Zibby is joined by doctor and New York Times bestselling author Abraham Verghese to discuss The Covenant of Water, a dazzling and unforgettable story of love, faith, and medicine that follows three generations of a family navigating a deadly curse in South India. Abraham reveals the inspiration behind this story and discusses the elements that stand out: loss, family, and arranged marriage. He also talks about his career in medicine and explains how it led him to write (it involves a scientific study on HIV, grief, and a spontaneous MFA). Then, he and Zibby discuss the beauty and power of fiction – it lets us escape, grows our empathy, and ultimately reveals fundamental truths and insights about our own lives. The Covenant of Water was just chosen as Oprah’s 101st book club pick!

Transcript:

Zibby Owens: Welcome, Abraham. Thank you so much for coming on “Moms Don’t Have Time to Read Books” to discuss The Covenant of Water.

Abraham Verghese: I’m so excited to be with you. Thank you for asking me.

Zibby: I have to tell you, Cutting for Stone — you must get this all the time, so this is probably boring to hear — was one of my favorite books. I read it. I cherished it. I took notes in the back so I could have it with me all the time. I just loved it. Thank you.

Abraham: That’s meaningful to me. I don’t get tired of hearing that.

Zibby: Of course, your latest book is also amazing. I have all these quotes that I have from it that I just loved. Maybe you could start by telling listeners a little about why you decided to write this book and your family relation to it and inspiration and all of that.

Abraham: I was looking for a setting for my new novel and was inspired by something that had happened some years ago. My mother, when she was in her seventies, was asked by my niece, who was then five and who grew up in America, “, what was it like when you were a little girl?” My mother was so taken with that question having lived in India, Africa, and then in Florida at the time that she began to write by hand, this long account with illustrations of what her childhood was like. It was funny. It was compelling. It was also very familiar, old anecdotes of eccentric family members. Reading it, I just had the realization that this is where I should set the next novel. I hesitated a little bit because I wasn’t born in Kerala. I was born in Africa, grew up there. I did know Kerala well because we would go there every holiday. Later in medical school, I was there a lot with my grandparents. That was my only hesitation. Then with the help of Mom, who passed away when she was ninety-four — she was actively engaged with my writing of the book until the very end.

Zibby: I’m sorry for your loss. Where did the idea of the family curse come from?

Abraham: I think there’s a lot at stake with families with arranged marriages being so common. This is a small, insular community that I talk about. It’s a Christian community who date their Christianity back to 52 AD when St. Thomas the Apostle landed. In that community and, really, in all communities where arranged marriages are common, it doesn’t take much to taint a bridegroom or bride — usually, more the bride than the groom — to taint their prospects. I think that was there in the back of my mind, these rumors people have about this family, that family. That’s where it began. I’ve been struggling with hearing loss, and so I think I was very attuned to a condition that affected hearing and balance. God knows. It’s not like I know the whole story. I wish I did. It just emerges organically. Something seems promising. You push along until you realize it’s a big waste of time. Then you backtrack, and you , as you know from writing your own novel.

Zibby: We can’t even compare our types of novels, but thank you for that. In this particular arranged marriage in your book, it’s between a girl of twelve and a forty-year-old. I know in history books and whatever, you read that. You’re like, oh, there used to be a big age gap. The way you brought that to life and thinking about just how young this twelve-year-old girl is and having to go leave her home and deal with a whole new family, you really brought that age gap to life, and the fear and all of it, even despite what ends up coming next. It was a great way to start really putting ourselves in her shoes.

Abraham: It goes against the grain in the sense that we have a visceral reaction when we hear about something like that. Honestly, that was my grandmother and great-grandmother’s story in the sense that they were married to this twelve-year-old or thirteen-year-old boy, but they really just became children in the same household. One of my aunts was telling me when she was going over a photo album, she said, “This girl, she went to her mother-in-law when she was thirteen or twelve and said to her mother-in-law, who she loved, ‘You need to get rid of that boy. He’s so irritating.'” She was talking about her husband, the son of this lady. There was a certain innocence, which would obviously end at a certain point. My great-grandmother actually married very young to a widower who already had three or four kids. She went on to bear him six or seven children. They had the happiest marriage. I never knew her, but according to my mother, it was just a — I like that idea of working against the reader’s presumption of how disastrous this is going to be.

