A Book Review on ‘My Own Country’
One of the most insightful books ever written is the one by Abraham Verghese entitled “My Own Country”. This book is a semi-autobiographical in the sense that it is basically culled from the experiences of Abraham Verghese.
The son of expatriate Indians who settled in Ethiopia, Abraham Verghese became an infectious disease specialist and settled in Tennessee, deep in the rural bible belt of America; then he gradually became more and more involved in the care of people with AIDS. AIDS soon absorbed him totally – his time, his skill, and his emotional life, threatening his marriage and making him become more and more of an outsider to his peer group. The result is My Own Country: A Doctor’s Story of a Town and its People in the Age of AIDS.
In My Own Country, Abraham Verghese, a young Indian doctor born and educated in Ethiopia, tells of the four years he spent in a Tennessee town as a specialist in infectious diseases. In late 1985, Dr. Abraham Verghese, freshly licensed infectious-disease specialist, arrived in Johnson City, Tennessee, to begin his practice. The number of AIDS cases was beginning to rise in the urban centers of the East and West Coasts. Dr. Verghese’s decision to leave Boston and return to rural Tennessee, the site of his residency, meant leaving this new and troubling epidemic behind. Or so he thought.
A few months before Dr. Verghese’s arrival in Johnson City, a young man who had left Tennessee years earlier for New York City arrived in the emergency room of the Johnson City Medical Center in extremis. He was successfully resuscitated but died three weeks later, after a bronchoscopy had confirmed the unthinkable: Pneumocystis carinii pneumonia. The patient had AIDS. When Dr. Verghese landed in Johnson City, hospital staffs were still debating what to do with the young man’s respirator. There were more than a few votes for burial or incineration.
At that time, Johnson City’s inhabitants had heard about AIDS, but saw it purely as a big-city problem, and had no idea that the disease could invade their own community, a “typical” Southern town with little experience of illegal intravenous drug use or overt homosexuality. But as this book would eloquently demonstrate, no community is immune to AIDS, and the disease had already made its way to Johnson City, silently infecting a number of people.
The simultaneous arrival of the young physician and the dread inner-city disease of gay men and drug users in the backwoods of the American South forms the story of My Own Country. This is rural America in the age of AIDS, and through the author’s eyes we see a region reluctantly come of age in the face of a changing reality. Even as the author’s practice grows from 1 to a dozen to 80 patients with AIDS, the townspeople go about their business, shopping at the Piggly Wiggly and drinking in the local taverns, utterly unconscious of the possibility that the person next to them might be infected with the human immunodeficiency virus (HIV). The town’s oblivion simply heightened Dr. Verghese’s concern about the expanding epidemic
By 1989, Verghese was caring for more than eighty HIV-positive patients and unlike most specialists, who focused only upon their respective areas of expertise; he was the patients’ primary care provider. And because the nature of the illness forces the doctor to confront and deal with intimate, private issues, Verghese found himself becoming intensely involved with the unique personal story of each patient’s life.
Analysis and Summary
The story also tells us how Verghese’s patients have struggle to deal with their illness, and vividly shows how their loved ones cared for them, even as both the patients and their families had to deal with societal prejudice. While some patients gave in to the disease, many found that being diagnosed as HIV-positive was not the end of their lives but the beginning of a new existence which, because of its precariousness, was more intense and far more precious.
Conflict arose when the doctor becomes too caught up in the problems and sickness of his patients that he soon begins to find his family life being torn into pieces. Verghese found himself drifting dangerously away from his wife, who was fearful of AIDS and felt shut out by her husband’s preoccupation with his patients’ lives. Verghese’s attempts to save his marriage and his simultaneous search for a home, for his “own country,” finally lead him away from the Tennessee he has grown to love, and where he had hoped after years of wandering to put down roots at last. But though Verghese must move on, in a spiritual sense he does find his “own country”–in his vocation as a healer. My Own Country, while it incorporates the stories of many patients, is primarily the story of a doctor and his very personal journey.
This particular book clearly tackles issues on identities. Shah, in his critical review of the book, notes that the book can be gleaned as a representation of Verghese’s life-long struggle with his own identity. In America, foreign implies another “homeland,” an ethnic home to which one can return. Verghese struggles between multiple worlds. On the revolution in Ethiopia, he says, “It was a terrible feeling, being labeled an expatriate in your own country” (Holley, 48). Verghese’s Ethiopian birth, Indian descent, and Christian faith create a complex identity. He confronts these “worlds” in his text. The migration of Indians from India to Africa is told through the story of his parents. This story continues in “the next wave on to Birmingham, Bradford, Bristol, London…and even Johnson City, Tennessee” (Verghese 16). Verghese connects to this tradition of displacement and migration, but does not find a sense of community there.
Among the Indian families in Johnson City, Verghese is an “outsider.” He refuses the financial success that lies at the “root of the hierarchy” (205), and finds joy in being a “hero of sorts” (206) amongst the children. Within the larger community, Verghese is aware of his status as a “foreign doctor.” However, his anger is directed against his fellow professionals, not the community: “Sometimes I felt that I was accepted only as long as they [medical community] needed me, as long as I could be of service to them” (308). In such explorations, he shows what it means to be at once a skilled professional and ethnic or racial outsider in a closely knit community, town or profession.
