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My Own Country: A Doctor's Story Paperback – April 25, 1995
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From Publishers Weekly
Indian physician Verghese recalls his experience practicing in the remote, conservative town of Johnson City, Tenn., when HIV first emerged there in 1985.
Copyright 1995 Reed Business Information, Inc.
NATIONAL BOOK CRITICS CIRCLE AWARD FINALIST
“A fine mix of compassion and precision.... Verghese makes indelible narratives of his cases, and they read like wrenching short stories.”
—Pico Iyer, Time
“A richly textured portrait of a small Southern town.... Immensely moving. In describing his own odyssey as a healer, Verghese displays rare candor and eloquence.”
“Memorable.... Fascinating. We come away from My Own Country with an abiding admiration for the good and compassionate work Dr. Verghese has conducted.”
—Michael Dorris, Los Angeles Times
“Remarkable.... An account of the plague years in America. Beautifully written, fascinating and tragic, by a doctor who was changed and shaped by his patients.”
—Perri Klass, The New York Times Book Review
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Two subjects predominate. One, of course, is AIDS. The book is studded with case studies, as Verghese sees a wide array of the insidious ways in which AIDS manifests itself and kills. Most of his patients had obtained HIV elsewhere and had moved back to the Johnson City area once they became ill. Acquisition for most was via unprotected homosexual contact, but for a few it was through tainted blood or plasma or via heterosexual intercourse. The disease was hellish in and of itself, but often the social ripple effects were also dreadful -- from contempt and rejection on the part of family members and community, to refusals to treat by doctors and dentists, to boycotting by undertakers. As Verghese writes, "I was improvising constantly to deal with the moral, ethical and social subtleties that were so much a part of this disease."
The second principal subject involves medical practice in general in this country. When Verghese chose to specialize in infectious diseases, he relegated himself to second-tier status among his physician colleagues, especially financially. Medicine was transforming itself into a get-rich business, and the big money was in conducting processes and performing procedures, as opposed to diagnosing patients and being their primary care physician. As Verghese came to realize, proper treatment often required a holistic approach, which in turn required an understanding of the dynamics of the patient's relationships with family, friends, and community. In the thirty years since, the economics of medicine has gotten more out-of-control, and the quality of medical care has decreased. Even in 1985, many of the doctors and medical staff in rural hospitals and in urban public hospitals were foreign-trained, working in the U.S. with visas. If the U.S. continues to insulate itself from the world at large, how will these roles be filled in the future?
Verghese, however, does not harp on these and other social/medical policy issues or become preachy. Foremost, MY OWN COUNTRY contains umpteen different tales of human suffering and endurance, surprisingly often heroic and dignified in nature. For every incident of contempt and rejection, there is one of care and compassion. Two heroes in particular stand out -- Essie Vines, who cared and advocated for her brother Gordon, and Fred Goodson, who did likewise for his partner Otis Jackson and also was the principal organizer and force behind the local AIDS-support group. Anecdotally, there are a handful of intriguing "human interest" stories, such as "John Doe", a debilitated old man with a stroke, diabetes and pneumonia who had been left at the emergency room entrance while the family went to "park the car" and were never seen again; or Vickie McCray, who got HIV from her husband, who unbeknownst to her often had had sex with a male friend from his youth and then went on to give the virus to Vickie's sister as well (Vickie told Verghese that "ever since I found out he has AIDS, I've been feeling too sorry for him to be angry with him. No one deserves to be sick lik'at. No one deserves to lose their mind lik'at.").
MY OWN COUNTRY is not a perfect book. At times, Verghese goes too far down rabbit trails of marginal relevancy (especially when he describes geography and the routes from one place to another); the book is a tad manipulative; occasionally Verghese, although a truly remarkable person, comes across as a little holier-than-thou; and the sentimental reference to "my own country" seems a wee bit hypocritical given that Verghese left the Johnson City area after four years, never to live there again.
That said, and even though the book now is over twenty years old, MY OWN COUNTRY deserves to be read. It is interesting throughout, it is very readable, and reading it will surely broaden almost everyone's horizons of humanity.
Over the course of the novel, Dr. Verghese shows his readers the immense role a physician can play in the lives of patients. His patients are dying. They are afraid. There is little he can do to ease these physical pains. But he is there for them. And it is clear that many of them feel a true patient-physician bond with him as he helps them navigate their journey from life to death. This isn’t an easy process for the patients dying of AIDS, or for Dr. Verghese.
As we see a community form around his perseverance to treat his patients with dignity, we also see how his job begins to overtake his life. As Verghese becomes indispensible to his patients, his relationship with his wife and family deteriorates. We feel for the doctor as he misses important moments in his personal life. We can feel how he is pulled in different directions. He needs to choose between his patients and his family. We see how he chooses his patients. By the end of the novel, it is clear that Dr. Verghese is burned out. His marriage is strained and he has nightmares about the infection that consumes his working hours. We end the book with the same uncertainty that he feels. It turns out that the doctor’s calling has drained his spirit.
The book ends with Dr. Verghese making an important discovery about the pattern of AIDS in rural areas, and deciding to leave Johnson city for somewhere new and more detached. It is a conclusion that fits the topic. This book is not just about a viral pandemic. It does a good job of detailing HIV before treatments, but it’s mostly about the evolution of an idealistic physician. Read this book if you’d like to understand how incurable diseases affect both patients and their healthcare providers. You’ll get a glimpse into the hidden and sometimes heart-wrenching world of doctor-patient relationships.