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Last Updated on August 6, 2019, by eNotes Editorial. Word Count: 636

Abraham Verghese recounts the story of his days learning medicine and then his experience working with AIDS patients. His career in infectious diseases—as well as his Indian heritage—isolated him from other people in his community and the medical profession. Still, he knew what he wanted. Verghese writes,

I had made...

(The entire section contains 636 words.)

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Abraham Verghese recounts the story of his days learning medicine and then his experience working with AIDS patients. His career in infectious diseases—as well as his Indian heritage—isolated him from other people in his community and the medical profession. Still, he knew what he wanted. Verghese writes,

I had made up my mind that I wanted a career in academic medicine. If there was glory in medicine, then I was not satisfied with the glory of saving a patient and having the family and a few others know about it. . . . I loved bedside medicine, the art of mining the patient's body for clues to disease.

This is what leads him to take a job working in a small town and, eventually, to working with people with AIDS.

One thing that affects Verghese is the perception of AIDS by other doctors and the people around him. People with AIDS are almost seen as a joke by them, which makes it more difficult for the patients and their families to get help. He writes,

But it was not always recounted as a sad story. "Did you hear what happened to Ray?" a doctor asked me. He proceeded to tell me how a young man had dropped into the emergency room looking like he had pneumonia but turning out to be "a homo from New York with AIDS." The humor resided in what had happened to the unsuspecting Ray, the pie-in-your-face nature of the patient's diagnosis.

A lot of the men he worked with left small towns to experience life in the big city; however, after contracting AIDS during a time when a medication wasn't as available, they would only come home sick and dying.

Verghese is haunted by the families of the people he treats. He becomes so entwined with the families that he feels their losses more deeply. Part of this is probably because he is isolated from his own family because of his contact with AIDS patients. He writes,

When I think now of the losses caused by AIDS, I am also haunted by the earlier losses, the times that might have been, the communication and sharing that for many will never be possible. I can picture Mr. Carter on his porch, years after his son's death, still fingering brochures and studying pictures of the Golden Gate Bridge.

When Verghese eventually leaves Tennessee, some of his reason for choosing a less patient-facing position is that he won't have to experience the same level of sadness due to losing his patients.

Verghese feels like Johnson City is his home in a way that other places haven't been before. His sense of belonging is offset, however, by the sadness he feels at the tragedy taking place around him:

I have lived for five years in a culture of disease, a small island in a sea of fear. I have seen many things there. I have seen how life speeds up and heightens in climates of extreme pain and emotion. It is hard to live in these circumstances, despite the acts of tenderness that can lighten everything. But it is also hard to pull away from the extreme, from life lived far from mundane conversation. Never before AIDS and Johnston City have I felt so close to love and pain, so connected to other people.

Even while his life is breaking up, he feels responsible for making sure people get both respect and treatment. A lot of the other medical staff working with him are reluctant to work with his patients. This means that he has to take on more cases than he would have with a more cooperative group. Verghese felt that his separation from those around him—which was also a result of his heritage—actually made his patients feel more comfortable with him, too.

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