And she asked a very simple question. And she said, What was it like when you were a girl? And in response to that, your mother, who was in her 70s wrote a 40 page manuscript with illustrations, with a family tree and anecdotes. And that actually became the inspiration for this book. And that became the source material in a way. So can you tell us, you know, how much of this manuscript that your mother wrote is in the novel, and how did it all come? Yeah,

Abraham Verghese  03:59

you know, so my mother was in her 70s. And she was a very talented artists. And so, when my niece asked her this question, she was taken aback by it, because, you know, how does she describe to this young girl growing up in America, what her life was, like in India, then, you know, moving at a young age to Africa to teach them to America to teach. So she began to write it was actually about 120 pages of a school notebook with beautiful illustrations. And I, you know, it was obviously a book that I mean, a little treasure for all our family. We made many copies. But it wasn't she was in her 90s and I finished two other books that I picked her up again, and I suddenly was reminded how rich you know, that culture and that community in that period of time, she was describing how rich it was, and I decided to set my story there. Mom was by then in her 90s very excited that I was setting the story there, she became my number one research assistant. Even even a few weeks before she died, she was calling me up to tell me some news story that she had remembered, you know, unfortunately, she didn't live to see the book come out. But even though I, you know, really drew on that manuscript for inspiration, I didn't really use the actual stories in there. instead. I mean, I used my familiarity with the situation, because, you know, every summer we would go to India, to Kerala, I spent the summer there in medical school, I went to medical school in India, in Madras, and I would go back to my grandparents house, but I used for inspiration really, my grandmother's, you know, I think the book is really about strong, heroic women that the world doesn't recognize these are unheralded heroes, their families recognize it. You know, these are women have gone through incredible hardship, both my grandmother's lost sons in their teenagers, one from in their teen years, one from rabies, one from typhoid, you know, and somehow, despite everything they kept going on, and it was because of their faith, it was because of their inner strength, and they kept the family together. And so I think my mother's document was the beginning and then calling on my own memories. And of course, then the rest is fiction, you just make up, you just make up a story. And you go from there.

Tara Khandelwal  06:35

Right, so the starting point, was really, you know, the grandmother figure and bigger marches character, you know, is also how the readers how the readers get into the book, right, because we see her as a 12 year old, and then we see her, you know, evolving and having own children and growing up through the book. And I really liked the book personally, because I had a grandmother at home and she was from Kerala. Yeah, and her father was a coconut, he used to climb the trees and pick the coconuts and then sell them. And, you know, she would always tell us stories about her childhood and all of those. And that character really reminded me in a way of, we used to call it Amma. So that character really reminded me of Amma. And, you know, since obviously, you know, you have this experience in medicine, and you're also a writer, I was very interested about how you came up with this condition that, you know, that marks this family over the generation that we see in this book. And it really sort of drives a lot of the actions, right, from big Ammachi to sort of, you know, the generations that follow. And, and the condition is that it's a very mysterious thing that, you know, sometimes a child, you know, dies because of drowning. So, what, how, like, what made you think of this condition.

Abraham Verghese  08:06

But I must say that, I'm not the kind of writer who knows the whole story. Before I begin, you know, I really wish I knew the whole story, I envy the writers who know everything, and then begin to write. So I always begin with a feeling with an image. And, you know, you mentioned cutting for stone, the image was that about non, you know, being pregnant. But with this book, The image was of a young bride, and I kept pushing it forward, pushing it forward. I didn't know that I wanted the story to be at least three generations, because I enjoy epic novels like that. But also, I think one of the thrilling things about being in medicine for as long as I've been in medicine, I've had the opportunity to see, you know, diseases that we only had a name for, then after 1520 years, we understand the mechanism, then, after another 10 years, we have a diagnostic test, and then we have a treatment, you know, and so that's a wonderful evolution. So, because the novel was set in Kerala, and I think that that's very important that geography is destiny, you know, you you put that story in some other geography becomes very different story. So because the story is set in Kerala, and because you know, water is such a ubiquitous metaphor, and Karolina happened to be on my way to Kerala, I mean, I'm in the outskirts of Kerala right now. And, you know, you can't escape the fact that water is everywhere. You know, water is the great circulatory system that connects everybody and the monsoon is the beating heart that pumps the water around. So, as a longtime teacher of medicine, I always keep in my in my back pocket, so to speak. I keep a collection of rare diseases over the years that I think about And anytime there's a slow moment on the wards, I will bring it out as a question to my students and residents. So you know what disease causes drowning that isn't that is heathered, her injury, hereditary. And so this was one such disease that I have known about for a long time, it's very rare. But when I was starting to write this novel, it just suddenly occurred to me, in this land where everybody swims before they walk, how interesting if I give them a genetic condition that makes them avoid water, and despite that wind up drowning, so, you know, it came about a little bit by serendipity a little bit by my knowledge of this condition. But I also think that writing is kind of mysterious, you don't really know what the subconscious is doing. It's busy making connections, and you become aware of it at some point.

