And the Band Played On
Encyclopedia
And the Band Played On: Politics, People, and the AIDS Epidemic is a nonfiction book written by San Francisco Chronicle
journalist Randy Shilts
, published in 1987. It chronicles the discovery and spread of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) with a special emphasis on government indifference and political infighting—specifically in the United States—to what was initially perceived as a gay
disease. Shilts' premise is that while AIDS is caused by a biological agent, incompetence and apathy toward those who were initially affected by AIDS allowed the spread of the disease to become much worse; AIDS was allowed to happen.
The book is an extensive work of investigative journalism, written in the form of an encompassing time line; the events that shaped the epidemic 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. The book begins its discussion in the late 1970s with the then-first confirmed case of AIDS, that of Grethe Rask
, a Danish doctor working in Africa. It ends with the announcement by actor Rock Hudson
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
called it "one of the most important books of the year", upon its release. 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 adapted into an HBO docudrama 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.
grew up in a conservative household near Chicago, Illinois and was active in Young Americans for Freedom
in high school. He earned a journalism degree at the University of Oregon
in 1975, where he also came out of the closet
as gay. Shilts was determined to live openly about his sexuality, but was unable to find steady work as a reporter due to what he believed was homophobia
in the media. He worked as a freelance reporter for the gay magazine The Advocate
before becoming one of thousands of gay men moving to San Francisco's Castro District. In a 1989 interview, Shilts recalled his anger as he was trying to get established as a reporter: "At the beginning I was angry at this big, nebulous 'them'—all the places where I couldn't get work. My anger became more specific as time went on."
Shilts worked for two Bay Area
television stations from 1977 to 1980, becoming somewhat of a star in the Castro neighborhood. With writer Armistead Maupin
, Shilts was voted one of San Francisco's most eligible bachelors in the gay community. He published a highly acclaimed biography of San Francisco politician Harvey Milk
in 1982 titled The Mayor of Castro Street
, and began working full time with the San Francisco Chronicle
reporting on gay issues in a city where 25% of the population was gay. Shilts had closely followed the story of the epidemic almost since its North American outbreak
covering the response and reaction of government agencies, local support organizations, medical researchers as well as individuals personally impacted by the growing crisis.
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
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."
The title of the book is a reference to the story about the string quartet in the first-class lounge of the RMS Titanic, which kept playing as the ship sank, thereby alluding to the multiple agencies and communities who neglected to prioritize a swift medical response to the crisis. 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."
" 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.
celebration in 1976 when sailors came from all over the world to New York. Some of them carried sexually transmitted disease
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 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 politicians 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 communicable disease, linked it to certain sexual practices, and made recommendations to gay men to avoid getting sick—stop having sex—a directive that defied the 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 such an undesirable population as gay men, 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
and Paul Popham
, 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. Shilts describes the desperate actions of the group to get recognition by Mayor Ed Koch
, and assistance from the 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. Many of the men who were involved in the early phases of community activism during the AIDS crisis realized their life's missions. Larry Kramer went on to form AIDS Coalition to Unleash Power
(ACT-UP) as a political activist organization that forced government and media to pay attention to AIDS. Cleve Jones formed the NAMES Project that created the AIDS Memorial Quilt, the largest folk art display in the world.
, James Curran, Arye Rubenstein, Michael S. Gottlieb
, and Mathilde Krim
—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, Kaposi's Sarcoma
, toxoplasmosis
, cytomegalovirus
, cryptosporidia, and other opportunistic infections that caused death by a grisly combination of ailments overtaxing a nonexistent immune system
. 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 U.S., doctors in Paris, France, were receiving patients who were African or who had lived in Africa with the same symptoms as Americans. Parisian researchers Jean-Claude Chermann, Françoise Barre
, Luc Montagnier
, and doctor Willy Rozenbaum
began taking biopsies of HIV-infected lymph nodes and discovered a new retrovirus
. As a scientific necessity to compare it to the American version of HIV, French doctors representing the Pasteur Institute
sent a colleague to the National Cancer Institute
, where Robert Gallo
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 and the National Cancer Institute
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
. 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
ans, and people who had received blood transfusions.
The discovery of AIDS in the nation's blood supply and subsequent lack of response by the blood banking leadership occurred as early as 1982, yet not until 1985, when AIDS antibody testing was approved by the Food and Drug Administration
(FDA), did blood bank industry leaders acknowledge that HIV could be transmitted through blood transfusions. Shilts' coverage revealed the feeling among blood bank industry leaders that screening donors for hepatitis
alone might offend the donors, and that the cost of screening all the blood donation
s provided across the country every year was too high to be feasible.
