Views & Reviews Medical Classics

Family Matters

BMJ 2009; 339 doi: (Published 08 July 2009) Cite this as: BMJ 2009;339:b2760
  1. Ellen Tullo, ST1 medicine, Newcastle
  1. ellentullo{at}

    One of the most compelling arguments for busy clinicians to find time to read novels is the opportunity to gain humanistic insight into the unfamiliar lives of others. Although literary characters are constructed by their author, their fictional role can vividly illuminate realities that readers may never face in their own lives.

    The protagonist of Rohinton Mistry’s novel Family Matters, Nariman Vakeel, is a retired professor of literature experiencing the gradual erosion of his autonomy through the relentless progression of Parkinson’s disease. The tale examines Nariman’s stoical adaptation to his chronic condition and the effect on those closest to him. His irritable stepdaughter Coomy, frustrated by Nariman’s tenacious attempts to hold on to the last scraps of his independence, cannot bear to accept the role of full-time carer. Somewhat inevitably, a defiant excursion by Nariman to the local market in his Mumbai suburb ends in a fall and a broken ankle. The implications for Coomy overwhelm her; enlisting the reluctant help of her submissive brother, Jal, she devises a scheme to send Nariman to the household of his youngest daughter, Roxana.

    Nariman is thus transposed to the midst of a loving but fraught household on the other side of the city. Through Roxana’s valiant efforts to offer him a dignified existence within the context of her own family dynamic, the book offers the reader a tender yet honest picture of the challenge of caring for an ailing family member. Many doctors try to empathise with the concerns of patients burdened by chronic illness and the family and friends who care for them, but, unless they have experienced that role themselves, it is virtually impossible to gain an in-depth understanding of the associated domestic realities.

    Family Matters never attempts to gloss over the gruelling realities of caring. The pervasive odour of faeces and unwashed dentures and the constant presence of Nariman and his needs drives Roxana’s husband, Yezad, to distraction, compelling him to seek solace, firstly in illicit gambling, later in the austere Parsi religious rituals that he has hitherto rejected. Roxana’s sensitive son Jehangir, ever alert to his parents’ anxieties, turns to playground deception to ease their financial burden. Yet, in association with the most difficult aspects of the family’s struggle, the book excels in capturing episodes of poignant and loving humour arising from the family interactions. Nariman’s grandsons argue passionately as to who should be allowed to sleep on the balcony now that grandpa occupies the sofa, and the worldly Nariman himself offers a wry commentary on his nature of his plight, punctuated by recollections of his life as a younger man in Mumbai.

    Rohinton Mistry’s achievement in offering credible insight into the nature of chronic illness and the trials and rewards of the associated caring role make Family Matters recommended reading for those interested in understanding more about the needs of patients and their carers.


    Cite this as: BMJ 2009;339:b2760


    • Family Matters

    • By Rohinton Mistry

    • First published 2002

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