An Interview with Abraham Verghese, by Celia Johnson

For Abraham Verghese, it is not a question of being a doctor or a writer. He is always both. Writing is a lens to view medicine and the world, and that lens is intricate, hopeful, and compassionate. Verghese has written two memoirs and one novel, all New York Times bestsellers. In each of his books, Verghese explores sickness and healing, focusing on the human aspects of the medical field.

Verghese’s characters don’t arrive in his mind fully formed. Neither does a plot. As the characters develop, Verghese sprints after them page by page, and they often lead him astray. His creative process involves a lot of reworking, but it is well worth the effort, as proven by his latest work, Cutting for Stone. The debut novel features characters that are astonishingly real, and it is easy to see how they might lead their creator in unexpected directions.

Cutting for Stone by Abraham Verghese book cover

One of the most striking elements of Cutting for Stone is the intimacy with not just one character, but an entirecast. Though Marion tells the story, we become deeplyinvolved in each person’s struggles, not just Marion’s.Which characters did you feel closest to while writingthe book? And why did others feel more distant?

Characters, by the way, do not start out rounded. They emerge. I think Ghosh is the character whose emergence and whose full blossoming I loved most. He is essentially fair, kind, and eminently faithful, a family man, and above all patient—all the qualities I would like to have myself, but don’t always. He is the consummate internist too, which I also aspire to be. He gives me something to strive for. Hema, too, is someone I deeply understood—or understand as well as a male writing a novel can understand a woman. Thomas Stone is both more alien and familiar—a doctor caught up in the illusion that work can redeem his character failings. Shiva—I let him be distant, impenetrable, because that is the nature of his character. My editor would sometimes be frustrated with me because she could not “see” Shiva, and I would say to her, “Yes! That is the point. There is a quality to him, an Asperger’s-like patina, that makes him hard to know.”

Ghosh offers a thought-provoking statement in Cutting for Stone: “Not only our actions, but also our omissions, become our destiny.” Which characters were particularlyruled by their omissions?

This is a well-known phrase in the analysis of stories and fairy tales. I think it applies to all of us, and certainly to all characters in any novel. Thomas Stone was clearly ruled by his omissions, what he didn’t do—he didn’t stay to mourn Sister Mary Joseph Praise, and he did not raise his twin boys. He omitted to tell Mary Joseph Praise about his feelings until it was far too late. And Ghosh’s character was defined by the actions he did take, the sacrifices he did make.

The story line in Cutting for Stone is complex, with many unexpected turns. Did you plot the entire tale before you began writing, or did it evolve over time?

The reason this first novel took so long to come to fruition is probably that I didn’t have the entire story in my head before I began writing. Many writers dohave the ending clear to them before they start, and John Irving—a hero of mine—is a shining example of that approach. But I don’t, can’t write like that. I would like to. I wish I knew the story that way. So, I let my characters develop and grow and go running after them. But this approach often requires a lot of cutting and reworking when the characters meander so far off base that they—and I—have to be reeled in. I have my editor Robin Desser to thank for her great patience—and her timing—in knowing when torein me in, in forcing me, almost, to think of the conclusion.

There’s an important turning point in Cutting for Stone when a young Marion discovers that “the adults weren’tin charge.” The walls of Missing were no match for thepolitical chaos and violence erupting around them. Canyou tell us about your own experiences witnessing thecivil unrest in Ethiopia?

I was a child about Marion’s age during the first period of civil unrest in Ethiopia, and it was the first time I was aware there were some things beyond the reach of a parent’s protection. Seeing dead people all around, dead bodies hanging from gallows—those acts of violence were very intimidating. The second time I saw all this was also shocking, but I wasn’t a child anymore. I was disturbed, but in a totally different way. Perhaps in a more profound and disappointing way came the realization that I was now one of those adults, and the acts of mayhem, the acts of torture that I knew of, the death of some of my classmates, that was all in a sense “our” doing—you could not shift the responsibility.

You’ve lived in many different places. What would you describe as home?

This is a question I get a lot, as I have moved around and lived in greatly different places over the years. I guess my answer is that home is a place in your heart. It’s not necessarily where your parents are, or where you live. As Hema pondered in Cutting for Stone about the definition of home, “Not where you are from, but where you are wanted.” Wanted and valued, I’d say.

You wrote two memoirs before your debut novel, Cutting for Stone. Did you encounter any unexpected challenge shifting from nonfiction to fiction? After writing both forms, is there one that you prefer to the other?

My preference is fiction by far, and I think you have to work harder at fiction to get your reader involved. What you are writing about didn’t happen, but readers need to feel that it did. It’s freeing because you can let your imagination go. With nonfiction, it’s a lot clearer what you are writing about and that it’s not made up. Indeed, I would say that is what you have going for you—the fact that it really happened makes it inherently interesting to us. But it’s also somewhat limiting as you can’t invent, only rearrange and dramatize.

What inspired you to write each of your books? Was there a moment of epiphany for each one, when you decided that you simply had to put that story down on paper?

Many moments of epiphany in all of my books. There was no real moment in time when any of them started, but very often for me, writing about something is a way to understand it better, or just understand it in the first place. I became a character in the stories with a sense of discovering the import as I wrote, rather than writing because I understood it. Living through the time of AIDS in Tennessee, and helplessly with David as he was spiraling down in El Paso—writing these first two books helped me more deeply understand those experiences. With Cutting for Stone, I arbitrarily chose twins, then twins became the motive for the story, and ultimately they were the focus for the characters’ redemption. I could not have anticipated any of that when I began writing, but it became clear as I progressed. A series of epiphanies, you could say.

*This interview is an excerpt from issue 11 of Slice. To purchase the issue and read the entire interview, click here.

Author photo by Barbi Reed.