Dr Kavery Nambisan has the sort of résumé that could give anyone a complex: she topped medical college in surgery, was sponsored by the University of Liverpool for higher training, came back to India to write a bestselling novel, followed it up with several more, got shortlisted for the Man Asian Literary Prize, and tirelessly ran rural hospitals in Bihar, Uttar Pradesh, Tamil Nadu, and Karnataka.

My first encounter with her (except for some fan-girl gushing at a literary fest about how much I loved The Story that Must Not be Told) was when I asked sheepishly if she could give me a quote for the cover of my first book, within five days. Despite being on a full-time surgical job, she did.

I was to experience her graciousness and warmth in person in a two-hour interview, in the lead-up to the publication of her forthcoming novel, A Town Like Ours (Aleph, due April 2014).

I know the most annoying question any writer can be asked is how much is autobiographical. So that’s not what I’m going to ask, but I do find a lot of echoes in terms of theme and characters in your work.

I was a surgeon when I started writing. I’ve always been fond of reading and language. I actually studied in the Kannada medium as a girl, and it was later that I moved to an English-medium school. So, Kannada was my stronger language. But it was through medical college and after, that English became my language of expression. Even now, I feel if my book were set in Karnataka, I would be thinking a lot of it in Kannada. Or maybe in my dialect, if it is in Coorg.

In fact, my father wanted me to take up literature and not be a doctor. (Laughs) You know, in those days, in Coorg, it was considered important to get married soon so he would say, “Why don’t you do literature? It’s much easier, and you’ll do well.” But I was stubborn even then, and I’m stubborn even now.

I don’t know why I took to writing ... but I started doing small things, like middles and short stories. I think it was vanity, when I think back. You want to see your name in print, it looks good, and you go, ‘My gosh, my name!’ So, I think my first reason was only that.

After that, I realised I was unsatisfied with what I wrote. I felt that was too easy. There was precious little in terms of outlets for writing back then. I remember I wrote for Femina and Eve’s Weekly. Again, friends would say, ‘Oh, I read your story, it was so nice, it was really good!’ and then I realised I was being false. Because, you’re saying, ‘Oh, for a women’s magazine, this is what they want. They want it to end in romance, they want this and that.’ So, I was contriving a story to fit those. I thought, ‘Is this really what I want?’ That’s when my interest in writing really started.

So I started writing children’s stories. And that’s how I found my voice, because when you write for children, you talk to them directly. You can’t fool them, you can’t deceive them, you can’t talk down to them. That’s when I realised I had a voice, and I could do something with it. That was my turning point. And then I moved to adult fiction.

That reminds me of Jo from Little Women. Did you enjoy writing your medical papers, before you took to writing novels?

No. Writing non-fiction is very hard for me. And with medical pieces, I like to write my viewpoint on something about healthcare; but if I’m writing an academic piece, no. I don’t know why. Even my husband (journalist and poet Vijay Nambisan) asks why I’m like that. I’ll think up all sorts of excuses to avoid writing an academic paper, although it’s so important as a doctor. However my husband is so good at writing non-fiction. I think he would write good fiction if he put his mind to it, but he’s more comfortable with non-fiction.

In your books, you’ve tended to use the first person. Even when you start out in third person, as in The Hills of Angheri or The Story that Must Not be Told, you switch to the first. What do you like about the first person?

I don’t know, I just go with my thoughts. If I’m doing a novel, I won’t have a story in mind, but I just think of a character. With The Story that Must Not be Told, I thought of an old man living by himself. And I thought of Madras as the place, because I have lived in Madras, and I do know it. That was it. I thought, ‘What would his life have been like? And he’s alone, what would his marriage have been like?’ I usually spend a year or so, just thinking. Once I have a character who interests me, I try to latch on to his or her life.

With Simon (the book’s protagonist), I initially thought of a woman, and then I decided no, it has to be a man. Then I created a family for him. And then this boy comes into his life. Obviously, someone has to do some work for him, bring things for him, and keep him in touch with others ... how do old people actually live? From there, it started.

Once I got to this idea of a slum being nearby, I got a story in my mind­—what are the discrepancies, and how many of us really want to know? We don’t want to know. So, you can have these very posh apartment complexes, and just next to them, slums everywhere. So, you’re sort of inhaling their lives, but you don’t know anything of their lives. In fact, you don’t see them, they’re like a blind spot.

