Chris Adrian: Imagining a Place Where People Become Better

Most good novelists, regardless of their spiritual bearings, sooner or later have a go at resurrection: as creators of characters, places, and events, however, they tend to focus less on the death-to-life transformation that is beyond human agency and more broadly on liberation from the very notion of mortality, with the result being anything the mind can imagine. Resurrection even comes as a premium to their books, for the moment we have read the last word we are free to return to the first—though with no guarantee of the same results.

Chris Adrian's highly acclaimed novels, Gob's Grief (2001) and the just-released Children's Hospital, are driven by an imagination completely free from the conventions of linearity and any staid notions of how the fantastical ought to be applied to either literary or historical fiction. Beginning in the wake of great tragedy and devastation, both narratives can't avoid suffering and death, but the promise of resurrection is the elasticity that allows these marvelous stories to evolve as they do—one a literal attempt at regeneration by a grieving brother, the other a collaborative attempt (angels are involved) by a small colony of survivors to redo humankind in a way that actually might work.

The bold interplay of biblical-mythical stagecraft, comic-book brio, and gritty medical realism often seems to be coming at you from all sides in Adrian's books, yet the time-immortal desires of the human heart never cower in the mix: "Never mind the sins and pleasures and miseries of the old world," a narrating angel declares in The Children's Hospital, "never mind the unknowable, indescribable satisfactions of the world to come, let me just watch them there, and let them just stay there, and let all of us finally be happy."

An emergency room pediatrician at Boston's Children's Hospital and second-year MDiv student at HDS, Adrian comes pretty close to substantiating the notion that you are your best work. If anyone were to tackle a story about the occupants of a children's hospital that is now afloat because a second great flood has killed off the rest of the earth's inhabitants, he's your guy.

"In The Children's Hospital," Adrian explains, "the medical student protagonist gets magical powers that let her go around healing all the sick kids and basically eradicating disease in the hospital—at least temporarily. I think a lot of what gets done in that book is a wish fulfillment that's probably pretty common among people who in their medical training just want to make everybody better, especially when you see the same kids coming in again and again with chronic illnesses and see how their illnesses shape their lives and their families' lives. Everybody wants to do something more for them, so it's kind of gratifying to imagine a place where people actually become all better."

For someone who writes about the machinations of angels, Adrian is surprisingly (or perhaps unsurprisingly) down-to-earth. He has the modesty and manners of a bygone era, though his conversational pepperings with words like "neat," "fun," and "stuff" betray a history of getting children to tell him where it hurts. Readers of his novels may find this image hard to square with the authorial voice that gets so much accomplished even with the gratuity of 600 pages—a tale-telling impresario on the order of the great and powerful Oz. Adrian, however, would be the first to (graciously) point out the man behind the curtain: "Sometimes I definitely feel like the story is getting away with itself or running away from me and I'm not up to the job of keeping up. I feel that half the time I can name five or six people who could write the same book and do a much better job than I'm doing with it. One of the pieces of writing advice that has stuck with me—a paraphrase of Hemingway, I think—is that you're doing a decent job of writing when what happens next is what has to happen next. A lot of times even when it's getting hairy and complicated, somehow you just kind of figure out what has to happen next, and after you get to a place where it seems like what happens next is the end and nothing can happen anymore, the work is going back and actually trying to glean through all that stuff and make the connections explicit that need to be explicit and tying up loose ends."

Adrian gives the impression that his life course, too, has adhered to this same what-has-to-happen-next philosophy—the Iowa Writers' Workshop, Eastern Virginia Medical School, pediatric residency at UCSF, and now the Divinity School. "I guess I think of [being a doctor, a writer, and now an MDiv student] as trying to get all the tools I need to do a certain kind of work," he observes, "and have my different obsessions and interests all come together in a way that allows me to do one job to get to where I want to be." He goes on: "In my writing I was thinking about the same sort of stuff people think about in divinity school, and part of the reason I wanted to come here was that I thought it would make me a more mature writer. I thought it would be good if I studied in a more systematic way and had a better (to borrow a term from medical training) fund of knowledge about Western philosophy and the sorts of things that the people whom I had admired as writers knew and had under their belt."

That a writer hailed for his "deep-veined intellect" and "prodigious talent" would need to get more under his belt might seem a bit like gilding the lily, but the pastoral care component of the MDiv program is what attracted Adrian to HDS. "There are definitely things I hope to bring back to medicine after having been through the MDiv program," he explains. "Like how to talk to a teenager who has a cancer that's not curable and knows he or she is going to die. If I've done, say, a chaplaincy internship, I'd be able to talk to them in a different way than I would have with regular old medical training. I have to say that you don't learn how to talk to patients in that way just doing the fellowship pathway; people get good at that sort of thing partly because they have to and partly because of the kind of person they are, being drawn to that kind of work."

And what kind of person is drawn to pediatric oncology, the field Adrian plans to pursue after he finishes at the Divinity School? Perhaps someone who has conscripted his own loss to the service of a wildly benevolent imagination, as Adrian did with Gob's Grief: "A lot of the motivation for the machine that the main character built to bring his brother and all the people who were killed in the Civil War back to life was coming out of the experience when my own brother died—of wanting to sort of imagine a context where not necessarily my own brother got to come back to life, but where somebody got their brother back."

