Drs. Abraham Verghese, Siddhartha Mukherjee, Atul Gawande, Sanjay Gupta and Sandeep Jauhar are physicians who also write.

Siddhartha Mukherjee – Abraham Verghese – Atul Gawande – Sanjay Gupta – Sandeep Jauhar

“Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passports, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”

-          Susan Sontag.

This quotation begins Dr. Siddhartha Mukherjee’s Pulitzer Prize winning biography of cancer, ‘The Emperor of All Maladies.”

In this series we pay tribute to five physicians who preside over ‘the kingdom of the sick’ with not only their healing hands but their powerful words: Drs. Siddhartha Mukherjee, Atul Gawande, Abraham Verghese, Sanjay Gupta and Sandeep Jauhar.

The Series:

Siddhartha Mukherjee-Battling the Emperor
Sanjay Gupta, CNN”s Doctor to the World
Atul Gawande – A Checklist for Success
Abraham Verghese – The Healing Touchstone
Sandeep Jauhar – The Human Factor

Siddhartha Mukherjee

Siddhartha Mukherjee – Fighting Cancer

It’s a battle between one man and a many-headed monster.  In his Pulitzer Prize winning debut book, ‘The Emperor of All Maladies’, Dr. Siddhartha Mukherjee takes on a formidable foe – cancer.  In his words, it is “a lethal shape-shifting entity imbued with such penetrating metaphorical, medical, scientific, and political potency” that it continues to outwit the world.

As The New York Times wrote, “He frames it as a biography, ‘an attempt to enter the mind of this immortal illness, to understand its personality, to demystify its behavior.’ It is an epic story that he seems compelled to tell, the way a passionate young priest might attempt a biography of Satan.”

Mukherjee’s book, a decade in the making, delves deep into cancer’s past, reconstructing its psyche, probing into the many real life characters who have waged the war against this baffling disease for 4000 years, from the ancients to early heroes like chemo-therapist Sidney Farber and socialite Mary Laskey to his own patients. The book, which is 600 pages, originally started out at 1800 pages as he excavated cancer’s past, doggedly following all leads, and even turning detective.

He recalled recently how he traced a cancer survivor through Internet comments and Facebook, taking a bus and car to reach her doorstep in Maine. When she asked him ‘Why have you come?’ he says, “I couldn’t explain it to her. I said, ‘If you weren’t there, if I hadn’t found you, I wouldn’t be able to write this book. You see, you are my book.”

What Mukherjee had started as a journal for a year at the Dana-Farber Cancer Institute and Massachusetts General Hospital in Boston has turned into this massive odyssey of cancer. Mukherjee calls it “a larger exploratory journey that carried me into the depths not only of science and medicine, but of culture, history, literature, and politics, into cancer’s past and into its future.”

Such is the power of this inscrutable disease that both physician and patient are pulled into its spinning vortex. Writes Mukherjee, “Immersed in the day-to-day management of cancer, I could only see the lives and fates of my patients played out in color-saturated detail, like a television with the contrast turned too high. I could not pan back from the screen. I knew instinctively that these experiences were part of a much larger battle against cancer, but its contours lay far outside my reach.”

In attempting a biography of cancer, Mukherjee takes on its past to explain its present. “The isolation and rage of a thirty-six year old woman with Stage 111 breast cancer had ancient echoes in Tossa, the Persian queen who swaddled her cancer-affected breast in cloth to hide it, and then, in a fit of nihilistic and prescient fury, had a slave cut it off with a knife.”

Emperor of All Maladies by Dr. Siddhartha mukherjee

The Emperor of All Maladies:

Greek tragedy, suspense novel & Dickensian melodrama rolled into one

The book is about cancer but this is no dry text book. Listen to Mukherjee describe something as prosaic as the cancer genome: “The language of cancer is grammatical, methodical, and even – I hesitate to write – quite beautiful. Genes talk to genes and pathways to pathways in perfect pitch, producing a familiar yet foreign music that rolls faster and faster into a lethal rhythm. Underneath what might seem like overwhelming diversity is a deep genetic unity. Cancers that look vastly unlike each other superficially often have the same or similar pathways unhinged.”

This remarkable book which sometimes reads like Greek tragedy, suspense novel and Dickinsian melodrama all rolled into one, won the Pulitzer Prize for non-fiction, among a gaggle of other awards and honors. It was among the top ten books on Oprah magazine, The New York Times and Time magazine. In 2011, Mukherjee was among Time’s Top 100 Influential People.  This leading researcher and oncologist is suddenly the publishing world’s blue-eyed boy and in demand, not only by his patients but by book-lovers everywhere, armed with the hefty copies of the book to be autographed.

Siddhartha Mukherjee, 41, is also an assistant professor of medicine at Columbia University and a cancer physician at the CU/NYU Presbyterian Hospital. His educational pedigree is very pretty impressive – he’s a Rhodes Scholar who graduated from Stanford University, University of Oxford and Harvard Business School. He’s been a Fellow at the Dana Farber Cancer Institute and an attending physician at Massachusetts General Hospital and Harvard Business School.

Interestingly enough, there were no writers or physicians in Mukherjee’s family. He grew up in New Delhi where his father Sibeswar Mukherjee worked for Mitsubishi and his mother Chandana was a school teacher.  His parents still live in Delhi. “We spoke Bengali and English at home, our house was immersed in books,” he recalls. “I have a very intimate relationship with Bengali literature, particularly Tagore, and I would say my interest besides reading at that point of time in my life was music.  And so, my memory of my household is of one immersed in books and music.”

Mukherjee graduated from St. Columbus (actor Shah Rukh Khan was six years his senior). Did he write when he was young? He did but he says he never considered himself a writer. “It is not clear to me that I would treat myself as a writer even now. For me writing is a mechanism by which information really gets moved, transmitted.”

Siddhartha Mukherjee - (Photo credit: Deborah Feingold)

“The Book was a Conversation That Went On in My Head All the Time…” – Siddhartha Mukherjee

Mukherjee is married to Sarah Sze, a MacArthur Genius award-winning sculptor whose work is in major museums from MOMA to the Met. “I have a long-standing interest in the arts so I actually knew Sarah’s work before I knew her,” says Mukherjee. “We were introduced by a common friend who knew I admired her work, so that is how we initially met.  What can I tell you about her? Sarah is the brains and soul of our family and she practices a very innovative inventive kind of sculpture that really challenges our perception of what sculpture is, what art is.”

The couple has two daughters, Leela, 5, and Aria, who is 18 months old. As he mentions, the book was ‘a rival sibling’ and the girls often fell asleep to the mechanical lullaby of “my furious typing and then awoke the next morning to find me typing again.”
The book, like the powerful disease it pursues, took over Mukherjee’s life completely. “I was thinking about it constantly. I mean the book was like a conversation that went on in my head all the time.”

Now that the book is done, what’s a typical day like?

“My day is very unstructured and I like to leave it unstructured,” he says. “One day of the week I see patients, the rest of the week is very unstructured. I run a laboratory and I try to focus on that, but I try to keep it very unstructured so that I can move in a more flexible manner between doing laboratory research, between doing writing, and doing scientific writing.”