Zibby: Wow. One of the themes in the book is loss. I know you wrote it during pandemic times and working in the hospitals during that time. Oh, my gosh, it’s amazing that you did that and could even write after instead of just — the whole thing is amazing. You had a number of beautiful lines about loss, one of which was just keeping their memory alive. You had one quote, you said, “‘I know she can see us,’ she says with conviction. She could tell him why, but he doesn’t need explanations, just the truth. ‘She watches over us in everything. She stays my hand when I want to add more salt. She reminds me when the rice boils over.'” It’s just so nice, the way we keep the departed in our day-to-day lives. It doesn’t have to be some big ghost appearance. It could be these little moments.

Abraham: For example, after my mother’s death, I was struck by the idea — I think I actually got it from reading it somewhere — that even though my mother is gone, the web of her presence is all around us. Even when she was here, it’s not as though I was with her every moment. I was with these artifacts of her life. Even by being around these artifacts, you still have that sense. When I was at the grave, I had the sense that Mom’s very much there. The web is there. The central character may not physically be present, but the effect is very much around. I might get criticism that there is a fair amount of death and loss in a novel like this that takes place over three generations, but I would say that that’s sort of inevitable. I often feel that people — this is a very broad characterization. I think people have a lot of denial about death and the fact that we are mortal beings. Life is a terminal condition, as John Irving says in The World According to Garp. Perhaps I’m much more conscious and driven by that sense of urgency. Even though I write a lot about medicine, I think of medicine as life-plus-plus, life on steroids, life most acutely observed, but it’s still a life that most people are going to encounter at some point.

Zibby: I actually just had John Irving on this podcast, I’ll have you know. I went back and read part of The Tennis Partner. I’m a huge tennis fan and started rereading that book. You refer to alcoholism in the same way, that it is a lifelong, not terminal, but it is a lifelong condition. It is something that has to be managed daily and never really recovered from in the same sort of way and that there should not be guilt and shame associated. Not shame. Perhaps guilt of actions, but no shame of the disease.

Abraham: That book was a profoundly moving book for me. To lose a friend to — his problem was actually cocaine addiction, a physician. Addiction is quite common in physician circles for many different reasons.

Zibby: I’m sorry, I didn’t mean alcoholism. I meant addiction. I’m so sorry.

Abraham: It’s fine. The differences are not very great. Addiction, once it takes hold, is a powerful disease. The disease metaphor is quite applicable. I’m glad you liked The Tennis Partner. I would’ve guessed that given your background, your husband’s, that tennis would be a — some readers appreciated the tennis. Others were more caught up with the story. I always love it when someone appreciated the tennis aspect of that.

Zibby: All of it. I’ve lost a friend. I’ve lost several friends over time. I had one really close friend in high school who had addiction problems. It’s, sadly, a very relatable situation that you were in. I’m so sorry for the loss. What a gripping story that was too. All of your writing, it’s so good.

Abraham: Thank you so much. I appreciate that.

Zibby: I know you have an MFA from Iowa in addition to being a revered doctor. I wonder how many people have those two degrees. You should do a little survey if you don’t already know. I can’t imagine there are more than a handful. Pairing the two is just so amazing. Tell me about the combination, what you took out of the MFA program you still use or what you even thought of going through that or how you marry these two parts of the brain.

