AIDS Comes Home

My Own Country: A Doctor’s Story by Abraham Verghese.  Vintage.  432 pp.  $16.00.

I’m full of admiration for this book, and there’s no single reason.  It’s an AIDS memoir, told from the standpoint of the doctor who cared for the patients, and who just happened to be a gifted writer who would later write a bestselling novel.  It tells the story of the patients in a completely sympathetic way, even though Verghese arrived at this job knowing little about AIDS or about gay culture.  The way Verghese is honest about his initial naiveté is endearing, and he shows the same kind of honesty throughout the book, a quality that I find rare in memoirs.

He talks initially about his arrival in Johnson City, Tennessee—not a likely hotbed for AIDS—and the kind of people he found there.  You might think they would be prejudiced against a dark-skinned man who is Indian by birth, was raised in Ethiopia, and did his medical training overseas as well, but most people were completely accepting, and he settled into the “good old boy” culture that he found (?); one of his best friends was a guy who owned the local gas station and would take him into the back room to sip a little moonshine.

There was a subculture of Indian people in the city, mostly involved in the medical profession, and Verghese writes about them as well, the way they stuck together, regularly socialized with one another, had a kind of social hierarchy.  He speaks also of his relationships with nurses, some of whom were reluctant to treat AIDS patients, or refused altogether, others who threw themselves into the work and were completely willing.

He was frank also about his own marriage, which was slightly shaky even when he had arrived; it had been semi-arranged, as was common in Indian culture.  He proposed after the third date, when he admitted he hardly knew his wife, and still felt he hardly knew her seven years later, as they settled into this new job and situation.  His wife didn’t like him working with AIDS patients in the mid-eighties, when there was all kinds of superstition and misunderstanding about how the virus could be transmitted.  She didn’t like the way he became obsessed with the disease, and it took over his life.

When he began his stay there had not actually been an AIDS patient at the hospital where he worked.  When he left four years later, he had cared for 80 people in various stages of the disease, and a number had died.

Verghese is that rare doctor—rare as hen’s teeth—who not only cared for his patients but got to know them, called them constantly, visited their houses, got to know their partners (who often became his patients as well).  All of that seems weirdly old-fashioned, as if this were a story about a kindly physician in the 1930’s or something, not the AIDS epidemic of the eighties.  He was completely open to gay culture and to the people he treated (apparently kept notebooks about their illnesses and their lives).  I can’t help thinking this kind of care was important to the healing process.  Not the process of getting cured—nobody did that—but of accepting the disease and living with it as well and as long as one could.  Not everyone did that—there was one a notable exception—but many did.

The most memorable for me (among many memorable characters) is a woman named Vickie McCray, who shows up throughout the book.  Only a superb writer like Verghese could have captured this woman on paper.  Most people would describe her as trailer trash, though she is feisty and strong and brave and has a wild verbal gift.  She first showed up at the hospital when her husband was so far gone with AIDS that he was demented and not making much sense.  When Verghese asked Vickie if Clyde had ever had sex with a man, she said, “Hell, no!” to which Clyde responded, in a moment of lucidity, “Yes.  I’ve had sex with men.  With Jewell, all the time.”  That was the first Vickie had heard of such a thing, and her life began to unravel.  Somehow this remarkable woman didn’t let it fall to pieces altogether.

Jewell was an older man, an important businessman in his community, who had apparently abused Clyde when he was young and continued having sex with him throughout his life.  He was the kind of bisexual man who would have sex with just about anybody, men and women, maybe an animal or two.  Clyde was like Jessie, had spread his seed all over the place; he’d actually had an affair with Vicki’s sister, and Vicki discovered them in bed.  Clyde and Vicki still lived in a trailer, and Clyde in his dementia was reduced to the status of a child, played with their children almost as one of them.  The children, fortunately, had not been infected by the virus.  Both Vicki and her sister were.

The story of Clyde and Vicki and Jesse and her sister and their children is a little vignette—there could be a whole book about them—but there are multiple stories in this book, told with just as much detail, and as much sympathy and attention.  I appreciated Verghese’s revelations about himself and his family, the Indian community and hospital life, but mostly I appreciated the stories of these patients, who nearly all followed the same trajectory.  They had grown up in this backwater, where they never felt at home because they were gay.  They left for some larger city where they could live with like-minded people, and where they had often been happy, but had also gotten infected.  Then they came home to die, and their families had to come to grips with—accept or reject—the people they had been all along.  It was one prodigal child after another.  But they were prodigal because people wouldn’t accept them in the first place.

I admired Cutting for Stone and wrote about my admiration here; one of my readers wrote back and said, “This guy’s a great writer.  You should read all his books.”  I’m now doing that, and I have to say I prefer My Own Country to Cutting for Stone.  Verghese is a marvelous novelist.  But the kind of honesty and sympathy he exhibits in this memoir is rare.