Tara Khandelwal  10:55

Write and, and I really love the, you know that it's a kerala novel, because it's such a beautiful place. And you really have brought that alive, you brought the whole texture of the place alive through the book, I want to go back a little, you know, and find out, you know, I'm sure that somebody would want to know more about you. So you grew up, you know, in Africa. And you, you mentioned that you used to come to India for your summer vacations. Medicine is part of your life. And you're also a writer. So where did it all begin? You know, the marriage between writing, and medicine? And did you write as a child?

Abraham Verghese  11:36

No, I mean, I think there was always a voracious reader. And I would say that that's a prerequisite to be a writer. In fact, I'm always shocked that, you know, well known physicians will send me manuscripts. And they somehow assume that because they wrote it, it's good. And they, they have no idea what the standard is of what the bar is. So I was blessed to be a voracious reader. And so I think I had a sense of what the bar is what the you know, what the threshold you must cross. But that said, I, you know, I was totally in love with medicine, I had no dreams of becoming a writer. I mean, I would write things within medicine, scientific papers, but sometimes op eds, or essays, you know, thoughtful ones. But what happened is I was I trained in HIV is an infectious disease in Boston, just as HIV was exploding in America. And I wound up finishing my training, just when the virus was finally discovered what it was, and there was a test for it. And I was moving to a small town in Tennessee population 50,000. And everybody said, in a town like that 50,000 rural, I might see one HIV patient every other year, instead of which is a very short time. I was following 100 patients, you know, and so, the great mystery was, why did the small town have so much HIV. And as it turned out, it wasn't a big mystery. After all, I mean, I understood what was happening very quickly. It was really an American story of migration and what's happening in every small town. So young men growing up in a small town, leave for the same reasons, you and I leave small towns, jobs, education opportunity. But they were also leaving because they were gay, and didn't want to live that lifestyle under the close scrutiny of their friends and relatives. And so they went to the big cities, San Francisco, New York, Miami, spent decades there, but at some point, the virus found them. And typically, their partners had gotten sick, they cared for them, the partner died, and now they were sick and coming back home. And so I was there I was at the tail end of this journey, you know, taking care of them. And I wrote a scientific paper describing this phenomenon of migration. And it was a, you know, very widely recognized paper, because it was claiming that this is happening in every small town. But I also felt that the, the language of science didn't begin to capture the heartache of this journey. The tragic nature of it for the families are my own, my own heartache of taking care of young men who were my age, and they were dying, and there was no treatment. It was one of the most it was the most moving experience of my life. And so that was the moment I became a writer is because I decided I want to tell that story. And, you know, I discovered that I mean, Writing is hard. But I discovered that I enjoyed trying to do it and enjoyed it. Well, it worked. I was never in a big hurry. Are you slow writer? So? Yeah, so that's really how I became a writer is quite by, by circumstance.

Tara Khandelwal  15:08

And you're not only a writer, I mean, you're one of the most celebrated Indian writers or celebrated writers now, you know. So there's one thing too, there's one thing to die, there's one single die the way you do. So, you know, how did you sort of hone your craft on that first experience is obviously, you know, a lot of passion, a lot of emotion that went into the writing, and that shows, even in the fiction, in the books, you know, the kind of empathy that you have your characters. But did you sort of have any, you know, mentors or feedback? Or how do you hone your craft?

