And the Band Played On
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''And the Band Played On: Politics, People, and the AIDS Epidemic'' is a 1987 book by ''
San Francisco Chronicle The ''San Francisco Chronicle'' is a newspaper serving primarily the San Francisco Bay Area of Northern California. It was founded in 1865 as ''The Daily Dramatic Chronicle'' by teenage brothers Charles de Young and Michael H. de Young. The pa ...
'' journalist
Randy Shilts Randy Shilts (August 8, 1951February 17, 1994) was an American journalist and author. After studying journalism at the University of Oregon, Shilts began working as a reporter for both '' The Advocate'' and the ''San Francisco Chronicle'', as wel ...
. The book chronicles the discovery and spread of the
human immunodeficiency virus The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immun ...
(HIV) and
acquired immune deficiency syndrome Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ma ...
(AIDS) with a special emphasis on government indifference and political infighting—specifically in the United States—to what was then perceived as a specifically gay disease. Shilts's premise is that AIDS was allowed to happen: while the disease is caused by a biological agent, incompetence and apathy toward those initially affected allowed its spread to become much worse. The book is an extensive work of investigative journalism, written in the form of an encompassing time line; the events that shaped the
epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of patients among a given population within an area in a short period of time. Epidemics of infectious ...
are presented as sequential matter-of-fact summaries. Shilts describes the impact and the politics involved in battling the disease on particular individuals in the gay, medical, and political communities. Shilts begins his discussion in 1977 with the first confirmed case of AIDS, that of Grethe Rask, a Danish doctor working in
Africa Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...
. He ends with the announcement by actor
Rock Hudson Rock Hudson (born Roy Harold Scherer Jr.; November 17, 1925 – October 2, 1985) was an American actor. One of the most popular movie stars of his time, he had a screen career spanning more than three decades. A prominent heartthrob in the Gold ...
in 1985 that he was dying of AIDS, when international attention on the disease exploded. ''And the Band Played On'' was critically acclaimed and became a best-seller. Judith Eannarino of the ''
Library Journal ''Library Journal'' is an American trade publication for librarians. It was founded in 1876 by Melvil Dewey. It reports news about the library world, emphasizing public libraries, and offers feature articles about aspects of professional pract ...
'' called it "one of the most important books of the year", upon its release.Eannarino, Judith (November 15, 1987). "And the Band Played On (book review)". ''Library Journal'', 112 (19), p. 71. It made Shilts both a star and a pariah for his coverage of the disease and the bitter politics in the gay community. He described his motivation to undertake the writing of the book in an interview after its release, saying, "Any good reporter could have done this story, but I think the reason I did it, and no one else did, is because I am gay. It was happening to people I cared about and loved." The book was later adapted into an HBO film of the same name in 1993. Shilts was tested for HIV while he was writing the book; he died of complications from AIDS in 1994.


Background

Shilts decided to write ''And the Band Played On'' after attending an awards ceremony in 1983 where he was to receive a commendation for his coverage on AIDS. As described in the book, television announcer Bill Kurtis gave the keynote address and told a joke: "What's the hardest part about having AIDS? Trying to convince your wife that you're
Haiti Haiti (; ht, Ayiti ; French: ), officially the Republic of Haiti (); ) and formerly known as Hayti, is a country located on the island of Hispaniola in the Greater Antilles archipelago of the Caribbean Sea, east of Cuba and Jamaica, and s ...
an." Shilts responded to the joke by saying that it "says everything about how the media had dealt with AIDS. Bill Kurtis felt that he could go in front of a journalists' group in San Francisco and make AIDS jokes. First of all, he could assume that nobody there would be gay and, if they were gay, they wouldn't talk about it and that nobody would take offense at that. To me, that summed up the whole problem of dealing with AIDS in the media. Obviously, the reason I covered AIDS from the start was that, to me, it was never something that happened to those other people." After publication of the book, Shilts explained his use of the title: "''And the Band Played On'' is simply a snappier way of saying 'business as usual'. Everyone responded with an ordinary pace to an extraordinary situation."Engel, Margaret. "AIDS and Prejudice: One Reporter's Account of the Nation's Response." ''The Washington Post'', December 1, 1987, p. Z10.


Summary

Shilts focuses on several organizations and communities that were either hit hardest by AIDS—and were given the task of finding the cause of the disease—or begging the government for money to fund research and provide social services to people who were dying. He often uses an omniscient point of view to portray individuals' thoughts and feelings.


