One Twist Too Many

500 or so pages into The Covenant of Water, matriarch Big Ammachi has a conversation with her god, grateful for her blessings, certainly not complaining

“But, there’s always something, Lord, isn’t there? Every year there’s a new worry…now and then, Lord, I could use some peace.”

Bless her heart. I had reached that point some 100 pages earlier.

The night before her wedding, a twelve year old girl hears her mother say,

“The saddest day of a girl’s life is her wedding day. After that, God willing, it gets better.”

So starts Verghese’s ponderous tome, a description I first read in an Archie comic book as a child. Ponderous, as in massive, heavy, long – but, by no means, cumbersome or boring.

The Covenant of Water, a story written in ten parts and 84 chapters, starts in 1900 with the marriage of child-bride Mariamma to a quiet forty-year old widower with a toddler. Both he and his son have a curious aversion to water. She will soon learn of deaths by drowning in every generation of her husband’s family. In 1974, several years after Big Ammachi’s passing, her namesake, her grand-daughter, will learn the medical name and cause of The Condition.

In between, evoking a multitude of emotions, readers are taken on a journey through time – three generations – and place, mostly, Kerala,

“…a fish-shaped coastal territory at the tip of India, its head pointing to Ceylon (now Sri Lanka) and its tail to Goa, while the eyes gaze wistfully across the ocean to Dubai, Abu Dhabi Kuwait and Riyadh.”

The ‘wild and hilly’ five hundred acres of Parambil, the widower’s home, too far from any body of water for his bride, become the reader’s home. Big Ammachi’s family expands – there are two children, Baby Mol, the happy child, “fixed in time” due to a thyroid condition, and Philipose, who has The Condition. Distant cousins and new residents arrive, Parambil grows, is ‘uplifted,’ thanks in large part to a man known as Uplift Master.

Like life, if one lives long enough, there is love and heartache, separations and reunions, joyous births and violent deaths, floods, famine, war, peace – which sounds like a little too much. Then again, thinking about my grandparents’ lives, my parents’ childhood in that India and during those decades, similar stories might be told (except the love and heartache part – so far, nothing that interesting).

After meeting the Parambil family, we are introduced to Digby Kilgour, a scarred – literally and figuratively – Scottish doctor in love with surgery and an artist fascinated by human anatomy – specifically bones and muscles.

‘He’s reassured to think that no matter how disappointing humans can be, the bones, the muscles, and the viscera are constant, an unchanging interior architecture…” (p.87)

In 1933 Digby leaves his bleak existence in Glasgow for India, peeling “off his past like a soiled glove.” He’s not prepared for the heat or the vibrant colors of Madras and its equally colorful people but welcomes it all. For the next two years Digby hones his skills running surgical wards for the “natives,” gains a family of sorts, acquires an enemy and a lover. It all ends badly, explosively, leaving Digby unable to operate. More scars and another escape to heal – this time to the mountains. Digby’s hands will be reconstructed by Rune, a Swedish physician devoted to caring for those with leprosy and, with the help of a nine-year old artist, Elsie, Digby will sketch again.

Initially, the author switches between Big Ammachi’s family in Parambil and Digby’s story every 90 or so pages. Of course, their lives will intersect – it is Rune who diagnoses Baby Mol’s condition before heading for the hills to the lazeretto. Then, Digby seems to be forgotten for about 300 pages. When he does reappear, it’s to move subplots along and feels a little forced.

It’s not so much that The Covenant of Water is long – a poorly written 200-page book can drag on interminably. My quibble is with the need to give most members of Big Ammachi’s clan some kind of drama, tragedy or a devastating secret, or all three. The last 100 pages, the final secret – the last twist, for me, was one twist too many. Nothing significant was added and it overshadows the ‘victory’

“The Condition now has a medical name and an anatomic location, which explain its strange symptoms: deafness, an aversion to water, and drowning. They’ve found the enemy, but the victory feels hollow.” (p.603)

Thankfully, the author’s consistently beautiful prose makes any extra pages more than bearable. Verghese seamlessly weaves centuries of history and geography into his stories within stories, incorporating the smallest of details which may seem meaningless to most but made me pause and remember…it’s not just a fountain pen, but a Parker; not any powder but the medicine-y smelling Cuticura.

Of course, Verghese shines in the detailed descriptions of disease symptoms, wounds and surgical procedures. While not for everyone, the writing is engrossing, relatable, unforgettable. Living with the pain of a losing a child is described as “… the way one lives with vision turned cloudy from a cataract, or the ache of an arthritic hip.” When a pregnant woman presents with a slit in her womb through which her baby’s fist has pushed, Verghese starts with a detailed description of the frightened mother-to-be, her sari and jewelry; the doctor then imagines the bloody path the knife blade must have taken. Any squeamishness fades with the last phrase of his summary:

“the blade simply pierced the abdominal skin and muscle and encountered a bigger, thicker, and stronger muscle: the uterus. It made a slit, a porthole in the womb, and the baby reacted like any prisoner: it reached for daylight.” (p. 411)

Almost every page has such prose – a reader with an affinity for all things medical couldn’t ask for anything more and yet, the author delivers, in the form of a lecture on inflammation:

“…the invaders (typhoid bacteria) are spotted by the hilltop sentries (macrophages), who send signals back to the castle (the bone marrow and lymph nodes). The few aging veterans of previous battles with typhoid (memory T-lymphocytes) are roused from their beds, summoned to hastily teach untested conscripts the specific typhoid-grappling skills needed, and then to arm them with custom lances designed solely to latch onto and pierce the typhoid shield–in essence, the veterans clone their younger selves. The same veterans of prior typhoid campaigns also assemble a biological-warfare platoon (B lymphocytes) who hastily manufacture a one-of-a-kind boiling oil (antibodies) to pour over the castle wall; it will melt the typhoid intruders’ shields, while not harming others. Meanwhile, having heard the call to battle, the rogue mercenaries (neutrophils), armed to the teeth, stand ready. At the first scent of spilled blood–any blood, from friend or foe–these mercenaries will go on a killing frenzy…” (p.579)

If there were a soulmate equivalent in authors then Abraham Verghese would be mine – to say his writing resonates is inadequate. The inflammation battle took me back to a college physics class for pre-med students. Coincidence or connection – public health, medicine and writing, starting my career when AIDS was raging and ravaging, geography – southeastern US, Texas, California, India…I don’t know. I only hope his next book won’t take 14 years.

[For another take on this book, see Lisa’s review]