Abraham Verghese  15:45

Well, I mean, thank you for what you said about me being a celebrated Indian writer, it's hard for me to feel that I feel I'm still the same person who began, I feel that I'm incredibly lucky, I feel that it's very, very common for people to write great novels that are not recognized in their lifetime, or never recognized, you know, so you need a lot of luck. And I've been very fortunate. So, you know, I think your your, your assumption is that I somehow had a master plan that's better than anybody else's. I don't think that's so I mean, I think by my goal is always a good story, well told, that's it. I'm not trying to advance a theme or, you know, advanced some sort of religious doctrine, nothing like that. It's just a good compelling story of the kind that I would enjoy reading. I think that most people don't realize how important a great editor is. And so I've been very blessed to have wonderful editors for both my novels, I actually think that the editors name should be on the front of the book, you know, because you go to someone that you trust, like an editor who has the confidence and the knowledge of the publishing world to say, these 500 pages are wonderful, but they don't belong in this book. On these 200 pages that you're tempted to get rid of, no, they're actually God. And, you know, sometimes I think my medical training makes me want to write too much technical stuff. But then the other three will say, No, this is interesting, you know, I wanted so you know, what can I say the way this happens, the way it works is a combination of luck, perseverance, hard work. I actually had a hard time with this novel, because I, you know, I really struggled to find the story. And I was taking a lot of time my, my publisher was getting very impatient, the editor I was working with was, I felt didn't share my vision. And so we actually parted ways, which was very dangerous thing to do. I had to, I owe them the money that they gave me as an advance, I still haven't paid back. But I have to, and I was, you know, the shopping for a new publisher. Now, this is a tainted manuscript. It's almost like, you know, you came to the altar, but you ran away from before the marriage or after the marriage, you know, so you're a tainted commodity, and was very lucky to find Grove publishing, which is one of the, of the big of the five big publishers in the US. It's the smallest and the only one that's privately owned. And I was lucky to find them and to find a brilliant editor Peter Blackstock. So what I'm trying to say is that, when I finished the novel, and when it was published, I would have been happy just to see it published, and hope that some of the readers from you know, caring for stone got to read it. I never expected everything that happened. So it's really God's grace. When can I say, in terms of models, I have so many, it's dangerous to mention. Too many but you know, I've always loved John Irving Faulkner, Dickens, Gabriel Garcia Marquez. You know, many, many of the wonderful writers like George Eliot, Souter number for another writer, but also, you know, many other too many dimension. The danger is that I'll mention some and it sounds like I'm neglecting somebody else. But I think Gabriel Garcia Marquez was a huge influence, because I tend to like the more ornate prose. Many people think, you know, a physician writers, they think of Somerset mom, and I love Somerset mom. But his style was very much a reporting style. You know, he gave you accurate reporting, and he let you construct the rest of it. Whereas I think I'm much more of the style of wanting to both do the reporting, but also get into the readers head and get at the heart of the complex of their own personalities. I don't know if that answers your question. But that's, that's the best.

Tara Khandelwal  20:02

Yeah, no. And I think it makes editors like me very happy when you said that you should put the name of the editor as well, because it is a lot of times a collaborative process. And you know, what you said about perseverance as well, right? Like you need to persevere. As

Abraham Verghese  20:21

mentioned, one more thing, the other important collaboration is actually with the reader. So I feel like, too often, people don't necessarily appreciate this. But you know, where does a book exist? It doesn't really exist in the bookshelf. It really is. The writer provides the words the reader provides their imagination. And somewhere in middle space, this fictional dream emerges, but it's very much belongs to the reader. And every reader has a slightly different fictional dream, they visualize the characters differently. So, you know, the, the great joy of writing is not, not to me not so much. The success of the book was just great. But you know, you write in such isolation, you write hours, Nobody knows, nobody sees you. Everybody thinks you're, you're a terrible person, because you didn't show up for their engagement anniversary, something. I always think, you know, that was a brain surgeon, and they said, I can't come to your function, because I'm in the operating room. Nobody has a problem with that. But if you say, I can't come because I'm writing, wow, you know, what kind of a person is this? But my point is that, you know, you write in such isolation, and you're picturing the moment when one reader, someone like you, your mother, you were telling me about earlier, when they pick up the book. And so when you find a find that they enjoyed the book, the fictional dream that they made was wonderful. That's the reward. You know, that's who we're writing for. We're writing for that. One person, you know, engaging with your words. And that's just priceless.

Tara Khandelwal  22:04

Yeah, I agree. And I love that thought, right? Because every reader imagines so differently, so there's sort of the more readers you have, there's so many different worlds being created, and all of our heads, and it's such a personal I love reading, because it's so intimate, right? You're right there in the story. In these in these characters, hands. And these characters in the book, I mean, right, from big ammaji, to, you know, her children, and Filipinos, or son, and Filipinos, why they all have such unique characters, and they all have such unique journey. So each character, you know, start somewhere, and then you know, each character and somewhere as well. And there's lots of nuances. So you meet somebody like a Digby who is a Scottish soldier, and he comes to India to practice. And then you know, he's sort of swept up in, you know, the culture of the place, he becomes friends with the characters, his life gets intertwined with the characters. So, you know, what, which character for you was sort of your favorite? And which one did you relate to the most? And which one was the hardest for you to write? And why

