In “Blushes,” your story in this week’s issue, a retired doctor volunteers to help at a hospital that’s struggling with the coronavirus crisis, knowing that it may cost him his own health or even his life. This is a real scenario that likely happened around the world in 2020. What drew you to the idea of tackling it in fiction?

Photograph by Basso Cannarsa / Alamy

I don’t think that, at first, I even had the idea. I rarely write anything with the aim of its being directly topical. I usually begin with something extremely insubstantial, not a located “idea,” just a feeling, a whisper, a mere ghost. It may well have been that I began with the word “ghost,” or the phrases “ghost town” and “ghost world,” which appear early in the story, with the ghostly image of a man driving around at dawn in a seemingly deserted world. I was then surprised to find myself writing a story that was, in part, about the pandemic. I’d found, though not by conscious intention, an angle on it, a doorway into it. But I can’t emphasize too much the element of surprise. I’ve come to believe that writing by surprise is the best and certainly the most exciting way to write. It’s the opposite of writing by premeditation. How do you write by surprise? I don’t really know, but I’ve developed an instinct for it. It’s not an everyday event, or it wouldn’t be surprising. Once you’re in a state of surprise you can make some extraordinarily quick—and again surprising—connections. I was surprised to find myself writing about the pandemic, but just as surprised to be writing about blushing. The one thing could scarcely be more serious, the other scarcely more superficial—literally so. But blushes are not unlike those insubstantial flutters that can surprise me into writing in the first place. Little scarlet ghosts.

As the doctor drives to the hospital, he returns in memory to a time when he was ten and suffering from scarlet fever. Why is he cast back to this particular moment in his life? Was it a pivotal one for him?

This is simply how memory works. We can expend a great deal of effort and intention on remembering things, but memory can also take us, extraordinarily, by surprise. It can suddenly put us back there, where we were, perhaps decades ago.

The scene in which Jimmy, his mother, and Dr. Henderson are all gleefully happy at the idea that he has now completed the list of required childhood illnesses is almost comical. Is it a landmark that you remember celebrating?

I don’t remember marking it or celebrating it, but I remember going through the broad process. When the story was taking shape, the connection between the pandemic and all those childhood illnesses that were curable but had once been deadly was another constructive surprise. Sorry to keep using this word!

Why does the current pandemic trigger these memories of a more peaceful (and even welcomed) illness?

This question and the last one, or my answers to them, really merge together. Polio, to which children were particularly prone, was once a truly terrifying disease. Iron lungs! Then a vaccine was found for it. I felt that there was a poignancy in the memory of all those illnesses that were essentially experienced by children, that children could go through and put behind them, even by the age of ten. Because those diseases belonged to childhood, they invoked a feeling of vulnerable, lost innocence. Ghost worlds, lost worlds. This became the atmosphere of the story.

On the other hand, the memory also represents a less cheerful turning point—it was your character’s last birthday before his parents separated and divorced and his world “disintegrated.”

And this, too, is an instance of lost innocence, of a world being shattered, though it has nothing to do with illness. At ten years old, just after a wonderful birthday party, and sick (but not, in his case, severely so) with scarlet fever, my character is unknowingly on the brink of such loss. But my story is not just about loss or pain. In many ways, it’s about the possession, the palpable touch, of happiness. One of the many strange reasons that we blush, as the story itself suggests, is out of sheer joy, its tingle on our skin.

As you noted in the Guardian a few years ago, you took a thirty-year break from writing short fiction, during which you wrote only novels. You mentioned that you found it thrilling to be writing short stories again. What is the thrill for you? Did you feel it while writing “Blushes”?

Yes, I felt it. And “thrill” is another good word for that insubstantial tremor that’s my starting point. And it’s close to the word—here I go again!—“surprise.” I can’t explain my “thirty-year break”—that makes it sound like some conscious decision. I’ve always loved short stories and been open to writing them. They just didn’t happen for a while—quite a long while! Novels happened instead. Much gets made of the differences between novels and short stories, but I think more should be made of what they have in common. They’re both narrative fiction—that’s the great thing, the thing to be celebrated about them. Novels are long stories. One of the attractions of writing short ones is that you can make yourself available to more thrills, more moments of being surprised. The short story is a demanding form, but so is the novel. In both cases, once you’ve experienced the first thrill, you have to do a lot of work. With novels, plainly, the first thrills aren’t going to happen so often, but with both you have to sustain the thrill even as you do the hard work. The short story, though it’s stubbornly less favored by publishers, has the claim to be the senior, dominant form. The novel is a relatively recent, specialized invention, but we’ve all been telling each other stories, in one way or another, since we’ve been human. We haven’t been telling each other novels.

Are you working on more stories? Has the lockdown been a productive period for you?

Yes, I’m more drawn to the short story at the moment, but the lockdown hasn’t been particularly productive for me. I don’t think this is cause and effect; nor am I bothered about it. You have productive phases, then you don’t. The dreadful year that’s just passed was one in which—unfortunately, perhaps—I published a new novel, “Here We Are.” Normally, while I’m seeing a new book into the world I don’t do much writing. That I’d one day bring out a book during a global health crisis is one of the many things I could never have predicted when I set out to be a writer. It’s true that there’s a simple, crude way in which a pandemic goes with writing short stories. When you feel that life is imperilled, then you feel you have to keep things short.