Special thanks to Vikram Paralkar for answering 5 questions about his recently featured book – The Afflictions

Vikram Paralkar was born in Mumbai, India. He moved to the United States in 2005 after completing medical school and is now a hematologist and researcher at the University of Pennsylvania. His writing has been published in the New England Journal of Medicine and he is a recipient of the American Society of Hematology’s Scholar Award. – From Lanternfish Press

Author’s Twitter: https://twitter.com/vikramparalkar

#1 – What was the impetus for The Afflictions?

I initially planned to write a short story modeled on the fable of the Tower of Babel. It would describe a town whose inhabitants awaken one morning to find that they all speak different languages, and can no longer understand each other. During the act of writing, the story turned into a scholarly report describing an epidemic. This revealed a template to me – I could take something intrinsic to the human state (like the need to communicate through language) and distort it to produce a fictional affliction (like an epidemic of new tongues). I could then write it as a clinical vignette, complete with case studies, speculations about causes, debates about treatment. I applied this template to other themes – personhood, identity, memory, exile, music, morality, love – and created multiple vignettes that contemplated these themes and dissected their relationship with human existence. The vignettes, put together, form The Afflictions.

#2 – The many varied medical disorders almost have a mythical quality to them. How did you go about combining both the real and imagined aspects of these disorders?

The earliest drafts of some of these afflictions were set in the modern world, with a backdrop of contemporary scientific understanding and vocabulary. But it became clear that I could drill more metaphysical oil out of them if I set them in a time when magical thinking was very much a part of medicine. In particular, highlighting the contrast between the immortal soul and the mortal flesh allowed me to bring theological speculations (as rich a literary mine as any) into the arena. In the 21st century, one can’t, in good faith, smuggle God and the Devil into serious medical discussions, but it was quite acceptable in Renaissance Europe, and so that’s where I set my afflictions. The mythical mood and tone followed.

#3 – Your book is a series of case studies. Were you inspired by any real-life case study books?

I can’t quite say I was inspired by medical case studies, but Italo Calvino’s ‘Invisible Cities’ and Jorge Luis Borges’ short fictions were obvious tonal and thematic influences.

#4 – As a hematologist, how did your training inform your book?

My medical training was helpful in two ways: (1) It allowed me to steer clear of actual diseases. You’d be astonished at the number of bizarre illnesses that exist in the real world. (2) Medical textbooks, journals and conferences have many idiosyncrasies – hair-splitting arguments about disease classification and nomenclature, contradictory theories about disease etiologies, discussions about how rising costs affect healthcare. As a physician, I’m very familiar with these aspects, and wove them into my writing. To give you an example: One of the fictional afflictions in my book – ‘Agricola’s Disease’ – leaves its victims deaf. A very expensive elixir can restore their hearing for a brief, intense period, after which the deafness returns. If no such treatment existed, the invalid would just have accepted his disease and lived with it, but a single taste of this elixir is so addictive that it destroys his life. The treatment is therefore a greater curse to him than his affliction. There are many such ways in which my medical training has seeped into the fictions of this book.

#5 – Are you working on any new books/projects you can tell us about?

I have completed a novel titled The Wounds of the Dead, which I’m currently working on getting published. It’s set in a clinic in rural India, where a small-time surgeon is visited one night by the dead, who beg him to mend their wounds so they can return to life at dawn.

[Image Credit: http://www.onethejournal.com/wp-content/uploads/2014/11/Vikram-Paralkar.jpg ]