Gay community

AIDS in the United States most notably struck gay communities in Los Angeles, New York City, and San Francisco. This was largely due to the general public's limited knowledge of the importance of protected ("safe") sex and IV drug using practices in preventing the transmission of diseases in the 1970s and 80s. Shilts' sources in the gay community tried to remember the last time everyone they knew was healthy, which was the
United States Bicentennial The United States Bicentennial was a series of celebrations and observances during the mid-1970s that paid tribute to historical events leading up to the creation of the United States of America as an independent republic. It was a central event ...
celebration in 1976 when sailors came from all over the world to New York. Some of them carried
sexually transmitted disease Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and or ...
s and rare tropical fevers. A marked difference in these cities arose in two phases of consciousness in the gay community: "Before" in 1980, and "After" by 1985. "Before", according to Shilts, was characterized by a care-free innocence, preceding the period when
gay men Gay men are male homosexuals. Some bisexual and homoromantic men may also dually identify as gay, and a number of young gay men also identify as queer. Historically, gay men have been referred to by a number of different terms, includin ...
were aware of a deadly infectious disease. "After" signified the realization that gay men knew most or all of their friends were infected with AIDS, and the syndrome became pervasive throughout the media. In San Francisco, particularly in the Castro District, gay community activists such as Bill Kraus and Cleve Jones found a new direction in gay rights when so many men came down with strange illnesses in 1980. The San Francisco Department of Public Health began tracing the disease, linked it to certain sexual practices, and made recommendations—stop having sex—to gay men to avoid getting sick, a directive that defied the chief reason why many gay men had migrated to the Castro, and for what gay rights activists in San Francisco had fought for years. Kraus and Jones often found themselves fighting a two-fronted battle: against city politicians who would rather not deal with a disease that affected gay men, who were seen as an undesirable population, and the gay men themselves, who refused to listen to doomsday projections and continued their unsafe behavior. In New York City, men like
Larry Kramer Laurence David Kramer (June 25, 1935May 27, 2020) was an American playwright, author, film producer, public health advocate, and gay rights activist. He began his career rewriting scripts while working for Columbia Pictures, which led him to Lo ...
and
Paul Popham Paul Graham Popham (October 6, 1941 – May 7, 1987) was an American gay rights activist who was a founder of the Gay Men's Health Crisis and served as its president from 1981 until 1985. He also helped found and was chairman of the AIDS Action Co ...
, who had previously shown no desire for leadership, were forced by bureaucratic apathy into forming the Gay Men's Health Crisis to raise money for medical research and to provide social services for scores of gay men who began getting sick with
opportunistic infections An opportunistic infection is an infection caused by pathogens (bacteria, fungi, parasites or viruses) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune ...
. Shilts describes the desperate actions of the group to get recognition by Mayor
Ed Koch Edward Irving Koch ( ; December 12, 1924February 1, 2013) was an American politician, lawyer, political commentator, film critic, and television personality. He served in the United States House of Representatives from 1969 to 1977 and was ma ...
and assistance from the city's Public Health Department to provide social services and preventive education about AIDS and unsafe sex. In these cities, however, the sizable gay communities in most instances were responsible for raising the most money for research, providing the money for and subsequently the social services for the dying, and educating themselves and other high-risk groups. Kramer would go on to form
AIDS Coalition to Unleash Power AIDS Coalition to Unleash Power (ACT UP) is an international, grassroots political group working to end the AIDS pandemic. The group works to improve the lives of people with AIDS through direct action, medical research, treatment and advocacy ...
(ACT UP), a political activist organization that forced government and media to pay attention to AIDS. Jones formed the NAMES Project that created the AIDS Memorial Quilt, the largest folk art display in the world.


