The Tennis Partner is a memoir about author Abraham Verghese’s friendship with medical student David Smith. The main source of conflict in Abraham’s relationship with David, as well as David’s other relationships, is his cocaine addiction. Substance addiction, and the nature of the disease, are thus one of the book’s central threads.

The prevalent theory in the US is that addiction is a disease, but unlike purely physiological ones, it is a disease that includes a behavioral component. Withdrawal symptoms, increased tolerance to the drug, and the physiological effects of the drug on the mind and body compel the user to keep using. However, it is the actions of the user that activate the addiction and prolong the illness. Thus, addiction treatment involves an important balance between objectivity and empathy. Dr. Talbott embodies this in the Prologue of the book when he reminds David that he has a disease, and therefore he can feel guilt for his actions, but he ought not to feel shame.

Still, as with any illness, physical or mental, management becomes difficult if the patient does not recognize the need for treatment or follow through with treatment protocols as directed. So, too, is the case with addiction.