My Own Country

by Abraham Verghese

  “How can they possibly respect us if we don’t conduct ourselves in a manner that they can identify with?”

  Since Ethan was still in the closet, what other choice did the “public” have but to go by those who were willing to speak out?

  As we got to know each other better, it became clear that Ethan understood that his two secrets would eventually come out; that, in fact, his neighbors and his sisters had a pretty good idea about why he was unmarried so long, and why the majority of his visitors were younger males.

  I decided to call Ethan. It took several rings before Ethan came to the phone. His voice was muffled and I could hear him panting from the effort.

  I had no plan of what I was to say to Ethan. What was I calling for? To chastise him? I told him what had transpired.

  “I know. The dentist already called me. He was mad at me.”

  “I think you should have told him.”

  “Well, I asked him when he called. I said, ‘If I had told you, would you have done the operation?’ He didn’t say nothing. He kept quiet.”

  “I am sorry the pharmacist betrayed your confidence, acted in such an unprofessional manner, I—”

  “Well, don’t worry, Doc. He’s just a snake, is all there is to it. And, Doc, I’m not going to worry about any of that. I dialed eight dentists in three counties. I called till my fingers were just tired of dialing. I gave them a false name, I said I was HIV and needed a tooth pulled—the tooth was killing me, honest to God—and not a one of them would do it, and they wouldn’t give me a name of someone who would.”

  “Didn’t you have a regular dentist? All these years—”

  “Well, let me tell you about my regular dentist! A few months ago I got a letter from his office saying he would not be able to see me any longer and asking if I wanted my records forwarded to a particular dentist.”

  “Why?”

  “Tell me, Doc! You figure it out. I guess he’s known me for years, had his suspicions and figured the way he would protect himself is get all the nellies out of his practice!”

  “So how did you pick Dr. J?”

  “Well, I just got tired of calling and calling and telling the truth. I just picked one—any one. To tell you the truth I don’t know how come I picked him. Why, every one of them has a big-old ad in the Yellow Pages like a goddamn used-car dealer: WE WELCOME NEW PATIENTS or SPECIALIZE IN NERVOUS PATIENTS or LATEST TECHNOLOGY or stuff like that. I figured that was me. I was nervous, new, and in need of the latest technology!”

  What could I say? I could certainly see his point of view.

  I TRIED TO DECIDE whether I should call the pharmacist and tell him off for what was a clear violation of ethics. Z Drugs was a new store, struggling to survive at a time when all around them the large drugstore chains were cutting prices and offering more sophisticated services such as home intravenous therapy and home health care. The one time I had gone to fill a prescription for myself at that pharmacy, the proprietor had been very solicitous, almost fawning. He was six foot six and towered over me. As opposed to the genuine warmth a Tennessean can project by being himself, the pharmacist’s sugar-coating, his dated used-car-dealer sweetness rang hollow. On the other hand, he had at least been a face and a name I could deal with on a personal level, unlike the large chains. He asked me to never hesitate to call him, he showed me how every patient’s record was on computer, how his was in fact a modern operation. He gave me a huge discount on my prescription. I called in prescriptions to his store whenever the patient expressed no preference and lived in that general area.

  When AZT came along, I called him and several other pharmacists and asked if they would stock the drug. They jumped at the opportunity: the average patient would spend $8,000 to $10,000 on AZT every year.

  I heard complaints from several AIDS patients who said they were made to feel uneasy in the store. After they dropped their prescriptions off and sat down to wait, there would be pin-drop silence behind the counter. There was not a doubt in the patient’s mind that the pharmacist had conveyed the nature of the prescription to the other employees behind the counter. Eventually the patient’s name would be called and he would step up to the counter, where every eye would watch him as he paid for the drug and then marched bravely down the aisle and out of the store. Otis had overheard a remark from one of the women in the store about “God’s revenge.” He vowed never to return.

