Last Updated on June 19, 2019, by eNotes Editorial. Word Count: 191
The autobiographical novel My Own Country tells the story of a young Indian doctor named Abraham Verghese, who worked in Johnson City, TN, when the city faced its first shocking and unexpected epidemic of AIDS in 1985. Educated in Ethiopia, Dr. Verghese specialized in infectious diseases and quickly became the primary expert in the disease for which the town was not at all prepared. My Own Country is a documentation of the stories Verghese picked up from various patients and of the crisis that invaded the once quiet and seemingly incubated town in the Smoky Mountains. This book also documents how Dr. Verghese, so involved in the lives of his patients, had to acknowledge the slow corruption of his marriage and attempt to rescue it, even as he attempted to rescue his patients. This book is powerful in that it shows how no town, community, or city is protected against the invasion of AIDS, and how the silently the disease can spread. It also depicts how those affected can still find new life, despite dealing with the effects of their illness and with all the pain and prejudice that comes with it.
Last Updated on May 5, 2015, by eNotes Editorial. Word Count: 1563
My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS is more than a series of case histories or a chronicle of the doctor-patient relationship. It is also an intensely personal story of one man’s search for a sense of belonging and a country to think of as home, and how he finds it, at least for a short while, among his AIDS patients and their families in a small, out-of-the-way corner of the world in rural Tennessee.
Abraham Verghese truly was a man without a home. The child of teachers from southern India, he was born and reared in Ethiopia, where he began studying medicine. His schooling interrupted by war and political unrest there, he came to America, finding work as an orderly in hospitals and nursing homes in New Jersey. Eventually finishing his medical education in India, he returned to the United States in 1980 (at about the same time the AIDS virus entered the country) and began his residency in infectious diseases at the Mountain Home Veterans Administration Hospital and Johnson City Medical Center in the foothills of the Smoky Mountains.
Upon completing his residency, he accepted a research fellowship at Boston City College, where, in July of 1983, he encountered his first AIDS patient. The fellowship completed, he turned down an offer to stay on at Boston to pursue his research, opting instead to return to rural Tennessee, where he had been offered a staff position at the VA hospital and an assistant professorship at East Tennessee State. He returned to Johnson City, “the embodiment of small-town America,” seeking a home, a secure environment for his wife, Rajani, and their infant son, Steven: “Johnson City was going to be my town. I felt at peace in this corner of east Tennessee. Finally, this was my own country.”
A sense of peace, however, proved more elusive than Verghese could have ever imagined. Instead, because of the wholly unexpected presence of a considerable number of AIDS cases in this town of fifty thousand—“a hundredfold more cases than the CDC would have predicted”—he became, by virtue of his specialization in infectious diseases, the area’s AIDS expert. At first called upon merely to give interviews to the local paper and lecture on safe sex at the area’s only gay bar, he had no AIDS patients until a year after his return to Tennessee. Then a former coworker, Essie Vines, asked him to examine her brother Gordon. Like many rural gays, Gordon had left his small town at the first opportunity, seeking the more accepting atmosphere of big-city life, only to return home to die of AIDS. Gordon’s plight, and his family’s compassionate and courageous reaction to it, drew Verghese inexorably into the emotionally charged world of AIDS.
After Gordon, AIDS patients began seeking out Verghese with increasing frequency, running the gamut from “Tennessee queens” to pillars of the community. Many managed to fashion courage, dignity, and humanity from the most desperate circumstances and leave an indelible impression on both Abraham Verghese and the reader: Ed Maupin and Bobby Keller, a diesel truck mechanic and a boutique salesclerk who had been having sex together since they were seven years old; “good old boy” Clyde McCray, who contracted the disease from a friend of his parents who seduced him as a child; Clyde’s wife Vickie, who, although HIV-positive herself, lovingly cared for the husband who infected her and in the process became active in AIDS organizations, making new friends and gaining self-respect; Norman Sanger, a hemophiliac who had already suffered a lifetime of horrifying health problems and was determined to face his final battle with courage and dignity; Will Johnson, a devout Christian and successful businessman, infected from a massive blood transfusion during heart surgery, and his wife, Bess, both of them fighting valiantly to keep their condition secret from their family and community.
