As part of Asian American and Pacific Islander Heritage Month, Brianna Clark, DO, MPH, CNPM, CLC, provides a unique look into the connection between small-town America, the AIDS epidemic and the role of Asians and Asian Americans during the crisis.
By Brianna Clark, DO, MPH, CNPM, CLC
I experience the world through books. Words across a page are lessons learned for me. I have seen more of America tucked away in a library than I have been able to through a car or an airplane. Books open a path to connection and have become a part of my why. I have met famous people through books and learned the power of human connection by reading books.
My own diversity, equity and inclusion (DEI) learning left me heartbroken to learn that many Americans cannot name a famous or influential Asian person when asked to do so. Dr. Sarah-SoonLing Blackburn, a professional educator located in the southern United States, has highlighted the need to expand upon our personal and organizational levels of understanding identity, diversity and justice as viewed through race and ethnicity. The lack of meaningful response when being asked to name a famous Asian person reflects directly on much of America’s ability to see Asian persons as leaders, creators, innovators, fellow citizens and neighbors. We are all called to learn American history and see Asian Americans as a part of that history.
One of the enduring authors that has had a long-lasting impact on my desire to work in rural primary care is Dr. Abraham Verghese. Although Dr. Verghese is not a part of “Team Family Medicine,” he has helped mold my reason why. I read Cutting for Stone when I was in graduate school. The dramatics of a trauma surgeon captivated me in Cutting for Stone, but his book My Own Country changed me. Just before starting medical school I found My Own Country at a library book sale and was fascinated by a book that had some of my personal favorite things—the 1980s, Americana and specifically the southern United States.
At the time, I did not realize that my quest to relive the decade that gave us Zack Morris, Alf and The Joy of Painting would lead me down a path to highlight the power of primary care and connection. My Own Country never touches on ‘80s pop culture, but it does highlight the AIDS epidemic and a snapshot of the rural physicians working on the front line in an era when “viral” was a term only uttered on infectious disease wards. Through detailed storytelling, Dr. Verghese uses a physician character that traveled far away from home and is immersed in a new culture for the sake of learning medicine as the pinnacle of human connection caring for local patients. These local patients—although generationally native to the area—were forgotten by the medical system and, in some cases, forgotten by their own families.
For me, My Own Country reminds me of how rural America was saved by Asian physicians who often immigrated far from their families to America to practice medicine. These doctors provided care that was intelligent and on the cutting edge of compassion and caring in small towns across America. Many of these physicians had immigrated from places such as China and India to small-town America for residency and to start their careers. These small-town American places are often forgotten in the descriptors of the AIDS epidemic due to their lack of shock value and perceived lack of diversity, when in fact, rural small-town America is the perfect place to understand diversity and inclusion.
The rural setting of the book and the migration of sick patients seeking their generational home highlights the need for human connection and yearning for inclusion as a crucial part of palliative care in an era when an AIDS diagnosis was a death sentence. Dr. Verghese explains that although many young, gay men would leave their small towns in the 1980s in search of opportunity and acceptance in large cities like New York, it was not uncommon for people to return home when they became sick. The search for belonging and desire to reconnect with home—the familiar—was not lost on the brave physicians that traveled across the world to care for small-town men seeking acceptance and belonging.
This retro-migration from the big city to small towns created a crossroads of diverse sexual orientations, various racial and ethnic origins, and at times multiple religions converging in small hospital rooms to provide the commonality of human connection. The great re-migration from the big city to small-town America is synchronous with Dr. Verghese’s physician characters who traveled across the world and found themselves in Johnson City, Tennessee, in search of purpose and belonging.
During Asian American and Pacific Islander Heritage Month, I continuously remind myself that many Americans cannot name a famous Asian person. I can name many famous Asian physician heroes who kept my mother’s small Texas town alive and many Asian content creators who have made medicine real to me through written and visual content. I hope to grow and learn about many more Asian influencers. I have one of my favorite authors to thank for teaching me where Johnson City, Tennessee is; the beauty of its country surroundings; and the power of human connection.