  I kept sending patients to that pharmacy primarily because the arrangement was already in place and, so far, the pharmacist himself had been professional, even if his staff may not have been. But this incident with the dentist and Ethan was the last straw. I would not send any more patients to him. But I decided I would not call him and chastise him. The damage was done.

  As I mulled over these thoughts, the phone rang. It was my friendly pharmacist. His tone was not that friendly anymore.

  “I heard from Dr. J that you weren’t happy with what I did. I thought I would call you and see if you wanted to speak to me.”

  “I wasn’t planning to call you. But now that you have called me, yes, I thought it was quite unprofessional of you to call the dentist on my patient. It does not inspire confidence—”

  He interrupted me. His tone was defiant: He said he felt an obligation to warn the dentist, to “take care of my doctors,” as he put it. He saw it as his civic responsibility. He didn’t see anything wrong with what he had done.

  I let him go on. It was clear to me that he knew he had overstepped his boundary, been unprofessional, but he was not about to admit it. Instead he was going to hide behind the shield of civic responsibility, of duty to God and country.

  I waited till he was done. I asked him, “Didn’t you think of the possibility of calling me first? After all, it was my patient. If you were going to get involved, why not call me and let me deal with it, instead of taking it on yourself to break the patient’s confidentiality?”

  There was a silence. “Well, I guess I could have done that.”

  “Am I to assume now that you will take it on yourself to call any other doctor who happens to be seeing the thirty-odd patients who fill AZT at your store? So that you can tell the doctor the patient has AIDS?”

  He had no reply.

  “You see, I’m afraid I can’t in good faith send you my patients because I don’t think I can be sure of your not betraying their confidence.”

  Now he dropped all pretense. The obsequious, fawning tone that he usually used with me was completely gone and in its place was this snapping, testy tone that revealed him for what he was: a weasel in sheep’s clothing. His voice was dripping with hate: “Well, I don’t want your business either. It doesn’t matter to me one bit. And I don’t want any of your patients. I’ll just take care of my doctors. Suits me fine.”

  He hung up on me.

  The words “foreign doctor” rang in my ears, even though he had not said them. My intuition was so strong that I could not write my discomfort off to paranoia. I caught the undertone, and all day the memory kept me uneasy.

  Sometimes it was possible to have the illusion that I was so much a part of the town, so well integrated, that I even looked like the townsfolk. But at times like this, I walked around gingerly, seeking my footing with great caution.

  Sometimes I felt that I was accepted only as long as they needed me, as long as I could be of service to them. I had fought the clannishness of the Indian community, felt embarrassed by their refusal to integrate. But now I wondered, did they understand something I did not?

  But even within the Indian community, the issue of belonging was not so simple. The north Indians were starting to have their own gatherings; the same was true of the south Indians. The Sikhs, in keeping with tumultuous events in India, no longer felt themselves in the mainstream Indian community; their poorly concealed delight in Indira Gandhi’s death did not sit well with the rest of the Indians. The Pakistanis, who till then had fit under the general rubric of “Indian,” now increasingly met by themselves.
And to all these groups, I was an outsider of sorts: an Indian born in Africa. Was there ever going to be a place in this world for me to call my own?

  That evening, I told Rajani the story of the dentist and my subsequent words with the pharmacist. She could see I was agitated.

  “He didn’t actually say ‘foreigner,’ right? You just felt like he said it.”

  “No, he didn’t say it. But, yes, I feel as if he said it.”

  Rajani could not see the point of my uneasiness. Her sympathies were with the dentist. And she was tired of losing my time and attention. She had once said to me, after seeing me come home yet again at an odd hour after answering a summons from the Miracle Center, “You have a choice, you know. You don’t have to do the AIDS stuff; if you were full-time at the VA you would have more regular hours, you would have no involvement with the Miracle Center. You could just opt to be full-time VA.”

  “But it’s not like cardiology or hematology,” I had said. “There is no one out there doing infectious diseases. If I didn’t do it, if Fil didn’t do it, then there would be no one for these patients.”