Is there another book in the works? Says Mukherjee, “I am working on one but it’s too early to talk about. When I write a book most of the time is spent thinking and only some of it is spent in writing it.  So when I would have a little bit more sense of it, I will let you know!”  And add one more item to an incredibly busy life: Mukherjee is collaborating with Standup to Cancer which is making a documentary based on ‘The Emperor of All Maladies.”

It is hard to imagine that Siddhartha Mukherjee has any time left over for leisure activities, and he cites his passion for reading and art, and says the conversations at home are often about science and art. “I find the boundary between what work is and what leisure is quite difficult to understand anyway,” he says.  One wonders what the possibilities are for Leela and Aria, growing up surrounded by an abundance of  arts and science.  Siddhartha Mukherjee smiles, “Well, they are going to teach us about something else, I think!”

© Lavina Melwani

(This article first appeared in Hi Blitz)

The Writer-Doctors Series:

Siddhartha Mukherjee-Battling the Emperor
Sanjay Gupta, CNN”s Doctor to the World
Atul Gawande – A Checklist for Success
Abraham Verghese – The Healing Touchstone
Sandeep Jauhar – The Human Factor

Sandeep Jauhar

Dr. Sandeep Jauhar – Becoming a Doctor, Remaining a Human Being…

Doctors are considered omniscient Gods but are actually very human, and no one conveys this truth better than Dr. Sandeep Jauhar. He is Director of the Heart Failure Program at Long Island Jewish Medical Center in New York, specializing in novel therapies for acutely decompensated heart failure. It is hard to believe that this accomplished cardiologist once was a conflicted intern and probably no physician has been able to capture that coming of age story more evocatively than Jauhar in his remarkable first book, ‘Intern: A Doctor’s Initiation.’

This unflinching and honest look at an intern’s life was well-received. Wrote Time Magazine, “In Jauhar’s wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, he takes readers to the heart of every young physician’s hardest test: to become a doctor yet remain a human being.”

Indeed, this self-awareness, honesty and empathy are what add to his qualities as a leader in his field. Jauhar became a physician in a roundabout way. The son of immigrants from New Delhi, he came to California by way of England and Wales. His father was a scientist, and Jauhar himself graduated Phi Beta Kappa from the University of California at Berkeley in 1989, and went on to earn a Ph.D. in experimental condensed-matter physics.

The death of a close friend made him think of moving into medicine. This had of course been the dream of his immigrant parents but he had rebelled against it, even though his brother Rajiv was already a successful cardiologist.

To Be A Writer – Or Not

Compounding the dilemmas of a career choice was his love of writing and he possibility of becoming a journalist. In school he had applied for and received a prestigious science journalism fellowship, leading to a summer internship at Time magazine in Washington DC. Later on, he had the gumption to call The New York Times and actually meet with the powers that be. In the long term this led to his writing for the Times.

“That was just another example of how important it is, sometimes when you’re young, not to know your own limitations, not to know what the etiquette is,” he says. “If I knew then what I know now about journalism, I never even would have thought of going to the top editor at the New York Times and asking him for a job. It was ridiculous but in the end it served me well.”

Intern: A Doctor's Initiation by Sandeep Jauhar

Jauhar finally opted for medicine at the relatively late age of 26, attending medical school at Washington University in St. Louis. He trained in internal medicine at the New York Hospital-Weill Cornell Medical Center in Manhattan, and completed cardiology fellowship training at New York University Medical Center, with specialized heart-failure training at Columbia Presbyterian Medical Center. Currently he is also Assistant Professor of Medicine at Albert Einstein College of Medicine.

An Intern’s Life

“I was an intern a decade ago now, but I still remember it the way soldiers remember war,” he writes in ‘The Intern.’  “After our son Mohan was born, my wife, Sonia, also a doctor, referred to the newborn period as a kind of internship, and it definitely wasn’t easy, staying up night after night. But taking care of a newborn was very different from internship.

In internship, when you were awakened in the middle of the night you had to be prepared to deal with almost anything – and in the worst possible state too. It didn’t matter if you felt like you were about to drop. You still had to be at the top of your game.”

This engrossing memoir is a must-read for anyone who’s ever doubted themselves and come out of the tunnel into the light, a competent professional. You can hardly put the book down as you follow the reluctant doctor-to-be as he passes through a trial of fire to emerge a full-fledged healer. You meet an amazing, colorful cast of characters and find that Jauhar is as skilled with words as he is wielding the scalpel. Always questioning medical practices, he wrote a piece for The New York Times as an intern, which caused quite a stir in the hospital.

Looking back on his internship years, he writes that medicine was more complex than he had imagined. “It was a glorious, quirky, inescapably human enterprise, with contentious debates, successes and failure, villains and heroes, oddities, mysteries, absurdities and profundities. It was a testament to the power of my profession that now I could not imagine a life without it.”

I had first interviewed him when the book had come out. Now three years later I asked him how life had changed for him since writing then.  He says: “I was already a full-fledged cardiologist when I wrote the book so my professional life hasn’t changed that much – I do what I do every day which is take care of patients and manage congestive heart failure.”

However the eyes with which he sees these experiences have changed. “Perhaps the day to day work is not as dramatic as when I was an intern, the learning curve is not so steep and the experiences are not as new as they once were,” says Jauhar. “So in that sense, the internship is a great time to start writing; everything is new and you are also going through a very physically and emotional tumultuous year. That sort of mixes everything up in your mind and gives you insights which a more humdrum, mundane schedule may not.”

The Making of a Doctor

Gone are the sleep-deprived frenetic days of an intern with 80 hour workweeks. What’s life like now, as the director of the entire program? Jauhar has a packed day seeing patients who are hospitalized for heart failure, meets with new consultations, teaches the fellows and interacts with residents. As part of the NorthShore-LIJ Health System, which is one of the largest in the nation, he’s also working on a progressive, case-based curriculum for the Hofstra NorthShore- LIJ School of Medicine at Hofstra University.

Writing remains a passion but one that has had to take a backseat to his active work and family life. He and his wife Sonia, an endocrinologist, have two kids, Mohan 6, and Pia, 2. Playing with the kids and interacting in their lives means the writing is done late at night. He still writes for The New York Times and other publications

Sandeep Jauhar with his son Mohan

The Writing Life…

So is there another book inside of him, waiting to come out?  “I think so. I’m starting to work on it – it’s still in the nascent stages,” says Jauhar. “One risks getting inured to the drama and the suffering that we see every day and the writing helps me to examine these issues in a fresh way so I don’t just accept it. It is hard to maintain that fresh perspective as you go on, in any field, as you accept the culture around you. That’s true in medicine as well.”

How does his writing evolve? “Writing is mostly editing – for me it involves putting a lot of thoughts down and seeing the threads. The way I’ve written the best is to allow my mind to be free and then let it go where it wants and see what comes out.  The thing which really makes me passionate about writing is the personal issues and the emotions which my day to day work stimulates in me.”