In Rushdie’s memoir, he speaks about how you can only tell stories when you know how your characters speak, in terms of language, in terms of rooting. Your characters are from very varied social and religious backgrounds. How do you capture the way they speak, especially with Tamil?

Tamil is a language I’m very fond of. I may not be strong in it. Before ’98, I worked in all sorts of rural hospitals in small places. But in ’98, Vijay quit his job, and I had jobs where there was no PF, no pension, just a few thousands a month. (Laughs) The family started cautioning us, and saying, ‘The way you people live, you’re going to find it very hard.’

So I woke up and said, I’d better look for a job that will pay me. I found the Tatas’ plantation jobs, which were rural and I would get to do the sort of work I wanted, but with a better salary structure. Once I joined Tatas, I moved to Anamalai. Before that, I’d worked in Madras, and I began to learn Tamil, because you have to, to talk to patients. So, as Vijay says, I know all the medical terms. (Laughs) I can’t make a speech, and I can’t write, but I can talk to my patients, bus drivers, and auto drivers. And now, in Coorg, there’s a large migrant population from here, so I can keep in touch. My husband was born and brought up in Tamil Nadu. So, that’s a link for me too. I guess that’s where the flavour comes from.

There’s so much detail in your settings. Have you ever found out, after writing a book, that you got something wrong?

Yeah, I do. Because somebody will tell you. Especially male things. If I write about a motorbike­—in my first book (The Truth about Bharat, Almost), this guy is always on a bike, and I’d got something wrong about the bike. One of my friends told me later. You’re bound to go wrong if you get into too much detail. Like in On Wings of Butterflies, I’d mentioned Goa. But I didn’t know Goa too well. I’d just gone there on holiday. So I couldn’t talk much about the place. It’s difficult to go into detail about a place you don’t know. So I decided to concentrate on the characters instead.

When you started writing, did you think about how it was such a different world from your chosen field?

Fortunately, I was not at all self-conscious that I had no literary background. I’m so glad. If someone had pointed out that I had no background in literature, I wonder what would have happened. But I do remember someone interviewing me after my first book, and he was amazed that someone so absolutely ignorant about literature was actually writing a book. Honestly, so many things he questioned me about, I would reply with, ‘But I don’t know, I have never heard of this person, you know?’ It was very funny; I think he mentioned it in the interview also. I wasn’t self-conscious about that.

But then I did start reading. When I sent the manuscript of Bharat to Penguin, David Davidar was the only person in charge, in 1990-91. So, he wrote back saying, ‘I like it a lot. I’d like to publish it.’ He also said if you’re coming to Bangalore sometime, we can meet. So we did. And then he asked me, ‘Where is this place that you come from? I’ve never heard of it.’ And I told him, and he couldn’t think that there was this small, remote place out there, and you could come from there, and still be literate and doing things. And he started talking to me about literature, and asking all these questions. So, I told him, ‘Look, David, I have no literary background. I haven’t a clue what you’re asking, and I’m not going to bluff you.’

And I’m very grateful to him, because he started suggesting books that I should read, and he lent me a lot of books, and introduced me to so many writers. Of course, I had read classics and the Russian writers, but I didn’t have that much time ... medical school is very intensive. And it was such a great thing to be told, ‘Okay, read these books, you’ll really like them.’

As a surgeon, where do you find the time and space to work yourself into a zone and sort of delve into your writing?

You know, I found that after a hard day’s work, writing was very relaxing. I’d come home and I didn’t need to rest or anything. I’d straight away make my tea and sit at my table and start off. And Vijay’d be mad, and he’d say, ‘What the hell! How can you do this? And here I am, finding it so difficult to write!’ (Laughs) But, that’s because my mind is disorganised, and I have to write to get it organised, while Vijay gets his thoughts properly in order, and only once whatever he’s writing is organised in his mind, does he start writing.

We’re very different writers. I need lots of drafts. I’ll write from instinct, then read it, and then I’ll know, okay, this is what I want to say, or I may find something I don’t like. I sit at the computer so much longer than Vijay does. I find that difference among writers. Some get every line perfect as they go along. How great that must be!

Your experience in medicine does tend to seep into your work. I especially liked how you’ve captured the way doctors can go on eating while they talk about these gruesome operations, and the rest of us are trying to keep our food down.