Although Reagan
Administration officials like Health and Human Services Secretary Margaret Heckler
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 1982 Chicago Tylenol murders
, and the recent emergence of Legionnaire's Disease in 1977. In October 1982, seven people died after ingesting cyanide
-laden Tylenol
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 employees worked on the case. Johnson & Johnson
disclosed they spent $100 million attempting to uncover who 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; Legionnaire's Disease was a public health emergency. Twenty-nine members of the American Legion
died in 1976 at a convention in Philadelphia. The National Institute of Health 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
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.
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 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.
, and made Shilts an "AIDS celebrity". In Rolling Stone
, Shilts is compared to great American writers whose careers were made by the circumstances surrounding them, such as Thomas Paine
in the American Revolution
, Edward R. Murrow
during the Blitz
, and David Halberstam
during the Vietnam War
. 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". In the American Journal of Public Health
, Howard Merkel characterizes And the Band Played On as the first volume of the historiography
of AIDS. Because the content expanded into law and science, reviews were published not only in literary sources but legal and medical journals as well.
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
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
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
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
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
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
and the entitlements like Social Security
are getting all the money when the homosexuals and the IV drug abusers with AIDS and the multiple sclerosis
patients are not." The Gay Community News in Boston
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.
, chronic fatigue syndrome
, Agent Orange
, and continued response to AIDS. However, the academic and scientific communities have been somewhat more critical. Howard Merkel, 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 "[Shilts] fused 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
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.
Wendy Parmet, a professor at Northeastern University Law School, 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".
Shilts is often quoted as claiming that Ronald Reagan neglected to mention AIDS publicly until 1987. However, Reagan briefly mentioned AIDS research in questions and answers during a news conference on September 17, 1985.
, 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 U.S., 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; the National Review
called Dugas the "Columbus of AIDS" and in their review of And the Band Played On states, "[Dugas] picked 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 Gaetan 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 Gaetan played a key role in spreading the new virus from one end of the United States to the other." Time
magazine titled their 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.
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 epidemiologist Andrew Moss. Moss wrote in a letter to the editor of The New York Review of Books, "There is very little evidence that Gaetan was 'patient zero' for the US or for California", 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 [Shilts], like them, is horrified by such creatures."
—based on his book The Mayor of Castro Street—at the Castro Theatre
. 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 "worshiped" 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". 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.
Randy Shilts died from complications of AIDS in 1994. 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."
, directed by Roger Spottiswoode
, and starred Matthew Modine
as epidemiologist Don Francis
and Richard Masur
as Dr. William Darrow at the Centers for Disease Control. Alan Alda
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
and Angels in America
, 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.
San Francisco Chronicle
thumb|right|upright|The Chronicle Building following the [[1906 San Francisco earthquake|1906 earthquake]] and fireThe San Francisco Chronicle is a newspaper serving primarily the San Francisco Bay Area of the U.S. state of California, but distributed throughout Northern and Central California,...
journalist Randy Shilts
Randy Shilts
Randy Shilts was a pioneering gay American journalist and author. He worked as a freelance reporter for both The Advocate and the San Francisco Chronicle, as well as for San Francisco Bay Area television stations....
, published in 1987. It chronicles the discovery and spread of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) with a special emphasis on government indifference and political infighting—specifically in the United States—to what was initially perceived as a gay
Gay
Gay is a word that refers to a homosexual person, especially a homosexual male. For homosexual women the specific term is "lesbian"....
disease. Shilts' premise is that while AIDS is caused by a biological agent, incompetence and apathy toward those who were initially affected by AIDS allowed the spread of the disease to become much worse; AIDS was allowed to happen.
The book is an extensive work of investigative journalism, written in the form of an encompassing time line; the events that shaped the epidemic 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. The book begins its discussion in the late 1970s with the then-first confirmed case of AIDS, that of Grethe Rask
Grethe Rask
Margrethe P. Rask , better known as Grethe Rask, was a Danish physician and surgeon who practiced medicine in what was then known as Zaïre...
, a Danish doctor working in Africa. It ends with the announcement by actor Rock Hudson
Rock Hudson
Roy Harold Scherer, Jr., later Roy Harold Fitzgerald , known professionally as Rock Hudson, was an American film and television actor, recognized as a romantic leading man during the 1950s and 1960s, most notably in several romantic comedies with Doris Day.Hudson was voted "Star of the Year",...
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
Library Journal is a 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 practice...
called it "one of the most important books of the year", upon its release. 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 adapted into an HBO docudrama of the same name
And the Band Played On (film)
And the Band Played On is a 1993 American television film docudrama directed by Roger Spottiswoode. The teleplay by Arnold Schulman is based on the best-selling 1987 non-fiction book And the Band Played On: Politics, People, and the AIDS Epidemic by Randy Shilts.The film premiered at the Montreal...
in 1993. Shilts was tested for HIV while he was writing the book; he died of complications from AIDS in 1994.