Jauhar says he’s always looked at the world of medicine through a personal prism and for him, the patient-physician relationship is a fascinating one, and one he thinks about a lot.

The Patient-Physician Relationship

Asked about what gives him the most joy and satisfaction, he tells the anecdote about a current patient, a man with a serious heart condition in the cardiac arrest unit. “He’s been my patient for a couple of years now, a salesman for Coca-Cola. I’ve known him for several years and provided him with good care and stuck by him.” Joking about Classic Coke versus New Coke, Jauhar mentioned to the patient and his wife that while growing up, his favorite drink was RC Cola, which is now no longer being produced.

The next day, the wife brought him two hoarded bottles of RC Cola – turned out it was her favorite drink too. “And she brought them for me,” marvels Jauhar. “It’s little things like that that really make you appreciate what you do every day – it’s this appreciation from patients whom you’ve done right by. This may sound sentimental but it is those moments, those really tangible human moments that keep you going despite the hassles of clinical medicine.”

Does he have a personal philosophy which keeps him going through good times and bad? Sandeep Jauhar seems still very much a man who mulls over and analyzes the world around him. He says, “I think it’s really one of trying to extract the most meaning out of every day and every experience. More and more I’m trying to learn just to be a witness to what’s going on and not get too wrapped up in the trivialities of the moment.”

He adds, “And with medicine, there’s a lot you can bemoan, there’s a lot of hassle, especially today, but then these tender moments really are the ones that last. So I think that’s what it is – trying to find the true meaning and the thing that lasts, which is eternal,   in the daily grind of what we do. It’s one of the reasons why I like to write – it is creating a sort of memorial of your life.”

© Lavina Melwani

(This article appeared in Hi Blitz)

The Series:

Siddhartha Mukherjee-Battling the Emperor
Sanjay Gupta, CNN”s Doctor to the World
Atul Gawande – A Checklist for Success
Abraham Verghese – The Healing Touchstone
Sandeep Jauhar – The Human Factor

Atul Gawande - photo by Fred Field

Dr. Atul Gawande:  On Improving healthcare…

Dr. Atul Gawande, in today’s lingo, is one cool dude. After all, which other noted surgeon listens to Bruce Springsteen as he performs surgery in the operation theater? As the lanky iconic writer-physician told a room full of fans at the New York Public Library, he’s in surgery twelve to fourteen hours and music helps him and his team get through the day.

“For me music is an important tool for doing that,” he said. “Number one, if I pick the music really well, then the nurses and the anesthesiologists that I want are likely to pick me for my room and I get known a little bit for my playlists, and get certain people I want coming in the door if I pick the music well. You do five cases in a day, it’s a long day. It definitely keeps me going. It’s great!”

Music is just one part of Gawande’s incredibly crowded rich life.  Look at his resume and be amazed.  He is a general and endocrine surgeon at Brigham and Women’s Hospital, and at the Dana Farber Cancer Institute. He is also Associate Professor of Surgery at Harvard Medical School and Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health

Wait there’s more – He has published research studies in areas ranging from surgical technique to US military care for the wounded to error and performance in medicine. He is also the Director of the World Health Organization’s Global Challenge for Safer Surgical Care.

And oh, yes, since 1998 he’s been staff writer for The New Yorker magazine. And the author of three critically acclaimed books. In 2006, he received the MacArthur Award for his research and writing. His book Complications: A Surgeon’s Notes On An Imperfect Science was a finalist for the National Book Award in 2002 and is published in more than a hundred countries. His book, Better: A Surgeon’s Notes On Performance was one of Amazon.com’s ten best books of 2007. His newest book, The Checklist Manifesto, is a New York Times bestseller. He also won the 2010 National Magazine Award for Public Interest writing for his New Yorker article, “The Cost Conundrum.”

So powerful is Dr. Atul Gawande’s writing that Charlie Munger, Warren Buffett’s partner, sent him a $20,000 check without ever having met him, after reading ‘The Cost Conundrum’ his piece about healthcare in The New Yorker.  Gawande, being Gawande, did not accept the check personally but donated it to Brigham and Women’s Hospital Center for Surgery and Public Health for an international project.

Gawande, who grew up in Ohio, is himself the son of two physicians: his father is an urologist and his mother a pediatrician. He is very much a renaissance man, with diverse interests ranging from music to literature.  He received his B.A.S. from Stanford University, M.A. – in politics, philosophy, and economics from Oxford University, M.D. from Harvard Medical School, and M.P.H. from the Harvard School of Public Health. He served as a senior health policy advisor in the Clinton presidential campaign and White House from 1992 to 1993.

In 2006 he received the MacArthur ‘Genius’ Award for his research and writing. He’s written not only for the New Yorker but other publications including the New York Times and Slate. His writings have appeared in the annual Best American Essays and in Best American Science collections.

“I have been trying for some time to understand the source of our greatest difficulties and stresses in medicine,” writes Gawande. “It is not money or government or the threat of malpractice lawsuits or insurance company hassles – although they all play their role. It is the complexity that science has dropped upon us and the enormous strains we are encountering in making good on its promise.”

The Checklist Manifesto by Dr. Atul Gawande

The Checklist Manifesto: How to Get Things Right

He fights this complexity with simplicity and offers a solution that is startling in its common sense value – the prosaic checklist. In his book, ‘The Checklist Manifesto- How to Get Things Right’, he shares insights on how not only physicians and medical personnel but just about everybody with a project on hand can benefit from implementing this simple tool.
Gawande himself has such a busy and complicated life that it would seem a checklist would be needed to accomplish everything he does! Add to this mix a busy family life in Newton, Massachusetts with his wife Kathleen Hobson and three kids– Walker, Hattie, and Hunter.

Perfecting outcomes has been a passion for Gawande and these are the issues he explored in ‘Complications’ and ‘Better: A surgeon’s notes on Performance’ which was a New York Times bestseller and one of Amazon.com’s ten best books of 2007.  As Time magazine described it, “Gawande is a writer with a scalpel pen and an X-ray eye. Diagnosis: riveting.”

In his latest book, he delves deep into the problem of failure even as we have ever more sophistication in training and high technology. As he points out, studies show that at least 30 percent of patients with stroke receive incomplete or inappropriate care from their doctors, as do 45 percent of patients with asthma and 60 percent of patients with pneumonia. Half of heart attack patients don’t get treated in time.

Other startling facts that he mentions: there’s been 36 percent increase between 2004 and 2007 in lawsuits against attorneys for legal mistakes. 2/3 of death penalties are overturned because of errors. And then there are the mistakes made when hurricanes or tornados hit, mistakes of ineptitude.

In an increasingly complex world, the smallest errors can bring about failure. “You see it in flawed software design, in foreign intelligence failures, in our tottering banks – in fact, in almost any endeavor requiring mastery of complexity and of large amounts of knowledge,” he writes.

Part of the solution lies in something so mundane that professionals tend to overlook it.  The simple checklist. Says Gawande: “They provide a kind of cognitive net. They catch mental flaws inherent in all of us – flaws of memory and attention and thoroughness. And because they do, they raise wide, unexpected possibilities.”

