Today's rebroadcast of Diane Rhem's interview of Dr. Verghese brought up ghosts from the past. By all accounts, Abraham Verghese is a success, the kind of success that many people might call a fulfillment of the American Dream. Senior Associate Chair for the Theory and Practice of Medicine at Stanford, he had also earned an MFA from the University of Iowa where he attended the Iowa Writers Workshop. Both aspects of Verghese, physician and writer, resonate with me but it is the idea and the ideal of being a physician that I am going to address today.
One does not speak of "working as a physician." To be a physician is identity. Contemporary society is separating the role and functions from the man (or woman) but among my generation a physician was who one was. It's like the ordination of priests. The man is changed forever. He becomes a priest in the eternal line of Melchizedek. As the author of the Letter to Hebrews (7:1-10) has it: "Without father or mother, without genealogy, without beginning of days or end of life, like the Son of God he remains a priest forever." During my youthful formation, two professions conferred upon the individual a change in their very nature. A priest became not just any man; he was a priest who had powers to lose or bind things in heaven as well as on earth. Likewise the physician. No other professions were like them. Both were a calling. Something deep inside the man called him to a life that was going to be defined by what he professed.
Now a man past the age of sixty I look at my past more and more as simply "the past." I unravel the elements of my experience from myself, from who I was and who I am becoming still. I see that life more as an expression of laws of circumstance and conditionality, much affected as we are still by such pivotal insights like Freud's idea of psychic conditioning. Man's life is the result of the past, and for me, the result of more than his own past in the conventional way we understand personal past. Past events release energy that continues to reverberate in the present. Energy, like Melchizedek, resides in timeless space and that space the space between the right and left ear of a man, in consciousness, in his thoughts, feelings, memories, in everything intangible but experienced nonetheless. This primal energy is not perceived through his other five senses which are physical but endure as ideas, or, as Plato called them, Forms. Energy is in matter for matter to exist and change with time but it participates in the "life" of that material "thing" without itself changing. Change is a product of its existence but is not what or who it is. It is in the fullness of created things as well as the emptiness of space but is neither things nor space. It possesses nothing and nothing possesses it. Unidentifiable by name, it still is the basis for everything that can be named. It is not even being itself unless by being we mean ongoing action which once over is gone without a trace, like lightning or the reassuring rainbow after the storm.
I came into medicine by a story I used to tell myself and tell others who happen to ask me. As a child I was drawn to the sacerdotal role of the priests in my family's Aglipayan church. Back then, for me the priest stood as conduit between the practical realities we dealt with in life like death, illness, worries, losses, gains, etc and the inchoate reality of the intangible, what our beliefs and thinking process conjure into influential existence. I wanted to be a man of such power but, according to my story, I knew I couldn't. I was certain my father who forbid it. I don't have any actual memory of my father doing or saying anything to support this idea. He did not attend mass when my mother gathered us three kids to attend church at the town square every Sunday but I have no recollection of any statements my dad made about the church, God or membership in the church. His not going with us spoke more loudly. So I decided to become a doctor—meaning back then, doctor of medicine, a physician.
What I needed to do then perhaps was to support the young fellow and tell him he was okay just as he was. Instead he needed to grow behind the aegis of an identity that sad to say while benefiting both the physician and the patient he or she is treating devolves into impersonality. A man studying medicine begins to dissociate from himself, from the first day he steps into the anatomy lab to cut away at a gray-and-brown mass of what was once a person. The student’s focus is on learning to identify the component parts of the cadaver and pretty soon he learns to treat sick people as objects of both study and treatment. How can he otherwise deal with the sublime dramas that reduce other people into helplessness? Dramas of loss and death? The physician works to save life and to focus on saving it he pays no attention to anything else, neither to the age of the person he is treating, its sex, color, social position nor anything else that to that person and his loved ones matter.
Years later I could finally come out behind the persona and little by little gained confidence in being just myself, this once-upon-a-time lost little person who’s still lost but at least no longer needs to hide it.
Verghese wrote three successful nonfiction books before embarking on writing a novel, Cutting for Stone. From what I read about it, many of the details, probably most if not all the emotions, come from his own fascinating history. Of course. We write about what we know and we know our lives best of anything else unless we are so introverted to see beyond the tips of our noses or extroverted to notice anything stirring between our ears. What we know is our story, and the most engaging story is our own made to fly even loftier through the art of fiction and makebelieve.
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