1. Though you’re an American by birth, you grew up in various and far-reaching parts of the world. How has this background affected your sensibility as a writer?
It had an enormous effect. I had a lot of powerful experiences as a kid, many of which took me a long time to understand and put in a larger perspective. I was always a foreigner, always an observer, and even though I haven’t lived overseas for more than twenty years I’ve never felt entirely at home in the United States, yet I don’t belong anywhere else either. I think this is a common feeling among people who spent their childhoods outside their own country. In the end, I suppose I’m an uneasy American.
2. What part of the world do you most want to revisit, and would you ever consider settling somewhere outside of the U.S.?
I would consider living outside the US again—the question is where? All of my personal connections are here, and I’m not sure I want my son to have the expatriate childhood that I did. In many ways I think that extensive traveling and exploring are better suited to adulthood. It’s all much clearer then, less bewildering.
3. You once said that being a doctor is “the best day job that a writer can have.” How does your work as a physician aid or contribute to your work as a writer?
As a doctor I get to talk to people from all walks of life, often about intimate and profound things, with whom I would never exchange words with elsewhere and might well in fact deliberately avoid. There is a danger, I think, in retreating into one’s own mind too much as novelist, relying too much on the imagination—often that results in empty pyrotechnics of one sort or another. It’s not that the imagination isn’t necessary, but rather that it has its limits, and to me at least some grounding in experience is critically important. One of the privileges of my job is I get to witness people in the midst of truly life-changing moments all the time, and I think it’s an enormous advantage for a writer. Of course, I’m not always able to do justice to that experience, but that’s one of the challenges.
4. Which came first for you, the decision to be a writer, or the decision to be a doctor?
The decision to be a writer, easily, because it wasn’t a conscious decision. I’ve written things since I was a kid.
Looking back, poetry for me was a kind of apprenticeship. It taught me a lot, and someday I think I’ll return to it, but there’s something about the larger form, the greater scale and scope of fiction, that’s exciting and liberating. Though I came to fiction relatively late, I also came to it fresh. I hadn’t been to any workshops, I hadn’t had any fiction teachers, and apart from my wife, Helena, I didn’t know any fiction writers. It was a new world to explore, and I was more mature, more experienced. So I’m glad I didn’t write fiction at all until I was in my thirties.
I read a lot, mostly fiction, but also some non-fiction. Right now I’m reading Home, by Marilynne Robinson, Man in the Dark, by Paul Auster, and The Echo Maker, by Richard Powers. I tend to read multiple books at once, which is probably bad.
7. There is a harrowing, vivid scene in Right of Thirst in which the narrator performs a back-country amputation; have you ever been obligated to perform an emergency surgery with less-than-optimal tools?
Thankfully, no, but I think I probably could have done what my character does, provided I had the nerve. I know an ER doctor who once performed a C-section in a hut in the middle of the African bush with absolutely no surgical training, using the same drug my character in the book does, and both the mother and child survived.
Amy O’Toole has worked tirelessly on behalf of this town, with little fanfare and without compensation, and she has had a dramatic effect on the lives of many poor families there. Given the themes of this novel, I’m donating part of its proceeds to ProSorata, and I hope that any readers who have made it this far, especially if they liked the book (which was after all much cheaper than a hardcover), will consider donating as well. 100% of the money goes to the town—it’s the most efficient charity I know of, and even a few dollars go a long way. Their website is ProSorata.org.
9. Do you feel that individuals with something to contribute, such as a medical background or executive experience—whatever it may be—have an obligation at one point or another to provide their services to communities in need, particularly those outside the orbit of Western development?
I suppose the answer to that is yes. I think the most basic challenge an examined life presents is that it asks us first to know ourselves, and second to be better than we are—to do what we don’t necessarily want to do, or are too lazy to do, but suspect on some level that we should do. At least, this is a dilemma for me—I tend to be somewhat cynical and detached, and in the end these tendencies can be both self-defeating and dangerous. I think many cynics are secretly ashamed of their cynicism, and I’m no different. I try to do the right thing for my patients even if it’s inconvenient, but I also know that I’m by no means an Amy O’Toole and never will be. Within the limits of one’s own nature, however, I think it’s important to do what one can, because without that, the world has little meaning. This is precisely the issue that Charles Anderson is wrestling with in the story, with not entirely conclusive results.
10. Right of Thirst is your third book and your second work of fiction. What’s next?