Medical community

Doctors were the first to deal with the toll that AIDS would take in the United States. Some—like
Marcus Conant Marcus Augustine Conant (born May 11, 1936, in Jacksonville, Florida) is an American dermatologist and one of the first physicians to diagnose and treat Acquired Immune Deficiency Syndrome (AIDS) in 1981. He helped create one of the largest priv ...
, James Curran, Arye Rubinstein, Michael S. Gottlieb, and
Mathilde Krim Mathilde Krim ( he, מתילדה קרים; née Galland; July 9, 1926 – January 15, 2018) was a medical researcher and the founding chairman of amfAR, American Foundation for AIDS Research. Biography Mathilde Galland was born in Como, Italy t ...
—would also realize their professional life's courses in dealing with patient after patient who showed up in their offices with baffling illnesses, most notably lymphadenopathy,
pneumocystis carinii pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus ''Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs of ...
,
Kaposi's Sarcoma Kaposi's sarcoma (KS) is a type of cancer that can form masses in the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limit ...
,
toxoplasmosis Toxoplasmosis is a parasitic disease caused by '' Toxoplasma gondii'', an apicomplexan. Infections with toxoplasmosis are associated with a variety of neuropsychiatric and behavioral conditions. Occasionally, people may have a few weeks or mont ...
, cytomegalovirus, cryptosporidia, and other opportunistic infections that caused death by a grisly combination of ailments overtaxing a compromised
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splint ...
. With no information on how the disease was spread, hospital staff were often reluctant to handle AIDS patients, and Shilts reported that some medical personnel refused to treat them at all. Shilts praised the Public Health Department of San Francisco's handling of the new communicable disease as they tracked down people who were sick and linked them to other people who had symptoms, although some of them were living in different parts of the country. He criticized the New York City Public Health Department for doing very little, specifically when Public Health Director David Sencer refused to call AIDS an emergency and stated that the Public Health Department need not do anything because the gay community was handling it sufficiently. Around the same time gay men were getting sick in the United States, doctors in Paris were receiving patients who were African or who had lived in Africa with the same symptoms as the Americans. Parisian researchers Jean-Claude Chermann, Françoise Barre, Luc Montagnier, and doctor Willy Rozenbaum began taking biopsies of HIV-infected
lymph nodes A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inclu ...
and discovered a new retrovirus. As a scientific necessity to compare it to the American version of HIV, French doctors representing the
Pasteur Institute The Pasteur Institute (french: Institut Pasteur) is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases, and vaccines. It is named after Louis Pasteur, who invented pasteurization and vaccines ...
sent a colleague to the
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
, where
Robert Gallo Robert Charles Gallo (; born March 23, 1937) is an American biomedical researcher. He is best known for his role in establishing the human immunodeficiency virus (HIV) as the infectious agent responsible for acquired immune deficiency syndrome ...
was also working on the virus. The colleague switched the samples, Shilts reported, because of a grudge he had against the Pasteur Institute. Instead of Gallo comparing his samples with the French samples, he found the very same retrovirus as the French sample, putting back any new results in AIDS research for at least a year. Departmental ego and pride, according to Shilts, also confounded research as the
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
and the
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
s battled over funding and who might get credit for medical discoveries that were to come from the isolation of HIV, blood tests to find HIV, or any possible
vaccine A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.
. Once AIDS became known as a "gay disease" there was particular difficulty for many doctors in different specialties to get other medical professionals to acknowledge that AIDS could be transmitted to people who were not gay, such as infants born from drug-using mothers, children and adults who had hemophilia (and later, their wives),
Haiti Haiti (; ht, Ayiti ; French: ), officially the Republic of Haiti (); ) and formerly known as Hayti, is a country located on the island of Hispaniola in the Greater Antilles archipelago of the Caribbean Sea, east of Cuba and Jamaica, and s ...
ans, and people who had received
blood transfusions Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mod ...
. The discovery of HIV in the nation's blood supply and subsequent lack of response by
blood bank A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a Clinical Pathology laborat ...
leadership occurred as early as 1982, yet it was not until 1985, when HIV antibody testing was approved by the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA), that blood bank industry leaders acknowledged that HIV could be transmitted through blood transfusions. Shilts' coverage revealed the feeling among blood bank industry leaders that screening donors for
hepatitis Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes ( jaundice), poor appetite, vomiting, tiredness, abdominal ...
alone might offend the donors, and that the cost of screening all the blood donations provided across the country every year was too high to be feasible.


Political and governmental agencies

The Centers for Disease Control (CDC), the agency responsible for tracking down and reporting all communicable diseases in the U.S., faced governmental apathy in the face of mounting crisis. Shilts reported how CDC epidemiologists forged ahead blindly after being denied funding for researching the disease repeatedly. Shilts expressed particular frustration describing instances of the CDC fighting with itself over how much time and attention was being paid to AIDS issues. Although Reagan Administration officials like
Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
Secretary
Margaret Heckler Margaret Mary Heckler (née O'Shaughnessy; June 21, 1931 – August 6, 2018) was an American politician and diplomat who represented in the United States House of Representatives from 1967 until 1983. A member of the Republican Party, she als ...
and Assistant Secretary Edward Brandt spoke publicly about the epidemic, calling it in 1983 its "Number One Health Priority", no extra funding was given to the Centers for Disease Control or the National Institutes of Health for research. What the U.S. Congress pushed through was highly politicized and embattled, and a fraction of what was spent on similar public health problems. Shilts made comparisons to the government's disparate reaction to the
Chicago Tylenol murders The Chicago Tylenol murders were a series of poisoning deaths resulting from drug tampering in the Chicago metropolitan area in 1982. The victims had all taken Tylenol-branded acetaminophen capsules that had been laced with potassium cyanide. S ...
, and the recent emergence of Legionnaires' disease in 1977. In October 1982, seven people died after ingesting
cyanide Cyanide is a naturally occurring, rapidly acting, toxic chemical that can exist in many different forms. In chemistry, a cyanide () is a chemical compound that contains a functional group. This group, known as the cyano group, consists of ...
-laced
Tylenol Tylenol may refer to: * Paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decr ...
capsules. ''The New York Times'' wrote a front-page story about the Tylenol scare every day in October, and produced 33 more stories about the issue after that. More than 100 law enforcement agents, and 1,100
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
employees worked on the case. Johnson & Johnson disclosed they spent $100 million attempting to uncover who had tampered with the bottles. In October 1982, 634 people were reported having AIDS, and of those, 260 had died. ''The New York Times'' wrote three stories in 1981 and three more stories in 1982 about AIDS, none on the front page. The Tylenol Crisis was a criminal act of product-tampering; Legionnaires' disease was a public health emergency. Twenty-nine members of the American Legion died in 1976 at a convention in
Philadelphia Philadelphia, often called Philly, is the List of municipalities in Pennsylvania#Municipalities, largest city in the Commonwealth (U.S. state), Commonwealth of Pennsylvania, the List of United States cities by population, sixth-largest city i ...
. The
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
spent $34,841 per death of Legionnaire's Disease. In contrast, the NIH spent $3,225 in 1981 and about $8,991 in 1982 for each person who died of AIDS. Shilts accused Ronald Reagan of neglecting to address AIDS to the American people until 1987—calling his behavior "ritualistic silence"—even after Reagan called friend Rock Hudson to tell him to get well. After Hudson's death and in the face of increasing public anxiety, Reagan directed Surgeon General C. Everett Koop to provide a report on the epidemic. Though Koop was a political conservative, his report was nevertheless clear about what causes AIDS and what people and the U.S. government should do to stop it, including sex and AIDS education provided for all people. On a civic level, the closure of
gay bathhouse A gay bathhouse, also known as a gay sauna or a gay steambath (uncommonly known as a gay spa), is a commercial space for gay, bisexual, and other men to have sex with men. In gay slang, a bathhouse may be called just "the baths", "the sauna", ...
s in San Francisco became a bitter political fight in the gay community. Activists put pressure on the San Francisco Public Health director to educate people about how AIDS is transmitted, and demanded he close bathhouses as a matter of public health.


