My Own Country: A Doctor’s Story (1995) (PDF) by Abraham Verghese

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Ebook Info

  • Published: 1995
  • Number of pages: 432
  • Format: PDF
  • File Size: 1,94 MB
  • Authors: Abraham Verghese

Description

By the bestselling author of Cutting for Stone, a story of medicine in the American heartland, and confronting one’s deepest prejudices and fears.

Nestled in the Smoky Mountains of eastern Tennessee, the town of Johnson City had always seemed exempt from the anxieties of modern American life. But when the local hospital treated its first AIDS patient, a crisis that had once seemed an “urban problem” had arrived in the town to stay.

Working in Johnson City was Abraham Verghese, a young Indian doctor specializing in infectious diseases. Dr. Verghese became by necessity the local AIDS expert, soon besieged by a shocking number of male and female patients whose stories came to occupy his mind, and even take over his life. Verghese brought a singular perspective to Johnson City: as a doctor unique in his abilities; as an outsider who could talk to people suspicious of local practitioners; above all, as a writer of grace and compassion who saw that what was happening in this conservative community was both a medical and a spiritual emergency.

User’s Reviews

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.

Reviews from Amazon users, collected at the time the book is getting published. It can be related to shiping or paper quality instead of the book content:

⭐ Abraham Verghese is a physician, a specialist in internal medicine and infectious diseases. His medical training was in Ethiopia and India. He came to the United States as an FMG (foreign medical graduate). After finishing his residency and a fellowship, he settled in Johnson City, Tennessee in 1985. Because of his work in Boston, he was the most knowledgeable doctor in the Johnson City area about AIDS, but AIDS was not yet present when he arrived. Four years later, when he left Johnson City, there had been dozens of deaths from AIDS and he had over eighty HIV-infected persons under his care. Johnson City, with its 50,000 residents, had a hundred-fold more cases than the CDC would have predicted for it. MY OWN COUNTRY is Verghese’s account of his four years in Johnson City, Tennessee, fighting an ever-mushrooming battle with AIDS and coming to love a corner of Appalachia.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.

⭐ Let me preface this by saying that I am extremely well read in matters of HIV/AIDS. Next to “And the Band Played On” this is the best book I have read so far. It focuses mostly on the people living with AIDS & their struggle to survive. However, it also focuses on the discrimination that the author faced in caring for these individuals. There were a few long winded sections about the scenery. I am a country girl so I skipped past those sections as I was not interested. May have been a total of 8 or 10 pages throughout the book but only a few paragraphs at a time. This is a well written and informative book. I would love it if the author wrote a follow up book in the years after 1996 and how his experience changed. If you have never read a book on the HIV/AIDS crisis this is where I would suggest that you start.Warning: In this book you will read stereotypical things about the homosexual population. Many of which the author readily admitted to and faced head on. If you are sensitive to this then you may want to skip this book. It did not bother me enough to stop reading it but it is there. Both in the author and the people he writes about.

⭐ I loved this book with all my heart. He is a great writer. I was an inpatient nurse during this Aids crisis time and I was happy to revisit some of the people I cared for. I was reminded of the man who looked at me and said, “Thank you for touching me, no one has done that for a long time.” His dedication to his patients is remarkable. His memory of family members gave such depth to the characters. When people are ill they sometimes are seen only as they are now. We forget or don’t ask about who they are, what they love, how they loved, what makes them laugh….etc. The dedication of some family members was so touching. I mean your husband brings this disease home to you and when he is so sick and out of his mind you are still standing there. It was beautiful and touching. A book that I keep, you’ll have to buy your own.

⭐ Abraham Verghese’s story perfectly illustrates a variety of aspects of society ranging from Tennessee suburban culture to medical hierarchy. The cover story is the spread of HIV and AIDS from the cities. He meets a diverse array of patients that help to highlight the different victims of the HIV and AIDS epidemic. First there was Gordon, a young gay man returning back home to Tennessee after catching HIV from one of his partners in the big city of Atlanta. Then there were Ed and Bobby, a gay couple that had previously tried to remain heterosexual. Next was Vickie and Clyde, a married couple that got HIV from the husband’s homosexual activities. A perfect example of “innocent” victims, were Will and Bess. Will was a successful businessman that got HIV through blood transfusions. He spread the infection to his wife through sexual intercourse. Another unfortunate victim was Norman, a hemophiliac that got HIV through one of his factor VIII injections. The personal story of each of these individuals help to show the true tragedy of the HIV and AIDS epidemic.In the foreground of the HIV and AIDS story is Verghese’s own battle against the medical establishment. The dire reality of the situation and lack of medical treatment brings up issues of euthanasia and DNR. In addition, Verghese’s position as an infectious disease specialist reimburses him at a lower rate than the other specialists in his field. His role as almost a primary care giver leaves him dealing with the most stressful aspects of patient care.My professor stated that this book could be viewed as a primary source document of the US HIV and AIDS epidemic. I agree 100%, Verghese’s book with its colorful descriptions is a on-the-grounds narrative suited for the those looking into the HIV and AIDS fear years.