Background
Randy ShiltsRandy Shilts
Randy Shilts was a pioneering gay American journalist and author. He worked as a freelance reporter for both The Advocate and the San Francisco Chronicle, as well as for San Francisco Bay Area television stations....
grew up in a conservative household near Chicago, Illinois and was active in Young Americans for Freedom
Young Americans for Freedom
Young Americans for Freedom is a 501 non-profit organization and is now a project of Young America's Foundation. YAF is an ideologically conservative youth activism organization that was founded in 1960, as a coalition between traditional conservatives and libertarians...
in high school. He earned a journalism degree at the University of Oregon
University of Oregon
-Colleges and schools:The University of Oregon is organized into eight schools and colleges—six professional schools and colleges, an Arts and Sciences College and an Honors College.- School of Architecture and Allied Arts :...
in 1975, where he also came out of the closet
Coming out
Coming out is a figure of speech for lesbian, gay, bisexual, and transgender people's disclosure of their sexual orientation and/or gender identity....
as gay. Shilts was determined to live openly about his sexuality, but was unable to find steady work as a reporter due to what he believed was homophobia
Homophobia
Homophobia is a term used to refer to a range of negative attitudes and feelings towards lesbian, gay and in some cases bisexual, transgender people and behavior, although these are usually covered under other terms such as biphobia and transphobia. Definitions refer to irrational fear, with the...
in the media. He worked as a freelance reporter for the gay magazine The Advocate
The Advocate
The Advocate is an American LGBT-interest magazine, printed monthly and available by subscription. The Advocate brand also includes a web site. Both magazine and web site have an editorial focus on news, politics, opinion, and arts and entertainment of interest to LGBT people...
before becoming one of thousands of gay men moving to San Francisco's Castro District. In a 1989 interview, Shilts recalled his anger as he was trying to get established as a reporter: "At the beginning I was angry at this big, nebulous 'them'—all the places where I couldn't get work. My anger became more specific as time went on."
Shilts worked for two Bay Area
San Francisco Bay Area
The San Francisco Bay Area, commonly known as the Bay Area, is a populated region that surrounds the San Francisco and San Pablo estuaries in Northern California. The region encompasses metropolitan areas of San Francisco, Oakland, and San Jose, along with smaller urban and rural areas...
television stations from 1977 to 1980, becoming somewhat of a star in the Castro neighborhood. With writer Armistead Maupin
Armistead Maupin
Armistead Jones Maupin, Jr. is an American writer, best known for his Tales of the City series of novels, based in San Francisco.-Early life:...
, Shilts was voted one of San Francisco's most eligible bachelors in the gay community. He published a highly acclaimed biography of San Francisco politician Harvey Milk
Harvey Milk
Harvey Bernard Milk was an American politician who became the first openly gay man to be elected to public office in California when he won a seat on the San Francisco Board of Supervisors...
in 1982 titled The Mayor of Castro Street
The Mayor of Castro Street
The Mayor of Castro Street is a book written by Randy Shilts telling the story of Harvey Milk. It was first published by St. Martin's Press in 1982.- Adaptations :...
, and began working full time with the San Francisco Chronicle
San Francisco Chronicle
thumb|right|upright|The Chronicle Building following the [[1906 San Francisco earthquake|1906 earthquake]] and fireThe San Francisco Chronicle is a newspaper serving primarily the San Francisco Bay Area of the U.S. state of California, but distributed throughout Northern and Central California,...
reporting on gay issues in a city where 25% of the population was gay. Shilts had closely followed the story of the epidemic almost since its North American outbreak
Outbreak
Outbreak is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place. It may affect a small and localized group or impact upon thousands of people across an entire continent. Two linked cases of a rare infectious...
covering the response and reaction of government agencies, local support organizations, medical researchers as well as individuals personally impacted by the growing crisis.
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
Bill Kurtis
Bill Kurtis is an American television journalist, producer, narrator, and news anchor. He is also the current host of A&E crime and news documentary shows, including Investigative Reports, American Justice, and Cold Case Files...
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
Haiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
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."
The title of the book is a reference to the story about the string quartet in the first-class lounge of the RMS Titanic, which kept playing as the ship sank, thereby alluding to the multiple agencies and communities who neglected to prioritize a swift medical response to the crisis. 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."
Subject
Shilts focuses on several organizations and communities that were either hit hardest by AIDS—and were given the "SisypheanSisyphus
In Greek mythology Sisyphus was a king punished by being compelled to roll an immense boulder up a hill, only to watch it roll back down, and to repeat this throughout eternity...