News media

Shilts was assigned to AIDS full-time at ''The San Francisco Chronicle'' in 1982. It was from this unique vantage point that he repeatedly criticized the U.S.
news media The news media or news industry are forms of mass media that focus on delivering news to the general public or a target public. These include news agencies, print media (newspapers, news magazines), broadcast news (radio and television), and ...
for ignoring the medical crisis because it did not affect people who mattered; only gays and drug addicts. Shilts noted most newspapers would print stories about AIDS only when it affected heterosexuals, sometimes taking particular interest in stories about AIDS in prostitutes. AIDS was not reported in ''
The Wall Street Journal ''The Wall Street Journal'' is an American business-focused, international daily newspaper based in New York City, with international editions also available in Chinese and Japanese. The ''Journal'', along with its Asian editions, is published ...
'' until it involved heterosexuals. Many stories called AIDS a "gay plague" or "homosexual disease" in articles that pointed to it showing up in new populations, like hemophiliacs or people who had received blood transfusions. Shilts recounted the irony of a reporter commenting on how little was reported about the disease, then linking it once more to rarer instances of transmission to non-drug-using heterosexuals. On the other end of the extreme, a general phobia of AIDS was exacerbated by the news media who erroneously reported that AIDS could be contracted by household contact, without checking any facts in their stories, which prompted mass hysteria across the United States.


Critical reception

The book became a commercial success, contrary to Shilts' own expectations. It remained on ''
The New York Times Bestseller List ''The New York Times'' Best Seller list is widely considered the preeminent list of best-selling books in the United States. John Bear, ''The #1 New York Times Best Seller: intriguing facts about the 484 books that have been #1 New York Times ...
'' for five weeks, was translated into seven languages, nominated for a
National Book Award The National Book Awards are a set of annual U.S. literary awards. At the final National Book Awards Ceremony every November, the National Book Foundation presents the National Book Awards and two lifetime achievement awards to authors. The Nat ...
, and made Shilts an "AIDS celebrity".Grimes, William (February 18, 1994)
"Randy Shilts, Author, Dies at 42; One of First to Write About AIDS"
''The New York Times'', p. D.17.
In ''
Rolling Stone ''Rolling Stone'' is an American monthly magazine that focuses on music, politics, and popular culture. It was founded in San Francisco, California, in 1967 by Jann Wenner, and the music critic Ralph J. Gleason. It was first known for its ...
'', Shilts is compared to great American writers whose careers were made by the circumstances surrounding them, such as
Thomas Paine Thomas Paine (born Thomas Pain; – In the contemporary record as noted by Conway, Paine's birth date is given as January 29, 1736–37. Common practice was to use a dash or a slash to separate the old-style year from the new-style year. In th ...
in the
American Revolution The American Revolution was an ideological and political revolution that occurred in British America between 1765 and 1791. The Americans in the Thirteen Colonies formed independent states that defeated the British in the American Revoluti ...
,
Edward R. Murrow Edward Roscoe Murrow (born Egbert Roscoe Murrow; April 25, 1908 – April 27, 1965) was an American broadcast journalist and war correspondent. He first gained prominence during World War II with a series of live radio broadcasts from Europe f ...
during
the Blitz The Blitz was a German bombing campaign against the United Kingdom in 1940 and 1941, during the Second World War. The term was first used by the British press and originated from the term , the German word meaning 'lightning war'. The Germa ...
, and
David Halberstam David Halberstam (April 10, 1934 April 23, 2007) was an American writer, journalist, and historian, known for his work on the Vietnam War, politics, history, the Civil Rights Movement, business, media, American culture, Korean War, and late ...
during the
Vietnam War The Vietnam War (also known by other names) was a conflict in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. It was the second of the Indochina Wars and was officially fought between North Vietnam a ...
. Writer Jon Katz explains, "No other mainstream journalist has sounded the alarm so frantically, caught the dimensions of the AIDS tragedy so poignantly or focused so much attention on government delay, the nitpickings of research funding and institutional intrigue".Katz, Jon (May 27, 1993). "AIDS and the Media: Shifting Out of Neutral", ''Rolling Stone'', Issue 657, pp. 31–32. In the ''
American Journal of Public Health The ''American Journal of Public Health'' is a monthly peer-reviewed public health journal published by the American Public Health Association that covers health policy and public health. The journal was established in 1911 and its stated miss ...
'', Howard Merkel characterizes ''And the Band Played On'' as the first volume of the
historiography Historiography is the study of the methods of historians in developing history as an academic discipline, and by extension is any body of historical work on a particular subject. The historiography of a specific topic covers how historians ha ...
of AIDS.Markel, Howard (July 2001). "Journals of the Plague Years: Documenting the History of the AIDS Epidemic in the United States", ''American Journal of Public Health'', 91 (7), p. 1025. Because the content expanded into law and science, reviews were published not only in literary sources but legal and medical journals as well.


