Abraham Verghese’s Sweeping New Fable of Family and Medicine

THE COVENANT OF WATER, by Abraham Verghese

Abraham Verghese occupies a curious place in the modern literary landscape. A doctor who decided midcareer to train at the Iowa Writers’ Workshop, he has gone on to achieve distinction in both fields. He is a professor of the theory and practice of medicine at Stanford Medical School, continues in clinical practice, has won the National Humanities Medal, speaks widely about the importance of the human element of what has become a technocratic practice, and has won awards for both fiction and nonfiction. His last novel, “Cutting for Stone,” spent more than two years on this newspaper’s best-seller list.

It is tempting to look at him as a man with multiple careers running in tandem, but all his work is anchored in a consistent, profound moral architecture of the spirit. He suffered considerably when he was younger — experiences he has chronicled in his earlier fiction and nonfiction — and emerged a romantic, determined to be kind and extravagantly compassionate, a genuine humanist. In an era when seriousness is often presumed to entail skepticism, he is serious about benevolence. By projecting his own best self, he hopes to coax out the best selves of others.

It is hard to operate consistently on such high principles, harder still to explain them to others, and hardest of all to demand that others rise to them. The modesty of ostentatiously kindhearted people can come off as smug, and in his public statements, Verghese occasionally assumes a bothersome tone of condescension. His new novel, “The Covenant of Water,” focuses almost entirely on good people (to whom many terrible things happen), and given the complexity of human beings, the surfeit of grace sometimes feels unrealistic and even pretentious, as though the writer is affiliating himself with standards that ordinary humans cannot attain. The lack of ill intent or even ambivalence among the book’s many heroes can become cloying. This is not a novel endowed with subtle psychological insights, and it is devoid of humor: on the part of the characters or about them.

It is, however, grand, spectacular, sweeping and utterly absorbing. Verghese has a gift for suspense, and his easy relationship to language draws you through the narrative so effortlessly that you hardly realize you are plowing through decade upon decade and page upon page. The book begins in 1900, as a 12-year-old girl in what is now the state of Kerala, in southwest India, prepares for an unwanted arranged marriage. It ends in 1977, when that girl’s physician granddaughter arrives at a shocking discovery. The family are Indian Christians, descendants of those first converted by St. Thomas in the first century A.D. They lead tough but often joyful lives, and they gradually make their way up in the world despite impossible-looking challenges. A plot synopsis would take a hundred pages and spoil the fun, but let it be known that this family loves and suffers in a cavalcade of ways.

The tone of the book is sometimes pedagogical: There are a lot of doctors here, and we learn in rather fine detail about surgical procedures, anatomical constructions and medical interventions. Verghese’s writing about all things medical is particularly adroit; his profound understanding of the human body is perhaps his greatest strength. Even if the personalities of the numerous physicians are not fully rounded, their identities as doctors are. We also learn a great deal about India, some of which we might already have known: the caste system; the social upheavals of the 20th century; a variety of foods; information about architecture, farming and family structure; the place of faith in the society; the eventual move toward socialism.

Like Amy Tan’s “The Joy Luck Club,” which catered to a voyeuristic interest in Asia by selecting its most accessibly endearing characteristics, this novel recalls the curry one might get in a small American farm town: exotic by local standards, not wrong in any way, but substantially softened for the locals. Some of the exposition can seem almost patronizing to a more worldly reader. The view of India does not achieve the plangent intimacy that, for example, Vikram Seth achieves in “A Suitable Boy.” This is populist writing, ambitious in plot but not in character, and populated with archetypes rather than people. So, in many ways, was the work of Charles Dickens, whose crackling but now rather historical method of storytelling may be among Verghese’s inspirations.

Credit…Sophia Deng

Yet why should we assume that sophistication requires cynicism? Sometimes it is satisfying when good things happen to good people, when the nastiness that has tended to reap rewards in the harsh world of modern fiction takes a break. People may not be as good as Verghese’s characters, but neither are they as bad as Philip Roth’s or Saul Bellow’s. Ugliness is not truer than loveliness, nor cruelty more so than kindness. Sometimes, the world’s insults are simple ones: a child who dies, a fire, a disease, a flood. There is pungent truth outside of malice.

This book may follow “Cutting for Stone” onto the best-seller list and stay there for a long time. It does not present the dark and fantastical complexity of India limned by Salman Rushdie in “Midnight’s Children,” and its occasional gestures toward the mystical feel contrived. Still, it will expose people without much connection to South Asian culture to beauties to which they might otherwise not have access. In a period of divisiveness, racism and anti-Asian hate, that is as important an accomplishment as changing our understanding of what fiction can do, or explaining how the world’s largest democracy came to elect Narendra Modi, or delving into the anti-Islamic face of Hindu nationalism. The arranged marriage that begins the book is a happy one; many are not, and the status of women in rural India remains often problematic; that should not, however, undermine the reality that such marriages succeed at least as often as those predicated on romance.

The trick is to read the book not as realism, but as a fable. The impetus to write it began with a notebook that Verghese’s mother wrote for an inquisitive granddaughter, and the earlier parts of “The Covenant of Water” have the soothing haze of sentimental recollection. Even as the book moves toward more recent times, when Verghese himself was alive, and begins to express some awareness of a troubled world, its plot is so thick with extremes and unlikely coincidences, so highly wrought, so dense with drama, that it doesn’t feel real. But it doesn’t need to. Verghese has given us entry to Cochin and Travancore as they once existed or never did, and to a family whose saga is full of grief and yet oddly reassuring.

The great novels about India by Indian expatriates are often traumatic to read. This one is not a literary accomplishment at the level of Jhumpa Lahiri’s “The Namesake” or Arundhati Roy’s “The God of Small Things”; nonetheless, I would happily spend months on end with it and I cried when it was done. While I don’t entirely believe in Verghese’s characters, I am moved by how much he loves them and, in so doing, makes the reader love them. At this moment, I am longing to go to Kerala; I am as nostalgic for Big Ammachi as I am for my own grandmother. It is a better world for having a book in it that chronicles so many tragedies in a tone that never deviates from hope.

Andrew Solomon is the author of “The Noonday Demon” and “Far From the Tree.”

THE COVENANT OF WATER | By Abraham Verghese | 724 pp. | Grove Press | $30

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