My Own Country: A Doctor's Story (review)

368 Review MY OWN COUNTRY: A DOCTOR'S STORY by Abraham Verghese, MD. pp. 250. New York: Simon & Schuster, 1994, $23.00 (hardcover); New York: Vintage Books, 1995, $13.00 (paper). My Own Country: A Doctor's Story recounts the four-year experience of Abraham Verghese, a foreign medical graduate, in Johnson City, Tennessee (Verghese, of Indian descent, was born in Ethiopia and received his medical degree in India). That part of the story is not unusual; foreign medical graduates have long been a crucial part of the health care dekvery system of rural America. What makes this story different is his specialty, which is infectious diseases, and the fact that the four-year period of practice he describes (19851989 ) spanned the early days of the AIDS epidemic; he watched AIDS become a part of the Smoky Mountain landscape that he came to consider his home. My Own Country does three basic things. It describes in a folksy manner the appearance of AIDS in a rural community and the successful assimüation (albeit a sometimes arduous one considering some of the prejudices he had to face) of a foreign medical graduate into the same community, and it provides evidence that the notion of community, even in small-town, rural America, is very weak and ineffectual when it comes to helping some of its members deal with tragic circumstances. Abraham Verghese's story is an interesting read, one which ekcited in me a variety of emotions: admiration, for both physician and patients struggling against the endless stream of opportunistic infections that pester, debilitate, and eventually kill; irritation, at the author's occasional simplistic tone and pat explanations of complex social phenomena; hopelessness, at the relentless onslaught of the HIV virus on the immune system of Verghese's patients; hope, at accounts of AZT staving off some symptoms and improving quality of life, at least for a time; anger, at famüy members and neighbors who aUowed fear, misunderstanding, and prejudice to mold their reaction to a loved one's or friend's disease into one of condemnation rather than love; sadness, that not only his patients but also Verghese's famüy, robbed of his time and attention, suffered at the hands of this dread disease; fear, that even among some medical professionals in the community described in the book, the facts concerning transmission of the HTV virus were not enough to override individual prejudice and ignorance; and shame, that I too have harbored some Journal of Health Care for the Poor and Underserved · Vol. 6, No. 3 · 1995 _________________________________________________________Taylor 369 of these same unfounded fears about transmission of the HIV virus and persons with AIDS. This book is a gripping page turner, drawing the reader into its web of emotion and human drama played out in the context of the life and death of Verghese's patients. But there is one major disappointment in the book. I found myself frustrated at not knowing how the doctor's wife and children felt about being the famUy of the town "AIDS doctor" and how they responded to the fact that he was completely consumed by his quest to combat the disease, which nevertheless proved fatal to all of his patients. Verghese, in fact, only briefly acknowledges that he even has a famUy. The picture of the selfsufficient physician standing alone against the onslaught is, in this instance, incomplete since the brief aUusions the author makes to his family paint a picture of pain, isolation, and frustration in this aspect of his life. One can speculate that this aspect of the story may have been the most painful for the writer, hence his apparent decision to simply not address it in depth. I believe there are three underlying things that this book achieves. First, it illustrates the coming of the HTV virus and AIDS to a smaU town in rural America. In poignant and emotional detaü, Verghese describes how the disease affected the Uves of so many in what was then his East Tennessee home. From the story of the first known AIDS death in Johnson City, a son who returned from New York City to die among famUy, to the experience of...