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A Piece of My Mind
November 8, 2006

Family Medicine

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2006;296(18):2181-2182. doi:10.1001/jama.296.18.2181

We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.—T. S. Eliot, “Little Gidding,” Four Quartets

This is my family: North Carolina farmers, white, fundamentalist Christian. They speak, and the drawl is honest. They are genuinely kind, tender-hearted. Their biases are a matter of tradition rather than a determined malice. Until my generation, everyone in my family worked with his hands, pulling tobacco, making shoes for Civil War soldiers, creating beautiful practical furniture, raising hogs. Hope for a heaven after this hard life has kept them fiercely loyal to the Southern Baptist Church. Our roots are vague, presumably a mix of Irish and Scottish. The limits of my ancestral knowledge are symbolized by the faded sepia photograph of my paternal great-great-grandparents in their tobacco field, Johnston County, North Carolina, date uncertain. They are separated by several rows of plants and are standing tall, turned to face the photographer with patient expressions, waiting to once again bend over the plow or pull weeds. Today, we consider ourselves solidly middle-class, owning homes that were built by my father and uncles, buying cars with little hardship, taking a vacation to the seashore now and then. Almost all of us live close to where we grew up. North Carolina defines my family.