Meet the man behind the fifty ‘surreal diseases’ 

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.

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. Paralkar chats with us about the idea behind his book, how his experience as a scientist helped him, and more... 

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. 
 
Works of Calvino and Borges are some of your primary inspirations. How did you go about intertwining medical jargon with fictive elements?
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 book 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, categorisation, 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.

Out of all the ‘afflictions’ delineated in your book, which one would you say you enjoyed conceiving? 
Conceiving these 50 afflictions wasn’t a linear process, and involved several incomplete draft afflictions as I wove back and forth to tweak and polish the themes.

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.

What are you reading? 
Right now, on my nightstand, 
I have Anuradha Roy’s All the 
Lives We Never Lived and Yelena Moskovich’s Virtuoso. For the near future, I’m looking forward to Marlon James’ Black Leopard, Red Wolf, said to be a monumental epic set in Africa.

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