Abraham Verghese  23:20

requested? I mean, I think, because they're your creations at some level, you're, you know, they're all precious to you, you know. But I think probably Philipose is the one I identify with the closest, because in many ways, is the, you know, they're all they all reflect on themselves, but he reflects the most and, you know, when this book was reviewed by the New York Times, book reviews, it was a, it was a pretty good review. But the critics said, all the characters seem to be too good to be true. They're all good. There's no evil. And I can disagree with that. I think. First of all, I think that the world is mostly people trying to be good, you know, nobody wakes up in the morning deciding to be evil, it's more like they people wind up doing things that are wrong. And with any luck, like Philipose, then they develop insight and they seek redemption, they try to correct what they have done wrong. So, you know, in that sense, I think all my characters are flawed in the sense we all make mistakes, human beings are flawed, we make mistakes. Hopefully, we get insight and we try to get better. There was a famous American actor, I think it was James Coburn, who always played the bad guy, or seemed to be, he always played the bad guy. And some reporter asked him, you know, why is it you always play bad guys? They said, I've never played a bad guy in my life. Which is exactly right. I don't think you know, he is playing a person whose actions the other one The other people in the world think are evil, but and you know, nobody, nobody thinks themselves evil, they're all very motivated by what they think is perfectly acceptable. Rationality, you know. So anyway, SO Philipose is the one that I thought it was them was, for some reason identified with the most closely. Maybe because of the three generations that I'm writing about the become a chi, and then his daughter, Maria, Maria, he's the the male, so I had to really work hard to imagine a woman's thoughts. But with Filipinos I could, I could get as close as I could. The character that was most difficult for me was probably LC, because without giving anything away to your, your readers or your listeners, you know, she, she does disappear from the story. And so she's a bit of a cipher, she's a bit of an unknown. And on the one hand, you want to describe her in a way that the reader fully can imagine her and yet, you have to sort of keep part of her unseen. So that was a bit tricky. Took a lot of a lot of work to do that.

Tara Khandelwal  26:08

I absolutely, so my favorite characters actually LCSW who, whose Philipose his wife? Yeah, it was because I was so fascinated with a story, you know, I mean, firstly, she's such as dynamic, vibrant kind of woman. And then, you know, I really like seeing the dynamic between her and Philipose change after marriage, and how, because she's an artist, and then you know, her role as a mother and her role and as a woman in the family, and how those things sort of, you know, almost in conflict with one another, and the whole mystery element, I think she, for me, was the most fascinating character of the book. And I also want to give away the ending, but that ending, I could not sleep at night, I just could not get over at the that was the most vibrant scene for me, it just just stuck in my head, you know, I just could not sleep at night, I just wow, you know, I just loved you know, the ending, I won't give away anything else. But yeah, I think all the characters also very interesting. And you really got to know, I think the great part about you know, having such a sort of long book, is that you also get to know each of them. And at no point is any information in the book feel irrelevant. You are so invested in each of those characters journeys. 

So one question that I had was, you know, there's a lot of the book is also full of hard events. And those obviously, you know, happen in everyone's life, we all lose people, we all have ups and downs. You know, and, you know, there are lots of losses, for example, it's in the back of the book as well, big, big Archie's step son from her husband, Joe, Joe, he has the drowning problem. And even though he is so, you know, scared of the water, and he's always on, you know, climbing trees. There's an unfortunate incident where he drowns in a ditch. And I had to just shut the book, you know, because it was just so heartbreaking. And then, you know, there were other heartbreaking moments that kept coming up, and had to shut the book, and then had to come back to it. So what was the process of sort of, you know, constructing, you know, all those hardships and why so many losses? Well,

Abraham Verghese  28:31

you know, I would argue that there aren't that many losses, you know, compared to the reality of life in that era, 1900 to 1976. You know, we think about it, as I mentioned, my, both my grandmother's lost a child, can you imagine losing a teenage boy, not a baby, whether, you know, someone that you've invested to our 16 years and one from rabies, one from typhoid. You know, as a physician, I think that I'm much more attuned to the fact that life is a terminal condition, you know, you and I are all going to die. I hope that's not a surprise for you, you know that it's okay. So I think most people live in a bit of denial about the degree of misfortune and tragedy that's out there. Admittedly, there might be more in the story in one family than, than you are comfortable with. But actually, that's also pretty common. I mean, think about all the inherited conditions where, you know, people discover too late that they're, you know, two of their three children are going to die, but slowly, you know, it's just, it's all around us. But I think the public doesn't get to see it as much as I do. But I didn't really plot those debts. They were just sort of moments in the story where just suddenly seemed to be that this was going to happen, and I was as sad as you were. I mean, I think every time I would revise this Some of those scenes and I won't mention names because I don't want to take away from your potential readers. It was then I would be in tears. Sometimes it was very hard because they were heartbreaking to me. But they were, I was in tears, I think because they were real, it felt real, it felt organic to the story. I don't think they ever manufactured, you know, tragedy just for the sake of it, it always seemed to be true to the plot. True to the story.

