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The Pulitzer-winning doctor-author- ‘My Indian identity is incidental’

 on what it takes to go beyond boundaries, both geographical and intellectual

On a grey and windy but still temperate Fall afternoon in Manhattan, the writer and doctor Siddhartha Mukherjee walked around his penthouse apartment showing me his collection of eastern and western art. I had come to interview him, but my eyes had immediately fallen upon the stone South Indian sculptures displayed on a long side-table by a bank of windows. The brick buildings across the street seemed close.

Mukherjee is a slim man of 47 with a large head that stresses the primacy of his intellect. He told me that the art in the house spanned roughly 2400 years — from 300 BC to 2000 AD. “The hand is very special,” he said, drawing my attention to a smooth, grey, stone sculpture resting on a hardcover copy of The Gene. “That’s the largest Gandhara hand that’s fully intact.” The house was studded with works by Robert Rauschenberg, Cindy Sherman, Kara Walker, Richard Serra, and Jamini Roy, as well as ancient sculptures from India, China, and Cambodia. A ceramic globe by Mukherjee’s wife, the artist Sarah Sze, sat in the living room. “We ran out of space, actually,” Mukherjee said.

It struck me, as Mukherjee spoke, how little he fit the stereotype of the harried scientist. Instead of presenting an unkempt mien, he was wellgroomed with a head of elastic, bouncy black hair. He wore a stylish open-collared dark-blue shirt that nearly matched his blue jeans, creating the impression of an urban judo uniform. An over-long red-blue cloth-belt dangling down from the front of his jeans completed this look. On his feet were shiny black clogs; he has dozens of identical pairs in his closet. Like Steve Jobs with his black turtlenecks, Mukherjee wears only one kind of shoe at a time.

The Emperor of Maladies, his first book, won the Pulitzer Prize. It attacked a very American subject, with a very American past: cancer. As Mukherjee noted in that book, “Society, like the ultimate psychosomatic patient, matches its medical afflictions to its psychological crises; when a disease touches such a visceral chord, it is often because that chord is already resonating.” The Gene wanders more broadly — from India to Austria to the Galapagos to Africa to the labs of Stanford; it is an astonishing undertaking, full of insight and pity for humanity itself. In the sections about mental illness in his own family, Mukherjee breaks into new, fertile, novelistic territory. In fact, he has become a frequent contributor to The New Yorker, colouring its pages with his sinuous, metaphor-drenched prose — an approach to science writing that differs from the more see-through efforts of the other great doctor-writer published in that magazine’s pages: Atul Gawande.

Gawande and Mukherjee are friends, and in our interview Mukherjee touched upon Gawande’s work and his own struggles with writing. But otherwise our conversation roved freely and widely, like the books themselves — from Delhi (where we both grew up) to Stanford (where we were both undergrads, though years apart) to New York and to the strange mental spaces you can only reach with great concentration.

Through it all, Mukherjee sipped a whiskey and swirled the ice in his tumbler. He speaks fast, commencing most sentences with a slightly higher-pitched “you know” from which to slide down his thoughts. He also deploys the words “particularities” and “fundamentals” repeatedly, like gunshots of emphasis. Excerpts from the interview:

When did you start collecting art?

We didn’t start collecting — most of it is work from our friends; some of it is things we’ve traded over the years; sometimes we find something amazing, though we don’t have infinite resources or space. But I’ve always loved [art], so I’ve been involved in it now coming up to twenty years. The first piece I bought here was a work by Chuck Close and that was fifteen years ago.

Were you drawn to a particular kind of Indian art? I’ve seen the pieces you have here, but I’m curious what the evolution was.

As a child I was particularly fascinated by what happened to Jamini Roy’s evolution as a thinker. He was trained classically as a painter and then he had to go through this process of returning, he had to go backwards, and that idea fascinated me. He tried to find a kind of genesis myth…

[There is a sound like wood being polished — soft barking. Mukherjee turns to his dog, a small brown and white Papillion] Ginger, stop it!

…And in doing so he began to create a radically new form of work. He abandoned oils, went back to tempera, often paint washes, which were the simplest possible thing. So that maybe relates to a larger question: you’re an Indian writer, you think of yourself in a particular way and then you have to ask your question — what does it mean to come from that place? And for Jamini, it meant totally reinventing himself. It meant coming to terms with a national identity he had abandoned before.

What is your version of that, with India?