Atul Gawande at NYPL

The hero in the Age of  Checklists

Gawande, who is the director of the WHO’s Global Challenge for Safer Surgical Care, conducted a pilot study of a safe surgery checklist in many hospitals across the world, and found that complications in surgery fell by a third.  Over a dozen countries have implemented the checklist in 2000 hospitals, and in the US about 10 percent of hospitals have adopted the checklist.

For readers, it’s an engrossing journey, and in a chapter titled ‘The Hero in the Age of Checklists’ you see firsthand the steps behind the recent breathtaking crash-landing of US Airways Flight 1549 on the Hudson River. With Gawande as traveling companion, we visit unlikely places such as a flight simulator, the bustling kitchen of a Boston restaurant, and into the guts and innards of emergency rooms and operation theaters. We see the difference a checklist can make, as in Columbus Children’s Hospital where an aviation style checklist helped to ensure that 100 percent of the appendicitis patients got the right antibiotics at the right time.

Atul Gawande’s evocative language fully embroils you in the action, right to the operation room as he gets involved in a life and death surgery where the blood – and our adrenalin – flows profusely until the checklist saves the day. After reading the book, most people would want a checklist to be part of any medical procedure they undergo. And having a checklist for just about anything we undertake – simple or complex – seems a great idea.

Medicine has always been a challenging field, dealing with the unknown, with the possibility for errors and of course, the fact that one is dealing with so many variables. “Ours is a team sport, but with two key differences from the kinds with lighted scoreboards: the stakes are people’s lives and we have no coaches,” writes Gawande. “The latter is no minor matter. Doctors are expected to coach themselves.”

Gawande’s writings are almost a road map to how not only physicians but just about everybody can be more effective in their work. One of the potent suggestions he gives is simple: Write something. Be it a paper or a poem or even a blog post, just write. “What you write need not achieve perfection. It need only add some small observation about your world.”

He talks about the power of writing and how he started to write only after he became a doctor. As he says, “Because medicine is a retail enterprise, because doctors provide their services to one person after another, it can be a grind. You can lose your larger sense of purpose. But writing lets you step back and think through a problem. Even the angriest rant forces the writer to achieve a degree of thoughtfulness.” To which he adds something which will resonate with readers everywhere: “Most of all, by offering your reflections to an audience, even a small one, you make yourself part of a larger world.”

Indeed, with his reflections on everything from improving healthcare to perfecting all that we do to facing mortality and death, Atul Gawande gives us a blueprint for living…

© Lavina Melwani

(This article appeared in Hi Blitz)

The Writer-Healer Series:

Siddhartha Mukherjee-Battling the Emperor
Sanjay Gupta, CNN”s Doctor to the World
Atul Gawande – A Checklist for Success
Abraham Verghese – The Healing Touchstone
Sandeep Jauhar – The Human Factor

Dr. Abraham Verghese with medical students

Dr. Abraham Verghese on Strength & Vulnerability

“Novels are instruction for living,” says Dr. Abraham Verghese, and for him writing and medicine are not two different disciplines – they are intricately linked. It’s almost as if the writing makes him a better doctor, completes him. Author of two acclaimed non-fiction books, ‘In My Own Country’ and ‘The Tennis Partner’, Verghese is the author of the best-selling novel ‘Cutting for Stone.’ It was on the New York Times Best Seller List for 60 plus weeks and over a million copies have been sold.

“I started reading it on a Friday evening and never put down the book till both my shoulders started aching and only interrupted my reading to meet my essential needs,” comments one reader, Sophie, on a blog. “I traveled with Mary Joseph Praise, I lived in Hema’s household, I cried and laughed with them. My heart burned to meet a doctor like Ghosh. When I slept for a few hours on the nights of Friday and Saturday, I dreamed about them.” Another fan wrote: “In both memoir and novel you expose your wisdom, your strength, your vulnerability, your humanity. Bravo.”

What causes these deep connections between his readers and Abraham Verghese? A thoughtful empathy seems to populate the pages of his writing and somehow touch many lives. ‘Cutting for Stone’ took over ten years to complete. On a deeper level, the book is an exploration of medicine, ethics, the relationship of patient and physician and the dichotomies of the healing profession. It is, in fact, for Verghese, a distillation of all these dilemmas seen through the lens of his own experiences and imagination.

The Journey

Verghese, who was born in Addis Ababa, has seen enough conflict in real life to be able to put pen to paper and create powerful writing. As a youth, the military coup in Ethiopia meant leaving home for the unknown: “It meant that I didn’t belong even though I thought I did,” he recalls. “There was a huge moment of disconnection with the place that I did love. After that you’re attached to places, but it’s not home, it’s not where your mother and your mother’s mother and everyone come from. I feel that loss.”

Currently Verghese  is Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine and Senior Associate Chair of the Department of Internal Medicine in California.

The journey from the past to the present is a rocky one, one of finding himself and his true calling.

From Ethiopia he came to America, where he worked as an orderly in New Jersey before leaving for India to complete his medical studies at Madras Medical College. He then found himself back in America, a lost and lonely foreign medical graduate doing a residency in Johnson City, Tennessee.  After that he did his fellowship at Boston University School of Medicine and worked at Boston City Hospital for two years.

Cutting for Stone by Dr. Abraham Verghese

These were the days of the start of the horrific AIDS epidemic and as an assistant professor of medicine he saw first hand the tragedy of AIDS in rural communities and how it impacted so many lives. His hands-on work with dying patients and the relationships he formed affected him deeply. Writing became an emotional outlet and he also enrolled at the Iowa Writers Workshop at the University of Iowa, earning a Master of Fine Arts degree there.
Verghese next moved to El Paso, TX where he was professor of medicine and chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center. He lived here for eleven years and this was also where his writing became a serious commitment.

His debut book, ‘My Own Country: A Doctor’s Story’ was a powerful memoir about working with AIDS patients in rural Tennessee, and in the process, finding himself. It was a finalist for the National Book Critics Circle Award and selected by Time magazine as one of the five best books of the year, and was also made into a film by Mira Nair.

“The Tennis Partner,” his next book, was about the drug addiction and death of his friend, a young medical student. It became a New York Times notable book and a national bestseller. His articles have also appeared in many publications including Granta, The New York Times and The Atlantic.

For Verghese, writing and medicine are closely knit.  He says that in medical school you are taught to observe, pick up on details and bring it all into a diagnosis, and these are factors fundamental to the process of writing too.

“I often feel I write in order to understand what I’m thinking – when I start to write, then it starts to emerge, a sort of secondary, tertiary  understanding that I wouldn’t have had if I hadn’t tried to write it – so that’s the part of writing that I think is utterly mysterious and enjoyable,” he says.

Verghese was the founding director of the Center for Medical Humanities and Ethics at the University of Texas Health Sciences Center in San Antonio, a novel program for medical students, with an emphasis on beside medicine, clinical examinations and empathy toward patients and their families.

