The Tennis Partner

These three books, which differ so in style and content, are persuasive evidence that the tradition of the physician-author lives on. The beauty of thought and clarity of word they convey merit the attention of any doctor.

Abraham Verghese has already made his literary mark with My Own County, a widely praised book about his medical and personal experiences when AIDS invaded a small rural community. Since then, Verghese, a specialist in infectious diseases, has moved to El Paso, Texas, where he is professor of medicine at Texas Tech University. His new book, The Tennis Partner, is an autobiographical novel. It tells the story of Verghese’s encounters with a drug-addicted physician, David Smith, an Australian tennis player who quits professional tennis to study medicine at Texas Tech. Verghese forms a bond with Smith on hospital wards and tennis courts. There, the games they play, at first hesitant but ultimately furious, are a metaphor for Smith’s battle against cocaine addiction and Verghese’s struggle to make something of Smith. But the bright, capable, deceitful, and self-deceptive Smith is as unable to win the final game as he is to find a life free of cocaine. The denouement is not a surprise, but it nevertheless shocks. Verghese writes lyrically about tennis and with sensitivity about the despair of addicted physicians. The book begins with a scene in the Talbott-Marsh Recovery Clinic, a real clinic for addicted physicians. Its head, G. Douglas Talbott, is past president of the American Society of Addiction Medicine and a pioneer in the treatment of addicted physicians. The Tennis Partner is rooted in the hopelessness and waste of drug addiction. Verghese uses his literary gift to deal with the problem in ways not possible in a technical paper.

In contrast to Verghese’s lean prose — as unadorned as a service ace — Gerald Weissmann’s Darwin’s Audubon can border on the baroque. But the baroque style has many admirers and merits, and it suits Weissmann nicely. Readers who can follow the sinuosities of Weissman’s odd connections and unexpected thoughts will appreciate this quirky book almost as soon as they begin it. The 24 essays in Darwin’s Audubon have been previously published, mainly in Hospital Practice. Collecting them in a single volume is a convenience and gives readers an idea of the scope of Weissmann’s interests. Among my favorites are “Puerperal Priority,” a beautiful account of the discoverers of the cause of puerperal sepsis; “Foucault and the Bag Lady,” which decries the displacement of hopelessly schizophrenic patients from psychiatric hospitals to the sidewalks; “No Ideas but in Things,” a marvelous essay about William Carlos Williams; and “Losing a MASH,” Weissmann’s story of his own experiences as an army doctor. Best of all is “Wordsworth at the Barbican.” I won’t tell you what this is about — all these short pieces are erudite, amusing, and stimulating: read them.

The Power of Hope is a reworking of Howard Spiro’s Doctors, Patients, and Placebos, published in 1986, and presented now with new ideas and considerations. Strictly speaking, it is not a literary work but a distillation of the experiences and thoughts of a physician who has practiced his art and profession for over 40 years. Yet the originality and elegance of this book justify its inclusion in this review. The Power of Hope has an important theme and challenges the reader with controversial ideas. Spiro emphasizes the difference between the perceptions of the doctor (disease) and those of the patient (illness). He tells us that the principal shift in mainstream medicine has been from the ear to the eye — doctors have lost the art of listening because they are too busy looking at images on x-ray boards or through endoscopes. “Physicians,” Spiro writes, “learn how to cure but little about how to care.” What Spiro is leading us to is his detailed contemplation of the placebo. What is a placebo? How does it exert its effects? Is the use of a placebo legitimate only in the setting of a clinical trial? Is it ethical for a physician to treat an individual patient with a placebo? Must the doctor always tell the patient, “You will (may) receive a placebo”? Who has the authority to judge whether the use of a placebo is ethical? (“In medical practice ethicist has come to mean those people who evaluate how doctors act with patients but who themselves rarely take care of patients.”)

Spiro moves from the placebo to alternative medicine. He argues that alternative medicine is a gussied-up placebo — a placebo with special qualities that distinguish it from the usual sugar pill. In a close analysis, Spiro deals with numerous “unconventional” approaches to the sick, from shamanism to Christian Science, always wondering if they do help the sick, and if so, by what mechanism. His examination is sympathetic, but he criticizes alternative medicine for refusing to be judged by the standards required of mainstream medicine. (“The holistic alternative medicine movement represents the romantic reaction to the sway of reason in medicine in our postmodern time.”) Yet Spiro also condemns the proposition that every ailment has a molecular or structural basis, and he blames our medical schools and teaching hospitals for inculcating doctors with the “scientific fallacy” of medical reductionism (“the more medical science does for disease, the less physicians do for patients”).

In The Power of Hope Spiro raises many disquieting questions about medicine and medical practice. He writes mainly for the lay public, but any doctor could profit from reading his book. Every page offers common sense and the perspective of a wise physician who has thought hard about doctors and patients, not as theoretical entities, but as real people.

