Abraham Verghese. 347 pages. New York: Simon & Schuster; 1994. $23.00.
Although an author's extraordinary background does not ensure an extraordinary book, in the case of Abraham Verghese, it has surely contributed. His background begins with his parents, communicants of the ancient church established by Doubting Thomas, who migrated from their home on the Malabar coast of southern India to Ethiopia as two of the many expatriate teachers in Emperor Haile Selassie's putsch. Verghese's own career odyssey from Addis Ababa to Newark, to India for medical school, to—of all places—the Smoky Mountains for residency, and to Boston for training in infectious diseases, says much about this author's world view, his intense focus on his own development and education, and his determination.
As an accident of history, the author's academic career has coincided with the onset of the acquired immunodeficiency syndrome (AIDS) epidemic. Like other infectious disease specialists, Verghese was immediately immersed in AIDS, which came to dominate his practice. Unlike most, Verghese not only embraced the diagnostic and therapeutic challenges of human immunodeficiency virus (HIV) disease but also entered the various worlds of infected persons with an empathy so intense it is palpable. His insights into the real-life meaning of AIDS for persons in widely disparate situations are unprecedented in the literature on AIDS. The author makes each person he describes come alive; his characterizations, and the warmth and reality of his vignettes, cut through the reader's preconceptions and biases and brilliantly display the humanity of each person.
The author's tale also provides a window through which one sees the emotional struggles of an Indian physician establishing a position of respect in America while dealing with the strong influences of his foreign background and his present Indian community. Verghese seems a bit ambivalent toward his proper connection with this community, but the reader benefits enormously from the narrative.
The book has some minor flaws. The constant use of the term "miracle center" to describe the Johnson City Medical Center rings annoyingly trite and thus perhaps detracts from the insights unfolding. Additionally, Verghese's discussions of his immediate family, which is clearly important to him and is referred to frequently, remain strangely one-dimensional.
This is a remarkable book. A physician whose background is far from mainstream, working in a backwater area of America, compassionately describes AIDS and deeply moves the reader. This commands respect for the author's character and career and provides the nonmedical reader with unprecedented access to those caring for patients with AIDS.
The book is highly recommended to all.
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