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Author: Abraham Verghese
Publisher:Simon & Schuster, New York ,1995
Price:$13
Pages:347
Reviewer:Susan Chacko, susan@pablo.niddk.nih.gov
Abraham Verghese is a doctor of Indian origin, specializing in infectious diseases. He grew up in Uganda, went to medical school in India, and came to the United States in the late '70s. In the early '80s he started working in small town in Tennessee. AIDS was just beginning to be identified on the two coasts at that time, but people in Tennessee thought of it as a big-city disease, and certainly nothing that would affect them in this 'safe', 'wholesome' corner of the American heartland.

Then the cases started tricking in -- a young gay man from New York who came home to die, then a gay couple in the same town, then an elderly heterosexual couple who had had blood transfusions before the blood test was developed, then a woman whose husband, unknown to her, was bisexual....within 2 years, he had a caseload of 50 patients in various stages of the disease. The book is only partly about these patients -- most of it is about his own reactions to the disease, to the patients, to gay and straight people, to 'guilt' and 'innocence', his growing inability to communicate with his wife...and the reverse as well -- the reactions of the town to a foreign doctor, to AIDS, to gayness...the indignity of the disease itself, and how the sufferers coped with their illnesses and watched their loved ones die. And the Indian medical community in Tennessee, their subtle hierarchies, their parties, their opinion of his 'poor' choice in medical specialities, and how he and his wife fitted into the Indian and Tennesse social circles.

Sounds like a lot to have in one book, but that is the power of the book -- it includes all the things that touched his life and shaped him. Although it sounds grim, it really is not -- there are touches of humour, and he writes about people with a clear vision which does not skip lightly over their problems but does not ignore their essentially human optimism.

It struck me that the response of small-town Tennessee to AIDS is much like that of the Indian community, both in India and abroad -- they think of it as a disease that affects others. But AIDS is growing rapidly in India, and many Indians in the U.S. are likely to know someone who has been touched by the disease. Perhaps it is time we examined our own thoughts about the disease and its patients, and this book is a great place to start. It is a remarkable piece of writing, and is highly recommended.

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