One tends to recall and discuss medical thrillers written by Robin Cook or Arthur Hailey but the genre is rarely explored in Indian fiction. Hyderabad-based Dr. Umanath Nayak’s Fatal Margin (Hachette publication; Rs.350) falls into this genre.
The book’s protagonist is an intelligent, hard working and revered surgical oncologist Veer Raghavan who is the face of a growing cancer centre in Mumbai. Veer is an ambitious surgeon recognised for his indisputable surgical prowess. Written in a racy style, the book traces how even the best of doctors can, if they aren’t watchful, falter from adhering to ethics. Fatal Margin goes beyond exploring the nexus between pharmaceutical companies and doctors for financial gains. It explains how a surgeon like Veer could ‘under-perform’ cancer surgeries so as to leave ‘positive margins’ that could cause relapse of cancer and thereby necessitate patients to cough up huge sums to undergo another cutting edge procedure. The catch lies in the fact that the new method, executed with a high-end gadget, hasn’t received FDA (Food and Drug Administration) approval. Veer also siphons funds with the hope of starting his own cancer specialty hospital.
“The public wants to know what happens within large hospitals. The nexus between pharmaceutical companies and medical practitioners is common knowledge. So I wanted to explore deeper and hence introduced the ‘positive margin’ angle to the plot,” says Nayak. He has previously written articles for medical journals, magazines and newspapers and authored a book titled Surviving Cancer . This book was a collection of inspirational stories of cancer survivors, meant to motivate family and friends of cancer patients.
Writing, realised Nayak, gave him immense creative satisfaction and he felt he was ready to write something in the mainstream fiction space. A surgical oncologist specialising in head and neck, associated with the Apollo Hospitals, he has a punishing schedule. “But once you want to do something, you’d find the time for it. Thoughts would come to me through the day and I’d spend an hour or two in the evenings to write. Certain days when I’ve performed long, exhausting surgeries, I would take it easy,” he says.
He had the first draft ready within a year, sent it to Hachette and it was approved within 48 hours. On circulating the manuscript between peers, he got the feedback that the book was far too technical. “Then followed the re-writing and editing process,” he says. Fatal Margin does a fine balance between making science accessible without dumbing it down. “From the feedback I receive from non-medical readers, I know the book has succeeded in appealing to general public. I think we as doctors underestimate the interest of people in scientific material,” he smiles.
Nayak writes as an insider, having been privy to the psychology of ambitious medical students and doctors, presenting their change in lifestyle while pursuing higher education in foreign soil (the US in this case) and their work atmosphere. He clarifies that the character of Veer Raghavan wasn’t inspired by any single person he has come across and is a culmination of several traits he observed around him. “Veer is a work of fiction,” he says.
While the plot explores the legal ramifications of Veer’s actions and traces his downfall and whether he manages to rise above the storm, his family remains at the background. “In the portions where Veer is in the US, there’s some romance through his colleague Jenny and much later, here and there, there’s his wife who plays a supportive role and is glad to be at the background. I didn’t want to take the attention away from the legal and medical battle by focusing more on the family, but there are hints here and there as to what the wife’s stance is,” he says.
While the promotional campaign for the book takes off in full swing over the next few weeks, Nayak is already working on another book, this time a comedy focusing on women.