As these patients struggled to come to terms with their disease, their doctor underwent his own odyssey. Acutely aware of the parallels between his own status as a “foreigner” and that of his gay patients, he gained insight into the plight of gays in “straight” society, particularly in a place such as rural Tennessee. Verghese realized that being an outsider probably made him more accessible to his patients, so that they confided in him more than in one of their own: “More than once I had the sense that a patient was opening up to me for this very reason, because of my foreignness.”
Verghese’s foreignness was made even more acute, however, by his association with AIDS, which alienated him from other doctors, his friends, and even his own wife and family. The intensity of living so close to death on a daily basis and the constant fear of being infected himself created a distance from his family. His marriage began to fall apart, as he could not bridge the growing gap between his world and that of his wife: “I seemed to be living in a separate world which those who had not been touched by the disease could not enter. I felt alone at my own table, alone and unclean.”
Verghese also questioned his place in the medical profession. As a foreign medical graduate, he found that the most desirable residencies were open to American-born doctors, while the least desirable, usually in large city and county hospitals, were left largely to the foreign-born doctors. His specialty, infectious diseases, is near the bottom of the medical hierarchy in desirability and prestige, largely because of the dearth of billable procedures involved. Verghese contrasts his long hours and intense involvement in his patients’ lives to the life of the big-city cardiothoracic surgeon, who zooms in his Ferrari from hospital to hospital, performing one coronary artery bypass graft after another on patients he never even sees awake.
Even among Johnson City’s active Indian community, which he describes in fascinating detail, Verghese did not feel entirely at home. Traveling easily between the Indian and non-Indian segments of the town, he felt comfortable in both worlds but completely at home in neither. While sometimes cherishing “the illusion that I was so much a part of the town, so well integrated, that I even looked like the townsfolk,” he nevertheless had nagging doubts as to the extent of his acceptance in the white world. He increasingly wondered whether this acceptance by the community was contingent upon their need of him and whether it would disappear if he could no longer be of service. Although he fought the clannishness of the Indian community, he sometimes wondered, “Did they understand something I did not?”
By his own admission, Verghese has never felt at home anywhere—“from the time I was born I lacked a country I could speak of as home”—and his longing for a sense of belonging permeates the book, beginning with the title. It is paradoxically in Johnson City, a place where he experiences his greatest sense of alienation from his peers and his family, that he feels the most “at home.” The old Mountain Home VA Hospital, the geography of Johnson City itself, the spectacular Tennessee countryside, and especially his patients and their families all contribute to a sense of belonging and a feeling of home: “I suppose this is when you know that a town has become yourtown: where others see brick, a broken window, a boarded up storefront, you feel either moved to tears or to joy. The map of the town becomes the map of your memories, . . . its geography becomes your destiny.”
Yet the devastation wrought by the disease was more than he could continue to bear. Abraham Verghese finally left his beloved Tennessee and the people he had loved more than any other. He had “maintained no distance, denying . . . that this was a fatal illness. The future, when all my patients were dying, seemed remote and vague. I convinced myself that I could handle that. But I simply did not understand how devastating it would be.” Although hooked on treating AIDS cases, he removed himself to the University of Iowa’s outpatient AIDS clinic, where he would be part of an AIDS team but not personally involved with each patient and family.
This book, despite its topic of death and disease, is a joy to read. Beautifully written, it is rich in stories of compassion, courage, humanity, and even humor. A book to reflect upon and reread, it abounds with contemplations of all manner of things, from the state of the medical profession to the “Indianization of the South.” Finally, however, the images that will linger are those of the AIDS patients and their families, who behaved with courage and dignity in the face of almost unbearable circumstances. Verghese says, “I will not be able to forget these young men, the little towns they came from, and the cruel, cruel irony of what awaited them in the big city.”
Sources for Further Study
British Medical Journal. CCCIX, October 29, 1994, p. 1169.
Chicago Tribune. June 12, 1994, XIV, p. 3.
JAMA: Journal of the American Medical Association. CCLXXII, August 10, 1994, p. 491.
Los Angeles Times. April 26, 1994, p. E7.
Nature. CCCLXX, August 25, 1994, p. 606.
The New York Times Book Review. XCIX, August 28, 1994, p. 1.
Newsweek. CXXIII, May 9, 1994, p. 62.
Publishers Weekly. CCXLI, March 21, 1994, p. 61.
Time. CXLIII, June 6, 1994, p. 70.
The Washington Post Book World. XXIV, May 15, 1994, p. 1.