" 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 U.S. first struck gay men and IV drug users in Los Angeles, New York City, and San Francisco. Shilts' sources in the gay community tried to remember that last time everyone they knew was healthy, which was the U.S. BicentennialUnited States Bicentennial
The United States Bicentennial was a series of celebrations and observances during the mid-1970s that paid tribute to the historical events leading up to the creation of the United States as an independent republic...
celebration in 1976 when sailors came from all over the world to New York. Some of them carried sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
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 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 politicians such as Bill Kraus
Bill Kraus
William James "Bill" Kraus was an American gay rights and AIDS activist and congressional aide who served as a liaison between the San Francisco gay community and Congress in the 1980s....
and Cleve Jones
Cleve Jones
Cleve Jones is an American AIDS and LGBT rights activist. He conceived of the NAMES Project AIDS Memorial Quilt which has become, at 54 tons, the world's largest piece of community folk art as of 2009...
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 communicable disease, linked it to certain sexual practices, and made recommendations to gay men to avoid getting sick—stop having sex—a directive that defied the 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 such an undesirable population as gay men, 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
Larry Kramer
Larry Kramer is an American playwright, author, public health advocate, and LGBT rights activist. He began his career rewriting scripts while working for Columbia Pictures, which led him to London where he worked with United Artists. There he wrote the screenplay for Women in Love in 1969, earning...
and Paul Popham
Paul Popham
Paul Graham Popham was an American gay rights activist who served as the president of the Gay Men's Health Crisis from 1981 until 1985. He also helped found and was chairman of the AIDS Action Council, a lobbying organization in Washington...
, who had previously shown no desire for leadership, were forced by bureaucratic apathy into forming the Gay Men's Health Crisis
Gay Men's Health Crisis
The Gay Men's Health Crisis is a New York City-based non-profit, volunteer-supported and community-based AIDS service organization that has led the United States in the fight against AIDS.-1980s:...
to raise money for medical research and to provide social services for scores of gay men who began getting sick with opportunistic infections. Shilts describes the desperate actions of the group to get recognition by Mayor Ed Koch
Ed Koch
Edward Irving "Ed" Koch is an American lawyer, politician, and political commentator. He served in the United States House of Representatives from 1969 to 1977 and three terms as mayor of New York City from 1978 to 1989...
, and assistance from the Public Health Department
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
to provide social services and preventive education
Sex education
Sex education refers to formal programs of instruction on a wide range of issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception, and...
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. Many of the men who were involved in the early phases of community activism during the AIDS crisis realized their life's missions. Larry Kramer went on to form AIDS Coalition to Unleash Power
AIDS Coalition to Unleash Power
AIDS Coalition to Unleash Power is an international direct action advocacy group working to impact the lives of people with AIDS and the AIDS pandemic to bring about legislation, medical research and treatment and policies to ultimately bring an end to the disease by mitigating loss of health and...
(ACT-UP) as a political activist organization that forced government and media to pay attention to AIDS. Cleve 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 ConantMarcus Conant
Marcus Augustine Conant is a leading American dermatologist and one of the first physicians to diagnose and treat Acquired Immune Deficiency Syndrome in 1981...
, James Curran, Arye Rubenstein, Michael S. Gottlieb
Michael S. Gottlieb
Michael Stuart Gottlieb is an American physician and immunologist known predominantly for his research in the identification of acquired immune deficiency syndrome and for clinical and philanthropic work associated with AIDS treatment....
, and Mathilde Krim
Mathilde Krim
Mathilde Krim, Ph.D. is the founding chairman of amfAR, an association for AIDS research.-Biography:Krim received her Ph.D. from the University of Geneva, Switzerland, in 1953...
—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
Lymphadenopathy
Lymphadenopathy is a term meaning "disease of the lymph nodes." It is, however, almost synonymously used with "swollen/enlarged lymph nodes". It could be due to infection, auto-immune disease, or malignancy....
, pneumocystis carinii pneumonia, Kaposi's Sarcoma
Kaposi's sarcoma
Kaposi's sarcoma is a tumor caused by Human herpesvirus 8 , also known as Kaposi's sarcoma-associated herpesvirus . It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS defining...
, toxoplasmosis
Toxoplasmosis
Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii. The parasite infects most genera of warm-blooded animals, including humans, but the primary host is the felid family. Animals are infected by eating infected meat, by ingestion of feces of a cat that has itself...
, cytomegalovirus
Cytomegalovirus
Cytomegalovirus is a viral genus of the viral group known as Herpesviridae or herpesviruses. It is typically abbreviated as CMV: The species that infects humans is commonly known as human CMV or human herpesvirus-5 , and is the most studied of all cytomegaloviruses...