Reviewed by Robert S. Schwartz, M.D.

Verghese had just taken a teaching position at Texas Tech University Medical School when he met intern David Smith, a former tennis pro who turned to medicine when his athletic career ended. With twice-weekly meetings over a net, a shared profession, and other common interests, the two became good friends. Verghese found in Smith and tennis a refuge from his own failing marriage and general middle-age angst. Just as Verghese began to discover renewed satisfaction in his work, Smith’s life became engulfed in turmoil. He had a number of destructive relationships with women, and, a former drug addict, he lapsed back into substance abuse, which left him unable–physically or legally–to continue in medicine. This is a meditation on friendship, its fragile underpinnings, and, sadly, its limits. But it also reveals that through the shared experience of sport, men especially can forge a relationship as enduring as any marriage. A melancholy and powerful reading experience. Wes Lukowsky

The acclaimed author of My Own Country (1996) turns his gaze inward to a pair of crises that hit even closer to home than the AIDS epidemic of which he wrote previously. Verghese took a teaching position at Texas Tech’s medical school, and its his arrival in the unfamiliar city of El Paso that triggers the events of his second book (parts of which appeared in the New Yorker). His marriage, already on the rocks in My Own Country, has collapsed utterly and the couple agree to a separation. In a new job in a new city, he finds himself more alone than he has ever been. But he becomes acquainted with a charming fourth-year student on his rotation, David, a former professional tennis player from Australia. Verghese, an ardent amateur himself, begins to play regularly with David and the two become close friends, indeed deeply dependent on each other. Gradually, the younger man begins to confide in his teacher and friend. David has a secret, known to most of the other students and staff at the teaching hospital but not to the recently arrived Verghese; he is a recovering drug addict whose presence at Tech is only possible if he maintains a rigorous schedule of AA meetings and urine tests. When David relapses and his life begins to spiral out of control, Verghese finds himself drawn into the young man’s troubles. As in his previous book, Verghese distinguishes himself by virtue not only of tremendous writing skillhe has a talented diagnostician’s observant eye and a gift for descriptionbut also by his great humanity and humility. Verghese manages to recount the story of the failure of his marriage without recriminations and with a remarkable evenhandedness. Likewise, he tells David’s story honestly and movingly. Although it runs down a little in the last 50 pages or so, this is a compulsively readable and painful book, a work of compassion and intelligence. — Copyright ©1998, Kirkus Associates, LP. All rights reserved.

“[Verghese] displays perfect pitch in this emotionally charged tale. . . . Readers . . . will be enthralled by his sleuthing into the human heart.” – Entertainment Weekly

“Abraham Verghese has show us once again that he is an old fashioned physician of the soul. Most extraordinarily, he finds metaphors for the blessings of humanity in the arts of tennis as healing. He recounts the living abundance of friendship and the dissolution of a brilliant friend and doctor. Dr. Verghese writes in a miraculous style-courageous yet tender. The Tennis Partner supersedes any memoir I’ve ever read. It is wonderful examination of what it means to be alive.” – Kaye Gibbons, author of On the Occasion of My Last Afternoon

“A tale of luminescent humanity. . . . It goes deeper than any book I have ever read to put its finger on the pulse of what friendship truly means. It is a book for everyone of us who has deeply loved and mourned the fragile, ever-changing nature of caring, with its inherent need to ultimately let go. A brave and honest book, The Tennis Partner, haunts and empowers with each volley.” – Denise Chavez, author of Face of an Angel

“This is a knockout book. Beautifully written, it broke my heart and made me happy all at the same time. I loved Verghese’s My Own Country and this even ups the ante—more intense, even closer to the edge.” – Natalie Goldberg, author of Writing Down the Bones

“Verghese is a fine writer, lyrical and controlled, and he captures the attachment between the two men–its motives, its allure–with both precision and charm. . . . Wise and compassionate.” – New York Times Book Review

“Verghese writes with such searching lucidity and is so attentive and engaging a figure that he could hold us just by describing his drives around town. . . . At its core his is a brave and heart-baring story about how even a teacher of internal medicine could not see inside the person closest to him. . . . It will speak to anyone who has looked with his heart instead of his eyes.” – Time

“With writerly grace, Verghese introduces us to the disciplines he holds sacred: tennis, internal medicine, fatherhood, male friendship. Everywhere he is a diagnostician, a teacher, a lover of physical presence. But finally as he walks the back alleys of El Paso searching for his drug-abusing colleague, we understand who Verghese is at his core, a man of honor who goes down mean streets and remains himself good enough for any world. This is an extraordinary book.” – Peter D. Kramer, author of Listening to Prozac

