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Two Souls Intertwined Abraham Verghese The Tanner Lectures on Human Values Delivered at University of Utah February 16, 2012 Abraham Verghese, MD, MACP, is Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine and Senior Associate Chair of the Department of Internal Medicine. He completed his medical education at Madras Medical College. From Johnson City, Tennessee, where he was a resident, he did his fellowship at Boston University School of Medicine, working at Boston City Hospital for two years. Abraham Verghese’s early work became the basis for his first book, My Own Country: A Doctor’s Story, one of five chosen as Best Book of the Year by Time and later made into a Mira Nair movie. Such was his interest in writing that he studied at the Iowa Writers Workshop at the University of Iowa, where he earned a master of fine arts degree. Since then, his writing has appeared in the New Yorker, Texas Monthly, Atlantic, the New York Times, the New York Times Magazine, Granta, Forbes​ .com​ , and the Wall Street Journal, among others. His second best-selling book, The Tennis Partner: A Story of Friendship and Loss, was a New York Times Notable Book. Today, in his writing and his work, he emphasizes the importance of bedside medicine and physical examination. His December 2008 article in the New England Journal of Medicine, “Culture Shock: Patient as Icon, Icon as Patient,” clearly lays out his viewpoint. His book Cutting for Stone also addresses the issue. [185] It is a great honor to deliver the Tanner Lecture at the University of Utah. Mr. Tanner, in outlining his goals for the series, said he hoped that it would lead to a “better understanding of human behavior and human values” and that it might have “practical consequences for the quality of personal and social life.” I took his words to heart in choosing the title “Two Souls Intertwined.” ◆ ◆ ◆ I will address the diad of the physician and the patient, a relationship that has interested me for a long time. I believe this relationship is sacred, timeless, and, in its ability to both do good and produce harm, unchanged since antiquity. In an era of unprecedented technologic and therapeutic advances that are coming at a pace unmatched in recent history, the patient-physician relationship is paradoxically under threat. Even as I promote a deeper understanding and a recommitment to the patientphysician relationship, I also propose taking advantage of technology to bring the patient-physician relationship to a new and better place. Destiny and Disembodiment Let me begin by sharing a personal story. I am a big believer in the quote “Geography is destiny.” I first heard this when I was in medical school, and it was taught to us as something that Freud said, speaking about the proximity of the birth canal to the interesting organs nearby. As a medical student, I thought that Freud’s statement was clever and profound. Imagine my disappointment many years later to find out that Freud did not coin the phrase—he was paraphrasing Napoleon. Napoleon, in saying “Geography is destiny,” was speaking about France’s position in the world. The origins of this phrase aside, it has been very relevant to my life: because I was born in Addis Ababa, the capital of Ethiopia, my destiny was completely different from that of my parents, who were born in the South of India. My parents hail from the state of Kerala in the Southwest of India, a lush land separated from the rest of the country (and historically spared many invasions and turmoil from the North) by the Western Ghat mountain range. This region of India is also called the Spice Coast. Arab traders in centuries past bought pepper—“black gold”—and other spices from Kerala and took them to Venice, selling them for huge profits. These traders were secretive about their source. Meanwhile, Europe was emptying its coffers to buy cinnamon, cloves, and “black gold.” It was only Thank you to Dr. Cari Costanzo Kapur for helpful discussions and Judy McCarter for assistance with manuscript preparation. The Tanner Lectures on Human Values 186 whenVascodaGamasailedaroundAfricaandfinallyendedupinCalicut, Kerala, that the source of the black gold became apparent to the West. I visited Kerala a few weeks before this lecture. I was there in part to research my next book—the story of the Arab traders and Vasco de Gama is germane to the book. While in Calicut I visited a...


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