My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (review)

The vast majority of AIDS literature has been written by people who are personally vulnerable to the disease—people with AIDS or HIV, or their loved ones or caretakers or seronegative members of the most stricken communities (for example, gay men). Abraham Verghese’s My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS marks a new departure in AIDS writing. The few physicians who had written personally about AIDS before were physicians with AIDS, and their brief commentaries were not intended to be read as crafted literature—for example, Stephen K. Yarnell’s contribution to When Doctors Get Sick and Hacib Aoun’s moving statements in the 7 September 1989 New England Journal of Medicine and the 15 February 1992 Annals of Internal Medicine. ¹ In My Own Country Abraham Verghese has written the first extended and frank testimony by a physician about his work with AIDS patients and about the profound changes that brought about in his professional and personal lives. In addition, Verghese portrays AIDS in a part of the country—the rural and small-city South—and among some risk groups that have rarely been featured in AIDS writing. At the same time, he echoes themes and motifs from earlier AIDS literature, implicitly underscoring how central they are to the genre. Furthermore, in his emotionality and personal frankness, Verghese follows fellow confessional physician-writers such as David Hilfiker, whose widely-hailed Healing the Wounds: A Physician Looks at His Work (New York: Pantheon, 1985) helped establish the tradition of self-conscious contemporary physician “unmasking” literature.

My Own Country recounts Verghese’s experience from 1985 to 1990 as he became the de facto AIDS doctor for scores of patients in and around Johnson City, Tennessee, and in the surrounding Kentucky-Virginia-North Carolina area. Verghese had completed his residency in internal medicine at the new East Tennessee State University Medical School in Johnson City and after an infectious diseases (ID) fellowship in Boston, had returned to Johnson City to teach and to work on the staff of the Mountain Home VA Center. Initially interested in academic medicine, Verghese is inevitably plunged by AIDS into primary care, and in the forefront of My Own Country are detailed and vivid portraits of his patients and their milieus that might be considered the literary equivalent of that specialty. Many of his patients are gay men, but, unlike those in most AIDS writing, the majority never left their small towns and remained closeted there (e.g., the couple Ed Maupin and Bobby Keller) or have returned from large cities to the care of their families (Gordon Vines and Hobart Carter). Even rarer in AIDS literature are the pictures Verghese gives us of HIV-positive heterosexual women (the working-class Vickie McCray, infected by her bisexual husband), hemophiliacs with AIDS (Norman Sanger, whose harrowing death Verghese depicts unsparingly), and people with transfusion AIDS (Will and Bess Johnson, who pose an extra level of challenge as well-to-do, “pillar-of-the-community,” fundamentalist Christians who insist on keeping their infection secret).

Almost as prominent in My Own Country are Verghese’s narrative of his own history and situation and his description of the effect his deepening involvement with AIDS has on his attitude toward medicine and on his private life. Three linked themes dominate this strand of the book. The first is Verghese’s multiply “alien” status. He is both an “FMG” (Foreign Medical Graduate) in the United States and an outsider among his fellow immigrants, both in the large Indian medical community around Johnson City—where being an ID specialist, “the pariah of specialties by virtue of its lack of procedures” (p. 67), was seen as “equivalent to being a...