“Heartbreaking. . . . Indelible and haunting, [The Tennis Partner] is an elegy to friendship found, and an ode to a good friend lost.” – The Boston Globe

“Hit[s] even closer to home than the AIDS epidemic of which he wrote previously . . . this is a compulsively readable and painful book, a work of compassion and intelligence.” – Kirkus Reviews

“Poignant. . . . The metaphors that underlie tennis permeate the book and give The Tennis Partner. . . . a power that resonates well beyond its topical interest.” – Chicago Tribune

“Remarkable. It’s a terrific read, even if you’re not a tennis fan.” – Star Tribune (Minneapolis)

“The Tennis Partner is beautifully written, an outstanding example of nonfiction writing that conveys facts about a subject without being pedantic. . . . Verghese’s sincerity makes an indelible impression on his readers while his revelations enlighten us.” – Chattanooga Free Press

“Verghese is a wonderful storyteller. The language is irresistible, clear as springwater, sharp as the ring of fine crystal. I enjoyed every word.” – W. P. Kinsella, author of Shoeless Joe and The Iowa Baseball Confederacy

“Despite the poignancy of the subject matter . . . Verghese’s telling of it never gets heavy-handed. Instead, he uses his bedside voice: caring, but also slightly detached and startlingly frank.” – New York

“Elegantly written.” – Sunday Times (London)

“Eloquent. . . . A beautifully wrought memoir. . . . This is a terribly sad story, gorgeously expressed.” – Newsday

“Excellent. . . . penetrating. . . . [The Tennis Partner] is no small literary achievement.” – Sports Illustrated

“Gripping. . . . moving. . . . Verghese shows himself to be a thoughtful and honest navigator through life. His pain . . . is impossible not to share.” – Detroit Free Press

In My Own Country, named one of the five best books of 1994 by Time magazine, Abraham Verghese ventured into the valley of the Smokey Mountains, where he bore witness to the arrival of AIDS in a town that had never expected the disease or its terrible consequences. The New York Times Book Review called the book “an account of the plague years in America, beautifully written, fascinating and tragic, by a doctor who was shaped and changed by his patients.” As an African-born Indian, Dr. Verghese revealed something essential about our American soul, reminding us, said Washington Post Book World “of what is honorable and charitable in the way humans behave toward each other.” My Own Country presents an unflinching portrait of men and women facing the prospect of premature death, yet sometimes learning for the first time in that bleak circumstance how it is to live.

In 1991, Verghese moved west, bringing his wife and two young sons to the boarder town of El Paso, Texas. There he crossed paths with David Smith, a medical student who came to America from Australia on a tennis scholarship and played briefly on the pro tour before deciding to become a doctor. Recognizing some spark of commonality–perhaps just that of two strangers on the very edge of America–Verghese cajoled him into playing tennis again.

On the wards, Verghese is teacher and mentor as he guides David through difficult and sometime colorful clinic problems seen in a country hospital. He teaches him how to read the signs from the human body, to use his hands to percuss, and to use his mind to listen. On the tennis court, their roles are reversed: The clinician becomes the student–almost. David helps Verghese hone his strokes and sharpen his game. But Verghese, a compulsive collector since childhood of tennis lore and trivia, a compiler of notebooks on tennis heroes, ephemeral styles, and trendy strategies, rekindles David’s love of the game, a love burnt out by the brutal competitiveness of the professional circuit. Perhaps this is how friendship between men are born: art work and at play.

When the two men test their newfound bond, their friendship becomes something quite remarkable. Verghese confesses that his marriage is failing–and David admits that he is a recovering intravenous cocaine addict, struggling mightily to hold on to his girlfriend, his career, his sobriety. Against the stubborn, unyielding backdrop of the desert, their relationship grows increasingly rich and complex, more intimate than two men usually allow. Whether they are cycling on Old Mesilla, seeing a critically ill patient, or commiserating about a failed romance, each anticipates the other’s needs, is there to buttress a fall, or to celebrate the small victories: David’s graduation, Verghese’s son’s birthdays.

Just when it seems that nothing can go wrong, that friendship will be able to conquer all, the dark beast from David’s past emerges once again. As Verghese scrambles to rescue him, David proves that he is friend to everyone but himself. When David spirals out of control, almost everything Verghese has come to trust and believe in is threatened. It is a defining moment, the kind each of us must eventually face–it is from such adversity that our lives are carved.

The Tennis Partner is a remarkable journey to the ends and the edges of friendship, to its heights of intimacy and clarity, and also to its hellish depths of deception and betrayal. It is, above all, an unforgettable, illuminating story of how men live, and how they survive.

A practicing physician and a professor of medicine at Stanford University, Abraham Verghese is the author of My Own Country and Cutting for Stone. His writing has appeared in The New Yorker, Granta, and other publications. He lives in Palo Alto, California.