I write by stealing time. The hours in the day have never felt as if they belonged to me. The greatest number has belonged to my day job as a physician and professor of medicine — eight to 12 hours, and even more in the early days. Lest it sound as if I resent my day job, I have to say that my day job is the reason I write, and it has been the best thing for me as a writer. Indeed, when I am asked for writing advice, which is rare, I offer this: Get a good day job, one that you love, preferably one that consumes you and that puts your boat out in the river of life. Then be passionate about it, give it your all, get good at what you do. All that gives you plenty to write about, and it also takes the pressure off the writing. Counting on writing to pay the mortgage or your kid’s college tuition is decidedly risky.

The next lien on time is held by family. I know, if I were being PC, I’d list family before work. But I’m being truthful. The current obsession for parents to be everything to their children, from purveyor of Mozart in utero to muse, coach, camp counselor and chauffeur to as many enriching activities as one can afford ultimately produces parents who accomplish too little at work. I wonder if it produces children who are more accomplished than the parents who had none of these things. (There, I said it. Someone must.)

Recently, someone asked my mother, who is in her 80s, how it was she nurtured her three sons’ talents. (My older brother is a professor at MIT; my younger brother is a computer scientist at Google.) She said: “I did nothing. I prayed.” Quite true. No writing camp or wilderness camp for me, and I am not complaining. I was happier constructing my own enrichment. My mum worked hard at her job and gave it her all, as did my dad. I saw and admired that. I offer the same example to my kids, if only because I was unable and uninspired to do the Little League, Webelo thing.

And after the family has gone to bed, the few hours remaining by all rights should belong to the medical journals stacked bedside. Right beside the journals is “Harrison’s Principles of Internal Medicine.” The enduring task I have given myself is to read this 4,000-page tome cover to cover in the two or three years before the new edition comes out. I’ve read perhaps 10 editions in my lifetime in this fashion, but it is getting harder. For one thing, the book (if you buy the single volume) weighs about 10 pounds. And “Harrison’s” does not read like Conrad or Forster, even if the subject matter is endlessly fascinating to me.

What remains, then, is the time that belongs to sleep. And it is most often from that cache that I must steal. It’s not a happy or ideal arrangement; I have as much need for sleep as the next person. I wake up wanting more sleep, and even on days when I plan to catch up on my deficit and go to sleep early, a novel or something else keeps me reading past the 15 minutes I allow myself.

Physician and author Abraham Verghese. ( © Barbi Reed)

Of course, I make no claim that this method is efficient. Writing my first book took four years; the second, five; the third, eight. Trollope will never be challenged by my output. Joyce Carol Oatesproduced two books while I was working on a long chapter. But I am not in a hurry to get the book out, just to get it right — my day job allows that luxury.

I realize, as I read that last sentence, that this sounds like a passive and unambitious strategy. That is not so. I dream of incredible things happening for each book I write: prizes, accolades and sales. One must dream big; one must aim for something that is the very best he can imagine. Why bother to write otherwise? (This is true of more than writing, but I’ll confine myself here). But — and this is the key — if great things do not happen, the world does not end, I don’t jump off a cliff. That’s because I still have my children, the people I love . . . and my work. There is still the great privilege every morning of seeing patients, meeting people from all walks of life, dealing with things acute and chronic that make the ambition of writing seem trivial. And there is morning report, grand rounds and the noon conference to attend, and the chance perhaps to walk over and visit a colleague in anthropology bursting with ideas that relate to my interests. And there is my Wednesday morning men’s group and . . . life goes on.

When my most recent novel, “Cutting for Stone,” took hold in my head, an interesting thing began to happen. My subconscious mind was carrying the story. The feeling was that of being in love with a beautiful woman, but she eludes you, she comes and goes, makes promises then withdraws, leaves you in heaven one evening and in the doldrums the next day. Carrying that turmoil around from the night before inevitably meant that the oddest things happened at work, insights that opened new vistas, led me forward, made me say, “I must remember that” (and yet just as often by nightfall I had forgotten). I know that my subconscious mind was looking for connections, links, avenues, exits, and the things that were said and done at work seemed to tether the wisp of this dream with that one, this fragment of a thought with that, this image with that color. . . . Sleeplessness helped.

As my book evolved, the pace picked up, and as my patient editor (patient as in the virtue, not the person) became, after some years, less than patient, I started to put a few writing days together — a Friday with a weekend or a Sunday with a Monday and Tuesday. Those strings of days were utter luxuries because I was able to take hold of large handfuls of the story and keep them all in my head as I assembled and rearranged. As the final manuscript became due, I took off a week here and there from work, but always with some apprehension. Medicine, you see, is my first love; whether I write fiction or nonfiction, and even when it has nothing to do with medicine, it’s still about medicine. After all, what is medicine but life plus? So I write about life. I plunge into the river every morning, let the current take hold. It is not the same river you stepped into yesterday. Thank God for that.

Verghese is the author of the best-selling novel “Cutting for Stone” and two memoirs, “My Own Country” and “The Tennis Partner.”