Abraham Verghese is a medical doctor who has just published a book, My Own Country, about his experiences with AIDS patients in rural Johnson City, Tennessee. Through the process of caring for his patients, Verghese chronicles, he learns not only about AIDS and how it appears in his rural area, but also about the gay people who make up most of his patient load.
While the experience was an enriching one for Verghese, it was trying for his wife, who was afraid Verghese would catch the disease himself or bring it home to infect their two little boys. The end of the book finds Verghese and his family leaving Johnson City for a “cooling off” period in Iowa as a way to save their marriage.
Verghese writes that he is going to Iowa to work at the less stressful environment of the University of Iowa outpatient a two-year long course at the Iowa Writers’ Workshop. Jyotsna Sreenivasan spoke to Verghese by telephone from his home in El Paso, Texas, where he is a professor of medicine and Chief of Infectious Disease at Texas Tech Health Sciences Center.
How did you decide to essentially give up your career for a few years to take a writers’ workshop?
I was pretty burnt out in Johnson City. I was following 100 AIDS patients by myself I had always been interested in writing short fiction and essays, and the previous summer, on a lark, I took a short writing workshop at the University of Iowa.
I went to the two-year workshop with the intent of writing the human side of the AIDS crisis. I wanted to elevate my writing style to tell the story ill a more compelling way. I felt in Johnson City that I had stumbled onto a major American social phenomenon: rural gay men moving away to the big city, catching AIDS, and coming back to their rural homes to die.
You mention in the book that you had very little experience dealing with gay people before you met them as your patients. Yet you seem so sympathetic to them. You get to know them as people, and the reader also comes to care for them. Did you have any homophobia at all—any feelings that they were disgusting, or that they deserved what they got?
I began with “homo-ignorance,” not homophobia. I grew up in Ethiopia and went to college in India, where I picked up the condescending buffoonery towards homosexuals. But I didn’t know any gay people. Homosexuality was very hidden in India. It wasn’t something I thought about a lot. I didn’t have a lot of revulsion or animosity to gays, but there was a lot of awkwardness with my first patients.
Being the perennial outsider, I’m loath to accept any stereotype. Outsiders find so many things strange in the U.S.: Rednecks are strange, ultra-conservative Christians are strange-yuppies in Boston, Ivy-League elitism–it’s all strange. Gay men are no stranger.
Even though AIDS is a disease with no cure, this is not an unbearably depressing book, and you were not depressed by the fact that you could offer little hope to your patients.
AIDS made me understand the difference between healing and curing. There is no cure for AIDS. In the last century, physicians would visit patients, sit with them. Now the Western physician gives penicillin and steps away. No healing just the cure.
With AIDS, I realized that even when no cure was possible, there was a healing function I could perform visiting patients at home, helping patients come to terms with the illness, just by being there, offering something of my spirit.
I was also struck in your book by how you were actually curious—and excited—by seeing a new patient with his disease!
Every time I see a patient, it’s an opportunity to describe something that’s never been described before. I’m still in love with medicine, sniffing out clues. When I was younger, I read Of Human Bondage by Somerset Maughem. It fostered my sense of passion and romance in medicine. I’m writing a novel now, called the Beautiful Indifference, which I hope will foster that sense of passion in young medical students today—the sense that, even if the work is hard, even if I weren’t making any money, I’d still do this. A lot of Indian kids are going into medicine, and I don’t know if all of them have this passion.
How has the Indian community reacted to your book?
I had a wonderful review in the American Association of Physicians of Indian Origin Journal. I think they are happy about the success of an Indian doctor. My parents read the book and understood certain thingsabout gay men and AIDS through it that I could never have explained verbally. When you read the book, you identify with me and go along on my journey. When I have a revelation, you do, too.
Some of my Indian friends from Johnson City have been very moved by the story. But others have not even read the book yet. I’ve heard some grumblings from Johnson City about how I’ve exposed the Indian community there by describing our parties and the little van that brings Indian food and spices for us to buy.
One of the sub-themes of your book is your marriage—how it got rockier the more involved you became in treating your patients. How is your marriage now?
It’s still rocky. My wife and I are separated. We live in the same town one mile apart. I see her and my kids everyday. We hope we can put it back together.
The title of your book, My Own Country, refers to the fact that you felt so at home in Johnson City after feeling an outsider in Ethopia and India.
Even though I grew up in Africa, we always had the strong sense of being expatriates. While I was in college there, the Ethiopian government closed the university and wanted to send the expatriates away. And even though I visited India a lot and liver there for a while, I didn’t feel like I belonged in India either.
America is a place that allows you to live whatever way you want. I become a citizen at the very first opportunity. It was a tearful moment for me. I felt I had arrived. At the time I thought it was Johnson City that made me feel that way. But now I’m very happy in El Paso.
Did working with AIDS patients change you in any way?
AIDS has a wonderful effect of compressing human existence. It tends to affect people in the prime of their life. Most people don’t think about their death when they’re young. AIDS patients do. It brings out a desire to find meaning in their life. They find the meaning in their life is not money, or a job—it is the loving relationships they’ve successfully nurtured. Many patients have said, “I would never have known the love of my father, or my brother—but for AIDS.”
When I used to visit my parents, I would regress into a surly teenager. One day I told my mom how much I loved her as a child. Now I have a wonderful relationship with her! Without my experience with AIDS, I might have waited till her deathbed to tell her that, and regretted it even after.
AIDS gives me a sense of not hesitating to chase my dream. I had the sense that if I wanted to write this book, I had to do it now.