Tara Khandelwal  30:30

Yeah, no, definitely. And, you know, amongst the medical conditions, and I really love this marriage of medicine, you know, the conditions that keep coming up, and how sort of that also drives the plot forward, I was very fascinated with the fact that you covered, you know, leprosy is a topic that you cover, and it's part of how the story comes together. And I, you know, growing up in India, you know, it's very sad, but we see a lot of, you know, the stigma around people who have the disease, we see them begging in the streets, and nobody wants to, you know, open the window of the car or the taxi and give them anytime, because there's so much fear around contracting, you know, this disease, and the look of it is, it is scary, right? And you have this character in the book, Dr. Rouen, who sets up a colony for them, and he treats them like his own, and he's not afraid of the infection. So how did this whole angle come up? You know, why did you include this disease in the book? And what did you want to show about it? Well,

Abraham Verghese  31:41

I think though, first of all, as an infectious disease physician, you know, leprosy is something that fascinates us, it's a very slow infection compared to say, I don't know streptococcal infection or staff, you know, this, what makes leprosy so difficult to treat is that the bacteria divides so slowly, that the kind of drugs that work for cell division don't really affect it, or you have to take it forever and ever. But more than that, I remember just like you as a child, being, you know, scared of seeing lepers in the street. And fortunately, I don't think we see them in the streets as much as when used to, would you agree? I mean, because I, I really, yeah, that has become much, much more controlled, or less common as, as the societies evolved, and I know people have better access to all kinds of things. But it was only in medical school that I sort of understood through our leprosy rotations, that, you know, the soul of the person inside, has nothing in common with this very scary exterior. In fact, that's the great tragedy of the disease is that, you know, you not only do have this condition that's paralyzing your nerves. Not only does it give you this grotesque appearance, but you are completely rejected by society in a way that's even more deadly than the disease itself. And so I think it was, it's always been a fascinating condition to me would have been very common in the time I was describing, and, you know, so I just put in my pet favorite things that I like to write about in medicine. And so that precedes record losses. These are all things that I dealt a lot with, and so always interested me.

Tara Khandelwal  33:31

Yeah, I think I was also very fascinated, because, you know, over time, you're right, you know, I, you see a lot less of people who have the disease on the road. And I was then I, it made me remember that, oh, you know, this was a real thing, when I was a child, and then I did a lot of research on it. And it was very fascinating. Also about the nature of the disease, and how, you know, you can contract it, and how it's so slow and what triggers it. So, so I thought that actually was one of the most interesting things for me to think about. And there's so many themes in the book, right? So there's, you know, we see from big Ammachi marrying an older man and then making her own way and creating this family to all the medical conditions that there are there are in the book to the character of Digby who sort of represents colonial India and even sort of feminism, right. So, there are themes like you know, sexual assault, addiction. There is caste you know, because they live in this you know, they live in an estate where, you know, they're the pulley hours which are less cost, and they work for them, you know, they will work for this family. And even towards the end of the book, you'll see a different kind of feminism from the one that Begum, Archie is paving the way for, you know, you see a more empowered kind of about kind of characters, which is congruent with the way that time is progressing. So did you ever worry that you know, there's so many themes and so many characters? Would you be able to do justice? Did you ever worry that you'd be able to do justice to them to at all?

Abraham Verghese  35:22

You know, yeah, I mean, I think you knew worry. You also want to make sure you don't, you know, you don't tax the reader, there's a very important idea and writing that one of my writing teachers, when I went to the University of Iowa late in my career for to the Iowa writers workshop, and one of my professors there used to say, you know, the reader is carrying a backpack and climbing up a mountain. So you want you want to be sure that anything you put in that backpack, they need when they get to the top of the mountain, if they get all the way up there carrying this thing and you, it turns out, they don't need it, they're going to be very upset with you, you know. So I think length is also an issue because, you know, my first publisher, you know, I told you, I switched publishers, the first publisher was very concerned with the length of the book, which I think is, you know, sort of not unreasonable because readers are less inclined to pick a big book off the shelf. But on the other hand, what a shame if you know, length dictates what what stories you publish, my new editor when I joined Grove, and Peter Blackstock, but one of the first things he said to me, is a book needs to be as long as it needs to be. A story needs to be as long as it needs to be. And we had other characters in the book, who minor characters were really interesting things, I loved some of their episodes. But by the time we sort of saw how the whole book was shaping up, what the true arc of the story was, it became clear that, you know, some of these characters were interesting, maybe funny, maybe entertaining, but they didn't advance the plot, and they were distracting. So for the most part, I would like to think that anybody who is in the book, not all of them, but most of them are advancing the plot in some way, or they're shedding light on some aspects of the story and therefore necessary. So you know, I think one of the most gratifying things that I hear about the book, and I heard this from Oprah herself, when she when we first talked, she said, You know, I got so absorbed in the book that, at one point, I looked to see how many pages were left, not because He was impatient with it, but because she didn't want it to end. You know, for a writer, that's the most magical thing. So you want you know, if you're engaged in the story, you don't really care how long the book is, you want to, you know, you don't want this experience of disappearing into another world. You don't want it to vanish, you just want to keep going.