⭐ In My Own Country is an autobiographical narrative of Dr. Abraham Verghese and his work as an infectious disease physician in rural Tennessee during the early years of the HIV pandemic. Verghese is a powerful writer, and his rendering of the AIDS crisis immortalizes the victims of the AIDS crisis in Johnson City. More than that, Verghese offers a rare perspective of the time—he starts out his story as little more than an outsider stumbling into an interesting medical phenomenon. He was not gay, had little connection with gay community, and was neither an advocate nor an enemy of gay men. Yet, over the course of the novel we see how their stories begin to envelope him. At first Verghese seems like an interested outsider, and we wonder if his fascination is purely medical. But when the young men come to him he learns their names, and he asks for their stories. Perhaps because he is a real foreigner in a place that has made them to feel foreign too, they open up to him. Giving his patients the opportunity to speak is one of the few medicines Verghese has. Medically speaking, he offers little in terms of real therapy. He becomes a doctor specializing in palliative care.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.

⭐ A Subtitled “A Doctor’s Story”, this autobiography was written in 1994, years before the author’s recent novel “Cutting for Stone” made it to the best seller list. It is set in the mid 1980s in rural Tennessee when the specter of AIDS was just beginning to show its ugly face and terrify the populace. Dr. Verghese, an Indian doctor who spent much of his life in Ethiopia, is now a professor at Stanford University School of medicine and is the author of the recently acclaimed novel “Cutting for Stone”. But “In My Own Country” is more up close and personal than that novel as it depicts his experiences as he learns more and more about AIDS while struggling with his own concerns about subjecting his wife and two small children to life in their new country as well the fear of the disease that terrified everyone at that time.Dr. Verghese is a fine writer and lets the reader get right inside his mind. He views his new world with the clear-eyed freshness of a foreigner in a new land. He is also a genius in describing medical details and making them clear for the non-medical reader. But most of all he is a great storyteller, a story that captured my interest from the very first page and kept me mesmerized through the last sentence.In this book we meet his patients and share their terror and bewilderment of this new disease. They each become real, with stories that touched my heart. This story is not set in a big city. Rural Tennessee is a place where people have known each other all their lives. The gay community is small and mostly hidden but was thrust into the light as the disease took its foothold. And then there is the story of a middle class couple who were both infected with AIDS after the husband received a blood transfusion. And the story of the hemophiliac who had suffered with that disease all his life only to become infected with this new scary virus. Yes, the author describes all the symptoms and various manifestations of the disease in excruciating detail and I must say it made me cringe. AIDS is a horrible disease and it is further complicated by the stigma it brings to its victims.The book however is not just a scary medical journal. It is the story of the victims, their caregivers and the one doctor who was quite alone in having to cope with it all. I did learn a lot about AIDS from this book. But I also felt I got to know the author and identified with his struggles with learning about this disease while also finding a place for himself in his new country.

