“In our rat-a-tat volleying at the net, in our mastery of spin, in the rallies, in the way the rackets functioned as extensions of our bodies, in the way we came to know each other’s tics and idiosyncrasies, in the way we controlled the movement of a yellow ball in space, we were imposing order on a world that was fickle and capricious.”

I typically do not write about books during a Grand Slam tennis tournament because I’m busy writing about tennis instead. But a casual glance at Abraham Verghese’s second book persuaded me to make an exception this past fortnight. The memoir, published in 1998, has haunted me all week as I have watched players battle it out at Wimbledon.

At the heart of the book lies the dark and tragic story of David Smith, an Australian medical intern in El Paso, Texas. The story is rendered with such force and insight, however, that it transcends the individual narrative to become a powerful meditation on life itself.

Just like his first book, My Own Country: A Doctor’s Story, which revolved around the AIDS epidemic in the Deep South, this one – a The New York Times Book Review Notable Book of the Year – draws from the author’s experiences as a physician. But it is a much more personal tale. It begins with his arrival in El Paso where he joins the faculty at the Texas Tech medical school. When he meets David, his new intern, a fourth-year student and a former tennis pro, Verghese is in the process of separating from his wife of more than a decade. A “newcomer to town,” he is drawn to David with whom he shares a passion for tennis. At first they are merely tennis partners, but soon their bond deepens.

Verghese takes him under his wing at medical school, lending him textbooks, teaching him what he knows, and creating opportunities for him. On the tennis court, their roles are reversed. Sometimes, when during their rotation at the hospital, Verghese notices a shadow pass over the intern’s face or hears his voice tremble as he presents a patient’s symptoms. Despite the time they spend together, David remains a mystery. Finally, one day, he reveals that he is a recovering cocaine addict. He has been allowed to stay on at medical school on the condition that he remain clean and undergo regular drug-testing. The stakes are high – a medical residency, a serious relationship, life itself. David’s fluid charm and boyish looks cloak a troubled soul, one that Verghese yearns to protect but ultimately cannot. For, David, his sponsor reminds everyone, is responsible for David.

Love and loss

The book’s subtitle – A Doctor’s Story of Friendship and Loss – gives away the ending. The story of David’s attempts at recovery and repeated relapses is heartbreaking. Verghese writes with the wisdom of hindsight, carefully peeling back layers to reveal the gradual yet relentless unravelling of his friend. He is wracked with guilt and anxiety about what he observes but can do little except watch as David self destructs. Even though we know at the outset that tragedy is inevitable, this taut and suspenseful narrative is engrossing, as we find ourselves willing David to stay the course.

David’s life runs parallel to the author’s. Verghese traces his struggle with loneliness, beginning with his childhood in Ethiopia, spent amidst the uncomfortable silence of his parents’ marriage. His loneliness as an adult stems from many factors – his outsider status as a foreigner in America, the breakup of his first marriage, and his arrival in El Paso, a border town that like him occupies a liminal space. Towards the beginning of the book, Verghese moves into an apartment where he proceeds to live a minimalist life, using an inverted U-Haul box as a dining table. He is forever “the foreigner looking to blend in, to provide for (his) children a geography more permanent than (his) had ever been.”

Rivers and borders

Geography is an important theme in the book. Verghese shows the same keen eye for detail when describing the landscape of El Paso as he instructs his students to employ. “We’re going to train your eyes to see, to notice everything,” he tells them. As he explores his new home, and the frontera culture, sometimes with his two young sons, and sometimes on his own, he makes note of the mountains, the Rio Grande, the valley where the river flows into irrigation canals, the coyotes and sycamores that populate the land.

The border between the US and Mexico is a constant presence. At Halloween, convoys of Mexican families cross over to trick or treat. When Verghese and his boys cross the barrier to Juarez, the scene strikes him as very familiar. The roadside vendors, lively market, and chaotic traffic, all remind him of Addis Ababa where he grew up, and Madras where he attended medical college. At night, he looks into the horizon and sees how “the white, sober streetlights of El Paso gave way to the shimmering green lights of Juarez, a tropical and brazen green that seemed to throb and surge, that seemed to say, Ni modo – anything goes.”

Abraham Varghese. Image Credit: www.abrahamverghese.com

The minutiae of the lives of drug-addicts are not as pretty as the landscape. As he discovers them, Verghese shares a range of details, from track marks on arms to rituals of rehab, and facts such as the one that some users are addicted to the needles themselves and will shoot up water when no drug is available. As an infectious disease specialist, Verghese sees many recovering addicts among his patients. He writes about them with empathy and compassion. But he is less generous towards the medical profession itself.