The question often asked is: what is Indian about what I write and what I think about and my usual answer to that has been: I’m not from India, I’m from Lithuania…That’s just meant as a provocation. What’s India, or not, is not interesting to me about what I write about. The notion of self is important, history, your micro-history, your origins, your parents, the journeys they took, how those journeys intersected with larger forces, how that creates the idea of who we are as humans, biologically, physiologically and anatomically, what that tells us about the kinds of things that we invent, the science we make, the kind of medicine we create — those lineages are important. But of course once you get to the point of thinking of these as elements of national identity you lose that textural detail and that’s what I’ve always avoided.

In Indian writing in English there’s an obsession with the national project of India, which sometimes results in books that are about Indian history or about exalting certain parts of the Indian experience but that aren’t able to contribute anything new to the understanding of human consciousness. Does something of this kind happen in science as well? People are always asking, for example: Why isn’t there a Google coming out of India?

The national project is of no interest to me whatsoever. It has only become of exalted interest now because of the aspirational quality of what that project means today. Honestly the national project was the most successful to me in writers when it was deployed into local questions, microquestions, particularities. Tagore, who breathes down your neck if you’re a Bengali of any form, Tagore is an internationalist but his most successful work is when he is deeply located in a particular village in West Bengal.

Like Gora…

Yes, Gora’s a great example. So if Tagore had written highfalutin’ works about internationalism, he wouldn’t be the same person. To some extent this is true of scientific projects as well. They are located in questions that are uninterested in the progress of capital as science but are more interested in extreme particularities that are generated by nature and the world. Why is it that things fall down not upwards? Newton wasn’t trying to create a new science, he was trying to answer extraordinarily important questions about how he observed the world to be. One of the crises is that if you set up to write the great book, the book comes out to be far from great.

What is your view of the work being done in your scientific and medical fields in India?

Medicine is an interesting arena in India. I experienced it directly when my father died. Medicine can be amazing in India. I’m writing a piece about it in The New Yorker. The main talking point has to do with the Challenger Shuttle. The Challenger Shuttle was an elaborate engineering contraption. It blew up because of a single fuse, an O-ring, as it were. Medicine in India is like experiencing O-rings. There’s an unbelievable quality, and then it fails because of some tiny systems error. Or an infrastructural error, something you can’t anticipate. The nurse can’t come because her baby’s sick and there’s no substitute and so all of a sudden in the middle of the night a patient has no nurse.

Delhi in the 1980s. What was it like?

It was a politically hyperconscious city. As you know, the riots had happened. I was 14. I have a very particular memory of that. I was in school and then all of a sudden my mother’s brother — sort of the elder of the family — suddenly appeared during break. He was a very dignified, quiet man and he said, “we should leave,” and it was a little confusing to me — I was 14, I wasn’t a child — and he said, “no, we should leave, we’ll discuss it later,” and I remember driving through the centre of Delhi and the most consequential thing in the centre was an eerie quietness. There was no one around. We were driving through these massive lanes, and by the time we got home you could see the smoke from the homes that were being burned. In fact, two homes down from ours, a home was burnt and one of the residents was killed.

Delhi was also a city slowly obsessing with its own growth. In 1987, 1988, the most consequential years, I was 17 and 18, we had begun to have access to a world that was foreign to us. The cinema houses which only had bad Hindi films and the occasional Soviet release suddenly [had foreign releases]. You could go see Orson Welles and Star Wars.

Do you feel the Indian education system or the ideas at its peripheries had an impact on you as an intellectual? We grew up, for example, in a very verbal, gregarious culture. There was a kind of fluency in Delhi. People are punning all the time; there is love of language. With you, there’s language, there’s science, there’s music [Mukherjee is an accomplished singer of Indian classical music].

I grew up on a diet of Enid Blyton and on a good day George Orwell. Particularly for my generation of writers, readers, intellectuals, Salman’s book [Midnight’s Children] was like a thunderclap. Someone described it to me once: in Delhi films were always made in Hollywood or in Bollywood and they seemed like places that were far away. Then there was one film I remember from my young adulthood where all of a sudden the bus was not a Hollywood bus, not a Mumbai bus but a DTC bus and I knew the bus and it was 623 and I remember the film too, it was called Aadharshila. To see that the film is not about an abstraction of somewhere far away but somehow at your doorstep and is part of your life… that was a real revelation. At 17, I had read Flaubert’s letters. I said to myself: who writes like this? What continent do these people live in? What do they eat? What are they anxious about? My anxieties seemed so different.

In what way did you hone your prose style at Stanford and Oxford?

