AIDS and alienation in a small town

Dr. Abraham Verghese couldn't get away from it.

"AIDS, AIDS, AIDS: The word seemed to inform my every action. Like barnacles on a ship's hull, the stories of the Scottys, the Clydes and the Otises of the town clung to me."


Dr. Verghese wasn't in New York City or San Francisco in the mid-1980s. He was a doctor in Johnson City, Tenn., a small town that viewed the AIDS epidemic as something as remote as Alcatraz or the moon.

"AIDS simply did not fit into this picture we had of our town," he writes in this breathtaking memoir. "You could shop in the mall, cut your hair in Parks & Belk, pick up milk in the Piggly Wiggly, bowl at Holiday Lanes, find bawdy entertainment at the Hourglass Lounge -- and never know that one of my patients was seated right next to you, or serving you, or brushing past you in the parking lot."


But AIDS came to Johnson City -- and because he was an infectious disease specialist, the few people with strange fevers and symptoms came to him first. He first saw AIDS as an interesting medical phenomenon, something to be conquered with the might of medical miracles.

Then his patients began to die. As Dr. Verghese drew closer to his patients -- mostly gay men who had picked up the disease in New York, California or Florida, but also wives, hemophiliacs, people who contracted HIV through blood transfusions -- the more determined he became to help them. But the more AIDS cases he saw, the more isolated he became.

His friends and medical colleagues drew away, repulsed at the topic and his patients. His wife reluctantly stuck by him, but she wanted him to leave his practice.

AIDS wasn't big enough in Johnson City to engender compassion. It didn't have any spokesmen or movie stars or red ribbons to make it a fashionable cause. Those who got it were utterly alone.

"At times I was angry with the town -- how could I be in this landscape of death, the unholy minister to a flock of dying people, while Johnson City went on with business-as-usual?" he asks.

"By God, if what I was doing was noble, why did it feel like something . . . something shameful?"

On its surface, the title reflects Dr. Verghese's personal quest. Born in Ethiopia to Indian parents, he is an American immigrant who went to medical school in India. He did his residency in Boston, then moved to rural Tennessee. He keenly describes the experience of being a foreign doctor, which is rarely an advantage despite the substantial role foreign doctors play in the U.S. medical system.

Dr. Verghese has spent his life seeking a home, a place where he belongs. Is he an outsider simply because he keeps observing and never belonging? Or does he belong with the surprisingly large social circle of Indian professionals in Johnson City? Or with his two young sons and his Indian wife, who wants a more conventional doctor's life?


"My Own Country" also means the land of AIDS. Dr. Verghese rode like a knight into this dismal, secretive world as a savior, only to realize he cannot stop AIDS or battle it into submission. He's a toy soldier with a plastic sword.

Dr. Verghese spares no detail in describing medical procedures or his patients' demise. Like a good photographer, he seeks out the symbolic and the odd, so we feel as uncomfortable as he does with the pus-infested nodules hanging off one man's face and body, the dying man whose wife takes care of him in their dingy trailer, the bodies wracked with pain.

It's uncomfortable. It's riveting.

Dr. Verghese left Johnson City in 1989, after five years. Now chief of infectious diseases at Texas Tech Health Sciences Center in El Paso, he also writes short stories and articles about AIDS.

"My Own Country" is devastating, inspiring, beautifully written. As long as AIDS has no cure, we're all living in that country, even if we keep the curtains closed and our doors shut tight.



Title: "My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS"

Author: Abraham Verghese

Publisher: Simon & Schuster

Length, price: 352 pages, $23