The Literature of AIDS
Caldwell, Mark
In the 1990s, if the optimists are right and the world is lucky, someone will be able to write the history of AIDS. If the epidemic has peaked by then—and some observers argue that this has...
...Feinberg's despair, on the other hand, belies and ultimately vitiates the vitality of his imagination...
...Then water...
...Nor how fast it is spreading...
...the variable and often very long latency period of the disease means epidemiological data about the nature and extent of its spread are slow to emerge...
...His book is superficially unsentimental, a tissue of stark and merciless comic contrasts...
...The problem is the one we began with—nobody knows exactly how AIDS spreads via sexual contact...
...It is every bit as riddled with panic and unexamined prejudice as its targets...
...To that Kramer added several vivid, if melodramatic, portraits of gay men coping with AIDS...
...AIDS and Its Metaphors neither whistles nor screams in the dark...
...It presents a series of vignettes from the lives of doctors, gay men with and without AIDS, activists, and observers, the common thread being the overheated Sidney Sheldonesque prose...
...Close your eyes...
...These modes—the latter particularly—appear far less efficient than anal intercourse, a point Fumento emphasizes heavily...
...Randy Shills had campaigned for the closing of the bathhouses in San Francisco...
...You hear muted music, the lower octaves from an organ...
...We are left with the nagging sense that Kramer has exploited a general tragedy to ventilate a personal one...
...You are encased in concrete...
...Fullblown" is the form in which the disease is inevitably fatal...
...B.J...
...There are projections aplenty, but the disease is ahead of us, and the fact that so far it is a relatively minor risk for heterosexuals doesn't mean it will remain so...
...Ever...
...William Hoffman's earlier play As Is had dramatized the personal dimensions of AIDS, but The Normal Heart was frankly polemical, offering a history of the anti-AIDS movement in New York and, more than incidentally, a dramatic lecture on the disease...
...B.J., though a New York University graduate student, is essentially frivolous and brainless, remaining as driven as ever in the quest (still unsuccessful) for a lover, but to that preoccupation is added the gnawing fear of AIDS and the nagging strain of living with sick friends from debility to debility and finally to death...
...Martin's Press, 1987), $24.95...
...It shouldn't be...
...it is useful, in ways that none of the other books considered here can match...
...Try to move...
...He more or less simply asserts that most Haitian AIDS cases are really homosexual but not admitted as such (there is a brief, lurid picture of homosexual brothels frequented by Americans in Port-au-Prince...
...Less surely, we know how HIV leads to the immunosuppression that in turn permits fatal opportunistic infection...
...The tone is sardonic, but B.J...
...It occurred when the Centers for Disease Control decided at first to put Haitians and Africans who had recently moved to America into a category in which the mode of AIDS transmission was "undetermined," and then into the pool of heterosexually transmitted AIDS cases, thus doubling rates without a single new case having emerged...
...As a result, AIDS and its relation to HIV infection have repeatedly been redefined, confusing the statistical picture of the epidemic and turning the disease into a murky universal signifier, fuzzy enough in its outlines to become a touchstone for a dozen kinds of terror...
...It gradually fades away...
...It is also typical of its genre in its taste for melodramatic utterance...
...Randy Shilts's And the Band Played On remains to date the most widely read and influential mass-market book on AIDS...
...We still don't have the scientific, social, or political knowledge to assess AIDS satisfactorily...
...But how much less efficient remains unclear...
...Michael Fumento's The Myth of Heterosexual AIDS promises at first to be an exercise in debunking...
...But that reservation is likely to be lost on the reader who follows Patient Zero's sinister course through the bathhouses and bars...
...But we'll know both its scale and when we can expect it to play itself out, even in the absence of a vaccine or completely effective therapy...
...Here, for example, is Don Francis, the Centers for Disease Control researcher on whose authority much of the epidemiological information in And the Band Played On seems to rely: The car swerved, jolting Don Francis awake...
...It has been demonstrated that it can be passed from man to woman and woman to man during normal heterosexual intercourse...
...In his widely praised novel about AIDS (and the golden age of the zipless fuck preceding it) Eighty-Sixed, David R. Feinberg at first seems to apply satire as a distancing technique to avoid self-promoting emotion...
...The Normal Heart has one strong advantage over And the Band Played On...
...In the middle of a crisis, without certainty, we settle for what helps at the moment: bricolage...
...In fact, it is highly unlikely...
