Doctors’ accounts of the pandemic as they’re witnessing it unfold are “war stories”, as physician and Kannada writer Guruprasad Kaginele calls them. These are stories that have travelled from the corridors of hospitals through the fog of disease and death to our homes to offer prescriptive, revelatory views of the virus at work.
They are accounts that stand out in the cacophony of various claims made on the present and future of the crisis. In the absence of a perfect cure, medical truths are all we have, to dispel some of the heightened anxiety that is progressively taking over the better part of our days.
Despite the tremendous emotional toll of being on the frontline, for doctors who are also authors, this moment in history presents itself as a rich source for writing. So I posed a few questions to eight doctor-authors on how they have been writing and reading during the Covid-19 crisis.
Have they felt the need to chronicle the last few months battling the virus? Have books come to their rescue in between shifts? Are we witnessing a shift in the way disease and health are being documented, disseminated and consumed by the public? And what kind of literature would they like to see emerging from the unprecedented medical crisis? Their answers are comfortingly meditative, thoughtful and unexpected.
Ambarish Satwik, Delhi
Have I felt the need to journal my experiences being on the frontline? Well, to quote Christopher Hitchens on this: “It would be useful to keep a diary, but I don’t like writing unpaid.” I am just kidding. It’s been quite busy, I’ve been in harness through the epidemic, so there’s very little time to collect my thoughts.
Also, I’m not much of a chronicler, and I don’t usually write on health and medical matters. My stock in trade, if I might call it that, as regards non-fiction, is the medico-sexual, Rabelaisian essay and argument about the body.
These are wantonly polemical tracts, against popular opinion and assumptions, and they might be, for a lot of people, politically and possibly morally infelicitous. The gadfly essays, if I’m allowed to call them that.
So, my commentary on Covid is entirely out of character. The piece that went viral was a WhatsApp message which, on a rare occasion, I sent out on the neighbourhood group. What precipitated it was news of the first Covid case in our locality and the incredibly incontinent and hysteric neighbourly anxiety over it, followed by a strange and scary commandeering of the situation by the local RWA.
A journalist friend and neighbour asked me to give the residents the lay of the land, and I decided to type out a message on my phone, which expanded into a thousand-word missive cum memo. The next morning, I got calls from Kolkata, Bengaluru and New York that it had gone viral. Things actually travel at the speed of light on WhatsApp. It’s astonishing how much the piece went around: its transmission can be a case study in mass communication. Social media broadcasts are the new pamphlets.
Could my experiences creep into a book in the near future? Possibly, in some form, they will. But not directly. The dark material underneath most of my writing comes largely from hospitals, medical journals and so on. Excess, abjectness, bodily disgust, pathology, for me, are the basic ingredients of both art and life. They’re all grist to the mill, as they should be.
I once wrote a fictive sexual history of the British Raj called Perineum: Nether Parts of the Empire. One of the stories in the book was called “Baker’s Scrotum”. It was about the great wrangle between Edwin Lutyens and Herbert Baker, architects of Imperial Delhi. Lutyens and Baker had initially concurred in considering Raisina Hill as the site for the two Secretariats. Their agreement to place the Secretariats (designed by Baker) in front of the Government House (designed by Lutyens) was based on a series of watercolours prepared by William Walcot.
Lutyens realised rather late that the perspectives depicted by Walcot were incorrect. The slope on Raisina was quite malicious. In collaboration with Baker’s Secretariats, the slope nearly blocked out the Government House (now Rashtrapati Bhawan). Lutyens made representations to the Government and fought the gradient, but it was too late, and it couldn’t be changed. Baker, on the contrary, was quite pleased with the effect of the slope and did not capitulate.
All affinities between the two architects and friends wound up in great haste, and their association came to an end much before Delhi’s inaugural celebrations.
In the story, Baker receives providential punishment in the form of a condition called Fournier gangrene. It is a spontaneous necrosis and liquefaction of the skin of the scrotum, which then has to be serially, incrementally and painstakingly removed by surgical procedures. For days he has to lower himself into a large vessel filled with bleaching powder solution for forty-five minutes – three times a day – to clear out the infection. Luckily, the skin necrosis stops just short of the anal opening and the bleaching powder baths clean up the large wound.