Abraham: To be honest, I never set out to be a writer. To this day, I still think of myself as all physician. I felt medicine was a wonderful calling. It’s been a great adventure. I never set out to write. I know this is somewhat disingenuous. Whenever people give me this physician and writer label, if I had to choose one, I would be all physician. What happened is I was living through this extraordinary story in a small town in Tennessee, well after I had specialized in infectious diseases, when HIV, the supposedly urban disease — I was seeing large numbers in this very small town. It was the desire to tell that story, that fascinating paradigm which no one had described, which was simply that gay men had left their homes years before because they were gay, quietly, part of the great exodus, and then they were coming back decades later because they had HIV. Their partners had died. Even though I wrote a scientific paper describing this migration, it never captured the grief of the families, the tragic voyage, or my own grief at taking care of these young men in those days when there wasn’t much in the way of treatment. They were my age. I wanted to tell that story. I decided to apply to Iowa. The only criteria then were two short stories. They took me, and I went. I was considered crazy by my colleagues because I gave up a tenured position and took my two young kids. It’s sort of ironic because I came to medicine because of two books. One was The Citadel by A.J. Cronin. Then the other one was Of Human Bondage by Somerset Maugham. It’s ironic that books should bring me to medicine and then at some point, I should be writing books. I think they come out of the same spirit and the same lens with which I go to work every day. I don’t think it’s markedly different, like two parts of the brain.

Zibby: Is the spirit helping people? Is that the main through line?

Abraham: Helping people, but more than that, it’s a curiosity and an empathy for your fellow human beings. I’m an internist, so I’m really trained to observe. Sometimes in an airport when I can see these people walking, I can pick out every pathologic gait known to man in that one-mile walk as they come to your gate. You’re taught to observe. You’re taught to take these disparate facts and put them together and come up with a unifying story or diagnosis. I think that that lens of empathy, interest, keen observation lends itself to both crafts. I do find that I, to my surprise, work out things that have happened at work that I don’t think I would’ve worked out except by writing about them, the emotions, I mean. I often say — I don’t know that this is original. I write in order to understand what I’m thinking. There’s just some other level of understanding, as you know, that comes when you actually sit and write as opposed to when I take a walk around the neighborhood and think about the book. It’s fascinating to me. I feel like the writing informs the medicine and vice versa. I can’t separate the two very clearly.

Zibby: That’s okay. It’s working for you. You can keep it up. Having that deep knowledge obviously informs the book, particularly this one. I think another theme of the book is love, all these different forms of love, parent/child and romantic love and all of that. If I could read one more quote, is that okay? You write, “‘Forgive me,’ he says. ‘It hurts me to think that we may not have a life together, but it doesn’t stop me loving you.’ He tastes tears on her lips, tears that could be his too. She raises her head to look at what he has done, the canvas of herself. She shakes her head in amazement. She whispers, ‘You’ve helped me find myself. Do you know?'”

Abraham: Thank you. Thank you for reading that passage.

Zibby: I love that.

Abraham: One of the things that really came on to me again in the COVID epidemic, as it had in the HIV epidemic, is, at the end of our lives or when our lives are prematurely threatened, what is it that we treasure? It’s really not so much our accomplishments and our possessions. It’s the meaningful relationships we had in our lifetime. Love bubbles to the surface, or the absence of it, when we are stressed like that. The thing that was very striking to me, here I was writing about a time period in the 1900s to 1970 and in the hospital observing this modern-day pandemic, but the emotions, the heartache, the way people find meaning in their loss, nothing had really changed. In fact, there was something about the lens of simplicity, looking back at the much simpler time that allowed you to see much more clearly how one dealt with it. These are age-old problems. None of us escapes them. It was actually a very interesting juxtaposition of — not that I’d wish it again — COVID on the one hand and writing about leprosy and diphtheria and so on in the 1900s.

Zibby: I feel like that’s also fed into when you said that one of your characters — I don’t want to give everything away. This character has been dead for years, and her body has now followed. Her soul has been dead for years, and her body has now followed. There’s something about going through loss and trying to get through life. What does it mean to live without love? All of these big questions.

Abraham: Big questions. I also think that to be much more aware of death is actually a way to live more fully. I don’t embrace these losses because I’m sort of a pessimist. It’s more, it just gives you a sense of being enormously grateful for each day. Every day above ground is a fabulous victory. It doesn’t make me a morbid person. Far from it. I think it makes me much more engaged with every moment that I’m here.

Zibby: I feel the same way. I feel like every day, I’m just fighting against time. I’m like, can I get stuff done today? Okay, I’m here. I’m okay. I can walk. I’m good. I shouldn’t have said, I can walk. Even if I couldn’t walk, it doesn’t matter. I’m healthy. My time is running out. I better make today worth it. That’s how I feel like loss inspires me personally.

