As a culmination of our March NPR Book Club reading of Cutting for Stone, we spoke to author Abraham Verghese, a doctor and writer, about his bestselling novel.
We took the questions for Dr. Verghese from our NPR Books Facebook page, where we were grateful to receive such thoughtful suggestions.
In our chat, Dr. Verghese talks about how the book came into being from the first images and faint impressions in his mind with the help of a caring editor. A deep passion for medicine guides the book, and Dr. Verghese says he sees his work as a physician and as a writer as a seamless process. When he takes on a new patient, he listens for a history, and the varying symptoms and diagnostic problems fit together in a similar fashion to how a literary story is constructed.
Thank you for taking the time to listen, and please share your thoughts about Cutting for Stone in the comments section below!
Highlights from the interview
On how the book started in the author's mind:
It all began with this image of a beautiful South Indian nun giving birth in a mission hospital in Africa. I don't quite know where that came from, but that was something I had in my mind. I also knew I wanted to pour into this book everything I loved about medicine, particularly the study of medicine, the sense of a young person entering this field; to me, it has always felt like a romantic and passionate pursuit. I wanted to populate the book with that strong sense of medicine, its ups and downs. I did not actually know the plot in any fashion, and I think I'm one of those writers who has an image and a tone and a voice and pushes it forward, which has led to a lot of dead ends, a lot of retreating. But as soon as I did begin to see patterns, I would go back and amplify them.
On the process of working with an editor to write Cutting For Stone:
Where [my editor] was so precious was, first of all, her faith in me; second her forbearance as I went down these dead ends. And she had the most wonderful way of saying, "Abraham, these 300 pages, 6 months of work, is just gorgeous stuff but it doesn't belong in this book." You have to have great faith in an editor to be able to take that. And frankly, there's a point where you lose all perspective. You want someone who's objective to reinforce the parts that are good, that you might not even recognize are good, and to take away those parts that you are very fond of but are tiresome to the reader. "Killing your darlings," as they say in writing; she was very good at helping me kill my darlings ... I honestly think that her faith that a story with so much of Ethiopia in it could be of compelling interest to the reader really carried the day.
On the similarities between being a doctor and writing a novel:
When I see a patient, I take a history, and what is a history but a story? And the older I get, the more I'm conscious that when I see a patient, if I'm able to add something to that patient or unearth something to help solve the issue that they're wrestling with, it's rarely because I bring some superior knowledge. Knowledge has become quite democratic, we carry it on cell phones and PDAs and so on. It's usually because I hear that story and I have a greater repository of stories that I can match that story with, or it echoes for me in a right brain sort of way with a vague story that I recall and I look for the other missing elements. Then I go to the body and I'm looking again for the parts of the narrative that would fit the story that I have in mind ... Physicians are all engaged in a kind of narrative, if you will.
On the choice between life and work:
Medicine presents us with this false dichotomy, or rather this temptation, that you come to medicine incomplete, you come to medicine because in a way you're wounded, and the grand privilege that medicine gives you is that you care for others and your woundedness becomes healed ... My sense was that if I just did this medicine thing very well, then I would be forgiven everything else. I didn't need to be a good husband or a father who was very present ... Perfection of the work won't get you perfection of the life. You have to think of these as two parallel trains; there's life and there's work, and they run on parallel tracks and there's times when one gets a little ahead of the other, but you can't let them get too far away ... Humans beings need to work to feel fulfilled; human beings need to love and feel loved ... Maybe that is the name for the two trains — instead of calling it life and work, you could call it love and work. And they can't get too far apart before you get into trouble.