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.[1] 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."[2] The book was later adapted into an HBO film of the same name in 1993. Shilts was tested for HIV while he was writing the book; he died of complications from AIDS in 1994.
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 Haitian."[3] 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."[2] 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."[4]
Shilts focuses on several organizations and communities that were either hit hardest by AIDS—and were given the task of finding the cause of the disease—or begging the government for money to fund research and provide social services to people who were dying. He often uses an omniscient point of view to portray individuals' thoughts and feelings.
AIDS in the United States most notably struck gay communities in Los Angeles, New York City, and San Francisco. This was largely due to the general public's limited knowledge of the importance of protected ("safe") sex and IV drug using practices in preventing the transmission of diseases in the 1970s and 80s. Shilts' sources in the gay community tried to remember the last time everyone they knew was healthy, which was the United States Bicentennial celebration in 1976 when sailors came from all over the world to New York.[5] Some of them carried sexually transmitted diseases 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.[6] "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.[7]
In San Francisco, particularly in the Castro District, gay community activists such as Bill Kraus and Cleve Jones found a new direction in gay rights when so many men came down with strange illnesses in 1980. The San Francisco Department of Public Health began tracing the disease, linked it to certain sexual practices, and made recommendations—stop having sex—to gay men to avoid getting sick, a directive that defied the chief reason why many gay men had migrated to the Castro, and for what gay rights activists in San Francisco had fought for years.[8] Kraus and Jones often found themselves fighting a two-fronted battle: against city politicians who would rather not deal with a disease that affected gay men, who were seen as an undesirable population, and the gay men themselves, who refused to listen to doomsday projections and continued their unsafe behavior.[9]
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.[10] Shilts describes the desperate actions of the group to get recognition by Mayor Ed Koch and assistance from the city's Public Health Department to provide social services and preventive education about AIDS and unsafe se Shilts focuses on several organizations and communities that were either hit hardest by AIDS—and were given the task of finding the cause of the disease—or begging the government for money to fund research and provide social services to people who were dying. He often uses an omniscient point of view to portray individuals' thoughts and feelings.
Literary reviews of the wor 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.[note 1] And the Band Played On won the Stonewall Book Award for 1988.[41] It earned the 10th spot on "100 Lesbian and Gay Books That Changed Our Lives", compiled by the Lambda Book Report.[42] 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.[43] 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.[44]
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 neg 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.[2] 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."[45] Boston's Gay Community News also criticized the book's implications that a diagnosis of HIV indicated that death was sure and imminent.[46] 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.[47]
Shilts' book has been used as a standard by the lay press when reviewing books chronicling subsequent medical crises including breast cancer,[48] chronic fatigue syndrome,[49] Agent Orange,[50] and continued response to AIDS.[51][52] However, the academic and scientific communities have been somewhat more critical. Howard Markel, in the American Journal of Public Health, notes Shilts' tendency to assign blame, writing "A requirement of the journalist, and certainly the historian, however, is to explain human society rather than to point fingers".[40] 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".[39]
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 S 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.[53]
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.[54] 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".[55]
The book includes extensive discussion of Gaëtan Dugas, a Canadian flight attendant who died in 1984.[56][57] Dugas was labeled Patient Zero of AIDS, because he was linked directly or indirectly with 40 of the first 248 reported cases of AIDS in the United States, and after he was told of his ability to infect others, defiantly continued to have unprotected sex. Many book reviews concentrated their material on Dugas, or led their assessment of the book with discussion of his behavior. Some reviewers interpreted Shilts' naming Dugas "Patient Zero" to mean that Dugas brought AIDS to North America; 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."[58] Shilts never stated this in the book, instead writing, "Whether Gaëtan Dugas actually was the person who brought AIDS to North America remains a question of debate and is ultimately unanswerable ... there's no doubt that Gaëtan played a key role in spreading the new virus from one end of the United States to the other."[59] Time titled its review of And the Band Played On "The Appalling Saga of Patient Zero", erroneously restating the claim that Dugas had brought AIDS to the continent.[60] 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.[61][57]
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."[4] The original study identifying Dugas as the index case had been completed by Wi 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."[4] 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," while also stating that Shilts did not overstress Dugas' lack of personal responsibility.[62] Sandra Panem in Science uses Shilts' approach toward Dugas' behavior as an example of his "glib" treatment of the science involved in the epidemic.[53] 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."[61] Many years later, in the 2000s, it was shown, by tracing the roots of the virus, that it had spread from Africa to Haiti, and then to the U.S. in the mid 1960s, before Dugas would have been very sexually active, if at all, and before he was working as a flight attendant.[63] Even the labelling of Dugas as "Patient Zero" was due to a misunderstanding of the study of sexual contacts amongst a group of men indicating how the disease was transmitted – he was identified in the study as ‘Patient [letter] O’, for "Out of California" – but people reading and discussing the research began referring to and thinking about a "Patient Zero" as the origin of the disease.[56][57]
In 2016, a study of early AIDS cases demonstrated that Dugas could not have been "Patient Zero".[64]
While Shilts was writing the book he was tested for HIV but insisted his doctor not tell him the results until the book was finished so it would not affect his journalistic integrity and judgment.[65][56] 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.[66] He was openly booed when he attended the premiere of The Times of Harvey Milk—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.[67] Following the publication of And the Band Played On, however, he was "worshipped" by many in the gay community for writing the book, but also seen as someone who pandered to publicity.[68]
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 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."[69] 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.[70]
Shilts died from complications of AIDS in 1994, age 42.[56] 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."[71] Larry Kramer said of him, "He single-handedly probably did more to educate the world about AIDS than any single person."[72]
And the Band Played On was used as the basis for a 1993 Primetime Emmy Award-winning HBO television film of the same name. It was produced by Aaron Spelling, directed by Roger Spottiswoode, and starred Matthew Modine as epidemiologist Don Francis and Richard Masur as 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 the play Angels in America: A Gay Fantasia on National Themes premiered, which prompted one reviewer to note it a triumph and a loss: 12 years after the epidemic had begun, such works of art were necessary still to draw attention to it.[73] 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.[74] 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.[75]
Gay community
See also