  “It would work out. The point is you have a choice. You’re choosing to do what you are doing, so you can’t complain about the hours.”

  My conversation with the pharmacist and the reporting of it to Rajani seemed to exaggerate my feeling of alienation. And my alienation had so much to do with the fact that I was taking care of persons with AIDS. I wondered if subconsciously Rajani viewed me the same way the pharmacist viewed me: tainted by the people I took care of.

  That evening, my motorcycle mechanic friend, Darryl, dropped by. Over the years, Darryl and I had worked out a barter system: he took care of my motorcycle and I helped with his kids’ medical needs. Now, as a sacrifice for being a father, I had sold the motorcycle. Rajani had argued that it was dangerous and hardly fitting for a father of two kids and I had very reluctantly agreed. Still, Darryl came by from time to time, and I often went by his shop to admire a Norton or an old Indian that he was restoring.

  Darryl and I started in the living room with a beer, and when he wanted to smoke, we moved out to the porch—Rajani could not abide the smell of cigarettes in the house. On the porch we had another beer. Steven stayed with us until Rajani summoned him up to bed. I debated telling Darryl the story of the pharmacist, but decided against it. I could not gauge how Darryl would respond: I could not handle a crack about “homos” or a response other than the one I had. Instead, we talked motorcycles and then marriage—specifically Darryl’s marriage, which was not going well. While he talked, Darryl pulled out a reefer. Its acrid smell was nostalgic, but the memories it brought back were all of more alienation: Ethiopia in the throes of a war, India on the eve of my departure for America.

  When Darryl finally left, I stumbled upstairs, red-eyed, my mind racing, my discomfort having only increased. Rajani handed me the kids who were too excited to sleep. She said, “You put them to bed then.” I didn’t think she took kindly to Darryl and perhaps she had smelled the reefer.

  I studied the map on Steven’s wall as I carried the baby. Idaho. Montana. Iowa. South Dakota. Texas. Was there some place in this country where I could walk around anonymously, where I could blend in completely with a community, be undistinguished by appearance, accent or speech?

  Still carrying the baby and telling Steven to wait, I went down to the basement and pulled out my guitar, which I had not touched in over a year. I came back to the kids’ room and Jacob allowed me to put him in his crib. I began to sing to the two of them. I sang song after song, with barely a pause.

  It seemed like hours later that I looked up to see Steven and the baby both fast asleep. And staring at me from the doorway across the room was my beautiful wife, a puzzled look on her face. I didn’t know how long she had been there watching me.

  Rajani loved me, wanted to help me, wanted to make my life easier, wanted our marriage to work. But looking at me as I sat there bleary-eyed, thumping out tunes, singing like a college kid, the floor that separated us was like an abyss that could not be bridged. As she walked away, I found myself crying, but without the heart to call out to her because I didn’t know what to say. I didn’t think words could fix us. Our lives had changed. I was going to have to find some compromise.

  19

  FEBRUARY 1988.

  It was dark when I left the house, dark when I came back, dark and cold when I was called out to see a patient after hours. My tennis buddy, Earl, would telephone every evening. We would commiserate over the weather, gauge our chances for the next few weeks and lament the inactivity, the damage done to strokes we had honed to near perfection through spring, summer and fall. If the temperature approached fifty, we would attempt to play. Never mind that the balls barely bounced in the cold, never mind that our joints creaked like rusty barn doors. Tennis was essential, especially in the Tennessee winter where everyone seemed sicker and older, where all battles seemed harder to fight.

  On a Sunday night we had a mini ice storm. It froze the bare limbs and shoots of the trees in a crystalline mesh. Near midnight, as I drove home from the Miracle Center, the raindrops stuck and then smeared on my windshield when I turned on my wipers.

  And then I was suddenly skating, the normally nimble and surefooted Z doing an elaborate figure eight on Dogwood Avenue, my steering wheel as useless as a severed rudder. The engine stalled, flooded and would not start. I abandoned my car, crawled to where road and pavement ended and lawn began, and walked home trying to stay on grass, feeling the ice crunch beneath my feet.