Grief is everywhere present in Adrian's novel—from the comforter Walk Whitman's attempt to harness the nation's almost atmospheric sadness in his elegy to the dead Lincoln to the piles of amputated limbs that viscerally reflect a nation torn asunder. And yet Gob in his obsession to repair and renew bears out Proust's claim that grief develops the powers of the mind. Grief is precisely the thing we do not want, but it also can't help but send our lives along to the next level—something Adrian sees in his daily work. "I've noticed that with parents whose child has had a chronic illness for a long time," he observes, "they have months and months really to let go or get ready for that. But the child who is in a car accident or is run over by a car or falls out a window suddenly goes from being just a regular happy kid going to school or toddling around the house to being in the ICU and then being dead. And it's a very different process for the parents. With an illness you have the time to sort of make sense of it, no matter how unsatisfactory that is. But with accidental death you have to do all that work afterwards, which is a lot harder. I've been thinking about that a lot lately as more and more American men and women die in Iraq; I'm so astounded by how young these people are."

Adrian has no qualms about calling death one of his primary "obsessions," a preoccupation that, as delineated in The Children's Hospital, begs the question, When all but a scrap of humanity is inexplicably obliterated, why should we even care about death on a small scale? Perhaps what that novel shows is that there is no prorated scale to death, and what Adrian embodies as a writer is Thomas Mann's assertion that "all interest in disease and death is only another expression of interest in life." We see this in Adrian's explanation of how The Children's Hospital came to be: "I was working on the book before my internship, but didn't really get a lot of it done—maybe 150 pages or so—before September 11, and after that I found there was a change. I'd already had the idea—which came from some weird place—of a hospital floating around an ocean. But then the idea of survivors and of a worldwide catastrophe developed—the idea of people who had survived this awful thing and thought of themselves as privileged because they survived and had been chosen, when in fact they were maybe not necessarily chosen. I was wondering how that might resonate with a larger community or nation where we've always thought of ourselves as privileged or chosen in some way, for better or worse, and whether that's an excuse for hegemony or a foundation to understand your obligations to other parts of the world. And it just seemed like the opportunities for allegory, whether for good or for ill, kind of multiplied exponentially after [September 11]."

Among the courses Adrian is taking this semester are an independent study with Stephanie Paulsell, who is helping him edit some stories, and another with Dorothy Austin on the literature of death and dying. "I think that being here will definitely make me more comfortable and more effective in ways that I have suspicions about already but think will make me a better pediatrician," he says. "I took a course with Cheryl Giles, an introduction to pastoral care class, where we role-played different scenarios and I found myself in the ER actually using some of the techniques that she was talking about." He notes, however, that this semester has been a little tougher than previous ones, given the book's publication and his full-time work at Children's Hospital. "With the ER, it's shift work," he explains, "so I don't have to be there every day five days a week; it's more like 13 or so shifts a month. Timing-wise it seems to work out, but if I get stuck—like if I'm supposed to go home at 2 [AM], but you can't really expect to go home from the ER—I can be there until 3 or 4 [AM], and the next day I'm falling asleep in class."

When asked about his faith, Adrian concedes that he has yet to declare a denominational affiliation, although, given the self-imposed ultimatum "to come down on one side of the fence," he says he's leaning toward either Unitarian Universalist or UCC. "I think that by not having much of the faith angle worked out yet and not being totally sure of what I am sure of and not sure of," he explains, "it is protective. All the decisions that I made about that sort of thing growing up as a Catholic I let go of slowly, when I was a teenager and into young adulthood, and now I'm in a place that's a little more nebulous. This history has set me apart from others more grounded in their beliefs. All the challenges to people certain of their understanding of God—the things that would be a stone in the road for them—just kind of push me in a different way. Hopefully I'll land in some kind of place where I can make sense of all this, but I'm definitely not there yet."

Adrian is more surefooted, however, when it comes to what has to happen next after HDS: "If everything works out, I'll apply for a PhD program in divinity and do that in conjunction with a fellowship in pediatric hematology/oncology intervention and have the divinity work count as the research portion of the oncology fellowship. The research would focus on religious attitudes and medical outcomes in oncology patients—looking at people's religious backgrounds and how they go through the palliative care process or even regular oncology care and the way decisions get made and resources get allocated."

On the fiction front, Adrian says he is putting together a manuscript for a story collection, one of which, still being written, makes quite the leap from pediatric to geriatric: "I've been working on a story about a man who plays one of those Thomas Jefferson impersonators who go around to colleges and answer questions about the president—one of those men who is older and has Alzheimer's disease and comes to think that he is Jefferson and escapes from the nursing home where he lives." If we take to heart what Gilead author Marilynne Robinson, whom Adrian studied with at Iowa, has said about him, we'll have much to learn from Adrian's runaway president: "every report he makes . . . enriches and enlarges our sense of the world we thought we knew."