Literary

Literary reviews of the work were generally positive, with reviewers commenting on the "hypnotic" and "thriller-like" qualities of the book. Shilts' investigative and journalistic endeavors were praised, and reviewers seemed genuinely moved by the personal stories of the major players.Judith Eannarino noted, "Shilts has the ability to draw the reader hypnotically into the personal lives of his characters. That, and his monumental investigative effort, would have made this a best-selling novel—if the contents weren't so horribly true."(Eannarino, Judith (November 15, 1987). "And the Band Played On (book review)." ''Library Journal'' 112 (19) p. 71.) A reviewer with the feminist magazine ''Hera'' agreed, saying, "''And the Band Played On'' reads like a mystery thriller. The fact that it is non-fiction adds to the intensity but also increases the rage the reader is left with."(Johnston, Peg. "And The Band Played On: Politics, People and the AIDS Epidemic; A Review of the book by Randy Shilts." ''Hera''. March 31, 1989. 9 (2), p. 3.) Elena Brunet in the ''
Los Angeles Times The ''Los Angeles Times'' (abbreviated as ''LA Times'') is a daily newspaper that started publishing in Los Angeles in 1881. Based in the LA-adjacent suburb of El Segundo since 2018, it is the sixth-largest newspaper by circulation in the U ...
'' called it "An important, masterful piece of investigative reporting".(Brunet, Elena. "And the Band Played On: Politics, People and the AIDS Epidemic by Randy Shilts." ''Los Angeles Times'': October 2, 1988. p. 14.) Anthony Clare in ''
The Times ''The Times'' is a British daily national newspaper based in London. It began in 1785 under the title ''The Daily Universal Register'', adopting its current name on 1 January 1788. ''The Times'' and its sister paper '' The Sunday Times'' (f ...
'' stated in a review, "''And the Band Played On'' is a formidable chronicle of wasted time, petty intrigue, bigoted posturing, blind faith and suffering", before warning the United Kingdom their response to AIDS was drawing too close a parallel to the United States'.(Clare, Anthony. "Chronicle of many deaths foretold: Review of 'And The Band Played On' by Randy Shilts", ''The Times'', February 28, 1988.) Joan Breckenridge in ''
The Globe and Mail ''The Globe and Mail'' is a Canadian newspaper printed in five cities in western and central Canada. With a weekly readership of approximately 2 million in 2015, it is Canada's most widely read newspaper on weekdays and Saturdays, although it ...
'' gave the book high praise for "an excellent piece of both investigative and political journalism", and for the style of writing, although cautioning that at more than 600 pages casual readers might be overwhelmed.(Breckenridge, Joan. "The awful epidemic that was allowed to happen: And the Band Played On: Politics, People and the AIDS Epidemic." ''The Globe and Mail (Canada)'', December 5, 1987.) Nan Goldberg in ''
The Boston Globe ''The Boston Globe'' is an American daily newspaper founded and based in Boston, Massachusetts. The newspaper has won a total of 27 Pulitzer Prizes, and has a total circulation of close to 300,000 print and digital subscribers. ''The Boston Glob ...
'' characterized it as a, "groundbreaking book on the history of the AIDS epidemic...every element of a thriller." (Goldeberg, Nan. "''Science Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine'' (book review)." ''The Boston Globe'', January 6, 2002.)
''And the Band Played On'' won the
Stonewall Book Award The Stonewall Book Award is a set of three literary awards that annually recognize "exceptional merit relating to the gay/lesbian/bisexual/transgender experience" in English-language books published in the U.S. They are sponsored by the Rainbow ...
for 1988. It earned the 10th spot on "100 Lesbian and Gay Books That Changed Our Lives", compiled by the ''Lambda Book Report''. In 1999, The New York City Public Library topped its list of "21 New Classics for the 21st Century" with ''And the Band Played On''. Two years after it was published however, Shilts remained "fundamentally disappointed" when a radical response to the AIDS crisis did not materialize, despite the reaction to his book. In a 1988 book review, Jack Geiger of ''
The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid d ...
'' commented that the detail in Shilts' work was too confusing, being told "in five simultaneous but disjointed chronologies, making them all less coherent", and notes that Shilts neglected to dedicate as much detail to black and Hispanic intravenous drug users, their partners and their children as to gay men. Geiger also expressed doubts that a swifter response by the government would have stemmed the spread of AIDS as quickly as Shilts was implying. Woodrow Myers from the ''
Los Angeles Times The ''Los Angeles Times'' (abbreviated as ''LA Times'') is a daily newspaper that started publishing in Los Angeles in 1881. Based in the LA-adjacent suburb of El Segundo since 2018, it is the sixth-largest newspaper by circulation in the U ...
'' was frustrated by Shilts not asking the right questions: "Shilts fails to probe the broader questions and stops where far too many of us stop: We don't ask why the
Department of Defense Department of Defence or Department of Defense may refer to: Current departments of defence * Department of Defence (Australia) * Department of National Defence (Canada) * Department of Defence (Ireland) * Department of National Defense (Philipp ...
and the entitlements like
Social Security Welfare, or commonly social welfare, is a type of government support intended to ensure that members of a society can meet basic human needs such as food and shelter. Social security may either be synonymous with welfare, or refer specifical ...
are getting all the money when the homosexuals and the IV drug abusers with AIDS and the multiple sclerosis patients are not."
Boston Boston (), officially the City of Boston, is the state capital and most populous city of the Commonwealth of Massachusetts, as well as the cultural and financial center of the New England region of the United States. It is the 24th- mo ...
's '' Gay Community News'' also criticized the book's implications that a diagnosis of HIV indicated that death was sure and imminent. Richard Rouilard, editor of '' The Advocate'' in 1992 criticized Shilts for being out of touch with the contemporary style of activism and its sexual overtones.