Abraham: I love it. I love the way you just phrased that. I also think that novels, which is what brings us together, are the only way I know to escape the relentless progression of time. What other magic do we have in this world where you pick something up and you go through three generations, many lifetimes, and you put it down and it’s just Tuesday? is what keeps you reading. It keeps me reading. It’s that wonderful way we’re escaping, but we’re not just escaping. We’re trying to pick up fundamental truths and insights about our own lives even though it’s in a fictional world. Dorothy Allison and Camus said much the same thing. Fiction is the great lie that tells the truth about how the world lives. It frustrates me that more of my colleagues, for example, don’t read fiction. They tend to lean towards nonfiction. I’m a serious kind of guy. I read nonfiction. I like to tell them, you know, a novel, Uncle Tom’s Cabin, is what ended slavery in this country, in a sense. It really made the idea of slavery distasteful. It swept the country. A novel called The Citadel in England, which I referred to, was the genesis of the National Health Service. Novels have the power to do more than we think. They’re not frivolous. They’re terribly important.

Zibby: I agree. Also, just to get out of your own experience. You don’t have to travel. You can be in your kitchen and yet a place you’ll never go in real life, understanding a culture you’ll never be a part of. It allows for such greater empathy. I think it’s so important. It’s different than nonfiction. It’s beautiful. I think it would be sad to have a life without reading fiction.

Abraham: From a writer’s point of view, having written both nonfiction and fiction, as you have, on the one hand, fiction is liberating because you can make anything up. You can get into anybody’s head. Characters can write from after they’re dead and so on. You have to work so much harder to grab the reader’s attention and keep them on the page. Whereas I think what you have going for you when you write nonfiction is the reader knows this really happened. I think we have this inherent curiosity about something that really happened. We have to work harder to suspend disbelief for something that’s “made up” even if it’s profoundly true in another way. I love the challenge. I actually think I prefer writing fiction. Mining my own life for material, after a while, was hard. I wound up revealing much more than I thought I would, but for the right reasons. The editor kept saying, “You can’t have the camera so intensely on these characters people.” Then you become a character. You can’t just put your hand on the lens when it turns toward you. I accepted that, but I found it difficult. If the reader’s done me the honor of getting the book — preferably, buying it, not borrowing it — they’ve earned a right to learn these things about me. It felt good in that sense, but it was hard for me.

Zibby: I understand that. Given people’s initial reluctance, perhaps, to getting into things that are not true, here you are coming out with a very long book. Did you think about the length? Was that even a consideration? Did you consider chopping any sections? How do you feel about it? How do you feel about people making time for longer books? Was it not an issue?

Abraham: It wasn’t an issue much for me, but I was very aware that certain readers would balk a bit at the size of the book. To be honest with you, it was a much longer book. We’ve made a lot of cuts in it. I keep having this ambition to write a shorter book. To tell the whole story, it has to be X number of pages. I found during COVID that I personally had an appetite for longer books. I almost got frustrated if something felt like a little amuse-bouche instead of the hearty meal that I was looking for, even if it was very good. I guess I’m reflecting my bias. I like the idea of a long novel, but I understand completely that it’s a little more challenging to get the reader into it. Once they’re in, if you’ve done your job, hopefully, they keep going.

Zibby: There was no challenge at all getting into your book. It was captivating from the start.

Abraham: I had a reader tell me, which I thought was a great comment, that they were so engrossed in the book that they looked to see how many pages they had left and were disappointed that there were only a hundred-something pages left. They wanted it to go on. As a writer, that’s exactly what you want. They want this to go on.

Zibby: One of my favorite things when I’m reading is when I have to cover my mouth or put my hand on my heart or my body gets engaged, which it doesn’t always. There was one scene — I don’t want to give things away, but really sad scene involving loss. I was reading it, and my hand was over my mouth and then on my heart. That’s how I know I’m really into it.