...But we can evaluate the images we've been constructing of it, and these in turn can afford us the distance we need to render the challenge manageable, without minimizing it but also without using it to empower our own most intractable mental demons...
...Then we may be in a position to assess AIDS, decide how it harmed us, and what, if anything, it taught us...
...The play's climax comes when Weeks is humiliatingly drummed out of the organization (this also happened to Kramer with GMHC) because he is too loud, too confrontational, too willing to make a public issue of his (and his friends') gayness...
...Nor how helpful or harmful drugs like AZT will prove to the bulk of those who take them...
...The real source of Fumento's attack on these figures is his belief that many, if not most, of the Haitian and African AIDS cases were homosexual in origin or at least traceable to other factors than "normal" male-female contact...
...We're in peril, Sontag argues, of transforming AIDS from a viral infection into a devouring moral monster, laden with all our meanest and most destructive cultural prejudices...
...The real crisis of the play has nothing to do with AIDS and everything to do with politics and the bottomless ego of the main character, Ned Weeks, widely reported to be a self-portrait of Larry Kramer...
...In all the disease literature of the period, there is usually a potent physician, like Sir Luke Strett in James's The Wings of the Dove, who mediates between the character facing illness and the mysteries and horrors of the disease...
...Then—finally—mud...
...The poem is called "Sensitivity Exercises for Death," and it could serve as an epigraph for the whole book...
...The scene isn't as self-pitying as a description of it implies: Weeks admits he's an asshole and begs not to be cut off from the group...
...Sontag is the only widely read writer who observes a peculiarly danger-fraught feature of AIDS: the slipperiness with which it's been defined permits it to be invested with all kinds of pernicious metaphors...
...You can't...
...Larry Kramer, The Normal Heart (New York: New American Library, 1985), $6.95 paper...
...Kramer did the same even more aggressively in New York, adding political agitation against the Koch administration, which had essentially ignored the early phases of the epidemic...
...Indeed, the contention that AIDS is invariably fatal depends partly on what doctors decided to define as AIDS—and keep in reserve as distinct earlier stages of the disease...
...But when he is left standing alone on stage, the play has reached its apogee...
...Shilts never denies that AIDS can be (and perhaps mainly is) spread by people who meet socially or at work, fall in love, and have sex with each other by normal middle-class firesides...
...But even they are most often ex-tricks, and, wherever the conversation ranges, it is eventually yanked back by B.J.'s lodestone: boyfriends, boyfriends, boyfriends...
...Or is it...
...As Shilts had, Kramer rails against the early denial, in both the scientific and the gay communities, that allowed the virus to spread...
...The problem with And the Band Played On is the grating emotionalism of its language...
...Sontag is astute on this point: That AIDS is not a single illness but a syndrome, consisting of a seemingly open-ended list of contributing or "presenting" illnesses which constitute (that is, qualify the patient as having) the disease, makes it more a product of definition or construction than even a very complex, multiform illness like cancer...
...Of all the widely circulated books about AIDS, only one suggests a more useful, less punishing approach: Susan Sontag's AIDS and 346 • DISSENT The Literature of AIDS Its Metaphors...
...But its point remains wholesome and tonic...
...Try as they might to paint a portrait of the disease, what they ended up offering was covert psychoautobiography...
...From the very beginning, any physician who paid attention to the epidemiological data, in fact any intelligent layperson, was in a position to guess—though not, until 1984, to know —that AIDS was a blood-borne and sexually transmitted disease, probably viral in origin...
...Nobody knows exactly how many people are now infected with HIV...
...But, generally, Sontag is the best kind of skeptic—neither overdramatizing the epidemic nor preoccupied with shooing it away...
...Francis regained control of his Volvo and continued home...
...There have been, in the West at least, arguably three contagious diseases in the twentieth century that match AIDS in psychological impact: tuberculosis (which at the end of the nineteenth century was the leading cause of death in the United States), the 1918 influenza epidemic, and polio...
...Now don't open them...
...Dugas is first shown in 1980 in San Francisco on the day of a gay parade, just after the removal of his earliest Kaposi's sarcoma lesion...
...In his "Notes on Sources," Shilts calls his book a "work of journalism" and disclaims any fictionalization, but adds that "for purposes of narrative flow, I reconstruct scenes, recount conversations and 342 • DISSENT The Literature of AIDS occasionally attribute observations to people with such phrases as 'he thought' or 'she felt.' " Such references, Shilts vaguely adds, "are drawn from either the research interviews I conducted for the book or from research conducted during my years of covering the AIDS epidemic...