But how does one close the wound? The scrotum had ceased to exist, the testicles were exposed. There was no redundant skin that could be surgically mobilised to give them sanctuary. The Professor of Surgery of the Medical College of Madras is called in to resolve the matter, and he effects an unlikely resolution. Each testicle is transposed into its respective thigh along with its attendant spermatic cord. With the testicles out of the way, the wound in the midline can be closed with sutures.
Baker’s perineum (and groin), in the end, becomes a metaphor for Raisina Hill. His testicles, homologous to his secretariat buildings, are out of the way. In the end, Lutyens writes in his journal that Nemesis is upon Baker: he will spend the rest of his life with his testicular Propylea out of the axis of his genius loci – the axis connecting his penis to his anal stoma.
The reason I’m telling you this is because the marrow and the pith for this story came to me from a young Delhi Police constable infected with HIV who suffered from a similar condition for three weeks and required testicular transposition under my care.
These calamitous Covid times are worth at least a short story, if not a novella.
We’ve had some incredibly stellar voices explaining the pandemic to us. And there have been pieces, not by physicians, but by writers and historians, on the cultural memory of the previous epidemics. They provide some continuity and also a narrative about how this is likely to end.
It’s quite staggering that both the human and the administrative response to epidemics has remained entirely unchanged from the time of the Justinian plagues. In Daniel Defoe’s A Journal of a Plague Year, which is a fine literary hoax, because it reads like an eye-witness account (he wasn’t even five years old during the plague years), he describes how in 1664, the local administration in London tried their best to fudge the number of plague deaths and made them appear lower by nominating other diseases as the cause of death.
All distempers and plagues were always depicted as visitations that had crept in from outside. The first rumours of the disease always got dismissed. People looked for scapegoats, blamed the émigrés and asylum seekers and travellers and returnees for the pestilence. People rushed to find some kind of miracle cure. They went to astrologers, they hoarded.
These writings have been an education: they’ve reminded us of the wisdom of Lucretius, conveyed the story of the birth of epidemiology, demonstrated the revelatory gaze of modern medicine.
But it’s prose fiction that I’m waiting for. We still have a long way to go. The high value of storytelling is not the distraction it provides and the palliative it becomes, but that it gives texture and acuity to our times. The purpose of literature, as they say, is to make stones stonier.
Vikram Paralkar, Philadelphia
I am a doctor and scientist at the University of Pennsylvania, and the last few months have involved a combination of increased activity at the hospital to care for Covid patients, combined with the sudden cessation for all laboratory work (except Covid research) in order to help “de-populate” university buildings.
A good amount of my time went into guiding the members of my laboratory through this abrupt transition, and work is just beginning to return to a new kind of normal. The cases in Philadelphia have reduced after intense distancing, and my research and my clinical care of patients with leukemia is returning to a cautious equilibrium. I hope the pandemic permits it!
I just finished reading The Sympathizer by Viet Thanh Nguyen, who won the Pulitzer Prize for Fiction in 2016. It’s an extraordinary work – rich, detailed, complex, disquieting. Highly recommended.
Ironically, the volume of commentary that has been pumped out into the public sphere about the societal implications of Covid has made me personally quite disinterested in chronicling my experiences of this period. I find it’s actually easier for me to write with greater clarity about settings that now seem quite distant – trains, restaurants, crowds.
I am working on my next novel, yes, about an eyemaker who gets entangled in a morally dubious relationship with his client. There isn’t any particular connection to this pandemic, and I feel no reason to try to fit in it. In my experience, attempts to force current events into one’s writing rarely work unless they are baked into the foundation from the very beginning. One day, this calamity will be behind us, and there will remain a need for books that explore every aspect of human experience beyond the strange lives that we are currently living.