⭐ In My Own Country (the title is taken from a Malcolm Cowley poem), published in 1994, a foreign-born doctor recounts his experiences over about a five-year period ending in December of 1989 caring for an AIDS patients in the heart of Appalachia during the mid to late 80s. At that time, little was known about the disease, fear and bias were rampant, and secrecy was common. Dr. Verghese’s story combines case histories of those he treats, which includes a lot of personal information about the patients because of his close connection to many of them; details about his personal life, his wife having given birth to their first child weeks before his arrival in Johnson City; information about the Indian American community with whom he comes in contact; and a recounting of his interactions with his patients and members of the gay community, who he encourages to get tested and helps disseminate information to about AIDS.Abraham Verghese was born in Africa to Christian missionary physics major teachers and moved to the US as a (p 14) “rookie doctor in 1980.” He worked in TN and Boston, MA, before settling in Johnson City, TN. Because Dr. Verghese became involved in treating AIDS patients when so little was known about the mechanism of its transmission, many persons, including health care workers, avoided interacting with the afflicted. In My Own Country he provides a number of examples of bias leading to bad behavior on the part of these persons as well as the admirable behavior of those who were a lot like him.My gripes are few, but include his contention, which I believe is unfounded, that certain patients chose to come to him for care because he was foreign born and so was less likely to judge him (p 116), “To come to a doctor’s office, even a distant doctor’s office, and tell their sexual secrets to a Caucasian face that could just as well have belonged to a preacher, a judge, or some other archetypal authority figure in their town, might have been difficult. I may have been flattering myself with these thoughts [methinks he was], but more than once I had the sense that a patient was opening up to me for this very reason, because of my foreignness.” Secondly, as an engineer in my pre-stay-at-home-mom life, I took offense at his slam of American students during his discussion of Indian born engineering students who attended university in the US, “After four years of cracking books in the library of some state university…and skewing the grade curve in a manner to make things impossible for their American student peers (who still held dear the three F’s of college life-fraternities, football, and frolicking with the opposite sex), they appeared quite lost.” Lastly, I think that his decision to repeat an anti-Reagan joke with the punch line, (p 206) “[President Reagan] can go out and [ ] the country for another four years!” was in poor taste.Notable, because of Dr. Verghese’s high interest in the gay lifestyle, almost, it seems, to the point of obsession, he learns a lot about his patients’ and their partners’ intimate behaviors and how they likely acquired the virus and provides a lot of information about the disease and conditions that those with it tend to suffer from. Through this informal knowledge gathering process, he learns that persons tended to acquire the virus from engaging in unsafe acts after moving from the country to the city or being infected by those who did, (p 403) “No matter how long I practice medicine, no matter what happens with this retrovirus, I will not be able to forget these young men, the little towns they came from, and the cruel, cruel irony of what awaited them in the big city.” Abraham Verghese’s ability to do what he did (until he burned himself out) in providing compassionate care for HIV infected patients at the start of the AIDS epidemic reminds me most of another awesome doctor, Paul Farmer, whose story Tracy Kidder recounts in his excellent book Mountains Beyond Mountains. On similar subjects: The Spirit Catches You and You Fall Down by Anne Fadiman and Winter’s Bone by Daniel Woodrell.

⭐ In this beautifully written memoir, Abraham Verghese documents what it was like to be a physician, patient and family member living (or at the time dying) with AIDS. As in his novel Cutting for Stone, Verghese has a way of drawing the reader in with his finely drawn descriptions of people and places. As a physician who completed a residency in an urban hospital right at the time period covered by Dr. Verghese, I feel that he brilliantly captured the impotence and despair we all felt during the mid to late 80s (especially before AZT came into use), when we watched our patients-mostly young and middle aged men–waste away and succumb to this horrible disease while we had little to offer them but our emotional support. I’ve read several books about the origins of the AIDS epidemic. My Own Country shines as one that captures the devastation at an individual level that is moving and rings true. What a compassionate physician and gifted writer he is!

⭐ Great book! Abraham Verghese’s case studies are riveting, both in their clinical and psychological aspects.We’re given an unusual glimpse into the affect of this dreaded disease on the soul of a caring physician and on the toll it takes on his family. The author presents revealing information about the American medical system while furnishing evocative descriptions of the physical beauty and of the sociology of this small Appalachian community as well as that of his Indian community. Abraham Verghese is fighting a lonely war on so many fronts, against ignorance, against prejudice, against his own sense of alienation, against death. Never judgemental, inordinately empathetic to his patients, he is far from condescending, as some reviewers have mistakenly stated. This book was an absorbing and educational read that will stay with me for a long time. Abraham Verghese is as gifted a story teller as he is a physician. I hope this book will soon be made available on Kindle.

⭐ I am in love with this Doctor. His compassion and frankness and evaluation of our flawed, yet brilliant medical services are told in compelling stories of actual lives of patients in rural America.His evaluation of the “story of how aids came upon our country” is clear and brilliantly evaluated.If you can stomach some difficult details, you will get inside the head of a true diagnostician. If you read his “Cutting for Stone”, and liked it….this story will bring you right into the next phase of Dr. Verghese’s life. His astute observations and parallels drawn between his story as an immigrant and those of unwanted patients with infectious disease will give you pause for evaluation.This is a brilliant telling of a difficult time in our country and his life, as well. I am so glad I read this book.

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