...Susan Sontag, AIDS and Its Metaphors (New York: Farrar, Straus and Giroux, 1989), $14.95...
...In 1900 or 1918 or 1950, some of the angst unleashed by the fear of a fatal disease could be dispersed in the trust you felt in your doctor and his profession...
...The image may (incidentally) be the truth, but it has the frisson of legend...
...Nothing illustrates this tendency better than Larry Kramer's 1985 play, The Normal Heart, the opening night of which figures as a landmark in And the Band Played On...
...Is such confusion peculiar to AIDS, or is it something to do with being gay...
...Randy Shilts, And the Band Played On: Politics, People, and the AIDS Epidemic (New York: St...
...Scientists and physicians, public health authorities, gay political leaders, and business interests are all castigated for not speaking out earlier...
...and was in bed by 8:30 P.M., as usual, so he could slip into the CDC headquarters on Clifton Road by 5 A.M...
...But the exact mechanism of transmission remains elusive (this is not new among epidemic diseases...
...Fumento trots out all the shot-in-the-dark explanations for the predominance of apparently heterosexual AIDS cases in Africa— unconfessed homosexuality, lack of circumcision, unsterilized hypodermic needles, a high general rate of sexually transmitted disease...
...Emotion remains the medium in The Myth of Heterosexual AIDS...
...The first half, "Ancient History," follows the hero, B.J., through 1980...
...Odd journalism indeed if, as Shilts appears to be saying, he has reconstructed other people's thoughts and utterances out of his own experience as an ace reporter in the field...
...This isn't simply sharp...
...It is brief, virtually a pamphlet, and not entirely novel, because it extends to AIDS a discussion begun in her earlier Illness as Metaphor...
...The screamer in this case is telling us to cool down rather than to gird for apocalypse, but he is shouting nonetheless, and it is ultimately his own passion that is being brought before us rather than the anatomy of an illness...
...But when we turn back to Fumento's discussion of Haiti and Africa, his arguments weaken...
...eventually, diagnosed with AIDS and told he is spreading it, he becomes a gay Typhoid Mary: "He would have sex with you, turn up the lights in the cubicle, and point out his Kaposi's sarcoma lesions...
...What the book really communicates is more the impact of the epidemic's spread on the emotions than its clinical and public health history...
...But an implicit faith in physicians and in the power of scientific medicine (which we've since lost) allayed some of the panic 344 • DISSENT The Literature of AIDS each provoked...
...the disease has been found in post mortem tissue taken from a patient who died in St...
...It gives us some perspective...
...But, sadly, when it comes to the literature of AIDS, what linked most writers in the 1980s was hyperbole...
...We're still being yelled at...
...But it too suffers from a division of soul: scene by scene it appears to unfold as a history of AIDS and a two-pronged diatribe against homophobia and the homosexual behavior that allowed AIDS to spread...
...Hard as he tries, Fumento can't make the statistics back up his contention that the likely spread of AIDS among heterosexuals has been oversold...
...Louis in 1969, well before Dugas...
...I'm going to die and so are you.' " Shilts carefully avoids claiming these incidents ever happened or, if they did, that Dugas perpetrated them...
...In Iris Murdoch's most recent novel, The Message to the Planet, a major character, dying of a disease that resembles AIDS (though we're told it's not), is brought back from the edge of death by a possible miracle...
...it helps us to decide, amid the dread and suffering surrounding the epidemic, which evils come from the virus and which from our imaginations...
...Between 1981 (when the first cases were reported) and 1985, AIDS continued to spread in the United States...
...If the epidemic has peaked by then—and some observers argue that this has already happened—we will still be living out the denouement of a widespread human tragedy...
...As Fumento correctly notes, this rise was a statistical artifact...
...The Dugas story appeals to an immemorial superstition that recurs in epidemics: the rumor of the anointer, the anonymous stranger who drifts into the city deliberately spreading the plague among the innocent...
...Shilts documents the dithering that afflicted virtually everyone who might have acted to publicize this theory...
...But at least the hope for escape from necessity animates the story, lets in some air...
...How is it that a diatribe against a disease and those who respond to it inadequately (at least as the play sees things) can devolve so thoroughly into a portrait of naked ego...
...comes up for air only for occasional rueful dinners with friends...
