When AIDS physician Dr. Abraham Verghese walked into the hospital room of a young man recovering from HIV-related pneumonia, he discovered a deadly crisis of spirit.
Norman Sanger, a hemophiliac who had contracted AIDS through blood transfusions, was terribly afraid of losing the dignity and courage which had bolstered him throughout a lifetime of pain.
Would AIDS make him sacrifice even this?
"He was looking at me as if I was supposed to reply," Dr. Verghese recounts. "As if, despite all his experience with medical people, for once he expected a pearl of wisdom to come from my mouth, something more than a platitude, something that would tangibly ease his mental anguish."
Instead, the doctor took Mr. Sanger's hand and held it tightly, transmitting the respect and strength that words, or drugs, could not provide. It was a moment of healing, one of many which Dr. Verghese has recounted in his critically acclaimed 1994 book "My Own Country."
Today Dr. Verghese will share some of the lessons he has learned from this devastating disease to the graduating seniors of Johns Hopkins University's School of Medicine.
Although recent classes have sought such nationally known commencementspeakers as former Surgeon General C. Everett Koop, this year's senior class chose a speaker who can tell them about the art of healing in a high-tech world. They chose a doctor who devotes much of his time to the kind of medicine that doesn't have billing codes: family visits, moral support and hand-holding.
"As medical students at Hopkins, we have dealt with people with AIDS. And what intrigued us was the way Dr. Verghese deals with the human side of things," says graduating senior Deborah Agnew who wrote the initial letter inviting him to speak.
"I'm not sure too many diseases have carried the metaphor that AIDS has carried," Dr. Verghese says. "I'm convinced it is two diseases: The first is the virus and the second, which is also lethal in its own way, is this huge metaphor of shame and secrecy and guilt.
"And, although we in big cities get lulled into thinking otherwise, the metaphor is still there."
It also shadows those who treat people with AIDS. Usually on the lower-paying levels of the medical specialties pyramid, these physicians must often defend such "depressing and hopeless" work to relatives and friends as well as to other doctors.
However, they have also become leaders in the movement to re-establish the importance of "the healing arts."
"I think many of us have rediscovered the role of the old-time physician," Dr. Verghese says. "If you think back 100 years, physicians generally had more respect and were held in higher esteem by the public than they are now -- which is curious given the fact that we can do so many more things.
"When you ask why those doctors were so effective, you wind up with the essential difference between 'healing' and 'curing.' Every time a patient presents with an illness, he or she wants the cure. They also want that ministry of healing that we seem to have forgotten about. They want you to lay hands on them, even if there is no need.
"AIDS made me discover that even when I had nothing to offer cure-wise, my inept presence at the bedside was still affecting something, was bringing about healing.
"And it was bringing healing for the family and for the physician as well."
Abraham Verghese, 39, has the clear vision of a thoughtful outsider. He was raised in Ethiopia by Christian parents who left Southern India for teaching opportunities. He came to the United States in the early 1970s to work as an orderly in various hospitals and nursing homes. He went to India to finish medical school -- war and political unrest had interrupted his studies in Ethiopia -- got married and returned to the United States in 1980 for an internship and residency in Johnson City, Tenn.
After being trained in infectious diseases in Boston, Dr. Verghese and his wife returned to Tennessee to raise a family, never suspecting he would become known as the regional AIDS expert over the next few years.
However, it was the mid-1980s. America was starting to realize how widely the disease had spread. Dr. Verghese began to see patients with various conditions he realized were HIV-related. There were young gay men and older gay men. There were elderly heterosexuals who were infected through blood transfusions. There were bisexual men who had exposed their wives to the disease.
Along with such conditions as pneumocystis carinii pneumonia, Dr. Verghese found himself confronting prejudice, humiliation, anger. And, most of all, fear.
He learned about the gay community, about the hatred that confronts many AIDS patients, about the extraordinary spirit that humans possess.
He also discovered how those who are dying can consume their caretakers.