I do think that society at large had suddenly realised that doctors and epidemiologists and healthcare experts ought to be taken seriously, and that a pandemic isn’t something to be trifled with or denied. That said, my primary goal as a writer of fiction is to create an aesthetic world that I hope can float free of my medical resumé, and would be convincing to the reader even if I had an entirely tangential profession.
It’s undeniable that this pandemic has revealed how fragile the habits and structures of our lives are, and the ways in which they can be disrupted by a microscopic biological upstart. Some of the themes arising from this may find their way into my future writing – I look forward to being surprised by them!
Sandeep Jauhar, Long Island
The last few months have been tough. With New York as the epicentre of the pandemic, our hospital at one point had 95% beds occupied by Covid patients. It was a lot of work. I worked in the intensive care unit other than focusing on cardiology. But since there was a dip in other kind of healthcare, the work kind of balanced itself out.
I have been reading quite a bit. But I must confess I have been watching a lot more Netflix. I have been doing things I always planned to do but hadn’t been able to. So I finally watched Breaking Bad, and I am glad I finally did. I am reading The Kite Runner by Khaled Hosseini, Scar Tissue by Michael Ignatieff and also A Heartbreaking Work of Staggering Genius by Dave Eggers, which is a memoir.
I reread Akhil Sharma’s Family Life, which is a wonderful book. I have been doing recreational things that are important to me because I do need to relax at the end of the day.
I haven’t been journaling as much as I used to. But I have published a few essays in the New York Times and The Wall Street Journal. I wrote on vaccine distribution for STAT. Readers are very interested in what’s going on in the pandemic. In the same vein, people have a newfound, newly reinforced respect for what healthcare providers do every day, taking risks and taking care of sick and contagious patients.
So it’s been a time where I think as a healthcare provider we have got reinforcement that has been very positive. On the flipside, patients need to understand there is only so much doctors can do. The best you can do is socially distance and avoid falling sick. But yes, doctors are engaging more with people during this time. There have been a lot of searing personal accounts written by doctors, and one of the most respected voices in the US right now, Anthony Fauci, is a doctor.
What kind of books do I see coming out in the next few years? Some of the literature I have really enjoyed in the last 10 years is dystopian fiction, and I think it is very relevant to what’s going on today. Cormac McCarthy’s The Road, set in a post-apocalyptic world, and Kazuo Ishiguro’s beautiful novel Never Let Me Go – I imagine we are going to see novels of that sort being written. What I am thinking of writing next, which hasn’t taken shape yet so there’s not much to tell, has nothing to do with the pandemic but you never know, since we don’t know when it will end.
Hansda Sowvendra Shekhar, Chandil
My reading since mid-March 2020 – when the first documented migrant of our block returned home – has been either zilch or negligible. There was just no time. There still is no time. I tried reading two novels in May-June, both very well written with good plots. Yet, their characters, themes, settings, everything seemed so distant from the reality that I was seeing and experiencing around me during that time.
The books were not wrong; it’s just that my vastly different and urgent situation was not in sync with them. So they didn’t provide me any comfort. However, towards the end of June, I managed to pick up and finish reading a book in four or five days flat despite my very hectic schedule. It’s called Bread, Cement, Cactus and it’s a bravely outspoken and heartbreaking work of nonfiction written by Annie Zaidi. It turned out to be the book that finally gave me comfort. Comfort is perhaps not the right word. I felt a kinship with it – something that I could not feel at all with those two books I had tried reading over May-June.
I might consider writing a pandemic-related book, but first I need to be able to survive the dire times we are presently living in. I would also have to consider a number of things before I write something on this subject. I think people have become more aware since there is no dearth of information nowadays.
There is the traditional media, there is the social media; the latter wielding a far greater influence on how and what kind of information people are receiving. People around me are curious to know about most of the Covid-related developments and not just accounts of doctors and healthcare professionals.
I am not writing anything full length at the moment. As for reading, I will – at this time, and if I find the time to read, that is – try and choose books that I feel a strong kinship with. Maybe another book like Bread, Cement, Cactus – something short but immensely effective.