The book opens with David being escorted to the Talbott-Marsh Clinic, a rehab centre in Atlanta meant exclusively for doctors, where “every speciality in medicine seemed to be represented.” Verghese blames the profound loneliness and high pressure situations of the profession for rampant drug use among physicians. In fact, the inside look at the lives of interns and attending physicians is one of the most fascinating aspects of this book. For instance, we learn that internal medicine residencies are not in high demand among American interns, which is why those positions are filled up with foreign medical graduates, a fact that in turn makes them less desirable. The American medical profession, Verghese says, is “caste ridden, hypocritical, unable to conceal its inherent bigotry.”

In this world of superficial and often ruthless interactions, Abraham and David find a genuine connection. Both of them live “on the border, looking in.” At the centre of this memoir lies the bond they share. Even though they live on opposite sides of the mountain, Verghese points out, “perhaps it was because we were both from elsewhere, not natives of the land, more familiar with dingos and hyenas than we were with coyotes, that I had felt quite at ease with him.”

He describes their friendship with the language and idioms of romantic love. Playing tennis with David makes him feel “youthful and virile.” He confesses to experiencing “startling jealousy” when he sees David talking and laughing with another surgeon. When he begins to confide in David about his marriage, and finds him opening up as well, he admits that “to tell a life story was to engage in a form of seduction.” Verghese resents David’s girlfriends for cutting into their time together. When he takes David to a newly discovered tennis court with a magnificent view, he says, “If our tennis partnership was special, different, sacred, like a marriage, we had finally found a setting to match.” He concocts a research project for David so he won’t leave town in the summer after his internship. “I just wanted him around, I didn’t want an interruption in our tennis ritual, and I didn’t want to share him with Gloria.” He fingers David’s new tie teasingly. At one point David’s girlfriend calls him co-dependent.

Confessions of a doctor

This underlying erotic strand, while never directly addressed in the memoir, makes the friendship both intimate and fraught. Ultimately, however, the nature of Verghese’s attraction for David is not really relevant. What matters is how much his protégé meant to him, a fact that makes the events that unfold more tragic, more significant for the author. “My friendship with David, during its inception, and during the heady period when our lives revolved so much around each other, had held out the promise of leading somewhere, to something extraordinary, some vital epiphany – what, precisely, I couldn’t be sure of. Still, that was how it felt – magical, special.”

Their friendship is most fully expressed through their tennis matches. His love for tennis is the one element that enables Verghese to exert some control or at least to make sense of things. Ever since he was a child, Verghese played tennis to alleviate his loneliness. The sound of the tennis ball hit against the side of a shed was at first therapeutic. Then, later when he was a medical student, his patients’ heartbeats reminded him of “the metronomic tattoo of the ball.” And later yet, during his internship in the States, he played tennis so excessively that his wife complained about it. Tennis, once an innocent diversion, becomes his drug of choice, a balm for his inner turmoil.

Anecdotes about iconic players like Bjorn Borg and Bill Tilden are scattered throughout the memoir, as are reports and analyses of actual matches such as the 1975 Wimbledon final between Arthur Ashe and Jimmy Connors, and the 1993 French Open final between Jim Courier and Sergei Bruguera. (My only gripe with this book, a minor one, is that it only mentions a couple of female players in passing and, while tennis offers him numerous life lessons, he does not appear to dwell on any women’s matches for those lessons.) His “tireless reading about theories and strategies” and his meticulous tennis entries in notebooks might seem seem obsessive, a fact Verghese is aware of, for instance when he speaks of his failing marriage: “If I had kept notes on love, if I had tuned my act each time there was a discordant note, a flubbed move, if I had recorded the things that worked, perhaps we could have saved the relationship…”

Perhaps that is why Verghese tries to use tennis to “save” his friendship with David. It is tennis that brings the two men together, and tennis that provides comfort at the darkest of times. How is it, he wonders, that some people like himself succeed in overcoming personal disaster, while others like David fail? The book is an attempt to connect the dots, to try and understand a tragedy in its aftermath.

And as always, tennis offers an insight, perhaps the only one possible. “It was terribly important,” Verghese says, “to keep playing with David, to play beautifully, to play exquisitely, and with great care, as if the universe rested on the flight of a ball.”

Oindrila Mukherjee tweets here.