Noe Valley Voice May 2005

Reign of the Rat:
A Medical Thriller from Our Local Expert on Leprosy

By Olivia Boler

While chatting with Noe Valley author Gil Smolin, whose debut novel, Reign of the Rat, hits the bookshelves May 1, one has to decide which is more interesting--his life or his fiction. Smolin, 69, is a doctor of medicine specializing in ophthalmology and infectious diseases, and his skills have taken him all over the globe, including several trips to India to work with patients afflicted with leprosy.

It all started in 1985 when a friend asked Smolin, who is a professor and researcher at the University of California Medical Center in San Francisco, if he would travel to India to work with leprosy patients and lecture on the disease. "Leprosy," Smolin explains, "is a disease in which the victim loses sensation because the nerves are no longer working. A person's tissues become unresponsive, and because they don't heal well, infections occur." These in turn can affect the eyes and lead to blindness. (According to the World Health Organization, almost half a million people worldwide suffer from leprosy, also called Hanson's Disease.)

After he arrived in India, Smolin was quite moved by the spirituality of the people he met, as well as by their tremendous need for modern, up-to-date medical systems. "If half the ophthalmologists in San Francisco left tomorrow, we would still have plenty of practicing ophthalmologists," he says. "But in some countries, like Gambia for example, there is only one ophthalmologist in the entire country."

Recognizing that he could have a much bigger impact in developing nations than here in resource-rich United States, Smolin decided to dedicate a part of his already busy schedule each year to raising awareness and traveling abroad. He eventually set up a microbiology laboratory at Aravind Eye Hospital in Madurai, India, where researchers conduct studies on the affects of diet on cataract development, among other projects. He also helped found the DeLoris Lange Foundation, a public charity that funds trips taken by doctors who want to do meaningful work in countries such as Nepal, Yemen, Ethiopia, and, of course, India. Additionally, he has helped the American Academy of Ophthalmology establish a registry for American and Canadian ophthalmologists to work overseas.

In 1995, Smolin was honored as the first recipient of the Francis I. Proctor Foundation Humanitarian Award. The Proctor Foundation is a research unit of UCSF, which conducts training and research in ocular diseases. Smolin also sees patients in his private practice in San Bruno.

As for writing a novel, Smolin approached that challenge as he has his profession--he jumped in with both feet. He isn't entirely a stranger to writing, having penned or edited eight textbooks, with titles such as The Cornea, Ocular Immunology, and Infectious Diseases of the Eye. He admits, however, that he doesn't really enjoy academic writing.

"Writing of science I found is very unpleasant, and it's hard work," he says. "All the rewards occur after the work is finished. With fiction, the actual process of writing is what I enjoy very much."

For the past 10 years, Smolin has "dabbled" in writing fiction. In recent years, he has cut down the amount of time he spends on his private practice and university work, and has looked for ways to keep mentally active. He tried piano lessons, but fiction writing has proven to be a better fit. He has taken workshop classes, read a couple dozen books on the craft, and attended several writers conferences.

It took him about five years to write Reign of the Rat, which is actually the second novel he has completed, having put the first one in a drawer. Although he has a literary agent, he found his publisher, Ad Lib Books of Raymore, Mo., on his own.

Smolin describes the protagonist of the novel, Michael Cohen, M.D., as a "glorified version of myself." Michael and his former lover, Dr. Alice Morgan-Wright, are tracking a deadly illness that has its origins in Nepal and threatens to spread globally. They discover that it's a drug-resistant form of leprosy, and they set off to find a cure.

Naturally for this book, Smolin relied upon his own knowledge and experiences in treating leprosy. He also explored the history of the disease, the earliest records of which date back to the 16th century B.C. Notable among those who have cared for leprosy sufferers--often treated as outcasts--were the member of the Order of St. Lazarus, a religious order established by Catholic monks in the 11th century.

In Smolin's novel, an amulet of St. Lazarus, a metal crucifix, is a key element in the plot, and adds a "bit of magic" to the story. There is also, as there should be in any successful thriller, an enemy of the doctors, who is trying to stop them from reaching their goal.

"I picked this particular subject for my novel because I wanted to educate as well as entertain," Smolin says. "I wanted to describe the world of rural Asia in general, and the plight of the people with leprosy in specific."

A native of Brooklyn and Queens, N.Y., Smolin came to San Francisco in 1966 for his fellowship at UCSF, and fell in love with the city. He recalls going to the Haight for the human be-ins and free concerts by bands such as Jefferson Airplane.

He lived in Pacific Heights until 1991, when the aftermath of the 1989 Loma Prieta Earthquake left his commute to the university and his practice in San Bruno a mess. That year, he and his wife Julia, a violinist, moved to their current home on 21st Street. Together, they are raising a daughter, Erica, 14.

"I love the friendly, family-oriented aspect of Noe Valley," Smolin says. "The weather, views, and convenience to my work are great too, but secondary."

If you want to meet both the author and the doctor, here is your chance. Smolin will sign his new book, Reign of the Rat, at Cover to Cover Booksellers on Castro near 24th Street on Saturday, May 21, from 7 to 9 p.m.


by Gil Smolin, M.D.



He had no time to rest, but Bhai, drenched by the incessant rain, stood barefoot in the muddy and infested water, gazing across the endless terraced fields of rice until they disappeared into the mist. Closing his eyes, he lifted his chin and allowed the prickling drops to massage the muscles of his young face. For the past five weeks, the warm rain of the summer monsoon had veiled the punishing sun. When he opened his eyes it was all still there; the vivid green terai of the Nepalese foothills, the only place he had ever known.

The rice stalks had to be picked; his family's survival depended on it. His parents, sister, and older brother all had to work in the fields in order to make a living. In the best of seasons, they would reap barely enough food to survive the winter. Buddha and Shiva had not been kind the previous spring.

Bhai sighed. He would never be able to leave the village, like the schoolmaster's son, to go to Tribhuvan University in Kathmandu. Even the village leader's daughter had gone off to school. A girl. And Bhai's grades were better than either of theirs. He pushed the bothersome thoughts out of his mind. The rice had to be picked. Ignoring the throbbing ache in his lower back that radiated down his leg, Bhai bent over and began pulling the stalks.

A sudden knifelike pain sheared through him, and gasping, he fell to his knees, the muddy water splattering his face. The long monsoon and harvest season were destroying his body as never before. Would both body and mind rot in the never-ending fieldwork?

Despite his youth, the aching grew steadily worse and he couldn't imagine how he would continue this work for many more years. He would have to speak to his father about his back. Maybe he could get permission to see the Vedic medicine man when the traveling healer returned to Baglun. Villagers said the practitioner had cured the old beggar woman
of her deafness.

Bhai remained on his knees, the only comfortable position left to him and continued picking the stalks. Crawling along, he peered over at the adjoining row and saw his father grimace, then look away. Illness could not and would not be tolerated during the harvest season.

Pulling out a handful of rice, Bhai noticed a deep cut on his middle finger. He turned his hand to examine the cut more closely and was surprised to see that two of his fingernails were gone. He patted the muddy ground, looking for them, and then realized the futility of his search. Many years ago he had heard a tale from his grandfather about rotting hands, when bad times tormented the valley, but he couldn't remember what it meant.

Refusing to surrender to despair, Bhai reached for more rice stalks. He would try to keep his hands as dry as possible when he was out of the fields and wait for the farm work to end with the arrival of the winter cold.

Copyright c. 2005 by Gil Smolin. Reprinted with permission. Reign of the Rat, published by Ad Lib Books, LLC.