Abraham: You’re not alone. When I was revising some of those scenes of tremendous loss and tragedy, I would weep every time. I couldn’t help myself. I knew what was going to happen. Especially when I was reading it aloud. These characters have become, evidently, quite real to me. They were concrete people that I knew better than I know some real people around me. It’s so funny, isn’t it?

Zibby: It is. Did you read the audiobook yourself? I can’t imagine. Did you?

Abraham: I did. I was moved to do that. I enjoyed the reading of Cutting for Stone that somebody else had done, but there were minor quibbles I had with the pronunciation of this and that. To give you an example, the word Madras, which is a city now called Chennai, a North Indian can say Madras in a somewhat contemptuous fashion without knowing it. They can say Madras . I don’t know the analogy I could use. To a South Indian, it would sound offensive. There were all these nuances that I was picky about. Nobody else would ever have noticed. This book, as you know, is full of a lot of different foreign-sounding phrases and language, even. I thought, let me give this a try. I auditioned for the role, actually. I told them, “I don’t want to do it unless you think I can do it better than anyone, not just the pronunciations.” I had to learn a lot. I had to learn how to perform the book. The fascinating thing to me, Zibby, is that I thought I knew this book. As I read it, I could see connections that I hadn’t made, that I had never consciously tried to make. The subconscious mind is this amazing thing. It was doing things that I hadn’t quite realized. It was such an experience to spend two weeks reading my own book and seeing things that I should’ve seen before.

Zibby: That’s wild. Are you working on a new book?

Abraham: Not yet. I’m tossing around a few ideas for one. I think the biggest question is geography. Where does one set this? I’ve gotten some mileage from setting two books now — that’s all I have to my credit, is two novels — in somewhat exotic places, for most readers. I’ve lived a long time in America. I’ve been here in Silicon Valley for fifteen years, Texas for seventeen years. I’m really looking to set a story in America, but I’m not sure what time period that will be. I find some time periods particularly fascinating. Our present time, so-so. Maybe I’m just reluctant to dive into the present craziness of our life. There’s something neat about going back to some sepia-tinged decades.

Zibby: You mentioned quickly, your hearing loss and that it’s genetic. How are you handling that?

Abraham: I think I have the best hearing aids one can get. Yet when you’re in a crowded room or a restaurant, nothing beats the human ear for being able to discern this sound in front of you from all the others. I’m just left marveling at the complexity of the human ear. I’m doing well. This is the first year, or the year before, where I realized that instead of being stressed by being in situations where I can’t hear, I’m just coming out with it. I just want to tell you I’m really struggling to hear in this setting. Just so you know. Announcing that sort of lets me off the hook, so to speak. Frankly, I don’t know if it’s my imagination, but restaurants are getting noisier and noisier. The idea of a quiet dinner with your partner, where do you go other than your own dining room?

Zibby: I did find a restaurant recently. We were out with friends in LA. We walked in, and it was so quiet. I was like, this is so nice. Restaurants are usually so loud. We were all looking around. We were the only people under maybe eighty or something. It was perfect. I loved it. Even if you don’t struggle with reduced hearing or whatever, being able to focus when you’re distracted by all the sounds — that’s why we do these podcasts in a quiet room. No distractions.

Abraham: It’s made me very conscious of how precious these senses are, our vision, hearing. You wonder about the old days. In the 1900s, there was a lot of deafness. My grandfather, I recall having to almost shout for him to understand what I was saying. None of this was available. It’s just getting better and better. I’m very hopeful.

Zibby: Excellent. Abraham, thank you. Thank you for this podcast. Thank you for researching me and knowing anything about me. That was so flattering. Thank you for all the hours I’ve spent with your stories. It’s really a blessing. I don’t even know how else to say it. Thanks.

Abraham: It’s an honor, Zibby. I’m hoping to visit your bookstore in Santa Monia.

Zibby: Please do, yes. That would be wonderful.

Abraham: Thank you for all you do for books and getting people to read. I really admire that.

Zibby: Thank you. Thank you so much. Take care. Buh-bye.

Abraham: Buh-bye.

THE COVENANT OF WATER by Abraham Verghese

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