Oh, yes, and we can just go on about it, without even realising the effect it’s having. Vijay sometimes tells me, ‘Not now. Don’t tell me all this now, I’m feeling very delicate.’ Balancing surgery and writing, you know, it is difficult, and I sometimes wish I had just the one career. But ... I’m a very serious surgeon, I care a lot about my work; it means a lot, and I’m very concerned about where it’s going, and what’s happening. And I think I’m the same about my writing. The only thing is—maybe because I got to it later—the intensity of what I felt very young as a doctor starting out, I think I missed out as far as writing is concerned. But with most of my writing, my thoughts come from my childhood, so much more than from my adult life. Childhood is magical, and all you have to do is dip into it. Childhood and dreams. I don’t know how it happens, and I’m afraid to look at it too deeply, but I know that my dreams influence my writing a lot.

But to get back to the idea of writing about things you’ve seen, and the influence on your writing, on the one hand, there’s doctor-patient confidentiality, and on the other hand, I’m sure you see cases which you want to write about because they’re so unique, or so comic.

Yes, but for me, the confidentiality is very, very important. In fact, I drill it into my junior doctors and nurses to never forget that what they tell you is confidential. But that doesn’t mean I can’t use it. I just change it, and not let anybody know who or where it came from, not even my husband. We work in small places—where people know each other—so it’s very important that you shouldn’t let it out. Sometimes it’s comic, sometimes it’s crazy, and sometimes it’s sensational, and you want to use it, but you must remember that people come to you with their suffering, and you need to make sure it can’t be traced back.

People are so curious, they come and ask, ‘But where is that case from? Who is that? Is this from Coorg, or elsewhere?’ I just change the subject, and refuse to tell them.

Have you met patients who have read your books? And does it feel like your worlds are colliding when that happens?

Yeah, I have met patients who’ve read them, or bring my books and ask for an autograph, and I’m so flattered, because hardly anyone in that setting knows I write; they think of me as a surgeon. I do get a bit embarrassed when I’m asked about it, and then I have to quickly change the subject and talk about medical problems!

We’re very different writers. I need lots of drafts. I’ll write from instinct, then read it, and then I’ll know, okay, this is what I want to say, or I may find something I don’t like. I sit at the computer so much longer than Vijay does. I find that difference among writers. Some get every line perfect as they go along. How great that must be!

We spoke earlier about the varied settings in your novels. Do you also feel the need to not be restricted by your own background, because your novels haven’t been set in Coorg for a while?

Not since The Scent of Pepper. Now, when I think of it, I wonder how I managed to get away with that story and everything. And that’s been the book that has not just lasted long, but also been very popular. Putting it in Coorg was David’s idea. After my first book, he asked me, ‘What about the next book?’

Bharat was a one-off, and I was quite happy with just that. And David said how about doing one on your place, it seems a very interesting place, Coorg and its people. I immediately said no, no, I’m not going to touch my own community, it’ll be very difficult. But suddenly I started, and I did it, you know!

That book did get me into trouble. When I did it, I didn’t think I would hurt anybody. But a few months after it was published, I got a blistering letter from somebody very close to me, saying, ‘How dare you write these things? You’ve insulted us; please ask your publishers to withdraw this book. It’s obscene.’ So, I replied saying, ‘Look, I just don’t get you, why are you so upset?’ And then, I heard from a lot of people who were upset. There was a horrible review in one of the Coorg papers, saying terrible things about me. I was stunned.

Then, someone I know well asked, ‘Why do you write like this? We Coorgis are known for our valour, and you haven’t talked about it at all.’ I said, ‘But you’re missing the point.’ It’s all there, but I’m not showcasing it. It’s not my job to flatter my community. I love my community, sure, but that means I write what I want to write.

That’s when I realised that if you’re talking about your community, people want you to say good things. We’re all so smug about our communities, if you really think about it. And finally, you don’t want the outside world to see your warts. But if you’re writing a natural story, about the troubles of a family, you have to put it in, to tell a real story. It should be truthful, in my eyes. So I stuck to that. Years later, as people read it and understood it, I started getting better responses. Now, everyone in Coorg has read it and loves it, and they’re all very quiet about how they treated me back then. (Laughs) But it was a very tough experience, so much so that I don’t think I would be able to ever attempt another work on Coorg.

