Abraham Verghese Photo (c) Joanne Chan

When I called Abraham Verghese for our phone interview to preview his upcoming appearance at Lamorinda's Three Communities, One Book Program on October 26th, I was expecting to wait.
He's a doctor, after all, and in my experience, that meant 30-60 minutes thumbing through Psychology Today, or Oprah's O Magazine (guilty pleasure,) before hearing his caramel-toned voice.
Instead, he was ready, willing, and most poetically able to answer questions about health care, medical training, being a physician and writing.
Although Verghese will appear at Lafayette's Veterans Memorial building to speak about his third book, Cutting for Stone, he was first, a doctor. An outspoken advocate on matters related to "bedside care," he continues to chair in the Department of Internal Medicine at Stanford University.
We began speaking about universal health care coverage.
"It's an industry that's huge. What people must understand is that every dollar spent on health care is a dollar of income for someone. It's going to be slow and painful to change the system. But we are a country with 40 million uninsured: we have to address it."
In addition to universal coverage, Verghese says there must be payment reform. "Right now, you get paid for services done to a patient, but not for what you do for a patient. We have bizarre structures, like free-standing flu and MRI centers. Have you ever seen a free-standing geriatric center? No, you haven't, because it's not profitable."
Verghese has treated AIDS patients extensively. He says the issue having dropped from front page headlines is "a phenomenon of the wonderful treatments that have developed. We're in a completely different place than 1994, but we're still a long way from a cure-and from dealing with AIDS in developing countries."
He refers to practicing medicine as a "spiritual calling," and explains: "You're not transacting business. You're meeting people at their most vulnerable moments. There should be an awe and appreciation at being permitted such access."
"Medical students don't need to be taught compassion," he continues. "They come to the profession with all the right qualities. We shift the focus from the person to the disease in medical training. We need to guard against that."
Verghese says the biggest challenges to medical students are the amount of information they have to digest, the length of schooling required, and the considerable debt graduates carry. The greatest difficulty for practicing physicians is that procedures are tied to profits. "An internist, such as I am, has to see 25 people a day, just to keep up with the overhead."
A man of science might turn to a less-cerebral challenge for stress relief, but Verghese fills his limited "spare time" writing. We talk about his process.
"Research is terribly important, because so often, I've stumbled upon things, not where I intended, but so useful for the book. It's often a great excuse not to write, so there is a time to stop, and get to the writing."
"My full-time job precludes a schedule. I write haphazardly and take what time I can get. I compose on the screen, but edit on the page. Since attending the Iowa Writer's Workshop, and benefitting from it, I care only about my editor's and my readers' feedback. You have to trust your editors and be willing to take what they say and not be crushed by it."
Matters of faith, death and dying emerge in Cutting for Stone. I wonder if Verghese is conscious of these themes prior to writing, or if they appear as a surprise. "You develop a story and push it out. I'm certainly impressed by people who are faithful to a calling, to their families. But I was not conscious of it as I wrote this."
About death, he says, "In the West, it is a bit of a surprise because we haven't developed enough rituals around it. I feel privileged to have taken care of people who were dying, to be entrusted."
Verghese says his interest in stories is natural. "It's surely a part of being a person: to be curious about the human experience. I have a fascination with fiction because it resonates with one's own story."
If he were restricted to only one book for the rest of his days, Verghese would immediately choose Love in the Time of Cholera, by Gabriel Garcia MÜrquez. "It's a gorgeous story and, more than that, every sentence and paragraph is musical."
I've just spent 45 minutes with a remarkable writer, teacher and physician. And it didn't cost me a cent. Universal health care does work, if you know where to get it.

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