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The AIDS Circus In the Battle Against the Disease ? the Wagons Just Keep Circling BY LARS EIGHNER THE GRAVEST SHOW ON EARTH: America in the Age of AIDS. By Elinor Burkett. Houghton Mifflin, 1995. 399 pages. $24.95. THIS IS A DANGEROUS REVIEW of a dangerous book. The danger is in writing anything true about AIDS. Whatever you write, someone will hate you, and if you write enough, everyone will hate you. Moreover, telling only part of the truth in hopes that only part of the people will hate you does not work, because in the swirling controversies, the acceptable truth today is tomorrow’s genocidal propaganda. For example, the evidence was clear early that Dr. Robert Gallo is a son of a bitch. At first AIDS activists found it perfectly acceptable to say so: Gallo’s vain efforts to show AIDS was caused by his HTLV, or a closely related virus, stymied AIDS research at a critical time, and Gallo’s claim to have found the cause of AIDS in HTLV-3 was at best the result of sloppy lab work and at worst, a conscious effort to rip off the French. Why shouldn’t he be criticized? Well, because he still has considerable clout in the federal health bureaucracy, and he still is the foremost retrovirus and HIV expert in the country. Not only is he our son of a bitch, he is a major son of a bitch and one of the best. In an American Congress, funding to follow up a discovery by an American scientist will always be easier to find than funding for research in which the French have precedence. Gallobashing was redefined as genocidal pandering to the likes of Jesse Helms. Burkett tells the story of AIDS personality by personality, mostly tragic figures, though seldom the people who are dying of the disease. Larry Kramer: raising the alarm, frustrated, angry, so long right when others are wrong that he becomes convinced he must always be right, lost at last in his anger and hubris, first of many, many Lars Eighner is the author of Travels with Lizbeth. His first novel, Pawn to Queen Four, was just published by St. Martin’s Press. Cassandras. Montagnier: who really made the discovery Gallo claimed, but doesn’t have the good grace ever to shut up about it or to cater entirely to American AIDS orthodoxy. Salk and Heimlich: old generals against disease, thrown into a battle they only dimly understood, certain to end ignobly for trying to fight old wars over. Doug Nelson: fighting for a little equity in AIDS-care funding and finding himself opposed by his heroes, the first heroes of the crisis who have too quickly turned into budget-hogging bureaucrats. It is a method of exposition that flirts with the excesses of tabloid television, but perhaps the only method our “Geraldo”-hardened attention spans can accept. The resulting picture is a double exposure: one of a complacent America lying in the sun, one of a spotlighted deer transfixed by conflicting impulses as it stares at its doom. It isn’t just the lack of progress, but the lack of movement of any kind that is so maddening. MUCH IN THIS BOOK is likely to comfort the likes of Jesse Helms. It is unavoidable; all the contro versy is on the side that regards AIDS as a serious problem and that wants to do something about it. On the other side, the side of Jesse Helms and Fred Phelps, who shows up at the funerals of people who have died of AIDS with demonstrators bearing “Fags must die” placards, there is no controversy, and there is little to write about. There are, of course, contradictions on the right, and some may be found in any speech. But bigotry is a wide umbrella, and hardly anyone is bothered when the reasons for hate differif only the correct people are hated. Not only is all the controversy on the fight-AIDS side, but also it could hardly be more acrimonious. For the most part, AIDS rhetoric begins with charges of genocide and gets nastier after that. AIDS is the eighth leading cause of death in America. No doubt everyone knows AIDS is the leading cause of death among young gay men. Not everyone knows that in New York and New Jersey it is the leading cause of death among young black women, and is second only to homicide as the cause of death of young black men. The rate of AIDS deaths among black men is five times higher than among white men, and times higher than among white women. Racial minorities account for more than half of AIDS cases. Little wonder, then, that words like “genocide” come easily to the lips. And by the way, Africa is dying. The scientific controversies are sharp enough. There is the orthodox view of AIDS: HIV alone causes AIDS, anyone into whose blood a sufficient amount of HIV is introduced will become infected with HIV, and everyone infected with HIV, who doesn’t die of something else first, will develop AIDS and die. All the heretics are grouped together under the name “rethinkers” \(so named from the title of a book, Rethinking AIDS, by Robert Rootfrom the purely crazy \(AIDS is caused by the orthodox anti-AIDS drug AZT, which fails to explain why there were AIDS cases the far-fetched \(AIDS is caused by accureally quite sensible \(HIV is a necessary condition of AIDS but not sufficient without some yet undiscovered co-factorcertain difficult-to-isolate mycoplasmas are There are several problems with the orthodox view. One is that some people with develop AIDS. At first this was easily dismissed, because HIV has such a long incubation time and very few people in America were infected before 1980. But with each passing year, the orthodox view that everyone infected with HIV will develop AIDS is harder to sustain. Another problem is that the orthodox view has thus far failed to explain exactly how HIV kills immune system cells. HIV uses immune system cells to reproduce itself and then infects other immune system cells. But why and The problem here is that it is politically impossible in America to study AIDS drugs under proper scientific controls. 6 DECEMBER 8, 1995