Science and law

Shilts' book has been used as a standard by the lay press when reviewing books chronicling subsequent medical crises including
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...
, chronic fatigue syndrome, Agent Orange, and continued response to AIDS. However, the academic and scientific communities have been somewhat more critical. Howard Markel, in the ''American Journal of Public Health'', notes Shilts' tendency to assign blame, writing "A requirement of the journalist, and certainly the historian, however, is to explain human society rather than to point fingers". Jon Katz in ''Rolling Stone'' refutes this by stating " hiltsfused strong belief with the gathering of factual information and the marshaling of arguments, the way the founders of the modern press did. In doing so, he has exposed the notion of objectivity as bankrupt, ineffective, even lethal". Although Sandra Panem in the journal ''
Science Science is a systematic endeavor that Scientific method, builds and organizes knowledge in the form of Testability, testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earli ...
'' praised Shilts' efforts and the attention the book brought to AIDS, she criticized his simplistic interpretation of science and the ways research is fostered and accomplished in the U.S. Panem furthermore believes Shilts gives appropriate weight to the issue of homophobia hampering attention on the disease, but remarks that even if AIDS had struck a more socially acceptable group of people, similar delays and confusion would have slowed medical progress.Panem, Sandra (February 26, 1988). "Review: A Drama and Questions", ''Science'' 239 (4843), pp. 1039–1040. Wendy Parmet, a professor at
Northeastern University Law School Northeastern University School of Law (NUSL) is the law school of Northeastern University in Boston, Massachusetts. Founded as an evening program to meet the needs of its local community, NUSL is nationally recognized for its cooperative legal ed ...
, highlights the greatest strengths of ''And the Band Played On'' to be "the pain and courage of individual confronted with AIDS" and how it "eloquently portrays the human side of the crisis" and believes the blame others criticized to be justified; but Parmet considers his technique of assigning an omniscient point of view a weakness, suggesting that it blurs the lines between fact and fiction. In '' Contemporary Sociology'', Peter Manning and Terry Stein also call Shilts' narrative method into question, and ask why, for a syndrome that affects people beyond race, class, and sexual orientation, that Shilts focuses so narrowly on AIDS as it is related to homosexuality. The writers, however, were mostly impressed with the book, calling it an "informative, often brilliant, overview of the emergent meanings of the AIDS epidemic".