, cryptosporidia, and other opportunistic infections that caused death by a grisly combination of ailments overtaxing a nonexistent immune system
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...
. 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
David Sencer
David Judson Sencer was an American public health official who orchestrated the 1976 immunization program against swine flu. Between 1966 and 1977, he was the longest serving director of the Centers for Disease Control and Prevention...
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 U.S., doctors in Paris, France, were receiving patients who were African or who had lived in Africa with the same symptoms as Americans. Parisian researchers Jean-Claude Chermann, Françoise Barre
Françoise Barré-Sinoussi
Françoise Barré-Sinoussi is a French virologist and director of the Unité de Régulation des Infections Rétrovirales at the Institut Pasteur in Paris, France. Born in Paris, France, Barré-Sinoussi performed some of the fundamental work in the identification of the human immunodeficiency virus as...
, Luc Montagnier
Luc Montagnier
Luc Antoine Montagnier is a French virologist and joint recipient with Françoise Barré-Sinoussi and Harald zur Hausen of the 2008 Nobel Prize in Physiology or Medicine, for his discovery of the human immunodeficiency virus...
, and doctor Willy Rozenbaum
Willy Rozenbaum
Willy Rozenbaum is a French physician.A co-discoverer of the human immunodeficiency virus with Jean-Claude Chermann of Luc Montagnier's team, he has since held the chair of France's "conseil national du SIDA" and before that had since 1989 practiced in the infectious and tropical diseases...
began taking biopsies of HIV-infected lymph nodes and discovered a new retrovirus
Retrovirus
A retrovirus is an RNA virus that is duplicated in a host cell using the reverse transcriptase enzyme to produce DNA from its RNA genome. The DNA is then incorporated into the host's genome by an integrase enzyme. The virus thereafter replicates as part of the host cell's DNA...
. As a scientific necessity to compare it to the American version of HIV, French doctors representing the Pasteur Institute
Pasteur Institute
The Pasteur Institute 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 made some of the greatest breakthroughs in modern medicine at the time, including pasteurization and vaccines for anthrax...
sent a colleague to the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
, where Robert Gallo
Robert Gallo
Robert Charles Gallo is an American biomedical researcher. He is best known for his role in the discovery of the Human Immunodeficiency Virus , the infectious agent responsible for the Acquired Immune Deficiency Syndrome , and he has been a major contributor to subsequent HIV research.Gallo is the...
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 and the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
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
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...
. 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
Haiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
ans, and people who had received blood transfusions.
The discovery of AIDS in the nation's blood supply and subsequent lack of response by the blood banking leadership occurred as early as 1982, yet not until 1985, when AIDS antibody testing was approved by the Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
(FDA), did blood bank industry leaders acknowledge that HIV could be transmitted through blood transfusions. Shilts' coverage revealed the feeling among blood bank industry leaders that screening donors for hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
alone might offend the donors, and that the cost of screening all the blood donation
Blood donation
A blood donation occurs when a person voluntarily has blood drawn and used for transfusions or made into medications by a process called fractionation....
s 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
Ronald Reagan
Ronald Wilson Reagan was the 40th President of the United States , the 33rd Governor of California and, prior to that, a radio, film and television actor....
Administration officials like Health and Human Services Secretary Margaret Heckler
Margaret Heckler
Margaret Mary Heckler is a Republican politician from Massachusetts who served in the United States House of Representatives for eight terms, from 1967 until 1983 and was later the Secretary of Health and Human Services and Ambassador to Ireland under President Ronald Reagan...
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 1982 Chicago Tylenol murders
1982 Chicago Tylenol murders
The Chicago Tylenol murders occurred when seven people died after taking pain-relief medicine capsules that had been poisoned. The poisonings, code-named TYMURS by the Federal Bureau of Investigation, took place in late 1982 in the Chicago area of the United States.These poisonings involved...
, and the recent emergence of Legionnaire's Disease in 1977. In October 1982, seven people died after ingesting cyanide
Cyanide
A cyanide is a chemical compound that contains the cyano group, -C≡N, which consists of a carbon atom triple-bonded to a nitrogen atom. Cyanides most commonly refer to salts of the anion CN−. Most cyanides are highly toxic....
-laden Tylenol
Tylenol
Tylenol is a North American brand of drugs advertised for reducing pain, reducing fever, and relieving the symptoms of allergies, cold, cough, and flu. The active ingredient of its original, flagship product, paracetamol , is marketed as an analgesic and antipyretic...
