Abraham Verghese

 

FRED DE SAM LAZARO: Abraham Verghese has all the credentials and degrees befitting a professor at Stanford Medical School. But he is best known and acclaimed for his writing — two best-selling memoirs and a new work of fiction that evoke a different kind of medical vocation.

ABRAHAM VERGHESE: My desire to be a physician had a lot to do with that sense of medicine as a ministry of healing, not just a science. And not even just a science and an art, but also a calling, also a ministry.

DE SAM LAZARO: His goal is to have today’s medical students aspire similarly to a calling­ as much as a career in medicine, to awaken a more basic curiosity as they sharpen their clinical acumen. These third-year medical students were studying abnormalities on a scan, specifically the prominence of certain blood vessels.

post01-vergheseVERGHESE: (Speaking to students) This is what’s called pulmonary redistribution. Have you heard that term? It’s an early sign of heart failure. Who’s got good hand veins that I can borrow?

DE SAM LAZARO: Verghese offered a simple physics explanation of why blood vessels should not normally be visible above the level of the heart.

VERGHESE: (speaking to students) The level of her right atrium is about here. So watch what happens as I raise her hand. You still see the veins, nice three dimension, right? See how they’re flattening out? Now they are gone.

DE SAM LAZARO: The bottom line: Well before an x-ray, a doctor might spot telltale signs of disease.

VERGHESE: (speaking to students) And you see their neck veins and they’re not coughing, speaking, singing, straining, they have increased venous pressure.

DE SAM LAZARO: Increasingly, he says students and practitioners of medicine in the West rely on technology in a system that stresses cognitive knowledge and machines over the skill that comes from touch and feel.

post02-vergheseVERGHESE: I’m the first to admit that the resolution of a hand feeling the belly doesn’t compare with the resolution of a CAT scan scanning the belly, but only my hand can say that it hurts at this spot and not at this spot. Only my hand can say that. Only my hand can say that this pulsatile mass, which might be an aneurism, is also painful, which is therefore maybe a leaking aneurism. You know, there are nuances to the exam that no machine is going to give you.

DE SAM LAZARO: It’s a theme Verghese has sounded repeatedly over the years, writing in magazines, including the New Yorker and Atlantic, and now in a best-seller called “Cutting for Stone.” It fulfills a long-held desire to write fiction, as he told this book club in Menlo Park, California.

VERGHESE: (Speaking at book club) Dorothy Allison, a wonderful American writer, she says fiction is the great lie that tells the truth about how the world lives.

DE SAM LAZARO: The setting for Verghese’s novel is far from Silicon Valley — a mission hospital in Ethiopia. It is a textured, 650-page narrative, set amid that country’s turmoil in the 60s and 70s. Its stories of medicine, doctors and future doctors at the hospital all illustrate what the author calls the “Samaritan role” of the healer. Verghese went from med school in India to Boston, Tennessee, Texas, then Stanford. He was born and raised in Ethiopia to parents originally from Kerala, India and from its Syriac Orthodox traditions. Faith was a big part of life for this and other expatriate communities in the Addis Ababa of his youth, which may unwittingly have shaped some of the novel’s characters.

post03-vergheseWoman at Book Club: You said that what really inspired you to write the book was you wanted to write a book that would get people interested perhaps in medicine. But there was so much in the book about faith and different types of faith, and so how did you come to have so much of this, of another theme in your book?

VERGHESE: Well, you know, the honest answer is I don’t really know. It all just sort of evolved that way. And I think when you’re in medicine, you agonize over matters of faith.

DE SAM LAZARO: The confluence of faith and medicine, and the mission hospital itself, attracted Duke University Divinity School dean Gregory Jones to Verghese’s book. It was a timely find, just before a recent trip to discuss his church’s own mission work.

GREGORY JONES, Duke University: It becomes a shaping institution that plays a really significant role in any developing country and one that we need to pay a lot more attention to. My trip to London was actually to deal with issues around southern Sudan, and so I was struck by the significant role this hospital was playing in the novel about Ethiopia.

DE SAM LAZARO: And even though its setting seems distant, Jones says the novel’s context is very relevant to many students he sees at Duke.

post04-verghese
Gregory Jones

JONES: I think a lot of Christians go into nursing or medicine or other health-related vocations out of a deeply formed and felt Christian vocation, but sometimes the practice of health care, in the United States particularly, often pushes those apart. And I think the novel portrays that in a really beautiful way.

VERGHESE: I joke but only half joke that if you show up in an American hospital missing a finger, no one will believe you until they get a CAT scan, MRI and orthopedic consult.

DE SAM LAZARO: All the emphasis on machines, he says, adds cost to the health care system, and comes at the expense of one of our most important rituals — a visit with one’s doctor.

VERGHESERituals are about transformation. You know, we marry with great ceremony to signal a transformation. We are baptized in a ritual to signal a transformation. The ritual of one individual coming to another and confessing to them things they wouldn’t tell their spouse, their preacher, their rabbi, and then even more incredibly, disrobing and allowing touch, which in any other context would be assault. You know, tell me that that’s not a ritual of great significance. If we short-change the ritual by not being attentive, or you are inputting into the computer while the patient’s talking to you, you basically are destroying the opportunity for the transformation. And what is the transformation? It’s the sealing of the patient-physician bond.

