You can be creative only to an extent. The good prose and narration serves you only to a point. You are limited by what happened. You can't invent and though you can dramatise, rearrange, bring all your writing skills to it, the story remains the same.

But writing a novel, writing Cutting for Stone..

In a novel, you have no limits. And the choices one has to make -- plot turns, voices, for instance -- to an extent slows down the process of writing. But the biggest challenge here is to engage the readers and get them hooked and move them.

Your last book was published over a decade ago.

I have never been in a hurry to publish a book. I would have a book published only when I am fully satisfied with it. Besides, I also teach and write for medical journals. But coming to Stanford has given me more time to write. Even then, I will not be rushed into completing a book.

Given the acclaim your previous books have received, it must not have been difficult to sell this novel...

After about a year or more of working on the novel, I decided to try and sell it; I had only about the first hundred or so pages. My agent wasn't keen on our doing that because it is not the norm. But I wanted some affirmation that it was worth continuing. I knew I had a long way to go and it would take me a few years... Luckily, Knopf bought the rights.

Your book has received a lot of praise much before it is released. Best-selling writer Mark Saltzman says if Vikram Seth and Oliver Sacks were to collaborate on a four-hour episode of Grey's Anatomy set in Africa, they could only hope to come up with something this moving and entertaining...

(Chuckles). Those are blurbs and I appreciate them. Atul Gawande (surgeon and best-selling writer ) also wrote a strong blurb. But I am waiting to see the book reach the readers at large. My previous two books have received a lot of good attention and I have been able to engage people throughout the country in discussing them.

In a nutshell, what do you say?

Among other things, it also looks at medical practice and the issues we face each day. Part of the book is set in Ethiopia where I grew up but this is a work of fiction.

Apart from having a good time reading the novel, what else do you want readers to take away from it?

To me, and I am sure to many doctors, entering medicine was a passionate and humbling quest. In a way it was a romantic pursuit, and surely to some, it is also a spiritual calling. The patients offer their bodies to us, and what we learn while treating a particular patient, we may be able to use that knowledge in dealing with other patients.

I don't think too many young people see in the West see medicine in this light, that it being a privilege and calling . In the mission hospital in Africa, there is nothing separating the doctor and patient; there is no astonishing technology or specialists there. For a physician to work there is a humbling and spiritual experience.

How has medicine helped you as a writer?

I have always been an admirer of old-fashioned and of bedside examination. It is important to be attentive in doing this. You pay attention to detail. And in writing, fiction as well as non-fiction, details matter a lot. In medical schools, we were taught that God resides in detail.

What else matters in good writing?

A good writer has to know about using attentiveness, observation, and imagination. It also requires a lot of stamina which we, as physicians, are very familiar with.

Where does the title Cutting for Stone come from?

There is a line in the Hippocratic Oath that says: I will not cut for stone, even for patients in whom the disease is manifest. It stems from the days when bladder stones were epidemic, a cause of great suffering, probably from poor quality water and who knows what else. Adults and children suffered so much with these -- and died prematurely of infection and kidney failure.

There were itinerant stonecutters -- lithologists -- who could cut either into the bladder or the perineum and get the stone out, but because they cleaned the knife by wiping it on their blood-stiffened surgical aprons, patients usually died of infection the next day. Hence, the proscription: Thou shall not cut for stone.

It has always seemed to me a curious thing to say when we recite the oath in this day and age. But I love the Hippocratic Oath (or oaths, because its origins and authorship are far from clear), and always try to attend medical school commencement.

When the new graduates stand and take the oath, all physicians in the room are invited to rise and retake the oath. You see many physician parents and physician siblings standing as their son or daughter or brother or sister takes the oath. It chokes me up every time.

Not only am I renewing my faith, but I am bursting with pride in seeing my students graduate -- another part of the oath is, to teach them this art, if they desire to learn it; to give a share of precepts and oral instruction and all the other learning to my children and to the children of those who instructed me and to pupils who have signed the covenant and have taken an oath according to medical law.

How does all this relate to your novel?

It isn't just that the main characters have the surname 'Stone.' I was hoping the phrase would resonate for the reader just as it does for me, and that it would have several levels of meaning in the context of the narrative.

Apart from having a good time reading the novel, what else do you want the readers to take away from it?

To me, and I am sure to many doctors, entering medicine was a passionate and humbling quest. In a way, it was a romantic pursuit, and surely to some, it is also a spiritual calling. The patients offer their bodies to us, and what we learn while treating a particular patient, we may be able to use that knowledge in dealing with other patients.

I don't think too many young people in the West see medicine in this light, that it being a privilege and calling. In the mission hospital in Ethiopia in my novel, there is nothing separating a doctor and patient; there is no astonishing technology or specialists there. For a physician to work there is a humbling and spiritual experience.

Also see: Anita Desai speaks to Tishani Doshi

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