On a fever pitch: Vikram Paralkar compiles ‘imagined, surreal diseases’ in The Afflictions

A book of ‘imagined, surreal diseases’ in Renaissance-era Europe sits at the heart of Vikram Paralkar’s The Afflictions.
Vikram Paralkar
Vikram Paralkar

A physician-scientist at the University of Pennsylvania, Vikram Paralkar’s The Afflictions is a unique book that is situated in a library in Europe, during the Renaissance.

“The jewel of this library is the Encyclopaedia Medicinae, a collection of all the medical knowledge of its time,” Paralkar tells us.

The book is then composed of fifty-odd ‘imagined, surreal diseases’ that are randomly browsed by Senhor Jose, the elderly librarian and his young apprentice.

“For instance, the first affliction — ‘Amnesia inversa’ — has invalids who are forgotten first by distant acquaintances, then by those with whom they interact in their day-to-day lives, and finally even by their loved ones, leaving them to wander the earth without anyone remembering that they exist,” the author states.

Here, Paralkar chats with Indulge about the idea behind his book, how his experience as a scientist helped him, and his upcoming projects. 

How did the idea behind The Afflictions take place? 
The initial idea for this book arose from a short story I was writing several years ago, structured around the fable of the Tower of Babel.

I intended to describe a town whose inhabitants awake one morning to discover that they all speak different languages and can no longer communicate with each other.

As soon as I began to write, I realised that the concept would work better as a medical vignette, written by a scholar describing the strange events that have transpired. That was how the first of these afflictions took birth. 

The works of Calvino and Borges are some of your primary inspirations. How did you go about intertwining medical jargon with fictive elements? How has your own background as a haematologist helped in the process? 
Borges and Calvino were enormous influences on my thinking at a time when I was beginning to understand, as a reader, the power of words and ideas.

Weaving medical language, and indeed medical thought, into The Afflictions took a certain amount of trial and error beyond planning out the literary outlines of the work.

It was important to find the right balance between the imaginative and fantastic on the one hand, and the concrete methodologies of doctors as they struggle to understand the diseases before them on the other.

Interestingly, my medical colleagues who read the book often notice aspects of the writing that non-medical readers miss.

Obsessions with nomenclature, categorization, the formulation of (sometimes contradictory) hypotheses to dissect maladies - they all strike familiar chords with physicians, who spend their days grappling with these kinds of structural issues.

Instincts that I surely absorbed through my own career and immersion in medicine.

Vikram Paralkar

Out of all the 'afflictions' delineated in your book, which one would you say you enjoyed conceiving the most? 
That’s a difficult question to answer, since conceiving these fifty afflictions wasn’t a linear process, and involved having several incomplete draft afflictions in progress at any given time as I wove back and forth through them to tweak and polish the themes I was trying to explore.

Indeed, it would be more accurate to say that I was writing networks of afflictions, with invisible threads running through and unifying several of them into patterns.

That said, the ones that perhaps resonated with me most were the afflictions dealing with exile, either societal or geographic.

One of my personal favourites is titled ‘Morbus geographicus’, in which the patient experiences pains and symptoms that can only be resolved by uprooting himself from his native land and migrating to a location dictated by the disease.

Over his lifespan, the disease drags the patient, against his will, across continents and oceans, and finally brings him back to the land of his birth when his life is to come to a close.
The book, placed in a Renaissance setting, is all about the human condition with all its bizarre and myriad accompaniments. What makes this narrative relevant in today's day and age, in your opinion?
Over the past centuries, human beings have radically shaped the world’s ecosystems and permanently marked the planet's surface with cities and civilisations.

But at our very core, we remain the same flawed, frightened creatures that evolved a few hundred thousand years ago in the savannahs.

Indeed, our longings, our hungers, our desire for immortality and our anxieties about impermanence - these are visceral forces that are as real and powerful today as they were throughout human history, and certainly during the Renaissance, when humans found themselves in a place when they could reflect anew on their nature, and could poke at dogmas about their existence and its constraints.

The “bizarre and myriad accompaniments” of the human condition, as you put it in your question, have continued to remain constants across this temporal journey.

What are you reading right now? Which books are on your reading wishlist? 
Right now, on my nightstand, I have Anuradha Roy’s All the Lives We Never Lived and Yelena Moskovich’s Virtuoso.

Both are authors whom I haven’t had the pleasure of reading before, but whose works come very highly recommended.

For the near future, I’m particularly looking forward to Marlon James’ Black Leopard, Red Wolf, said to be a monumental epic set in Africa.

Any upcoming writing projects? Is there any genre you would like to experiment with? 
I am working on my third novel, about an eyemaker, who is able to spy on the past lives of his clients through their eyes.

He chooses to just be a witness to their secrets without ever interfering, until something happens that draws him into a dangerous entanglement with one of them.

As for the issue of genres, I think genre categorizations exist to make life easy for publishers and book distributors. Readers and authors should ignore genre boundaries entirely!

HarperCollins India, INR 399.

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