Did you have to do a lot of research for your other books?

No, I’ve never done any research except for The Scent of Pepper. But the books don’t need much research. With The Story that Must Not be Told, you’ll see a dedication to Kalpana Sharma. She wrote a non-fiction book on the slums of Dharavi, and I loved the book. I’m very closely associated with slums, in the sense that I’ve worked among people who belong to slums, as a doctor, particularly in Maharashtra. Most of the characters from the slum are from my real life. I’ve changed a few things, of course.

I used to think, even then, about how we use these people in our homes, but we don’t know anything about them. And how it must be for them to work for us. I had the courage to ask one guy, who delivered milk. But he wouldn’t tell me. I try to put myself in their place, and I think I would hate our guts. I think they would put us all under one label: ‘the rich people’. Maybe some they would take to more than others, because some people are kind, but I think by and large, they must hate us. I’m still not sure, I’ve never been able to get an answer.

At a literary festival ... I asked a question, where I said, ‘Don’t you think there are other issues? Feminism is fine, that you care about women, you want to stop women’s oppression. But how about children who are oppressed, or men who are oppressed, or animals who are oppressed? Don’t you think we should also look at those areas, and not just restrict ourselves to this?’

I wonder about it often. Because, even in my life: what my salary was ten years ago, and what it is now, it has increased by so much, and so many things have got better. The people working in our office—the nurses and ambulance drivers—their salaries are just crawling up. So why is it that the top people get such fantastic salaries? And each year, we’re greedy for bonuses and whatnot. But these people have gone on for 30 years, 35 years, they retire with a pittance. I wonder when justice is going to come about in such things, if it ever is.

In The Story..., it seems any intervention from us will only be interference, not engagement.

There’s no solution. We all wonder, ‘What can we do?’ I might feel I should do this-this-this, but when it comes to it, I don’t have the energy to make that huge leap. I can do small things, I know that. It may touch a few lives, but the fact is, we’re not going to solve the problem. We’re not able to attack the current which is going that way.

If you really ask me what I feel will happen to humanity, I’m really depressed about it. I just don’t see hope. There are very few who really do something.

In the book, even when someone tries to change all that, the reaction is hostile. It’s like oh, you got us a water-cooler, big deal.

Yeah, and I leave it confused, because I’m confused. I don’t know the answers. Simon’s dilemma is my dilemma, and your dilemma. I feel do what you can do, do it properly, and just do that much. There are any number of people who don’t care, and who don’t even want to talk about it. Is your life just about your family and your kids and your career? Or can you do something else for someone else?

I see it all the time because most of my patients are poor. You have someone who makes Rs. 6,000 a month, and somebody in the family has cancer, and he borrows from everywhere, and spends lakhs on treatment, and a few months later, the person dies. If you don’t spend that money, you live with the guilt. We doctors often don’t take the time out to tell them what could happen. They come back and tell us you did everything, but I feel no, you didn’t do everything if you didn’t speak to them about the outcome; that whatever you do, this is going to happen. They have to take much harder decisions than we do.

From the things you say, and from the way you ended On Wings of Butterflies, I know you don’t identify as a feminist, or a radical feminist. But as a woman writer, in a place like India where literature festivals are picking up, you often get slotted into a panel which discusses things like subjugation of women, or women’s rights. Does that pose difficulties?Yes. In fact, at one literature festival, I felt so bad. There were three women writers on the dais, and they were speaking about how important feminism is in writing. And I asked a question, where I said, ‘Don’t you think there are other issues? Feminism is fine, that you care about women, you want to stop women’s oppression. But how about children who are oppressed, or men who are oppressed, or animals who are oppressed? Don’t you think we should also look at those areas, and not just restrict ourselves to this?’ I think injustice, against whoever, is wrong. And it can be against men.

They were so furious with me. They all started attacking me. I said okay. (Throws up her hands and laughs) I didn’t mean it that way.

It’s like I tell gay writers: I have many friends who are gay, and when we talk about writing, I’ve asked, ‘Why are you compelled to write only about gays?’ It’s true that they have had a tough time—I was shocked when I heard about the sort of biases they face everywhere—in jobs, in life. You can write about that, but how about looking out? It would be so interesting to find a writer from the community who’s coming into the mainstream. How does a gay man look at a woman? How about his friendship with a woman? Can you not write more socially, about a wider circle? I would find that more interesting than the victim narrative. I feel that to have powerful literature, you need to be inclusive in a certain way. Some people understand that, but some say no.

