Today’s book is And the Band Played On: Politics, People and the AIDS Epidemic by Randy Shilts

Randy Shilts’s book is a masterwork of journalistic writing and activism. Twenty-five years have passed since it was published, and it still remains a classic. Shilts’s book focuses on the early years of the AIDS epidemic– the time period when people did not realize they even had an epidemic on their hands. It begins in an eerie manner, with a young Scandinavian doctor coming back from practicing medicine in central Africa in the last 1970s and dying of an unknown and devastating disease. From there, Shilts shifts his focus to the United States, chiefly the gay populations in San Francisco and New York, where the epidemic begins to take shape.

Shilts pulls no punches in this book. He unleashes a righteous fury at all the failures that allowed AIDS to take hold in both the United States and the world– the politicians who refused to grant funding for research, the doctors who were baffled by a disease that did not fit into a neat “box,” some members of the gay community for their wariness of the medical establishment, local governments for failing to recognize what was going on (especially the blood banks– many people died because of their refusal to face the facts), the US Government and CDC, and the infighting among certain researchers that slowed down the chances of getting a grip on the epidemic.

In the early years there were four mains groups of people who got AIDS, Haitians, hemophiliacs, Intravenous Drug abusers and Gays. And in the early years it was seem primarily as a “gay disease,” even though there was evidence that it could be spread among heterosexuals and through blood donations. For this reason, finding help for sufferers was an uphill battle, as the disease spread among members of society that were seen as “undesirable.” Almost everyone involved played politics with the disease, or were the victims of politics. What astounded me in the reading of this book was how it was so easy for the American people and government to deny the humanity of certain groups of people. Almost as if gay folks and drug abusers deserved this horrifying plague.  As Shilts puts it ” Later, everybody agreed the baths should have been closed sooner; they agreed health education should have been more direct and timely. And everybody also agreed blood banks should have tested blood sooner, and that a search for the AIDS virus should have started sooner, and that scientists should have laid aside their petty intrigues. Everybody subsequently agreed that the news media should have offered better coverage of the epidemic much earlier, and that the federal government should have done much, much, more. By the time everyone agreed to all this, however, it was too late. Instead people died. Tens of thousands of them.”

People died because people played politics with their lives in an astounding number of ways. Yet, heroes did emerge during the epidemic. The doctors who latched onto the new virus and kept trying to untangle it despite cuts to their funding and pressures from hospital administrators. The City of San Francisco for trying to curb the disease through innovative health measures (the City played politics too, but it did a heck of a lot better than other places with large populations of AIDS sufferers.) The gay community for fighting for help and for caring for those who were dying. And other, at times unlikely allies come to light, such as conservatives Orrin Hatch and J Everett Koop. Hatch fought for legislation to keep AIDS testing confidential, and Koop was the first member of the Reagan Administration to outline a multi-pronged,  sensible and pragmatic attack on the virus–much to the dismay of many of his more conservative supporters (the administration had muzzled him for five years, keeping him from speaking on the health crisis.)

The book is huge (600+) pages but it reads easily, almost like a mystery in the early portions. It contains a massive amount of information, names and dates, but it is a compelling read. While Stilts writes only on the AIDS epidemic you can’t help but wonder what would happen is some other new disease would pop up that was just as deadly– one likes to think that politicking and infighting would not ensue within the government and public health facilities that are supposed to protect us, but no doubt they would.

Last summer I was in San Francisco visiting a friend who is a doctor when we walked into an airy, bright store that sold all sorts of neat gift-shop sorts of things. My friend said to me quietly “This shop raises money to help care for those with AIDS and to help fund research locally. They also sell lots of neat stuff. Whenever we need a unique gift for someone we try to buy here. They do good work.”  San Francisco (and New York  as well as other cities) is a city that lost a generation of young people who did not have to die. The early years of the AIDS epidemic are fading from public memory, mainly because in developed countries the disease can be treated more as a chronic condition if you are lucky and have the means. People now talk about AIDS being an “African problem,” which it most definitely is, but few Americans want to realize that it remains a problem within their own country.  People still don’t want to talk about it or face the reality that is a terrifying disease that is transmitted sexually.

Read Shilts’s book. Read it to realize what happens when you mix a disease with ignorance, hate, and politics. Read it to understand that we are all human beings and as a collective humanity that we all suffer when a fellow human suffers from this disease. Read it so that we don’t forget, and so that we continue to learn from the mistakes of the past.

Ciao for now,

Bookish C