Book Report: And the Band Played On

And the Band Played On is one of the best books I have ever read. It is a pretty quick and easy read considering how big the book is. At times it is enraging, other times dispiriting, and sometimes really, really sad. Maybe most importantly, the lessons on policy and politics are huge.

I think the first take away is that services cost money. This point is crystal clear in this book. The Reagan administration wanted to cut the size of government based on their belief that government is wasteful and does too much. What happens in reality though is that government is prevented from doing the things it should be doing. Of course, Reagan cared little for the populations originally affected by AIDS - homosexuals and IV drug users (why hemophiliacs were not more sympathetic is surprising), but more importantly, Reagan and his budget office did not see the value in government-run medical research and disease prevention.

The author also makes the point often about how the press largely ignored this issue until it seemed like it might affect straight people as well. With the press ignoring the issue, the Reagan administration was able to get off the hook even when Congress pressed. In fact, at times it seems that the author (a journalist himself) blames the press more than he blames Reagan. And so do I; you expect Reagan to be heartless, but not journalists.

Also, quite a few public officials from that time come off looking really bad. Mayor Ed Koch did nothing to help educate people or otherwise prevent the spread nor did he provide funding for services to care for those that were developing it. Mario Cuomo as governor of New York was no better. Diane Feinstein also looks bad - although not quite as bad as Koch and Cuomo (her main flaw was to oppose closing the bath houses until late). Other public officials actually surprised you and did the right thing. The one that comes to mind is Orin Hatch.

What was most dispiriting was how many people acted in their own interest instead of doing what in retrospect was clearly the right thing to save the most people. Bath house owners fought to stay open and blood banks refused to test their blood.

Parts of the medical community also come off looking bad in the book. Actually, it is more accurate to say that research and academics looked bad, while many general practitioners - the few heroes in this epidemic - fought valiantly to raise awareness and help those that were diagnosed.

The author also shows the big fights inside the gay community over this issue, and it is painful to see those that were sounding the alarm getting viciously attacked. I don't imagine that this was an easy issue in the moment, especially the early days, for those in the gay community. But the real lesson should be that when something like this comes up, we need to do everything we can to look at the issue objectively and if not without emotion, than at least with the right kind of emotion.

Everyone should have been most focused on the lives being lost and the great potential for so many more if action wasn't taken (as happened because action was not taken). Instead people focused on petty concerns (money) and non-petty concerns (gay rights / defending against sexual morality attacks) that still paled compared the health risks.

I will say this again - this is one of the best and most important books I have read. I wish everyone would read it.