Illness as Metaphor
In Night Theater, Penn oncologist Vikram Paralkar merges magical realism and the macabre.
In rural India, a village surgeon waits testily for the arrivals of a promised vaccine shipment, a new sterilization machine, and a nurse to assist him. His pharmacist, meanwhile, armed with an ill-fitting mask, assumes the duties of the absent nurse, along with tackling everything else from cockroach-proofing to electrical repairs. Vikram Paralkar’s new novel, Night Theater, might at first put the reader in mind of the desperation faced by hospital personnel around the world during this spring’s coronavirus pandemic. But the fictional set-up is a jumping-off point for an imaginative medical story that merges magical realism and the macabre while touching on questions of morality and humanity.
A physician-scientist who specializes in leukemia at the Perelman School of Medicine, the Mumbai-born Paralkar began writing fiction a few years back while completing a fellowship at Philadelphia’s Temple University. “I began to realize that the more we learn about science, about the body, about treatment, the more our knowledge falls into gradations,” he says. “There are many things we do in medical practice where the certainties and uncertainties—about diagnoses, clinical paths—go hand in hand. We saw that with the unfolding of coronavirus and COVID-19. Yet the doctor is often not allowed to be just another imperfect being.”
Night Theater presents its protagonist with the greatest challenge imaginable to his presumed expertise: bringing back to life a family that has been brutally murdered. It’s an absurd premise, of course, but after allowing the surgeon and his assistant to express understandable fright and astonishment at the sight of this pregnant wife, her husband, and their eight-year-old son—each sporting gaping wounds that expose their innards, each walking and talking despite having lost all their blood—Paralkar moves on to the surgeon’s strained attempts to accommodate this bizarre request. “The dead seemed to think him a magician, with mystical devices and superhuman powers,” Paralkar writes. “How many disappointments was he destined to inflict on them? And what agonies? Would they feel pain?”
Paralkar, 39, came to the United States after completing his medical training in India. He grew up in a book-loving household with a surgeon father and gynecologist mother. “Both of my parents were fairly avid readers,” he recalls, “and we were always going to book fairs and coming back with bags of books. As a kid, a lot of what I read wasalong the lines of Agatha Christie and P. G. Wodehouse. It wasn’t until my late teens that I started reading my way systematically through the classics and came to love authors like Dostoevsky and [Jose] Saramago.
“Underlying every major literary novel—whether it’s about identity, relationships, belonging, or what have you—are human bodies made up of bone and sinews and organs and blood,” he points out. “Those components have to function or not in order for the book’s themes to unfold. These characters have language, they invent, love, and mourn—but there’s no escaping that they are housed in bodies that need nutrition and are susceptible to decay.”
Living above the store, so to speak—his parents ran their own hospital, complete with an operating room and patient beds, on the first floor of the building where the family lived—Paralkar also gained an early immersion into the daily stuff of doctoring. “There are so many aspects of day-to-day medicine that are second nature to those practicing the profession,” he says. “But if you look at the enterprise from the outside, there are peculiarities: the obsession with classification, the nitpicking of diagnoses, the vagaries of prognoses, the debates about treatment.”
In his first work of fiction, 2014’s The Afflictions, Paralkar considered those facets and “assembled them into a volume of imaginary illnesses where each one is a distortion of some of the elements that make us human,” he says. So, in this series of phantasmagorical micro-fictions, we learn about Amnesia inversa, where instead of growing removed from and forgetful of loved ones, the sufferer is forgotten by more and more people, from the most distant and casual acquaintance to those nearest and dearest. The ailment Lingua fracta similarly turns the idea of lingua franca on its head, depicting a state where native speakers only retain a few words of their language and the resulting jumble has been merged “into a single dissonant, bristling tongue that is capable of almost a full range of expression.”
While Night Theater is tinged with the nightmarish qualities of Kafka and Poe, The Afflictions revels in clever language and gentle observations on human nature. Those plagued by Libertine’s Disease are said to have been treated (unsuccessfully) with “chasteberry and rue,” which sound like inventive jokes but according to Google are real medieval medicines. Akin to but different from truth serum, the effects of Erysifia poisoning cause those afflicted to see the absolute, unvarnished truth. In especially severe cases, it “turns the victim’s gaze upon himself, making him witness to the horrors of his own soul.” No wonder we soon learn that the “only recorded deaths from Erysifia are suicides.” The afflictions, says Paralkar, “take pieces from a real disease and turn them into something larger that connects to society and the human condition.”
In between running his lab and treating his patients, Paralkar has begun writing his third novel. (It concerns a maker of prosthetic eyes who, as he looks into the good eye of his clients, is able to view their past and future.) This trio of endeavors share one trait, he says: curiosity. “In medicine, we are trying to discover what’s ailing our patients so we can help them. And in science, we are investigating the body or its cells. In writing, we are digging deeper into understanding what it means to be a human being.”