Tara Khandelwal  38:05

I have the same experience, I did not want the book to end, I am very fast reader. And I started reading a book and I said, You know what, I'm going to slow down, I'm going to say, Well, every because this is a book that comes once in a while, you know, and I have to enjoy and make the most of it. So I really, you know, we're saving every page. And I was so sad when the book ended. And I think that, you know, this is one of those books that you can read again. So I'm very much looking forward to reading it again with say, like a year or to when my memory is sort of a little lower than being you know, rediscovering these characters. I'm sorry,

Abraham Verghese  38:43

I have a suggested instead of reading it again, I had the good fortune to record the audiobook. Oh, it was a lot of fun, because, you know, and I chose to audition to do that because I didn't want some well known Hollywood actor, perhaps butchering all the pronunciations of these ethnic words, you know, so I auditioned. It's it's not you know, it's not a given that a writer can read their book because you're not reading it, you have to perform the book. So I had a lot of fun performing the book and, you know, trying to getting all these accents, but not too much not overdoing it. And anyway, the the audiobook has done exceedingly well. It's like, it was the number one download for a long, long time. So if you're gonna do it again, maybe treat yourself to the odd Yeah, that's

Tara Khandelwal  39:35

a good idea. Definitely. It'll come alive even more. And so I have to talk about the Oprah effect you know, because we had actually scheduled this interview right before you got on Oprah and and it didn't happen. I'm so happy we're speaking today. And I follow her book club and I've never seen her gush about a book so much. I have never seen her go into as much detail as she has done with your book. So how did it feel for you to sort of, you know, have somebody like Oprah vouch for this book so much. And, you know, I'm sure it affected the sales of the book as well.

Abraham Verghese  40:13

Oh, I mean, it's a bit unreal, it was really unreal, because obviously, I want people to like the book I would have loved I loved the idea of Oprah picking the book. But you're right, her enthusiasm was just amazing. And, you know, I think she What can I say? I mean, it's I don't know, what to say other than to be enormously, enormously grateful. And I think she's been very helpful in sort of helping me to come to terms with, with what has happened with this book, you know, first of all, I think that, I don't know that I can ever write a book like this, again, it's really sort of a once in a lifetime thing that happens, it took a long time to write the lot of hardship in finally getting there. So you know, I'm just trying to relish the phenomenon that of her of her and so many other readers. And you from you know, all the things you said I just exactly wonderful for me to hear is what I dreamt might happen, but by no means that I know it would happen. But she is pretty amazing. Because, you know, I have had friends, in all the places I've lived from Boston, Tennessee, El Paso, San Antonio, California, who I would say are really not readers, they're not readers. But they are so enamored with Oprah that they have read every one of her 104 selections so far. You know, and so, to be able to bring readers to books, she has done more for reading in America and maybe outside of America, then anybody I know, Mark Twain said that, you know, the difference between people who don't read, and people who won't read is no difference at all. And I think, you know, she has brought so many to the book. She's a pretty amazing woman and her passion for it has been inspiring to me. She has been telling me to pay attention to what readers are saying about the book, because I think at some level, she must have been frustrated, but surprised by my inability to say, oh, yeah, I planned all this. And I knew this is exactly what's going to happen. I don't think I'm really not that. I'm honestly not feeling that I knew I had that kind of story. In my hands. I prayed that it would be a story that was received like that. So and

Tara Khandelwal  42:45

how did she get the book in her hands? How did she like come across the book? I'm sorry? How did she come across the book?

Abraham Verghese  42:52

Well, you know, I think she has a whole crew of people. But she's read, she's reads constantly. And every month they put in her hand, I suspect the maybe 10 to 12 or 20 candidate books, and you know, and she comes to others on our own, or people recommend to her that she's always reading, if you look at her Instagram, half the posts are about her sitting somewhere and reading. And she says that this book was instead of the bunch that they they gave her to for that month. And she kept moving it from here to there, because it was big book, you know. And then she says that she began to read it. And when she got to page three, page three, she knew this was the book.

Tara Khandelwal  43:38

I have the same experience. You know, I read the first few pages and I was like, oh, okay, like, I gotta like, you know, read this properly, because this is something

Abraham Verghese  43:49

that, you know, I told her that very first phone call. I said sorry, though. I never thought about you picking this book. Because with the previous book, set in Africa, it was about women and obstetric fistula. I thought, this is a natural book for Oprah. I lit a candle praying that Oprah would, oh, wow. If the book I told her this, and she didn't read this book, and it didn't cross my mind. I just thought, you know, I don't know, this happens to other people. Doesn't happen to me. And she said, Well, you know what? God has a different time timeframe than you do. You know, you lit the candle. It wasn't for that book. It was for this book.