“The humanities are vital in helping students maintain empathy with their patients,” he says.  “Students come to medicine with a great capacity to imagine the suffering of others. In their clinical years, however, they are taught to take the patient’s unique story of illness and translate it into the depersonalized language of the chart. We want to keep alive their innate humanity, integrity and empathy.”

Abraham Verghese -  A Detective at the Bedside

In his current work at Stanford, Verghese finally gets a chance to merge his two callings – medicine and writing. He’s a professor with tenure which is something reserved for those with research grants and scientific breakthroughs under their belt. He says, “It’s just very humbling to see how over time the effect of my writing has been that it’s taken to be the equivalent of scientific research. I think it’s looked at as seriously a contribution as research – and that’s really gratifying to me.”

Dr. Abraham Verghese with a patient

He now has a room of his own to write and to explore the world of medicine not only through charts and X-rays but through the written word. He also works with medical students in internal medicine and relishes the opportunity to shape young minds at a time when health care seems to be in crisis.  As he says, “We have never had more ability to bring patients a cure or better their medical conditions, yet I think there has never been a time when patients have been more dissatisfied with medicine.”

The Human Touch

Indeed, one of the things which really irks Verghese is the disconnect between physician and patient as technology takes over and the human touch is lost.  “It’s a very strange paradox – science is at this brilliant phase where we are curing some cancers with a single pill,” he says. “The public, I think, feels quite the opposite, that medicine is getting further and further away from the patient, from one human being interacting with another. It’s more like you’re getting swallowed up by a system when you have an illness and being farmed out to all these tests and specialists.”

The case of the invisible patient, the I-patient who exists just on the physician’s computer monitor as so much data,  while the real live patient in the bed is ignored,  has become an important issue for Verghese, both in work and his writing.

“I think that there’s a very special transaction that takes place between physician and the patient during the course of a careful examination,” he says. “It’s during that exam when the physician touches you and pulls your eyelid down and looks into your eyes and thumps on your chest – that’s when a very ritualistic bond is formed and if you shortchange that by just sitting behind your desk and saying ‘Let’s send you for this test, let’s send you for that test,’ you have essentially shortchanged yourself from an important transaction.”

The Power of the Written Word

As a young voracious reader, it was the written word which had introduced him to the world of medicine, of idealistic doctors and the power to heal, and he is a believer in the power of literature to add another dimension to the doctor’s skills. “Students come to medicine with a great capacity to imagine the suffering of others. Through the humanities — literature, art, theater, and film — we can keep the students’ imagination of the suffering of others alive. Fiction is, as novelist Dorothy Allison said, ‘the great lie that tells us the truth about how the rest of the world lives.’”

Verghese gets a real pleasure from teaching his students about this disappearing world of real doctoring, where the patient is not a piece of virtual data on a computer screen nor a number on a  hospital bed but a real human being.

“In this era of technology, it’s almost like being a kind of artisan and preserving an older art form or something!” he says. “The students uniformly came to medicine imagining that it would be something like this, the sense of being a detective at the bedside. I think that they thrill to someone who can show this to them – they love it and it’s very relevant to them.”

© Lavina Melwani

(This article first appeared in Hi Blitz)

The Series:

Siddhartha Mukherjee-Battling the Emperor
Sanjay Gupta, CNN”s Doctor to the World
Atul Gawande – A Checklist for Success
Abraham Verghese – The Healing Touchstone
Sandeep Jauhar – The Human Factor

Tips for happiness in the new year that's dawning from Dr. Srikumar Rao, author of 'Happiness at Work'

Happiness at Work - and Play…

As the dawn of a New Year envelops us, there we go again – making those resolutions, wish lists which will help us be more accomplished, more focused, more successful in the New Year. A six figure job, a trophy spouse, an earth-shattering romance – we certainly think all these things will make us more happy – and isn’t happiness what we all seek and hunger for?

Yet listen to this: “There is nothing that you have to get, do, or be in order to be happy. I repeat, nothing. In fact, happiness is your innate nature. It is hardwired into your being, It is part of your DNA. It is always with you.”

This is reassuring to know in a world where one’s self worth or ‘happiness’ is tied to the job we have, the success that we are. These words of wisdom come not from some spiritual text or soothsayer but from Dr. Srikumar S. Rao, the very practical and philosophical professor who has made happiness an achievable goal…

Srikumar Rao:  Resilience, Motivation and Success

Dr. Srikumar S. Rao is the author of ‘Happiness at Work: Be Resilient, Motivated and Successful – No Matter What’ – a handy manual in our transformed work environment where it’s hard to be resilient, motivated or successful – or sometimes even find a job! Yet Rao knows what he is speaking of when he says ‘No matter what.’ He shows how in almost every situation, it’s possible to have a turnaround. You can read more about him here and also follow him on Twitter @srikumarsrao

Rao has taught ‘Creativity and Personal Mastery’, his motivational course to thousands of Fortune 500 workers, entrepreneurs, and students at Columbia Business School, Kellogg School of Business, Haas School of Business at the University of  California at Berkeley,  and London Business School. Not surprisingly employees from Google, Microsoft and IBM, Johnson and Johnson and other major corporations have attended these programs.

While the book is meant to be about the work life and professional sphere, Srikumar Rao’s suggestions, anecdotes and exercises can enhance life in every setting. The book offers scores of tips, exercises to help define the true meaning of success and to build new habits into our lives and put those suggestions into practice.

A great way to start a new year.

Srikumar Rao’s Blueprint for Happiness…

Here are four valuable tips to get you started on your journey into 2011, equipping you to overcome fear, face whatever lies ahead and be successful – on your terms. ‘Happiness at Work’ ,  of course,  has many more astute game-plans  and powerful lessons  in its 35 chapters.

1.Don’t carry excess baggage from the past.

A new year is beginning but many of us tend to carry past angst, unfinished business, old enmities with us and all these weigh us down. Writes Rao: “Are there troublesome people in your life? The next time you meet one, forget the history. Don’t expect the interaction will be unpleasant. Expect that it will be delightful, and if isn’t, then let it go. Don’t carry it over to the next time you meet.

Do the same with unpleasant situations. Note how many times your existing expectations sour your experience. Consciously drop the past. It’s hard, but with practice, you will get the hang of it.”

2.Manage yourself – and managing time will take care of itself.

Life is a constant struggle with work deadlines, procrastination and a churning whirlpool of things to be done and people to meet but as Rao points out, all of us get the same hours in a day and it’s all about managing ourselves, rather than the fleeting hours.

“Observe yourself as you go through the day. How often do you start a task only to set it aside as something else grabs your attention – e-mail, Twitter notifications, Facebook requests, instant messages, colleagues dropping in?

Try turning off your cell phone and shutting down the communication functions on your PC unless you absolutely need to be connected. Many of the distractions that sap your energy just disappear. This will drive home that you don’t really have a problem managing time. You do have a huge problem managing yourself.”

Dr. Srikumar S. Rao is the author of 'Happiness at Work'. (Photo: Paresh Gandhi)

3. Don’t Multi-task – embrace mindfulness.

Multi-tasking is the mantra by which most of us live our harried lives and we take pride in the fact that we can do many things simultaneously. But do we end up doing any of them well?  We over-schedule ourselves and struggle with information overload and living simultaneously in the time zones of past, present and the future.