I never considered myself a prose stylist and never sat down and honed prose. Rather I sat down and read prose, which helped me. Who were they? In non-fiction: Primo Levi, Orwell — I’m just looking up at this bookshelf and you’ll find them — Oliver Sacks, who else happens to be on this bookshelf? And in fiction McEwan and Hollinghurst and Chekhov obviously, over and over again. Who else is on this list? Atul [Gawande], [Richard] Selzer, Lewis Thomas…

What was it like being an Indian at Stanford at the time and then at Oxford?

I was so uninterested in the idea of it, so uninterested in where I had come from. Of course, I spoke the language, I had facility with it. Yes, sure, on occasion, I would wear some Indian clothes and land up in some [festival]. But that was not the dimension I was intrigued by…

But Indian identity wasn’t forced upon you by other people? That would be the form it would some times take.

If it was, I was so immune to it. I was disengaged. To a fault, I think. It was not the realm through which I wanted to make friends or engage the world. It was purely incidental — an incidental passport which I happened to have.

Ironically, of course, I’m a third generation transplanted Bengali who knows how to write and read Bengali. I have more facility in the language than virtually anyone I know.

Why is there a tradition of doctor-writers in particular? In another interview you talk about admiring Primo Levi’s ability to break down concepts and the clarity of his style.

I think it has to do with the intensity of experience. Erving Goffman talks about total cultures— self- enclosed universes. Medicine is a total culture. It has its own laws, its own code, its own rituals, its own commandments. When patients enter the culture of medicine they feel as if they’ve entered a total culture. As human beings we want dispatches from total cultures. We want to know about them because they’re so self-enclosed they elude us.

And yet medicine has a twofer, which is that you know you’re going to be part of that total culture as well at some point in the future. It’s an inevitability. You too will have to learn the code because the code will affect you. That’s part of obsession with the idea of medicine.

But why do practitioners of medicine feel the urge to send dispatches out of the total culture of medicine? I can understand people wanting to receive these dispatches. But there are plenty of people who are happy existing within arcane cultures, hoarding knowledge.

It’s not knowledge that people are trying to disperse from the archives of medicine; what they’re trying to disperse is a sense of what it means to belong in it. Here’s an activity that is extraordinarily intimate.

Atul [Gawande] was speaking here three nights ago and we had dinner. I was reading this piece by Atul about itching in The New Yorker. I was trying to dissect the piece. What’s interesting about it is that you can’t take your eyes off the piece. And the reason it’s great is because of the total culture of it. You enter this woman’s brain and you can’t get the hell out of it. Carla in Emperor [of Maladies]: you enter her brain and you can’t get the hell out of her.

I was very intrigued as a child — I‘ve written a small piece about it but never published it — by the famous and somewhat lovely fable about Krishna swallowing a clod of earth.

His mother comes and opens his mouth and she looks inside and all of a sudden the whole cosmos is inside it. You feel, when you’re a doctor, that you swallow the clod of one particular patient’s story and everything is inside it. There’s a macabre fascination because you could be that person, you could be the doctor, the observer, the child, the friend.

Your books are about imperfect flows of information. I wondered: is that the sort of thing that is not covered in the way medicine and science are taught to young scientists or doctors?

You caught an important piece of this. The books are fundamentally about the way we acquire, disperse, and deal with knowledge. They are about the care and feeding of knowledge, the way you would care and feed for an animal. Sometimes you underfeed, sometimes you overfeed, but I think about the books as being about the physiology of knowledge.

In what ways has writing made you a better doctor and scientist and in what ways has it made you worse?

Like many other people I write to think. So knowing the structure and the nature and the limitations of how we know and what we know is crucial. That makes you a better doctor and scientist. On the flipside, the enormity of this — the enormity of what we don’t know — can be distracting. The New Yorker pieces take the druthers out of me because they are so hard to do, they have to be condensed. The background to each individual piece — I know this from Atul’s work as well — involves hundreds of interviews and then it’s sent out to dozens of people; all of that gets seeped or stocked into one little thing. It’s like getting a sponge and taking everything out of it. All of this is not about the labour of writing but to remind us that every time you uncover a particular realm of knowledge there’s a kind of humiliation that comes with it.

We’re living in an unusually antiscience period in modern history. Are there ways in which science itself has fostered that backlash? Are there things science could communicate better?

Yes I think that’s absolutely the case. This goes back to the two cultures problem, the many cultures problem, really. Scientists became obsessed with their own jargon. The jargon is very useful in some ways. It was and remains important. For the longest time scientists wrote to think. Newton and Einstein wrote to think. Dawkins writes to think. But the professionalization of science and medical writing cut that cord. You were no longer writing to think but to talk to your colleagues. That’s a problem. We lost a kind of interiority and the depth that comes with interiority when we started writing to our colleagues. It was like a telegram versus an autobiography.