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 employees worked on the case. Johnson & Johnson
Johnson & Johnson
Johnson & Johnson is an American multinational pharmaceutical, medical devices and consumer packaged goods manufacturer founded in 1886. Its common stock is a component of the Dow Jones Industrial Average and the company is listed among the Fortune 500....
disclosed they spent $100 million attempting to uncover who 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; Legionnaire's Disease was a public health emergency. Twenty-nine members of the American Legion
American Legion
The American Legion is a mutual-aid organization of veterans of the United States armed forces chartered by the United States Congress. It was founded to benefit those veterans who served during a wartime period as defined by Congress...
died in 1976 at a convention in Philadelphia. The National Institute of Health 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
Surgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
C. Everett Koop
C. Everett Koop
Charles Everett Koop, MD is an American pediatric surgeon and public health administrator. He was a vice admiral in the Public Health Service Commissioned Corps, and served as thirteenth Surgeon General of the United States under President Ronald Reagan from 1982 to 1989.-Early years:Koop was born...
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
Gay bathhouse
Gay bathhouses, also known as gay saunas or steam baths, are commercial bathhouses for men to have sex with other men. In gay slang in some regions these venues are also known colloquially as "the baths" or "the tubs," and should not be confused with public bathing.Not all men who visit gay...
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 mediaNews media
The news media are those elements of the mass media that focus on delivering news to the general public or a target public.These include print media , broadcast news , and more recently the Internet .-Etymology:A medium is a carrier of something...
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 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
Phobia
A phobia is a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational...
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
Hysteria
Hysteria, in its colloquial use, describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or,...
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 for five weeks, was translated into seven languages, nominated for a National Book AwardNational Book Award
The National Book Awards are a set of American literary awards. Started in 1950, the Awards are presented annually to American authors for literature published in the current year. In 1989 the National Book Foundation, a nonprofit organization which now oversees and manages the National Book...
, and made Shilts an "AIDS celebrity". In Rolling Stone
Rolling Stone
Rolling Stone is a US-based magazine devoted to music, liberal politics, and popular culture that is published every two weeks. Rolling Stone was founded in San Francisco in 1967 by Jann Wenner and music critic Ralph J...
, Shilts is compared to great American writers whose careers were made by the circumstances surrounding them, such as Thomas Paine
Thomas Paine
Thomas "Tom" Paine was an English author, pamphleteer, radical, inventor, intellectual, revolutionary, and one of the Founding Fathers of the United States...
in the American Revolution
American Revolution
The American Revolution was the political upheaval during the last half of the 18th century in which thirteen colonies in North America joined together to break free from the British Empire, combining to become the United States of America...
, Edward R. Murrow
Edward R. Murrow
Edward Roscoe Murrow, KBE was an American broadcast journalist. He first came to prominence with a series of radio news broadcasts during World War II, which were followed by millions of listeners in the United States and Canada.Fellow journalists Eric Sevareid, Ed Bliss, and Alexander Kendrick...
during the Blitz
The Blitz
The Blitz was the sustained strategic bombing of Britain by Nazi Germany between 7 September 1940 and 10 May 1941, during the Second World War. The city of London was bombed by the Luftwaffe for 76 consecutive nights and many towns and cities across the country followed...
, and David Halberstam
David Halberstam
David Halberstam was an American Pulitzer Prize-winning journalist, author and historian, known for his early work on the Vietnam War, his work on politics, history, the Civil Rights Movement, business, media, American culture, and his later sports journalism.-Early life and education:Halberstam...
during the Vietnam War
Vietnam War
The Vietnam War was a Cold War-era military conflict that occurred in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. This war followed the First Indochina War and was fought between North Vietnam, supported by its communist allies, and the government of...
. 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". In the American Journal of Public Health
American Journal of Public Health
The American Journal of Public Health is a monthly peer-reviewed medical journal published by the American Public Health Association covering health policy and public health. The journal was established in 1911 and its stated mission is "to advance public health research, policy, practice, and...
, Howard Merkel characterizes And the Band Played On as the first volume of the historiography
Historiography
Historiography refers either to the study of the history and methodology of history as a discipline, or to a body of historical work on a specialized topic...
of AIDS. 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 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 TimesThe Times
The Times is a British daily national newspaper, first published in London in 1785 under the title The Daily Universal Register . The Times and its sister paper The Sunday Times are published by Times Newspapers Limited, a subsidiary since 1981 of News International...
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
The Globe and Mail is a nationally distributed Canadian newspaper, based in Toronto and printed in six cities across the country. With a weekly readership of approximately 1 million, it is Canada's largest-circulation national newspaper and second-largest daily newspaper after the Toronto Star...
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
The Boston Globe is an American daily newspaper based in Boston, Massachusetts. The Boston Globe has been owned by The New York Times Company since 1993...
