Tamil literature is replete with references to Siddha practitioners, traditional healers, and the faith, or lack of it, that people have in them. A segment of Tamil literature that has focused on class and caste hierarchies has also looked sharply and sensitively at the socio-economic determinants for access to health care. Among the pioneers of drawing technology and science into his writings in Tamil was the legendary, prescient novelist and screenwriter Sujatha. But in modern Tamil fiction, the employment of medicine and medical issues as the central theme and plot has been rather minimal.
While there might be only a few texts in popular, modern Tamil fiction that weave the story around a medical condition, these form a significant contribution to the genre. Muthumeenal’s Mul focuses on leprosy, and Sivakami’s Pazhayana Kazhithalum offers a health perspective couched in caste discrimination.
Among the Tamil writers who have formed a strong bond between their stories and health issues, Imayam stands tall, not merely through sheer numbers, but through depth of content. Many of his short stories and novels couch the essential human experience he portrays in medical conditions, each wrapped in the other, not distinct, but influencing and impacting each other.
Health in Tamil fiction
But before we dip into Imayam’s work, a full-length novel of note on a core health issue is Mul (thorn) by Muthumeenal, a deep and personalised account of living with leprosy. The narrator is a young girl whose life has been upended when she finds suspicious patches on her body. She moves into an institution where medical care is provided, around which the story is built, and the multiple angles, including stigma, politics, loneliness, and internal struggle, are woven into this autobiography. The public-health message is stigma-busting: that leprosy is treatable, and early therapy can cure it.
In retired IAS officer Sivakami’s work, a Dalit feminist treatise, Pazhayana Kazhithalum (The Grip of Change), the text deals strongly with the social determinants of health — caste violence, gender-based violence, bodily autonomy, and the mental and physical toll of bigotry.
In Imayam’s Ippothu Uyirodirukkiren (I’m Alive… For Now), the author artfully folds in the themes of both the above novels — crafting a social commentary within the nephrology ward of a government hospital where a teenager with end-stage kidney disease has been admitted. It follows his rapid decline, his transition onto dialysis, and organ donation. Reviewers have praised its ‘authentic’ portrayal of nephrology, the disease, and the treatment.
But this is an achievement across various novels that Imayam, a school teacher and politician, has penned. While known for his sharp critique of caste and gender hegemonies, Imayam has also built a strong subgenre of medical literature. Unlike authors who use disease as a generic plot device or a melodramatic tool to lead up to a crisis, he treats medical conditions with gripping sociological depth and clinical accuracy.
A Sahitya Akademi winner, Imayam attempts to explain the human condition through pain, suffering and debility, and as his longtime collaborator-translator Justice Prabha Sridevan says, “an astonishingly astute understanding of the feminine condition.” His recent novel, Noiputtru (disease), also talks of life derailed by leprous patches.
Set in a Tamil Nadu leprosarium in the 1960s, the novel documents the lived experiences of patients ostracised from their families and confined to State-run institutions, including detailed descriptions of the diagnostic and treatment processes. The descriptions of the impact of leprosy are merciless — thickening ears, flattened noses, and physical disfigurement — there’s no way to conceal this in the deliberate, yet sparse prose of the author.
Imayam’s world of illness
Very few novels in Tamil come with the searing commentary that he delivers in Sellatha Panam (A Woman Burnt). Unlike in the case of the protagonist of the above-mentioned novels, here, Revathi, an upper-caste woman who is forced to take the extreme move after her inter-caste marriage, is trapped in a liminal world and confined to bed. Around her, in the waiting corridors of the burns ward, social realities are exposed, the niceties ripped off, though his most effective literary tool is conversations between people. It is said Imayam spent time observing the JIPMER burns ward while researching the book.
Just launched, the English translation of Uppu Vandikaran (The Salt Vendor) harks back to the dark, panic-driven emergency of the pandemic lockdown. It’s not just about falling ill with COVID-19; instead, it exposes the lacunae and inadequacies in the medical system, as Chellamuthu goes from one hospital to the other, being rejected by each one of them since he cannot produce a certificate confirming his infection- a situation the world was familiar with during the first couple of years of the 2020s. Similarly, his short story Government Pinam (The Government Corpse) is situated in the pandemic, focusing on a boy quarantined with his sick father in a house sealed shut by government officials.
In Imayam’s debut novel Koveru Kazhudaigal (Mules), over three decades ago, a significant segment is about how the women of the Vannar community deliver through traditional midwifery practices, outside of medical institutions. He also broaches the subject of patient attendants, a subject gaining currency in a nation growing increasingly grey, and the care of the elderly comes into the spotlight. In Pinathuku Sondhakkari (Owner of the Corpse): Meenakshi, a live-in attendant, is left alone to handle her elderly employer Ramanan’s sudden death, his children away and slow to return.
Manamurivu (Divorce) deals with the gendered nature of infertility, dragging the reader through IVF clinics, menstrual cycles, hormone injections, and the inordinate stress to bear children on the woman in the relationship.
Since the COVID-19 pandemic drew science and medicine into drawing rooms and headlines, willy-nilly, it remains to be seen whether Tamil literature will now make room for more health-related content.