Rao suggests getting rid of the mental clutter.

“You’re weighted down with your memories, your desires and hopes, your fears and aversions. You lack the ability to lie in the present as you flit between the near and distant pasts and your visions of tomorrow and the day after.”

The remedy is to shut out the noise and roar of the crowd and to concentrate on the job at hand. Rao suggests turning off the phone, the email and other distractions and taking some deep abdominal breaths.

“Note the time and commence your task with complete attention. Don’t allow any distraction to take away from your focus. Remember that ‘hurry’ is in your mind. Work unhurriedly, but as fast as you are able. Imagine yourself as a container of golden energy and pour yourself into the task.”  Sure, unbidden thoughts will still jump into your mind but Rao says to observe them calmly and let them go. This mindfulness can be practiced for increasingly longer and longer times until it becomes a habit.

4.Instead of a Me-Centric Universe, Embrace the World

Instead of insisting that the world revolve around you, try being part of the larger universe, of helping others on the planet, genuinely caring for others. Says Rao, “When you honestly, sincerely, completely and mindfully have the intention of being of service to your fellow human beings, something magical happens in the way you experience the world. There’s really no way to describe this – you just have to discover it for yourself.”

‘Happiness at Work’ is full of thought-provoking suggestions and exercises based on wisdom and principles gleaned from ancient text and the contemporary world, and fine-tuned in Srikumar Rao’s course, ‘Creativity and Personal Mastery’. ( He is teaching this course in January at Columbia) ‘Happiness at Work’  shows you how to create your own definitions of success and happiness.

An email message that I exchanged with Dr. Srikumar Rao had this quote by Howard Thurman: “Don’t ask yourself what the world needs, ask yourself what makes you come alive. And then go and do that. Because what the world needs is people who are alive.”

Well, 2011 is the first year of the rest of your life and it can be anything you want it to be!

Tips for happiness in the new year that's dawning from Dr. Srikumar Rao, author of 'Happiness at Work'

Sheena Iyengar’s Art of Choosing

When Sheena Iyengar went to Spain, people sometimes came up and asked her for a lottery ticket. “Because that is what blind people do in Spain,” she explains. “They sell lottery tickets. And when I was in Japan, random people would come up to me and take my hands and start putting them on their backs or on their necks because they expect blind people to perform magical massages.”

These people would have been stunned to learn that though Iyengar is blind, she is a noted researcher, a professor at Columbia and the author of a critically acclaimed book ‘The Art of Choosing’, in which she dissects and analyzes choice – the ability one has to take on destiny – or even competing brands of cola.

In life, how much can you choose and how much is pre-destined? Can you fight circumstances or is your role pre-ordained? When faced with cultural mores or society’s expectations, do you acquiesce or should you chart out your own course? And if you have the power of choice, how do you choose wisely? In a world which is almost scary in its range of choices, how do you make the smart choice?

These are eternal questions we’ve all grappled with, and in her thought-provoking new book, she writes, “Choice, ranging from the trivial to the life-altering, in both its presence and its absence, is an inextricable part of our life stories.”

Sheena Iyengar, who is the S.T. Lee Professor of Business at Columbia University and a leading expert on choice, has topnotch credentials. A graduate of the Wharton School of Business and a recipient of the Presidential Early Career Award, she has a doctorate in psychology from Stanford, and her groundbreaking work has been funded by major institutions and cited in the media.

Sheena Iyengar

Sheena Iyengar’s Story

Since childhood, she started losing her eyesight and by the age of 18 was completely blind. How this child of Sikh immigrant parents overcame the restrictions of cultural conditioning and roles to rewrite the script of her own life is what makes this book particularly intriguing. Her own story is woven into her meticulous research and draws you into engrossing studies conducted amongst ordinary people, from preschoolers to shoppers in supermarkets. As she writes, “Choice, ranging from the trivial to the life-altering, in both its presence and its absence, is an inextricable part of our life stories.”

In ‘The Art of Choosing’ Iyengar documents many different studies and takes us into many different worlds to show the power of choice.  How much control we have is determined by how much control we perceive we have: “Whether the bars are real or metaphorical, when one has no control, it is as if nothing exists beyond the pain of this loss.”

She goes on to say that “Unlike captive animals, people’s perceptions of control or helplessness aren’t entirely dictated by outside forces. We have the ability to create choice by altering our interpretations of the world.”

So much is in the mind and she writes, “One could even argue that we have a duty to create and pass on stories about choice because once a person knows such stories they can’t be taken away from him. He may lose his possessions, his home, his loved ones, but if he holds on to a story about choice, he retains his ability to practice choice.”

Face to Face with Sheena Iyengar

Q: In life, how much do you think is choice and how much destiny?

Sheena Iyengar: It’s a great question, right, because you could take any event in your life, you know when you were born or what happened in your life, you know what career you picked or whom you married and you could tell that story in terms of destiny or chance  - or you could tell that story in terms of choice.  And any one of those would be just as accurate as the other.

I think what happens is, depending on how you tell the story of your life,  it shapes what you do next, so you know fate and chance free you from having to contemplate whether you should revise or exit out of whatever it is you are doing.  You don’t think about that because that is obviously not a choice, and it forces you to contemplate how to adjust or make compromises based on whatever it is that life has dealt you, so to speak.

By contrast, if you think of the story of your life in terms of choice it is at once the most powerful tool we have in life, because it is the only thing we have that enables us to go from who we are today to whom we want to be tomorrow; but at the same time it is a burden, because we are constantly thinking about should I exit or should I continue? And I suppose that therein lies choice – its power and its mystery.

Q:  I guess it is kind of a scary decision to make and if someone else makes the decision for you, you don’t have to row anymore, for the boat is taking you where you were destined to go. With choice at least you feel that you had a hand in your own destiny. So how much can you really control things?

Sheena Iyengar: I guess there are two questions to that.  One is, is there anything gained from thinking of your life in terms of choice and then the second question is can you actually control your life?

There is certainly a lot that is gained by thinking of your life in terms of choice. When people believe they have control over their life they can often make the difference between life and death, like people who are very ill; even if it is an illusion  - if they believe that somehow they have control over cancer or control over whatever deadly disease they have – it may not actually extend their life, but it might and it certainly makes whatever life they have left at times happier.

So they do experience positive moods as they believe that they have control over it.  It is true that as long as we believe we have control,  we are more empowered, it can make a difference in terms of how long we live and whether we live

On the other hand, do we have control over our life?  Well, we certainly do not have control over everything. We are constantly being manipulated, constantly being influenced. So much of our life is determined by the circumstance, by the other people around us.  We are essentially socially trained to follow a certain path in life. And so to think that we can operate as completely independent agents in life is a bit optimistic, but to think that we need to be victims of circumstance is perhaps a bit too pessimistic.

You need to be choosy about what you choose, because these days you can choose everything from your eye color, to your career, to your spouse, to how many spouses, to what products you are going to attach to yourself and everything nowadays becomes an identity,  and even what soda you drink has become part of people’s identity.