Kavery Nambisan, Kodagu
I have been working at my clinic during the pandemic and also see patients at home. But reading is one of my favoured pleasures and a must every day. Besides reading the news in The Hindu and a few online essays, I read medical information regularly. This I think is important for every doctor, especially those who are retired, like myself.
As essential for me is the reading of fiction. I re-read favourites: Harold Pinter’s plays. Naipaul’s early novels. Ragtime, by EL Doctorow. And my all-time-favourite, The Brothers Karamazov.
I don’t keep a journal of experiences. But my books are steeped in my experiences and observation and childhood memory. I have contributed a few articles, personal impressions and taken part in web conferences. The present crisis affects me deeply for the utter injustice of how we have handled it, more than the possible risks for me.
I am amazed to see that people of my background, well-to-do and educated, believe that the pandemic is being handled in the best way possible and we need only concern ourselves with our safety. As a people, we have failed in our response to the pandemic.
I am working on a novel right now. It is a long process for me but I enjoy it, I guess. Since it is set far back in time, the current situation does not affect it. A blessing. Also, my first non-fiction work – a sort of medical memoir where I share my views on the healthcare system – is being published by Speaking Tiger. It was to be out by August-September, but will now get postponed by at least six months.
Guruprasad Kaginele, Minnesota
Books have always been a source of comfort to me, pandemic or not. I always try and make some time to read at least a few pages every day, no matter how bad my day has been at the hospital. The last few months have been unusual for obvious reasons.
As a physician working in the emergency department, I have had to do lots of reading on Covid for writing the hospital protocols and also because the management algorithms keep changing every day. Besides, our medical fraternity knew nothing about taking care of Covid patients. So, reading medical literature did take precedence over everything else.
I read for leisure too, whenever I had time. Some of the books I read include Purdah and Polygamy by Iqbalunnisa Hussain, Listen To Me by Shashi Deshpande, Blindness by Jose Saramago, Don’t Let Him Know by Sandip Roy, and Cobalt Blue by Sachin Kundalkar. I also had the opportunity to read several Kannada manuscripts by fellow authors and found them to be phenomenal. I am pretty sure that in the coming years, readers can expect more exceptional works of fiction in Kannada.
I have documented some of my experiences in magazines. These mostly comprise my life as a doctor during Covid and how it changed my world. The pandemic has deeply affected us all at several levels. Post-Covid literature will definitely be different from the existing literature.
My challenge as a writer will be to internalise and capture the themes of the pandemic: the vulnerability, isolation, loneliness, greed, bigotry and most importantly, human grit and resilience. This may sound like something any sensible human being would do, but medicine in the US is so protocoled that caregivers run the risk of forgetting that they are dealing with human beings.
When the physical signs of life are defined by the cardiac monitor’s visuals of squiggly lines and the oximeter’s green zone readings, one may not realise that there is a living entity attached to these machines, one with a family, friends, job and responsibilities like most of us. Which is why I try and make it a point to talk to the patient’s family at least a few times in a day to reassure them about the treatment and care, and perhaps to reassure myself that I am still human and capable of understanding human emotions.
This may sound dramatic but the present pandemic has changed a lot including the order in which we take care of the patients. When someone arrives unresponsive at the Emergency Department, my doctor instinct tells me to rush to him and start CPR whereas the hospital protocol during Covid requires me to put on the PPE first. I am pretty sure every doctor has faced this dilemma.
If I write a book, it will not be about Covid per se, but the reader will be able to notice the themes I have encountered and the lessons I have learnt during the pandemic. Doctors’ accounts of how the health crisis is playing out are like war stories. A soldier always has great stories to tell. But these are usually someone else’s stories. Similarly, a physician on the frontline in these times has a lot of stories to tell. These are again someone else’s stories.
Believe it or not, most of the Covid battles on the frontline are fought long before you encounter the enemy – assembling the adequate equipment, prepping the ancillary staff, gearing up with proper PPE, conserving the PPE, and so on. Nobody will tell you this story as it may not be worthy of listening to.
