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Last night, a friend and I attended the lecture by Dr. Abraham Verghese, whose first novel, “Cutting for Stone”, was published last February.

From wikipedia:

Abraham Verghese (born 1955) is the Professor for the Theory and Practice of Medicine at Stanford University Medical School and Senior Associate Chair of the Department of Internal Medicine. He was born in Ethiopia to parents from Kerala in south India who, along with hundreds of Keralites, worked as teachers.

His first novel, Cutting for Stone, is set in Ethiopia and written at a time when the old order gave way to the new, a time of great loss for the author himself, who as an expatriate had to leave the country even though he had been born there.

You can read his detailed bio here.

He spoke very eloquently about his upbringing and how it came to pass that he wanted to not just practice medicine, but be a physician. He compared growing up in a middle-class Indian family to growing up within a Jewish family: “You can be a doctor, you can be a lawyer, you can be an engineer, or you can be a failure. Those are your choices.”

One of the more sentimental moments came when he spoke of his work during the AIDS crisis in the late 1980s. There are a few things that can make me cry on a whim; as a gay man, AIDS is one of them. Gay men from all around the country came to Johnson City, Tennessee seeking his treatment and comfort. Mostly this was due to the anonymity of it. “They would contract the disease from large metropolises and come here to die.”

After his talk, he sat down to answer questions from the audience. In a very elegant manner, he broke down what was extremely wrong with the healthcare system in this country. Some of the major problems stem from a decline in primary care professionals, the way in which doctors are compensated, and how patients do not know the costs of their services until after the fact.

More often than not, medical students take on substantial amounts of debt to pay for their tuition costs. After college, they are faced with being a primary care doctor, which pays relatively little, or with working within a speciality such as dermatology, which pays substantially more. “I know skin is important, but it’s not that important,” he said. He further added that “doctors are paid to give services, not listen or provide comfort … you could come in with a broken finger, and you could be given a CAT scan before they ever diagnose it as such.” These are, quite obviously, problematic for him.

When asked how healthcare in India compares to healthcare in America, he said how in India you get a list of procedures and their cost. Here, it’s similar to “a menu without prices.”

Finally, he described what could only be the worst medical folly of all: medical records have become the patient. That is to say that diagnosis is based almost entirely on some words in a computer. The physical patient is rarely, if ever, examined.

To be fair, I have still not read his book, but that did not prevent me from gaining anything substantial from his talk. If anything, it only solidified the fact that I must read it.

12 replies on “Seattle Arts and Lectures Series: Dr. Abraham Verghese”

  1. Get thee to a bookstore and read the damn thing. It’s excellent. I had to slow down because I did not want it to end. You will thank me later, sending me donuts from Top Pot.

  2. I work in a bookstore. I even got a free copy of it. However, my stack of books to read is probably three feet tall. Working a full-time job and interning consume about 90% of my life right now.

  3. For the record, in addition to doctor and lawyer, Verghese also offered “engineer” as an acceptable career path within an Indian/Jewish family

  4. Fine, then send me some of those unread books. I’ll write up some pithy but complete synopsis / opinion in 150 words or fewer.

    I like the old-fashioned cake donuts with the chocolate frosting on top…. ๐Ÿ™‚

  5. I listened to him on KUOW yesterday morning and was struck by his eloquence. He makes beautiful use of the English language; his book HAS to be a great read.

  6. Patients knowing the cost of things wouldn’t matter as long as it’s insurance that covers it. It’s not that we have menus without prices. It’s that we all split the tab, so everyone orders Surf and Turf.
    Specialization and division of labor is the way capitalism is supposed to work, is it not? Why is it shocking to find that as medicine has become more technological, it’s also become more like a factory. That’s inevitable.
    What’s shocking is that we’ve seen so much specialization and division of labor, but at the same time costs keep going up and up. The consequence is supposed to be increased productivity and falling prices.

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