Most importantly, the book also describes the identities of those suffering with AIDS. Verghese explores how easy it is for society to give a disease an identity, but it is impossible for those affected by the disease to refuse that identity. In Johnson City, as in many places at the outset of the AIDS crisis, homosexuals were seen as “deserving” AIDS, while others are described as “innocent victims.”
In the book, one Will Johnson contracts AIDS from a blood transfusion and passes it on to his wife, Bess. His struggle to keep his condition a secret from his community, friends, and family illustrates how “They [Will and Bess] believed the ugly metaphors of AIDS: AIDS = gay, AIDS = sin. They could not get past what it seemed to imply about lifestyle and morality” (291). Will and Bess had so deeply internalized what society said it meant to have AIDS, that they could not see that they were in a position to dispel the myth, and their story illustrates ways in which identity is formed as much from the (mis-)conceptions of others as it is a matter of individuals coming to terms with themselves.
In one of the reviews I read about the book, it was mentioned that there were various stop-and-go episodes in the book that fell a little too short of enticing the reader’s imagination. As noted by the New England Journal of Medicine, the book begins breathlessly, with the author’s staccato description of the emergency room resuscitation of Johnson City’s first patient with AIDS. But the reader expecting a high-speed chase will be disappointed. Instead, we are taken on a leisurely stroll down a shaded country lane, the bright glare of the AIDS epidemic at times illuminating and at times casting new shadows on the people and culture of the rural South. I have to agree that I felt the same thing when I was reading the story but it did not matter much to me after the author successfully got my interest from the moment I started reading page one.
It is interesting to note that most of the characters in the story — from the gay men with AIDS returning to their families to die after years away, to the man with hemophilia who tenaciously battled his joint deformities only to lose the battle against HIV, to the devoutly religious company president and his wife who kept the fact of their HIV infection from town, company, and family for years — are described with considerable sympathy and poignancy. Some of the themes, such as the strain Dr. Verghese’s devotion to his patients puts on his marriage, are tantalizing but incompletely explored.
Other details — differences in pay between surgeons and internists, arranged marriages in Indian culture, nuances of the physical examination — are disconnected ruminations that fail to enlighten the reader. Brisker editing would have helped.
One other interesting to point out is the fact that Dr. Verghese has a keen ear for dialogue and writes in clear, uncluttered prose. From time to time the writing is even inspired, as when he describes how he might have used large doses of morphine to hasten the death of a suffering patient:
Morphine disconnects the head from the body,
makes the isthmus of a neck vanish, diminishes the awareness of suffering.
It is like a magic trick: the head on the pillow, at peace, while the chest toils away.
Proper commendation should be given to the book and the author because, in my opinion, it is one of the first to describe the experience of the care giver in the age of AIDS. Despite its flaws, it captures the maelstrom of excitement, fatigue, tragedy, and ultimate gratification that AIDS care givers feel. Dr. Verghese is a man who gives much of himself — driving miles to visit a patient’s family “to get a clearer picture of this strange man,” scrubbing to watch the surgery on one of his patients, helping form a local support network when he perceived one was needed. That he finishes his five-year sojourn in Johnson City with his basic decency and optimism intact is a tribute to his strength of character. That the tale ends with Dr. Verghese packing up with his family to move to Iowa, emotionally and physically drained, his marriage at risk, is poignant evidence that the AIDS epidemic has claimed more victims than simply the patients.
Hence, it can be said that the life stories of the patients are the core of the book. They tell of prejudice, bigotry, blind hatred, and intolerance. They tell of the varied reactions of patients to all this – the guilt, the shame, the anger, and the rages. AIDS is not just another disease like legionnaire’s disease or leukaemia. The treatment meted out to gay men with AIDS, especially in small rural areas apparently the world over, can be compared only to medieval witch burnings.
What is most remarkable about My Own Country is that it takes a foreign-born, heterosexual doctor with very little exposure to the American culture or that of the gay community for that matter to make himself at home and comfortable in its midst. In the process, he cares for his patients as only a small-town doctor can do –with utmost personal attention, continual self-examination, openness, tears and rage.
After reading the book, it can be said that the reader is left with the images of people caught in the struggle of AIDS, not stereotyped views of society. According to Nishu Shah, Verghese’s discussion in the book leaves few stones unturned. He uses his book to discuss the flaws in current health care delivery, the victimization of patients, the role of privacy and confidentiality between doctors and patients, ignorance and prejudice, and being foreign in America. The transformation Verghese chronicles with the emergence of AIDS is closely tied to an awakening toward his own identity.
San Jose Mercury News (1994). Anonymity and My Own Country
Available at: http://www.meredithmaran.com/mag_sjmerc_anonym.htm
[cited on December 12, 2006]
Shah, Nishu (1998). Abraham Verghese
Available at: http://www.english.emory.edu/Bahri/Verghese.html
[cited on December 12, 2006]
The New England Journal of Medicine (1994). My Own Country
Available at: http://content.nejm.org/cgi/content/full/331/16/1100
[cited on December 12, 2006]
Verghese, Abraham (1994). My Own Country. New York: Simon and Schuster.