Most of your books tend to be the voices of young women, somewhat indecisive women. And suddenly, in The Story That Must Not be Told there was this part-cynical, part-idealistic old man. Were you worried about taking on a male voice?

No, I never get that feeling when I write. As a writer you must be able to think from a ... I don’t know whether to call it a bisexual point of view, but you have to deal with sex. And you have to know how to write from both sides. And you have to make a certain switch. Otherwise, we will tend to write only as women, which is okay, but if you have a character who is male, how do you bring out his thoughts?

Do you feel that your characters take charge of themselves, you don’t have to think for them?

Once you’ve created them, yeah. The most difficult part of writing a novel is knowing whether you have created an authentic character, and whether you’re really able to think their thoughts. It’s so easy to think you’ve created a character, while actually, your thoughts are just being vented through somebody else.

When I’m thinking out a novel, I keep a notebook in which I write little things: maybe a phrase, or a sentence, anything that comes to mind. And when I read it, I get lots of material there. It’s like a seed.

I was intrigued by certain recurring ideas. One is the preoccupation with interreligious marriages. I guess that’s partly because my marriage is intercultural. Vijay is not from Coorg, and I’m not Malayali. But also, as doctors, we see so many of them. And it gives you a nice fire: a platform you can use. Obviously, there’s going to be some sort of conflict, or some sort of tension. The dynamics are different to a marriage where the couple have the same background.

I wonder if two interesting characters, again recurring, are people you actually know—Fakira the watchman, and this ward boy who comes over and accurately predicts death.

Oh, yes, Fakira is the actual name of a watchman in Brindavan. The other guy is created. But Brindavan is such a quaint place, full of religious nuts and sadhus. I worked there five years. The patients who came in, you never knew who or what would land up. It was such a peculiar place, the type of people I’ve treated there. The ward boy came out of something I have seen: I have heard people who say they can tell death by the way your ears are standing, or because your ears are purple. (Laughs)

Do you remember any of the cases from which you’ve drawn for The Hills of Angheri? There are some quite bizarre ones in there.

I think there was one about some gauze that gets left in. What happened in real life was that a senior of mine was operating. It was late at night and a really bad case, and I’d gone to help. During the surgery, the patient died. So my senior was closing, and towards the end, he said, ‘I’m so tired, you close.’ The patient was dead, and it was just the closing, so I said okay. But after I closed, nurse tells me the gauze is missing. I said oh, we’d better open. We can’t leave it because every case is post-mortem anyway in England. We opened the abdomen, but couldn’t find it.

So what to do? I didn’t want to call my senior, because he was so tired. I spoke to the anaesthetist, and he said we can’t leave it, we have to get an X-ray. Can you imagine, the person is dead and we were X-raying him? So we could see the gauze. But where was it? Finally, I called the surgeon, and said, ‘Look, I’m so sorry, I can’t find it.’ He came back, and couldn’t find it either. But then he remembered that he’d opened the stomach to find the source of a bleed. We opened it again and finally found it in there. But it’s this recurring nightmare I have, that I may leave a swab inside. It hasn’t happened, but I have that nightmare all the time.

I often wonder about the sensitivity of the writer who wants to get to know the community versus the surgeon who is taught to distance herself from the patient, to be able to operate.

Well, I guess as you get older, you understand what distancing is about, and at the same time, how to be compassionate and tender with your patients.

In the last five years or so, writing has become such a marketing-driven profession. You have all these lit fests, and all these promotional tours. Is it hard to take time off for these?

Oh, yeah, I try not to go to more than one lit fest a year. I find it so exhausting, more painful than writing a book. I feel so false at a book-reading, and I’m always relieved that it’s over. I can talk to a few people, but having to talk to an audience, and answer questions like, ‘Why are you not a feminist writer?’ ... oh, that’s so difficult for me!

Instinctively, which of your two careers do you feel more at home in?

As a surgeon, definitely, as a doctor. I’ve been that longer than I have been a writer. I’m very happy to be able to write, to be doing this, but I still don’t think I was meant to be a writer—whatever I write, I’ve loved, but my medical career is equally important to me. So, that’s a difficult question to answer.