I usually avoid books that even mention AIDs but our group chose this well-written book and I am glad I read it. The member who chose this book said that it always made him cry at the end. Another member said that the last few pages were captivating.
However, one of out members said, ‘I gave up- half way through. It’s a very dull book and the author doesn’t discern what matters and what doesn’t. He just includes everything; it doesn’t manage successfully to turn autobiography into a novel.’
The chapters are short so it can be savoured. We learn that doctors were homophobic in early days of AIDs but that this has changed as they got to know patients and their relatives and saw the ordinary lives they lead.
The two main characters are foreigners adjusting to a new country but David’s life shows the dark underside of the American dream of renewal. He stands at a juncture between two opposite paths: an orderly middle class existence in medicine with a wife and a “dream house”; and the hell of drug addiction, shame, poverty, disease and death. Is his choice of hell a rejection of a hollow, spiritually vacant, respectable middle class existence?
The author sees the doctor as a ‘minister of healing’: touch more important than gadgets. Storing medical records on computers, he says, doesn’t make up for the shortage of primary-care physicians (he reckons all trainee doctors should do a year of prima care in a poor area) and does nothing for the true care of the anxious patient. US Medicare pays doctors to do rather than listen. Verghese says that diagnosing is like looking for a white tennis ball which you can’t always see. One member said that he would love to have Abe as his doctor; he is so good at observation. However, another member said that ‘the constant medical detail was a bit bugging.’ Doctors believe that their role is top make people better, yet Abe seems to be dedicated to lost causes: AIDs and drug abuse.
What is the nature of David and Abe’s relationship? Is it that of mentor and mentee? Or is there some sexual attraction? Abe knew David’s schedule much as new lovers do. (Abe looks at men’s bodies in the showers but with the eye of a medic looking for signs of illness.) David’s other addiction is said to be women but Abe does wonder if he is a sexual compulsive and if the gender really matters so long as he gets his fix. Whatever the nature of the relationship it is obvious that Abe loved David. It’s a very moving love story about hope and disappointment. We are left wondering why Abe’s marriage broke up. Is it because many medics put one hundred percent into their job so have no time left to nurture relationships?
Is drug addiction a “disease” like diabetes or cancer, or is talking about it like this harmful because it absolves the addict of responsibility? And what do we make of the statement that “David is responsible for David”. The Samaritans think so and don’t intervene unless called to do so. But are we now our brother’s keeper in some way?
Is David’s suicide an act of despair, wanting to cease to feel, to exist, or is it a positive statement of belief in something better to come?
Drugs don’t surface until a third of the way through the book so we get to know the characters first, without prejudice. That the hospital gives David many second, third, etc. chances suggests that drug abuse is common among medics. After all, they have access to them. However, would it tolerated in today’s target-driven culture?
I was squeamish about some of the medical descriptions so I wouldn’t agree with the doctor who said that surgery was like sexual release. I do, however, know my own body enough, like one of the doctors, to shave by feel, not using a mirror.
There are some good expressions: ‘Man cannot live on spaghetti alone.’ The morgue has ‘a baffle of short corridors’
There is a lot of detail about tennis, e.g. leaning forward to serve. One of our members said that ‘some of the tennis stuff was a bit unbelievable.’ “Tennis was so much more than a game,” he writes at one point, yet he acknowledges at the end, it is also just a game — a simple, even slightly absurd ritual “of the yellow ball.” This ritual weaves together many of the threads of the story. Playing tennis together for the sheer joy of it, each finds release. Tennis becomes the route through which each can unburden himself to the other and find solace in a difficult time. Through it “we found a third arena outside of the defined boundaries of hospital and tennis court . . . at a time in both our lives when friendship was an important way to reclaim that which had been lost.” Otherwise, “The doctor’s world is one where our own feelings–particularly those of pain, and hurt–are not easily expressed, even though patients are encouraged to express them. We trust our colleagues, we show propriety and reciprocity, we have the scientific knowledge, we learn empathy, but we rarely expose our own emotions.”
There is also, however, a hint of escapism: they are frequently flying above their city and there are lyrical descriptions of the mountains below which, on terra firma restrict them.
One final question: is the author related to medical missionary Mary Verghese? Google hasn’t helped me on this one.
We will probably still remember this book in a year’s time.