Notes The story in these pages is entirely fictional, as are all the major and minor characters, but I have tried to remain true to the real-world events of that time. The Japanese bombing of Madras was real; the characters of the viceroy, his first secretary, and the governor of Bombay are all imagined and bear no semblance to the actual individuals who held those positions. Longmere Hospital is fictional; I am proud to have attended Madras Medical College and to have visited Christian Medical College several times; however, the events and characters that relate to these two institutions are imagined. The Maramon Convention is legendary and I hope to visit some year; the Uplift Master scene at the Convention is fictional; Triple Yem does not exist nor does it resemble any hospital I know. The priests I knew from my childhood, as well as the one bishop—Mar Paulos Gregorios (born Paul Varghese) who was a family friend—have been inspiring, wonderful human beings. The depictions of the church and its officers are entirely fictional.
The line “father’s breath was now just air” is after “Caelica 83” by Baron Brooke Fulke Greville. The material on spices and Vasco da Gama draws heavily from Nigel Cliff’s wonderful book, Holy War (Harper, 2011) and from Spice by Jack Turner (Vintage, 2005). Big Ammachi and Koshy Saar’s thoughts on story draw from remarks of Dorothy Allison, and on maxims from Robert McKee’s excellent book, Story (ReganBooks, 1997). Most Bible verses are italicized and are from the King James Version; the formal prayers are from the St. Thomas Christians’ Evening Prayer Book or from online versions of the St. Thomas Christian liturgies. Matron’s thoughts on public schools are inspired by the BBC documentary Empire. “Giving up the necessities but not the luxuries” is paraphrasing a similar quote ascribed to either Frank Lloyd Wright or Oscar Wilde. Celeste’s description of London is paraphrasing M. M. Kaye’s account in The Sun in the Morning (Viking, 1990), and also Empire Families (Oxford University Press, 2004) by Elizabeth Buettner. Honorine’s saying that roses would be just weeds if they never withered and died is an idea from Wallace Stevens: “Death is the mother of beauty. Only the perishable can be beautiful.” The lines by Veritas to The Mail about the boys of La Martinière are a paraphrase from Paper Boats in the Monsoon (Trafford, 2007) by Owen Thorpe. The letter writer’s comments about Brahmin’s failing when admitted to the highest rank is from Brian Stoddart’s A People’s Collector in the British Raj: Arthur Galletti (Readworthy Publications, 2011). “The secret of the care of the patient is in caring for the patient” is Francis Peabody’s famous quote well known to all physicians (JAMA, 1927; 88:877). Celeste’s observation about her husband’s outward civility despite his true inner feelings is inspired by John le Carré’s character George Smiley, who says, “The privately educated Englishman is the greatest dissembler on earth” in The Secret Pilgrim (Knopf, 1990). When Rune delivers bad news to Big Ammachi, she thanks him, “habit being so strong”; these words are from Raymond Carver’s poem “What the Doctor Said” in New Path to the Waterfall (Atlantic Monthly Press, 1990). Rune’s observations about the thumb are attributed to Isaac Newton in Charles Dickens’s All the Year Round (1864, Vol. 10, p. 346), and later found in A. R. Craig’s The Book of the Hand (Sampson Low, Son & Marston, 1867): “In want of other proofs, the thumb would convince me of the existence of a God.” Koshy Saar’s recitation is from Tennyson’s 1854 poem “The Charge of the Light Brigade.” Digby’s inscription in Elsie’s Gray’s Anatomy is from Robert Burns’s “Death and Doctor Hornbook” (1785). The family with the blue tint to the whites of their eyes and fragile bones has osteogenesis imperfecta. The woman in the ENT clinic with an exophytic growth in her nostril has rhinosporidiosis. Prior to 1985 there remained much confusion around the two forms of neurofibromatosis; many patients with what is now called neurofibromatosis type 2 or NF2—“the Condition” in this novel—were lumped together with neurofibromatosis type 1 or NF1—the “classic” von Recklinghausen’s disease, whose features are skin and subcutaneous nodules. It is now clear that these are separate genetic diseases with different clinical expressions, and involving different chromosomes (chromosome 17 for NF1 and chromosome 22 for NF2). “The Condition” is loosely based on a description of a large kindred in Pennsylvania (JAMA, 1970; 214(2):347–353). The material on the famine is from public sources. The lines from the radio play that Philipose hears are from Act 5 of Hamlet. Philipose’s lines, “Lucky you can judge yourself in this water,” and later, “Lucky you can be purified over and over,” are lines from the 1977 poem “Lucky Life” by the late poet (and my Iowa teacher and friend) Gerald Stern. The degree “MRVR” after the wart doctor’s name is based on an anecdote in Evolution of Modern Medicine in Kerala by K. Rajasekharan Nair (TBS Publishers’ Distributors, 2001). The line that references “the round world and its imagined corners” is after John Donne’s Holy Sonnet 7. The sin of the disastrous translator who preceded Uplift Master is inspired by Jorge Luis Borges’s words “the original is unfaithful to the translation” in his essay On William Beckford’s “Vathek” in Selected Non-Fictions (Viking, 1999). Cowper’s words, “Abiding happiness and peace are theirs who choose this study for its own sake, without expectation of any reward,” is a tenet of Zoroastrian teaching. “Living the question” is from Rilke’s Letters to a Young Poet (Norton, 1993) and it is advice I often give my mentees. “In a time of deceit, telling the truth is a revolutionary act” is a phrase often attributed to George Orwell. Lenin and Arikkad’s escape after the failed raids in Wayanad is imagined, but the Naxalites were (and still are) real, as is the execution of Arikkad “Naxal” Varghese (1938–1970), who toiled for the Adivasis in Wayanad. In 1998, Constable P. Ramachandran Nair admitted that he shot Varghese on orders of K. Lakshmana, DSP. In 2010, a court found Lakshmana guilty of compelling Nair to shoot; he was sentenced to life imprisonment and a fine of ten thousand rupees. The fishmonger’s disparagement of the vaidyan’s pills is inspired by Oliver Wendell Holmes’s address to the Massachusetts Medical Society on May 30, 1860: “. . . if the whole materia medica as now used could be sunk to the bottom of the sea, it would be all the better for mankind—and all the worse for the fishes.” Philipose in the chapter “The Hound of Heaven” draws on the 1890 poem of the same name by Francis Thompson. Philipose’s letter saying that the real voyage of discovery consists not in seeking new landscapes, but in having new eyes, is a paraphrase of a similar thought in Proust’s ? la recherche du temps perdu (Gallimard, 1919–1927), in Volume 5. For Broker Aniyan’s “Set the date!” I am indebted to my Stanford Graduate School of Business colleague, Baba Shiv, who shared this memorable anecdote in his brilliant lectures on decision-making. Thank you, Baba! Broker Aniyan’s statement about secrets is a quote from Sissela Bok in Secrets: On the Ethics of Concealment and Revelation (Vintage Reissue, 1989). Digby’s observations while performing a tendon transfer are based on the words of the pioneering surgeon Paul Brand: “The surgeon must practise the patience of an earthworm feeling its way between roots and stones, and he must not force a way through rigid structures or the tunnel will not be lined with yielding material,” in The Journal of Bone and Joint Surgery, British Volume, 43-B, No. 3, 1961. “Call no man happy before he dies” are Solon’s words to Croesus, in Herodotus, The Histories, (Penguin Classics, 2003); “Wherever you go, whatever happens to you, it happens to me” is a line from e. e. cummings, “i carry your heart with me” (Complete Poems, Liveright, 1991).