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
Stonewall Book Award
Sponsored by the Gay, Lesbian, Bisexual, and Transgender Round Table of the American Library Association , the Stonewall Book Award is for LGBT books...
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 New York Times is an American daily newspaper founded and continuously published in New York City since 1851. The New York Times has won 106 Pulitzer Prizes, the most of any news organization...
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
Los Angeles Times
The Los Angeles Times is a daily newspaper published in Los Angeles, California, since 1881. It was the second-largest metropolitan newspaper in circulation in the United States in 2008 and the fourth most widely distributed newspaper in the country....
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
United States Department of Defense
The United States Department of Defense is the U.S...
and the entitlements like Social Security
Social Security (United States)
In the United States, Social Security refers to the federal Old-Age, Survivors, and Disability Insurance program.The original Social Security Act and the current version of the Act, as amended encompass several social welfare and social insurance programs...
are getting all the money when the homosexuals and the IV drug abusers with AIDS and the multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
patients are not." The Gay Community News in Boston
Boston
Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...
also criticized the book's implications that a diagnosis of HIV indicated that death was sure and imminent. Richard Rouilard, editor of The Advocate
The Advocate
The Advocate is an American LGBT-interest magazine, printed monthly and available by subscription. The Advocate brand also includes a web site. Both magazine and web site have an editorial focus on news, politics, opinion, and arts and entertainment of interest to LGBT people...
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 cancerBreast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
, chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...
, Agent Orange
Agent Orange
Agent Orange is the code name for one of the herbicides and defoliants used by the U.S. military as part of its herbicidal warfare program, Operation Ranch Hand, during the Vietnam War from 1961 to 1971. Vietnam estimates 400,000 people were killed or maimed, and 500,000 children born with birth...
, and continued response to AIDS. However, the academic and scientific communities have been somewhat more critical. Howard Merkel, 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 "[Shilts] fused 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 (journal)
Science is the academic journal of the American Association for the Advancement of Science and is one of the world's top scientific journals....
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
Homophobia
Homophobia is a term used to refer to a range of negative attitudes and feelings towards lesbian, gay and in some cases bisexual, transgender people and behavior, although these are usually covered under other terms such as biphobia and transphobia. Definitions refer to irrational fear, with the...
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.
Wendy Parmet, a professor at Northeastern University Law School, 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
Contemporary Sociology
Contemporary Sociology is an academic journal in the field of sociology, published bimonthly by Sage Publications on behalf of the American Sociological Association since 1972. Contemporary Sociology publishes reviews and discussions of the most important recent works in sociology and in related...
, 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".
Shilts is often quoted as claiming that Ronald Reagan neglected to mention AIDS publicly until 1987. However, Reagan briefly mentioned AIDS research in questions and answers during a news conference on September 17, 1985.
Gaëtan Dugas as "Patient Zero"
The book includes extensive discussion of Gaëtan DugasGaëtan Dugas
Gaëtan Dugas was a Canadian who worked for Air Canada as a flight attendant. Dugas became notorious as the alleged patient zero for AIDS, though he is now more accurately regarded as one of many highly sexually active men who spread AIDS widely before the disease was identified.-Patient Zero...
, 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 U.S., 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; the National Review
National Review
National Review is a biweekly magazine founded by the late author William F. Buckley, Jr., in 1955 and based in New York City. It describes itself as "America's most widely read and influential magazine and web site for conservative news, commentary, and opinion."Although the print version of the...
called Dugas the "Columbus of AIDS" and in their review of And the Band Played On states, "[Dugas] picked 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 Gaetan 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 Gaetan played a key role in spreading the new virus from one end of the United States to the other." Time
Time (magazine)
Time is an American news magazine. A European edition is published from London. Time Europe covers the Middle East, Africa and, since 2003, Latin America. An Asian edition is based in Hong Kong...
magazine titled their 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.
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
William Darrow
William "Bill" Darrow is a Professor of Public Health at Florida International University in Miami, Florida.Before accepting a position at FIU in August, 1994, Darrow served as Chief of the Behavioral and Prevention Research Branch, Division of STD/HIV Prevention, at the National Center for...
, but it was called into question by University of California San Francisco epidemiologist Andrew Moss. Moss wrote in a letter to the editor of The New York Review of Books, "There is very little evidence that Gaetan was 'patient zero' for the US or for California", 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
Douglas Crimp
Douglas Crimp is an American professor in art history based at the University of Rochester.- Biography :Born in Idaho, Crimp went to Tulane University in New Orleans on a scholarship to study art history. His career started after moving to New York in 1967, where he worked as an art critic,...
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 [Shilts], like them, is horrified by such creatures."
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. 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 MilkThe Times of Harvey Milk
The Times of Harvey Milk is an 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...