So if I keep track of the things that are really important to me, it is probably not going to be more than five.  For those few I can exercise some amount of free will.  Not that I can change the world, not that I can completely change myself at times, but by becoming aware of what I want and what I don’t want, I can veto things, and that can often be the most powerful way in which we can exercise free will.

One Amazing Thing by Chitra Banerjee Divakaruni

Chitra Divakaruni’s  One Amazing Tale about Strangers Together

A gossamer web of stories ensnares the reader in ‘One Amazing Thing,’ Chitra Banerjee Divakaruni’s new novel, taking you into distant lands, hidden places in the heart and into the hidden strengths people have.

Nine very different people drawn by chance or luck or destiny into the same spot just as disaster strikes. These are people you would hardly give a second look to, everyday people going  about everyday chores. They are all gathered for obtaining visas to India in the basement of the Indian consulate in an unnamed American city when a powerful earthquake strikes.

As the building collapses around them, they are marooned together, unable to escape, stuck without food and light, with the water rising around them. They are strangers in a strange world, and are slowly losing their cool and civility as the situation worsens.

In order to help them keep their sanity, one of them, Uma, suggests they tell each other one amazing thing in their lives which they haven’t shared with anyone ever. Slowly the stories come out and you realize that each life is unique, with its own turmoil and triumphs.

Divakaruni’s inspiration for the book came from the firsthand experiences she had volunteering with victims of Hurricane Katrina who had sought refuge in Houston, and then came Hurricane Rita and she found herself a victim, caught in the frenzy and the fear. It intrigued her to find different people reacted very differently to disaster, and that’s what formed the kernel of ‘One Amazing Thing.’

Chitra Banerjee Divakaruni (Photo: Neela Banerjee)

Chitra Divakaruni: Immigrant Journeys

In an earlier interview I had asked Divakaruni if she felt that the immigrant journey has become commonplace today and she had responded:  “No journey is commonplace. Each person’s journey is unique and changes that person in a special way. I hope I am able to show that through my different characters.”

In this ambitious novel, she takes on a more diverse group of people, from different nationalities and walks of life. As their stories unfold, you get involved in the past of the victims in the water-clogged basement, and you see how the power of shared tales can bring disparate people together, making them into a community. The language is often lyrical, showing her roots in poetry, which I remember well from her early ‘Leaving Yuba City.’

I got a chance to explore the various themes which run through her books – women’s issues, immigration and the journeys of people – in a one-on-one interview with her for SAJA, the South Asian Journalists Association, in a live webcast on Blogtalk Radio, introduced by Sree Sreenivasan, co-founder of SAJA and professor at Columbia University.  Divakaruni, who has her finger on the pulse of the ever burgeoning South Asian Diaspora, was always articulate, upbeat and humorous in this hour-long interview. You can hear it here.

Chitra Divakaruni with Lavina Melwani on Blog Talk Radio

Related Post – I had done a comprehensive interview with Chitra Divakaruni earlier which ran in Hi! magazine. You can read it here.

Trimukhi Ganpati from 'Eternal Ganesha'. Courtesy Vendome Press and Dinodia

When the writer Gita Mehta was growing up in Orissa, a small ancient image of Ganesha was unearthed in a mound of dirt as the foundations of their family home were being laid. “ As nothing else was excavated, as no other idols appeared to suggest that a long forgotten temple lay crumbling under the ground, the little stone figure was deemed to be a sign of divine blessing,” she recalls. “ Everyone agreed the house would be lucky since the Lord of Beginnings had chosen to hide in the earth until the house was ready to be built.”

This is the story that Mehta recounts in her book, “Eternal Ganesha’ (Vendome Press) which is a virtual celebration of this wonderful, delightful God who is universally loved as a harbinger of good luck and the remover of obstacles, and for his benign interaction with the affairs of humans.

This sumptuous oversized book is laden with 125 color images of the elephant headed deity who appears just about everywhere from the walls of ancient temples to contemporary art work to posters plastered in the bazaars. He is the most popular god of the Hindu pantheon and everyone feels intimately connected to Him.

“I’ve always kept the Ganesha which came out of my parents’ home,” confided Mehta when I interviewed her once in New York. “That is the one image that goes with me wherever I go. He came out of the Indian soil so to me he’s like an umbilical cord that connects me to India. So it doesn’t matter where I live – he is my India.”

Indeed, when Mehta was asked to write this book, she felt it was an auspicious sign because she had just had a new grand-daughter, and isn’t Ganesha the Lord of New Beginnings? Mehta, who is the author of several books including ‘Karma Cola’ and ‘Snakes and Ladders’, brings the many myths and attributes of Ganesha alive in this book.

Fun loving and jovial, Ganesha is very accessible and is believed to be the Pitcher of Prosperity, the Granter of Boons and the Guarantor of Success. He is the Lord of Wisdom, a scribe who broke off his own tusk to use as a pen when transcribing the epic tale of Mahabharata for the sage Vyasa.

With his elephant head, his potbelly, his weakness for sweets and his preferred vehicle of a mouse, he is quite irresistible. He is a god who has crisscrossed faiths in India to become the icon of protection, of good luck and prosperity.

In India, Ganesha has super celebrity status and his image is everywhere. Any new task – be it the signing of a business deal, the making of a movie or the buying of a house – will begin only after Ganesha is invoked.

Mehta writes that his trunk is symbolic of the plough, his belly of a bursting granary and farmers have worshipped him as the Lord of Farming and as the Lord of Water; his festival is celebrated in the season of rains in the hope of bountiful harvests. He is the one who safeguards homes, and rare is a Hindu home without an image of Ganesha.

“ Unsurprisingly the lord of Prosperity also attracts the deep devotion of the business community,” she writes. “ Yesterday’s traders may have become today’s venture capitalists but neither would dream of engaging in financial speculation without the protection of their favorite deity, the Guarantor of Success.”

As she points out, Ganesha is also the special god of India’s vast student population: “Many students believe if they slice a closed text book with a Ganesha medallion the book will fall open at the very topic on which they will be examined, and before entering an examination hall cautious students might recite the Ganesha prayer.” .

But he’s much more than just a good luck emblem: She says: “He is regarded as the Origin of the Universe, the Lord of Connection, of Cause and Effect, the Moment of Creation. He’s really a metaphor for a philosophical quest, an eternal search.”

In the most humble hut a Ganesha idol might consist of a simple triangle made of mud with a streak of vermilion on its apex. Ganeshas have been fashioned out of ust about anything from green bananas, peanuts, marigolds, and in some cases matchsticks or discarded rubber tires. This jovial god is very much a people’s god.

Ganesha images are now exported to all parts of the world to meet the needs of the Indian Diaspora. And at home, the images often have a contemporary touch: during cricket fever, Ganesha is shown with a cricket bat in his hand and the Olympics finds him in a tracksuit! Yes, he’s worn everything from a Gandhi cap to a Windsor knot under his elephant trunk.