DE SAM LAZARO: Ironically, Verghese says, research is emerging that corroborates the importance of this bond, the virtue of the Samaritan healer.

VERGHESE: We’re learning that you can have a powerful effect on patients, or a powerful negative effect on patients based on context, based on your tone of voice. They are actually associated with significant chemical changes in the brain. The Parkinson’s patients’ dopamine levels go up with a placebo. We’re now able to show that the words of comfort trigger biological reactions which are the very things that you want, and you can use drugs to get there, or you can use words of comfort to get there, which would make your drugs so much more effective. It’s an incredible insight, and you know, a couple of decades now of practicing medicine, it’s lovely to come full circle to where I started, but with the science to back it up.

DE SAM LAZARO: For Religion & Ethics NewsWeekly, this is Fred de Sam Lazaro.

  • Georgia Porcher

    Having read Dr. Verghese’s fiction & his 2 memoirs, I was thrilled to see & hear him. I lost a brother to Aids in 1985. You can’t imagine what his memoir My Own Country did for me. How many of us ever know how the physician is dealing with patients for which there is no hope. I found my brother’s doctor in NYC to be incredibly sensitive, also, but I never knew the toll that it takes on the doctor. Dr. Verghese has learned how to show compassion and is that not a step toward healng—–maybe not the body but the soul?

  • Suzanne Kelley RN

    Hello, Kristen’s daughter Allie told me about this site. I am so honored to know you and think about you often when I see your books in my library. During my 45 year nursing practice I urged nurses to be sensitive to how they touch our patients; as well as monitoring their tone of voice. I provided them with education on the power of touch in the healing process.
    In my career I studied for 11 years in NM at the Harjo Foundation. We studied Celtic, Native American, and Buddist spiritual rituals and healing practices. I was exposed to people around the world and eventually became part of the teaching practioners. I also specialized in psych nursing for 38 years and started several inovative nursing groups which focused on how spirituality and ritual enhances the quality of not only the healing process, but life in general. Believe me I was faced with uphill battles with corp administrators, but once they saw a forensic patient say a prayer before a meal and the sincere socialization with each other afterwards, they began to listen to me.
    I am retired now and live in a cabin in the Lincoln County Natl Forest, Ruidoso, NM. From my deck I see only mountains and trees, deers, brown bears, elks, foxes, ravens and multiple mountain birds. I am so very grateful to Jim for giving it to me. I am getting back into my art projects and even “chop” my own wood for my huge fireplace. …. Once again, I am so proud to know you and respect your extremely vital purpose in this earth walk.
    Sincerely,
    Suzanne

  • Jolly Ann Ellis

    CUTTING FOR STONE was the first of Verghese’s books that I have read. Now I am almost finished reading
    MY OWN COUNTRY and am convinced that Verghese is the epitome of the true physician–skilled, smart, compassionate, level-headed, and committed. I wish I could mee this extraordinary man.

    When I finish MY OWN COUNTRY, I will pass it on to my own primary care physician as he is of the same mold
    as Verghese. He knows me, my name, and has an idea of who I am before looking through the file, He ministers to my physical, emotional, and other needs,

    The world is a better place because of doctors such as Abraham Verghese and Jason Nelson.
    Jolly Ann Ellis, Seguin, Texa s78155

  • sheilA SCHARNOWSKE

    I am so impressed with your books, Tennis Parner broke my heat and My own courntry capitavated my attemtion. You are an exceptional writer. I am a nurse and love patitent/md interaction./ I cried hard at the end of the Tennis partmer/ As I have lost a s son age 30 to alcohool abuse. He was adopted from India and we raised him in Colorado. H e went to Univ. of CO and graduated with a degreee in film stidoes/ But he never met hils potential, alcolhol claimied his life at age 30. I sitll weep as I write these words, He was such a wonderful talented person, just as your DAVID was! I am a nurse and hope you will write another npvel wilth medical lnstruactions as I am a Masters prepared nurse and really learn a lot from your writing,! I look forward to the future writings of you and your children and the wonderfull way you ïntrospect”in your writings. All the best tto you and your wirfe sylvila and your 3 children. Sheila Scharnowski, sheila.scharnowski23@gmaill.com

    Sheila Scharnwoski, RNC, MS 331 Inverness DR. , Huntsville, ALA 35802

  • sheila scharnowski, RNc, MS

    Loved all your books. I had a son adopted form India, he came to us at 3 months and 5 pounds. He was bright and full of energy . A joy to railse. He found alcohol when he was 16. and age 30 died from alcohol intoxication. A heart break. the book about David was very similar to the problems we had with Benari. We had him from age 3 months util agef 30. He did graduate form college (Uof Colorado) but never was able to keep a job. 3 episodes of rehab ( only 4 weks each) and at the end cloisterd himself in a motel room and drank himself to death. we are all devastated. So similar to your DAVID.