I’ve read both of Abraham Verghese’s other works:
Cutting for Stone
My Own Country: A Doctor's Story
. I’ve given both my special “6-star” rating for superlative works. Could he do it a third time, and in an area that is my adopted home, the deserts of the American Southwest? I decided not to ponder the question long, for there was an additional special pull: the compelling weekly tennis game.
Verghese provides loving descriptions of the diverse places he has inhabited on this good earth, from the eucalyptus trees perfuming the high African city of Addis Abba, to the lush green wooded hills and dales of eastern Tennessee that he has declared to be his home, but one that he would depart for professional reasons, to settle for a piece in El Paso, Texas, and find a lovely tennis court, high on a hill, just north of the city, where he could look across the Rio Grande at night, and observe the twinkling lights of one of the most violent cities on earth, Juarez, Mexico.
Verghese is a medical doctor, and his novels so accurately depict the medical field, to those who have partaken. He is a “lowly” internist, as he would wryly note in “My Own Country,” at least in terms of financial remuneration. Like Chekhov, and a few others, the internists are the observers, always noting skin hues, abnormalities, a slight puffiness here and there, even in their friends, socially. The good ones can also observe the heart and soul. In Verghese’s own words: “My Luddite streak was aroused. Would that I could wave a wand and bring back a simple pedal bike, bring back wooden rackets, bring back doctors who didn’t need batteries of blood test to diagnose conditions that were staring them in the face, bring back…”
No need for a “spoiler alert.” The “medical outcome” is in the dedication: “In memory of David Smith, M.D, 1959-1994." Verghese and Smith balance their strengths and weaknesses. Verghese is now an accomplished doctor, based on his work in east Tennessee. Smith is the resident, still learning. Smith is also a very good tennis player, once out there on some loop of the semi-professionals. Verghese is aspiring, still learning. Smith accepts him on the Court, and Verghese accepts him on the medical rounds. Smith is Australian, and on a bit of a different career trajectory. And he has a “secret” that much of the hospital knows, and Verghese is late to discover: a history of opioid drug addiction. But all that is now safely in the past… or is it? As is well-known, on a percentage basis, those who work in the medical field are more likely to abuse drugs for two straightforward reasons: ease of access, and the pressure of always having to “get it right,” or, as the expression has it, you bury your mistakes. And it is the Emergency Room that is the worse place to work. Hum.
This work touched me personally more than the other two. I once worked in a vast open-air Emergency Room for a year. A fellow medic was addicted to the morphine we carried, and would shoot up all of his, and anyone else’s he could grab. And if a soldier was wounded, he would use Thorazine instead. A shudder from those who know the real implications of that. And what do you do about it? What is fair and reasonable for him, as well as the men in his unit? Turning him in, and he gets a one-way ticket to LBJ (Long Binh Jail), and the unit has no medic. Is an addicted medic better than none at all? It was a difficult call I did not have to make. But when Verghese wrote of his own rationalizations, the cover-ups, the “just one more chance…” I was right along, on edge the whole way.
Far more pleasantly, there were my own tennis games, with a medical doctor, who was NOT an addict. Neither of us were anywhere near the tennis league of Smith, nor even Verghese. But it was a lot of fun. The ritual, the passion, the wonderful exhaustion experienced thereafter, when two players are so evenly matched in their ineptitude. Every Tuesday night, a weekly highlight. Certainly it would be uncharitable to bring up my partner's dyslexic line calls…
And then there is the matter of my son’s long-term girlfriend, now finishing her third year of med school. We talk books over dinners, and this is the one she really wants to read. Bravo. But I really think it should be in the “core curriculum” of any medical school.
As a final point, Verghese would do the same as he did in east Tennessee; he’d visit his patients outside the hospital setting, and in this case, it meant walking along the Rio Grande, looking in the bushes, for his partner who once was on the other side of the net. Empathy, and more than a bit of courage. I complete the three works with another 6-star determination, and realize that Abraham Verghese is the only author I have read who has received that determination for every work. May there be a fourth.