...Since the early 1980s, however, other infections and conditions have been added to the list as sufficient indicators for the diagnosis of "frank" AIDS, and other diagnostic devices (like T4 cell counts) have come into play as well...
...In the poem we are exhorted to imagine ourselves floating through helium...
...Now it is solid...
...It simply reflects the mockery by which an implacable fate reaffirms its power over the characters...
...But, for better and worse, we've since deconstructed organized medicine, leaving nothing between ourselves and the microbe, no social network to lessen the sense of isolation and powerlessness that a mortal disease brings...
...B.J.'s principal, though unmet, goal is a boyfriend, a search that takes him from trick to trick, and to the St...
...both its passions and its detachment are in the right places...
...And despite its reportorial character, this is generally true of And the Band Played On...
...The book is so ferociously fettered to the SUMMER • 1990 • 345 The Literature of AIDS experiences it recounts, whether libertine or anhedonic (in Feinberg's world the two blend inextricably), that catharsis becomes impossible...
...SUMMER • 1990 • 347...
...Like And the Band Played On, The Normal Heart did mark a sociopolitical if not a creative breakthrough, and there is no question that it helped propel discussion of the disease into public discourse...
...is so obsessed with sex—albeit in the guise of romance—that his story, even as it cannonballs along through days of mindless libertinism, becomes claustrophobic and essentially joyless...
...The implication of the story is that in Dugas, who persisted in a voracious career of bathhouse sex after contracting AIDS, researchers had tracked down— and Shilts had made public—the origin of the epidemic in America...
...That speculation becomes the basis for a brief indulgence in some are-we-living-intheend-of-time rhetoric...
...Fumento's tone is so commonsensical that one might think he has finally escaped the emotional distortion characteristic of the genre...
...he demonstrates how statistics have been distorted to present future prospects in the worst possible light...
...Gradually you make your way across the room...
...The mud is warm and soothing...
...Possible—but far less ironclad and not as reassuring as Fumento would have us believe...
...The reader is afforded no distance, no perspective...
...It acknowledges the tentativeness of what we know about AIDS and doesn't, like so much other writing in this uniquely 1980s genre, renounce that tentativeness...
...Eighty-Sixed is most remarkable for the inevitability with which its unhinged first half predicts and ushers in the nihilism of its second half, "Learning How to Cry," which takes B.J...
...AIDS was first recognized not by its underlying etiological cause, the human immunodeficiency virus, but by the commonest (and worst) opportunistic infections that characterize the potentially fatal stages of infection: Kaposi's sarcoma and pneumocytis carinni pneumonia...
...Patient Zero, Gaetan Dugas, is a dream image, an allegory of our own terror...
...The book and its characters are as skeptical about the possibility of magic as the most hardened late-twentieth-century positivist could wish, and much of The Message to the Planet explores the possibility that the cure was a result of chance...
...He is also refreshingly hardheaded about how political interests on both the left and the right have manipulated the crisis in pursuit of their own ends...
...The facts are a veneer, essentially beside the point...
...It was you against the disease, his ethos went, and the disease might win if you let up for one day...
...I've got gay cancer,' he'd say...
...The book's comic edge sharpens here but doesn't function as relief...
...But that isn't the role sex plays in the book...
...At times Sontag succumbs to the reigning taste for apocalypse...
...to get a few hours of work done before the meetings began...
...Right now we know the etiological cause of the disease: HIV, the human immunodeficiency retrovirus...
...The stinging rebukes administered to Weeks by the other characters and his own self-criticism demonstrate Kramer's recognition of this problem, but they don't solve it...
...Throughout the decade AIDS set loose the personal demons of virtually all who wrote about it...
...Michael Fumento, The Myth of Heterosexual AIDS (New York: Basic Books, 1990), $22.95...
...no one has settled how tuberculosis and polio spread...
...Watch out for rocks...
...Though much of what has been written on AIDS may have done some good, most of it is shrill, muddled, tendentious...
...L the 1980s Shilts was far from alone in reacting this way to AIDS...
...But this doesn't prevent Shilts from dramatizing him heavily, as an at first ignorant but ultimately willful angel of death...
...To downplay the danger of AIDS to heterosexuals, Fumento makes heavy use of a flurry of 1986 press reports announcing that in one year the proportion of heterosexually transmitted AIDS cases had doubled from 2 to 4 percent of the total...
...The mud hardens...
