The Power of Fiction: The Lie that Tells the Truth


At Dr. Abraham Verghese’s National Medal of the Arts and Humanities presentation in 2015, former President Obama said, “Every human being has separate people living inside his skin.”1 Verghese is Professor and Vice Chair of Medicine at Stanford University School of Medicine. He is also the author of two nonfiction books and two historical novels: the bestseller Cutting for Stone (Knopf, 2008) and The Covenant of Water (Grove Press, 2023). When I asked him about his twin abilities to perform as a physician and an author, he offered his unique perspective on this skill. Instead of the wearing-two-hats concept, Verghese believes, “the lens through which I see the world is colored by being a physician.” He brings that same lens to his writing. After his stint at the Iowa Writers’ Workshop, he is more aware of the craft of writing. But, he says, it’s still him: “The same persona, same lens, and a gaze (clinical at times) looking for telling details and then trying to cobble them together into a whole.” He does write slowly, noting, “My day job dictates that pace.” And he worries that “the lens would be altered” if he gave up medicine.

Verghese was born in Ethiopia to parents from Kerala, India. Later, having moved to the United States, he wrote his first nonfiction book on his experiences as a physician there. Understandably, his first historical novel is set mainly in Ethiopia. However, for his latest novel, The Covenant of Water, Verghese sets the story mainly in Kerala. I asked him about his selection of the locale. He mentioned discovering a unique primary source that encouraged his decision: a handwritten, illustrated manuscript that his mother had penned for his niece, who was curious about what life was like for grandmother as a little girl. His mother’s notebook was rich with familiar tales she had told, stories about family, her schooling, her naughty cousins, and the rituals and mythologies of everyday life in Kerala. Although Verghese didn’t use the stories in his mother’s manuscript, he notes, “Their existence reminded me of the richness of this culture.” He is familiar with the region, having visited Kerala during his summer vacations and having attended medical school in Madras.

In a previous interview, Verghese disclosed his inspiration for the title of his 2008 bestseller, Cutting for Stone, which was, interestingly, the physician’s Hippocratic Oath.2 I asked him about the stimulus for the title of this second novel, The Covenant of Water. Verghese replies, “Titles should be mysterious and should work at many levels. The readers should make their own interpretation, just as they should interpret the novel.” He mentions, “Any visitor to Kerala couldn’t help being impressed with water as the defining element of life there. The narrow coastal territory, on the southwest coast of India, is bounded inland by an impressive mountain range, the Western Ghats. Forty-plus rivers course down to the sea, forming a latticework of ponds, lagoons, backwaters, and lacy tributaries. Water is the great connector of people, as it is the primary means of transportation, a giant circulatory system. So, water was inevitably the controlling metaphor.” As for “covenant,” Verghese says, “I was impressed with how families often come together around a central myth or family secret. A family’s reputation means everything in a community that intermarries and depends on arranged marriage. The ‘covenant,’ in that sense, is about a family being bound by the secret they try to keep from outsiders.”

Verghese is well-regarded in the medical profession for his conviction about the importance of bedside medical examinations for patients, and he leads the Stanford Medicine 25 Program. Being curious, I wanted to know more about this program. He responds, “I was always enamored by the kinds of physicians who were adept at ‘reading’ the body — seeing a patient walk in and making Sherlock Holmes-kind of deductions. When that kind of skilled clinician examined the undressed patient, it was magical: they could percuss and auscultate the lungs and predict what the chest x-ray would look like, or, after a quick neurological examination, sketch out what the CAT scan would show.” He continues, “The Stanford 25 effort is one way to re-popularize the practice by focusing on a few skills that are pretty technique-dependent.” He hopes that “helping young doctors build a repertoire of such skills gives them a hunger to improve.” Verghese’s trained eye for physical details shows in his writing, and he also passes those insights to the readers.

In earlier interviews, Verghese has frequently mentioned the following quote from several notable authors, including Albert Camus, Dorothy Allison, and Neil Gaiman, and he uses it in his recent novel: “Fiction is the great lie that tells the truth.” When I asked him to elaborate on this concept, Verghese replies, “When a novel resonates with us, it goes beyond entertaining us because it seems to affirm what we know to be true about human nature, about ourselves, about the nature of human conflicts; we recognize the archetypal personalities who populate our world. Novels have the power to change societies: Uncle Tom’s Cabin for ending slavery in America, and, in the UK, The Citadel by A.J. Cronin caused an outcry about the existing medical practice and is said to have been responsible for the National Health Service.” Verghese believes “reading fiction, and the practice of taking words on a page to make our own mental movies, keeps alive some part of our brain that is primed for stories. Not reading fiction would lead to an atrophy of the imagination.”

Verghese has made his mark on both the medical and literary worlds. He is widely applauded and honored for his efforts in improving the medical examination process. His nonfiction and fiction books have been well-received. Readers interested in being transported to fascinating lands with unforgettable characters can eagerly await his next offering.


  1. The White House, “Remarks by the President at the Presentation of the 2015 National Medals of the Arts and Humanities.”
  2. Jaipur Literary Festival, 2013.

About the contributor: Waheed Rabbani is a historical fiction writer and a book reviewer for the Historical Novel Society. He resides in the historic town of Grimsby, Canada, by picturesque Lake Ontario.

Published in Historical Novels Review | Issue 105 (August 2023)

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