Randy Shilts’s And the Band Played On: Politics, People, and the AIDS Epidemic is the first major history of the Acquired Immune Deficiency Syndrome (AIDS) epidemic. There is no reading this book without feeling intense anxiety about one’s health and the health of one’s loved ones; furious anger toward the organizations and individuals who have cost thousands of lives through their blindness, prejudice, and egotism; enormous respect for the people who have bravely sought to cure this disease; and a bottom-of-the-well despair for the unfathomable suffering this plague has caused and will continue to cause tens and hundreds of thousands of innocent people.
Shilts is exceptionally, perhaps uniquely, qualified to write this book. Not only is he a health reporter, but he is also self-avowedly gay—a fact of critical importance, since the AIDS epidemic was and largely still is identified as a gay disease in this country. Since 1982, Shilts has worked in San Francisco, the gay mecca that would be so hard hit by this epidemic, for the San Francisco Chronicle, perhaps the only newspaper in the United States to recognize the epidemic as a newsworthy topic almost from the first signs of its arrival. Since 1983, Shilts’s sole professional topic has been the AIDS epidemic. And the Band Played On is filled with information that only someone in Shilts’s position could have culled, from doctors and government officials interviewed month by month to early AIDS sufferers now long dead. At more than six hundred pages, the book is a heroic attempt to cover the ramifications of this plague from every possible perspective: political, medical, journalistic, social, and personal. It is also clearly the work of someone who has lived on intimate terms with horror for five very long years.
The book is structured chronologically, beginning in 1976, when Dr. Grete Rask, a Danish surgeon working in Zaire, first fell ill with a mysterious and wasting disease. Shilts concentrates heavily on the period from 1980 through 1985, those critical first years of the American AIDS epidemic, and concludes with a brief update to 1987. Organizing his material under precise date headings, Shilts jumps from topic to topic within his overall subject. In the sections devoted to 1983, Shilts’s entries follow each other with only a few days’ interval—the year was that critical to the AIDS epidemic. Such an approach has its shortcomings: There is an enormous amount of redundancy—something perhaps excusable in a book that documents the redundant, hapless efforts of scientists, gay activists, and a few politicians to save lives. There is also diffuseness, a blunting of some of Shilts’s arguments because of his peripatetic structure. Yet Shilts’s method has one supreme merit: It allows the reader to watch the unfolding of this grisly drama linearly, with a scope and understanding one could not possibly have had while actually living through it. And the Band Played On is not a historian’s book, but a reporter’s, raw and undigested but vital.
The disease that would eventually be known as AIDS first came to attention in the United States in 1980, when men in both San Francisco and New York began to fall ill with a form of skin cancer known as Kaposi’s sarcoma and a pneumonia called Pneumocystis carinii, both rare and deadly diseases ordinarily found in someone with an immune system damaged by birth defects or chemotherapy. It was in December, 1980, when Dr. Donna Mildvan of Beth Israel Medical Center first noticed that these diseases were attacking homosexual men; April, 1981, when Dr. Michael Gottlieb of the University of California at Los Angeles first identified this as a new epidemic; and June, 1981, when the Center for Disease Control’s Morbidity and Mortality Weekly Report published the first paper on the disease. As infants, drug users, transfusion recipients, hemophiliacs, Haitians, and Africans fell victim to the disease, scientists in the United States and abroad struggled to define its nature and to identify the means of transmission.
By December, 1981, French doctors Jacques Leibowitch and Willy Rozenbaum had already concluded that a virus was responsible for the disease. It would not be until April, 1984, however, that an American government official would announce that the new virus had been identified. The delay was the result of a number of factors: insufficient funding to finance medical research, the unconscionable lag in publication caused by the endless reviewing procedures of top medical journals; and the egotism and prejudice of a few doctors themselves.
Emerging as a shadowy figure in the medical drama is Dr. Robert Gallo, a retrovirologist with the National Cancer Institute in Bethesda. According to Shilts, Gallo threatened colleagues who left his domain to work for other researchers and relentlessly fought with French doctors pursuing the same line of work. Ultimately, the Pasteur Institute filed a lawsuit against the National Cancer Institute, resolved only in 1987 out of court by Jonas Salk. Four years after French scientists had applied for a patent on the AIDS virus, the American government finally allowed them to share credit for the discovery with Gallo. Yet Gallo’s behavior is the...