Tara Khandelwal  44:30

Yeah, I think I read your first book as well. I think when it bought a few years after it first came out, so I think it was around like 10 years ago that I read it. And after this book, I just, like got my copy over here. And I'm gonna read that one again, too. And that one was a phenomenon. I mean, that one was also a phenomenon. So

Abraham Verghese  44:52

the interesting thing was it was not a phenomenon when it first came out and we were killed by a terrible review in The New York Times review of books by someone, no one knows, I don't even know who this person was. But it stopped the book in its tracks, and then in paperbacks, organically through book clubs and word of mouth. And next thing we know, suddenly, it became a phenomenon. So that's why I was saying, you have to be incredibly lucky. I mean, I don't think that I'm the kind of writer I'm not writing popular murder mysteries where, you know, I think if you do a couple of well, then everybody's waiting. The kind of book I write is, I mean, it's God's grace, if it comes out any good. And I'm, I've been very, very lucky.

Tara Khandelwal  45:36

And obviously, you will take a lot of patience, and you also have a demanding day job. So, you know, for people who want to write books, how did you sort of how do you manage the time between writing a book like this, which requires so much as it has so many layers? And this busy and demanding job? How do you manage it? Yeah, I

Abraham Verghese  45:56

think, you know, one of the blessings of why having a job that I love, a calling that I love is that I'm not in a great hurry. You know, I mean, I don't have to turn out another book in another book, I can take my time. And, you know, I have many writer friends who pay the bills by virtue of the next book and the next book, and that's a lot of pressure. So I've never felt that pressure. In my early years, you know, there were no medical schools that were giving me any protected time to write but I've been very lucky at Stanford has been very supportive of my writing, they see it as the equivalent of research scientists going to their lab, I'm given protected time, I'm, I'm my worst enemy. I always wind up squandering that time doing other medical stuff. But you know, I'm a slow writer, I don't watch a lot of television. I don't play golf. So, you know, if you do something fairly regularly, and even then I'm not as regular as I could be, somehow the pages add up. And you know, one day you finally have a finished manuscript.

Tara Khandelwal  47:06

Yeah, it's about that persistence. So, you know, I really like reading books that are in Kerala, because it's such a beauty. I think all Indians, you know, we just love Kerala with the they're just so beautiful. The food is great. The people are wonderful, what a lovely culture. And so, you know, one of my favorite books, obviously, god of small things, we recently interviewed, a book called Oh, now in an IT which takes, you know, look at close to get Katla from a woman who's lived away from Kerala and moved back during the lockdown. It's really funny book. So would you have any recommendations about books set in Kerala that you would other books that are in Kerala that you would recommend to your readers? Yeah,

Abraham Verghese  47:50

I think, you know, there are quite a few wonderful books, Southern Kerala. But I always think that the great tragedies some of the most beautiful writing about Kerala is in Malayalam. And if you don't read Malayalam, which I don't read, well, it's close to you. So we were only able to read people in translation. But nevertheless, you know, in translation, I've really enjoyed the books of Paul Zachariah. I love you know, the god of small things. And I am such a fan of the way that the ROI is so brave in, you know, everything she does, whether it's writing essays or speaking out. So, Anita Nyer, there's a book called the better man. But again, the problem is that I have probably, you know, 15 other books on my shelf that I'm forgetting at this moment as we talk, but I think that there, if you can get your hands on some of the older Kerala writers who are translated such as Muhammad Bashir and Paul Zachariah, as I mentioned, and more recently, this is more Tamil and Malayalam is good days. translated. So this is a ton of beautiful writing out there. I just wish that more of it was translated. That's that's the key.

Tara Khandelwal  49:14

Definitely, yeah, I wish I thought you were what do you read? For fun? What are some recommendations you have? What

Abraham Verghese  49:20

I do for fun, read for fun. I'm sorry, one more.

Tara Khandelwal  49:24

What do you read for fun? So what are your some of it?

Abraham Verghese  49:28

I wind up reading mystery books for fun, because they really are finding pick it up and there's a immediate conflict that's presented you something's something's gone wrong, and you just racing to find out who did it, you know, they're entertaining and very often I don't remember thinking about them later. So I listen to a lot of audiobooks and sometimes, I'll re listen to a previous audiobook I downloaded ages ago, a mystery book. And I have no memory What the plot was I can enjoy all over it. I read those things for just for kicks, you know, but I also try and read a lot of more serious literature especially because I wasn't medicine. So when I could have been reading like an English Lit major I never did. So, recently I you know, reread Dostoyevsky's, The Brothers Karamazov, I just loved it. More than I remember liking it when I tried it as a young person. So I began to read all of the CFC. I did the same for Saul Bellow. So, so a lot of my reading is sort of, you know, rewinding college kind of reading that I should have done, I never did

Tara Khandelwal  50:47

it. Yeah, I didn't study English literature, either. I did economics. And so I always try and read as much as possible to, to educate oneself. And also the books are really enjoyable. So, you know, in terms of the book, there's so many vivid scenes. And my favorite scene is the ending scene, which I can't give away. And there's a lot of scenes, which I don't want to give away, either. But is there a particular scene that you know, that has stood out the most to you, and if you can share that, to, you know, our listeners,

Abraham Verghese  51:21

you mean, a meaningful scene or a special scene, like

Tara Khandelwal  51:26

the scene in the book that like, has like that you it's your favorite scene.