—based on his book The Mayor of Castro Street—at the Castro Theatre
Castro Theatre
The Castro Theatre is a popular San Francisco movie palace which 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 Spanish Colonial Baroque façade that pays homage—in its great arched central window...
. 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 "worshiped" 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". 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.
Randy Shilts died from complications of AIDS in 1994. 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 Emmy-winning HBO movie of the same name. It was produced by Aaron SpellingAaron Spelling
Aaron Spelling was an American film and television producer. As of 2009, Spelling's eponymous production company Spelling Television holds the record as the most prolific television writer, with 218 producer and executive producer credits...
, directed by Roger Spottiswoode
Roger Spottiswoode
Roger Spottiswoode is a Canadian-born film director and writer, who began his career as an editor in the 1970s. He was born in Ottawa, Ontario. He has directed a number of notable films and television productions, including Under Fire and the 1997 James Bond film Tomorrow Never Dies starring...
, and starred Matthew Modine
Matthew Modine
Matthew Avery Modine is an award-winning American actor. His film roles include Private Joker in Stanley Kubrick's Full Metal Jacket, the title character in Alan Parker's Birdy, high school wrestler Louden Swain in Vision Quest, football star turned spy Alec McCall in Funky Monkey and the...
as epidemiologist Don Francis
Don Francis
Donald Pinkston Francis is an American epidemiologist who worked on the Ebola outbreak in Africa in the late 1970s, and researched on HIV and AIDS. He retired from the U.S. Public Health Service in 1992, after 21 years of service. According to him, the White House wanted him fired, but in order to...
and Richard Masur
Richard Masur
Richard Masur is an American actor who has appeared in more than 80 movies during his career. From 1995-1999, he served two terms as president of the Screen Actors Guild . Masur sits on the Corporate Board of the Motion Picture & Television Fund.-Biography:Masur was born in New York City to a...
as Dr. William Darrow at the Centers for Disease Control. Alan Alda
Alan Alda
Alphonso Joseph D'Abruzzo , better known as Alan Alda, is an American actor, director, screenwriter, and author. A six-time Emmy Award and Golden Globe Award winner, he is best known for his role as Hawkeye Pierce in the TV series M*A*S*H...
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
Screen Actors Guild
The Screen Actors Guild is an American labor union representing over 200,000 film and television principal performers and background performers worldwide...
pay. The film was released the same year as Philadelphia
Philadelphia (film)
Philadelphia is a 1993 American drama film that was one of the first mainstream Hollywood films to acknowledge HIV/AIDS, homosexuality and homophobia. It was written by Ron Nyswaner and directed by Jonathan Demme. The film stars Tom Hanks and Denzel Washington...
and Angels in America
Angels in America
Angels in America: A Gay Fantasia on National Themes is the 1993 Pulitzer Prize winning play in two parts by American playwright Tony Kushner. It has been made into both a television miniseries and an opera by Peter Eötvös.-Characters:...
, 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.
See also
- Timeline of early AIDS casesTimeline of early AIDS casesThis article is a timeline of early AIDS cases.An AIDS case is classified as "early" if the death occurred before 18 June 1981, when the AIDS epidemic was formally recognized by medical professionals in the United States.-1959:...
- Zero PatienceZero PatienceZero 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...
- Hot ZoneHot zoneHot zone may refer to:* Hot zone refers to an area that is considered to be dangerous due to biological, chemical, or nuclear contamination.* "Hot Zone" , an episode of the TV series Stargate Atlantis...
- Sexual EcologySexual EcologySexual Ecology: AIDS and the Destiny of Gay Men is a book by Gabriel Rotello written in his days as a gay activist. Rotello makes the point that the large number of sexual partners available to members of the "gay fast lane" created an ecological niche which allowed the rapid early spread of...
, - Koolaids: The Art of WarKoolaids: The Art of WarKoolaids: The Art of War is a novel written by Rabih Alameddine, a successful painter who lives in both San Francisco and Beirut. He grew up in the Middle East, in Kuwait and Lebanon. Published in 1998, Koolaids is Alameddine's first novel. The majority of the story takes place in San Francisco...
- Gaetan DugasGaëtan DugasGaëtan Dugas was a Canadian who worked for Air Canada as a flight attendant. Dugas became notorious as the alleged patient zero for AIDS, though he is now more accurately regarded as one of many highly sexually active men who spread AIDS widely before the disease was identified.-Patient Zero...
External links
- Lyrics to "The Band Played On"
- Shilts' obituary from the Los Angeles Times
- Gay Men's Health Crisis Website
- San Francisco AIDS Foundation Reported by Shilts originally as the San Francisco KS Foundation, started by Cleve Jones and Dr. Marcus Conant.