Gaëtan Dugas as "Patient Zero"

The book includes extensive discussion of
Gaëtan Dugas Gaëtan Dugas (; February 19, 1952 – March 30, 1984) was a Québécois Canadian flight attendant and a relatively early HIV patient who once was widely regarded as " Patient Zero," or the primary case for AIDS in the United States. This ...
, a Canadian flight attendant who died in 1984. Dugas was labeled Patient Zero of AIDS, because he was linked directly or indirectly with 40 of the first 248 reported cases of AIDS in the United States, and after he was told of his ability to infect others, defiantly continued to have unprotected sex. Many book reviews concentrated their material on Dugas, or led their assessment of the book with discussion of his behavior. Some reviewers interpreted Shilts' naming Dugas "Patient Zero" to mean that Dugas brought AIDS to North America; ''
National Review ''National Review'' is an American conservative editorial magazine, focusing on news and commentary pieces on political, social, and cultural affairs. The magazine was founded by the author William F. Buckley Jr. in 1955. Its editor-in-chief ...
'' called Dugas the "Columbus of AIDS" and in their review of ''And the Band Played On'' states, " ugaspicked up the disease in Europe through sexual contact with Africans. Traveling on his airline-employee privileges, he spread it here from coast to coast." Shilts never stated this in the book, instead writing, "Whether Gaëtan Dugas actually was the person who brought AIDS to North America remains a question of debate and is ultimately unanswerable... there's no doubt that Gaëtan played a key role in spreading the new virus from one end of the United States to the other." ''
Time Time is the continued sequence of existence and events that occurs in an apparently irreversible succession from the past, through the present, into the future. It is a component quantity of various measurements used to sequence events, ...
'' titled its review of ''And the Band Played On'' "The Appalling Saga of Patient Zero", erroneously restating the claim that Dugas had brought AIDS to the continent. Even a press release by St. Martin's Press made the connection between Dugas and the introduction of AIDS to the Western World in its title, but not its text.Crimp, Douglas (Winter, 1987). "How to Have Promiscuity in an Epidemic." ''AIDS: Cultural Analysis/Cultural Activism'' 43 pp. 237–271 When the book was released, Dugas' story became a controversial subject in the Canadian media. Shilts claimed that "the Canadian press went crazy over the story" and that "Canadians... saw it as an offense to their nationhood." The original study identifying Dugas as the index case had been completed by William Darrow, but it was called into question by
University of California San Francisco The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It condu ...
epidemiologist Andrew Moss. Moss wrote in a letter to the editor of ''
The New York Review of Books ''The New York Review of Books'' (or ''NYREV'' or ''NYRB'') is a semi-monthly magazine with articles on literature, culture, economics, science and current affairs. Published in New York City, it is inspired by the idea that the discussion of i ...
'', "There is very little evidence that Gaetan was 'patient zero' for the US or for California," while also stating that Shilts did not overstress Dugas' lack of personal responsibility. Sandra Panem in ''Science'' uses Shilts' approach toward Dugas' behavior as an example of his "glib" treatment of the science involved in the epidemic. Author Douglas Crimp suggests that Shilts' representation of Dugas as "murderously irresponsible" is in actuality "Shilts' homophobic nightmare of himself", and that Dugas is offered as a "scapegoat for his heterosexual colleagues, in order to prove that hilts like them, is horrified by such creatures." Many years later, in the 2000s, it was shown, by tracing the roots of the virus, that it had spread from Africa to Haiti, and then to the U.S. in the mid-1960s, before Dugas would have been very sexually active, if at all, and before he was working as a flight attendant.The Cell That Started a Pandemic
''Radiolab.org'', with guests and research from: Nathan Wolf author of '' The Viral Storm'';
Carl Zimmer Carl Zimmer (born 1966) is a popular science writer, blogger, columnist, and journalist who specializes in the topics of evolution, parasites, and heredity. The author of many books, he contributes science essays to publications such as ''The Ne ...
, author of '' A Planet of Viruses''; Michael Worobey, MicrobeWorld.org's "Meet the Scientist Podcast";
David Quammen David Quammen (born February 24, 1948) is an American science, nature, and travel writer and the author of fifteen books. His articles have appeared in '' Outside Magazine'', '' National Geographic'', '' Harper's'', ''Rolling Stone'', ''The New Yo ...
, author of '' Spillover''; Beatrice H. Hahn of Penn Center for AIDS Research.
Even the labelling of Dugas as "Patient Zero" was due to a misunderstanding of the study of sexual contacts amongst a group of men indicating how the disease was transmitted – he was identified in the study as 'Patient etterO', for "Out of California" – but people reading and discussing the research began referring to and thinking about a "Patient Zero" as the origin of the disease. In 2016, a study of early AIDS cases demonstrated that Dugas could not have been "Patient Zero".


