Thursday, August 21, 2014

Pandemics

The resurgence of the Ebola virus in Africa and the recent discovery of smallpox vials where they should not have been made me want to reread Randy Shilts's book, And the Band Played On. It's an in-depth account of the early years of AIDS in North America and Europe: the early cases, the discovery of the virus, the tragic losses, the mobilization of entire communities, the political battles for recognition and resources. Some of the medical researchers mentioned in And the Band Played On were involved in quashing an outbreak of Ebola, and in officially eradicating the smallpox virus. And strangely enough, this very year, stray vials of smallpox were discovered in an old government storeroom, and Ebola fever is raging again in Africa.

With all the technological progress we've made, we can still be undone by microorganisms.

And the Band Played On chronicles the beginning of the AIDS horror in the US, its exponential spread, and the extent to which it decimated communities. For me, one statistic illustrates the scale of this horror. As reported in The AIDS Generation: Stories of Survival and Resilience (Perry N. Halkitis), only 20% of those diagnosed before January 1, 1985, were still alive in 1990. 20% survival over five years: staggering.

Shilts's book was published in 1987, before the watershed year of 1996, when the protease inhibitors that have done so much to curb the deadliness of HIV became available. Sean Strub's book Body Counts: A Memoir of Politics, Sex, AIDS, and Survival is a personal account of the AIDS pandemic, but his account extends to the present. Protease inhibitors arrived in the nick of time for Strub, who was in the very late stages of AIDS (internal Kaposi's sarcoma) when the new medication brought him back from the brink. "I started to see events in my life as 'last times' ... When a postcard arrived to remind me of an upcoming dental checkup, I threw it away," Strub writes. And then he found himself not only alive but improving, reclaiming a future. Strub's book therefore covers a broader sweep of the American part of the pandemic. Sadly, Shilts could not write such an account himself: he died in 1994, of complications from AIDS.

I lived through these years myself, but I did not live inside this pandemic. I knew two people who died of AIDS in the early 1990s, but they were friendly acquaintances, not close friends. I was not going to funerals every week nor monitoring my own T-cell count. My view of AIDS was an outsider's view; the disease cast a long shadow, and for a while, everyone was afraid. And I well remember the panic caused by unhelpfully euphemistic terms like "body fluids."

AIDS is still a problem, although because of improvements in understanding and treating it, in the US, AIDS is now often seen through a sort of historical, rear-view mirror. David Levithan's novel, Two Boys Kissing, includes narration from the souls of gay men from the era most affected by AIDS, addressing the young gay men of today: "We were once like you, only our world wasn't like yours. You have no idea how close to death you came. A generation or two earlier, you might be here with us." Also: "If you are a teenager now, it is unlikely that you knew us well. ... We are characters in a Tony Kushner play, or names on a quilt that rarely gets taken out anymore."

Our literature contains the records of this plague. Plagues have always been part of human experience, and right now a particularly devastating one is unfolding in West Africa. This story unfolds again and again; each time we hope for a better ending, a swifter resolution.

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