The Afflictions
by Vikram Paralkar
Lanternfish Press, 2014
175 pages, $12
Reviewed by Gabino Iglesais


When I heard about Vikram Paralkar’s The Afflictions, I ignored the massive piles of review copies surrounding my desk and dropped the folks at Lanterfish Press an email asking for a copy. The idea of an entirely fictional encyclopedia of medicine appealed to me, but what pushed me to request a copy was the fact that the author is a hematologist and researcher at the University of Pennsylvania, so he was bringing a lot of knowledge into the project and, what’s more important, had chosen to fictionalize something he’s both passionate about and understands on an academic level. I was not disappointed.

Máximo, probably pushed to it by his own physical shortcomings, shows up asking for work at the Central Library. The first day he follows an elderly librarian around and gets a peek at the Encyclopedia of Medicine. It’s a massive tome that collects maladies of the body, mind, and spirit. From Amnesia inversa, a type of amnesia that causes everyone around you to forget you exist, to Confusio linguarum, an epidemic that leaves towns full of confused residents who suddenly find themselves speaking in tongues they don’t understand, the Encyclopedia explains a wide variety of diseases, their personal and collective effects, and offers narratives about individuals who have suffered them. The introduction to the volume is the most crucial part of the future librarian’s tour of the place, and what he learns from it is as bizarre as it is interesting.

The Afflictions offers a plot that’s almost a throwaway, an excuse for Paralkar to deliver what really matters within a context that explains the existence of the encyclopedia. However, the author was aware of this and refrained from trying to achieve too much with these two characters. Instead, the main focus is the study and history of medicine at the Central Library and, more specifically, the entries contained in the voluminous book. These entries, all of which work even as stand-alone micronarratives, are crafted in a language that makes them feel like true encyclopedic texts while simultaneously inhabiting the realm of the fantastic:

Farmers and blacksmiths struck with Dictio aliena awaken on their humble straw beds with the speech and inflections of aristocrats. Their consonants are crisp, their vowels haughty, their delivery florid. Squatting around bonfires with their simple, baffled neighbors, they speak with excruciating politeness and, unbeknownst to them, pretension. Barons and dukes experience the opposite trauma. Their cultivated diction degenerates into the frank, coarse speech of townsfolk and laborers, with garbled syntax and words devoid of culture and breeding.

The beauty of The Afflictions comes from the fact that it is an unabashedly entertaining narrative that revels in weirdness and impossibility while also packing a much more profound layer in which Paralkar explores the frailty, failures, and absurdity of human nature. In fact, he sometimes does this while dealing with a disease that can be found in a real medical encyclopedia, or at least a version it. For example, Membrum vestigiale is a condition in which a patient has a vestigial limb sprouting from his body. While an extra finger is not unheard of in real life, the limbs here as seen not as simple extra appendages but as “a sign of some yearning within man to escape the limits nature places on him” and may contain “primordial tissues with the potential to confer clairvoyance, glands capable of secreting patience and perseverance, perhaps even outgrowths from the fragile organ of compassion, resistant to the atrophy that so rapidly consumes its natural counterpart.”

Once the reader is deep into the mystical world of pseudo-diseases Paralkar has created, it’s easy to miss what’s happening on a secondary level: the author is exposing society’s deepest fear, giving physical properties to concepts and ideas, exploring beauty, ugliness, and desire, and shining a light on the plethora of preoccupations that stem from the limits imposed by human physicality. As the narrative closes, the door to these ponderings remains open, and the mind can’t help but ponder what other maladies could eventually become part of the Encyclopedia of Medicine.

Vikram Paralkar is a talented author with a knack for the fantastic. He knows medicine, but it’s his understanding of the relationship between diseases and the human mind and spirit that make The Afflictions a great read.