  By the next morning, the ice was gone from the road. The car started on the first turn of the key. But that night, it snowed again and I dreamed of blood. I was in a white coat, white-coated students and residents gathered around me. We were a circle in the snow. My hands applied pressure to a wound on a faceless patient; blood was trickling over my fingers, into the cuticle, into the little hangnails. I watched with alarm as blood seeped over the callus on the side of my right thumb, a callus from tennis, a callus that in winter grew dry and chapped and would fissure every time I played. In my dream, I struggled to be nonchalant as the house staff watched me. I carried on with my little lecture on cellulitis and its common causes. I did not recoil from the wound nor did I wash my hands. Instead, I finished dressing the patient’s wound, my pride and the stupidest form of courage supplanting common sense. I made light conversation with the students. They looked at my hands. I dismissed them and hurried to the sink to wash. Deep inside, I knew I was infected. I could picture the virus tagging onto my CD4 cells. I heard the nurses whisper: “He’s got it now.”

  I awoke in a black depression, a sense that all was lost. It took several seconds of looking around the room, of feeling Steven next to me, seeing the naked bough of the oak tree coated with snow and framed in the bedroom window, before I realized that this was a dream.

  WINTER SHOWED IN the faces of my patients. When Vickie McCray came by my office at the VA to pick up a prescription for Clyde, her mood was black. It seemed like a lifetime ago that we had sat on the stoop of her trailer and felt the sun on our skin. She wore a down vest that made her shoulders look huge. I made her sit. I brought a cup of coffee for her: black with four spoons of sugar.

  I had started Clyde on high-dose AZT—there was some evidence that this might work for AIDS dementia. However, the improvement he made predated the AZT; I credited Vickie’s nursing with much of that. I asked Vickie how he was doing, how he was tolerating the AZT.

  She said Clyde had started to tinker with his car, an old clunker that had started life as a Ford Fairlane but now had a Chevy engine, a Bonneville’s front seat, and a radio from a Toyota pickup. I had seen it parked well behind the trailer when I came to visit. Vickie said, “He parks it out of view because he has this silly notion that someone might try to steal it, though Lord knows why anybody would want it.” Clyde had a special place in his heart for the car. And now he would work on it or just sit in it before retreating into
the house to rest.

  Vickie said that one morning she heard the engine come to life. “I couldn’t believe it. I looked out of the window and there was Clyde smiling at me. He pulled the car around the trailer and off he went. He must have charged the battery or got one off his cousin. I don’t believe he was ever happier than when he was on the road. Happiest day of his life was when he got his big-rig license. Looking back, though, that’s exactly when he was starting to get sick.”

  “Is he safe to be driving?”

  “No! My mother-in-law called me yesterday. ‘Vickie,’ she says. ‘I seen Clyde driving around. Either something is wrong with the car or something is wrong with him, ‘cause he ain’t driving right.’ So yesterday evening I said, ‘Clyde, drive me to the store.’ He came right off the sofa—he’ll go anywhere if it means driving the car. Well, I sat next to him, and my daughter Danielle was in the back. You know how you have to pull across the Bristol Highway from our road to point you back to town? Well, he misjudged the distance of the cars coming at him. I thought for sure we’d be kilt, but Clyde didn’t even know it and we squeaked by. Then after that he kept going over the white line and over the yellow line, like he was drunk or something but I knew he wasn’t. I said, ‘Clyde, you ain’t driving straight.’ He said, ‘Vickie, it’s the car. The front end is loose is what it is.’ Well, coming back from the store I told him I was going to drive. And he was right, the front end was a little loose. You had to concentrate and keep turning on the wheel to keep the car in a straight line. But I could do it. And he couldn’t. When we got back, I told him he could not drive anymore. He’s real mad with me. Says I’m being hateful to him. I done taken the keys away.”