Abraham Verghese  51:32

One of the scenes that I had the most fun writing was the scene of uplift master at this religious convention, where he's translating for a white preacher who has come to town. And, you know, when I do readings at bookstores, I always wish I could read that scene, but it's just a just a bit too long to be the right one to read at that setting. So, but I've always thought that that scene was, to me particularly interesting, there's a couple of scenes when rune, the Swedish surgeon is, you know, giving advice about life to the younger surgeon. And, you know, to me, those are the distillation of a lot of wisdom that, you know, I wish I had when I was a young physician, I wish that I had listened to if I heard that as a young physician. So there are some, you know, particularly moving moments in the book like that to me, either funny or poignant for different reasons.

Tara Khandelwal  52:30

The lots of small moments like that, like the uplift masters, you know, so funny because he's translating it all wrong. You know, I was really funny scene. And I really liked the scene between Philipose and sham, Sham Ooh, son, where, you know, he Philipose is trying to sort of you know, blow the cast boundaries a little offer him something, you know, and get him to stay. But he, you know, I like the fact that these characters can say no, you know, that was very empowering. So, yeah, before we move on to the rapid fire answer last round, one memory from you know, your childhood in Kerala that has still stayed with you, you know, all these years, and that

Abraham Verghese  53:13

my grandmother's kitchen, the smell of it, and the the wonderful sense of her fingers feeding me. Rice dipped in something. Oh,

Tara Khandelwal  53:23

lovely. Okay, so yeah, that brings us to the last round of the interview, which is a rapid fire round where I would ask you questions, and you can reply in one sentence or one word. Okay. One male character in the book that you wish you met in real life. room. Okay. One common American saying that Maloofs don't get

Abraham Verghese  53:52

God is in the details. Okay.

Tara Khandelwal  53:54

Well, one common Malou phrase that Americans will ever get

Abraham Verghese  54:00

if you spit upwards it's pointless because it's gonna just fall on your face. Interesting. TRANSLATION It doesn't come out as clean as it comes out in Medellin.

Tara Khandelwal  54:14

Okay, one word to describe the medical system in America versus India.

Abraham Verghese  54:22

Mirtha expensive and excellent and parts. India. Scattered expensive, but not broad enough for the masses

Tara Khandelwal  54:36

to books on your nightstand right now.

Abraham Verghese  54:41

honoree Jeffers book, The Love Songs of W. E DuBois. And I was just picked up Patrick O'Brien's Master and Commander again. Read it a long time ago reading it again.

Tara Khandelwal  54:55

And where do you write

Abraham Verghese  54:58

to understand what I'm thinking

Tara Khandelwal  55:01

Not so where did you rate where? Okay, but that's also great.

Abraham Verghese  55:06

To understand what I'm thinking, yes, the where is actually in my living room, but facing a blank wall, I'm gonna live alone. So I can use any room in the house, the living room is the most spacious. And I right at the same spot by computer but facing a blank wall, I think all the romance of you know, having a view with the sea and the legs that that gets in the way of anything like writing, projecting

Tara Khandelwal  55:30

the oil onto the blank wall. And the last one is What are you writing next?

Abraham Verghese  55:36

I don't know. I think I'm just enjoying this moment moments like this with you. And it's just been too soon to even think about what to write next. I'm sure I will something. But I don't know what or I just know that this was a one time this was a one of a kind this covenant. It's been a magic and I'm just trying to enjoy the miracle of what's happened.

Tara Khandelwal  56:02

Absolutely. And I think you know, I think the This is a once in a once in a while kind of book for readers as well, this kind of book does not come around very often. And that's why I think it's done so well. That's why you know, that particularly with women, actually, you know, I've seen that, at least for me, like a lot of my like friends Well, women are the women in my family have really gravitated towards this book. And every single one of them is love them. Loved it. So thank you so much for taking the time and speaking to me. And I really do hope that you write your next book soon because you know, it's such a pleasure and I'm gonna go read start your rereading of the first the first fiction, one cutting for stone as well today. So thank you so much for your time.

Abraham Verghese  56:52

Thank you very much.