After two searing memoirs, Abraham Verghese writes Cutting for Stone, an epic novel following twin brothers born to a South Indian nun in Ethiopia who grow up to become doctors.

What made you turn to fiction after such success with memoir?

I always wrote fiction; it was my way of taking a moment from my AIDS work. The memoirs came about accidentally. I published my first story in the New Yorker and was asked to write a nonfiction piece about being a doctor in Tennessee, which became the book proposal for My Own Country. And while writing that, I was living through another extraordinary experience and wrote The Tennis Partner.

You still practice medicine. Do you find it conflicts with your writing?

I don't see any obstacle because the fundamental way I see myself is wrapped around being a physician. I think of my writing as having emerged out of my love for medicine. To me writing is a blessing that I'm allowed to do, but being a physician is the primary occupation that drives everything, and I don't see that changing.

This novel covers countries, generations, history. Did you expect it would?

I did want to write a novel that was epic in nature and captured the grand sweep of medicine, both the very poor and the rich aspects of medicine. I didn't quite know all the branch points it would take. I wanted to bring out what a lifetime of medicine has shown me, that often we go into medicine because we have a sense of something missing in us and medicine seems to promise that if you take care of others, you'll be taken care of... but I've also seen the seamy side of medicine... how it can destroy families... the hubris and the ego and inattentiveness to your personal life because you are so needed elsewhere.

Ethiopia feels like a character in the book. Did you want to tell the story of Ethiopia?

I did. I'm very conscious of place because I don't have a home to speak of. I've lived in so many countries and cities. I'm conscious that out of geography emerges destiny and emerges character in a sense. Being born in Ethiopia made my destiny.

And what's next?

I would love to continue writing novels. I learned so much with this book. I was so humbled. I feel I want to take these lessons that took so many years and use them again. I love that quote that fiction is the great lie that tells the truth about how the world really lives... something like that.