After publication

While Shilts was writing the book he was tested for HIV but insisted his doctor not tell him the results until the book was finished so it would not affect his journalistic integrity and judgment. On the day he sent the final manuscript to the publisher, he learned he was HIV-positive. He also revealed that he received abuse from gays for the articles he wrote for the ''San Francisco Chronicle'' supporting the bathhouse closures, as well as for ''And the Band Played On'', saying it was common for him to be spat upon in the Castro District. He was openly booed when he attended the premiere of ''
The Times of Harvey Milk ''The Times of Harvey Milk'' is a 1984 American documentary film that premiered at the Telluride Film Festival, the New York Film Festival, and then on November 1, 1984, at the Castro Theatre in San Francisco. The film was directed by Rob Epstein, ...
''—based on his book ''The Mayor of Castro Street''—at the
Castro Theatre The Castro Theatre is a historic movie palace in San Francisco that became San Francisco Historic Landmark #100 in September 1976. Located at 429 Castro Street in the Castro District, it was built in 1922 with a California Churrigueresque fa ...
. Footage he had shot as a television reporter was included in the film, but during the construction of the documentary he was so controversial that the film's editors removed him from footage showing him with Milk. Following the publication of ''And the Band Played On'', however, he was "worshipped" by many in the gay community for writing the book, but also seen as someone who pandered to publicity. Shilts declared while promoting the book in Australia in 1988 that AIDS in the western world could be eradicated, and by 1994, "AIDS could be as manageable as
diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...
". However, in reference to Africa, Shilts noted, "At this point it's inconceivable that there will be an AIDS-free world in Central Africa, as we're looking at a death rate on the scale of the Holocaust." Shilts gave an interview in 1991 where he noticed, "the stellar AIDS reporters in the early years...the people who did the best job—and the reporters who wanted to cover AIDS but their male editors wouldn't let them—tended to be women", and made a connection that if more women were allowed to write about the epidemic, media coverage would have been vastly different. Shilts died from complications of AIDS in 1994, age 42. Upon his death he was eulogized by Cleve Jones, who said "Randy's contribution was so crucial. He broke through society's denial and was absolutely critical to communicating the reality of AIDS." Larry Kramer said of him, "He single-handedly probably did more to educate the world about AIDS than any single person."


Film

''And the Band Played On'' was used as the basis for a 1993 Primetime Emmy Award-winning HBO
television film A television film, alternatively known as a television movie, made-for-TV film/movie or TV film/movie, is a feature-length film that is produced and originally distributed by or to a television network, in contrast to theatrical films made for ...
of the same name. It was produced by Aaron Spelling, directed by
Roger Spottiswoode John Roger Spottiswoode (born 5 January 1945) is a Canadian-British director, editor and writer of film and television. Early life He was born in Ottawa, Ontario, Canada, and was raised in Britain. His father Raymond Spottiswoode was a British ...
, and starred Matthew Modine as epidemiologist Don Francis and
Richard Masur Richard Masur is an American character actor who has appeared in more than 80 films. From 1995 to 1999, he served two terms as president of the Screen Actors Guild (SAG). He is best known for Nick Lobo on ''Rhoda'' (1974-1977), Stanley Uris in th ...
as William Darrow at the Centers for Disease Control.
Alan Alda Alan Alda (; born Alphonso Joseph D'Abruzzo; January 28, 1936) is an American actor, screenwriter, and director. A six-time Emmy Award and Golden Globe Award winner, he is best known for playing Captain Benjamin "Hawkeye" Pierce in the war come ...
portrayed controversial viral researcher Robert Gallo, and many other stars appeared in supporting and cameo roles, who agreed to appear in the film for union-scale pay. The film was released the same year as ''
Philadelphia Philadelphia, often called Philly, is the List of municipalities in Pennsylvania#Municipalities, largest city in the Commonwealth (U.S. state), Commonwealth of Pennsylvania, the List of United States cities by population, sixth-largest city i ...
'', and the play '' Angels in America: A Gay Fantasia on National Themes'' premiered, which prompted one reviewer to note it a triumph and a loss: 12 years after the epidemic had begun, such works of art were necessary still to draw attention to it. Reviews of the film were mixed, claiming that it was a noble try, but failed to be comprehensive enough to cover all the intricacies of the response to AIDS. However, ''And the Band Played On'', along with other well-received films at the time, was noted for raising the standards of HBO-produced films.Natale, Richard. "HBO filmmaker gives TV movies a new image." ''The Washington Times'', May 1, 1994, p. D1.


See also

* Timeline of early HIV/AIDS cases * ''
Zero Patience ''Zero Patience'' is a 1993 Canadian musical film written and directed by John Greyson. The film examines and refutes the urban legend of the alleged introduction of HIV to North America by a single individual, Gaëtan Dugas. Dugas, better know ...
'' (1993 Canadian musical film) * '' Sexual Ecology: AIDS and the Destiny of Gay Men'' (1997 non-fiction book) * '' The Hot Zone: A Terrifying True Story'' (1994 best-selling non-fiction thriller)


Notes


Citations


Bibliography

* Stoner, Andrew E. (2019). "The Journalist of Castro Street: The Life of Randy Shilts," University of Illinois Press. * Marcus, Eric (2002). ''Making Gay History'', HarperCollins Publishers. * Shilts, Randy (1987). ''And the Band Played On: Politics, People, and the AIDS Epidemic'', St. Martin's Press. {{ISBN, 0-312-24135-6 1980s LGBT literature 1987 non-fiction books 20th-century history books American political books American history books Non-fiction books adapted into films Books by Randy Shilts English-language books History books about HIV/AIDS History books about politics Investigative journalism LGBT literature in the United States Sociology books St. Martin's Press books Stonewall Book Award-winning works tr:Ve Orkestra Çalmaya Devam Ediyor