Ganesh Chathurti - Eternal Ganesha. Photo: Vendome Press& Dinodia Photo Library

In the book, there are chapters about the myths and the meanings and marvelous images of the Ganesh Chathurthi festival. How does one reconcile the elephant head with the human body? Writes Mehta, “The comically corpulent body indicates the physical appearance is an illusion which must be overcome to reach truth. It is also symbolic of a divinity vast enough to contain the entire universe and all the contradictions that exist within it.”

Indeed, one finds Ganesha with three heads, six heads, and even six arms, eight arms, sometimes 32 arms, and Mehta explains the many contradictions of Ganesha, who has the head of an elephant, the body of a man, bound by a snake, and rides on a mouse.

“These contradictory animals – elephant and mouse, serpent and man – are contained within a single image, pointing to the supreme goal of Hindu metaphysics, finding an overarching unity in which all apparent contradictions can be contained. They also point to a moral imperative – that opposites can and must live in peaceful coexistence.”

She adds, “It is the union of the small with the great, the microcosm with the macrocosm. Illustrating the intimate connection between all life forms, as a meditational diagram Ganesha incarnates Hindu philosophy’s fundamental law, the unity in diversity that it is humanity’s primary duty to maintain.”

Turning the pages of the book, you feel it is a celebration of pure faith, love and devotion. Says Mehta: “What I love about Ganesha is that he symbolizes the greatness of Sanatana Dharma. The best thing that happens to you is that he forces you to explore yourself, the greatness within you.”

© Lavina Melwani

Suketu Mehta, author, Maximum City: Bombay Lost & Found. Photo: Lavina Melwani

Suketu Mehta’s Maximum City

It all started with the balcony.

Yes, all the high drama, the tall tales of tall cities like Bombay and New York started on a narrow balcony on a narrow street in Bada Bazaar in an old and densely packed part of Calcutta. The son of a Gujarati diamond merchant, Suketu Mehta lived in this very old house on Burtolla Street with his entire extended family till the age of six.

“The first floor was my grandfather’s gaddi – an old style office where the men would sit on these beds with takkias and conduct business,” recalls Mehta. “All kinds of traders would come in, my grandfather dealt with GIs during the war, travelers and ambassadors.

There was a balcony which overlooked the street and on the street all day long there was a constant procession of all the wonders of the world – the rickshaw-wallas and poor people and rich people and people with animals and sword-swallowers and fire-breathers.”

In the hurly burly of the street there was even a temple with clanging bells and religious ceremonies going on all day long. Nearby was the milk seller who would miraculously get hot milk flying from vessel to glass endlessly. People were constantly selling things, coming and going. Says Mehta, “It was a real feast for the eyes – I’d just stand on the balcony and look all day long.”

This balcony was Suketu Mehta’s kaleidoscope into the larger world and it has not only made him a very visual writer, but it also made him love crowds. These are the rare talents which helped him pull off that maximum feat – telling the many layered story of that many layered city – Bombay. Like a wandering bard, he went into the high towers and deep recesses of this complex city to get Bombay’s x-ray, warts and all.

‘Maximum City: Bombay Lost and Found’, his powerful debut book, went on to get glowing reviews internationally, won the Kiriyama Prize, was nominated for the Samuel Johnson Book prize for non-fiction, the Lettre Ulysses Prize, the Guardian First Book Award, and was a Pulitzer Prize finalist.

Mehta, who is also a fiction writer, has won the Whiting Writers Award, the O. Henry Prize, and a New York Foundation for the Arts Fellowship for his fiction. Just recently he received the prestigious 2007 Guggenheim fellowship to pursue his new venture, a book on New York.

Suketu Mehta’s Other Big City by the Sea

And so now Suketu Mehta is tackling that other Big City by the Sea – New York. After all, it is his other home, having lived there for three decades. He had moved there with his parents at the age of 14, and so knows many of the byways of the city like the back of his hand.

‘Maximum City’ took 7 years of research and writing. Will New York be a similar gargantuan effort? “God, I hope not!” groans Mehta in mock horror. “I was asked once if I’d write a book about New York, and I said, ‘Only if I’m very drunk!’ You can’t write a small book about a big city.”

The challenge with New York is that it has already been written about by some of the greatest writers but Mehta hopes to shine the light on new immigrant communities which have yet to be depicted in contemporary non-fiction. He says this will be a bigger challenge because he will be writing about the Congolese and Mexicans and Russians and Bangladeshis and the myriad other communities that make up frenetic New York.

“I’m much more of an outsider so it’s harder to get access. But it’s the city that I’ve lived in for 30 years on and off and why should Indian writers write only about India? So I decided that I may fail spectacularly but I’m going to try it. I’m going to try to do for New York what I did for Bombay – write a book about the city and my place in it.”

And so these days you find Suketu Mehta shadowing the city, finding stories in its crevices and corners. He says, “When we walk about these cities as individuals these cities can make us feel crushed. If you look at the buildings all around us, we live like insects in insect colonies. So we’re fungible, it’s very easy to lose our sense of individuality. So I’m interested in these individual lives, in going deep into their characters.”

Mehta is currently an associate professor of journalism at New York University, his alma mater. Growing up in the outer borough of Queens, he was never allowed to live on campus by his strict parents and so now he is getting to fulfill a boyhood dream – living in Greenwich Village.

Fortunately his teaching and his writing research gel because he’s teaching literary reportage and a journalism course about New York. With the skyscrapers and concrete canyons of Manhattan as his open campus, he is data-collector, fact-finder, story-gatherer, architect of tales.

“Architects write about buildings,” he says. “I write about the people in the buildings. I’m constantly thinking about the city – it’s all New York all the time, complete immersion journalism.”

Mehta, who is divorced, often takes his two young sons with him on his expeditions into the outer boroughs of the city. He says, “I think I’m doing this book most of all for my children. Both of them were born in New York and I want to give them a book about their city – it’s their father’s understanding of the city where they were born.”

Suketu Mehta: Diamonds on the Shag Carpet …

Many years ago, Suketu Mehta’s father had tried to make a diamond merchant out of his writer son. He laughs ruefully: “I was a disaster. Once, I remember, my father brought home these diamonds and I spilt them on this shag carpet and I had to spend the next few days unraveling the carpet, picking the diamonds out of the yarn! I was not a natural fit for the diamond industry.”

And yet, years later he put his experience in the diamond market to good use. He has written the script for a soon to be released short film by Mira Nair, called ‘Kosher Vegetarian’ in which Irrfan Khan plays a Jain diamond merchant to Natalie Portman’s Hassidic broker, a brief romantic encounter set in New York’s diamond district.

Even now, Mehta wanders the city looking for diamonds in the rough, uncut histories of ordinary immigrants which can be burnished and shone to tell the larger story of New York. And when it comes time to write his opus, he will move back to Bombay to get perspective and distance, just as he moved to New York to write about Bombay.

“New York and Bombay are cities of my heart,” he says. “I give myself freedom to get mad at them. They will give you a chance but no more than that. They can beat you down but they can also lift you up.”

(C)  Photo and text: Lavina Melwani