The fact that the entire world wants to hear a Covid story places doctors and physicians in the coveted “storyteller’s” seat. There is a tendency to selectively narrate an “interesting” story and sometimes even distort the facts. We live in an era of fake news and fabricated reports. The doctor-writer has the added responsibility of being objective even about a subjective recall of an incident or a patient encounter and use his literary skills cautiously so that his story doesn’t end up being fake.
Tripti Sharan, Delhi
Covid-19 has driven us into unprecedented times in an already unpredictable world, unmasking the worst face of society and reshaping its economy, politics and human behaviour.
During this period I read several books on Shiva, my favourite god who suffers from no fear, no hunger and teaches us about the “immortal soul”. As time passed, Covid tragedies started mounting. The cases became known faces, the dead now had familiar names. The fear of death hung around me all the time. I wanted to read something positive. I picked up some light romance novels but they couldn’t hold my attention for too long.
It was at this time that writing came to my rescue. To me it will remain the most therapeutic thing in the world. I wanted to use my creative energies to drive away all my fears and negativity. And I had my hands full. But halfway through my new novel I started feeling disconnected again.
I took to speaking my heart out, participating in webinars and live sessions. Some were academic; some literary. I finished writing some chapters on medical issues surrounding pregnancy. In between, I even researched and wrote articles on Covid-19 that got published in medical journals. And then I started writing Corona thoughts, My Covid diaries: short cryptic messages, sometimes sarcastic, sometimes downright funny. But they all carried a message. I also wrote a series of blogs – Death of a Doctor, Death of a Hospital and The Warrior. Doctors all over the country could relate to my sentiments.
The pandemic has changed the way we perceive the world and taught each one of us something. As a reader and writer, it has influenced me tremendously and made me want to read and write only on subjects that hold some meaning and significance in today’s world. Interestingly, I have come across confessions, stories of love and betrayal from doctors who have been on Covid duties. The pandemic has been very inspiring and I would definitely like to chronicle my experiences one day. After all, my grandchildren should know what all we went through!
Rajesh Parikh, Mumbai
Books have been a significant part of my life. I started reading at an early age and by the time I was 18 I was reading a book a day. Books have not only influenced my desire to write (in fact they deterred me for a long time because I never felt up to the task of matching the great authors I loved) but they also have influenced my way of being.
The authors I am deeply indebted to are Tagore, Chekov, Shakespeare, Moliere, Montaigne, Steinbeck, Maugham, Garcia, Camus, Freud, Kafka, Plato, Pasternak, Sontag, Neruda, Seth, Rushdie, among many others. Reading has never been a struggle but has given me unquantifiable exultation and inspiration. I wish I could say the same for writing!
While putting in eighteen-hour workdays at Jaslok Hospital and Research Centre in Mumbai in February, I got a call from Milee Ashwarya, publisher, Penguin Random House India. Our conversation about the new Coronavirus – its virology, medical response and the political and economic implications for China and the world – seeded the idea for the book, The Coronavirus: What You Need to Know about the Global Pandemic, being released this month.
As I was preoccupied with the many Covid-related protocols, I roped in two co-authors, my son Swapneil and my colleague Maherra Desai. Milee accommodated my request and commissioned the book, giving us two weeks to prepare a manuscript; eventually, we needed eight.
The three of us put in countless hours and pored over 600 references in the course of writing the book. As we had not collaborated in this manner before, the experience was novel and fulfilling. Almost everything we predicted in the book in February has been borne out. How we wish we were wrong.
The Coronavirus: What You Need to Know about the Global Pandemic begins with an overview of past pandemics, moving on to a description of the events in Wuhan, China, and the rest of the world, followed by details about the virus and the recent treatment options along with some dos and don’ts based on our current understanding. Due to the flotsam of conspiracy theories and misinformation on social media, we thought it relevant to address and debunk them. We also look beyond COVID-19 to draw lessons on human strength and vulnerability. This book, like the disease it talks about, is interactive and a work in progress.
This series of articles on the impact of the coronavirus pandemic on publishing is curated by Kanishka Gupta.