...clinic (inevitably) and, as the stakes rise inexorably, the still more surreal Greenwich Village lab where you went to have stool samples tested for intestinal parasites ("This is not the correct consistency," the Nordic technician icily informs B.J...
...But its dramaturgy reveals another and deeper-rooted preoccupation...
...Everything that follows this moment, including a deathbed marriage to his dying lover, Felix, is an anticlimax...
...An even more extreme case of Shilts's overdramatizing is his account of Patient Zero, Gaetan Dugas, the French-Canadian airline steward who had documented connections to a number of gay men who contracted the disease early in the epidemic...
...Fumento effectively deflates the sensationalism rampant in press and broadcast treatments of AIDS...
...In the preachy, improbable character of Emma, a physician, he offers advice on prevention: stop having sex...
...As what is immature is destined to become mature, what buds to become fullblown, . . . the doctors' botanical or zoological metaphor makes development or evolution into AIDS the norm, the rule...
...We know in a general way how HIV can be spread — sexually, by the sharing of blood products, and from mother to fetus...
...Much of the plot revolves around his founding of an anti-AIDS volunteer group at the beginning of the epidemic—as Kramer had founded Gay Men's Health Crisis (GMHC...
...Francis had learned such rigorous schedules when he was fighting smallpox in India...
...Shilts briefly concedes the improbability that the virus could ever be tracked to a single human carrier: "Whether Gaetan Dugas actually was the person who brought AIDS to North America remains a question of debate and is ultimately unanswerable...
...Unfortunately, The Myth of Heterosexual AIDS is simply panic in reverse...
...Then fog...
...Eighty-Sixed is, in other words, despite its veneer of hardboiled skepticism, as contrived as either The Normal Heart or And the Band Played On...
...It is perhaps surprising that literary criticism, Sontag's milieu, should prove so powerful a medium for discussion of AIDS...
...Shilts designates Rock Hudson's death from AIDS in 1985 as a watershed, converting the panicked silence of the press and broadcast media into relentless publicity...
...No wonder, Shilts seems to be saying, such stuff leads to AIDS...
...after his first effort...
...And the Band Played On adopts, often disastrously, the language of pulp fiction...
...In the effort to document this, however, And the Band Played On ultimately gives, as with Gaetan Dugas, the appearance of demonstrating objectively what it can't possibly know: that the disease spread mainly in the dark, seedy shadows of sex clubs...
...It's dark, threatening, disgusting sex...
...The night before, he had arrived home at 6 P.M...
...rlor is it only gay writers or those convinced of AIDS as a social phenomenon who have let the disease colonize their imaginations (and in turn let their imaginations colonize the disease...
...It is aware that it plays out violences of emotion not strictly related to AIDS...
...She entertains more or less seriously, for example, Harvard biologist Stephen Jay Gould's speculation that AIDS may ultimately kill off a quarter of the human race...
...he describes the public smarminess and private homophobia with which Hollywood has faced the disease...
...Shilts expertly shows how hesitation or denial in the early 1980s prevented effective action...
...It is true, as Fumento says, that rates didn't really double, but it is also true, as long as you accept that AIDS cases among Haitian and African emigres were heterosexual in origin, that such cases had been underestimated by half...
...And this decision rests on a notion no less primitively metaphorical than that of a "fullblown" (or "full-fledged") disease...
...through 1986, the year when the consciousness of AIDS became, at least among gay men in New York, a kind of monomania...
...The book has the merit of demonstrating a point almost nobody would now dispute: the epidemic could have been stemmed, if not stopped, by early action...
...His book is punctuated by short, usually comic, prose-poem riffs, but one, in "Learning How to Cry," is unforgettable for the black hole into which it sucks the reader, the writer, and, apparently, the novel...
...Mark's Baths, the Ramble in Central Park, the gay stretch at Jones Beach, the New York University gym, the V.D...
...SUMMER • 1990 • 343 The Literature of AIDS gay community's early reluctance to shut down the baths, a cause for which Shills was an advocate...
...The effect, as with The Normal Heart and And the Band Played On, is ultimately narcissistic...
...Reassuring...
...But the book itself accelerated that process, helping to establish the vocabulary in which popular discussion of AIDS has been conducted ever since...
...One of the book's recurrent themes is the Books Discussed in This Essay David B. Feinberg, Eighty-Sized (New York: Penguin, 1989), $7.95 paper...
...The mud is viscous...
Vol. 37 • July 1990 • No. 3
