My Own Country
is a 1994 autobiographical work by physician and educator Abraham Verghese. It documents his time as a young physician for infectious diseases while working in Johnson City, Tennessee during the 1980’s. At the time, the AIDS epidemic had yet to emerge as a critical event, and Verghese became by default the city’s AIDS expert after being sought out by so many people suffering from their unknown illness. Verghese recounts the destructive stigmas that accompanied the epidemic; he also relates many of the emotions he experienced while comforting patients from their diagnosis to their deathbed without an established cure.My Own Country
begins in late 1985. Dr. Abraham Verghese, newly licensed as an infectious disease specialist, arrives in Johnson City to begin practicing medicine. At the time, the amount of AIDS-related cases was beginning to multiply in urban areas on the east and west coasts of the United States. Verghese recalls moving from Boston to the more rural Johnson City, where he had lived before and during residency, as an attempt to leave the epidemic behind, critiquing his naivety.
A few months before his move to Johnson City, the hospital where Verghese was about to start work had encountered a gay man who had also started in Tennessee but moved to New York City. Coming to the emergency room on the verge of death, he was resuscitated, but died weeks later after an AIDS diagnosis combined with pneumonia symptoms. When Verghese arrived in Johnson City, the hospital staff were deciding what to do with his respirator. He recalls observing them debate whether to burn or bury it, believing it contaminated.
The arrival of Verghese combined with the stigma of the “inner city disease” attributed commonly, especially in rural areas lacking education, to gay men and drug users, forms the background to the book. Verghese observes the transformation over time in the city’s perceptions of AIDS, reluctantly realizing its reach cannot be quarantined by stigmatizing it. Verghese’s own practice quickly grows from 1 patient to over 80 who have AIDS. Meanwhile, the townspeople try to maintain life as usual, drinking and shopping and declining to acknowledge a growing epidemic. He notes that they hypocritically do not suspect their own people as having a risk of infection with HIV, the precursor virus to AIDS. This frightens Verghese, who begins to see the extreme ignorance central to the spread of the epidemic.
The latter events in the book gradually recall different characters Verghese meets during his tenure at Johnson City Hospital. He meets gay men with AIDS who return to their families to die after having left for years. He describes one man who suffers from hemophilia who struggled in a battle against various joint deformities only to, ironically, contract and die from complications of HIV. Another character, an extremely religious corporate executive, comes to the hospital with his wife, who reveals they have collectively kept their HIV status a secret from the town and their family out of fear of stigma. Verghese describes all of these characters sympathetically, casting humanizing lights on the fear and shame that births their ignorance. He recalls with regret how he felt strained in trying to maintain healthy relationships with his patients knowing their fate. He details other aspects of hospital culture as well, such as pay disparities between surgeons and interns, his own Indian heritage’s custom of arranged marriages, and the social complexities of doing physical exams on humans. These anecdotes further color this account of his professional ethos and life. He recalls utilizing morphine to ease patients’ suffering and allow them to pass away faster, knowing that it disconnects the brain from the physical ailments of the body, letting a sufferer rest peacefully.
Verghese comes across as someone who is extremely devoted to the social complexities of his craft, sometimes driving miles to get a clearer perspective on a patient he considered strange, or personally attending a surgery on one of his patients, or personally helping to form a social support network for AIDS sufferers, noting none existed in Johnson City. Ultimately, he finishes a five-year stint in Johnson City. He expresses gratitude for his experience and relates that he remains optimistic about the disease.
The book concludes with a scene where Verghese packs up his things with his family to move to Iowa, both physically and emotionally exhausted from his work. He notes that his marriage was strained at the time from his family having to endure the secondhand trauma, suggesting that the human consequences of AIDS transcend the ailments of the human body.
Verghese’s book is a unique novel in the literary canon about AIDS and stigma around medical issues, focusing on recent history’s most contentious one. It provides a unique personal perspective on the complexes of excitement, exhaustion, death, and personal gratification that people working for AIDS sufferers and the larger epidemic feel.