You are a high achiever. You’ve done a lot of different things. Do you have darker Dostoevskyian moments where you want to smash it all? Is there a side of you that’s not generally seen by the public?

When my father died last year, in October, I sort of fell into a depressive funk. I go through funks all the time. So much of it for me is getting through a creative funk. I’m in one right now because I have to write another book. You could make a compelling oeuvre about writing about creative funks, and many people have, and it’s useful: we like to read them to get out of our own creative funks.

How did you overcome the barrier of writing about something as personal as mental illness in your family — given, as you write yourself, that your parents “[like] most Bengalis… had elevated repression and denial to a high art form”?

Once I started it was not hard. The first step was to get over the first step. I wrote the introduction to The Gene on a bus. I was going to Martha’s Vineyard and the kids had taken the ferry and I decided I was going to take the bus to the ferry that goes from Rhode Island and then take the ferry across to meet them. It was the fastest way I could see them. I had four-and-a-half hours and I had been ruminating and puzzling about all this and then I sat down and wrote it down on that trip.

What do you perceive as your own flaws as a writer?

I have many. The common complaint around The Gene, and Emperor too, has been that the personal elements don’t integrate fully. That there’s still a schism, an artifice, in moving between the visit with my father to the place where he grew up in Calcutta and the history [of genetics]. People say: what’s the connection, why are we reading this? To eliminate the artifice is tough because it felt real to me but doesn’t feel real to other people and maybe in the end these books have to just turn colder.

I think long before we know a book we know the mood and temperature of a book. I’m a very instinctive reader. When I read a paragraph I can tell you if it is blue, or red, or cold, or hot.

Do you actually have synesthesia?

I don’t have synesthesia but I have a reader’s version of synesthesia, which is that long before I understand the meaning of a poem or a paragraph, I can tell you the sense that it evokes. I’m very quick at that. I read quickly. I can look at an art work and tell the temperature very quickly.

What do you mean by cold versus hot?

I get a sense of whether the mood is ruminative versus angry, polemic versus introspective. Ultimately a piece of writing is located in some kind of dimensional space, and I can generally tell where in the dimensional space it sits.

I’ll tell you about my process. Very often I’m speaking with my editors — like after I finished writing The Gene — and I’ll say, “Don’t tell me about content. Let’s talk first about speed, temperature, mood.” This idea that I call “thereness.” The first question I ask about a piece: do you feel the “thereness” of it? Do you feel you were there, have you moved there? And this is true of knowledge. The only way we understand knowledge is when we are there, we understand its context. What was it like to be Darwin? And why is that important today?

So that’s one of the first questions I ask my editors, and if they say no, in that case I have to rewrite things. It doesn’t mean [I do] new journalism. [I don’t have to go] to the Galapagos. What it does mean is to make the history of ideas alive. What was it like not having that moment of discovery? What was it like not knowing that medicine, that kind of discovery?

You’ve written in The Emperor of Maladies that “Scientific revolutions…typically occur in basements, in buried-away places removed from mainstream corridors of thought.” Have you been able to carve out that kind of mental basement space for yourself in New York?

Well, it’s tough. It happens only when you are alone and you have to find alone time in New York or elsewhere. There’s a sense of rejection that a person feels when you say, “I really want to be alone”— your kids feel a sense of abandonment. But it’s one of the last luxuries, having time to yourself.

Where do you find it?

All the time, as much as I can, everywhere: on a flight, in a room, behind a closed door, in the mornings, in the afternoons. The only way that I write is to have an interior conversation. Once that conversation goes you’re dead as a writer and as a scientist. Then you become an outward being. The hall of mirrors of your brain has been broken and there’s nothing left.

Finally, I wanted to get to the most important question about cancer, which you didn’t answer in your book. Does coffee reduce cancer? [laughs]

[Laughs] I think essentially it does reduce cancer. We’ve been trying forever to show how villainous coffee is and every time they run a trial it turns out to not be villainous at all. I don’t know what the advantages are but it turns out that coffee’s not so bad for you.

(Karan Mahajan is an Indian-American novelist who has written The Association of Small Bombs and Family Planning)

This interview is from the book Peerless Minds: A Celebration edited by Pritish Nandy and Tapan Chaki, to be published by Harper Collins. The book is supported by a grant from Sunil Kanti Roy of the Peerless Group. All royalties from the book will go to the Ramakrishna Mission’s Sister Nivedita School for Girls

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    The interview has exposed many ideas which are important for study amd analysis in present times

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